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The hospital provides health services such as inpatient, outpatient, and emergency departments. The quality of nursing care is crucial as patients rely on nurses to address their complaints. This study aims to determine the relationship between nurse burnout and patient safety culture with the quality of nursing care. An analytical observational design with a cross-sectional study approach was conducted in two Type B Hospitals in Central Sulawesi Province with 235 nurse respondents in the inpatient room, using purposive sampling. Data analysis included the Pearson product-moment test and multivariate modeling. Results indicated a significant relationship between nurse burnout and nursing care quality (p-value <0.05), as well as between patient safety culture and nursing care quality. The dominant variable related to the quality of nursing care was patient safety culture (β = 0.723). The study highlights that nurse burnout negatively impacts the quality of nursing care, whereas a strong patient safety culture improves it. Theoretically, this research expands the understanding of the interplay between nurse burnout, patient safety culture, and nursing care quality, emphasizing the need for organizational support and effective communication. Practically, it suggests that hospital administrators should implement strategies to reduce nurse burnout and foster a positive patient safety culture, such as stress management programs and a supportive work environment, to enhance nursing care quality and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To explore nurse managers' perceptions of patient‐centered care (PCC), its influence on quality nursing care, nurse job satisfaction, and to provide baseline data for a context‐driven PCC model. Design: The study utilized a qualitative, phenomenological design, employing individual in‐depth interviews to collect data on nurse managers' PCC perceptions until data saturation. Methods: Sampling involved purposive selection of Northern Ghana, random selection of the tertiary hospital cluster with the three participating hospitals, and purposive sampling of the nine nurse managers. Data analysis employed thematic analysis based on a six‐phase framework. Methodological trustworthiness was ensured through various strategies including prolonged engagement, supervisor discussions and crosschecking with interviewees. Results: Three main themes emerged from the study including nurse managers' conceptualization of PCC, perceived patient‐centred practices and its influence on nursing quality and job satisfaction. The findings emphasized the patient's individuality, cultural values, holistic care, the importance of strong nurse‐patient relationships and a patient‐centric environment. The nurse managers perceived PCC as positively influencing quality nursing care and nurse job satisfaction. The findings offer nuanced insights into nurse managers' perspectives on patient‐centeredness and highlight areas for improvement. [ABSTRACT FROM AUTHOR]

Abstract Aim To explore nurse managers' perceptions of patient‐centered care (PCC), its influence on quality nursing care, nurse job satisfaction, and to provide baseline data for a context‐driven PCC model. Design The study utilized a qualitative, phenomenological design, employing individual in‐depth interviews to collect data on nurse managers' PCC perceptions until data saturation. Methods Sampling involved purposive selection of Northern Ghana, random selection of the tertiary hospital cluster with the three participating hospitals, and purposive sampling of the nine nurse managers. Data analysis employed thematic analysis based on a six‐phase framework. Methodological trustworthiness was ensured through various strategies including prolonged engagement, supervisor discussions and crosschecking with interviewees. Results Three main themes emerged from the study including nurse managers' conceptualization of PCC, perceived patient‐centred practices and its influence on nursing quality and job satisfaction. The findings emphasized the patient's individuality, cultural values, holistic care, the importance of strong nurse‐patient relationships and a patient‐centric environment. The nurse managers perceived PCC as positively influencing quality nursing care and nurse job satisfaction. The findings offer nuanced insights into nurse managers' perspectives on patient‐centeredness and highlight areas for improvement.

Successful relationships require patients to trust the nurse. This study described patient perspectives of nursing interventions when receiving care for a totally implantable vascular access device. Such perspectives can help nurses identify behaviors to model to promote trust and quality care. [ABSTRACT FROM AUTHOR]

The quality of nursing care is essential and contributes to restoring people's health and well-being, especially when people are hospitalized. Various factors relating to the quality of nursing care have been identified, including nursing shortages. However, in China, there has been little research undertaken on factors influencing nursing care quality. This cross-sectional study aimed to develop and test the Chinese Model of Quality Nursing Care. A multi-stage, proportional stratified random sampling was used to recruit 784 registered nurses in three affiliated hospitals of a medical university in the People's Republic of China. Eight Instruments were used for data collection: a demographic data form, the Good Nursing Care Scale, the Nurse Staffing Item, the Practice Environment Scale of the Nursing Work Index, the 3-item Utrecht Work Engagement Scale, the Psychological Empowerment Scale, the High-performance Work Systems Scale, the 8-item Survey of Perceived Organizational Support. In addition, the Analysis of Moment Structure software program was used to test the hypothesized model. Results indicated that the modified model fitted the empirical data and explained 31% of the variance in the quality of nursing care. Nursing practice environment, psychological empowerment and work engagement had positive direct effects on the quality of nursing care, with the nursing practice environment having the strongest total effect. Nursing practice environment, high-performance work systems, and perceived organizational support indirectly positively affected the quality of nursing care through psychological empowerment and work engagement. Unexpectedly, the patient-to-nurse ratio had no significant influence on the quality of nursing care. The results support the need for hospital managers to take action to improve the organizational support and work environment and create high-performance work systems to retain more nurses and midwives to enhance the quality of nursing care. The model requires further testing in practice and possible refinement. [ABSTRACT FROM AUTHOR]

Background: Quality has increasingly become a critical part of life in every aspect. Patients are today continuously looking for good quality services from health professionals. Professional nurses are expected to render quality care to fulfil the patients’ healthcare needs. Poor nursing care has led to several litigations and the loss of patients’ lives. It is essential to explore professional nurses’ viewpoints regarding quality nursing care. Objectives: To explore and describe the understanding of professional nurses regarding quality care rendered to patients in the selected hospitals of Limpopo Province. Method: This study utilised a qualitative, exploratory-descriptive design. Individual semi-structured interviews were conducted for data collection. Participants comprised 35 professional nurses who were purposely selected. Data collected were audio-recorded and transcribed verbatim. Data were analysed using Tech’s eight-step data coding process, which led to the emergence of themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability. Results: Three themes emerged: professional nurses’ descriptions, meanings, and expectations of quality nursing care. The findings highlight that quality nursing care means meeting patients’ needs through advocacy, empathy, fulfilment of patients’ needs, good interpersonal relationships and teamwork. Challenges experienced included the lack of resources and staff shortage. Conclusion: Hospital management needs to develop effective ways to support professional nurses in delivering quality nursing care. In discussion with the Department of Health (DoH), hospitals should be fully equipped with resources to render quality care to patients. Evaluation of service quality and patient satisfaction should be ongoing for improving the quality of patient care. Contribution: The study reveals that professional nurses perceive quality nursing care differently. Moreover, it emphasises the importance of maintaining and promoting quality nursing care as the cornerstone of healthcare.

Abstract Patients are the main users of every hospital service particularly the emergency department. Hence, patients’ perception is one of the quality care measures. Thus, this study purposed to assess the patients’ perception of quality nursing care and services in emergency department in Jordan. A cross-sectional, descriptive correlational design was adopted on a sample of patients who attended the emergency department (N = 427). Findings demonstrated that most of the health sectors in Jordan had a high level of patients’ perception of quality nursing care and related emergency department services (M = 3.93, SD = 0.72). Furthermore, the private sector had the highest mean score (M = 4.18, SD= 0.70), while the government sector had the lowest mean (M = 3.11, SD= 0.38). The level of perception had positive relationship with income (r = 0.097; p < 0.05) and qualifications (r p.b = 0.093; p < 0.05). The number of visits showed a significant negative correlation with patients’ perception level (r = − 0.095; p < 0.05). Thus, there is a need for improving the quality of nursing care and services in the emergency department at hospitals by strengthening the policy and enhancing the nursing services supporting system. Establishing plans to develop the infrastructures, equipment, physical environment, sanitation, and facilities in the emergency department to meet the patients’ needs to enhance the quality of care and services are needed. [ABSTRACT FROM AUTHOR]

Abstract Aim To develop and evaluate psychometric property of quality nursing care scale (QNCS) from nurses’ perspective in the Chinese context. Design A cross‐sectional survey design. Methods This study was conducted in two phases. In Phase I, literature review and interviews were conducted to develop the items. In Phase II, content validity was evaluated by five experts. Construct validity was tested through exploratory factor analysis (EFA) among 302 nurses and confirmatory factor analysis (CFA) among 510 nurses from October 2014 to January 2015. Additionally, internal consistency reliability was tested. Results The EFA extracted six factors including staff characteristics, task‐oriented activities, human‐oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable.

Abstract Background Quality Nursing Care (QNC) is fundamental to the profession of nursing practice. Perception of QNC differ across the globe because of differences in social norms, cultural values and political ambiance and economy. This study aimed to develop a QNC instrument congruent with the Mongolian (QNCS-M) healthcare system and cultural values and societal norms. Methods Exploratory sequential mixed-method design was implemented to develop and assess performance of QNCS-M. First, we focused on developing the components of QNCS-M and their operational definitions. Second, we dedicated to ascertaining psychometric performance of QNCS-M. The field testing consisted of assessing the construct validity and internal consistency reliability. Correlation between QNCS-M and the criterion tool, Quality of Nursing Care Questionnaire-Registered Nurse was evaluated. Results The initial version of QNCS-M contained 66 items of which 7 (I-CVI .7). Results from Spearman rank-order correlation analysis of the remaining 44 items indicated relationship between social desirability and 6 items (r = −.09 to r = .11). These items were excluded to reduce the likelihood of potential information bias. A total of 38 items remained for exploratory factor analysis. Results from exploratory factor analysis yielded eigenvalues > 1.0 for the 9 domains. Three domains contained items fewer than 3. These domains and 2 items (factor loading

Background: Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim: This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods: The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results: We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions: This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system. [ABSTRACT FROM AUTHOR]

Aim: To understand nurses' perceptions of quality nursing care in the dementia-specific care unit. As the world's population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses' perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method: A grounded theory study was conducted to understand nurses' perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings: Three themes emerged from this study— Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love. [ABSTRACT FROM AUTHOR]

Aim: To develop and evaluate psychometric property of quality nursing care scale (QNCS) from nurses' perspective in the Chinese context. Design: A cross‐sectional survey design. Methods: This study was conducted in two phases. In Phase I, literature review and interviews were conducted to develop the items. In Phase II, content validity was evaluated by five experts. Construct validity was tested through exploratory factor analysis (EFA) among 302 nurses and confirmatory factor analysis (CFA) among 510 nurses from October 2014 to January 2015. Additionally, internal consistency reliability was tested. Results: The EFA extracted six factors including staff characteristics, task‐oriented activities, human‐oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable. [ABSTRACT FROM AUTHOR]

Reintegration is an integral part of nursing care. Nurses play a critical role in contributing support, dependence, and continuity of care from rehabilitation to reintegration. While the reintegration of patients is a concept often used in nursing, its theoretical origin has remained unclear. This article aimed to conduct a concept analysis of reintegration for the development of nursing as a discipline and improve nursing care and health outcomes. The evolutionary strategy to concept analysis of Roger was utilized, which resulted in the characteristics of reintegration as to its attributes, antecedents, consequences, and exemplar in nursing practice in the context of COVID-19. The capacity to adapt, reorganize, offer support, and build a network of resources are attributed to the concept of reintegration. Antecedents include rehabilitation, survivorship from illnesses, trauma, and injuries, and disruption of social and physical functional performances and activities. The identified consequences include transition to recovery, quality of life, independence, successful adaptation, job satisfaction, holistic care, and continuity of care. The new conceptual definition of reintegration emerged. Reintegration is a process of nursing care among patients who demand assistance and support before transitioning to regain normality or on their way to being restored to the community in the presence of adaptation from health adversities. The patient in all areas is cared for holistically, offering support to meet his needs and overcome challenges in terms of physical, mental, social, and emotional aspects. Concept analysis is as essential as operationalizing a concept in the nursing discipline. [ABSTRACT FROM AUTHOR]

The nursing shortage continues to grow, leaving healthcare systems and patients in a precarious situation. A major reason for the shortage is the lack of nursing faculty to educate future nurses, which has hindered nursing programs nationwide from accepting students interested in a nursing career. This qualitative study explored the existing academic nurse educator shortage and sought solutions that an important stakeholder group, the public and business sector/business owners, might implement to mitigate the dual shortage of professional nurses and academic nurse educators. Using a modified Nominal Group Technique (NGT) design, the research team identified five major stakeholder groups which could benefit from addressing the academic nurse educator shortage. Team subgroups reviewed relevant literature and crafted recommendations to address the academic nurse educator shortage. This article discusses findings from one of these major stakeholders: the public and business/business owner sectors. Forty-five academic nurse educators were recruited from volunteers engaged in a national nursing education online forum and 25 participants completed the study. Five themes emerged: encourage lobbying efforts with legislators; engage the media in exposing the relationship of the academic nurse educator shortage and the nursing shortage; incentivize higher education opportunities for nurses to become academic nurse educators; elevate the life experience of patients; and stakeholder collaboration. A continued partnership between the public/business sectors/business owners and leaders within the profession of nursing must exist to enhance the academic nurse educator role. Only with this partnership can those within the profession of nursing continue to serve the public sustainably for years to come. [ABSTRACT FROM AUTHOR]

Background: Quality Nursing Care (QNC) is fundamental to the profession of nursing practice. Perception of QNC differ across the globe because of differences in social norms, cultural values and political ambiance and economy. This study aimed to develop a QNC instrument congruent with the Mongolian (QNCS-M) healthcare system and cultural values and societal norms. Methods: Exploratory sequential mixed-method design was implemented to develop and assess performance of QNCS-M. First, we focused on developing the components of QNCS-M and their operational definitions. Second, we dedicated to ascertaining psychometric performance of QNCS-M. The field testing consisted of assessing the construct validity and internal consistency reliability. Correlation between QNCS-M and the criterion tool, Quality of Nursing Care Questionnaire-Registered Nurse was evaluated. Results: The initial version of QNCS-M contained 66 items of which 7 (I-CVI <.78) were deleted after item-content validity assessment. The total-item correlation analysis yielded to exclusion of another 3 items (<.3). Additional 12 items were excluded after inter-item correlation (<.3, >.7). Results from Spearman rank-order correlation analysis of the remaining 44 items indicated relationship between social desirability and 6 items (r = −.09 to r =.11). These items were excluded to reduce the likelihood of potential information bias. A total of 38 items remained for exploratory factor analysis. Results from exploratory factor analysis yielded eigenvalues > 1.0 for the 9 domains. Three domains contained items fewer than 3. These domains and 2 items (factor loading <.4) were eliminated, yielding to 6 domains with 36-item. Results from internal consistency reliability yielded an overall Cronbach's α =.92; the coefficient values for the 6 domains ranging between.72 and.85 and Pearson correlation for stability reliability yielded an acceptable (r =.82, P <.001). Conclusion: Improving the quality of healthcare services delivered by nurses is a priority for the Mongolian government. The development of QNCS-M is a major stride in addressing this concern. The final version of QNCS-M which contains 36 items, loaded into 6 domains, was morphed to the specifics of the Mongolian healthcare systems and cultural values and societal norms. QNCS-M demonstrates a high level of content and construct validity with acceptable reliability. [ABSTRACT FROM AUTHOR]

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' well‐being and ability to provide safe and quality care for patients in the context of COVID‐19. [ABSTRACT FROM AUTHOR]

Background: The examination of the literature indicates that practicing nurses are barely engaged in developing enhancement programs for quality nursing care. There are numerous studies on the value of nursing care, but none offers ways of assessing the value of care provided by nurses. Identifying the essence of quality nursing care can facilitate effective enhancement approaches. It was prudent to explore the relationship between advocacy, caring, and empathy in delivering quality nursing care. Purpose: This study aimed to comprehend the views of Saudi Arabian nurses on how empathy, advocacy, and caring act as measurements of quality of nursing care. Methods: A qualitative investigative, descriptive design was used to explore the advocacy, empathy, and caring from the viewpoints of practicing nurses. Twenty-one general and specialized medical care nurses from King Saud Medical City in Saudi Arabia were recruited through purposive sampling. The researchers conducted semistructured interviews that were recorded, written out, and subjected to thematic analysis. Results: The findings have led to the establishment of quality Saudi nursing care with the identification of core themes: empathy, advocacy, and caring. The findings of this study elevate the understanding of the quality of nursing care in the Saudi context. Conclusion: The participants aver that patient advocacy, empathy, and care are parts of the characteristics of nursing profession. These characteristics aid in listening and comprehending patients' perspectives. Following the findings, it is suggested to provide training to the nurses to overcome the challenges faced by nurses in reflecting empathy. [ABSTRACT FROM AUTHOR]

Quality nursing care is a multidimensional concept that has attracted the interest of nurse professionals and healthcare organizations globally as it is a vital component of overall healthcare quality at all times. This study's aim was to explore nurse and patient perceptions of quality nursing care in public secondary and tertiary care hospitals in Mongolia. A qualitative descriptive approach was employed with 21 registered nurses using in-depth interviews and 18 patients using focus group discussions, and the data were analysed by using content analysis. Seven categories emerged and the essential components of quality nursing care were determined as: Symptom management, Activities of daily living, Encouragement, Emotional support, Nurturing relationship, Respect for religious beliefs and Concern for cultural differences. Our findings provide a deep, holistic understanding of nurses' perceptions of quality nursing care performance and patients' perceptions of their experiences and expectations related to that care. The findings can be used as a foundation for developing a valid and reliable instrument to measure quality nursing care, as well having the potential to facilitate practice changes, and drive improvement of patient outcome. [ABSTRACT FROM AUTHOR]

Critical care education among nursing students is an emerging topic globally.Nurses lead a vital role in all hospital setting. Critical care nursing skills must be taught to the student nurses to provide optimum care during emergency situation.The present study assessed the impact of critical care education among students in SRM College of Nursing. A quantitative study with one group pre and posttest design was used.Totally hundred students between age group 18-20yrs participated in the study. After explaining and getting their consent by convenient sampling technique pretest was taken with 18 self structured objective type questions.Education on critical care was given by experts on current trends, technologies, evidenced based practice, pharmacological management, and role play, quality nursing care during ventilator support and legal responsibilities in critical care for 6 hrs. After the education post assessment was done with same questionnaire. Analysis was done with descriptive, MCNemar's test, and student paired t test. The post knowledge of students with care of patient in mechanical ventilator was significant with p < 0.05. This study high lights the need for educating the staff in critical care in the hospital setting. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to synthesize the experiences of people with disorders of sex development. Background: The quality of life of people with disorders of sex development depends largely on the availability of good psychosocial and psychosexual management. There is a lack of qualitative systematic reviews of the literature on the experiences of people with disorders of sex development. Design: The seven steps of qualitative meta‐ethnography were employed in this review. Data Sources: The following electronic databases were systematically searched until January 2017: Science Direct, Scopus, Sage online, CINAHL, PsycINFO, Medline, Wiley Online Library, and Google Scholar. Search terms for this review were "disorders of sex development," "intersex," "ambiguous genitalia," "experiences," "qualitative study," and "method". Review Method: A 13‐item scale was applied to evaluate the quality of the selected studies and synthesized using the principles of meta‐ethnography. Findings: Twelve studies met the eligibility criteria. Six major themes described the experiences of people with disorders of sex development. These included a range of physical, psychological, social, and sexual experiences which affect their quality of life. Different coping strategies were employed by individuals who live with the lifelong condition. Conclusion: Disorders of sex development affect the quality of life of people living with these disorders. Nurses are tasked with providing holistic care for people with disorders of sex development in order to improve their quality of lives. As such, there is a need to explore the experiences of nurses in the management of disorders of sex development. [ABSTRACT FROM AUTHOR]

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Café” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

Aim: To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Background: Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. Design: A cross-sectional survey. Methods: The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. Results: The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. Conclusions: This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. [ABSTRACT FROM AUTHOR]

Background: The quality of nursing care rendered today is markedly reducing and the amount of time spent with patients listening to and explaining issues concerning their conditions is gradually diminishing. The therapeutic touch and the listening ear of the nurse are no longer accessible to the patient. Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of consideration. Although recent literature has highlighted the necessity of introducing soft skills training and assessment within medical education, nursing education is yet to fully embrace this skills training. Objectives: The aim of this study was to explore nursing students’ understanding of the concept of soft skills and to acquire their perception on the need for soft skills training to promote quality nursing care. Methods: A quantitative research design with descriptive and explorative strategies was used. One hundred and ten nursing students were sampled after permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee. Results: The results indicated that a majority (68.8%) of respondents understood the concept of soft skills and agreed with the definition of ‘soft skills’. They furthermore agreed that soft skills should be part of the training that student nurses receive during their professional training. Conclusion: The study revealed that there is a need for nursing students to be educated in soft skills and that this will enhance their job performances in the clinical environment and improve the way in which they communicate with their clients.

The health system was reorganized in key best companies. They are introduced to the concepts of effectiveness and efficiency that has made quality the primary objective to be pursued in the delivery of health care. The quality is evaluated today starting through the Evidence Based Nursing that represents the extension, in the nursing field, Evidence Based Medicine. In the article we performed a systematic review of meta-analyzes in order to identify critical issues and good practice and see how the EBN in addition to theoretically enrich the discipline to answer the fundamental question underlying assessment using this approach. [ABSTRACT FROM AUTHOR]

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Limited research has been conducted on how nurses define or perceive "quality nursing care." We conducted focus groups to identify nurses' perceptions of quality care at a Midwestern academic medical center. Transcripts of the focus group sessions were analyzed using thematic analysis techniques, and 11 themes emerged: Leadership, Staffing, Resources, Timeliness, Effective Communication/Collaboration, Professionalism, Relationship-Based Care, Environment/Culture, Simplicity, Outcomes, and Patient Experience. [ABSTRACT FROM AUTHOR]

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the "World Café" method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care. [ABSTRACT FROM AUTHOR]

Background: Good nurses show concern for patients by caring for them effectively and attentively to foster their well-being. However, nurses cannot be taught didactically to be “good” or any trait that characterizes a good nurse. Nurses’ self-awareness of their role traits warrants further study. Objectives: This study aimed (a) to develop a strategy to elicit nurses’ self-exploration of the importance of good nurse traits and (b) to explore any discrepancies between such role traits perceived by nurses as ideally and actually important. Research design: For this mixed-method study, we used good nurse trait card play to trigger nurses’ reflections based on clinical practice. Nurse participants appraised the ideal and actual importance of each trait using a Q-sort grid. The gap between the perceived ideal and actual importance of each trait was examined quantitatively, while trait-related clinical experiences were analyzed qualitatively. Participants and research context: Participants were 35 in-service nurses (mean age = 31.6 years (range = 23–49 years); 10.1 years of nursing experience (range = 1.5–20 years)) recruited from a teaching hospital in Taiwan. Ethical considerations: The study was approved by the Institutional Review Board of the study site. Findings: Good nurse trait card play with a Q-sort grid served as an icebreaker to help nurse participants talk about their experiences as embodied in good quality nursing care. Nurses’ perceived role–trait discrepancies were divided into three categories: over-performed, least discrepant, and under-performed. The top over-performed trait was “obedience.” Discussion: Patients’ most valued traits (“patient,” “responsible,” “cautious,” and “considerate”) were perceived by participants as ideally important but were under-performed, perhaps due to experienced nurses’ loss of idealism. Conclusion: Good nurse trait card play with Q-sort grid elicited nurses’ self-dialogue and revealed evidence of the incongruity between nurses’ perceived ideal and actual importance of traits. The top over-performed trait, “obedience,” deserves more study. [ABSTRACT FROM AUTHOR]

Background: There is scarcity of questionnaires specifically on the quality of the nursing care provided to patients diagnosed with cancer. The available questionnaires have been developed without attributing a holistic approach to the care provided with important patient’s needs remaining without assessment. The main aim was to develop a self-administered cancer specific questionnaire exploring patients’ views on quality nursing care provided in oncology settings. Methods: The development of the scale proceeded through three phases. As part of the first development phase areas of concern and items of interest were identified through a literature review. The second phase included a pilot study of the QONCS and a subsequent validation phase through a multicentre study in 3 hospitals, 4 departments and 418 patients diagnosed with cancer and receiving care as inpatients. The study was designed to select items, identify dimensions, measure reliability, content and construct validity. Results: The QONCS consisted of 34 items. A factorial analysis grouped the items into five categories that define quality nursing care: a) Being supported and confirmed, b) Spiritual caring c) Sense of belonging, d) Being valued and e) Being respected. Cronbach’s alpha was 0.95 for the entire questionnaire. The factor solution explained 68.53% of the variance. Conclusions: QONCS appears to measure with adequate reliability and validity the attributes of quality nursing care within the oncological settings and to patients with a variety of cancer diagnoses and at different phases of the cancer trajectory. The instrument is quick to disseminate and easy to complete, making it a suitable instrument for nursing professionals to evaluate patients’ self-perceived quality of nursing care as a mean to promote the quality of the care provided in oncological settings. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This paper is a report of a study to describe the attributes of quality nursing narrated by a sample of patients with cancer, their advocates and their nurses. Background: Quality nursing care is a multifaceted concept which is open to interpretation. Studies show that while nurses are striving to succeed in providing quality care for their patients and the patients are urging for better nursing care, the complexity in understanding the concept often causes confusion among patients and nurses. Method: The study was a phenomenological hermeneutical study based on the ideas of the French Philosopher Paul Ricoeur. Twenty-five patients with cancer, six advocates and twenty cancer nurses were recruited in Cyprus by a purposive method. The informants were encouraged to narrate their lived experiences of receiving and providing quality nursing care. A discussion follows whether the findings can be regarded as a theory of quality in cancer care. Findings: Based on the informants'' narratives the following six attributes of quality nursing care materialized: a) being valued, b) being respected c) being cared for by communicative and supportive nurses, d) being confirmed, e) being cared for religiously and spiritually and f) belonging. Conclusion: The six attributes can be proposed as a descriptive theory of quality nursing care within the tension between empirical data and pre-understanding. The theory emphasizes the existential needs such as communicated with, being respected, and being cared for which should be considered important when providing nursing care to patients with cancer. [Copyright &y& Elsevier]

Abstract: This article presents the findings from a hermeneutic-phenomenological study looking at the meanings of “quality nursing care” through the experiences of patients with cancer, their advocates and their nurses. Twenty-five patients were interviewed from which fifteen also participated in two focus groups. Six patients'' advocates participated in a focus group and twenty nurses were individually interviewed. The informants came from the three major hospitals in Cyprus which provide in-patient cancer care. Patients'' advocates came from the two major cancer associations in Cyprus. Having analysed the data, seven major themes were identified: receiving care in easily accessible cancer care services, being cared for by nurses who effectively communicate with them and their families and provide emotional support, being empowered by nurses through information giving, being cared for by clinically competent nurses, nurses addressing their religious and spiritual needs, being cared for in a nursing environment which promotes shared decision-making, and patients being with and involving the family in the care. These findings stress the need to integrate these aspects in the care of patients with cancer. In doing so, nurses will need support and adequate training in order to acquire the relevant skills towards better caring for the patients. [Copyright &y& Elsevier]

Historically, the economic value that nursing brings to the patient care process has not been recognized or quantified. Improving the quality of nursing care through work environment changes or increases in staffing is viewed by many as an added cost, but the benefits in terms of money saved through improved nursing satisfaction and patient outcomes are not considered. This article introduces nine articles that were originally presented at the Economics of Nursing Invitational Conference: Paying for Quality Nursing Care held at the Robert Wood Johnson Foundation in Princeton, New Jersey, June 13 and 14, 2007. Recommendations are to conduct research on the impact of policy and payment changes on the nursing workforce and quality of care and to correct the misalignment of socioeconomic and business case incentives for quality by payment systems and other changes. [ABSTRACT FROM AUTHOR]

Purpose: To study nurses’ job satisfaction, patients’ satisfaction, and quality of nursing care in a Jordanian educational hospital. Design: A descriptive cross-sectional comparative design was used. The total populations at the educational hospital where the study was conducted were: 200 nurses (response rate 60%), 510 patients (response rate 49%), and 26 head nurses (NHs) (response rate 92%). Mueller/McCloskey Satisfaction Scale (MMSS) 1990; Eriksen’s (1988 ) scale of The Satisfaction with Nursing Care; and Quality of Nursing Care Questionnaire-Head Nurse of Safford & Schlotfeldt (1960) were used to measure the phenomena of interest. Findings: Nurses were ‘neither satisfied nor dissatisfied’ in their jobs, nurses who work in wards reported a slightly better job satisfaction than nurses who work in critical care units. Patients reported that they were ‘moderately’ satisfied, and head nurses reported that nurses ‘usually (practically)’ provide a high of quality of nursing care. There were no significant differences between critical care units and wards in regard to patients’ satisfaction and quality of nursing care. Conclusions: Jordanian nurses’ job satisfaction is on the borderline, which arguably requires more interventions. Patients’ satisfaction and quality of nursing care have to be enhanced to reach the levels of ‘very satisfied’ and ‘always’ consecutively. [ABSTRACT FROM AUTHOR]

Aim. This paper reports the findings of a study that generated a conceptual model of the nursing behaviours and social processes inherent in the provision of quality end-of-life care from the perspective of nurses working in an acute care setting. Background. The majority of research examining the issue of quality end-of-life care has focused on the perspectives of patients, family members and physicians. The perspective of nurses has generally received minimal research attention, with the exception of those working within palliative or critical care. The vast majority of hospitalized patients, however, continue to be cared for and die on medical units. To date, little research has been conducted examining definitions and determinants of quality end-of-life care from the perspective of nurses working in acute adult medical settings. Method. Grounded theory method was used in this study of 10 nurses working on acute medical units at two tertiary university-affiliated hospitals in central Canada. Data were collected during 2002 by interview and participant observation. Findings. The basic social problem uncovered in the data was that of nurses striving to provide high quality end-of-life care on an acute medical unit while being pulled in all directions. The unifying theme of ‘Creating a haven for safe passage’ integrated the major sub-processes into the key analytic model in this study. ‘Creating a haven for safe passage’ represents a continuum of behaviours and strategies, and includes the sub-processes of ‘facilitating and maintain a lane change’; ‘getting what's needed’; ‘being there’; and ‘manipulating the care environment’. Conclusion. The ability of nurses to provide quality end-of-life care on an acute medical unit is a complex process involving many factors related to the patient, family, healthcare providers and the context in which the provision of end-of-life care takes place. [ABSTRACT FROM AUTHOR]

The purposes of this study were to examine relationships among 3 of the American Nurses Association's 10 nursing-sensitive quality indicators: nursing hours per patient day, percentage of RNs, and nosocomial urinary tract infection (NUTI), and to identify the best predictor of NUTI in a hospital in Thailand. The results showed a negative relationship between nursing hours per patient day and NUTIs, indicating that with more nursing hours per day, there were fewer NUTI. These findings document the importance of nursing staff in minimizing hospital-acquired urinary tract infection. [ABSTRACT FROM AUTHOR]

The relationship between quality of care and the cost of the nursing workforce is of concern to policymakers. This study assesses the evidence for a relationship between the nursing workforce and patient outcomes in the acute sector through a systematic review of international research produced since 1990 involving active hospitals and adjusting for case mix. Twenty-two large studies of variable quality were included. They strongly suggest that higher nurse staffing and richer skill mix (especially of registered nurses) are associated with improved patient outcomes, although the effect size cannot lie estimated reliably. The association appears to show diminishing marginal returns [ABSTRACT FROM AUTHOR]

Purpose: To review the propositions of a theory-driven approach and to discuss its application to evaluating the quality of nursing care. Organizing Framework: The focus in the theory-driven approach to evaluation is on identifying patient, professional, and setting characteristics that affect the processes of care at micro and meso levels, which in turn contribute to outcome achievement. Implications for examining the interrelationships among characteristics, processes, and outcomes are discussed and illustrated with examples from published research. Conclusions: Determining how these variables influence each other provides a valid and comprehensive understanding of the contribution of nursing within the health care system. [ABSTRACT FROM AUTHOR]

Patient satisfaction is a major indicator of quality care. There are several theories on the types of concepts that should be measured concerning patient satisfaction with nursing care. Given the different theories of patient satisfaction, the issue of accurate measurement of this concept presents nurse researchers, clinicians and leaders with a challenge. This paper will discuss the findings of a patient satisfaction survey that was conducted in two acute care surgical wards, using the revised 28-item La Monica–Oberst patient satisfaction scale and telephone interviews. Data were analysed using descriptive statistics. Textual data were managed using NUD*IST and analysed for common emerging themes and categories. The findings of the quantitative and qualitative data were compared in order to determine similarities and differences. The survey results revealed very high levels of patient satisfaction; however, the qualitative data revealed some anomalies. Specifically, due to the numbers of nurses involved in the care, some patients had difficulties answering the questionnaire. Moreover, they were unable to discriminate nursing care from the rest of their overall patient experience. Within this study, it seemed that patients’ perceptions of nurses influenced the way patients rated quality nursing care. Based on this information, the authors question the accuracy of the measurement of patient satisfaction and raise issues that need to be considered in order to further clarify the measurement of this concept. [ABSTRACT FROM AUTHOR]

This grounded theory study explored and described the delivery of quality nursing care from the perspective of nurses. Data were gathered by tape recorded interviews, published literature and some participant observation. Ten registered nurses from an acute-care public hospital located in Perth, Western Australia were interviewed. Twelve additional transcripts from interviews conducted by postgraduate students were also used. Quality nursing care was perceived to relate to the degree to which patients’ physical, psychosocial, and extra care needs were met. The consequences of quality care were interpreted as ‘therapeutic effectiveness’, where the therapy provided by nurses was perceived to positively affect patients’ healing. This was gauged by the patient’s psychosocial and physical response to illness, safety, and satisfaction. Therapeutic effectiveness was facilitated by the development of positive relationships between nurses and patients, nurse’s positive attributes and competent practices, as well as a functional nursing team. The problem of nurses’ inability to consistently provide quality nursing care to all patients was identified. Insufficient time (caused by a lack of human and physical resources) was perceived as the main reason for this. Dissatisfaction and stress in nurses was related to this problem. To deal with this, nurses used a process named ‘selective focusing’. Work was planned to most effectively utilize the time available, within the parameters of safety. Implications for nursing practice, education and management are discussed, and directions for further research are provided. [ABSTRACT FROM AUTHOR]