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Aim: The aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses., Background: Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses' intention to stay; more comprehensive theoretical foundations for examining nurses' intention to stay and its related factors are lacking., Design: Cross-sectional., Methods: A purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013-June 2014. Structural equation modelling was employed to test the theoretical models of the relationships among the constructs., Results: Our data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate., Conclusion: Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses' intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses' intent to stay. Transformational leadership did not directly influence nurses' intention to stay; however, it reduced emotional labour, thereby increasing intention to stay., (© 2016 John Wiley & Sons Ltd.)

Aims: (1) To explore the attitudes and perceived barriers to reporting medication administration errors and (2) to understand the characteristics of - and nurses' feelings - about error reports., Background: Under-reporting of medication administration errors is a global concern related to the safety of patient care. Understanding nurses' attitudes and perceived barriers to error reporting is the initial step to increasing the reporting rate., Methods: A cross-sectional, descriptive survey with a self-administered questionnaire was completed by the nurses of a medical centre hospital in Taiwan., Results: A total of 306 nurses participated in the study. Nurses' attitudes towards medication administration error reporting were inclined towards positive. The major perceived barrier was fear of the consequences after reporting. The results demonstrated that 88.9% of medication administration errors were reported orally, whereas 19.0% were reported through the hospital internet system. Self-recrimination was the common feeling of nurses after the commission of an medication administration error., Conclusions: Even if hospital management encourages errors to be reported without recrimination, nurses' attitudes toward medication administration error reporting are not very positive and fear is the most prominent barrier contributing to underreporting., Implications for Nursing Management: Nursing managers should establish anonymous reporting systems and counselling classes to create a secure atmosphere to reduce nurses' fear and provide incentives to encourage reporting., (© 2016 John Wiley & Sons Ltd.)

Aims: To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit., Background: Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses., Methods: A census survey collected data from 392 nurse administrators via a mailing method., Results: Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence., Conclusions: Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health., Implications for Nursing Management: Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence., (© 2016 John Wiley & Sons Ltd.)

Aims and Objectives: We aimed to encourage nurses to release information about drug administration errors to increase understanding of error-related circumstances and to identify high-alert situations., Background: Drug administration errors represent the majority of medication errors, but errors are underreported. Effective ways are lacking to encourage nurses to actively report errors., Methods: Snowball sampling was conducted to recruit participants. A semi-structured questionnaire was used to record types of error, hospital and nurse backgrounds, patient consequences, error discovery mechanisms and reporting rates., Results: Eighty-five nurses participated, reporting 328 administration errors (259 actual, 69 near misses). Most errors occurred in medical surgical wards of teaching hospitals, during day shifts, committed by nurses working fewer than two years. Leading errors were wrong drugs and doses, each accounting for about one-third of total errors. Among 259 actual errors, 83.8% resulted in no adverse effects; among remaining 16.2%, 6.6% had mild consequences and 9.6% had serious consequences (severe reaction, coma, death). Actual errors and near misses were discovered mainly through double-check procedures by colleagues and nurses responsible for errors; reporting rates were 62.5% (162/259) vs. 50.7% (35/69) and only 3.5% (9/259) vs. 0% (0/69) were disclosed to patients and families. High-alert situations included administration of 15% KCl, insulin and Pitocin; using intravenous pumps; and implementation of cardiopulmonary resuscitation (CPR)., Conclusions: Snowball sampling proved to be an effective way to encourage nurses to release details concerning medication errors. Using empirical data, we identified high-alert situations. Strategies for reducing drug administration errors by nurses are suggested., Relevance to Clinical Practice: Survey results suggest that nurses should double check medication administration in known high-alert situations. Nursing management can use snowball sampling to gather error details from nurses in a non-reprimanding atmosphere, helping to establish standard operational procedures for known high-alert situations.

Aims To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. Background Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. Method Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. Results Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. Conclusions Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. Implications for nursing management The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing. [ABSTRACT FROM AUTHOR]

Summary: Aim: The aim of the study was to develop and validate an instrument to evaluate nurses' knowledge and to understand the obstacles that they encounter when administering resuscitation medications. Background: Insufficient knowledge is a major factor in nurses' drug administration errors. Resuscitation involves situations in which doctors issue oral orders, and is inherently highly stressful. Sufficient knowledge is vital for nurses if they are to respond quickly and accurately when administering resuscitation medications. Methods: A cross-sectional study was conducted. A questionnaire (20 true-false questions) developed from literature and expert input, and validated by subject experts and one pilot study, was used to evaluate nurses' knowledge of resuscitation medications. Stratified sampling and descriptive statistics were applied. Results: A total of 188 nurses participated. The overall correct answer rate was 70.5% and the greater the nurse's work experience the higher the score. Only 8% of nurses considered themselves to have sufficient knowledge and 73.9% hoped to gain more training about resuscitation medications. The leading obstacle reported was “interruption of the drug administration procedure on resuscitation” (62.8%). Seventeen out of 20 questions achieved a discriminatory power of over 0.36, indicating good to excellent questions. In the study, a total of 16 resuscitation medication errors were reported by the participants, in which the errors involved atropine (five cases), epinephrine (three cases) and others (eight cases). The errors mainly involved misinterpretation of orders, insufficient knowledge and confusing certain drugs for other look-alike drugs. Conclusion: Evidence-based results strongly suggest that nurses have insufficient knowledge and could benefit from longer working experience and additional training about resuscitation medications. Further research to validate the instrument is needed and the education of nurses regarding resuscitation medications is recommended. [Copyright &y& Elsevier]

Background: The characteristics of the drugs that are used in chemotherapy have given rise to many issues, one of which is whether nurses are competent when working with chemotherapy. Methods: Nurses' knowledge of chemotherapy was evaluated with a questionnaire that included 20 true-or-false questions. The questionnaire was developed from literature and expert input and validated by subject experts (content validity). A pilot study (contrasted-groups approach) was also conducted. Results: A total of 203 nurses participated in the study and achieved an average overall correct answer rate of 60.9%. Most of the respondents, 63.5% (129 of 203), had a score of less than 70, and 77.3% (157 of 203) hoped to undergo more training on chemotherapy. Their knowledge of chemotherapy came mainly from consultation with colleagues (4.0 ± 0.8) and in-hospital continuing education (3.9 ± 0.8). Conclusion: The evidence-based results suggested that nurses have insufficient knowledge about chemotherapy. More fundamentally, however, nurses need more education about chemotherapy in nursing school and through in-hospital continuing education. [ABSTRACT FROM AUTHOR]

Abstract: The incorrect administration of high-alert medications can have serious consequences. A previous study by the authors of this study developed and validated 20 true-false questions concerning high-alert medications and suggested that the topic be taught to nurses. The perspectives of faculty and nurses, however, needed to be assessed before such teaching could be implemented. The aim of this study was to understand the views of faculty and nurses about training in high-alert medications: its importance, the frequency with which it is provided, and the ideal stage at which it should be provided. A cross-sectional study was conducted in 2008 in Taiwan. A questionnaire was used to determine whether the 20 questions are important, whether its content was being taught, and the ideal time for teaching it. Snowball sampling and descriptive statistics were used. A total of 136 faculty and 199 nurses participated. From the perspectives of faculty and nurses, all 20 questions regarding high-alert medications were important (faculty vs. nurses: 4.65±0.35 vs. 4.45±0.67) but the issues to which they related were insufficiently taught (faculty vs. nurses: 3.88±0.87 vs. 3.06±0.94). Faculty believed that the ideal stage at which to provide training on high-alert medications was during formal, in-school nursing education (94.3%) while nurses believed that the ideal stage was during in-hospital continuing education (48.9%). For training in high-alert medications, the researchers recommended the inclusion of classes on the subject as part of formal, in-school nursing education, as well as of hospital-based continuing education. The instrument''s questions highlight the important concepts concerning high-alert medications which should be taught to nurses and nursing students. [Copyright &y& Elsevier]

Summary: Aim: This study explores the effectiveness of an educational intervention on nurses'' knowledge regarding the administration of high-alert medications. Background: Nurses'' insufficient knowledge is considered to be one of the most significant factors contributing to medication errors. Most medication errors cause no harm to patients, but the incorrect administration of high-alert medications can result in serious consequences. A previous study by the same authors validated 20 true/false questions concerning high-alert medications and suggested that the topic be taught to nurses (Hsaio, et al., 2010. Nurses'' knowledge of high-alert medications: Instrument development and validation. Journal of Advanced Nursing, 66(1), 177–199.). Methods: A randomized controlled trial was employed in 2009 in Taiwan. Twenty-one hospital wards and 232 nurses were randomized to control and intervention groups. The sixty-minute educational intervention was based on the viewing of a Powerpoint file developed for this study. The results were compared pre-intervention and six weeks post-intervention by means of a test comprising the 20 questions regarding high-alert medications. Findings: The pre-intervention baseline data for correct answer rate was 75.8% (mean; n=232). After the intervention, the post-test showed significant improvement in the intervention group (n=113) (pre vs. post; 77.2±15.5 vs. 94.7±7.6; paired t=10.82, p<0.0001) but not in the control group (n=112) (pre vs. post; 74.3±14.7 vs. 75.5±14.2; paired t=0.60; p=0.247). Conclusions: Educational intervention appears to be effective in strengthening nurses'' knowledge of high-alert medications. The Powerpoint file presented teaching material which is both suitable and feasible for hospital-based continuing education. [Copyright &y& Elsevier]

Title. Nurses’ knowledge of high-alert medications: instrument development andvalidation. Aim. This paper is a report of the development and validation of an instrument to measure nurses’ knowledge of high-alert medications and to analyse known administration errors. Background. Insufficient knowledge is a factor in nurses’ drug administration errors. Most errors do not harm patients, but incorrect administration of high-alert medications can result in serious consequences. Sufficient knowledge about high-alert medications is vital. Method. A cross-sectional study was conducted in 2006 in Taiwan using a questionnaire developed from literature review and expert input, and validated by subject experts and two pilot studies. Section 1 of the questionnaire (20 true–false questions) evaluated nurses’ knowledge of high-alert medications and section 2 was designed to analyse known administration errors. Snowball sampling and descriptive statistics were used. Findings. A total of 305 nurses participated, giving a 79·2% response rate (305/385). The correct answer rate for section 1 was 56·5%, and nurses’ working experience contributed to scores. Only 3·6% of nurses considered themselves to have sufficient knowledge about high-alert medications, 84·6% hoped to gain more training, and the leading obstacle reported was insufficient knowledge (75·4%). A total of 184 known administration errors were identified, including wrong drug (33·7%) and wrong dose (32·6%); 4·9% (nine cases; 9/184) resulted in serious consequences. Conclusion. The questionnaire was valid and reliable. Evidence-based results strongly suggest that nurses have insufficient knowledge about high-alert medications and could benefit from additional education, particularly associated with intravenous bolus administration of high-alert medications. Further research to validate the instrument is needed. [ABSTRACT FROM AUTHOR]