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Background: Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave. Purpose: This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices. Methodological orientation: This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression. Results: The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction. Conclusions: Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan. Implications for practic: To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system. [ABSTRACT FROM AUTHOR]

Aim and objectives: This study aimed to determine the influence of work excitement, workplace violence and the violence prevention climate on professional commitment and turnover intention. Background: Workplace violence can easily cause the quality of nursing care to decline. Improvements in the working environment and working conditions can improve nurses' professional commitment and satisfaction. Design: A cross‐sectional multicentre study with convenience sampling was conducted. We have complied with the guidelines of STROBE Checklist in presenting this research. Methods: Out of 900 questionnaires, 696 were deemed valid for analysis (77.33%). This study collected data on sociodemographic information, experiences of workplace violence, professional commitment, work excitement, violence prevention climate and turnover intention. Results: The results show that professional commitment has a significant effect on turnover intention. Professional commitment positively influences work excitement, especially when the work is challenging and varied. It also indirectly influences turnover intention by generating work excitement. Workplace violence introduces an interactive moderating effect on the relationship between professional commitment and work excitement. A violence prevention climate changes the interactive moderating effect of workplace violence on professional commitment, which in turn influences turnover intention. Conclusions: Positive work experience, institutional organisational policies and support systems are the mediating and moderating factors in the relationship between professional commitment and turnover intention. Nurses expect organisations to maintain good staff relations, provide a positive working environment and learning opportunities and strengthen communication channels, all of which affect nurse retention. Relevance to clinical practice: Workplace violence is a serious crisis that can lead to turnover intention among hospital nurses. To enhance interpersonal relationships in the workplace and improve nurse retention, hospitals should schedule an adequate amount of staff and provide sufficient equipment and supplies to create a safe and positive work environment. [ABSTRACT FROM AUTHOR]

The aim of the authors in this study was to identify factors associated with resilience that helped abused nurses face and cope with violent events. The data for this cross-sectional study were collected from June 2013 to December 2013; 272 participants were recruited from emergency rooms and psychiatric wards in four hospitals in central Taiwan. Among these participants, 230 (84.6%) met the inclusion criterion and completed all questionnaires; 69 (30%) of them reported having experienced only verbal violence; 46 (20%) reported having experienced only physical violence, and 115 (50%) reported having experienced a combination of verbal and physical violence. The following were positively associated with resilience score: having a college education or greater (exp(β) = 1.045,p =.018), extraversion (exp(β) = 1.012 per unit increase in the score,p <.001), family support (exp(β) = 1.004 per unit increase in the score,p =.031), peer support (exp(β) = 1.008 per unit increase in the score,p =.006), and lower level of neuroticism (exp(β) = 0.983 per unit increase in the score,p <.001); 43.6% of the variance in resilience was explained by the variables assessed. Adequate support and advanced education are important for abused nurses to enhance their resilience. [ABSTRACT FROM PUBLISHER]

Aim and objectives. This correlation study examined the relationship among recently workplace violence, depressive tendency, social support, and resilience of victimised nurses, and we also tried to identify protective factors and potential targets for preventive interventions for these nurses. Background. Workplace violence in hospitals negatively affects occupational health and safety of medical professionals, especially for emergency department nurses. Design. A cross-sectional, correlation research design was applied. Methods. Hierarchical regression was used to examine data which were collected from June 2013 to December 2013 from emergency departments in Taiwan. One hundred and eighty nurses were recruited from two hospitals. Structured interviews and questionnaires were applied to collect data, including the Social Support Scale, the Resilience Scale and the Center for Epidemiologic Studies Depression. Results. A total of 159 (88-33%) nurses had suffered from physical or verbal violence by patients or their family. Resilience and peer support were significantly higher in the group without depressive tendency. Components of resilience of personal strength, social competence, structure style and religious beliefs were significant factors which accounted for 46-0% of variance in depressive tendency. Three of the five components of resilience: personal strength, social competence and structured style were found to have profounder effects against depressive tendency than peer support. Conclusions. Hospital managers should establish a safer working environment for emergency department nurses and reinforce their resilience against depression when they encounter workplace violence. Relevance to clinical practice. This study showed that three of the five components of resilience: personal strength, social competence and structured style are protective factors against depressive tendency in victimised nurses. Improving these three components with coping and problem-solving skills by healthcare manager would be effective measures for enhancing their resilience in situations of workplace violence. [ABSTRACT FROM AUTHOR]

Purpose This study investigated the relationship among personality traits, social network integration (SNI), and resilience in emergency department (ED) nurses who had suffered from physical or verbal violence by patients or their families. Design and Methods A cross-sectional study with convenience sampling was conducted for exploring the related factors of resilience on abused nurses. A total of 187 participants met our inclusion criteria and completed all questionnaires. Findings Higher degrees of extraversion and peer support were associated with greater resilience among all abused nurses, whereas neuroticism was inversely associated with their resilience. Conclusions Among all forms of SNI, only peer support was shown to enhance an individual's resilience. In addition, personality traits were associated with resilience, and religions did not play an important role in enhancing resilience among our participants. Clinical Relevance Through a clearer understanding of the role of peer support in resilience among ED nurses, healthcare managers should provide and enhance their peer support to intensify their resilience for prevention of consequences of workplace violence. [ABSTRACT FROM AUTHOR]

Background: An increasing number of survivors of intimate partner violence (IPV) have begun to seek help from hospital emergency departments. This study was conducted to develop a list of requisite clinical competencies for emergency nurses to provide adequate care for women experiencing IPV. Method: An e-mail survey using the Delphi technique was administered, involving three rounds of questionnaires from 30 participants. Participants were asked to score the importance of each item on a 4-point Likert scale. Results: The study identified three dimensions, comprising 38 items of competencies related to care for individuals experiencing IPV, including Knowledge (10 items), Attitudes (11 items), and Practice (17 items). Conclusion: The emergency department is where direct medical treatment and care is provided for those who have experienced IPV. The study findings can provide a reference for the development of in-service educational programs in hospitals and can guide future policy making. J Contin Educ Nurs. 2015;46(6):272-278. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice is important to clinical health care professionals. Clinical nurses can make informed decisions by applying the best evidence to their care. However, standardized curricula on evidence-based medicine are lacking in nursing education programs. This study evaluated a critical appraisal education program and assessed its value in increasing nurses' knowledge of critical appraisal and confidence in their critical appraisal skills. Methods: A controlled before-and-after study design was used. The education program integrated lectures, practice, and group discussion. A questionnaire was used to evaluate participants' knowledge and confidence in critical appraisal pre- and postintervention. Results: Participants' knowledge and confidence in critical appraisal improved significantly postintervention (both p < .001). Conclusion: A 1-day, small group discussion education program can effectively improve nurses' knowledge and confidence in critical appraisal. Educators and administrators may replicate this education program to improve the quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners (NPs) in Taiwan have practiced mainly in acute care hospitals since 2006. Although organizational support and level of support have been associated with the successful integration of NP roles and effective practice outcomes, organizational support in the context of NPs in inpatient settings is an area that has been rarely explored in the literature. Purpose: The purpose of this study was to investigate the relationship between organizational support and the practice outcomes of job satisfaction, care effectiveness, and intention to leave in NPs. Methods: A national survey of 512 NPs was conducted that included a demographic characteristics datasheet, the Nurse Practitioner Primary Care Organizational Climate Questionnaire, the Misener Nurse Practitioner Job Satisfaction Scale, and the Nurse Practitioner Care Effectiveness Scale. Multiple regression analysis was applied to explore the specific factors associated with job satisfaction. The statistical significance level was set at.05 with a two-tailed test. All statistical analyses were conducted using SPSS Statistics Version 22.0 software. Results: More than half of the participants were found to be dissatisfied with their hospital managers (54.8%) and with each dimension of organizational support. Overall, 82.1% of the participants were satisfied with their current practice. A multiple regression analysis showed that the participants who perceived higher levels of organizational support in the workplace (β =.53, p <.001), expressed satisfaction with working with their managers (β =.25, p <.001), or perceived better care outcomes (β =.10, p <.001) reported higher job satisfaction. In addition, the participants who expressed intention to leave within 1 year (β = −.09, p <.001) and those with higher patient loads (β = −.09, p <.001) reported lower job satisfaction. Organizational support was found to explain 50% of the variance in job satisfaction. Conclusions/Implications for Practice: The results of this study highlight organizational support as the most important factor affecting job satisfaction in NPs. Therefore, administrators work to promote organizational support and improve the work environment to enhance the job satisfaction, increase the clinical practice retention, and improve the care outcomes of NPs. [ABSTRACT FROM AUTHOR]