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OBJECTIVE: To estimate and contrast the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census, to understand the association of staffing hours with dementia care quality. DATA SOURCES AND STUDY SETTING: A national sample of nursing homes during 2017-2019 (pre-COVID). Data included the Payroll-Based Journal, Medicare Claims, Nursing Home Care Compare, and Long-Term Care Focus. STUDY DESIGN: Retrospective, regression analyses. We estimated separate linear models predicting six long-term facility-level outcomes. Independent variables included staffing hours per resident-day (HPRD) interacted with the facility percentage of dementia residents, controlling for other resident and facility characteristics. DATA COLLECTION/EXTRACTION METHODS: Hospital-based nursing homes, those with fewer than 30% dementia residents, and missing data were excluded. PRINCIPAL FINDINGS: We found that registered nurses and certified nurse assistants HPRDs were likely to exhibit positive returns in terms of outcomes throughout most of the range of HPRD for both high and low-census dementia facilities, although, high- and low-dementia facilities differed in most outcome rates at all staffing levels. Average predicted antipsychotics and activities of daily living as functions of HPRD were worse in higher dementia facilities, independent movement, and hospitalizations did not differ significantly, and Emergency Rooms and pressure sores were worse in lower dementia facilities. Average marginal effects were not statistically different [CI included zero] between the high and low dementia facilities for any outcome. CONCLUSIONS: These findings suggest that increasing staffing will improve outcomes by similar increments in both low- and high-dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low- and high-dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low- and high-dementia census facilities.

ABSTRACT Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non‐mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five‐step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed‐methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non‐mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a ‘choice.’ This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders. [ABSTRACT FROM AUTHOR]

Background: In Italy, Diagnosis-Related Groups (DRGs) have been adopted for hospital services reimbursement. In some Italian regions, nurse staffing allocation is purely volume-based, with different minutes/patient/day categories determined by the type of hospital ward. The Information System of Nursing Performance (SIPI) is a valid and reliable tool assessing nursing care complexity as an indicator of the actual nursing care demand. Evidence is lacking about the ability of current resource allocation methods to account for the nursing care demand. Objective: To evaluate the association between (1) DRG rates and nursing care complexity and (2) hospital ward categories of nurse staffing and nursing care complexity. Methods: All patients discharged from the medical department of an Italian hospital over a data collection period were eligible. To assess the association between nursing care complexity (SIPI) and DRGs, the distribution of the DRG rate (median and first–third quartile) was compared for cases with high or low complexity. To evaluate the association between nursing care complexity (SIPI) and nurse staffing, the frequency of high complexity within nurse staffing categories (120/180/240 min/patient/day) was compared. Because the sample was very large, methods of statistical inference were not applied, and only descriptive measures were reported. Results: 6872 hospitalizations were included. The median DRG rate for high and low complexity admissions were very similar (EUR 3536 and EUR 3285, respectively). The proportion of admissions with high complexity decreased for wards with higher staffing allocation rates. Conclusion: DRG reimbursement and the nurse staffing allocation systems were ineffective in accounting for nursing care complexity. The SIPI could help identify areas requiring more financial and staffing resources for nursing care. [ABSTRACT FROM AUTHOR]

Few studies have empirically tested the argument by psychological contract theory regarding 'supervisors as the makers of employees' psychological contracts'. To bridge this gap, this research was conducted on the impact of transformational leadership on relational and transactional psychological contracts, associated the emotional labour coping strategies to develop a research model, and investigated the mediating impacts of relational and transactional psychological contracts to validate the theoretical model. The hypotheses proposed in this study were tested through SEM with AMOS 22.0 software, which was also applied to the data collected from 236 nursing staff in 60 private, nonprofit long-term care institutions in Taiwan. As a result, transformational leadership was proven to have direct and opposite effects on the fulfilment of both relational and transactional psychological contracts. The fulfilment of relational and transactional psychological contracts had direct and opposite effects on deep and surface acting. Following that, the transactional and relational psychological contracts fully and negatively mediated the impacts of transformational leadership and surface acting, while the relational and transactional psychological contracts partially and positively mediated the influences of transformational leadership and deep acting. This study has important managerial implications for human resource management in the long-term care industry and institutions. [ABSTRACT FROM AUTHOR]

Background: Employees' decision to speak up or to stay silent can have implications for health care providers, employees and people who need care. As a result, a shift is needed from blindly following guidelines to implementing a sustainable proactive organizational culture in which employees, especially nurses, can evaluate their work environment and take advantage of growth opportunities. The aim of this review is to analyse the characteristics of employee voice opportunities in the health care context, particularly for nurses. Methods: The search was conducted in April 2023 in the following databases: MEDLINE via PubMed, CINHAL via EBSCO, Scopus via Elsevier, Wiley/Web of Science and Cochrane Library. The search results were imported into the COVIDENCE program and screened by two researchers separately. We used the following search components: health care organization, opportunities, and employee voice. The review followed the PRISMA-ScR guidelines. We identified 951 studies in five databases and via citation tracking. After we removed 102 duplicates and screening 839 titles and abstracts, 23 full texts were assessed. According to our inclusion and exclusion criteria, we included 9 studies. Results: Three main characteristics of employee voice opportunities that need to be considered to enable nurses to have a voice in the organization were identified. These main categories are individual factors, organizational culture, and available voice channels. It is not possible to rank them in order of importance; they are interrelated. Conclusions: To conclude, employee voice is a process. In order for utilize employee voice opportunities, individual employee factors, organizational culture and its embedded context must be considered. Individual internal and external motivation, which is influenced by socio-cultural aspects and work hierarchies, must also be considered for successful use of opportunities. [ABSTRACT FROM AUTHOR]

Background: Night shift work negatively affect human health by disturbing circadian rhythm & altering biological functions, due to poor sleep quality. These disturbances have been linked to insulin resistance & poor glycemic control in type 2 diabetic patients (T2DM). Objectives: to investigate the association between rotating night-shift work and glycemic control among type 2 diabetic nursing staff. Materials and Methods: case-control study included 104 T2DM nursing staff (65 of them on rotating night shift work & the other 39 on fixed day work) in addition to 104 healthy control subjects at Menoufia University hospitals, Egypt. They were subjected to a pre-designed self-administered questionnaire & blood samples for assessment of glycemic control were withdrawn as fasting, two-hour post prandial blood glucose and glycated hemoglobin. Results: overnight work (62.5%) had significantly worse glycemic control assessed by glucose parameters (FBG, 2Hppg and HbA1c) than those performing day work (37.5%). There was significant association between unhealthy diet, physical inactivity, obesity and night-shift working and DM (p<0.05). Multiple regression analysis revealed factors like positive family history, unhealthy diet, obesity and night-shift working were significant predictors for poor diabetic control. Conclusion: This study revealed that T2DM nurses working rotating night shifts had poor glycemic control due to chronic circadian misalignment and several factors associated with night shift working as bad dietary foods habits, weight gain, less exercise, night light exposure and endocrinal disturbances. Occupational diabetic health practitioners should be aware of modifying mealtimes, adjusting insulin dosing schedule avoiding factors triggering hypoglycemia episodes by consulting diabetic specialists. [ABSTRACT FROM AUTHOR]

OBJECTIVE The investigation of the nursing staff’s perceptions of the types and causes of missed nursing care, as well as the possible relationship of this phenomenon with their professional satisfaction. METHOD The research was carried out from January to March 2022. The sample of the research was 149/280 nurses of all ranks (response rate 53%) of the staff of the “Agios Panteleimon” General Hospital of Nikea -“Agia Varvara” General Hospital of Western Attica. Data collection was performed using a questionnaire on the types and causes of missed nursing care (Miss nursing care, MISSCARE), which also included a set of questions regarding nurses’ job satisfaction. Data analysis was performed with the Statistical Package for Social Sciences (IBM SPSS), version 25.0. RESULTS The average value of the omitted nursing care of the participants ranged in moderate levels, while the elements of nursing care that are omitted with greater frequency, often or always, were changing the position of patients every two hours, attendance at the medical visit made for patients, oral care and hand washing. The most important reason for missed nursing care is the insufficient number of staff, while nurses are satisfied or very satisfied with their work in their current position (77%), with the fact that they are nurses (79.7%), and with the level of teamwork in their department (89.8%). At the same time, nurses who were not satisfied with their work seemed to record a higher frequency of absenteeism, while a higher level of missed nursing care characterizes those who hold a master’s degree, those who have missed more than six shifts, those who intended to leave their job over the next six months and people who felt that the staffing of their department was not satisfactory at all. CONCLUSIONS The utilization of the results of the present investigations could contribute to a gradual improvement of the health services provided by the National Health System through the reduction to the minimum possible number of omissions in nursing care. [ABSTRACT FROM AUTHOR]

Staffing planning, recruitment, and retention is a primary function of hospital management teams to ensure sufficient health care professionals and ensure the delivery of quality health care to patients. The purpose of the study is to reveal the leading problems related to attracting and retaining nursing staff in hospital structures. Material and methods: A survey was conducted of students from the Master's Program in "Healthcare Management" from the Faculty of Public Health "prof. Dr. Ts. Vodenicharov, MD" of Medical University - Sofia during the academic year 2023/2024. There were 64 participants in the study. The obtained data were processed with a statistical program. The results show that the leading negative factor on the retention of nursing staff in hospital structures is the low salary, as well as the lack of a policy for the development of health care professionals. In order to ensure sufficient nursing staff in medical institutions, it is necessary for hospital managements to implement a policy for the selection and retention of staff. It is necessary to introduce an objective methodology for determining the workload of nursing care and adequate remuneration of nurses, based on their professional qualification and development. [ABSTRACT FROM AUTHOR]

Nosocomial infections are a significant cause of morbidity, mortality, and increased treatment costs in hospitals. This study aimed to analyze the factors determining the implementation of biosafety measures by the nursing staff of four hospitals in Piura via a structural equation modeling (SEM) approach. A total of 215 nurses from various hospitals in the region participated by completing an online survey. The results demonstrated that extrinsic factors (FEX) positively influence the implementation of biosafety measures (BIOM) (β = 0.319 ***), as do intrinsic factors (FINT) (β = 0.520 **). Furthermore, intrinsic factors mediate the relationship between extrinsic factors and the implementation of biosafety measures (β = 0.443 ***). In conclusion, this study provides a deeper understanding of biosafety dynamics in healthcare settings and lays the groundwork for the development of customized interventions and ongoing training programs that ensure the optimal implementation of biosafety measures in hospitals. [ABSTRACT FROM AUTHOR]

The aim of this study was to comparatively investigate education, job, and professional development satisfaction among intensive care unit nurses in Poland and England. A total of 258 ICU nurses from both countries were interviewed (72 Polish nurses working in Poland and 186 of various national backgrounds in England, including 50 of Polish origin). We used an 11-item structured survey followed by an open-ended qualitative interview retrospectively coded for statistical analysis. Regardless of national origin, nurses in England report significantly higher education satisfaction, attributed to better theoretical knowledge gain but not to other dimensions (such as practical knowledge or personal satisfaction). They also express greater satisfaction with job conditions regarding professional development, a state-of-the-art work environment, teamwork, and finance. The UK system is also considered significantly superior in promotion opportunities and participation in post-graduation training. In conclusion, systemic factors play a crucial role in career satisfaction and advancement in nursing, with the British band system having a clear advantage over the Polish one. [ABSTRACT FROM AUTHOR]

Aims/Background The prevalence of pressure injuries (PIs) is a widely used clinical indicator of patient safety and quality of care. Nurses' understanding of pressure injury (PI) can significantly impact the treatment outcomes for patients. This study, based on latent profile analysis (LPA), reveals the characteristics associated with PI knowledge levels among clinical nurses in district and county tertiary medical institutions. We aim to help nursing managers formulate training plans accurately so that clinical nurses can provide high-level skin care services for patients. Method In June 2023, 1482 nurse staff from 4 tertiary general hospitals at the district and county level in Chengdu were chosen as research subjects using the convenience sampling method. Responses to the general information questionnaire, the Chinese Version of Pressure Ulcer Knowledge Assessment Tool (C-PUKAT), and the Chinese Version of Attitude towards Pressure ulcer Prevention (C-APuP) were used to compare the population's characteristics based on LPA. Results Three latent profiles of nurses' PI knowledge were identified: weak foundation type (46.3%), strengthening foundation type (42.7%), and special improvement type (11.0%). Subjects' departments, administrative positions, highest degrees and PI prevention attitude scores, as well as whether they have participated in the training, all differed significantly between latent profile groups (p < 0.05). Conclusion The PI knowledge level of nursing staff at the district and county tertiary general hospitals requires urgent improvement. Nursing managers should prioritize the management level and quality of PI training among clinical nursing staff. Precise training programs can be developed based on different categories of nursing staff to enhance their PI knowledge, thereby effectively improving the quality of healthcare for inpatients. [ABSTRACT FROM AUTHOR]

Objective: Workplace health promotion (WHP) in Germany is receiving increasing support from health insurance funds. Nevertheless, there is hardly any knowledge on the process of how health outcomes are achieved, especially in nursing. The aim of the study was to find out how and what can be implemented in different care settings and to examine the reactions and interactions of the participants under routine conditions. Methods: Guided by a logic model, a holistic WHP approach was implemented in four acute care hospitals, seven inpatient care facilities and four outpatient care services from April 2021 to October 2022. Data on realized WHP interventions, participant assessment and topics of work design was collected and analyzed descriptively. Results: The realized WHP interventions were adapted depending on the content and context. Mainly short relaxation interventions were delivered or those with an event character were received by participants. The highest participation rate of planned participants was achieved in team building training. Participants predominantly assessed WHP interventions as useful, the quality as (very) good and were generally (very) satisfied with the intervention components. For work design topics, intentions for the design of work organization were mainly documented in action plans. Conclusion: Cooperation with practitioners in research should be continued as a contribution to quality development. This could provide suggestions as to which content adjustments lead to greater acceptance by the target group in a specific context. Trial registration: The project was registered in the German Clinical Trial Register (DRKS00024961, 2021/04/09). [ABSTRACT FROM AUTHOR]

Background: Communication is an essential element in the success of any health care organization. Nurse Managers and staff nurses dissatisfied with unmanaged grapevine communication; therefore, nurse managers should understand the power of grapevine communication and play a proactive role in developing strategies to effectively manage grapevine communication. Aim: To assess the nurse managers' management of grapevine communication among nursing staff. Subjects and Method: Setting: The study was conducted at Tanta University Main Hospital. Subjects: Included (35) all nurse managers; supervisors, head nurses, and charge nurses and a simple random sample of 260 staff nurses. Two tools were used: Grapevine Communication and Nurse Managers' Management of Grapevine Communication Questionnaire. Results: 77.2% of nurse managers agreed that the causes of using grapevine are regarded to share information without check if correct or not, while 93.1% of staff nurses agreed that the causes of using grapevine are regarded to increasing the divide between senior management and nursing staff. Also 94.3% of nurse managers had highly management level of creating trust-relationship with the nursing staff, providing nursing staff with adequate access to information and elimination of information overload in the workplace. Conclusion: There is a significant positive correlation between causes of using grapevine communication in work environment and the management of grapevine among nurse managers. Recommendations: Hospital administration need to develop a system for transmission of formal and informal communication, to accept and interpret types of informal communication to be very beneficial. Nurse Managers keep effective communication practices and updating professionals often can build trust between managers and their staff and provide more opportunities for staff nurses to express their ideas and opinions. [ABSTRACT FROM AUTHOR]

Background: Sleep is a critical component of existence and vital for the rejuvenation of the body. A minimum of 7 h of sleep is needed for adults for optimal wellness. In the present condition, extended periods of wakefulness are a common occurrence. Such wakefulness can be acute total sleep deprivation or chronic partial sleep restriction. Both forms can negatively impact cognitive abilities. It is prevalent among nursing professionals, who play a vital role in health care, remaining alert during working hours, especially night shifts. Aims and Objectives: This study aims to examine the effects of altered sleep patterns on working memory among nursing personnel working day and night shifts. Materials and Methods: The necessary documents for conducting the study were obtained from the institution and the participants. For this cross-sectional study, 31 nursing staff, age group of 25-40 years, males - six, and females - 25 were chosen according to the selection criteria. They were posted to wards on rotational day and night shifts. Rey-Osterrieth figure copy and recall test (Rey-Osterrieth complex figure test [ROCF]) was used for assessing working memory. The performance was based on a copy score and a recall score. Results: A paired "t" test with one-way repeated within the subject analysis of variance test was applied for analysis. Recall scores of ROCF were significantly less. Copy scores of ROCF were also less but statistically insignificant. Conclusion: The present study showed that the recall scores were significantly less in nursing professionals at the end of the night shift duration indicating poor working memory. [ABSTRACT FROM AUTHOR]

OBJECTIVES: In an aging society coping with workforce challenges, successful hospital management hinges on the recruitment and retention of nurses. It is of utmost priority to address job stress and fortify mental resilience. While quantitative research supports investigating the stress-alleviating effects of mindfulness for nursing staff, obtaining a direct perspective from nurses is essential to comprehend how they navigate burnout and apply mindfulness for stress management. This qualitative study aimed to explore newly graduated nurses’ experiences who participated in a mindfulness course and evaluate the practical application of acquired strategies in their work and daily lives, providing insights for retention strategies in health-care institutions. MATERIALS AND METHODS: Thirty-one recently graduated nurses participated in an 8-session weekly in the mindfulness program. Qualitative data were obtained through focus group discussions during each session and subjected to thematic analysis. Results: Five key themes were generated to show how nurses experience mindfulness training: (1) shedding light on workplace stress and adaptation; (2) stress upon entering the workforce; (3) reactions to the vicious cycle of anxiety responses to stress through mindfulness practices; (4) discovery of daily life pleasures and obstacles encountered during the mindfulness course; (5) obstacles encountered during the mindfulness course. Through participation in the program, the subjects’ levels of mindfulness of stress responses were enhanced. Conclusion: This study underscores the advantages of mindfulness courses for newly graduated nurses and emphasizes the crucial role of workplace support. Practical recommendations for nursing administrators and educators include fostering familiarity with the health-care environment, promoting teamwork, and addressing anxiety related to handovers. Mindfulness breathing training has proven effective in alleviating pressure during shift transitions. Nursing managers can enhance staff well-being by creating moments of happiness, encouraging positive experience sharing, and organizing outdoor activities. Suggestions for future research involve refining the implementation of the Mindfulness-Based Stress Reduction course for accessibility and effectiveness, extending courses to other health-care professionals to promote team harmony, and positively impacting nursing staff’s well-being and performance.

Abstract Background Employees’ decision to speak up or to stay silent can have implications for health care providers, employees and people who need care. As a result, a shift is needed from blindly following guidelines to implementing a sustainable proactive organizational culture in which employees, especially nurses, can evaluate their work environment and take advantage of growth opportunities. The aim of this review is to analyse the characteristics of employee voice opportunities in the health care context, particularly for nurses. Methods The search was conducted in April 2023 in the following databases: MEDLINE via PubMed, CINHAL via EBSCO, Scopus via Elsevier, Wiley/Web of Science and Cochrane Library. The search results were imported into the COVIDENCE program and screened by two researchers separately. We used the following search components: health care organization, opportunities, and employee voice. The review followed the PRISMA-ScR guidelines. We identified 951 studies in five databases and via citation tracking. After we removed 102 duplicates and screening 839 titles and abstracts, 23 full texts were assessed. According to our inclusion and exclusion criteria, we included 9 studies. Results Three main characteristics of employee voice opportunities that need to be considered to enable nurses to have a voice in the organization were identified. These main categories are individual factors, organizational culture, and available voice channels. It is not possible to rank them in order of importance; they are interrelated. Conclusions To conclude, employee voice is a process. In order for utilize employee voice opportunities, individual employee factors, organizational culture and its embedded context must be considered. Individual internal and external motivation, which is influenced by socio-cultural aspects and work hierarchies, must also be considered for successful use of opportunities.

Nosocomial infections are a significant cause of morbidity, mortality, and increased treatment costs in hospitals. This study aimed to analyze the factors determining the implementation of biosafety measures by the nursing staff of four hospitals in Piura via a structural equation modeling (SEM) approach. A total of 215 nurses from various hospitals in the region participated by completing an online survey. The results demonstrated that extrinsic factors (FEX) positively influence the implementation of biosafety measures (BIOM) (β = 0.319 ***), as do intrinsic factors (FINT) (β = 0.520 **). Furthermore, intrinsic factors mediate the relationship between extrinsic factors and the implementation of biosafety measures (β = 0.443 ***). In conclusion, this study provides a deeper understanding of biosafety dynamics in healthcare settings and lays the groundwork for the development of customized interventions and ongoing training programs that ensure the optimal implementation of biosafety measures in hospitals.

Background. The shortage of healthcare human resources is currently one of the most discussed topics in both Russian and global discourse. Along with the study of such important problems in the healthcare system, as its unevenness, a lack of access to health services among the most vulnerable groups, a low quality of the care provided, etc., much attention is currently paid to the professional competence, adaptation, and retention of mid-level specialists in medical organizations. One possible solution to the above problems is seen in the institute of mentorship.Objectives. To analyze the main approaches to defining the concept of “nursing mentorship” in the foreign and Russian research literature.Methods. A comparative analysis of literature sources by foreign and Russian authors addressing the definition, content, and implementation of nursing mentorship was conducted using the PubMed and eLibrary.ru databases.Results. Three main approaches — “dyadic”, “triadic,” and “integrated” (mixed) — to defining the concept of nurse mentorship were identified. The dyadic approach focuses on the analysis of interpersonal interactions between mentor and mentee. Such interactions arise during a specifically planned and goal-oriented activity aimed at a dynamic psychosocial intervention in the mentee’s professional life to bridge gaps in his/her knowledge and skills and to increase self-confidence. Dyadic mentoring can be of individual, group, distance, peer, cascade, and reverse types. The triadic approach implies interaction not only between mentor and mentee, but also involvement of the medical organization as a party. The administrators are interested in personnel stability, improved professional skills of the staff, increased loyalty and commitment to the organization. The main focus here is on the functionality, formalization, and comprehensiveness of mentoring programs, allowing the goals of the medical organization to be achieved. Within the integrated (mixed) approach, the negative experience of mentoring and the possibilities of forming a culture of mentorship are analyzed. The mentorship culture, while reflecting the interests of the medical organization, bolsters “authentic friendship” within the nursing team. Mentorship is considered as a set of activities that influence mentors, mentees, and the medical organization as a whole, passing through various development phases and stages in the interests of the three interacting parties. The contribution of Russian authors to the development of mentorship consists in the elucidation of issues related to the professional development and sociocultural adaptation of young specialists in the healthcare system, as well as in modeling mentorship relations. Mentorship is considered not only in terms of the specifics of interpersonal professional relations that arise in the mentor and mentee interaction, but also as an instrument in labor management. Mentorship programs can increase the personnel’s commitment to their profession and the results achieved.Conclusion. In the current scientific literature, different approaches to defining the concept of mid-level medical personnel mentorship are presented. The existing experience in organizing mentorship programs may significantly improve their qualitative level, thereby contributing to professional self-realization of both mentors and young nursing specialists.

Abstract Objective Workplace health promotion (WHP) in Germany is receiving increasing support from health insurance funds. Nevertheless, there is hardly any knowledge on the process of how health outcomes are achieved, especially in nursing. The aim of the study was to find out how and what can be implemented in different care settings and to examine the reactions and interactions of the participants under routine conditions. Methods Guided by a logic model, a holistic WHP approach was implemented in four acute care hospitals, seven inpatient care facilities and four outpatient care services from April 2021 to October 2022. Data on realized WHP interventions, participant assessment and topics of work design was collected and analyzed descriptively. Results The realized WHP interventions were adapted depending on the content and context. Mainly short relaxation interventions were delivered or those with an event character were received by participants. The highest participation rate of planned participants was achieved in team building training. Participants predominantly assessed WHP interventions as useful, the quality as (very) good and were generally (very) satisfied with the intervention components. For work design topics, intentions for the design of work organization were mainly documented in action plans. Conclusion Cooperation with practitioners in research should be continued as a contribution to quality development. This could provide suggestions as to which content adjustments lead to greater acceptance by the target group in a specific context. Trial registration The project was registered in the German Clinical Trial Register (DRKS00024961, 2021/04/09).

The aim of this study was to comparatively investigate education, job, and professional development satisfaction among intensive care unit nurses in Poland and England. A total of 258 ICU nurses from both countries were interviewed (72 Polish nurses working in Poland and 186 of various national backgrounds in England, including 50 of Polish origin). We used an 11-item structured survey followed by an open-ended qualitative interview retrospectively coded for statistical analysis. Regardless of national origin, nurses in England report significantly higher education satisfaction, attributed to better theoretical knowledge gain but not to other dimensions (such as practical knowledge or personal satisfaction). They also express greater satisfaction with job conditions regarding professional development, a state-of-the-art work environment, teamwork, and finance. The UK system is also considered significantly superior in promotion opportunities and participation in post-graduation training. In conclusion, systemic factors play a crucial role in career satisfaction and advancement in nursing, with the British band system having a clear advantage over the Polish one.

Patient safety culture is relevant both in the delivery of care and in the training of nursing staff, its purpose being to prevent and reduce risks associated with health care. This research aims to evaluate patient safety culture from the perspective of the nursing teams in a highly complex public hospital in the city of Valparaíso, Chile. A cross-sectional study with a quantitative approach applying descriptive, bivariate, and inferential statistical analysis was conducted on 259 nurses and nursing assistants from 13 adult medical–surgical units of the Carlos Van Buren hospital. The participants were obtained through a non-probabilistic convenience sample, answering the hospital survey on Patient Safety Culture version 2.0 (HSOPS 2.0), adapted to the Chilean population. The best-evaluated dimension was communication and receptivity; the worst was the support administrators provide for patient safety. This study identified the weaknesses and strengths of the hospital, the most worrying weakness being the shortage of human capital, material, and financial resources necessary to improve patient safety. This study was not registered.

Abstract Objective To explore the application effect of procedural pathways combined with information management in the construction of nursing staff skills training system. Methods This was a quasi-experimental study with a control group and an experimental group. A total of 300 newly admitted nurses or nurses who required training within three years of admission were selected as the experimental group, and 267 nurses who were trained in the same hospital during the same period in 2020 were selected as the control group. The experimental group received skills training using a system that combines procedural pathways with information management, while the control group received traditional teaching mode. The outcome measures included theoretical score, operation score, nurse competency, patient satisfaction, and nursing-related adverse events. The data were analyzed using t-test, chi-square test, and rank-sum test. Results The experimental group had higher scores in theoretical assessment, skills assessment, nurse competency, and patient satisfaction, and lower incidence of nursing-related adverse events than the control group (P

Abstract Background As society ages, the need for nursing home care is steadily increasing and end-of-life care of nursing home residents has become increasingly more important. End-of-life care differs between Germany and the neighbouring Netherlands. For example, a much higher proportion of German compared to Dutch nursing home residents is hospitalized at the end of life. Therefore, the aim of this study was to evaluate end-of-life care in German and Dutch nursing homes. Methods In this cross-sectional study, a postal survey was sent to 600 randomly selected German and Dutch nursing homes each and addressed to the nursing staff management. Participants were asked to estimate the percentage of nursing home residents whose wishes for emergency situations (e.g. cardiopulmonary resuscitation) are known and to indicate whether facilities offer advanced care planning (ACP). They were also asked to estimate whether general practitioners (GPs)/elder care physicians (ECPs) and nursing home staff are usually well trained for end-of-life care. Finally, participants were asked to estimate the proportion of nursing home residents who die in hospital rather than in the nursing home and to rate overall end-of-life care provision. Results A total of 301 questionnaires were included in the analysis; 199 from German and 102 from Dutch nursing homes (response 33.2% and 17.0%). German participants estimated that 20.5% of residents die in the hospital in contrast to the Dutch estimation of 5.9%. In German nursing homes, ACP is offered less often (39.2% in Germany, 75.0% in the Netherlands) and significantly fewer wishes for emergency situations of residents were known than in Dutch nursing homes. GPs were considered less well-trained for end-of-life care in Germany. The most important measures to improve end-of-life care were comparable in both countries. Conclusion Differences in (the delivery and knowledge of) end-of-life care between Germany and the Netherlands could be observed in this study. These could be due to structural differences (ECPs available 24/7 in the majority of Dutch nursing homes) and cultural differences (more discussion on quality of life versus life-sustaining treatments in the Netherlands). Due to these differences, a country-specific approach is necessary to improve end-of-life care.

Abstract Background Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Abstract Background Introducing new working methods is common in healthcare organisations. However, implementation of a new method is often suboptimal. This reduces the effectiveness of the innovation and has several other negative effects, for example on staff turnover. The aim of the current study was to implement the ABC method in residential departments for brain injured patients and to assess the quality of the implementation process. The ABC method is a simplified form of behavioural modification based on the concept that behaviour operates on the environment and is maintained by its consequences. Methods Four residential departments for brain injured patients introduced the ABC method sequentially as healthcare innovation using a stepped-wedge design. A systematic process evaluation of the implementation was carried out using the framework of Saunders et al. Descriptive statistics were used to analyse the quantitative data; open questions were clustered. Results The training of the ABC method was well executed and the nursing staff was enthusiastic and sufficiently involved. Important aspects for successful implementation had been addressed (like a detailed implementation plan and implementation meetings). However, facilitators and barriers that were noted were not addressed in a timely manner. This negatively influenced the extent to which the ABC method could be properly learned, implemented, and applied in the short and long term. Conclusions The most challenging part of the introduction of this new trained and introduced method in health care was clearly the implementation. To have a successful implementation serious attention is needed to tailor-made evidence-based implementation strategies based on facilitators and barriers that are identified during the implementation process. Bottlenecks in working with the ABC method have to be addressed as soon as possible. This likely requires ‘champions’ who are trained for the job, next to an organisation’s management that facilitates the multidisciplinary teams and provides clarity about policy and agreements regarding the training and implementation of the new method. The current process evaluation and the recommendations may serve as an example for the implementation of new methods in other healthcare organisations.

Abstract Background Since 1999, reimbursements for nursing services for inpatients have been paid differentially according to the nurse staffing ratios in Korea. However, differentiated nursing fees are insufficient for nurse staffing; thus, steps have been taken to improve the policy. This study aimed to identify the impact of a policy that changed the method of calculating nurse staffing ratios from the nurse-to-bed ratio to the nurse-to-patient ratio on improving the nurse staffing ratio in medical institutions. Methods Data were collected from 1,339 medical institutions that continuously provided medical services from 2017 to of 2021, and a prospective cohort was used for analysis. A generalized estimating equation for longitudinal ordered logistic regression was used to identify the impact of this policy change on the nurse staffing ratios in medical institutions. Results During the cohort study, 59.8% of the first-applied group of medical institutions and 65.6% of the second-applied group of medical institutions improved their nurse staffing ratios. However, only 22.6% of the medical institutions to which the revised calculation method was not applied improved their nurse staffing ratios. A statistically significant difference was found in the improved nurse staffing ratio depending on whether and when the revised calculation method was applied (χ2 = 89.830, p

Standardized blood pressure (BP) measurements for patients with chronic kidney disease (CKD) are paramount in the management of hypertension. Evidence shows nursing staff adherence to best practice guidelines for BP measurement are suboptimal. A pre-/posttest pilot study implementing a six-week hybrid educational intervention for nursing staff was conducted in an outpatient nephrology office. The Evidence-Based Practice (EBP) Beliefs Scale was administered to participants (n = 6) to assess individual beliefs about EBP and implementing EBP guidelines for BP measurement. One Likert-type question measured participant change in BP measurement. Improvement was noted in EBP beliefs and ability to implement EBP guidelines post-intervention. A favorable response was present for participant change in BP measurement per guidelines post-intervention. The intervention is a feasible method to improve staff adherence to EBP guidelines for BP measurement. [ABSTRACT FROM AUTHOR]

Background: Compared to other providers, nurses spend more time with patients, but the exact quantity and nature of those interactions remain largely unknown. The purpose of this study was to characterize the interactions of nurses at the bedside using continuous surveillance over a year long period. Methods: Nurses' time and activity at the bedside were characterized using a device that integrates the use of obfuscated computer vision in combination with a Bluetooth beacon on the nurses' identification badge to track nurses' activities at the bedside. The surveillance device (AUGi) was installed over 37 patient beds in two medical/surgical units in a major urban hospital. Forty‐nine nurse users were tracked using the beacon. Data were collected 4/15/19–3/15/20. Statistics were performed to describe nurses' time and activity at the bedside. Results: A total of n = 408,588 interactions were analyzed over 670 shifts, with >1.5 times more interactions during day shifts (n = 247,273) compared to night shifts (n = 161,315); the mean interaction time was 3.34 s longer during nights than days (p < 0.0001). Each nurse had an average of 7.86 (standard deviation [SD] = 10.13) interactions per bed each shift and a mean total interaction time per bed of 9.39 min (SD = 14.16). On average, nurses covered 7.43 beds (SD = 4.03) per shift (day: mean = 7.80 beds/nurse/shift, SD = 3.87; night: mean = 7.07/nurse/shift, SD = 4.17). The mean time per hourly rounding (HR) was 69.5 s (SD = 98.07) and 50.1 s (SD = 56.58) for bedside shift report. Discussion: As far as we are aware, this is the first study to provide continuous surveillance of nurse activities at the bedside over a year long period, 24 h/day, 7 days/week. We detected that nurses spend less than 1 min giving report at the bedside, and this is only completed 20.7% of the time. Additionally, hourly rounding was completed only 52.9% of the time and nurses spent only 9 min total with each patient per shift. Further study is needed to detect whether there is an optimal timing or duration of interactions to improve patient outcomes. Clinical Relevance: Nursing time with the patient has been shown to improve patient outcomes but precise information about how much time nurses spend with patients has been heretofore unknown. By understanding minute‐by‐minute activities at the bedside over a full year, we provide a full picture of nursing activity; this can be used in the future to determine how these activities affect patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aims to create a healthy, capable, and content India by establishing a network of health and wellness infrastructure and providing health insurance to 40% of the population deprived of secondary and tertiary care services.1 Nurses play a crucial role in delivering government health schemes, making them accessible to all, therefore assessing nurses’ knowledge is essential before implementing any health-related scheme. Objectives: 1. To assess the knowledge regarding Ayushman Bharat Yojana among nursing staff at selected hospitals, Jaipur. 2. To find out the association between knowledge regarding Ayushman Bharat yojana and selected socio -demographic variables among nursing staff at selected hospitals, Jaipur. 3. To develop an information booklet on Ayushman Bharat Yojana. Material & Methods: A descriptive study was conducted in Selected Hospitals (SMS Hospital) at Jaipur among 80 nursing staff, selected by using Non probability convenient sampling technique. Data analysed using descriptive and inferential statistics. Chi-square test examines association between knowledge of Ayushman Bharat Yojanawith selected demographic variables among nursing staff. Results: Knowledge was inadequate in 54 (67.50%) nursing staff while 26 (32.50%) staff have moderate knowledge and none of the nursing staff have adequate knowledge regarding Ayushman Bharat Yojana. Nursing staff achieved a mean of 44.36% in knowledge about Ayushman Bharat Yojana, with a 3.80 standard deviation. Knowledge of Nursing staff is significantly associated with demographic variables like Professional Qualification, Previous Working Area, and Previous knowledge Regarding any of the Health Scheme, but not with Age, Present Working Area, or Total Working Experience at 0.05 level of significance. Conclusion: The majority of Nursing Staff have inadequate knowledge regarding Ayushman Bharat Yojana. Training sessions and develop an information booklet is necessary to improve knowledge of nursing staff regarding Ayushman Bharat Yojana. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Background: A community hospital reported 21 staff assaults with injuries and 242 emergency response code green (CG) calls for violent behaviors, resulting in a loss of time in the 2022 fiscal year. Evidence has shown that exposure to violent behavior can compromise effective patient care and lead to job dissatisfaction, high turnover, and higher healthcare costs. Purpose: This quality improvement project aims to develop and implement behavioral optimization and outcome support team (BOOST) in a medical–surgical telemetry unit to reduce patient-to-staff assaults/injuries. Methods: BOOST was piloted for 15 weeks; process data included staff knowledge and satisfaction with BOOST; outcome data included the number of BOOST and CG calls and staff assaults/injuries. The team members included registered psychiatric nurses, nursing supervisors, and security officers. Data were collected and analyzed weekly using a run chart. Results: The survey data demonstrated increased staff knowledge of the behavioral response team and staff satisfaction with the BOOST implementation. No staff injuries or assaults were reported during the BOOST implementation. Conclusions: Behavioral optimization and outcome support team was effective in de-escalating patients and the team provided support to nursing staff. BOOST utilization can effectively reduce assaults and injuries in the workplace. [ABSTRACT FROM AUTHOR]

Objective: To explore the application effect of procedural pathways combined with information management in the construction of nursing staff skills training system. Methods: This was a quasi-experimental study with a control group and an experimental group. A total of 300 newly admitted nurses or nurses who required training within three years of admission were selected as the experimental group, and 267 nurses who were trained in the same hospital during the same period in 2020 were selected as the control group. The experimental group received skills training using a system that combines procedural pathways with information management, while the control group received traditional teaching mode. The outcome measures included theoretical score, operation score, nurse competency, patient satisfaction, and nursing-related adverse events. The data were analyzed using t-test, chi-square test, and rank-sum test. Results: The experimental group had higher scores in theoretical assessment, skills assessment, nurse competency, and patient satisfaction, and lower incidence of nursing-related adverse events than the control group (P < 0.05). Conclusion: The strategy of procedural pathways combined with information management provides a new perspective and method for nursing operation skills training, effectively improves clinical nursing quality and ensures patient safety. [ABSTRACT FROM AUTHOR]

Background: As society ages, the need for nursing home care is steadily increasing and end-of-life care of nursing home residents has become increasingly more important. End-of-life care differs between Germany and the neighbouring Netherlands. For example, a much higher proportion of German compared to Dutch nursing home residents is hospitalized at the end of life. Therefore, the aim of this study was to evaluate end-of-life care in German and Dutch nursing homes. Methods: In this cross-sectional study, a postal survey was sent to 600 randomly selected German and Dutch nursing homes each and addressed to the nursing staff management. Participants were asked to estimate the percentage of nursing home residents whose wishes for emergency situations (e.g. cardiopulmonary resuscitation) are known and to indicate whether facilities offer advanced care planning (ACP). They were also asked to estimate whether general practitioners (GPs)/elder care physicians (ECPs) and nursing home staff are usually well trained for end-of-life care. Finally, participants were asked to estimate the proportion of nursing home residents who die in hospital rather than in the nursing home and to rate overall end-of-life care provision. Results: A total of 301 questionnaires were included in the analysis; 199 from German and 102 from Dutch nursing homes (response 33.2% and 17.0%). German participants estimated that 20.5% of residents die in the hospital in contrast to the Dutch estimation of 5.9%. In German nursing homes, ACP is offered less often (39.2% in Germany, 75.0% in the Netherlands) and significantly fewer wishes for emergency situations of residents were known than in Dutch nursing homes. GPs were considered less well-trained for end-of-life care in Germany. The most important measures to improve end-of-life care were comparable in both countries. Conclusion: Differences in (the delivery and knowledge of) end-of-life care between Germany and the Netherlands could be observed in this study. These could be due to structural differences (ECPs available 24/7 in the majority of Dutch nursing homes) and cultural differences (more discussion on quality of life versus life-sustaining treatments in the Netherlands). Due to these differences, a country-specific approach is necessary to improve end-of-life care. [ABSTRACT FROM AUTHOR]

Background: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 crisis, spirituality can offer support to patients, assisting them in coping with the disease despite its associated pain and suffering. Objectives: This study investigates the spiritual experiences of patients who have recovered from COVID-19. Methods: This qualitative, interpretive phenomenological study utilized in-depth, semi-structured interviews with 16 patients, selected via purposive snowball sampling. All interviews were recorded and analyzed using Van Manen's interpretive phenomenological approach. Results: Data analysis revealed four major themes and eleven sub-themes, each conceptually named to reflect its essence. The major themes are "the miracle of spirituality," "discovering a new meaning for life," "strengthening spiritual beliefs," and "rebirth of spiritual life." [ABSTRACT FROM AUTHOR]

Staff in 24/7 group housing services for adults with intellectual disability are responsible for ensuring safe medication management processes and supporting the residents in their health-related issues. Ten interviewed nurses reported several challenges in the medication management process emerging at the staff level, the level of the group home, and the level of the social and healthcare system, and were often related to issues in communication and responsibility. They reported a variety of complex tasks in the medication management process, for which they need a multiple skill set. They also act as healthcare advocates for residents, but healthcare services do not always match residents' needs. Training for social and healthcare professionals, access to healthcare services and the collaboration of social and healthcare services should be improved to provide the people with intellectual disability the best possible pharmacotherapy and healthcare. [ABSTRACT FROM AUTHOR]

Background: Falls are themost frequent accident experienced by inpatients in hospitals. As falls affect patient outcomes, high fall risk factors should be studied to prevent falls and improve patient safety. However, the relationship between hospital unit characteristics and fall risk has never been assessed. Purpose: This studywas designed to identify the unit characteristics significantly related to fall risk. Methods: A cross-sectional study was conducted on the medical records of patients hospitalized in a Japanese academic hospital between 2018 and 2019. This study quantified unit activities and utilizedDiagnosis Procedure Combination data to examine unit characteristics related to falls based on unit day. Results: Data on 16,307 patients were included in the analysis, and 355 unit days were certified as fall events. Based on patient condition and medical treatment, the results identified antineoplastic injections, radiation therapy, aseptic treatment room, and functional status of partly assisted transfers,meals, and oral care as unit characteristics associated with increased fall events. Decreased nursing time per patient at night (odds ratio [OR] = 0.75, p = .04) and higher numbers of partially assisted transfer patients were also identified as unit characteristics associated with higher fall incidence rates (OR = 5.56, p = .01). Conclusions: The results of this study are expected to assist nurses to predict falls based on unit characteristics; reducing nursing time in the units was found to be a factor associated with higher fall risk. Nursemanagersmust understand the unit-related fall risk factors, appropriately assign nurse staffing numbers, and demonstrate nursing leadership to prevent falls in their units. [ABSTRACT FROM AUTHOR]

Background: The Chandler Regional Medical Center (CRMC) neonatal intensive care unit (NICU) began a phased implementation of Eat-Sleep-Console (ESC) for the management of those at risk for neonatal opioid withdrawal syndrome (NOWS). Purpose: The purpose of this initiative is to track short-term outcomes as well as the program's effect on nursing workflow and job performance rating/satisfaction. Methods: A retrospective review of the ESC implementation process at CRMC from the years 2018-2020. The study consisted of 3 epochs: (1) traditional pharmacologic management; (2) parent-led ESC management; and (3) parent/nurse-led ESC management. Length of stay (LOS), treatment pathway assignment, and proportion of infants treated with pharmacologic agents were compared between epochs. In addition, a survey of NICU nursing staff was distributed to measure nurses' perceptions and attitudes towards the ESC program and the management of infants with NOWS. Results: The proportion of infants treated via ESC increased (0%, 53%, and 100%), with an associated decrease in LOS (18.4, 10.5, and 9.3 days) during each epoch of the study period. Thirty-seven nurses completed the survey, with 94% of nurses reporting being comfortable caring for ESC patients and 89% feeling supported in their ESC nursing assignments, with only 11% stating that caring for ESC patients significantly alters their other nursing care processes. Implications for Practice and Research: Implementation of an ESC treatment program for infants with NOWS significantly decreased LOS and the proportion of infants treated pharmacologically. This phased implementation process was not associated with self-reported negative nursing perceptions of the program and its treatment goals/outcomes. [ABSTRACT FROM AUTHOR]

Patient safety culture is relevant both in the delivery of care and in the training of nursing staff, its purpose being to prevent and reduce risks associated with health care. This research aims to evaluate patient safety culture from the perspective of the nursing teams in a highly complex public hospital in the city of Valparaíso, Chile. A cross-sectional study with a quantitative approach applying descriptive, bivariate, and inferential statistical analysis was conducted on 259 nurses and nursing assistants from 13 adult medical–surgical units of the Carlos Van Buren hospital. The participants were obtained through a non-probabilistic convenience sample, answering the hospital survey on Patient Safety Culture version 2.0 (HSOPS 2.0), adapted to the Chilean population. The best-evaluated dimension was communication and receptivity; the worst was the support administrators provide for patient safety. This study identified the weaknesses and strengths of the hospital, the most worrying weakness being the shortage of human capital, material, and financial resources necessary to improve patient safety. This study was not registered. [ABSTRACT FROM AUTHOR]

Our study aimed to examine how care centers for older persons acted and adapted during the COVID-19 pandemic period by considering the opinions of the beneficiaries, employees, and managers of such centers. The research was conducted between February and June 2022, and we used a mixed-methods approach. For the quantitative research, we applied a questionnaire to 430 institutionalized older persons from Timis County, Romania. For the qualitative analysis, we conducted interviews with 31 institutionalized older persons, 7 employees, and 4 managers. Most institutionalized older persons were mainly satisfied with their lives in the care centers. The main difficulties they faced were the impossibility of being close to loved ones and the difficulty of adapting to the living conditions within the center. Additionally, the older persons were satisfied with their interactions with the staff of the care centers. The conducted research provides a view of the lifestyle of older persons in care centers during the pandemic. It highlights their struggles and can be used as a reference point for further improvement of the lifestyle of older persons within care centers. [ABSTRACT FROM AUTHOR]

Background: Introducing new working methods is common in healthcare organisations. However, implementation of a new method is often suboptimal. This reduces the effectiveness of the innovation and has several other negative effects, for example on staff turnover. The aim of the current study was to implement the ABC method in residential departments for brain injured patients and to assess the quality of the implementation process. The ABC method is a simplified form of behavioural modification based on the concept that behaviour operates on the environment and is maintained by its consequences. Methods: Four residential departments for brain injured patients introduced the ABC method sequentially as healthcare innovation using a stepped-wedge design. A systematic process evaluation of the implementation was carried out using the framework of Saunders et al. Descriptive statistics were used to analyse the quantitative data; open questions were clustered. Results: The training of the ABC method was well executed and the nursing staff was enthusiastic and sufficiently involved. Important aspects for successful implementation had been addressed (like a detailed implementation plan and implementation meetings). However, facilitators and barriers that were noted were not addressed in a timely manner. This negatively influenced the extent to which the ABC method could be properly learned, implemented, and applied in the short and long term. Conclusions: The most challenging part of the introduction of this new trained and introduced method in health care was clearly the implementation. To have a successful implementation serious attention is needed to tailor-made evidence-based implementation strategies based on facilitators and barriers that are identified during the implementation process. Bottlenecks in working with the ABC method have to be addressed as soon as possible. This likely requires 'champions' who are trained for the job, next to an organisation's management that facilitates the multidisciplinary teams and provides clarity about policy and agreements regarding the training and implementation of the new method. The current process evaluation and the recommendations may serve as an example for the implementation of new methods in other healthcare organisations. [ABSTRACT FROM AUTHOR]

Background: Since 1999, reimbursements for nursing services for inpatients have been paid differentially according to the nurse staffing ratios in Korea. However, differentiated nursing fees are insufficient for nurse staffing; thus, steps have been taken to improve the policy. This study aimed to identify the impact of a policy that changed the method of calculating nurse staffing ratios from the nurse-to-bed ratio to the nurse-to-patient ratio on improving the nurse staffing ratio in medical institutions. Methods: Data were collected from 1,339 medical institutions that continuously provided medical services from 2017 to of 2021, and a prospective cohort was used for analysis. A generalized estimating equation for longitudinal ordered logistic regression was used to identify the impact of this policy change on the nurse staffing ratios in medical institutions. Results: During the cohort study, 59.8% of the first-applied group of medical institutions and 65.6% of the second-applied group of medical institutions improved their nurse staffing ratios. However, only 22.6% of the medical institutions to which the revised calculation method was not applied improved their nurse staffing ratios. A statistically significant difference was found in the improved nurse staffing ratio depending on whether and when the revised calculation method was applied (χ2 = 89.830, p <.001). The analysis of nurse staffing ratios of medical institutions from 2017 to 2021 showed that the likelihood of improving the nurse staffing ratio increased gradually after the revised calculation method was adopted. Also,the likelihood of the nurse staffing ratio improving in the first-applied group was 1.41 times higher (odds ratio = 1.41, 95% confidence interval = 1.04–1.92) than in the non-applied group. The odds ratio for the improvement of nurse staffing ratio in the second-applied group was 2.35 (95% confidence interval = 1.76–3.14). Conclusions: Financial incentives inherent in the new policy can be regarded as the driving force behind improvements in nurse staffing ratios. The revised calculation method should be extended to all medical institutions nationwide, and the law should be revised to secure the minimum number of nurses. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the phenomenon of "overqualification" in the nursing personnel of a public general hospital, in relation to the existence of "professional boredom". METHOD A cross-sectional study was conducted in January--February 2022, on 146 nursing personnel, at the Public General hospital of Crete. Scale of Perceived Overqualification and Scale of Work-related Boredom were employed to collect the data. A convenience sampling method was applied. The Statistical Package for Social Sciences (SPSS), version 26.0, was used for the statistical analysis. RESULTS The rate of "overqualification" responses among nursing personnel was found to be low (20.5%) (p<0.05), as was the rate of "professional boredom" (8.2%) (p<0.05). A statistically significant association was found between "overqualification" and "professional boredom", with participants with boredom reporting a higher frequency of overqualification than those without boredom (83.3% versus 14.9%, p<0.001). Additionally, it was observed that the higher qualification surplus score is associated with the participants' higher levels of education (p=0.002) (objective qualification surplus), i.e. those with a master's/doctorate degree, versus those with a basic degree or school or two-year nursing assistant degree (47.4% versus 17.0% and 15.2%, respectively, p=0.017). CONCLUSIONS The present study identified two phenomena, overqualification and work boredom, that have a direct impact on the manifestation of low job satisfaction and poor work performance in the Greek health sector but have received insufficient attention. To investigate the relationship between these two phenomena and other parameters is necessary to enhance the leadership's role as a mediator and to conduct new studies on a larger scale. [ABSTRACT FROM AUTHOR]

Rheumatological conditions are complex and impact many facets of daily life. Management of people with rheumatological conditions can be optimised through multidisciplinary care. However, the current access to nursing and allied health professionals in Australia is unknown. A cross-sectional study of nursing and allied health professionals in Australian public rheumatology departments for adult and paediatric services was conducted. The heads of Australian public rheumatology departments were invited to report the health professionals working within their departments, referral pathways, and barriers to greater multidisciplinary care. A total of 27/39 (69.2%) of the hospitals responded. The most common health professionals within departments were nurses (n = 23; 85.2%) and physiotherapists (n = 10; 37.0%), followed by pharmacists (n = 5; 18.5%), psychologists (n = 4; 14.8%), and occupational therapists (n = 4; 14.8%). No podiatrists were employed within departments. Referral pathways were most common for physiotherapy (n = 20; 74.1%), followed by occupational therapy (n = 15; 55.5%), podiatry (n = 13; 48.1%), and psychology (n = 6; 22%). The mean full-time equivalent of nursing and allied health professionals per 100,000 population in Australia was 0.29. Funding was identified as the most common barrier. In Australia, publicly funded multidisciplinary care from nurses and allied health professionals in rheumatology departments is approximately 1.5 days per week on average. This level of multidisciplinary care is unlikely to meet the needs of rheumatology patients. Research is needed to determine the minimum staffing requirements of nursing and allied health professionals to provide optimal care. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality. [ABSTRACT FROM AUTHOR]

Background: In clinical nursing practice, professional accountability is a notion that impacts decision-making, safety standards, staff values. It is connected to both legal and ethical aspects of the profession. The aim of the study: To assess nursing staff's perception of professional accountability and ownership. The research design: A descriptive - correlational design was used. The subjects: All (n=247) nursing staff working at El Mogama Eltyby Hospital affiliated to The Health Insurance Authority. The tools: Two tools for data collection were used, Nursing Staff's Perception of Professional Accountability Questionnaire and Nursing Staff' Ownership Scale. The results: More than two thirds (72.9%) of nursing staff had a high perception level of professional accountability. About half (47.0%) of nursing staff had a high level of ownership. The conclusion: There was a highly statistically significant positive correlation between nursing staff perception of professional accountability and their ownership. The recommendations: Health care facility management provide educational programs, seminars and workshops for nursing staff about professional accountability and ownership to increase their opinion about professional accountability and ownership. [ABSTRACT FROM AUTHOR]

Background: Agile health care organization is proactive and purposeful answer to erratic and continuous alterations in the environment, which enables hospitals to continue and devolved in competitive market. So, managers of healthcare organizations required to be significantly more agile, flexible and provide the highest level of patient and nursing staff needs, expectations, and demands. Agile health care organization plays a mediating role to promote professional growth and achievement of goals transition into advanced practice, and job enrichment for nursing staff. Aim: To assess the relation between agile healthcare organization and job enrichment of nursing staff. Design: Descriptive correlational research design. Setting: Tanta University International Teaching Hospital .Sampling: All (n=41) head nurses and a stratified proportional random sample (n=286) of nursing staff. Tools: Tool I: agile healthcare organization questionnaire. Tool II: job enrichment questionnaire. Results: Nursing staff 56.3% showed high level of overall agile healthcare organization. Also 63.6% of nursing staff showed high level of overall job enrichment. A highly strong statistical significant correlation between levels of overall agile healthcare organization and nursing staff job enrichment at r=0.533 (p<0.001).Conclusion: There was a strong statistical significant correlation between overall agile healthcare organization and nursing staff job enrichment. Recommendation: Nursing administration required to provide periodical in-service training programs to sustain nursing staff idea of remaining adaptable and agile in the current competitive environment. [ABSTRACT FROM AUTHOR]

Background: A crisis as pandemics has a tremendously harmful impact on organization and its ability to implement an original plan. Management is a crucial issue that affects the success or failure of any organization especially during crisis. Aim: To assess the nursing staff’s perception regarding crises management during pandemics. Research design: A descriptive design was utilized. Setting: The study was conducted in all departments and ICU at Tanta Chest and Tanta Fever Hospitals which affiliated to Ministry of Health and Population. Subjects: all available nursing staff (340) of Tanta Chest hospital (n= 113) and Tanta Fever Hospital (n=227). Tool: Nursing Staff Perception about Crises Management Questionnaire was used. Results: 100% of nursing staff at Tanta chest and Tanta Fever hospital had a high perception level about crises management as well as about crises leadership. Conclusion: The nursing staff had a high perception level regarding crises management. Recommendation: Providing continuous assessment of all nursing staff on preparedness, response, recovery and evaluation of crisis management. [ABSTRACT FROM AUTHOR]

It is necessary for nursing staff to have adequate knowledge of malnutrition in older people in order to provide high quality care. This study was conducted to update the Knowledge of Malnutrition—Geriatric (KoM-G) questionnaire to fit different settings and to cross-culturally adapt it to the German, Czech, Dutch and Turkish languages. In Part 1 of the study, the KoM-G questionnaire was updated and adapted for use in different settings. Content validation of the KoM-G 2.0 was carried out in a Delphi study with 16 experts. The final KoM-G 2.0 questionnaire consists of 16 items with a Scale Content Validity Index/Average of 94.5%. In Part 2, the English KoM-G 2.0 was cross-culturally adapted into the German, Czech, Dutch and Turkish languages. In the pilot test, between 96.9% (The Netherlands) and 97.8% (Austria) of the nursing staff rated the items as understandable. The KoM-G 2.0 is an up-to-date questionnaire with a highly satisfactory Content Validity Index. It was cross-culturally adapted into the German, Czech, Dutch, and Turkish languages, and the understandability was high. At the moment, the necessary comprehensive psychometric testing of the KoM-G 2.0 is in process. Afterwards it can be used to compare nurses' knowledge between various countries and settings. [ABSTRACT FROM AUTHOR]

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Background/Aims: Low morale and burnout is a widely acknowledged problem among healthcare professionals, with implications for staffing levels and quality of care. This study aimed to provide insight into the wellbeing of nurses, midwives and healthcare support workers, and propose strategies to support a resilient workforce and organisational development. Methods: An online survey was conducted with 462 nursing and midwifery staff at one NHS health board in Wales. Validated scales were used to measure key indicators, such as workload, bullying and burnout. Descriptive analysis was undertaken of the quantitative data and content analysis of the qualitative data. Results: The survey found high levels of work intensification and burnout, with considerable proportions of respondents reporting intentions to leave their job and profession. Low levels of organisational support and trust in senior management were reported, which qualitative analysis indicated was contributing to intention to leave. Conclusions: Healthcare leaders need to place more importance on the wellbeing of staff and consider the impact of workplace climate. An inclusive, localised approach to challenges in the working climate is recommended to effectively promote a resilient and sustainable workforce. [ABSTRACT FROM AUTHOR]