The divergent opinions of nurses, nurse managers and nurse directors: the case in Lebanon.

AIM: The present study provides an overview of the status of the nursing profession in Lebanon and compares and contrasts the opinions of directors, nurse supervisors/managers and nurses regarding the nursing profession and the workplace. BACKGROUND: There are limited publications concerning the working conditions of nurses in Lebanon, and no studies on the views of directors, supervisors/managers and nurses regarding the priorities of the nursing profession. Such data are necessary to build a sound theoretical basis on which recommendations for improving the nursing profession in Lebanon are made as well as to compare and contrast cross cultural findings. METHOD: Data were collected from 45 hospitals using a mixed methods design. Qualitative data was obtained from 45 nursing directors whereas quantitative data were collected from 64 nursing supervisors and 624 nurses. RESULTS: Similarities and differences in the opinions of nurses, nurse supervisors/managers and nurse directors regarding critical issues for the nursing profession are discussed and contrasted. CONCLUSIONS/IMPLICATIONS: Nurses are more likely to be satisfied and committed to their profession when they feel that their opinions are being heard and that their work environment promotes professional advancement.

In-situ simulation-based intervention for enhancing teamwork in the emergency department.

Simulation-based learning activities in the emergency department (ED) improve communication and teamwork and familiarise personnel with existing protocols. The authors' objective was to develop standardised in-situ simulations and to assess their effects on team performance during simulated patient care. The study was a prospective, single-centre pre-in-situ and post-in-situ simulation-based intervention in the ED of an academic hospital between March 2017 and February 2018. Teams of three to five participants (n=46) were in two simulation interventions 2 weeks apart; each simulation was followed by debriefing with good judgement. The adapted Simulation Team Assessment Tool (STAT) Score was the primary measure for team performance. Skills are measured on a scale of 2-0 based on the complete and timely performance of tasks for a total (adapted) score of 171. Overall STAT scores improved significantly between simulations I (60.5 (28.3)) and II (81.1 (24.6)), p=029; notably in airway and teamwork domains, p=022 and p=023, respectively. A sub-analysis showed that participants performed significantly better when treating adult versus paediatric simulated patients (87.9 (20.1)), p=003, particularly in teamwork, p=01. The study yielded statistically significant improvement in clinical management, teamwork and resource management skills among ED personnel.