Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction.

Objectives: This study aimed to estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in Oman. Methods: A cross-sectional retrospective study was conducted on all patients who presented to the emergency department at Sultan Qaboos University Hospital and Royal Hospital, Muscat, Oman, and underwent primary percutaneous coronary interventions during 2018-2019. Results: The sample included 426 patients and the median DTB time was 142 minutes. The result of the bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were 3 times more likely to have a delayed DTB time, when compared to patients who presented with typical symptoms (odds ratio [OR] = 3.003, 95% confidence interval [CI]: 1.409-6.400; P = 0.004). In addition, patients who presented during off-hours were 2 times more likely to have a delayed DTB time, when compared to patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284-4.087; P = 0.005). Conclusion: To meet the DTB time recommendation, it is important to ensure adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care.

An Agreement Among Nurse Educators on Infection Prevention and Control Practices to Ensure Safe Clinical Training Post-COVID-19.

Background: Infection Prevention and Control (IPC) practices during nursing students' clinical training are based on standardized precautions. However, the spread of COVID-19 raised the need to revise these practices. We aimed in this study to assess nurse educators' agreement on items that represent precautionary guidelines, which enhance safety during clinical training of students. It aimed to reach an agreement among nurse educators on IPC practices to ensure safe clinical training. Materials and Methods: This descriptive explorative, cross-sectional study included 243 Jordanian and Omani educators. The study questionnaire was based mainly on evidence reported in the literature. The study questionnaire comprised items for trainers to practice and items to supervise students. It was developed based on available evidence and recommended training practices during COVID-19 suggested by the WHO and the literature. Both the face and content validity processes were adopted to validate the study questionnaire. The final version was composed of 26 items for trainers and 20 items for students subsumed in the following themes: protecting self, protecting others, and essential training needs. Results: All questionnaire items were rated above the midpoint indicating agreement among participants on including the new IPC practices. All suggested practices (26 items for the trainers and 20 items for the students) were supported by the study participants. Conclusions: Clinical training is an important component of nursing students' preparation. Findings suggest the importance of adding new IPC practices to improve student IPC practices, protect themselves and others, minimize cross-infections, and enhance students' training within a safe clinical environment.

Glycaemic control and its associated factors among adult Omanis with type 1 diabetes mellitus: a cross-sectional survey.

OBJECTIVES: This study aimed to investigate the relationship between glycemic control and diabetes self-management (DSM) and other associated factors among adult Omanis with Type-1 Diabetes Mellitus (T1DM). METHODS: A cross-sectional, descriptive design was used to collect data among 210 adult Omanis with T1DM who were conveniently recruited. All tools were self-reported, whereas the HbA1c was collected from the patient's electronic medical records. RESULTS: The HbA1c mean value was 8.6 (SD = 2.5), 30.5% had optimal glycemic control (<7.0). A significant negative relationship between HbA1c and DSM (r = - 0.191, p = 0.006) and diabetes knowledge (r = - 0.153, p = 0.026) was found. Furthermore, the mean HbA1c was significantly lower for persons with a single marital status, have higher education level, have children, are unemployed, were not admitted to the hospital in the last year, and have a health care professional as a family member. Additionally, marital status, level of education, DSM, and social support were significant predictors of glycemic control. CONCLUSIONS: The results suggested that better glycemic control could be achieved by optimizing DSM, social support, and diabetes knowledge. Sociodemographic factors should be considered when treating individuals with T1DM to reach good glycemic control.

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman.

Objectives: This study aimed to explore the relationships between nurses' work environment, job stress and job satisfaction, along with the moderating effects of work environment and empowerment on the relationship between job stress and job satisfaction. Methods: A descriptive correlational design was utilised for this study. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. Moreover, a self-report questionnaire that included a set of instruments was used to collect the data. Results: Nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment and perceived their work environment as less favourable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction, whereas no support was found for indirect or moderating effects. Furthermore, the hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables. Conclusion: The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment and tackle job stress to enhance levels of job satisfaction.

Factors associated with millennial nurses' intention to pursue formal leadership roles: a cross-sectional study.

PURPOSE: This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles. DESIGN/METHODOLOGY/APPROACH: This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020. FINDINGS: Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses' intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout. ORIGINALITY/VALUE: Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses' intentions to pursue formal leadership roles.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses.

BACKGROUND: Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses. OBJECTIVE: To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses. METHODS: A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables. RESULTS: Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (ß = - 0.481, p = 0.031), ethical/moral conduct (ß = - .408, p = 0.043), managerial ability and support (ß = - 0.497, p = 0.018), and adequate staffing and resources (ß = -.068, p = 0.028) were all associated with lower job burnout. CONCLUSIONS: Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

Determinants of Physicians' Job Satisfaction: A national multi-centre study from the Sultanate of Oman.

Objectives: This study aimed to examine and assess job satisfaction of physicians across several factors, such as quality of care, ease of practice, relationship with leadership and inter-professional collaboration. Methods: The data for this descriptive cross-sectional study were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician job satisfaction and inter-professional collaboration. Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of the 396 physicians contacted, 354 responded (response rate: 89.4%). Results showed that out of the 354 physicians, 4.3% were not satisfied with their jobs, 36.5% expressed a moderate level of satisfaction and 59.2% were highly satisfied. There was no difference in the mean job satisfaction score among different groups of study participants, except for gender and the working grade (P <0.05). The overall job satisfaction rates were higher for the quality of care (mean = 3.93 ± 0.61) and ease of practice (mean = 3.89 ± 0.55) and lower for relationship with leadership (mean = 3.67 ± 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (P = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care and for ease of practice and lower for relationship with the leadership. Relationship with leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates.

Healthcare costs and outcomes associated with surgical site infections after coronary artery bypass grafting surgeries in Oman.

BACKGROUND: Surgical site infection (SSI) after coronary artery bypass graft (CABG) surgeries is considered a key indicator of the quality of healthcare services. OBJECTIVE: This study aimed to estimate the healthcare outcomes associated with SSIs after CABG surgeries in Oman in terms of mortality rate, case-fatality rate, LOS, readmission rate and healthcare costs. METHODS: The nested case-control study design was used based on retrospective data, which was conducted from 2016 to 2017. The case group encompassed all CABG patients with confirmed SSIs within 30 days of the surgery (n = 104) while controls were CABG patients without SSIs (n = 404). RESULTS: Forty-four (42.3%) of the SSI patients were readmitted to the hospital compared to eight (2%) of the control group (p < .001). Patients in the case group had a longer LOS (M = 24.4, SD = 44.6 days) compared to those in the control group (M = 11, SD = 21 days, p = .003). The mean healthcare costs of cases (M = Omani Rial [OMR] 3823, SD = OMR 2516) were significantly greater than controls (M = OMR 3154, SD = OMR 1415, p = .010). CONCLUSION: Results from this study can be baseline data for formulating new hypotheses and testing the causal relationship between SSIs after CABG surgeries and the readmission rate, LOS and health care costs.Key messagesSurgical Site Infections (SSIs) are still a major complication after cardiac surgeries in Oman.SSIs after cardiac surgeries are associated with substantially increased healthcare costs and length of stay.SSIs after cardiac surgeries are associated with negative outcomes such as mortality and case-fatality rates.

Role transition from education to practice and its impact on the career futures of Omani nurses.

AIM: The aim of this study was to examine new Omani graduate nurses' role transition from education to practice. We also sought to describe factors that may affect the effective transition of new Omani graduates to their professional nurse role. BACKGROUND: There is a substantial literature on the process of transition from graduation to being a professional nurse in countries across the globe; however, little is known about new Omani graduate nurses' role transition from education to practice. DESIGN: This study had a descriptive cross-sectional design. METHODS: Data were collected from nurses who at the time of the study had been working for at least 3 months but not longer than 2 years. Role transition was assessed with the Comfort and Confidence subscale of the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004). The survey consists of a 24-items that are rated on a 4-point Likert scale. We conducted a multivariate regression analysis to assess the factors that influence nurses' role transition. These factors included participants' demographic information, employment orientation durations, preceptorship duration and length of time before employment. RESULTS: The total sample consisted of 405 nurses working in 13 hospitals in Oman. Most (68.89%) had worked as a nurse for less than 6 months. The average internship and orientation durations were approximately 6 months (SD = 1.58) and 2 weeks (SD = 1.79), respectively. The number of preceptors assigned to new graduate nurses ranged from none to four. The average score on the Comfort and Confidence subscale was 2.96 (SD = 0.38). Results from the regression analysis demonstrated that age (ß = 0.029, SE = 0.012, p = .021), waiting time before employment (ß = -0.035, SE = 0.013, p = .007) and employment orientation duration (ß = -0.007, SE = 0.003, p = .018) were statistically significant factors influencing role transition experience among newly joined nurses. CONCLUSION: The results suggest that appropriate intervention strategies at the national level are needed to enhance the transition of nursing school graduates to their professional role. Strategies directed toward shortening the waiting time before employment and improving the internship experience are examples of priority-level tactics that can enhance Omani nursing graduates' transition to their professional role.

Prevalence and Predictors of Loneliness Among Youth During the Time of COVID-19: A Multinational Study.

BACKGROUND: Given the restrictions associated with COVID-19, feelings of loneliness among youth may increase. AIMS: The aims of the current study were to assess the prevalence of loneliness among young people at the time of COVID-19 and to identify whether selected variables related to the pandemic predicted the level of loneliness. METHOD: A cross-sectional study using WhatsApp and Facebook social media platforms was conducted to survey 1,057 young people aged 15 to 24 years from six Middle Eastern countries. Participants completed survey items including demographic and COVID-19-related questions; the Depression, Anxiety and Stress Scale (DASS); the Satisfaction With Life Scale (SWLS); and the UCLA Loneliness Scale. RESULTS: The prevalence of experienced loneliness was 1 (0.1%), 625 (59.1%), 429 (40.6%), and 2 (0.2%), reflecting low, moderate, moderately high, and high experiences for loneliness, respectively. History of depression or anxiety, being dissatisfied with life, and having depression at the time of COVID-19 were significant predictors of loneliness among youth. The model was significant (F = 44.95, p < .05) and accounted for 29.8% of the variance in UCLA Loneliness Scale scores. CONCLUSIONS: We found that the high prevalence rate of loneliness during the COVID-19 pandemic was correlated with depression and impaired life satisfaction among Middle Eastern youth. Thus, special attention and interventional action plans need to be developed taking into consideration the youths' special situation during COVID-19.

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman.

Background: There is limited information about the incidence and risk factors of surgical site infections (SSIs) after coronary artery bypass (CABG) surgeries in the Omani population. Aim: To estimate the prevalence and describe possible risk factors of SSIs after CABG surgeries in Oman. Method: A retrospective nested case-control design was used to screen 596 patients who underwent CABG surgeries over 2 years (2016-2017) in two tertiary hospitals in Oman. The CDC definition for SSIs was used to identify the infected cases. Results: Prevalence rate of SSIs was 17.4% and 17.5% in 2016 and 2017, respectively. The most isolated microorganism was Gram-positive bacteria (45.2%). Risk factors of SSIs include female gender (OR = 3.2, p < 0.001), diabetes (OR = 5.83, p < 0.001), overweight or obese (OR = 2.14, p < 0.05) and shaving technique [using razor shaving] (OR = 8.4, p < 0.001). Readmission rate for the case group was 44.2%. Conclusion: The infection rate of SSIs after CABG surgeries in developing countries, such as Oman, is considerably high. There is an urgent need to establish SSIs preventive program at the national level. Frequent and systematic assessment of infection control practices before and after CABG surgeries is fundamental and priority strategy to prevent SSIs.

Acceptance, attitudes, and barriers of vaccine booster dose among nursing students: A multicounty survey.

AIM: This study investigated the acceptance and attitudes of nursing students toward the COVID-19 vaccine booster dose in two Gulf Cooperation countries and the potential influencing factors for taking a COVID-19 vaccine booster dose. BACKGROUND: The world is still battling coronavirus because of the emerged of variants and because protection against COVID-19 has waned over time. Vaccination is a powerful and effective method of reducing the outbreak of COVID-19 and decreasing the loss of lives. DESIGN: This research was a survey using a cross-sectional design. METHODS: The study's sample was two nursing colleges. The study tool was adopted according to recent information concerning the COVID-19 vaccine published by the World Health Organization. Data was collected through an online survey during March to April. RESULTS: A total of 216 nursing students completed the survey, of which 69.4% (n = 150) were male students and more than half of the participants were from Saudi Arabia (55.1%, n = 119). Two-thirds of the students (75.5%, n = 161) reported that they agreed to receive a COVID-19 vaccine booster. The total attitude scores for the students ranged from 28 to 35, with a mean score of 15.8 (SD = 2.5), representing 73% of the highest possible score, with 79.3% classified as 'positive attitude toward booster dose of COVID-19'. Vaccine booster might cause infection, vaccine booster ineffective, worried about adverse effects and not safe were major barriers influencing the acceptance of the COVID-19 vaccine booster. CONCLUSION: Nursing students revealed high acceptance rates related to COVID-19 vaccine booster. However, more attention should be paid from nursing educators to barriers influencing the acceptance of the COVID-19 vaccine booster. Preparing nursing students with positive attitude of COVID-19 vaccine booster is very important to patient and community safety. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing educators and managers must make an effort to educate the nursing students regarding safety and effectiveness from COVID-19 vaccine booster and ensure that it is necessary to reduce their perception of the injury of COVID-19 infection.

Nurses' job burnout and its association with work environment, empowerment and psychological stress during COVID-19 pandemic.

AIM: The aim of this study was to assess the influence of perceived work environment, empowerment and psychological stress on job burnout among nurses working at the time of the COVID-19 pandemic. BACKGROUND: Nurses experienced high levels of job burnout during the pandemic, which impacted their mental health and well-being. Studies investigating the influence of work environment, empowerment and stress on burnout during the time of COVID-19 are limited. DESIGN: The study utilized a cross-sectional design. METHODS: Data were collected from 351 nurses in Oman between January and March 2021. The Maslach Burnout Inventory, the Practice Environment Scale of the Nursing Work Index, the Conditions of Work Effectiveness Questionnaire and the Perceived Stress Scale were used to assess study variables. RESULTS: About two-thirds of the nurses (65.6%) reported high levels of job burnout. Nurse managers' ability, leadership and support; staffing and resources adequacy; and nurses' access to support were significant factors associated with a reduced level of burnout. CONCLUSION: Supporting nurses during the crisis, ensuring adequate staffing levels and providing sufficient resources are critical to lower job burnout. Creating a positive and empowered work environment is vital to enhance nurses' retention during the pandemic.

Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout.

BACKGROUND: Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship. AIM: To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout. METHODS: A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout. RESULTS: Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout. CONCLUSION: Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.

ICU-acquired central line-associated bloodstream infection and its associated factors in Oman.

BACKGROUND: Despite the extensive use of central lines for ICU patients in Oman, no studies have been conducted among adult ICU patients to assess the prevalence, and predictors of CLABSIs. AIM: To estimate the prevalence of ICU-acquired CLABSIs, identify the most common causative microorganisms, and define possible related risk factors associated with ICU-acquired CLABSIs among adult ICU patients in Oman. METHOD: A retrospective case-control design was used to screen electronic medical records of for all adult ICU patients admitted over 2 years (2018-2019) in 2 tertiary hospitals in Oman. The CDC definition of CLABSIs was used to allocate a cases group (n = 58), and a randomly selected controls group (n = 174). RESULTS: The prevalence of ICU-acquired CLABSIs was 8.9 and 8.31 per 1,000 catheter days for the years 2018 and 2019 respectively. The most common isolated microorganisms were gram-positive bacteria (46.6%). The risk factors for ICU-acquired CLABSIs are: heart failure (Odds Ratio [OR] = 11.67, P < .001), female gender (OR = 0.352, P = .035), presence of other infections (OR = 3.4, P = .009), tracheostomy (OR = 5.34, P = .004), and Total Parenteral Nutrition (OR = 3.469, P = .020). CONCLUSIONS: The prevalence of ICU-acquired CLABSIs in developing countries like Oman is higher than most of developed countries. The current study provides baseline data that can be used as a reference for future national studies and help in building strategies to prevent and control ICU-acquired CLABSIs.

Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses.

BACKGROUND: As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored. AIM: This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction. METHODS: This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman. RESULTS: Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations. CONCLUSION: Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.

The impact of perceived nurses' work environment, teamness, and staffing levels on nurse-reported adverse patient events in Oman.

BACKGROUND: Fostering a healthy work environment becomes a necessity in health care institutions that value quality care and patient safety. However, limited studies investigated the impact of work environment characteristics including staffing and teamness among healthcare teams on adverse patient events in Oman. AIMS: To examine the (1) impact of work environment, interprofessional teamness, staffing levels on adverse patient events and (2) predicting factors of perceptions of work environment among nurses in the Sultanate of Oman. METHOD: A cross-sectional descriptive design was utilized to collect data from 2113 nurses. Participants completed a self-report questionnaire that included a set of instruments. RESULTS: The results showed a strong positive relationship between work environment and teamness (r = 0.59, p < 0.001). Nurses working in a favorable environment that has positive teamwork reported a reduction in adverse events including patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medication errors (p < 0.001). There was a nonsignificant correlation between staffing and adverse patient events. CONCLUSION: Fostering a healthy and supportive work environment continue to be crucial for ensuring patient safety. Nurse administrators should strive to improve work environment through creating a culture that values interprofessional teamwork and collaborative relationships.

Authentic leadership and nurses' motivation to engage in leadership roles: The mediating effects of nurse work environment and leadership self-efficacy.

BACKGROUND: Leadership styles of a nurse manager have a profound influence on staff nurses' motivation to engage in formal nursing leadership roles; however, the mechanism underlying this pattern of influence remains unknown. AIM: To assess the direct and indirect effect of nurse managers' authentic leadership on staff nurses' motivation to engage in formal leadership roles, through the intermediary role of nurse work environment and leadership self-efficacy. METHODS: This cross-sectional study involved 1534 nurses from 24 acute care hospitals in the Sultanate of Oman. FINDINGS: Nurse managers' authentic leadership was associated with staff nurses' motivation to engage in formal leadership roles. Nurse practice environment and leadership self-efficacy mediated partially the association between authentic leadership and motivation to engage in formal leadership roles. CONCLUSION: Results of this study underscore the value of authentic leadership in creating a healthy work environment and fostering nurses' leadership self-efficacy, resulting in greater motivation to engage in nursing leadership roles. IMPLICATIONS FOR NURSING MANAGEMENT: Organizational strategies to attract nurses to undertake leadership roles should include measures to bolster authentic leadership behaviours in nurse managers through theory-driven leadership development programmes or interventions, continuing education, effective succession planning and creating a supportive work environment.

COVID-19 pandemic and remote teaching: transition and transformation in nursing education.

Remote teaching (RT) was the only option left to educators to continue education with public policy of lockdowns and social distancing during COVID-19 pandemic. RT is the online mode of instructional delivery. Globally it has become mandatory for all nurse educators to switch to RT mode. Many factors have been identified for effective implementation of RT, of which the major elements are choice of online teaching mode, pedagogy to choose the platform or technology, faculty preparedness, and the learner motivation and expectations. The dire need to meet the educational objectives demanded sudden transition to online mode. The paradigm shifts to RT brought many challenges and pragmatic guidance for teachers and institutions Remote teaching is flexible, student centered and feasible with opportunities to develop technically empowered faculty and coherent digital education strategies. However, tackling threats like academic integrity, inequity in accessibility and limited faculty preparedness necessitates attention. RT being flexible tool is weakened by low self-motivated students and low connectivity with digital inequity and security issues. The challenges opened opportunity to enhance faculty technical competency and learning management system.

Authentic leadership, nurse-assessed adverse patient events and quality of care: The mediating role of nurses' safety actions.

BACKGROUND: Authentic leadership has been consistently cited as a strong precursor of sustained job performance and work effectiveness in nurses; however, studies linking authentic leadership with nurses' safety actions, nurse-assessed adverse patient events and nursing care quality are scarce. AIM: To examine whether nurses' safety actions mediate the relationship between authentic leadership, nurse-assessed adverse events and nursing care quality. METHODS: A multi-centre, cross-sectional study involving 1,608 nurses employed in acute care facilities in Oman. Multi-stage regression analysis was conducted in testing for the mediation model. FINDINGS: Nurse managers in Oman were perceived to be highly authentic by their staff nurses. Authentic leadership significantly predicted nurses' safety actions (ß = 0.168, p < .001), decrease in nurse-assessed adverse events (ß = -0.017, p = .024) and increase in care quality (ß = 0.121, p < .001). Further, the association between authentic leadership and nurse-assessed adverse events (ß = -0.063, p = .057) and care quality (ß = 0.038, p = .002) was mediated by nurses' safety actions. CONCLUSION: Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' safety actions and reduce adverse patient outcomes and promote nursing care quality. IMPLICATIONS FOR NURSING MANAGEMENT: Organizational efforts to address patient safety issues should be directed towards developing authentic leadership in nurse managers through leadership programmes, periodic evaluation of leadership competencies (e.g., 360-degree or a bottom-up performance evaluation), and a creation of a safe culture in which nurses can openly report safety concerns for corrective action.