The risk of COVID-19 infection among nurses working with COVID-19 patients.

Working with 2019 coronavirus disease (COVID-19) patients is currently considered one of the main fears and challenges that face healthcare workers (HCWs), especially nurses. This challenge can jeopardize the quality of health care services for those patients and cause a serious mental burden to HCWs. To understand and estimate the risk of COVID-19 infection among HCWs who directly serve COVID-19 patients. Before the community spread of the disease, 270 nurses who worked with COVID-19 wards were followed for 11 weeks to report the COVID-19 cases. On the other hand, during the community spread of the disease, 981 registered nurses (300 worked in COVID-19 wards and 681 worked in non-COVID wards) were followed for up to 16 weeks to report the COVID-19 cases. Before the community spread of COVID-19, none of the nurses who worked with the COVID-19 patients got the infection. On the other hand, during the community spread of the COVID-19 infection, 30% of the 300 nurses who worked in the COVID-19 wards got the COVID-19 infection, while 64% of the 681 HCWs who worked in the non-COVID wards got the infection. The relative risk of getting COVID-19 infection among HCWs who worked in the COVID-19 wards was reduced to about half in comparison to other HCWs who worked in the non-COVID wards (RR = 0.469). HCWs should not fear working with COVID-19 patients. Considering appropriate personal protective measures and infection control standards, the risk of infection transmission from the community is higher than that of COVID-19 patients, if any.

The effectiveness of COPA-based training program on the infection-control competencies of newly hired healthcare professionals.

Competency-based education that relies on nurses' and healthcare professionals' needs assessment is crucial to tackling healthcare crises such as COVID-19. Strengthening the capacities of human resources by implementing customized infection control training programs is therefore mandatory. This study aims to measure the effectiveness and satisfaction of the Competency Outcomes and Performance Assessment (COPA)-based training program. The study implemented a single group pretest-posttest experimental design. A single-stage cluster sampling technique was used. All field hospitals in Jordan were listed, and one hospital was randomly selected. A total of 87 personnel from different disciplines agreed to participate after reading the letter of information and signing the informed consent. A panel of experts representing different disciplines and hospital units initially met and agreed upon a list of competencies required for the training program, and the program was accordingly developed. The study measured the healthcare professionals' competencies in infection control and prevention before and after the administration of the competency-based training program. The results revealed significant differences between participants' pretest and posttest scores in all infection control domains and the total scores. For example, the increase in participants' total competency scores after the training was statistically significant (P < 0.007). The mean total satisfaction score was 61.18 + 7.00 reflecting that the participants were highly satisfied with the provided training. In conclusion, it is imperative to provide healthcare professionals with adequate clinical training to ensure that healthcare services are going to be delivered in the highest possible quality and minimize the possible adverse events.

Knowledge of health care workers regarding COVID-19 pandemic response plan; A study from a university affiliated hospital in Jordan.

BACKGROUND: The education and training of healthcare workers (HCWs) about pandemic response plans, infection control protocols (ICP), and precautions are critical for breaking the virus transmission chain. This study aimed to assess the knowledge of HCWs regarding the COVID-19 pandemic response plan and the ICP. Concomitantly, evaluating the effectiveness and impact of institutional measures, policies, and training programs. METHODS: A cross-sectional study using an electronic questionnaire was used to collect data from 267 HCWs at a University-affiliated-hospital during April 2020. RESULTS: In this study, 90.7% of participants were nurses and 66% were females. 60.3% of participants received specific training about caring for COVID-19 patients while at least 94.3% reviewed the pandemic response plan and ICP for COVID-19. 47.5% and 29.2% of participants provided direct care for suspected or confirmed COVID-19 patients, respectively. Between 85.7% and 100% of the participants answered all items correctly regarding the COVID-19 pandemic response plan, measures, and precautions. Furthermore, the correct answers were above 95% for each item. CONCLUSION: HCWs have a high level of knowledge about the COVID-19 pandemic response plan and ICP. Training and disseminating updated plans and protocols in different methods such as an intranet and onsite training in addition to regular methods were very effective.

Involvement of Jordanian Head Nurses' in Health Policy Development: A Cross-Sectional Study.

BACKGROUND: Despite the importance of involving nurses in health policy, nurse's involvement faces many challenges. Literature showed that there is a low level of nurses' and nurse leaders' involvement in health policy development. AIM: The aims of this study were to examine (a) the level of Jordanian head nurses' involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. METHODS: A cross-sectional descriptive correlational study design was adopted in this study. A convenience sampling of 250 participants from hospitals affiliated to three health sectors in Jordan (private, governmental, and university) were recruited to complete a self-administered questionnaire. Descriptive statistics and Pearson correlation coefficient were used to answer the study questions. RESULTS: The results revealed a moderate level of involvement of head nurses in the policy development. The most frequent cited political activity was "providing written reports, consultations, research." "Lack of time" was the most perceived barrier, while "improving the health of the public" was the most perceived benefit. Workshops or sessions at conferences is the most indicated source of knowledge. Participants had an excellent level of skills with positive relationships between the competence and both of the levels of professional and personal involvement in health policy. Participants reported a low level of confidence in performing political activities as well as the impact of such activities on health outcomes. Positive relationship was indicated between self-efficacy and the levels of professional and personal involvement in political activities.Implications: Health policies affect nurses and their practice. Overcoming the barriers and enhancing the levels of head nurses' knowledge and competence regarding health policies can help activating their roles in health policy development process. This will help in activating nurses' role in health policy development, which in turn will have a positive impact on health outcomes.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration.

PURPOSE: The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan. DESIGN: This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan. METHODS: We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication. FINDINGS: A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit. CONCLUSIONS: The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system. CLINICAL RELEVANCE: Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

Positive COVID19-PCR patients as negative controls for COVID19 antibody tests.

COVID-19 serological antibody tests are recently needed for a relatively quick, affordable, and valuable assessment of the immunity toward COVID-19 infection. Furthermore, they can help with evaluating the sufficiency of the vaccination process and its longevity. There are limitations in the current approach of choosing the positive and negative control samples for the validation of those tests. Herein, we are proposing the use of blood samples from positive COVID-19 patients, at the beginning of the disease course, as negative control blood samples for the antibody tests. For more precision, both the negative and the positive control samples can be obtained from the same patients where the accuracy of the test will depend on its ability to detect the seroconversion, from negative to positive antibodies detection, within the same patient. Furthermore, when the validation of the test is accompanied by detecting/sequencing the viral genome in those COVID-19 patients, this can also aid in determining the accuracy of the test in detecting the immune response to specific viral variants. The latter notion is needed for the proper management of the COVID-19 crisis, new vaccines' manufacturing, and evaluating the vaccines' efficiencies. Finally, this approach could be requested/formulated by the regulatory agencies as part of the tests' validation and can be "in-house" obtained by health facilities before its clinical use.

Knowledge and compliance with standard precautions among registered nurses: A cross-sectional study.

BACKGROUND: Nurses and patients are often exposed to various types of infections during their clinical practice. Knowledge and compliance with standard precautions are essential to prevent hospitals associated infections and protect patients as well as medical workers from exposure to infectious agents. AIMS: This study aimed to assess the level of knowledge, level of compliance, and associated factors toward compliance with standard precautions among registered nurses in the North of Jordan. METHODS: A cross-sectional study was conducted at three hospitals in the North of Jordan. Two were public hospitals and one was a university-affiliated hospital. A questionnaire concerning the knowledge and compliance with the standard precaution guidelines was distributed among 300 registered nurses of whom 266 completed the questionnaire (response rate 88.7%). RESULTS: 53% of the participants were from governmental hospitals and 57.1% were females. The age median of them was 30 years (IQR = 28-32). The majority of the participants were medical/surgical RNs (33.1%) while only 8.3% of them were from the pediatric/gynecology departments. The overall knowledge score was 16.27 (SD = 3.15), and the total compliance score was 49.15 (SD = 12.36). Besides, the study showed a moderate positive correlation between the level of knowledge, experience in years, and the standard precautions compliance (r = 0.387, p = 0.01), (r = 0.341, p = 0.01), respectively. CONCLUSIONS: standard precautions are the basic level of the infection control process. The participants may possess satisfactory knowledge and compliance levels. However, more training programs and more focusing on the standard precautions by educational institutes are needed for nurses to improve their knowledge and compliance with infection-control standard precautions.

Missed nursing care, staffing levels, job satisfaction, and intent to leave among Jordanian nurses.

Patient safety is an important outcome for nurses who provide patient care within an environment that may increase the incidence of errors or impose them to omit care; these errors mostly happen because of staff shortage. The purpose of this study is to identify the types and reasons of "missed nursing care" among Jordanian nurses, and to examine the relationships between "missed nursing care", staffing, intent to leave, and job satisfaction. A cross-sectional descriptive design was used. A convenience sample of 300 nurses completed the Arabic version of MISSCARE which included items to measure types and reasons for "missed nursing care", staffing adequacy, job satisfaction, and intent to leave. The results of this study indicated that Labor resources were the most common cause of "missed nursing care". The results also showed that a low number of nurses per shift were associated with a high level of "missed nursing care". Nurse managers need to tackle staffing problems that may increase the rate of missed care and result in negative outcomes on the patients, nurses, as well as organizations. Nurse administrators could conduct evidence-based staffing plans to manage nurse to patient ratio to decrease missed care and enhance satisfaction.

The lockdown may contribute to the COVID-19 cases in developing countries, different perspectives on the curfew act, a report from Jordan.

COVID -19 has driven an unprecedented challenge to the economic, social, and health aspects of human life worldwide. The daily increasing numbers of human life loss encourage us, the healthcare and public health communities, to share best practices and lessons learned to mitigate the resurgence of this pandemic. On the other hand, the pandemic itself or alternatively our policies in dealing with it has led to a dramatic loss and disastrous effects on many aspects including the food and nutritional systems and the world of work. The economic and social disruption caused by the pandemic is devastating; tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year. The number of workers who are losing their jobs and the number of bankruptcies for small businesses are increasing. This report aims to bring the attention of policymakers, especially in the developing countries including Jordan, to different perspectives about crucial law acts, the lockdown and the curfew act, that have tremendous effects on the economy and may soon become a main contributor to the increased level of COVID-19 transmission and the main source of the new COVID-19 cases. We hypothesize for a mathematical model based on the comparison between the number of sporadic new cases, number of new cases/family, and the average number of family members to anticipate the value and the sufficiency of the lockdown or the curfew acts on modulating the transmission and the number of new COVID-19 cases in societies.

Nursing Empowerment: How Job Performance Is Affected by a Structurally Empowered Work Environment.

OBJECTIVE: The purpose of this study is to investigate the level of structural empowerment and explore its relationship with job performance among nurses. BACKGROUND: Empowered nurses display more authority and an awareness of the accomplishment of their contribution to organizational goals. METHODS: A cross-sectional study was conducted with a convenience sample of nurses in 4 hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS: A total of 195 nurses responded to the questionnaires, including 88 males (45.1%) and 107 females (54.9%). Overall, participants perceived their work environment to be moderately empowering. There is a significant positive correlation between structural empowerment and job performance. CONCLUSIONS: Highly empowered nurses display higher performance than less empowered nurses. Nurse managers must create an empowering work environment that supports nurses' job performance positively through structural empowerment. Applying structural empowerment in the work setting is crucial for ensuring the highest quality of patient care, improving nurses' performance, and reaching the organizational goals.

Prevalence of positive COVID-19 among asymptomatic health care workers who care patients infected with the novel coronavirus: A retrospective study.

BACKGROUND: Limited information is available about COVID-19 infections among health care workers. Sensitive detection of COVID-19 cases in health care workers is crucial for hospital infection prevention policy, particularly for those who work with vulnerable patients. The aim of this study is to describe the prevalence of positive COVID-19 among asymptomatic health care workers who took care of patients with COVID-19 during the pandemic. METHODS: This retrospective study included all health care workers at King Abdullah University Hospital who take care of patients infected with COVID-19 patients from March 18, 2020 to April 29, 2020. They were tested for COVID-19 infection by use of real-time reverse-transcriptase rRT-PCR on samples from nasopharyngeal swabs. RESULTS: A total number of 370 health care workers were screened. The majority were nurses followed by physicians and other personnel. This study showed that all asymptomatic health care workers were tested negative for COVID-19Q. CONCLUSION: Unexpectedly, the prevalence of positive COVID-19 among asymptomatic health care workers who take care of patients infected with the novel coronavirus was 0%. This result must be cautiously interpreted. Further studies are needed in order to find effective strategy of screening health care workers to insure a safe working environment.

Large Outbreak of Coronavirus Disease among Wedding Attendees, Jordan.

In March 2020, a wedding in Jordan led to a large outbreak of coronavirus disease (COVID-19). We collected data on 350 wedding attendees, 76 who of whom developed COVID-19. Our study shows high communicability of COVID-19 and the enormous risk for severe acute respiratory syndrome 2 virus transmission during mass gatherings.

Effect of Health Care Accreditation Council survey site visit on perceived stress level among Jordanian healthcare providers.

AIM: To assess perceived stress levels among healthcare providers in public and private hospitals before and after Health Care Accreditation Council (HCAC) survey site visits. METHODS: A cross-sectional, descriptive design was used in this study. A convenience sampling technique was used to recruit study participants. A self-administered questionnaire (PSS-10) was used to collect data. Descriptive statistics, dependent sample t test, independent sample t test, and multiple linear regression analysis were used to analyze data. RESULT: The results showed that stress levels were higher before a HCAC survey site visit (M = 18.39, SD = 4.3) than after ( M = 14.09, SD = 6.1) ( t(210) = 8.7, P ≤ 0.000) among healthcare providers. Between hospitals, the perceived stress level of healthcare providers was higher in the public hospital ( M = 19.03, SD = 4.3) compared with the private hospital ( M = 17.8, SD = 4.2) ( t(209) = 2.16, P = 0.031) before the HCAC survey site visit. In contrast, there were no differences in perceived stress level for the public and private hospitals ( t(209) = 0.001, P = 0.999) after the HCAC survey site visit. Finally, the type of hospital was the only sociodemographic characteristic that predicted the perceived stress level before the HCAC survey site visit ( ß = -0.157, P = 0.040). In contrast, there were no sociodemographic characteristics that predicted the perceived stress level after the HCAC survey site visit. CONCLUSIONS: The current study indicated that hospital accreditation is a process associated with significant stress (P = 0.000) among healthcare providers in both hospitals before and after an HCAC survey site visit. Moreover, there was a significant level of stress before an HCAC survey site visit in the public hospital ( M = 19.03) compared with the private hospital ( M = 17.8, P = 0.031).

Correlating Emotional Intelligence and Job Performance Among Jordanian Hospitals' Registered Nurses.

PROBLEM: Emotional intelligence (EI) is an ability to recognize our and others' emotions, and manage emotions in ourselves and in relationships with other people. A large body of research evidence outside nursing shows that measured (EI) abilities correlated with employee performance, motivation, and job satisfaction; and preliminary nursing research evidence shows the correlation between EI ability and nurses' clinical performance. There is less research on the EI ability of Jordanian nurses, and the present study was undertaken to address this gap. METHODS: A descriptive, cross-sectional, correlation comparative design (nonexperimental) was employed. Six Jordanian hospitals were included in the study. Two hundred fifty questionnaires were distributed to prospective participants. One hundred ninety-four questionnaires were returned, giving a response rate of 78%. EI was measured using the Genos Instrument. Clinical performance was measured using a self-report measure. FINDINGS: Findings demonstrated significant positive relationships between all subscales of EI and job performance, ranging from r = .250, p = .000 to r = .193, p = .007. Regression analysis indicated working in medical-surgical wards, recognizing and expressing emotions scores (ß = 0.186, p = .048), and controlling emotions (ß = 0.255, p = .027) explained 19.1% of variance in nurses' job performance. CONCLUSIONS: The study findings confirm the correlation between nurse EI ability and clinical performance.

The impact of training program on nurses' attitudes toward workplace violence in Jordan.

BACKGROUND: Nurses' attitudes toward workplace violence are still inadequately explored, and possess an impact in preventing, and managing the violent incidents and the quality of nursing care. Creating a demand for an effective intervention program to improve nurses' knowledge of and attitudes toward workplace violence. OBJECTIVE: To study the impact of the training program on nurses' attitudes toward workplace violence in a military hospital in Jordan. METHODS: One group before-after design was employed. A stratified random sample of 100 nurses working in three shifts was recruited. Data were collected earlier and after the preparation program using the Attitudes Toward Patient Physical Assault Questionnaire. "The Framework Guidelines for addressing workplace violence in the health sector", was adopted in this work. The preparation sessions were for one day each week over five weeks. The post-test assessment was over five weeks using the same questionnaire. RESULTS: A total of 97 nurses completed the survey. The outcomes demonstrated the significant impact of the training program on nurses' attitudes towards workplace violence (t=6. 62, df=96, p=0.000). The prevalence of verbal abuse by patients and visitors was 63.9% and for physical abuse, 7.2% were from patients and 3.1% of visitors. Most violent incidents occurred during day duty and during delivering nursing care (40.2% and 32%, respectively). Major source of emotional support for abused nurses was from the nursing team (88.7%), while the legal support was from nursing management (48.5%). CONCLUSION: The study highlights a general concern among nursing staff about workplace violence. Confirming that violence prevention education for staff is a necessary step forward to deescalate the problem. A significant effect of the training program was evident in this study.

The impact of educational interventions for nurses on mechanically ventilated patients' outcomes in a Jordanian university hospital (pages 2205­2214).

AIMS AND OBJECTIVES: To determine the effect of educational interventions for nurses on the success of weaning trials, ventilation period and reintubation incidence for mechanically ventilated patients in a Jordanian university hospital. BACKGROUND: Sharing decision between healthcare providers about weaning should be based on specific guidelines or protocols to avoid complications associated with wrong weaning estimation. DESIGN: A nonequivalent, pretest­post-test (quasi-experimental) study. METHODS: The study used a convenience sample consisting of 135 ventilated patients. The historical control group (n = 65) data were collected from patients' files before the implementation of the educational interventions for the experimental group (n = 70), which was recruited from intensive care units at a university hospital. The experimental group received educational interventions on Burns Weaning Assessment Protocol items over one month through in-service education, bedsides and hands-on application. Data were collected about Burns Weaning Assessment Protocol scores, failed trials, reintubation incidence and ventilation period for all participants. RESULTS: The results showed that the number of failed trials and reintubation incidence was less in the experimental group compared with the control group. On the other hand, there was not any significant difference in the score of ventilation period between the experimental and control groups. CONCLUSION: Educational interventions for nurses on Burns Weaning Assessment Protocol have a significant impact on reducing incidence of failed trials and reintubation. RELEVANCE TO CLINICAL PRACTICE: The improvement of outcomes of patients on mechanical ventilators is a result of shared decision based on effective planning and communication between nurses and physicians.

Work stress inventory for dental assistants: development and psychometric evaluation.

OBJECTIVES: The purposes of this study were to develop a work stress inventory for dental assistants (WSI-DA) in Jordan and examine its psychometric properties and to describe potentially stressful work-related conditions related to the profession of dental assistance in Jordan. METHODS: A total of 542 dental assistants working in private dental clinics in Jordan participated in this study. The stages of instrument development included selecting an initial item pool, choosing the best items, deciding on the questionnaire format, pretesting the instrument, and determining its reliability and validity. An initial set of 55 items was selected and categorized into nine hypothetical categories. Further testing and using factor analysis ended with a 35-item, nine-scale instrument. The raw score for each scale was calculated by adding the responses for individual items and then transformed to 0-100 scales. The item-level validity, item internal consistency, item discriminant validity, and Cronbach's alpha were assessed. RESULTS: Nine factors had eigenvalues greater than one. The nine factors accounted for 78.7 percent of the total variability in the 35-item questionnaire. All item-scale correlations were greater than the recommended correlation of 0.40. Except patient's suffer scale (Cronbach's alpha = 0.56), all other scales demonstrated acceptable internal consistency with Cronbach's alpha exceeding the minimum standard of 0.7 and ranging from 0.71 to 0.87. Test-retest reliability showed acceptable reliability in all nine scales and ranged from 0.61 to 0.92. CONCLUSIONS: The 35-item, nine-scale WSI-DA demonstrated acceptable validity and reliability when used among dental assistants in Jordan.

Nurses' career commitment and job performance: differences across hospitals.

The interrelatedness of nurses' career commitment and job performance is debated. In nursing, few studies have focused on the relationship between the two concepts. A convenience sample of 640 registered nurses (RNs) from 24 hospitals was recruited. A comparative design was used to assess differences among governmental, teaching and private hospitals in regard to the concepts measured. In general, nurses were found to "agree" that they had a lifelong commitment to their careers, and that they were performing "well" their jobs in accordance with standards. Hospitals in the sample differed in most demographics except in gender, areas of work and decision-making styles. Based on the total scores of nurses' career commitment, there were no significant differences across hospitals. Based on the total scores of nurses' job performance, F-tests indicated some differences; the highest mean was at private hospitals. Using dimensional means of nurses' job performance uncovered no significant differences among hospitals. Individual items of nurses' job performance subscales differed, in some cases significantly, particularly for nurses working at private hospitals: nurses' career commitment was correlated positively and significantly with their job performance. Consistent with the current researchers' hypothesis, nurses' career commitment appears to influence job performance and is influenced by the nurses' characteristics and organizational factors in the workplace. Enhancing nurses' career commitment and their job performance should produce positive outcomes for nurses, patients and organizations.

Predictors of career commitment and job performance of Jordanian nurses.

BACKGROUND AND AIMS: Few studies focused on nurses' career commitment and nurses' job performance. This research aimed at studying variables of nurses' career commitment and job performance, and assessing the relationship between the two concepts as well as their predictors. METHODS: A survey was used to collect data from a convenient sample of 640 Registered Nurses employed in 24 hospitals. RESULTS: Nurses 'agreed' to be committed to their careers and they were performing their jobs 'well'. As a part of career commitment, nurses were willing to be involved, in their own time, in projects that would benefit patient care. The highest and lowest means of nurses' job performance were reported for the following aspects: leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal relations/communications and professional development. Correlating of total scores of nurses' career commitment and job performance revealed the presence of a significant and positive relationship between the two concepts. Stepwise regression models revealed that the explained variance in nurses' career commitment was 23.9% and that in nurses' job performance was 29.9%. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should promote nursing as a career and they should develop and implement various strategies to increase nurses' career commitment and nurses' job performance. These strategies should focus on nurse retention, staff development and quality of care. CONCLUSIONS: Nurses' career commitment and job performance are inter-related complex concepts that require further studies to understand, promote and maintain these positive factors in work environments.