The Multidimensional Nursing Generations Questionnaire: development, reliability, and validity assessments.

PURPOSE: To develop and perform reliability and validity assessments of the international Multidimensional Nursing Generations Questionnaire. BACKGROUND: There are three generations of nurses in the European workforce. There is little research on the characteristics of these generations and the ways in which to manage them professionally, and no instrument has yet been developed to measure these aspects specifically. METHODS: With results from previous studies, 69 nursing generations-oriented items were created in English, translated into Italian and Finnish, and pretested to form the basis of an instrument that was tested between September and October 2014 on a sample of Finnish and Italian nurses (n = 1302) using principal component analysis and Cronbach's alpha. RESULTS: Fifty-four items and eight components (Cronbach's α range: 0.61-0.81) were identified in the instrument: (1) conflicts between generations; (2) patient safety view; (3) relationships between generations; (4) working as a multigenerational team; (5) orientation to change; (6) presenteeism and job propensity; (7) intention to leave, and (8) flexibility and availability. CONCLUSIONS: The instrument showed acceptable preliminary psychometric properties and satisfactory internal consistency. IMPLICATIONS FOR NURSING MANAGEMENT: The Multidimensional Nursing Generations Questionnaire is a useful tool to measure the characteristics of different generations of nurses and to develop management strategies tailored to those generations.

Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.

Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.

[Generations of Italian nurses compared: an exploratory study]. / Generazioni infermieristiche italiane a confronto: uno studio esplorativo.

AIM: The influence that generations have on complex nursing work environment have not been investigated yet in Italy. The majority of studies realized on this topic up to now has a small sample size and is monocentric. None Italian study has directly investigated nursing multigenerational workforce. The study aimed to investigate the existence of generational differences in Italian nurses professional within the italian context and describe their characteristics. METHODS: A 33 items questionnaire devised for the purpose was administred to a sample of 317 nurses of two major Italian North-East hospital. Five dimensions were analyzed: professional space, professional role, professional culture, orientation to care, relationships among generations. RESULTS: Data showed statistically significant differences among nurses generations in 9 items. The dimensions with the greatest number of significant items were found to be relationship among generations (6 items), followed by orientation to care, professional space and professional role (1 item each). CONCLUSIONS: Results highlighted the existence of generational differences and give some information on perceptions and relationships between italian nurses generations. Being the first exploratory study on Italian nurses, it is currently impossible to compare these results with those of previous studies. Further investigation is needed to make more comparisons with international literature.

[Safety culture of nursing staff. A descriptive study in a Piedmont Hospital]. / La cultura della sicurezza tra le figure di assistenza. Una indagine conoscitiva presso un'Azienda Ospedaliera Piemontese.

Assessing safety culture is the first step towards a responsible and wary system to the errors and to the quality of the performance. The aim of the study was to assess nurses' safety culture, in order to identify improvement's priorities. A survey of nursing staff, using a questionnaire was carried out in a Piedmont hospital. Of 1056 health care workers, 707 participated (67%). The staff's perception of patient safety was positive: the results of the domains "Information and communication", "Suggestions and development" and "Safety guarantees" tend to be fair, while "Teamwork" was sufficient. The weakest areas were related to involvement (Items: "We are consulted when choosing equipment and devices to be used", 25.9% agreement, "At the end of the year we discuss together activities carried out and results" 31,8%), and "Work organization (shifts, workload) doesn't cause overload and stress", 25.3% agreement, "When an error occurs we know how to communicate with the patient as we have a guideline to lead us" 35.8% agreement. The study shows that, even if the safety culture is overall positive, there are some critical aspects that lead to distress and uncertainty between nursing staff. Improvement strategies may include: staff training to improve teamwork skills and staff involvement, increasing opportunities for discussion, organizing systematic multi-professional audit, to reflect in a structured way on clinical practice.