Accountability focus and nurses' performance: A moderated-mediation model by using experiment design simulations.

AIM: The aim of this study was to test a moderated-mediation model, explaining how and under which circumstances a process- or an outcome-accountability focus affects performance. DESIGN: Randomized controlled design, using screen-based simulations. METHODS: Data were collected during 2021. Two screen-based simulations of medication administration (for low- and high-complexity tasks) were used. Each participant was randomly assigned to one of the six experimental conditions. Nurses completed validated questionnaires on strain levels and their perceptions of the simulated task complexity and accountability focus. Performance was assessed via validated checklists assessing nurses' performance of the simulation. RESULTS: Task complexity significantly moderated the relationship between accountability-focus conditions and strain. For the process-accountability-focus condition, strain levels were lower during high-complexity tasks compared with low-complexity tasks, while for the outcome-accountability-focus condition, strain levels were lower during low-complexity tasks compared with high-complexity tasks. The highest strain levels were observed under the no accountability-focus condition. Additionally, this interaction had an impact on performance, with nurses' strain playing a mediating role. CONCLUSIONS: Any accountability focus reduces strain levels and enhances performance compared with having no accountability focus. The choice of accountability focus should be based on task-complexity considerations. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Managers can effectively reduce nurses' strain and improve performance by prioritizing outcome accountability focus for simpler tasks and process accountability focus for complex tasks. IMPACT: The study addressed previous ambiguous findings regarding the type of accountability focus that better motivates nurses' performance. By considering accountability focus, nurse managers can balance nurses' strain levels with improved performance. REPORTING METHOD: We have adhered to the relevant EQUATOR guidelines: CONSORT. PATIENT OR PUBLIC CONTRIBUTION: There is no patient or public contribution, as the study only concerns the providers of the service, that is the nurses themselves.

Risk factors for child abuse: quantitative correlational design.

The aim of this research study is to identify risk factors typical of different types of suspected child abuse reported at a hospital. The study was based on 114 cases of children for whom some type of abuse was reported. Physical abuse was the most frequently reported of all types of suspected child abuse. Most victims of sexual abuse were female and at least half the cases of neglect and physical abuse were attributed to parents. Most cases were identified in the emergency room by nurses. Children older than 10 were more susceptible to physical abuse and neglect.

Views of the Israeli public on expanding the authority of nurses.

AIM: To explore the views of the Israeli public on expanding the authority of nurses and identify factors affecting these views. BACKGROUND: New advanced nursing roles are currently being introduced and nursing is undergoing dynamic change. Public views on expanding the authority of nurses and factors affecting public views await investigation. METHOD: In a correlational study, a questionnaire was administered to 200 male and female Israelis aged 18 and older treated at a hospital or healthcare clinic at least once over the past year. RESULTS: Most respondents are in favour of expanding the authority of nurses, considered vital for patients. In addition, the public is in favour of certifying clinical nursing specialists in all fields. Influential factors were ethnicity, personal acquaintance with nurses, income and religiosity. CONCLUSIONS: The public has a positive perception of expanding the authority of nurses, and major determinants are familiarity with nursing, ethnicity, income and religiosity. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding public views on expanding the authority of nurses in Israel will help policymakers adjust their actions according to social perceptions and needs. This will help nursing managers further the process of expanding nurse authority, to the satisfaction of both nurses and the public they serve.

The Effect of Outcome vs. Process Accountability-Focus on Performance: A Meta-Analysis.

Background: The foundation of a safe practice is accountability, especially outcome- rather than process-focused accountability, particularly during pandemics such as COVID-19. Accountability is an essential behavior that promotes congruence between nursing actions and standards associated with quality of care. Moreover, the scant research examining whether one accountability focus is superior in motivating humans to better task performance yields inconclusive results. Aims: Systematically examine the effect of an outcome- vs. process-accountability focus on performance and identify any moderating variables. Design: Systematic review and meta-analysis. Data sources: PsycINFO, Medline, PubMed, Scopus, and CINAHL databases, with all publications to November 2020. Review methods: A systematic search using Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Statistical analysis and forest plots were performed using MetaXL 5.3. Heterogeneity was presented using I2 statistics and Q tests, and possible publication bias was assessed with a Doi plot and the LFK index. Results: Seven studies representing nine experiments involving 1,080 participants were included. The pooled effect of the nine experiments on task performance failed to show significant differences (mean = -0.09; 95% Confidence Interval [95%CI]: -0.21, 0.03), but a significant moderating effect of task complexity was demonstrated. Specifically, outcome accountability exerts a beneficial effect in complex tasks (mean = -0.48 [95%CI: -0.62, -0.33]) whereas process accountability improves the performance in simpler tasks (mean = 0.96 [95%CI: 0.72, 1.20]). Conclusion: These findings demonstrated that accountability focus by itself cannot serve as a sole motivator of better performance, because task complexity moderates the link between accountability focus and task performance. Outcome accountability exerts a beneficial effect for more-complex tasks, whereas process accountability improves the performance of simpler tasks. These findings are crucial in nursing, where it is typically assumed that a focus on outcomes is more important than a focus on processes.

Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior.

BACKGROUND: Medication errors are common among nursing students. Nonetheless, these errors are often underreported. OBJECTIVES: To examine factors related to nursing students' intention to report medication errors, using the Theory of Planned Behavior, and to examine whether the theory is useful in predicting students' intention to report errors. DESIGN: This study has a descriptive cross-sectional design. SETTINGS: Study population was recruited in a university and a large nursing school in central and northern Israel. PARTICIPANTS: A convenience sample of 250 nursing students took part in the study. METHODS: The students completed a self-report questionnaire, based on the Theory of Planned Behavior. RESULTS: The findings indicate that students' intention to report medication errors was high. The Theory of Planned Behavior constructs explained 38% of variance in students' intention to report medication errors. The constructs of behavioral beliefs, subjective norms, and perceived behavioral control were found as affecting this intention, while the most significant factor was behavioral beliefs. The findings also reveal that students' fear of the reaction to disclosure of the error from superiors and colleagues may impede them from reporting the error. CONCLUSIONS: Understanding factors related to reporting medication errors is crucial to designing interventions that foster error reporting.