Structural empowerment, workplace incivility, nurses' intentions to leave their organisation and profession: A path analysis.

AIM: The aim of this study is to test the theoretical model involving the relationships between nurses' perceptions of structural empowerment, supervisor and coworker incivility, and their intention to leave both the organisations and the nursing profession. BACKGROUND: Studies investigating the relationships between structural empowerment, workplace incivility and nurses' intentions to leave their organisation are increasing. However, the results of studies indicating the effects of structural empowerment on these variables are inadequate. METHODS: We used a cross-sectional, correlational study to investigate relations among the variables with a sample of 574 nurses. RESULTS: Structural empowerment had significantly direct negative effects on supervisor incivility, coworker incivility and nurses' intentions to leave their organisation, as well as indirect negative effects on intention to leave the profession through its negative influence on intention to leave the organisation. CONCLUSIONS: Strong evidence points out the importance of making plans to reduce nurses' intentions to leave their organisation and profession, to increase the structural empowerment in organisations and to reduce workplace incivility is presented. IMPLICATIONS FOR NURSING MANAGEMENT: The results of this study can provide guidance for managers attempting to improve working conditions for nurses by drawing attention to the various factors affecting nurses' intentions to leave.

Predictors of nurses' intentions to leave the organisation and the profession in Turkey.

AIM: To examine the predictors of nurses' intention to leave the organisation and intention to leave the profession in Turkey. BACKGROUND: Although numerous studies have investigated nurses' intention to leave the organisation and intention to leave the profession, knowledge about the predictors of nurses' intention to leave remains insufficient. METHODS: A descriptive cross-sectional research design was conducted based on a sample of 799 nurses at 16 hospitals. Data were collected through a questionnaire including questions about nurse characteristics, the intention to leave the organisation and the intention to leave the profession, job satisfaction and the Maslach burnout index and the practice environment scale of the nursing work index. Data were evaluated using a stepwise logistic regression analysis. RESULTS: Dissatisfaction, the number of years worked at the organisation, emotional exhaustion, depersonalisation, collegial nurse-physician relationships and the adequacy of staffing and resources were predictors of nurses' intention to leave the organisation (R(2)  = 44%), whereas dissatisfaction and emotional exhaustion were predictors of nurses' intention to leave the profession (R(2)  = 27%). CONCLUSIONS: Although there were differences between the patterns of nurses' intention to leave the organisation and intention to leave the profession, dissatisfaction and emotional exhaustion were common across both groups and were the most important predictors of nurses' intention to leave. IMPLICATIONS FOR NURSING MANAGEMENT: Managers should focus on approaches that will increase satisfaction and prevent burnout in nurses. Nurse managers should consider nurses' suggestions when developing plans related to staffing and resources and should encourage interdisciplinary cooperation.

Cultural adaptation of the revised Basel Instrument for Rationing of Care to the Turkish context: a study of validity and reliability.

Background: Studies have shown that nurses do not complete one or more necessary nursing care elements in their last shift due to lack of time. The Basel Extent of Rationing Nursing Care (BERNCA) instrument is one of the most used scales to measure the rationing of nursing care. Aim: This study is aimed to culturally adapt the revised BERNCA (BERNCA-R) instrument to the Turkish language and to test its validity and reliability. Methods: A cross-sectional and methodological study was used. The instrument was adapted in three stages: translation and adaptation, content validity testing and validity and reliability. Data were obtained from 350 nurses working in two public acute care hospitals in Turkey, between September 2019 and January 2020. The descriptive statistics, content validity index, exploratory and confirmatory factor analyses, Cronbach's α, Guttman split-half and inter-item reliability analyses were performed for the analysis of the data. Results: The Turkish version of the BERNCA-R instrument with a 27-item and three-subscales (monitoring, daily care and needs and psychosocial care) structure was found to have acceptable and good fit indices. Conclusion: The Turkish version of the BERNCA-R instrument is valid and reliable tool to measure rationing of nursing care.

Pilot study for evidence-based nursing management: improving the levels of job satisfaction, organizational commitment, and intent to leave among nurses in Turkey.

Because of the nursing shortage problem, an important goal for nurse managers is preventing nurses from leaving the organization. This study analyzed the effect of evidence-based nursing management practices on nurses' levels of job satisfaction, organizational commitment, and intent to leave using the Promoting Action Research Implementation in Health Service framework as a guide. This study employed a single-group, quasi-experimental, pretest-post-test design with repeated measures. Data were collected using the Minnesota Job Satisfaction Questionnaire and the Organizational Commitment Scale. The study was conducted at a 127-bed private, accredited hospital. The sample was composed of 58 nurses who participated in all three measurements. Data analysis was conducted using repeated-measures anova and the Cochrane Q-test. An improvement was observed in the nurses' intrinsic, extrinsic, and total satisfaction levels, and in the degree of normative commitment. Nurse managers stated that they benefited from this study. In order to find effective and long-lasting solutions to the nursing shortage problem, evidence-based recommendations should be used in nursing management.

The effects of a preceptorship program on newcomer nurses' turnover intention, commitment and job satisfaction: Quasi-experimental study.

AIM: The aim of the present study was to examine the effect of an organizational socialization model-based preceptorship program on the organizational outcomes of newcomer nurses. BACKGROUND: Preceptorship programs need to be strengthened to ensure the organizational socialization of newcomer nurses. DESIGN: This study was conducted with a one group pretest-posttest design. METHODS: The sample consist of newcomer nurses from the university hospital of Izmir (N = 56) in Turkey. Data were collected using scales on turnover intention, professional and organizational commitment and job satisfaction. The dependent t-test was used for data analyses. RESULTS: The newcomer nurses' intention to leave their unit and profession, organizational and professional continuance commitment, professional normative commitment and job satisfaction levels were similar at the end of the one-year preceptorship program compared with the baseline (p > .05). It was also determined that the participants' intention to leave the organization increased (t = -4.153, p < .001), while their affective (t = 4.443, p < .001) and normative commitment to the organization (t = 3.443, p < .001) and their professional affective commitment decreased (t = 7.390, p < .001) by the end of the program. CONCLUSIONS: The organizational socialization model has the potential to be used as an effective framework to improve the organizational outcomes of new graduate nurses. Although organizational socialization meets some dimensions of institutional and professional needs of newcomer nurses in the first year, there is still a need to use different strategies and enrich organizational socialization to support their adaptation process.

Turkish adaptation and psychometric testing of the caring assessment tool-administration.

PURPOSE: The purpose of this study was to adapt the Caring Assessment Tool-Administration (CAT-Adm) to Turkish and to test the psychometric properties. DESIGN AND METHODS: The study was carried out in a cross-sectional and methodological design. The sample consisted of 578 nurses. FINDINGS: The total score correlation coefficients of the items in the scale ranged from 0.69 to 0.90, and the Cronbach alpha reliability coefficient was 0.98, indicating excellent reliability. The results of the factor analysis confirmed the single-factor structure of CAT-Adm and the scale fit was good. CONCULATION: In this study, CAT-Adm was determined to be a reliable and valid tool. PRACTICE IMPLICATIONS: With the use of CAT-Adm, nurses' perceptions of nurse managers' approach can be evaluated.

Frequency of pediatric medication administration errors and contributing factors.

This study examined the frequency of pediatric medication administration errors and contributing factors. This research used the undisguised observation method and Critical Incident Technique. Errors and contributing factors were classified through the Organizational Accident Model. Errors were made in 36.5% of the 2344 doses that were observed. The most frequent errors were those associated with administration at the wrong time. According to the results of this study, errors arise from problems within the system.

Reasons for leaving nursing: a study among Turkish nurses.

BACKGROUND: Reasons for the growing nursing shortage are often complex and multidimensional. AIM: To explore the phenomenon of why Turkish nurses leave nursing. METHODS: The sample in this descriptive study was 134 nurses who had left the profession. A snowball sampling method was used to identify subjects and multiple methods were used to elicit reasons for leaving. Data analysis included descriptive statistics. RESULTS: The main reasons for leaving nursing were related to unsatisfactory working conditions and a negative perception of nursing. Of the respondents, 69.4% received education in a non-nursing field. The most popular career choice was teaching (27.6%). The results of this study indicate that working conditions and public opinion adversely affect a nurse's interest in the profession. CONCLUSIONS: The results of the study indicate a need to improve working conditions and to approach this subject from a multidimensional perspective.

Barriers to research utilisation by staff nurses in a university hospital.

AIM: To identify self-reported perceptions of the barriers to research utilisation by Turkish staff nurses working in a university hospital and to ascertain whether involvement in research-related activities influenced their perception of the barriers. BACKGROUND: Research utilisation in nursing has been a prominent concern for the last 30 years. While investigators in several countries have identified nurses' perception of barriers to research utilisation, this is the first study to investigate such barriers in Turkey. DESIGN: This is a descriptive, cross sectional study with a sample of 329 staff nurses working in a university hospital. Two instruments were used; a demographics questionnaire that investigated research activities and the Barriers Scale to measure perceptions. An additional item, 'studies are published in English' was added to the scale. RESULTS: The lack of time to implement new ideas was the most frequently, 84·5%, perceived barrier. The second most frequently perceived barrier was difficulty in reading English. The top six barriers were all related to the setting. Additionally, research-active nurses found insufficient time less of a barrier but unawareness of research findings and being isolated from knowledgeable colleagues as greater barriers to research utilisation. CONCLUSIONS: Turkish nurses' perception of barriers is similar to the findings in other countries, i.e., that the top six barriers were related to setting. Language barrier compares similarly with studies in other countries that investigated this variable. RELEVANCE TO CLINICAL PRACTICE: The gap between theory and practice in nursing can be minimised by identifying strategies to increase research utilisation in clinical settings. Such strategies can also improve patient care outcomes.

A longitudinal analysis of the self-directed learning readiness level of nursing students enrolled in a problem-based curriculum.

Self-directed learning is an important outcome of nursing education. Although problem-based learning is believed to facilitate self-directed learning, previous studies have reported conflicting results. This longitudinal survey explored the perceived changes in self-directed learning for 4 years in a baccalaureate nursing education program with an integrated problem-based learning curriculum. Fifty of 59 students (response rate, 85%) completed the Self-Directed Learning Readiness Scale at five different time points: at the beginning of each academic year and at program completion. Scores were significantly lower during the first academic year compared with other years, and fourth-year scores were significantly higher than in previous years. Scores on the three subscales (i.e., self-management, desire for learning, and self-control) increased significantly during the 4 years of the program. These findings support self-directed learning as a maturational process. Implications for nursing faculty and curriculum development are discussed.

Predicting nurses' organizational and professional turnover intentions.

AIM: Nursing shortages remain one of the most important problems in health care around the world. Existing nurses' turnover intention further exacerbates this problem. The aim of this study was to investigate the predictors of nurses' organizational and professional turnover intentions. METHODS: This study was conducted as a secondary analysis of existing data from the original cross-sectional study, which was conducted in three public hospitals between February, 2013 and May, 2013. Of the 1389 nurses who were working in these hospitals, 791 returned usable surveys. The data were collected by using a demographic and organizational characteristics form, an organizational and professional turnover intentions questionnaire, Organizational Commitment Scale, and Professional Commitment Scale. The data were analyzed with a stepwise logistic regression analysis. RESULTS: The common variables that predicted the organizational and professional turnover intentions were marital status, work shift, organizational affective and normative commitment, and professional affective commitment. CONCLUSION: The relationship between the commitment and the turnover intention of the nurses was not completely consistent with the collectivist characteristics of Turkish society. The findings showed that the organizational affective and normative commitment and professional affective commitment play a significant role in influencing nurses' organizational and professional turnover intentions. It is important for organizations to recognize the significance of these variables, not only to retain their nursing workforce but also to attract new nurses.