Assuntos
Sucesso Acadêmico , Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , EstudantesRESUMO
BACKGROUND: The number of PhD nursing programs in the U.S. has increased, but the number of nursing students entering and completing these programs remains stagnant. It is crucial to consider innovative approaches to recruit, nurture, and graduate more diverse nursing students. PURPOSE: This article presents the perceptions of PhD nursing students regarding their programs, experiences, and strategies to support their academic success. METHODS: This study used a cross-sectional, descriptive design. Data were obtained from an online 65-question student survey completed between December 2020 and April 2021. RESULTS: A total of 568 students from 53 nursing schools completed the survey. Five themes emerged regarding the barriers students experienced during their programs: Faculty issues, time management and balance, insufficient preparation for dissertation research, financial barriers, and COVID-19 impact. Student recommendations for improving PhD nursing programs were also captured in five themes: Program improvement, coursework improvement, research opportunities, faculty, and dissertation. The low numbers of male, non-binary, Hispanic/Latino, minority, and international survey respondents indicate a need for innovative recruitment and retention strategies to increase diversity of PhD students. CONCLUSION: PhD program leaders should complete a gap analysis based on the recommendations in the new AACN position statement and perceptions of PhD students reported from this survey. By doing so, PhD programs will be better positioned to implement a roadmap for improvement to better prepare the next generation of nurse scientists, leaders, and scholars.
Assuntos
COVID-19 , Educação de Pós-Graduação em Enfermagem , Estudantes de Enfermagem , Humanos , Masculino , Estados Unidos , Estudos Transversais , Docentes de EnfermagemRESUMO
AIMS AND OBJECTIVES: This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. BACKGROUND: Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. DESIGN: A prospective observational study was employed. The study followed STROBE checklist for observational studies. METHODS: Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness. RESULTS: A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts. CONCLUSIONS: The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. RELEVANCE TO CLINICAL PRACTICE: Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.
Assuntos
Enfermeiras e Enfermeiros , Tolerância ao Trabalho Programado , Humanos , Avaliação Momentânea Ecológica , Admissão e Escalonamento de Pessoal , Sono , República da CoreiaRESUMO
ABSTRACT: Empathy has been associated with improved patient outcomes in practicing nurses, but empathy levels have been shown to decline in nursing students with increased clinical exposure. Integrating content from the humanities in the nursing classroom, not common in nursing education, supports professional empathy development and maintenance. Whether competencies gained from humanities-based liberal education courses support empathy in nursing students as they emerge into practice is not known. The purpose of this quantitative, nonexperimental, descriptive, pilot research was to explore the relationship between humanities-based liberal education and empathy in recently graduated, baccalaureate-prepared practicing nurses ( n = 40).
Assuntos
Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Empatia , Ciências Humanas/educação , PensamentoRESUMO
AIMS: The aim of this study is to describe primary care nurses' perceptions of their formal leaders' leadership behaviours and outcomes and explore differences based upon nurses' individual and work setting characteristics. BACKGROUND: Formal nursing leadership is positively associated with patient, nurse workforce and organizational outcomes, yet no studies have examined primary care nurses' perception of formal leadership behaviours and outcomes in the United States. METHODS: Cross-sectional survey data from 335 primary care nurses were analysed to assess perceived leadership behaviours associated with transformational, transactional and passive-avoidant leadership styles, perceived leadership outcomes and individual and work setting characteristics. RESULTS: Positive leadership behaviours (transformational) were lower than those reported for other settings. There were significant differences in nurses' perceptions of their leaders' leadership behaviours and outcomes based upon individual and work setting characteristics. CONCLUSION: This study confirmed differences in perception of leadership and that individual and work setting characteristics influence nurses' perception of their leaders in primary care. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders must be versatile and consider the unique needs of each staff member and the influence of clinic characteristics.
Assuntos
Enfermeiros Administradores , Enfermagem de Atenção Primária , Humanos , Liderança , Satisfação no Emprego , Estudos Transversais , Percepção , Inquéritos e QuestionáriosRESUMO
AIMS: To evaluate the relationships between workload, nursing teamwork and nurse fatigue and the moderating effect of nursing teamwork on the relationship between workload and fatigue. DESIGN: This cross-sectional online survey study used data from 810 United States hospital nurses collected between March and April 2021. METHODS: Workload, nursing teamwork and fatigue were measured using the Quantitative Workload Inventory, the Nursing Teamwork Survey, and the Occupational Fatigue Exhaustion Recovery scale. Hierarchical multiple linear regression models were used. RESULTS: All the nursing teamwork subscales (i.e. trust, team orientation, backup, shared mental model, team leadership) were significantly negatively related to acute and chronic fatigue. Nursing teamwork components of team orientation, shared mental model and team leadership moderated the relationship between workload and chronic fatigue. The relationships between workload and chronic fatigue were stronger when these components of nursing teamwork were high. No moderating effects were found with acute fatigue. CONCLUSION: Efforts to increase nursing teamwork may be a promising strategy in managing nurse fatigue. It is equally important to monitor and modify high workload to protect nurses from elevated fatigue. IMPACT: WHAT PROBLEM DID THE STUDY ADDRESS?: Fatigue is negatively associated with the health and safety of hospital nurses and patients. Nursing teamwork has been shown to improve the nursing care of hospitalized patients; yet, it is rarely explored in relation to nurse fatigue. WHAT WERE THE MAIN FINDINGS?: Greater nursing teamwork is significantly associated with lower acute and chronic fatigue. The relationships between workload and chronic fatigue were stronger when nursing teamwork (i.e. team orientation, shared mental model and team leadership) was high than when nursing teamwork was low. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Improving nursing teamwork, in addition to monitoring and modifying workloads, can be a promising approach for managing fatigue in healthcare organizations.
Assuntos
Síndrome de Fadiga Crônica , Recursos Humanos de Enfermagem Hospitalar , Estudos Transversais , Hospitais , Humanos , Carga de TrabalhoRESUMO
PURPOSE: This study aimed to evaluate the relationships among nurse fatigue, individualized nursing care, and nurse-reported quality of care. DESIGN: The study used a cross-sectional design. Data from 858 registered nurses providing bedside care in hospitals were collected between March and April 2021 in the United States. METHODS: Participants completed a self-administered online survey, including the Occupational Fatigue Exhaustion Recovery scale, the Individualized Care Scale-Nurse version, and a single item assessing nursing care quality. Relationships among the study variables were examined using multiple linear and logistic regression models. FINDINGS: Nurses' higher levels of acute fatigue were significantly associated with decreased perceptions of individualized nursing activities provided to patients on their last shifts, specifically related to personal life condition and decision-making control. Nurses' higher levels of chronic fatigue were significantly associated with decreased perception of individualized nursing activities provided to patients on their last shifts related to clinical condition, personal life condition, and decision-making control. Nurses with higher levels of acute or chronic fatigue, and who perceived their nursing care activities as less individualized were less likely to assess their quality of care as excellent. CONCLUSION: These findings suggest that addressing hospital nurses' acute and chronic fatigue may contribute to promoting the delivery of individualized nursing care and in improving patients' quality of care. CLINICAL RELEVANCE: Healthcare institutions are encouraged to regularly monitor and manage nurse fatigue to improve the delivery of individualized and quality nursing care to their patients.
Assuntos
Síndrome de Fadiga Crônica , Cuidados de Enfermagem , Recursos Humanos de Enfermagem Hospitalar , Estudos Transversais , Hospitais , Humanos , Inquéritos e Questionários , Estados UnidosRESUMO
BACKGROUND: High rates of mental health conditions and poor healthy lifestyle behaviors are reported in nurses, other clinicians, and health science students but have not been compared across different professions. PURPOSE: The purpose of this study was threefold: (1) describe rates of mental health problems and healthy lifestyle behaviors across the Big 10 health professional faculty and students, (2) compare the health and healthy lifestyle behaviors of the Big 10 health sciences faculty and students across health sciences' professions, and (3) identify factors predictive of depression, stress, and anxiety. METHODS: Faculty and students from eight health science colleges at the Big 10 Universities responded to the study survey, which included: demographics, healthy lifestyle behavior questions, and three valid/reliable mental health scales. Descriptive statistics described the findings and multiple linear regression identified factors associated with mental health conditions. RESULTS: Eight-hundred and sixty-nine faculty and 1087 students responded. Approximately 50% of faculty and students reported 7 h of sleep/night, a third achieved 150 min of physical activity/week; 5.5%-9.9% screened positive for depression; and 11.5%-25.5% had anxiety. Age, sleep, and physical activity were associated with lower depression and anxiety. CONCLUSIONS: University leadership must build wellness cultures that make healthy lifestyle behaviors easy to engage in and enhance mental well-being.
Assuntos
Saúde Mental , Universidades , Docentes , Estilo de Vida Saudável , Humanos , Estudantes , Inquéritos e QuestionáriosRESUMO
ABSTRACT: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
Assuntos
Fadiga/epidemiologia , Fadiga/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , COVID-19/enfermagem , Humanos , Recursos Humanos/estatística & dados numéricos , Local de Trabalho/organização & administração , Local de Trabalho/psicologiaRESUMO
PURPOSE: This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals. DESIGN: This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018. METHODS: A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone. FINDINGS: The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue. CONCLUSIONS: High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone. CLINICAL RELEVANCE: It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.
Assuntos
Fadiga/epidemiologia , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem Hospitalar/psicologia , Doenças Profissionais/epidemiologia , Jornada de Trabalho em Turnos/psicologia , Local de Trabalho , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , República da Coreia/epidemiologia , Inquéritos e QuestionáriosAssuntos
Fadiga/psicologia , Política de Saúde , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem Hospitalar/psicologia , Segurança do Paciente/normas , Guias de Prática Clínica como Assunto , Transtornos do Sono-Vigília/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gestão da Segurança/métodos , Sociedades de Enfermagem/normas , Estados UnidosRESUMO
This integrative literature review was conducted to examine the relationships between safety culture and patient safety and quality of care outcomes in hospital settings and to identify directions for future research. Using a search of six electronic databases, 17 studies that met the study criteria were selected for review. This review revealed semantic inconsistencies, infrequent use of a theory or theoretical framework, limited discussions of validity of instruments used, and significant methodological variations. Most notably, this review identified a large array of nonsignificant and inconsistent relationships between safety culture and patient safety and quality of care outcomes. To improve understanding of the relationships, investigators should consider using a theoretical framework and valid measures of the key concepts. Researchers should also give more attention to selecting appropriate sampling and data collection methods, units of analysis, levels of data measurement and aggregation, and statistical analyses.
Assuntos
Segurança do Paciente/normas , Qualidade da Assistência à Saúde/normas , Gestão da Segurança/normas , Humanos , Avaliação de Resultados em Cuidados de Saúde/métodos , Psicometria/instrumentação , Psicometria/métodosRESUMO
BACKGROUND: Few studies have evaluated technical efficiency of nursing care, and no such studies have been conducted in intensive care units (ICUs). PURPOSE: To explore relative technical efficiency of US ICUs and identify organizational factors associated with efficiency in providing quality of nursing care. METHODS: A total of 404 adult ICUs from the 2014 National Database of Nursing Quality Indicators were included. Data envelopment analysis was used to estimate technical efficiency, and multilevel modeling was employed to determine effects of organizational factors on efficiency. RESULTS: Nurse-to-patient ratio showed the strongest positive correlation with technical efficiency. Units in non-Magnet and small-size hospitals had higher technical efficiency than those in Magnet and medium- or large-size hospitals. CONCLUSIONS: A higher nurse-to-patient ratio greatly improved technical efficiency of nursing care in ICUs and the effect differed between hospitals. Administrators and policy makers can translate the study findings into management strategies to provide efficient nursing care in ICUs.
Assuntos
Eficiência Organizacional/normas , Unidades de Terapia Intensiva/estatística & dados numéricos , Estudos Transversais , Humanos , Unidades de Terapia Intensiva/organização & administração , Admissão e Escalonamento de Pessoal/normas , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Fatores de TempoRESUMO
Lesbian, gay, bisexual, and transgender (LGBT) people make up 4% of the adult population in the United States; however, it is unclear if there is sufficient material in nursing textbooks for students to learn how to provide care for sexual minority populations. A content analysis of two commonly used health assessment textbooks was completed to identify material that prepared nurses for LGBT patient interactions. Topics such as gender neutrality, same-sex partners, and other terms referring to LGBT persons were considered LGBT content. Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare was used as the theoretical framework to assess the textbooks' content on five constructs: awareness, knowledge, skill, encounters, and desire to learn. Eleven pages in one text and 14 in the other had at least one line that addressed LGBT health assessment. Investigators found content related to the constructs of awareness, knowledge, and skill in both textbooks. In all cases, the content was limited in depth; both textbooks lacked exemplars and application of LGBT-specific health content. Inclusion of this information in textbooks or other learning resources is needed to enhance nurses' cultural knowledge and skill to improve health care outcomes within this vulnerable population.