The role of nurses' adherence to clinical safety guidelines in linking nurse practice environment to missed nursing care.

INTRODUCTION: While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care. METHODS: This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale. RESULTS: A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (ß = 2.492, p < 0.001) and a lower frequency of missed nursing care (ß = -0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (ß = -0.055, p < 0.001). CONCLUSION: Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care. CLINICAL RELEVANCE: Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.

Determinants of Nurse Managers' Transformational Leadership: The Role of Individual Unit and Organizational Characteristics.

OBJECTIVE: The aim of this study was to examine the relationship between various factors and self-perceived transformational leadership among a sample of Filipino nurse managers (NMs). BACKGROUND: Transformational leadership plays a crucial role in promoting positive outcomes in healthcare settings, particularly for NMs. Understanding the factors that influence NMs' self-perceived transformational leadership is essential for improving leadership practices and enhancing organizational effectiveness. METHODS: A cross-sectional research design was used to collect data from 260 NMs using standardized measures. RESULTS: Employment status, the number of units managed, the type of hospital employment, psychological distress, and job satisfaction were factors that significantly influenced their leadership perceptions. CONCLUSION: By addressing the identified factors, nursing organizations can create an environment that promotes effective leadership practices, ultimately enhancing patient outcomes, staff satisfaction, and overall organizational performance.

Stress as a mediator between abusive supervision and clinical nurses' work outcomes.

AIMS: This study aimed to test whether stress could mediate the association between abusive supervision and nurses' work engagement, absenteeism, and turnover intention. BACKGROUND: Abusive supervision has been attributed to suboptimal work performance and reduced productivity among employees in different sectors. While existing nursing literature links abusive supervision to a wide range of work-related outcomes in the nursing workforce, little is known regarding the mechanism underlying this relationship. DESIGN: Data for this descriptive study were collected from 770 direct-care nurses from seven acute care hospitals in the Philippines, utilizing five standardized scales. RESULTS: Abusive supervision had direct positive effects on absenteeism (ß = .189, p < .001) and intent to leave (ß = .138, p < .001) and a direct negative effect on job engagement (ß = -.131, p < .001). The relationships between abusive supervision and absenteeism (ß = .175, p < .001), intent to leave (ß = .131, p < .001), and work engagement (ß = -.122, p < .001) were partially mediated by stress. CONCLUSIONS: Stress mediated the relationship between abusive supervision and nurses' work outcomes, including turnover intention, absenteeism, and work disengagement. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The evident connection between abusive supervision, stress, and work-related outcomes underscores the importance of focusing on enhancing managerial supervisory styles as a potential organizational strategy to enhance staff retention and well-being.

Umbrella Review: Stress Levels, Sources of Stress, and Coping Mechanisms among Student Nurses.

Prelicensure nursing students face significant stress from their education and clinical placements, highlighting the crucial need for the development of effective coping mechanisms with which to manage both academic and clinical responsibilities, ultimately enhancing the wellbeing and academic performance of these students. This umbrella review aims to evaluate and synthesize existing review articles that examine stress levels and coping mechanisms among student nurses during their education and training. Five databases (PsycINFO, PubMed, CINAHL, Scopus and Web of Science) were searched for review articles published from 2010 onwards. This review includes twelve articles, encompassing 189 studies. The review findings demonstrate that student nurses experience moderate-to-high levels of stress during their nurse education. Major sources of stress include academic demands, patient care responsibilities, and interactions with nursing staff and faculty. Commonly utilized coping skills involve problem-solving behaviors, transference, and maintaining an optimistic outlook. Given the adverse consequences of stress, nurse educators play a critical role in the development of strategies with which to reduce stress and enhance coping skills among student nurses. This study was not registered.

Abusive Supervision and Its Relationship With Nursing Workforce and Patient Safety Outcomes: A Systematic Review.

Despite efforts to improve management and leadership behaviors among nurse managers, studies have shown the pervasive nature of abusive supervision in nursing practice, with strong evidence linking this type of behavior to reduced work productivity among nurses. This systematic review aimed to appraise and synthesize peer-reviewed studies that examine nurse-related and patient safety outcomes associated with abusive supervision. The review searched nursing literature from five databases (PubMed, CINAHL, Scopus, Web of Science, and PsycINFO) between August and November 2022. A total of 21 relevant studies were identified, with the Abusive Supervision Scale being the most frequently used measurement tool. Through content analysis, the review identified 29 outcomes which were categorized into six groups: (a) affective-based, (b) behavior/performance-based, (c) relationship-based, (d) cognitive-based, (e) health and well-being, and (f) nursing care. In addition, 10 mediators were identified and grouped into three categories: (a) affective-based, (b) motivation-based, and (c) health and well-being. The review findings provide compelling evidence regarding the detrimental effects of abusive supervision in the nursing workforce. Moreover, the review emphasizes the need for further research to explore how such behavior can impact patient safety outcomes. To address abusive supervision, it is crucial to promote positive behaviors among nurse managers through human resource mechanisms, relevant rules and policies, and theory-driven leadership development programs.

Utilizing Artificial Intelligence-Based Tools for Addressing Clinical Queries: ChatGPT Versus Google Gemini.

BACKGROUND: Artificial intelligence (AI)-based text generators, such as ChatGPT (OpenAI) and Google Bard (now Google Gemini), have demonstrated proficiency in predicting words and providing responses to various questions. However, their performance in answering clinical queries has not been well assessed. This comparative analysis aimed to assess the capabilities of ChatGPT and Google Gemini in addressing clinical questions. METHOD: Separate interactions with ChatGPT and Google Gemini were conducted to obtain responses to the clinical question, posed in a PICOT (patient, intervention, comparison, outcome, time) format. To ascertain the accuracy of the information provided by the AI chat bots, a thorough examination of full-text articles was conducted. RESULTS: Although ChatGPT exhibited relative accuracy in generating bibliographic information, it displayed some inconsistencies in clinical content. Conversely, Google Gemini generated citations and summaries that were entirely fabricated. CONCLUSION: Despite generating responses that may appear credible, both AI-based tools exhibited factual inaccuracies, raising substantial concerns about their reliability as potential sources of clinical information. [J Nurs Educ. 2024;63(8):556-559.].

Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study.

INTRODUCTION: Nurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department. AIM: This study has two-fold purposes: (a) to examine the association between nurses' demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses' caring ability and nursing care quality, as well as its impact on adverse patient events and missed care. METHODS: This cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data. RESULTS: A total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (ß = 0.259, p <.001), a reduction in adverse events (ß = -0.169, p <.05), and a decrease in instances of missed care (ß = -0.158, p <.01). CONCLUSION: This study emphasizes the significance of nurses' characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.

Development and psychometric testing of the clinical adjustment scale for student nurses (CAS-SN): A scale for assessing student nurses' adaptation in clinical settings.

BACKGROUND: Nurse education is critical for preparing student nurses for clinical practice, but the transition to clinical settings poses numerous challenges. A standardized scale to assess student nurses' adjustment in the clinical area is lacking in the Philippines. OBJECTIVE: This paper described the development and evaluation of the Clinical Adjustment Scale for Student Nurses (CAS-SN). DESIGN: An exploratory sequential research design. SETTINGS: Nursing schools in three government owned universities in the Philippines. METHODS: Expert panels and field pretesting established content and face validity. Inter-item and inter-total correlations and Cronbach's α were used to assess the reliability of the scale. Construct validity was evaluated using exploratory factor analysis (EFA). Criterion validity was evaluated with established measures. RESULTS: The CAS-SN comprises 15 items across three subscales: (1) Professional Growth and Interpersonal Engagement, (2) Clinical Competence and Confidence, and (3) Coping and Support Strategies Reliability was excellent and the validity was satisfactory, with significant correlations with academic adjustment, psychological distress, and dropout intention. CONCLUSION: The CAS-SN was found to be a valid and a reliable for assessing student nurses' clinical adjustment. IMPLICATIONS FOR NURSE EDUCATION: The CAS-SN provides a structured framework to assess and monitor student nurses' clinical adaptation, enhancing our understanding of their competence, resilience, and professional identity development. Its integration into nurse education programs can significantly improve the assessment of clinical learning experiences and contribute to better student learning outcomes.