Research on the relationship between nurses' compliance with standard precautions, servant leadership and emotional exhaustion: A cross-sectional survey.

AIM: This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. DESIGN: A cross-sectional survey. METHODS: This descriptive cross-sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China. RESULTS: The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. CONCLUSION: The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. IMPACT: We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement. IMPACT STATEMENT: Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance.

Facilitators and Barriers Affecting Implementation of Neonatal Palliative Care by Nurses in Mainland China.

Neonatal nurses in mainland China encounter various challenges when it comes to delivering palliative care to neonates. The aim of this study was to determine the barriers and facilitators of neonatal nurses' attitudes to palliative care for neonates in mainland China. A simplified Chinese version of the Neonatal Palliative Care Attitude Scale was piloted, administered, and analyzed using survey methods. Nurses in neonatal intensive care units in mainland China regardless of experience in the field were invited to take part in. Over a five-month period in 2019, we surveyed neonatal nurses from 40 hospitals in five provinces of China. The response rate was 92.5% (N = 550). This study identified eight facilitators and four barriers to neonatal palliative care implementation. In terms of nurses' attitudes on providing palliative care, younger and older nurses were more positive, whereas middle-aged nurses were less so. Nurses' emotional wellbeing was rarely impacted by neonatal death. They considered neonatal palliative care, particularly pain management, to be just as important as curative treatment. Parents were invited to participate in decision-making by nurses. Nurses reported having access to professional counseling and talking about their concerns with other healthcare professionals. The following barriers to neonatal palliative care were identified in this study that were not observed in the original English version scale research in 2009: a lack of clinicians, time, clinical skills, systematic education, neonatal palliative care experience, and social acceptance. Future research is required to investigate each barrier in order to improve the implementation of neonatal palliative care in mainland China.

Sleep Quality as a Mediator in the Relationship Between Perceived Stress and Job Burnout Among Chinese Nurses: A Structural Equation Modeling Analysis.

Background: Job burnout has become an increasing prevailing phenomenon among nurses in both developed and developing countries. There is a paucity of research exploring the relationship between perceived stress (i.e., the level of one's perception or appraisal of stress rather than objective stressful events) and job burnout and no existing literature examining the mediating role of sleep quality in the relationship between these two constructs. The objective of the study was to examine if sleep quality mediates the relationship between perceived stress and job burnout. Methods: Cross-sectional data were collected from a total of 1,013 nurses working in six public tertiary hospitals in China. The self-administered questionnaire included demographic information, the Maslach Burnout Inventory-General Scale, the Pittsburgh Sleep Quality Index and the Perceived Stress Scale. Hierarchical multiple regression (HMR) analyses were performed to examine the contribution of each covariate to the prediction of job burnout. Structural equation modeling (SEM) was employed to test whether the proposed relationships between variables involved existed. Results: Both perceived stress and poor sleep quality exhibited strong positive associations with job burnout among Chinese nurses. The SEM analysis confirmed the direct pathway from perceived stress to burnout and the indirect pathway mediated by sleep quality. The direct effect of perceived stress on job burnout was found to be statistically significant and positive (ß = 0.69, p < 0.05). There existed statistically significant effects of sleep quality on both perceived stress (ß = 0.48) and job burnout (ß = 0.29). The path coefficients of perceived stress on job burnout were significantly reduced (ß = 0.56) when sleep quality was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that sleep quality had a significant mediating effect on the relationship between perceived stress and job burnout (a * b = 0.139, BCa 95%, CI: 0.110~0.174). Conclusion: Perceived stress might exert significant effects on burnout both directly and indirectly through the mediating role of sleep quality. Efforts to reduce burnout among nurses in clinical settings may benefit from interventions for coping with perceived stress and practices for promoting healthy sleep.

Methicillin-resistant Staphylococcus aureus in health-care workers with cystic fibrosis in Sydney.

Cystic Fibrosis (CF), the most common lethal inherited disorder in Australia, is associated with increased respiratory tract colonization/infection. Given that many adults with CF work as health-care workers (HCW), which has been associated with an increased risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization/infection, we examined these risks in 252 adults with CF at our centre between 2001-2015. Demographic and clinical characteristics, including pathogens, were compared for HCW and non-HCW groups. MRSA colonization/infection was found in 20 subjects, comprising 2/19 HCW, and 18/233 non-HCW (p = 0.66). Sixteen of these 20 subjects undertook eradication therapy, with success in 2/2 HCW and 5/14 non-HCW. This study showed that the rate of MRSA colonization/infection did not differ between adults with CF who work in the health-care setting versus other areas. This suggests that choosing a health-care profession does not necessarily result in an increased risk of MRSA colonization/infection for an adult with CF.