Comparison of self-competency and executive (charge) nurse competency assessments of clinical nurses.

AIM: This study compared nurses' self-competency assessments and their managers' nurse competence assessments. BACKGROUND: Nurse competence is important for nursing care quality and patient safety. Executive (charge) nurses play a main role in the nurse competency assessment. METHODOLOGY: In this study conducted at a university hospital between January and December 2020, the self-efficacy evaluations of nurses (n = 162) working in services other than the emergency department, operating room, and outpatient clinics of the university hospital were compared with the evaluations of nurse executives (charges) on these nurses (n = 21). Data were collected using the personal information form and the Nurse Competence Scale. A cross-sectional study design was used. The Strengthening the Reporting of Observational Studies in Epidemiology guideline was used for reporting. RESULTS: Service nurses' self-assessments and nurses treating charge's assessment of clinical nurses evaluated the competence levels as excellent in both groups. The self-competency assessments of the nurses were higher than the charge nurses' competency assessments. DISCUSSION: In this study, the lower competence assessment of nurses by the charge nurses was may be due to their ability to observe nurses in their teams in general and that they have more experience in evaluation. CONCLUSION: It is suggested that professional development and competence programs be created to further develop the competencies of nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse competency assessments support planning to ensure patient safety. Patient care burden and planning of risky patients according to the nurse competency level will provide safe patient care.

An authentic leadership training programme to increase nurse empowerment and patient safety: A quasi-experimental study.

BACKGROUND: Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate. PURPOSE: The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate. DESIGN: A quasi-experimental study using a one-group pretest-posttest design consistent with TREND guidelines. METHODS: The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis. RESULTS: Following the intervention, safety climate and authentic leadership scores increased among both leaders and followers. Structural and psychological empowerment scores also increased among followers. We found that authentic leadership and structural empowerment were predictors of safety climate. CONCLUSION: The implementation of the education programme resulted in positive changes in participants' perceptions of authentic leadership and empowerment, which can enhance patient safety. IMPLICATIONS: Healthcare organizations can implement similar multi-faceted training programmes focused on authentic leadership, and nurse empowerment to increase patient safety. Achieving effective results in such programmes can be facilitated by motivating participants with the support of the top management. PATIENT OR PUBLIC CONTRIBUTION: The study included nurses in the intervention and the data collection processes. IMPACT: Patient safety is a global concern, and improving patient safety culture/climate is a key strategy in preventing harm. Authentic leadership and nurse empowerment are essential in creating healthy work environments and delivering safe, high-quality care. Training programmes addressing these issues can help bring about improvements in healthcare organizations.

Opinions of emergency nurses in Turkey on their work environment during the COVID-19 pandemic and its relationship with their health: A qualitative study.

Introduction: COVID-19 patients being admitted to emergency service pose a high risk of exposure and infection to emergency nurses. Therefore, one of the primary responsibilities of hospital management is to provide an appropriate work environment for nurses. Aim: To analyze the opinions of emergency nurses about their work environment, and to understand how the working environment is related to their health during the COVID-19 pandemic. Methods: The study employed a qualitative descriptive research design and purposive sampling method. It was conducted in the emergency service of a state hospital in the central Anatolia region of Turkey, which was providing COVID-19 care at the time. The data were collected through semi-structured individual interviews held between January and February 2021. Each interview was conducted only once via WhatsApp video calls. Data collection was continued to reach data saturation (n:14). The data were analyzed using Colaizzi's seven-step content analysis. The Consolidated Criteria for Reporting Qualitative (COREQ) Studies checklist was followed in the study. Results: Three themes emerged in the analysis of the data obtained from a total of 14 emergency nurses: (a) "Insufficient Physical Environment"; (b) "Inadequacies in Managerial Roles and Skills"; and (c) "The Effect of the Work Environment on Nurses' Health". It was determined that the work environment of emergency nurses was inadequate in terms of resting areas, ventilation and separation of clean and infected areas, and they stated that they had not received adequate support from their managers and encountered difficulties due to equipment shortage, particularly in the early stages of COVID-19. It was also determined that the work environment caused psychological and ergonomic health issues. Conclusions: It is important to provide adequate managerial support and to make arrangements that resolve the physical and mental obstacles in improving the work environment of emergency nurses.

Evaluation of the cost-effectiveness of a multicomponent fall prevention program in hospitalized patients.

The aim of this pre- and post-interventional study was to analyze the cost-effectiveness of the multicomponent fall prevention program in hospitalized patients. To achieve this aim, cost-effectiveness analysis performed using decision tree modeling was compared with the implementation of the fall prevention program and usual care. The primary outcome was the number of patient falls. The uncertainty in cost and effectiveness data was evaluated using one-way sensitivity analysis, best-worst-case scenario analysis, and probabilistic sensitivity analysis. According to cost-effectiveness analysis, implementation of the fall prevention program was dominantly cost-effective. As a result of the probabilistic sensitivity analysis, it was revealed that, even if willing-to-pay per-fall prevented value was 0, the probability of being cost-effective was 54.4% for the fall prevention program. Economic evaluation results showed that implementing the multicomponent fall prevention program was dominantly cost-effective in hospitalized patients. Nurses and nurse managers can benefit from economic evaluations in their decision-making processes to implement fall prevention programs.

Scientific View of the Global Literature on Medical Error Reporting and Reporting Systems From 1977 to 2021: A Bibliometric Analysis.

BACKGROUND: Error reporting is vital for the prevention of medical errors. Despite the importance of error reporting, underreporting of medical errors is a common reality in many countries. Therefore, barriers to error reporting and reporting systems are a constantly evolving field of research. For this reason, studies on medical error reporting and reporting systems should be evaluated multidimensionally. AIM: The aim of this study is to evaluate the global research on medical error reporting and reporting systems through bibliometric analysis to obtain a structured macroscopic overview of the features and developments. METHODS: A bibliometric analysis of 1464 publications from 1970 to 2021 was performed to map the literature of medical error reporting and assess the structure of the scientific community. RESULTS: After 2000, the number of publications increased annually until a maximum of 2020 was reached. The International Journal for Quality in Health Care and the Journal of Patient Safety have been the most productive journals when it comes to publishing on the subject. Trend topics of keyword plus have changed over time. The United States (1399), England (580), and Australia (478) are the 3 nations with the highest number of publications. On the other hand, it is seen that the subject has yet to be discussed in a few developing or underdeveloped countries. CONCLUSIONS: This bibliometric analysis shows that the number of publications and authors and cross-country cooperation are low regarding error reporting. The low number of publications and the lack of cooperation, especially in developing countries, reveal the importance of global cooperation.

Nurses' view of implementation evidence-based fall prevention interventions: A qualitative study.

AIM: The purpose of this descriptive qualitative study was to evaluate nurses' views of implementation evidence-based fall prevention interventions. METHODS: The study was conducted with participation of nurses who worked in a training and research hospital after evidence-based fall prevention interventions had been implemented. Interviews were done with 17 nurses who participated in all training courses. RESULTS: The evaluation of the interventions was examined, and three themes were extracted through analysis: 'effectiveness of training programme', 'barriers' and 'suggestions'. CONCLUSION: Nurses emphasized that evidence-based fall prevention interventions are usable in hospital, but team collaboration and administrative support are required for better outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: The study result shows that fall prevention interventions should be introduced to all health care professionals, through the use of various training methods. Training should be given to patients and their caregivers, and barriers that nurses stated like understaffing, lack of materials and tools that ensure patient safety and internet (research/scientific information) access restriction should be reduced.

Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey.

AIMS: To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses. BACKGROUND: Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams. METHODS: This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016. RESULTS: Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest. CONCLUSION: The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.

Cross-cultural adaptation and psychometric evaluation of the Turkish version of the Self-Efficacy for Preventing Falls-Nurse.

AIM: The aim of this study was to test the psychometric properties of the Turkish version of the Self-Efficacy for Preventing Falls-Nurse. BACKGROUND: Patient falls have negative effects on patients and health care services. Nurses' self-efficacy for preventing falls can affect their performance in interventions to prevent falls. METHODS: The sample of this methodological study included 326 nurses who work at a university, a training and a public hospital in Turkey. The construct validity of the scale was assessed using the exploratory factor analysis, the confirmatory factor analysis and the known-group technique. The reliability of the scale was assessed through internal consistency approaches and test-retest reliability. RESULTS: Two factors were extracted through the exploratory factor analysis, and the factors explained 68.69% of total variance. The confirmatory factor analysis showed a significantly good fit for a two-factor structure. Satisfactory evidence was found for test-retest reliability and internal consistency reliability. CONCLUSION: The Turkish version of the Self-Efficacy for Preventing Falls-Nurse is a reliable and valid scale for assessing nurses' self-efficacy for preventing falls. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can assess nurses' self-efficacy for preventing falls by using the Turkish version of the Self-Efficacy for Preventing Falls-Nurse. Moreover, they can identify where to focus on improving nurses' self-efficacy by analysing scores of subscales and items.

Role of job satisfaction and work environment on the organizational commitment of nurses: a cross-sectional study.

Background: Nursing shortage is a major global concern about healthcare. In this regard, nurses' organizational commitment is an important issue that should be focused on. Since limited data are available about the factors associated with nurse organizational commitment, further research is needed.Aim: This study aimed to examine the influence of job satisfaction and work environment on the organizational commitment of nurses.Design: A predictive design was employed.Methods: The sample comprised 595 nurses at a university hospital in Turkey. A hierarchical regression analysis applied to analyze the data.Results: Significant predictors identified as "self-realization", "nurses' participation in management and representative power", "nurse managers' attitudes and leadership qualities", "general quality", and "communication among physicians, nurses and colleagues".Conclusion: The development of strategies for increasing job satisfaction among nurses and creating positive work environments may lead administrators to increase organizational commitment in helping to the problem of nursing shortage.

Nurses' view of their work environment, health and safety: A qualitative study.

AIM: This study aims to determine the nurses' view of the work environment on nurses' health and safety. BACKGROUND: The creation of positive work environments has become one of the key determining factors to improve nurse outcomes. METHODS: The research, a qualitative descriptive design, was conducted between January and October 2017 with a total of 17 nurses. Nurses were selected for the study using the purposive sampling method, and in-depth interviews were carried out with these nurses under the guidance of a semi-structured interview form. Thematic analysis was conducted to analyse the interviews. RESULTS: In line with the views of nurses, two main themes as "physical environment regulations" and "administrative arrangements" and six sub-themes (room structures and plans, hygiene conditions, lack of materials, occupational precautions, the attitude of the managers, team collaboration and communication) were determined as the nurses' health and safety issues on their work environment. CONCLUSIONS: Personal, administrative and institutional improvements are needed, especially for the prevention of work accidents and injuries. IMPLICATIONS FOR NURSING MANAGEMENT: The study results will serve to guide legislators and upper-middle-sub-level managers in developing interventions to create supportive work environments for the health and safety of nurses.

Views of key stakeholders on the causes of patient falls and prevention interventions: A qualitative study using the international classification of functioning, disability and health.

AIMS AND OBJECTIVES: To examine the views and suggestions of healthcare professionals, patients and family members on the causes of inpatient falls and fall-prevention practices. BACKGROUND: Patient falls are one of the most prevalent medical errors in the hospitals. In order to prevent patient falls, it is necessary to identify and classify the situations causing falls in detail and preventive interventions for these situations need to be developed. DESIGN: The study was designed using a descriptive qualitative research method. METHOD: The semi-structured interviews were conducted with four physicians, four charge nurses, 12 nurses, four support staff members, eight patients and eight family members of patients in the palliative, internal disease, surgery and orthopaedic clinics in a training and research hospital between March 2017-May 2017. Thematic analysis method was used to analyse data. The defined themes were classified based on the International Classification of Functioning, Disability and Health Core Set for Falls in Acute Rehabilitation Settings. RESULTS: In this research, 71 themes related to situations causing falls and 30 themes related to prevention interventions were determined. Defined themes were linked with 44 categories under five International Classification of Functioning, Disability and Health domains and organised accordingly. Among the categories included in the International Classification of Functioning, Disability and Health Core Set for Falls in Acute Rehabilitation Settings, 65% were verified, while 22 new categories that were not included in the original core set were defined. CONCLUSION: In accordance with this result, evaluating the opinions of all stakeholders on the research and development of fall-prevention programmes will increase the effectiveness of fall prevention in hospitals. The ICF model can be used to classify the causes of falls and fall-prevention interventions to create a common language about this topic. RELEVANCE TO CLINICAL PRACTICE: To prevent falls, more detailed and useful information can be obtained by key stakeholders (all healthcare professionals, patient and patient family). ICF Core Set For Falls can be used to systematically classify causes of falls and fall-prevention interventions.

Nurses' identification and reporting of medication errors.

AIMS AND OBJECTIVES: To investigate hospital nurses' involvement in the identification and reporting of medication errors in Turkey. BACKGROUND: Medication safety is an international priority, and medication error identification and reporting are essential for patient safety. DESIGN: A descriptive survey design consistent with the STROBE guidelines was used. METHODS: The participants were 135 nurses employed in a university hospital in Turkey. The survey instrument included 18 sample cases and respondents identified whether errors had been made and how they should be reported. Descriptive statistics were analysed using the chi-square and Fisher's exact tests. RESULTS: The sample case of "Patient given 10 mg morphine sulphate instead of 1.0 mg of morphine sulphate" was defined as a medication error by 97% of respondents, whereas the sample case of "Omitting oral/IV antibiotics because of the need to take the patient out for X-rays for 3 hr" was defined as a medication error by only 32.1%. It was found that eight sample cases (omitting antibiotics, diluting norodol drops with saline, giving aspirin preprandially, injecting clexane before colonoscopy, giving an analgesic at the nurse's discretion, dispensing undiluted morphine, preparing dobutamine instead of dopamine and administering enteral nutrition intravenously) were assessed as errors and reported, although there were significant statistical differences between the identification and reporting of these errors. CONCLUSION: Nurses are able to identify medication errors, but are reluctant to report them. Fear of the consequences was the main reason given for not reporting medication errors. When errors are reported, it is likely to be to physicians. RELEVANCE TO CLINICAL PRACTICE: The development of a commonly agreed definition of a medication error, along with clear and robust reporting mechanisms, would be a positive step towards increasing patient safety. Staff reporting medication errors should be supported, not punished, and the information provided used to improve the system.

The influence of authentic leadership on safety climate in nursing.

AIM: This study analysed nurses' perceptions of authentic leadership and safety climate and examined the contribution of authentic leadership to the safety climate. BACKGROUND: It has been suggested and emphasised that authentic leadership should be used as a guidance to ensure quality care and the safety of patients and health-care personnel. METHODS: This predictive study was conducted with 350 nurses in three Turkish hospitals. The data were collected using the Authentic Leadership Questionnaire and the Safety Climate Survey and analysed using hierarchical regression analysis. RESULTS: The mean authentic leadership perception and the safety climate scores of the nurses were 2.92 and 3.50, respectively. The percentage of problematic responses was found to be less than 10% for only four safety climate items. Hierarchical regression analysis revealed that authentic leadership significantly predicted the safety climate. CONCLUSIONS: Procedural and political improvements are required in terms of the safety climate in institutions, where the study was conducted, and authentic leadership increases positive perceptions of safety climate. RECOMMENDATIONS FOR NURSING MANAGEMENT: Exhibiting the characteristics of authentic leadership, or improving them and reflecting them on to personnel can enhance the safety climate. Planning information sharing meetings to raise the personnel's awareness of safety climate and systemic improvements can contribute to creating safe care climates.

Barriers to Medical Error Reporting for Physicians and Nurses.

The purpose of the study was to determine what barriers to error reporting exist for physicians and nurses. The study, of descriptive qualitative design, was conducted with physicians and nurses working at a training and research hospital. In-depth interviews were held with eight physicians and 15 nurses, a total of 23 participants. Physicians and nurses do not choose to report medical errors that they experience or witness. When barriers to error reporting were examined, it was seen that there were four main themes involved: fear, the attitude of administration, barriers related to the system, and the employees' perceptions of error. It is important in terms of preventing medical errors to identify the barriers that keep physicians and nurses from reporting errors.

Efficacy of frequent blood pressure and heart rate monitoring for early identification of bleeding following percutaneous coronary intervention.

Monitoring of patients' vital signs is an important component of postpercutaneous coronary intervention (post-PCI) for bleeding early detection. This study was performed in order to identify the efficacy of frequent blood pressure (BP) and heart rate (HR) monitoring for early identification of bleeding following PCI. The descriptive study was conducted at the cardiology unit of a university hospital with a study sample of 1292 patients. Data collection instruments were designed by the authors. In a comparison of the presence of abnormal BP-HR between the groups with and without bleeding, the difference was not significant on arrival and not at 15, 45 and 60 min posttransfer. There is no association between the frequent vital sign measurement in the first hour and early diagnosis of bleeding. The frequency of follow up after PCI should be based on the patient's condition, the nurse's clinical expertise and the institutional protocols.