"Jumping on the Blood Pressure Bandwagon": Nurse, GP, and Patient Perspectives of a General Practice Nurse-Led Hypertension Management Intervention.

To explore the perceptions and experiences of general practice nurses, general practitioners, and patients who participated in a nurse-led intervention to improve blood pressure control. Given the impact of hypertension on rates of premature death and disability, it is important that interventions be evaluated to reduce blood pressure. A key component of such evaluation is understanding the experiences of participants and clinicians. Understanding these experiences can provide insight into acceptability and feasibility that informs future research and implementation. Qualitative descriptive study within a mixed methods project. Semi-structured interviews were conducted post-intervention with six patients, five nurses, and three general practitioners. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. The COREQ checklist guided reporting. Three themes around the need for change, navigating change, and sustaining change were revealed. In highlighting the need for change, participants recognized that it was time to actively work toward improved blood pressure control. In navigating change, general practice nurses were perceived as ideally placed to communicate risks around uncontrolled blood pressure and support lifestyle change. The final theme, sustaining change revealed the feasibility of the intervention in practice, however, clinician participants identified that appropriate funding is required to ensure sustainability. Nurse-led intervention to improve blood pressure control in general practice is feasible in practice and acceptable to patients. This highlights an opportunity for nurses to play a more proactive role in hypertension management within general practice. To ensure sustainability, however, issues such as funding, teamwork, and collaboration need to be addressed. Trial Registration: Australian and New Zealand Clinical Trials Registry: ACTRN12618000169246.

Investigating nurses' self-efficacy in pressure injury management within surgical services.

BACKGROUND: New research is crucial in addressing the role of nurses in preventing pressure injuries (PIs) and remedying deficiencies in their self-efficacy in this area. PURPOSE: The aim of this study was to examine the self-efficacy perceptions of nurses in managing PIs within surgical services. METHODS: The study involved 186 nurses from surgical services. Data were collected using a self-efficacy scale and a personal information form designed to assess nurses' PI management skills. Analysis involved descriptive (number, percentile) and inferential statistics (ANOVA, t- s) in SPSS-24. RESULTS: Surgical nurses reported their self-efficacy in managing PIs with a mean score of 47.38 ± 21.87 on a self-efficacy scale, indicating a broad range of perceptions. Average scores were 43.55 ± 23.47 for evaluation, 48.39 ± 25.65 for planning, 43.68 ± 25.34 for surveillance, and 50.64 ± 22.23 for decision-making. Of note, nurses reported the lowest self-efficacy scores for evaluation. No significant differences were found based on employment duration, gender, or education. Significant differences were observed based on age, service level, and post-graduate education (P < .05). CONCLUSION: This study highlights the need for enhanced nurse self-efficacy in PI management in surgical services, emphasizing the role of education programs focused on evaluation skills.

Justice sensitivity among nurses and physiotherapists in a Croatian rehabilitation hospital.

The aim of this study was to investigate and compare justice sensitivity between self-perceived beneficiaries, victims, and observers in a sample of 90 healthcare workers (nurses and physiotherapists) at the Varazdinske Toplice Special Medical Rehabilitation Hospital, Croatia. For this purpose we used a questionnaire consisting of demographic data and the Croatian version of the justice sensitivity inventory developed by Schmitt. Regardless of its limitations, our study clearly shows that healthcare professionals at Varazdinske Toplice are most sensitive to injustice from the beneficiary's perspective, that is, as persons who personally benefitted from injustice, although they may not have been instrumental to this effect. They are less sensitive to injustice perceived on the outside (observer's perspective) or to injustice suffered by themselves (victim's perspective). Another important finding is that participants of female gender, rural residence, and nurses (who are all women) are significantly more sensitive to injustice, whereas age and marital status do not seem to contribute to justice sensitivity. Future research should investigate the perception of injustice over a longer timeframe and involve all healthcare workers. It could also address different approaches to management, especially in terms of worker rewards and career advancement. Qualitative research among healthcare workers could provide a broader and clearer idea of social injustice at their workplace.

Factors predicting the level of vaccine protection against hepatitis B virus infection among physicians and nurses in Sabac, Serbia.

As healthcare workers run a high and constant occupational risk of hepatitis B virus (HBV) infection through exposure to biological material, vaccination is mandatory as well as the monitoring of antibody levels one to two months after complete immunisation. The aim of this descriptive cross-sectional study was to determine HBV vaccine coverage of 200 primary and secondary healthcare workers (100 each) from Sabac, Serbia and their blood anti-HBs titre. We also wanted to identify factors that could predict the titre. Anti-HBV vaccination covered all participants, of whom 89.5 % were fully vaccinated, and 85 % had a protective antibody titre. We found a statistically significant association between antibody titre and the number of received vaccine doses, chronic jaundice, autoimmune disease, and cancer in our participants. The fact that 15 % did not achieve the protective antibody titre confirms the necessity of its control after immunisation, which is not routinely carried out in most countries, Serbia included. It is, therefore, necessary to develop a detailed strategy for monitoring vaccination and serological status of healthcare workers in order to improve their safety at work. An important role should also be given to continuous education of healthcare workers from the beginning of schooling to the end of their professional career.

Self-compassion and work engagement among Chinese nurses: exploring mediating effects of depression, anxiety, and stress.

Objective: Work engagement significantly influences both the quality of nursing care and nurses' job performance. In this study, we aimed to explore the mediating effects of negative emotions on the relationship between self-compassion and work engagement among Chinese nurses. Method: A cross-sectional study was performed on nurses in a tertiary A hospital located in Henan province from September, 2023 to December, 2023. Custom-designed digital surveys were disseminated to gather pertinent data. Structural Equation Modelling (SEM) were utilised to analyse the data and determine relationships among self-compassion, negative emotions and work engagement. Results: A total of 1,201 nurses were included. According to the statistical model, self-compassion (ß = 0.116, CI: -0.036 to -0.008, p < 0.001) and negative emotions (ß = -0.372, CI: -0.053 to -0.033, p < 0.001) were correlated with work engagement. Furthermore, our analysis revealed that negative emotions partially mediated the relationship between self-compassion and work engagement (ß = 0.174, CI: -0.066 to -0.020, p < 0.01). Conclusion: These findings indicate that incorporating self-compassion and negative emotion regulation in interventions targeting work engagement may enhance the overall level of work engagement among nurses, thereby improving job satisfaction and the quality of patient care.

Knowledge and Performance on Intravenous Medication Administration to Patients: A Cross-Sectional Observational Study Among Nurses of Nepal.

AIM: To evaluate knowledge and performance levels regarding intravenous (IV) medication administration to patients among nurses working in paediatric centers of Nepal. DESIGN: A cross-sectional descriptive observational study. METHODS: Enumerative sampling method was used for participant selection from the four hospitals having paediatric units. Data were collected using knowledge survey and observational checklist on four phases of IV medication administration. RESULTS: Of 115 nurses, 14 (12.2%) had adequate knowledge about IV medication administration whereas none had good level and only 20 nurses (17.4%) had fair level of performance. There was a weak negative correlation between knowledge and practice scores. Nurses working 8-h shifts had better performance than those working 6-h shifts; however, the recommended nurse-patient ratio was not maintained in 80% of observed shifts. The findings highlight the importance of upgrading nurses' knowledge and professional competencies on medication administration to improve the quality of patient care.

Medical staff in Poland in 2012-2022 - challenges related to the distribution of human resources.

INTRODUCTION AND OBJECTIVE: Today's shortage of medical staff is a global healthcare issue. This leads to unfulfilled, growing health needs and rising wage pressure. The aim of the study is to evaluate employment trends among medical professionals in Poland from 2012-2022, paying particular attention to the employment sector, forms of employment, age, gender, and geographic distribution. MATERIAL AND METHODS: A quantitative analysis was carried out using public records and documents to identify trends over a decade, by the desk research method. Sources included: Organisation for Economic Co-operation and Development databases, Central Statistical Office databases and Ministry of Health Statistical Bulletins. RESULTS: The observed increasing trend of physicians and nurses ratio after 2019, was caused mainly by a change in the methodology of calculating the indicator. There was a notable increase in the number of contracted medical professionals - 303% for nurses and 312% for midwives, and a decrease in the number of employed professionals. The number of contractors and employers in in-patient and long-term care has increased across all professional medical groups, while in outpatient care, the number has decreased. A definite ageing of medical staff was noted, with the percentage of midwives over 65 rising from 5.7% to 19.1%, and nurses over 65 rising from 5.4% to 22.3%. CONCLUSIONS: The demand for health services has increased, but the supply of medical staff has not kept pace with this demand. In addition to strategies related to increasing the number of human resources, solutions to better match resources to sectors of healthcare and better regional distribution should be considered. Solutions related to the skill-mix concept and the admission of new professions to the health sector may also be an opportunity for consideration.

Exploring client violence during home visits: a qualitative study of perceptions and experiences of Israeli nurses.

BACKGROUND: Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector. METHODS: Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted. RESULTS: Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient's natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses' professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients' homes. CONCLUSIONS: Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them.

The influencing factors of nurses' job engagement in tertiary, A grade hospitals in East China: A cross-sectional study.

AIM: To explore the effects of demographic characteristics, mental workload, and Adversity quotient (AQ) on the job engagement of nurses in East China. DESIGN: A quantitative and cross-sectional study. METHOD: The survey collected questionnaire data on mental workload, adversity quotient, and job engagement from 473 nurses selected working in 12 Grade-A tertiary hospitals based on informed consent in East China between July 2020 and March 2021. RESULTS: The total score of mental workload was 78.24 ± 11.65, the adversity quotient score was 128.26 ± 15.84, job engagement score was 42.32 ± 7.79. Job engagement has a remarkable positive correlation with adversity quotient (r = 0.613, p<0.001), and a negative correlation with mental workload (r = -0.499, p<0.001). Mental workload has an apparent negative correlation with adversity quotient (r = -0.291, p<0.001). Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance could predict 70.9% of job engagement of nurses. CONCLUSIONS: The mental workload of nurses was higher, the AQ was at a medium level, and the job engagement of nurses was also slightly higher. Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance had predictive effects on nurses' job engagement. It is necessary to take a variety of measures according to the social-demographic characteristics, improve the adversity quotient, and evaluate the mental workload correctly, to improve the job engagement of nurses. IMPACT: The epidemic situation and other emergencies make the work pressure of nurses in Grade-A tertiary hospitals increase suddenly. It should pay attention to the influence of different demographic factors, and pay attention to the correct guidance of work demand-mental workload, as well as the cultivation, and improvement of job resource-AQ, which can improve the job engagement of nurses to some extent. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Poor Work Ability Is Associated with Workplace Violence in Nurses: A Two-Wave Panel Data Analysis.

Healthcare personnel must deal with two problems of growing importance: violence in the workplace and the loss of work ability due to the aging of the workforce. Our objective was to evaluate, with a two-wave perspective design, the relationships of work ability, social support, and occupational stress with workplace violence in nurses. In an Italian public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analyzed the relationship between this indicator and the violence experienced in the previous and following years. A total of 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR = 0.94 CI95% = 0.90; 0.98 p < 0.01) and in the following year (OR = 0.88 CI95% = 0.84; 0.92 p < 0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR = 3.65 CI95% = 1.90; 7.03 in the previous year, OR = 3.54 CI95% = 1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental states can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

Prevalence and associated factors of insomnia symptoms among doctors and nurses under the context of high prevalence of multiple infectious diseases: a cross-sectional study.

Introduction: Insomnia symptoms are prevalent among healthcare workers and represent a potential public health problem. However, there is currently insufficient evidence on insomnia symptoms among doctors and nurses under the context of high prevalence of multiple infectious diseases after the pandemic in China. The purpose of this study was to analyze the prevalence of insomnia symptoms among doctors and nurses in third-grade class-A general hospitals under the context of high prevalence of multiple infectious diseases, and to explore the influence of demographic characteristics, work-related factors, health and lifestyle-related factors on insomnia symptoms. Methods: An institution-based cross-sectional survey was conducted among doctors and nurses in two third-grade class-A general hospitals. A structured questionnaire was used to collect information on demographic characteristics, work-related factors, health and lifestyle-related factors, and insomnia symptoms among doctors and nurses. Multivariate logistics regression analysis was applied to identify factors significantly associated with insomnia symptoms among doctors and nurses, respectively. Results: A total of 1,004 participants were included in this study, including 503 doctors and 501 nurses. The prevalence of insomnia symptoms in doctors and nurses was 47.7 and 51.3%, respectively. Multivariate logistics regression analysis showed that workplace violence (OR: 1.631, 95% CI: 1.050-2.532), doctor-patient relationship (OR: 1.603, 95% CI: 1.049-2.450), chronic pain (OR: 4.134, 95% CI: 2.579-6.625), chronic disease (OR: 1.825, 95% CI: 1.164-2.861), and anxiety symptoms (OR: 2.273, 95% CI: 1.357-3.807) were associated factors with insomnia symptoms in doctors. Education (OR: 0.301, 95% CI: 0.106-0.851), service years (OR: 1.978, 95% CI: 1.304-3.002), weekly working hours (OR: 1.694, 95% CI: 1.061-2.705), chronic pain (OR: 5.359, 95% CI: 3.241-8.860), and anxiety symptoms (OR: 2.472, 95% CI: 1.478-4.136) were associated factors with insomnia symptoms in nurses. Conclusion: The prevalence of insomnia symptoms among doctors and nurses was high, and affected by many factors. This information can inform tailored interventions to insomnia symptoms by doctors and nurses who play an important role in public health.

Proactive Personality and Caring Behavior of Clinical Nurses: A Moderated Mediation Model of Emotional Intelligence and Disgust Sensitivity.

The aims of the research were to investigate the mediating effect of emotional intelligence and the moderating effect of disgust sensitivity on the relationship between proactive personality and caring behavior among clinical nurses. A cross-sectional design while adhering to STROBE guidelines was used for this study. Three hundred ninety-three purposely selected nurses from three tertiary general hospitals completed an online survey. Measures included proactive personality, emotional intelligence, disgust sensitivity, and caring behavior. The findings showed that proactive personality positively predicted nurses' caring behavior, and that emotional intelligence played a mediating role in the relationship between proactive personality and caring behavior. Disgust sensitivity indirectly and negatively moderated the impact of proactive personality on nurses' caring behavior mainly in the second half of this moderated relationship. The findings underscore that the nursing managers may consider incorporating emotional intelligence topic in practical nursing skills training and improving nurses' ability to control their disgust sensitivity can improve their professional behavior, thus to provide patients with high-quality nursing services.

Moderating role of relationships between workloads, job burnout, turnover intention, and healthcare quality among nurses.

BACKGROUND: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. METHODS: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023. RESULTS: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses. CONSULSION: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care.

Psychometric evaluation of a Spanish translation of the moral injury symptom scale for healthcare professionals.

BACKGROUND: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish. METHODS: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability. RESULTS: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835. CONCLUSION: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury.

Analysis of turnover intention and influencing factors among female nurses with two children in Grade A tertiary public hospitals in Sichuan province: a cross-sectional study.

Objective: This study aims to examine the current status of turnover intention among female nurses with two children and explore the factors influencing their decision to resign, ultimately providing a basis for reducing nurses' turnover intention and stabilizing the nursing workforce. Methods: A convenience sampling method was used to select 1,370 in-service female nurses with two children from 65 Grade A tertiary public hospitals in Sichuan Province from September to December 2023. Data was collected through a general information questionnaire, work-family behavioral role conflict scale, regulatory emotional self-efficacy, and turnover intention scale. Results: This study revealed that the average score for turnover intention among female nurses with two children was (13.11 ± 3.93). There was a positive correlation between work-family behavioral role conflict and turnover intention (r = 0.485, p < 0.01), while regulatory emotional self-efficacy showed a negative correlation with turnover intention (r = -0.382, p < 0.01). The main influencing factors for resignation among these nurses included age, number of night shifts per month, average monthly income, primary caregiver for children, work-to-family conflict and family-to-work conflict, and the ability to express positive emotions (POS), the capacity to regulate negative emotions such as despondency/distress (DES), and the skill to manage anger/irritation (ANG). Collectively, these factors explained 29.5% of the total variance in turnover intention scores. Conclusion: Turnover intention among female nurses with two children is relatively high. To address this issue, hospital managers shall implement effective measures through various channels to settle work-family conflict, enhance nurses' regulatory emotional self-efficacy, and reduce turnover intention resulting from work-family conflict. Together, these efforts will reduce nurse turnover and foster a stable nursing workforce.

Stock, composition and distribution of the nursing workforce in Brazil: a snapshot.

OBJECTIVE: to analyze the availability (in terms of stock and composition) and accessibility (in terms of geographical distribution) of the nursing workforce in Brazil. METHOD: this is a descriptive, cross-sectional study with retrospective data collection, identified by combining databases available on institutional websites and structured according to indicators from the World Health Organization's "National Health Workforce Accounts". The study considered nursing professionals at senior level (nurses) and middle level (nursing auxiliaries and technicians). Indicators of stock, composition, distribution (by age group and gender) and the ratio of nurses to doctors were included. RESULTS: there was an increase in the number of personnel between 2005 and 2010, mainly in middle and technical level professionals. There are more personnel aged between 36 and 55, with a predominance of women in all categories, despite the increase in men. There was an uneven distribution of personnel across the country's regions, with the Southeast having the largest number of professionals. The ratio of nurses to doctors is less than one in the South and Southeast. CONCLUSION: despite the large number of nurses, their distribution is uneven. The growth of nursing technicians has significantly outstripped that of nurses, indicating more intensive technical training policies than those found in higher education.

Factors Affecting Nurses' Disaster Preparedness in Türkiye: A Cross-Sectional Study.

OBJECTIVE: It is of critical importance to determine the factors that contribute to nurses' disaster preparedness. This study aimed to examine nurses' perceptions of disaster preparedness and the factors affecting it. METHODS: This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the "Personal Information Form," "The Scale of Perception of Disaster Preparedness on Nurses," and the "Adult Motivation Scale." Linear regression analysis was used to analyze the influencing factors. RESULTS: It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation. CONCLUSIONS: The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses' perception of disaster preparedness to develop solutions for such disasters.

Accessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil.

OBJECTIVES: to understand nurse perspectives regarding homeless pregnant women's accessibility to prenatal care. METHODS: a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil. RESULTS: nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses' work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women. FINAL CONSIDERATIONS: the Street Outreach Office's work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.

Nurses' perception of epidural services in a Johannesburg academic setting.

BACKGROUND:  Labour pain is associated with detrimental maternal and foetal physical and psychological effects. Labour analgesia is a basic right for all women and labour epidural analgesia has been accepted as the gold standard for providing such, with reported improvement in patient satisfaction. In South Africa, studies have shown that labour epidural rates are low. At an academic hospital in Johannesburg, a 24-h labour epidural service combined with an awareness campaign and educational programme (LEAP) was initiated with the aim of improving labour epidural rates. Results showed a short-lived uptake with a subsequent decline. OBJECTIVES:  This study explored the experiences of labour ward nursing staff regarding the labour epidural service at this academic hospital including perceived limitations and possible recommendations regarding improving service provision. METHOD:  A qualitative, descriptive and exploratory study was conducted. Purposive sampling was used with semistructured, audio-recorded individual interviews, thematic analysis was performed using Braun and Clarke's six-phase approach. RESULTS:  The key theme is required education and supervision of epidural insertion (see page 3), management of childbirth and challenges related to epidural service provision. CONCLUSION:  A positive sentiment was expressed by the participants; however, deficiencies in the service such as shortages of experienced personnel, work constraints and insufficient training may be affecting service sustainability. Further studies are recommended to form guidance towards the development and implementation of interventions to improve service delivery.Contribution: Provision of continual training and increased staffing of healthcare personnel will help improve the sustainability of the labour epidural service.

Associations of night shift work with weight gain among female nurses in The Netherlands: results of a prospective cohort study.

OBJECTIVE: This study aimed to prospectively investigate associations of working night shifts with weight gain in the Nightingale Study, a large cohort of female nurses. METHODS: This study included 36 273 registered nurses, who completed questionnaires in 2011 and 2017. Cumulative number of nights, mean number of nights/month and consecutive number of nights/month in 2007-2011 were assessed. We used Poisson regression to estimate multivariable-adjusted incidence rate ratios (IRR) of >5% weight gain from 2011 to 2017 among all participants and assess risk of development of overweight/obesity (BMI≥25 kg/m2) among women with healthy baseline body mass index. The reference group consisted of women who never worked nights. RESULTS: Overall, working night shifts in 2007-2011 was associated with >5% weight gain [IRR 1.07, 95% confidence interval (CI) 1.01-1.13]. Associations differed by menopausal status in 2011, with an increased risk of gaining >5% weight limited to postmenopausal women who worked nights (IRR 1.23, 95% CI 1.10-1.38). Postmenopausal women had an increased risk of >5% weight gain when they worked on average ≥4 nights/month (4-5: IRR 1.29, 95% CI 1.09-1.52, ≥6: IRR 1.27, 95% CI 1.11-1.47) or ≥4 consecutive nights/month (IRR 1.37, 95% CI 1.19-1.58), compared to postmenopausal women who never worked nights. For postmenopausal women with healthy weight at baseline, night shift work was associated with an increased risk of overweight/obesity at follow-up (IRR 1.24, 95% CI 1.03-1.50). CONCLUSIONS: Working night shifts was associated with a slightly increased risk of weight gain and overweight/obesity development among women who were postmenopausal at study inclusion. Our findings emphasize the importance of health promotion to maintain a healthy weight among (postmenopausal) night workers.