The role of organizational culture and communication skills in predicting the quality of nursing care.

AIMS: This study aims to identify the level of nursing care quality and examine its predictors considering nurses' demographic data, organizational culture, and communication skills. BACKGROUND: Quality of care is a determinant of the sustainability of any healthcare organization. Therefore, it is imperative to understand how factors may contribute to the quality of nursing care. Limited research is available on the interaction between the concepts of quality of nursing care, communication skills, and organizational culture. METHODS: A cross-sectional multi-site correlational design was used in this study. A convenience sample of 200 nurses from four Jordanian hospitals was recruited. Data was collected using self-reported questionnaires. Descriptive statistics, Pearson correlations, and multiple regression were performed to achieve the study's aims. RESULTS: The majority of the nurses in this study were females with bachelor's degrees. Age ranged between 22 and 53 years whereas experience ranged from 1 to 30 years. Communication skills significantly predicted the quality of nursing care; however, organizational culture was not a significant predictor of the quality of nursing care. Nevertheless, Pearson r correlation results revealed a significant correlation between organizational culture and communication skills (r = 0.57, p < 0.05). CONCLUSION: Nurses and organizational managers can increase the level of quality of nursing care by investing in programs that target improving nurses' communication skills. Providing a good environment in the hospital can increase communication skills between staff members, ultimately increasing the quality of nursing care. Further studies are recommended to elaborate and further uncover concerns related to the current research.

Validation and cross-cultural adaptation of the six-dimension scale of nursing performance- arabic version.

BACKGROUND: Nursing performance is a key indicator of patients' care quality and safety. Most healthcare research tools are available in the English language; however, nurses around the world can employ these tools if rigorously adapted and cross-culturally validated. AIMS AND OBJECTIVES: This study aims to provide a cross-cultural adaptation and validation of the six-dimension scale of nursing performance to be used among Arabic-speaking nurses. DESIGN: The study employed a descriptive, correlational design with a cross-sectional approach. METHODS: A five-step cross-cultural adaptation process was adopted. The scale was administered to 216 Jordanian nurses between January 2022 to April 2022. SPSS and AMOS were used for descriptive and correlation analyses and testing the six-dimension model through structural equation modeling (SEM). RESULTS: The current study produced a valid, reliable, culturally adapted Arabic language version of the six-dimension scale of nursing performance. The internal consistency of the tool was supported by a Cronbach Alpha's value of 0.99. The model's goodness of fit indices were: CFI = 0.96, RMSEA = 0.048, and CMIN/df = 1.49. The exploratory factor analysis (EFA) of the scale identified three factors with eigenvalues greater than 1.00., explaining 75.22% of the variance. A subsequent EFA, specifying six factors, yielded 79.79% explained variance. All item factor loadings exceeded 0.30, confirming the scale's robust factor structure. CONCLUSIONS: This study proved that following a robust cross-cultural adaptation process results in a reliable and valid measure of nursing performance to be used among Arabic-speaking nurses. The study supports the dimensionality of nursing performance as evidenced by the SEM results. Therefore, the findings have the potential to considerably enhance studying nursing performance in healthcare fields in Arabic-speaking nurses. RELEVANCE TO CLINICAL PRACTICE: The validation and cross-cultural adaptation of the Arabic version of the Six-Dimension Scale of Nursing Performance have direct implications for improving the quality of nursing services, enhancing patient safety, promoting cultural competence, and supporting the professional growth of Arabic-speaking nurses.

Depression stigma, depression literacy, and psychological help seeking attitudes among school and university students.

Very little research has specifically investigated depression stigma and its correlation with depression literacy and help-seeking attitudes among students. This study aimed to assess the levels and correlations of stigma, literacy, and psychological help-seeking attitudes related to depression among a sample of high school and university students in Jordan. A descriptive, correlational, cross-sectional design was employed using an anonymous, online, self-report survey. This study included a total of 650 students aged 16 to 24 years. The participants were found to have high levels of depression stigma, low levels of depression literacy, and negative attitudes towards seeking psychological help. The most frequently reported sources of psychological help were family members, relatives, and friends. A significant negative correlation was found between depression stigma and depression literacy. The predictive factors of depression stigma were depression literacy, age, gender, education, father's educational level, family size, and having history of mental health problems among family members, relatives, or friends. This study provides valuable information on the common mental health needs and concerns among students in Jordan. The findings also highlight the importance of developing and implementing depression awareness and prevention education campaigns for students in schools and universities. Such campaigns may increase students' knowledge about depression, enhance their use of mental healthcare services, and prevent or decrease their risk of developing depression.

The effectiveness of COPA-based training program on the infection-control competencies of newly hired healthcare professionals.

Competency-based education that relies on nurses' and healthcare professionals' needs assessment is crucial to tackling healthcare crises such as COVID-19. Strengthening the capacities of human resources by implementing customized infection control training programs is therefore mandatory. This study aims to measure the effectiveness and satisfaction of the Competency Outcomes and Performance Assessment (COPA)-based training program. The study implemented a single group pretest-posttest experimental design. A single-stage cluster sampling technique was used. All field hospitals in Jordan were listed, and one hospital was randomly selected. A total of 87 personnel from different disciplines agreed to participate after reading the letter of information and signing the informed consent. A panel of experts representing different disciplines and hospital units initially met and agreed upon a list of competencies required for the training program, and the program was accordingly developed. The study measured the healthcare professionals' competencies in infection control and prevention before and after the administration of the competency-based training program. The results revealed significant differences between participants' pretest and posttest scores in all infection control domains and the total scores. For example, the increase in participants' total competency scores after the training was statistically significant (P < 0.007). The mean total satisfaction score was 61.18 + 7.00 reflecting that the participants were highly satisfied with the provided training. In conclusion, it is imperative to provide healthcare professionals with adequate clinical training to ensure that healthcare services are going to be delivered in the highest possible quality and minimize the possible adverse events.

The perception of shared governance and engagement in decision-making among nurses.

BACKGROUND: Shared governance is a structural framework for operationalizing nursing ownership and accountability for nursing practice. Healthcare institutions are striving to promote healthy and satisfactory work conditions to retain their qualified personnel and achieve organizational stability and high care quality. However, little is known about nurses' participation in governance in developing countries. AIM: This study aims to evaluate the levels of shared governance, also known as professional governance, among nurses in Jordan. The demographics of the study participants will also be assessed. METHODS: The current study used a cross-sectional design implementing an anonymous online survey technique to collect data from 111 nurses on the Index of Professional Nursing Governance (IPNG). Descriptive statistics were performed to evaluate the nurses' perception of the concept of shared governance in the domains of personnel, information, resources, participation goals and conflict resolution, and practice. RESULTS: Among the 111 nurses, 55% of the participants were females, 45.5% were affiliated with governmental hospitals, and about half of them worked in critical care units. The analysis showed that the mean score for the total IPNG was 113 (SD = 26.28). The analyses of the mean scores of IPNG domains ranged from 11.5 (SD = 4.6) for goals and conflict resolution to 23.8 (SD = 5.7) for access to information. DISCUSSION: The results revealed that nurses' average perception of professional governance demonstrated shared governance, and more specifically, in the lower level of shared governance where decisions are made primarily by management with some staff input. Analysis of the domains of governance revealed that participants' scores corresponded with shared governance in the areas of information, resources, goals and conflict, and practice, while traditional governance was prevalent in the governance of nursing personnel and participation. CONCLUSION: There is an agreement on the need of moving the position of frontline nurses to the center of their organizations where equity, accountability, and ownership are the pillars of participative governance. Frontline nurses need further empowerment to be more actively engaged especially in the management of nursing staff and related structures and in the participation in structures connected to governance activities at different organizational levels such as in committees.

The predicting effects of professional governance and structural empowerment on job satisfaction among Jordanian nurses: A cross-sectional study.

AIM: This study aimed to investigate the role of professional governance and empowerment in predicting nurses' job satisfaction. BACKGROUND: Nurses can lead the way to enhance health care quality for all if they work in safe, satisfying and empowering environments. Professional governance and structural empowerment are associated with favourable work conditions and environments. However, studies addressing the predicting effects of professional governance and structural empowerment on job satisfaction are still limited. METHODS: A cross-sectional design was applied. Online self-reported questionnaires were completed by 126 nurses. The analysis consisted of descriptive statistics, Pearson r correlation and hierarchical multiple regression to address the research aim. RESULTS: Job satisfaction moderately correlated with structural empowerment (r = .40, p < .001) and professional governance (r = .30, p < .001). The final regression model revealed that 30% of the variation in job performance scores can be predicted by professional governance, structural empowerment and some demographic characteristics (R2 = .30, F = 8.67, p < .001). CONCLUSIONS: Working in an environment that incorporates empowerment conditions, genuine support and valuable opportunities will increase the nurse's job satisfaction. Additionally, nurses will have higher job satisfaction if they have their voices heard. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should properly assess the existing situation in each institution, implement already-tested-for-effectiveness and efficiency interventions and create new ones based on nurses'-specific needs.

A study of the relationship between nurses' experience, structural empowerment, and attitudes toward computer use.

OBJECTIVE: This study examined the relationship between structural empowerment and nurses' experience and attitudes toward computer use. METHODS: This study was conducted using a cross-sectional quantitative design. A total of 184 registered nurses from four hospitals in Jordan participated in the current study. Data were collected using a demographics questionnaire, the Conditions for Work Effectiveness Questionnaire-II (CWEQ-II), and the Pretest for Attitudes toward Computers in Healthcare (PATCH). RESULTS: The median of experience in years among nurses was 5.0, ranging from one to 26 years. The mean score for the attitudes toward computer use was 61.90 ± 11.38. Almost half of the participants, 45.11%, were in the category of "feel comfortable using user-friendly computers." The participants' mean average of the total structural empowerment was 12.40 ± 2.43, and the values for its four subscales were: opportunity 3.57 ± 0.87, resources 2.83 ± 0.85, information 3.06 ± 0.79, and support 2.95 ± 0.86. The frequencies analysis revealed that most participants had a moderate level of empowerment (n = 127, 69.02%). The bivariate correlation between nurses' experience and attitudes toward computer use was significant (r = -0.17, P < 0.05). The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak (r = 0.20, P < 0.01). CONCLUSION: The results indicated that more experienced nurses are more reluctant toward computer use. However, creating an empowering work environment can facilitate nurses' attitudes toward computer use.

Reliability and validation of the Arabic version of the Conditions for Workplace Effectiveness Questionnaire-II.

OBJECTIVE: This study aimed to examine the psychometric properties of the Conditions for Workplace Effectiveness Questionnaire-II-Arabic Version (CWEQ-II-AV), which measures structural empowerment among nurses. To enhance the usability and credibility of the CWEQ-II among researchers within Arabic-speaking countries, a valid and reliable Arabic version of the measure is necessary. METHODS: A cross-sectional research design was used. From December 2018 to June 2019, 275 nurses working in 4 hospitals participated in the study. Reliability was assessed by examining internal consistency and split-half reliability. A confirmatory factor analysis was performed to evaluate the factor structure of the CWEQ-II-AV. RESULTS: The psychometric properties of the CWEQ-II-AV were excellent regarding the six-factor model (opportunity, information, resources, support, formal power, and informal power). The results showed the following fit indices meet the criteria set a priori: comparative fit index (CFI) = 0.96, root mean square of error approximation (RMSEA) = 0.06, and χ 2/df = 2.08. Cronbach's α coefficient was 0.95 for the total questionnaire and ranged between 0.83 and 0.89 for the individual subscales. The split-half reliability was 0.91 for the total questionnaire and ranged from 0.83 to 0.87 for individual subscales. CONCLUSION: This study provides evidence that CWEQ-II-AV is both a reliable and valid measure of structural empowerment among Arab nurses.

Structural empowerment, formal and informal power, and job performance quality: A moderated mediation analysis.

AIM: To explore complex relationships among structural empowerment, formal power and informal power in predicting job performance quality. BACKGROUND: Job performance is a major determinant of organisations' progress towards their goals and providing quality care. Job performance quality is an aspect of job performance and complex phenomenon that requires a more in-depth understanding of complex relationships predicting its quality in nurses. METHODS: This was a cross-sectional quantitative study. Participants were 195 nursing staff providing direct patient care in four hospitals in Jordan. Hayes process was used to examine moderated mediation relationship predicting job performance quality. RESULTS: The proposed model in this study explained 86% of the variance in job performance quality. The results showed that structural empowerment effect on job performance quality was significant for direct and indirect paths. However, those effects varied at different levels of informal power. CONCLUSION: This study suggested that the relationship between structural empowerment and job performance quality was none linear. IMPLICATIONS FOR NURSING MANAGEMENT: This study stresses the importance of considering complex relationships in promoting job performance quality. Understanding the nonlinear relationship between structural empowerment and job performance quality is expected to help nursing researchers, administrators and policymakers promote job performance quality.

Prevalence of medical errors and barriers to report among nurses and nursing students in Jordan: A cross-sectional study.

BACKGROUND: Medical errors (MEs) are serious but preventable threats to patient safety. Annually, 421 million hospitalizations take place worldwide, from those an estimation of around 43 million MEs occur. Low-middle income countries account for two-thirds of these MEs. AIM: To examine the prevalence and contributing factors predicting MEs and its reporting among Jordanian nurses and nursing students. METHODS: The study used a cross-sectional descriptive design. A total of 178 nursing students and 123 bedside nurses participated in this study. Study data were collected through a five-section newly developed survey. RESULTS: MEs are highly prevalent in Jordanian hospitals. More than 70% of nurses and nursing students have no previous training in preventing and reporting MEs. The most prevalent type of MEs were related to changing positions for bedridden patients followed by medication errors, iatrogenic infections, and falls. Staff shortage was the main cause of MEs from participants' perspectives. CONCLUSION: A central concern of these results is the need for providing effective programs on identifying and preventing MEs in health-care settings and integrate these programs into graduate nursing curriculums. Strategies should be implemented to establish electronic systems that are accessible, confidential, and a time-saver to enhance reporting MEs.

The role of structural empowerment in predicting computer use among Jordanian nurses: A cross-sectional study.

AIM: The study aimed to examine the relationship between structural empowerment and attitudes towards computer use among nurses. BACKGROUND: Empowering organizational structure is a significant factor affecting employees' attitudes and behaviours towards using organizational resources. Health information technologies were proven to improve health care quality. No previous studies examined the relationship between structural empowerment and attitudes towards computer use. METHODS: A cross-sectional correlational design was used. Self-reported questionnaires were completed by 200 Jordanian nurses. Descriptive statistics, Pearson r correlation and linear regression analyses were used to address the research aim. RESULTS: Structural empowerment was significantly and positively associated with attitudes towards computer use. Dimensions in structural empowerment that predict positive attitude towards computer use were access to opportunity (ß = 0.382, p = .000), formal power (ß = -0.252, p = .006) and informal power (ß = 0.176, p = .046). CONCLUSIONS: Strengthening access to empowerment structures is essential to increase nurses' work efficiency. Improving empowering structures can be achieved by enhancing opportunities to increase professional knowledge and skills towards computerization. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should promote work conditions that motivate nurses towards positive recognition of innovation through efficient collaborations with the information technology teams.

Identifying the nurse characteristics that affect anticipated turnover.

BACKGROUND: Nurse turnover is a prevalent and serious issue in Jordan, with many nurses leaving their jobs to search for better opportunities outside the country. It is therefore important to assess anticipated nurse turnover and the factors that may affect this, to prevent the costly and unnecessary loss of staff. AIM: To assess anticipated nurse turnover and its predictors, and to compare these between public and university-affiliated (teaching) hospitals. METHOD: A descriptive, cross-sectional and comparative design was used. Anticipated nurse turnover was measured using the Anticipated Turnover Scale, which consists of 12 items related to a nurse's intention to leave their job that are rated using a seven-point Likert-scale. Questionnaires were distributed to 280 nurses from three public hospitals and one university-affiliated hospital in the north of Jordan. Data were analysed using descriptive statistics, multiple regression and independent t-tests. RESULTS: Questionnaire responses were received from 250 nurses, yielding a response rate of 89%. This study identified that 68% of respondents intended to leave their job. Being older, more experienced and with a higher level of education increased the likelihood of nurse turnover. Nurses working in the university-affiliated hospital had a higher intent to leave compared with those working in public hospitals. CONCLUSION: This study found that a high proportion of nurses working in hospitals in the north of Jordan were considering leaving their jobs, and nurses' characteristics had a significant role in determining anticipated turnover. The results of this study could provide policymakers and stakeholders in Jordan with guidance to develop policies and retention programmes that could improve nurses' work environment and reduce turnover.

Nursing Empowerment: How Job Performance Is Affected by a Structurally Empowered Work Environment.

OBJECTIVE: The purpose of this study is to investigate the level of structural empowerment and explore its relationship with job performance among nurses. BACKGROUND: Empowered nurses display more authority and an awareness of the accomplishment of their contribution to organizational goals. METHODS: A cross-sectional study was conducted with a convenience sample of nurses in 4 hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS: A total of 195 nurses responded to the questionnaires, including 88 males (45.1%) and 107 females (54.9%). Overall, participants perceived their work environment to be moderately empowering. There is a significant positive correlation between structural empowerment and job performance. CONCLUSIONS: Highly empowered nurses display higher performance than less empowered nurses. Nurse managers must create an empowering work environment that supports nurses' job performance positively through structural empowerment. Applying structural empowerment in the work setting is crucial for ensuring the highest quality of patient care, improving nurses' performance, and reaching the organizational goals.

The relationship between occupational stress, psychological distress symptoms, and social support among Jordanian healthcare professionals.

Occupational stress is a major problem for healthcare providers, with some professionals experiencing higher numbers of stressful situations than others. Although it is difficult to eliminate stress in professionals' daily lives, providing social support can lower psychological distress symptoms. This study aims to investigate the relationship between occupational stress and social support, and the effects of social support on psychological distress symptoms of healthcare professionals. A cross-sectional descriptive design was utilized. Self-administered questionnaires were completed by a convenience sample of 211 participants (physicians, nurses, and pharmacists) from a Jordanian hospital. Bivariate analyses were used to examine the relationships between the study variables. Multiple regression analyses were used to determine if occupational stress, demographic characteristics, and social support predict depression, anxiety, and stress. Results showed that healthcare professionals with more social support showed less depression than those with a lower score of social support. Females had higher scores of depression and anxiety than males. Pharmacists had significantly higher occupational stress than both nurses and physicians. Occupational stress negatively influences healthcare professionals' mental health. To improve the productivity and psychological wellbeing of healthcare professionals, occupational stress should be diminished by implementing effective management approaches to facilitate social support for healthcare professionals.

Effect of nurse managers' leadership styles on predicted nurse turnover.

BACKGROUND: Predicting nurse turnover is important to prevent expensive and avoidable staff loss. One factor that may influence nurse turnover is nurse managers' leadership styles. Three main leadership styles have been identified: transactional, in which leaders give contingent rewards; transformational, in which leaders inspire and motivate; and passive-avoidant, in which leaders are absent. AIM: To assess the effect of nurse managers' leadership styles on predicted nurse turnover in Jordanian hospitals. METHOD: A descriptive, cross-sectional, and correlational study design was used. The Multifactor Leadership Questionnaire (MLQ-5X) was used to assess nurses' perceptions of their nurse managers' leadership styles, while the Anticipated Turnover Scale was used to assess nurses' intention to leave the job. The questionnaires were distributed to 280 nurses in three public sector hospitals and one university-affiliated (teaching) hospital in the north of Jordan. RESULTS: Responses were received from 250 nurses working in a variety of clinical areas, yielding a response rate of 89%. The respondents perceived that the transactional leadership style was the most common among their nurse managers, followed by the transformational style and passive-avoidant style. It was also identified that, on average, respondents had a slight intention to leave their jobs. The transformational leadership style was found to reduce predicted nurse turnover, while the passive-avoidant and transactional leadership styles had no significant effect on this. CONCLUSION: Understanding the effect of nurse managers' leadership styles on predicted nurse turnover may improve retention. Therefore, nurse managers should undertake training programmes on effective leadership to improve nurses' job satisfaction and reduce turnover.

The effectiveness of early position change postcardiac catheterization on patient's outcomes: A randomized controlled trial.

BACKGROUND: Nurses play a substantial role in maintaining patient homeostasis postcardiac catheterization. Patients frequently complain of back pain and discomfort as a result of the prolonged bed rest postcatheterization. AIM: This study aims to evaluate the effectiveness of early position change postcardiac catheterization on reducing patients' pain and discomfort. SETTINGS: The study was conducted at two cardiac units in a university hospital in Jordan. PARTICIPANTS: A total of 120 patients were used in the study, 60 patients in each of the two groups-control and intervention. METHODS: The randomized controlled trial design was used. Data were initially collected 1 hour after sheath removal postcardiac catheterization. After that, the protocol was applied to the interventional group. RESULTS: Early position change 1 hour after sheath removal after cardiac catheterization was found to be effective in reducing back pain as compared with the control group (P < .001). Also, the study intervention was found to be effective in reducing urinary discomfort (X2 = 50.83, P < .001), and increasing comfort level (X2 = 120, P < .001). However, although participants in the intervention group were less likely to have constipation and hematoma than those in the control group, this outcome was not statistically significant at P > .05. CONCLUSION: Early position change 1 hour after sheath removal postcardiac catheterization has significant positive effects on patient outcomes by reducing the intensity of back pain and urination problems and increasing patients' comfort level without increasing incidents of vascular complications such as bleeding and hematoma.