Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review.

Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.

Workplace barriers and facilitators to nurses' healthy eating behaviours: a qualitative systematic review.

BACKGROUND: Globally, nurses and midwives have a higher rate of being overweight/obese than the general population, influenced by workplace environments that impact dietary habits. OBJECTIVE: This systematic review aimed to identify barriers/facilitators to healthy eating among nurses in clinical settings. DESIGN: This systematic review followed Joanna Briggs Institute's guidelines for qualitative systematic reviews. METHODS: Eight electronic databases: PROQUEST CENTRAL, SCIENCEDIRECT, MEDLINE, CINAHL, PsycINFO, WEB SCIENCE, PUB MED, and SCOPUS were searched. Articles were screened using JBI SUMARI®, and quality assessment was done using the JBI critical appraisal checklist. Data were extracted using the JBI data extraction tool. RESULTS: Nine qualitative studies were reviewed, involving 488 nurses, concluding 37 distinct findings. Two synthesised findings emerged: barriers, and facilitators to healthy eating, related to organisational (shift work/long working hours), personal, physical workplace environment, and social factors. CONCLUSIONS: The review emphasises the necessity of promoting attainable healthy eating practices at organisational, personal, environmental, and social levels within the workplace. REGISTRATION: PROSPERO International prospective register of systematic reviews, ID: CRD42022309259.

The lived experiences of nurse preceptors in training new nurses in Qatar: qualitative study.

BACKGROUND: The role of preceptors is vital in the successful integration of new graduate nurses in hospital settings. This study aimed to explore the experiences of nurse preceptors in training newly joined nurses in Qatar. METHODS: Qualitative study was conducted between May 2022 and May 2023. Online semi-structured interviews were conducted through MS Teams with 13 nurse preceptors who had completed preceptorship training and trained at least one newly joined nurse. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis. RESULTS: The results of the study revealed several main themes: teaching strategies and progressive skill development in preceptorship, challenges faced by the preceptor and preceptor better supported in training new nurses. The preceptors utilized different techniques to support new nurses including demonstration, discussion, use of technology, application of real-life clinical scenarios, simulations, and a gradual decrease in supervision to promote independence. However, a significant challenge was also reported including preceptors experienced high levels of exhaustion from the dual responsibilities of training new staff while also performing their regular care duties. CONCLUSIONS: The study underscores the fundamental role preceptors play in the training and development of newly joined nurses. While the challenges are considerable, particularly related to managing workload, the sense of achievement following the successful completion of training a new nurse suggests a strong commitment to this role. Despite the challenges, preceptors demonstrated innovative strategies to ensure the successful development of their preceptees, highlighting the importance of preceptorship in nursing education and practice.

Unveiling final-year students and new graduates' concerns, preparedness, and learning experiences during the pandemic in Qatar: A cross-sectional survey.

Background: The emergence of COVID-19 interrupted education worldwide and educational institutions were forced to switch to an online learning (E-learning) environment. Objectives: To explore the perceived educational experiences, worries, and preparedness to enter clinical practice among final-year nursing students and new graduate nurses after studying during the COVID-19 pandemic. Design: A cross-sectional survey design. Setting: and participants: An online survey of final-year undergraduate bachelor of nursing students at a single university in Qatar and new graduates across 14 health facilities in Qatar was undertaken between May 2022 and July 2022. Methods: Participant demographics, experiences of E-learning and perceptions of readiness for practice were collected using validated instruments and open-ended questions. Descriptive statistics and thematic exploration were used to analyze the data. Results: Fifty-nine final-year students and 23 new graduates with an average age of 23.95 years (SD = 3.89) responded to the survey. Face-to-face clinical placement learning was preferred by 50 % of students and 66.1 % of graduates. During COVID-19, the majority of the participants indicated that strategies like practice kits and online simulations were implemented. While 61 % of new graduates felt well-prepared in their nursing skills, and 87 % felt confident, less than half of the students still in their final year of education felt prepared or confident. Increased stress and a perceived impact on education quality were reported due to changes in learning modalities. Despite these challenges, 81.1 % of students and 95.7 % of graduates felt they had developed sufficient professional values, with most looking forward to becoming registered nurses. The qualitative themes that emerged related to 1) adjusting to online learning, 2) experiencing restrictions in clinical learning skills, 3) feeling less confident and 4) experiencing increased stress. Conclusions: Despite experiencing emotional and educational challenges, the participants in this study felt that their education prepared them for clinical practice. Innovative strategies and unique educational experiences used by educators enhanced participants' clinical skills and readiness for practice.

Assessment of nurse's perceived just culture: a cross-sectional study.

BACKGROUND: The non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses' perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT). METHODS: This descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust. RESULTS: The study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were "continuous improvement" dimension (88.44%), "quality of events reporting process" (86.04%), followed by "feedback and communication" (80.19%), and "openness of communication" (77.55%) The dimensions such as "trust" (68.30%) and "balance" (52.55%) had a lower positive perception rates. CONCLUSION: A strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame.

Development and validation of the Nursing Journal Club Perception Scale (NJCPS).

BACKGROUND: The Journal Club is an excellent platform for participants to engage in the critical evaluation of articles and the extraction of evidence to support evidence-based nursing practices. The study aims to develop and validate a reliable instrument, the Nursing Journal club perception scale (NJCPS), for assessing the perceived educational value and the perception of virtual journal club experiences. MATERIALS AND METHODS: The current study is a scale development and validation study. The scale-level content validity indices (S-CVI) and item-level content validity indices (I-CVI) were assessed by eight experts. Eleven experts from various nursing fields evaluated the instrument regarding its relevance, clarity, meaningfulness, and completeness. Finally, the scale was introduced to 90 clinical nurses from two facilities to assess the internal consistency during the period of March- April 2022. RESULTS: The content validity of the scale S-CVI/average and S-CVI/UA was 0.97 and 0.86, respectively, which indicates adequate relevance of the questionnaire content. Principal component analysis indicated that the construct validity of the perceived educational value and the perception of the virtual journal club domain was 67.8% and 66.5%, respectively. In the two domains of the perception of educational value (supporting clinical practice and supporting research), Cronbach's Alpha was 0.93 and 0.91, respectively. Similarly, for the two domains of virtual JC (learning experience and benefits of virtual journal club)), Cronbach' Alpha was 0.95 and 0.74, respectively. CONCLUSIONS: The NJCPS tool is a valid and reliable scale to measure the educational value and virtual journal club experience of the participants from various fields of healthcare.

Nurses' self-esteem, self-compassion and psychological resilience during COVID-19 pandemic.

AIM: This study aimed to identify self-esteem, self-compassion and psychological resilience among staff nurses during the COVID-19 pandemic in Qatar. DESIGN: Descriptive cross-sectional survey design. METHODS: The study was conducted on January 2022 (during the third wave in Qatar). Anonymous data were collected through an online survey using Microsoft forms from 300 nurses in 14 health facilities in Qatar. Socio-demographic information, Connor-Davidson Resilience Scale, Rosenberg Self-Esteem Scale and Self-Compassion Scale-Short Form were used to collect the data. Correlation, t-test and ANOVA analyses were conducted. RESULTS: Participants expressed a high level of resilience, self-esteem and self-compassion. Resilience scores were positively and significantly correlated with self-esteem and self-compassion. The education level of nurses was a statistically significant contributing factor to self-esteem and resilience.

Leadership styles and transformational leadership skills among nurse leaders in Qatar, a cross-sectional study.

AIM: There is a continuing need to implement strategies that create opportunities to develop leadership in Qatar, and to build institutions that can produce effective health managers and leaders. The scarcity of information and studies relating to leadership in this major healthcare corporation must be addressed. This article aims to explore nursing leadership styles and transformational leadership skills among nursing leaders, in Qatar. The study was conducted from October 2020 to January 2021. DESIGN: A cross-sectional Study. METHODS: A validated survey was administered to explore the prevalence of leadership styles and transformational leadership skills. Subsequent statistical data analysis achieved the research objectives. The Multi-Factor Leadership Questionnaire (Western Journal of Nursing Research, 1996) was used as an online de-identified validated questionnaire. RESULTS: Eighty-nine nurses completed the survey. The nurse leaders in this study exhibited leadership traits or qualities that confirm transformational leadership. Some nurse leaders also exhibited transactional and autocratic leadership styles. Directors of nursing exhibit higher levels of transformational leadership style than head nurses, while the latter is more likely to manifest an autocratic leadership style. This study indicates that a development roadmap is needed to transform more nursing leaders into transformational leaders, particularly head nurses, and to universally improve transformational leadership skills among all nursing staff members.

The improvement in research orientation among clinical nurses in Qatar: a cross-sectional study.

BACKGROUND: The main barrier to engaging nurses in research is the lack of research knowledge and skills. AIM: To explore the influence of research workshops on the research orientation of nurses in a large referral hospital in Qatar. DISCUSSION: This article describes a cross-sectional study involving 564 nurses working in 14 health facilities who attended research workshops in Qatar. The authors collected data using the Edmonton Research Orientation Survey (EROS) as well as questions considering support and barriers to research. Descriptive statistics were used to summarise and determine the sample characteristics and distribution of participants. The participants who attended the workshop were found to have a higher orientation towards the EROS sub-scales of evidence-based practice, valuing of research, involvement in research, being at the leading edge of the profession and support for research, compared to those who did not attend the workshop. There was no statistical difference between the groups in the research barrier sub-scale. CONCLUSION: Despite significant improvements in their responses to the EROS research orientation sub-scales after attending the workshop, the nurses still reported many barriers to being actively engaged in research. IMPLICATIONS FOR PRACTICE: Healthcare organisations should assist with integrating evidence-based practice into healthcare. There is a need for research education for clinical nurses to bring evidence into clinical practice to improve the quality of patient outcomes. Increasing the research capacity of nurses will lead to their emancipation in addressing the flaws in clinical practice and motivate them to use evidence in patient care.

The nurses perceived educational values and experience of journal club activities - A cross-sectional study in Qatar.

BACKGROUND: Journal club (JC) is widely used as an educational method to support nurses in up-to-date clinical practices, acquire critical appraisal skills, and promote evidence-based nursing practice. Traditionally, JC activities were conducted as face-to-face sessions. However, after the emergence of the pandemic, many educational activities including JC turn to the online platform. This study aims to assess the perceived educational value of JC and the experience of virtual journal club (VJC) among nurses. MATERIALS AND METHODS: A cross-sectional research design was used to gather the information from the nurses using the Nursing journal club perception scale. A purposive sampling method was used to enroll 450 participants from the JC attendees of various facilities between May andAugust 2022. The data were analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. RESULTS: The data from 450 participants were analyzed with a response rate of 40.1%. The majority of the participants were females (82.4%) and belonged to the 35-44 years' age group (39.6%). Mostly, the subjects were registered nurses or midwives (78%) and had more than 5 years of clinical experience (45.8%). The mean perceived educational value of JC and VJC was 62.9 ± 8.3 and 56.3 ± 8.9, respectively. The nurse educators are holding higher educational value of JC as compared to other participants including clinical nurses, charge nurses, head nurses, and director of nurses (P = 0.03). Additionally, 90% of participants strongly agreed that the nursing journal club helps them to disseminate and reinforce evidence-based practice, update their clinical knowledge, and was very informative. Furthermore, 80% of participants agreed that educational standards, social networking, and time allocation of the VJC are enhancing the chance of attending more sessions. CONCLUSION: The JC has a vital role in preparing nurses for promoting research culture and practicing evidence-based nursing care. The national health strategies are focused on improving research capabilities and enhancing research within the national context. The implementation of evidence-based practice in healthcare involves enhancing formal research opportunities, promoting continuing education in research, developing skills in addressing research gaps, and enhancing research-oriented cultures in healthcare facilities. The nursing leadership can play a key role to support the initiatives to develop and conduct nursing JC in their facilities to improve the nurse's research skills and evidence-based nursing practice.

The impact of COVID-19 on nurses' job satisfaction: a systematic review and meta-analysis.

Background: The global healthcare landscape was profoundly impacted by the COVID-19 pandemic placing nurses squarely at the heart of this emergency. This review aimed to identify the factors correlated with nurses' job satisfaction, the impact of their job satisfaction on both themselves and their patients, and to explore strategies that might have counteracted their job dissatisfaction during the COVID-19 pandemic. Methods: The Joanna Briggs Institute (JBI) methodology for systematic reviews of prevalence and incidence was used in this review. The electronic databases of CINAHL, MEDLINE, SCOPUS, PsycINFO and Academic Search Complete were searched between January 2020 to February 2023. Results: The literature review identified 23 studies from 20 countries on nurses' job satisfaction during the COVID-19 pandemic. A pooled prevalence of 69.6% of nurses were satisfied with personal, environmental, and psychological factors influencing their job satisfaction. Job satisfaction improved psychological wellbeing and quality of life, while dissatisfaction was linked to turnover and mental health issues. Conclusion: This systematic review elucidates key factors impacting nurses' job satisfaction during the COVID-19 pandemic, its effects on healthcare provision, and the potential countermeasures for job dissatisfaction. Core influences include working conditions, staff relationships, and career opportunities. High job satisfaction correlates with improved patient care, reduced burnout, and greater staff retention. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023405947, the review title has been registered in PROSPERO and the registration number is CRD42023405947.

Prevalence of Multimorbidity in the Middle East: A Systematic Review of Observational Studies.

BACKGROUND: There has not been a review that evaluated the prevalence of multimorbidity in the Middle East. This review aims to measure the prevalence, demographic factors, and consequences of multimorbidity in the Middle East region. STUDY DESIGN: A quantitative systematic review includes cross-sectional and longitudinal cohort studies. METHODS: The prevalence systematic review approach from the Joanna Briggs Institute was applied. We searched PsychINFO, MEDLINE, EMCARE, CINAHL, Scopus, Science Direct, and the Cochrane Central Register of Controlled Trials. Data were extracted methodically in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Studies written in English and released between 2012 and March 2022 were included. For the meta-analysis, a random-effects model was applied. PROSPERO registration number: CRD42022335534. RESULTS: The final sample consisted of eight cohort and observational studies. The number of participants varied from 354 to 796,427. Multimorbidity was present in all populations with a prevalence of 21.8% (95% confidence interval (CI): 21.7-21.8%). CONCLUSION: Multimorbidity affects a significant section of the world's population. A uniform operationalization of multimorbidity is required in the Middle East in order to enable reliable estimates of illness burden, effective disease management, and resource distribution.

Sexual experiences of cancer survivors: A qualitative study in Jordan.

BACKGROUND: In Jordan, cancer is the second leading cause of death after cardiac disease. The impact of cancer on sexual relationships is a taboo subject and hence, such issues are underreported research among Jordanian people examining unmet needs. AIM: To examine the experiences and preferences of Jordanian cancer survivors related to communication regarding their sexual needs. METHODS: Qualitative study conducted between May and June 2020 using semi-structured face-to-face interviews using the snow-balling approach for recruitment. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis. RESULTS: Analysis of participants' interview data identified three main categories: 1) The psychological impact of cancer of sexual relationships; 2) Physician support; 3) Variations in sexual life and sexual experiences. CONCLUSION: The study revealed that there is a substantial psychological impact of cancer on sexual relationships among Arab Jordanian cancer survivors. Feeling powerless, being labelled as 'sexually disabled', and lack of communication with physicians were emphasized by participants as a barrier to discuss sexual needs with their physicians. Lack of physicians support negatively impact Jordanian cancer survivors sexual experience and led to increased their sense of powerlessness and loss of control over sexual relationships. IMPLICATIONS FOR PRACTICE: Overall, the study indicated a crucial need for physicians to encourage patients to disclose their sexual experience to help them maintain their sexual and mental health while in the fight against cancer. The physicians, nurses and allied health professionals should be engaged in the conversation with patients by taking an active role in the discussion. Additionally, the family and partners of the patients should also be approached and engaged by health professionals in the discussion to address their needs or sexual issues.

Medication Adherence Rate in Arab Patients With Cardiovascular Disease: A Systematic Review.

BACKGROUND: Cardiovascular disease (CVD) is one of the most common chronic illnesses in the Eastern Mediterranean. There have been few studies on medication adherence in Arab patients with CVD. AIM: To investigate the rates and the reasons for medication adherence in Arab patients with CVD. METHODOLOGY: The Joanna Briggs Institute methodology for prevalence systematic reviews was used. MEDLINE, EMCARE, CINAHL, Scopus, Science Direct, PsychINFO, and the Cochrane Central Register of Controlled Trials were searched. RESULTS: Thirteen quantitative studies on medication adherence in Arab adult CVD patients were included.Pooled data from nine studies demonstrated that 53.2% (95% confidence interval = [51.2%, 55.1%]) of patients were adherent to their medications. Reasons for nonadherence to medication include personal factors, understanding, and complexity of treatment regimes, medication knowledge and structural barriers. CONCLUSION: Medication adherence appears to have a social gradient, and families should be actively involved in future strategies to increase medication adherence.

The Adherence to Healthy Lifestyle Among Arab Patients With Cardiovascular Disease: Mixed-Method Review.

INTRODUCTION: Cardiovascular disease (CVD) accounts for 25% to 45% of deaths among Arab people. The purpose of this review was to investigate the level, predictors, motivators, and barriers to adherence to lifestyle recommendations among Arab patients with CVD. METHOD: A systematic search of the literature was conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMCARE, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched. Studies that explored adherence to a healthy lifestyle among Arab adult patients with CVD were included. RESULTS: Twelve studies were included. Quantitative results showed low adherence among Arab people with CVD. Qualitative synthesized results revealed that internal motivators, personal desire as well as structural drivers impact the patient's ability to adhere to a healthy lifestyle. DISCUSSION: Multidimensional solutions that consider religion and culture and include active involvement of families are required to improve adherence.

Understanding the support needs of Australian nursing students during COVID-19: a cross-sectional study.

Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed.Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework.Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis.Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching.Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises.Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.

Generational differences in psychological wellbeing and preventative behaviours among nursing students during COVID-19: a cross-sectional study.

BACKGROUND: Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations. METHOD: A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey. RESULTS: An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19. CONCLUSION: Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events. IMPACT STATEMENT: Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.

COVID-19: Knowledge, anxiety, academic concerns and preventative behaviours among Australian and Indian undergraduate nursing students: A cross-sectional study.

AIMS AND OBJECTIVES: To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID-19 pandemic. BACKGROUND: Based on the World Health Organization's direction for containment of the novel coronavirus (COVID-19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education. METHODS: Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID-19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data. RESULTS: Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID-19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID-19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD-1.08; 95% CI -1.94, -0.23). Australian students reported significantly higher levels of anxiety (MD 1.99 95% CI 1.21, 2.78), difficulty sleeping (OR 18.00; 95% CI 6.76, 47.96), concentrating (OR 33.22; 95% CI 13.85, 79.67) and eating (OR 14.05; 95% CI 3.19, 61.84). Greater number of Australian students indicated that they would go to the University if they needed to meet with other students (OR 9.21; 95% CI 3.08, 27.55), had to access the library (OR 7.20; 95% CI 3.26, 15.90) or had a group assignment (OR 2.93; 95% CI 1.26, 6.77). CONCLUSIONS: Wide variations were present in knowledge, anxiety, academic concerns and preventative behaviours among undergraduate nursing students in two countries. RELEVANCE TO CLINICAL PRACTICE: Undergraduate students may benefit from additional support from the University and staff in the clinical setting with online learning and resources in order to adjust to the 'new normal' and enable them to achieve academic success.

Effectiveness of Clinical Nurses' interventions in reducing medication errors in a paediatric ward.

AIMS AND OBJECTIVES: To evaluate a bundle of interventions, developed and implemented by nurses, to reduce medication administration error rates and improve nurses' medication administration practice. BACKGROUND: Medication administration errors are a problematic issue worldwide, despite previous attempts to reduce them. Most interventions to date focus on isolated elements of the medication process and fail to actively involve nurses in developing solutions. DESIGN: An Action Research (AR) three-phase quantitative study. METHODS: Phase One aimed to build an overall picture of medication practice. Phase Two aimed to develop and implement targeted interventions. During this phase, the research team recruited six clinical paediatric nurses to be part of the AR Team. Five interventions were developed and implemented by the clinical nurses during this phase. The interventions were evaluated in Phase Three. Data collection included medication incident data, medication policy audits based on hospital medication policy and Safety Attitudes Questionnaire. Quantitative analysis was undertaken. The Standards for QUality Improvement Reporting Excellence (SQUIRE) checklist was followed in reporting this study. RESULTS: Postimplementing the interventions, medication error rates were reduced by 56.9% despite an increase in the number of patient admissions and in the number of prescribed medications. The rate of medication errors per 1,000 prescribed medications significantly declined from 2014 to 2016. The ward nurses were more compliant with the policy in postintervention phase than preintervention phase. The improvement in SAQ was reported in five of the seven domains. CONCLUSION: Clinically based nurse's participation in action research enabled practice reflection, development and implementation of a bundle of interventions, which led to a change in nursing practice and subsequent reduction in medication administration error rates. Active engagement of nurses in research empowers them to find solutions that are tailored to their own practice culture and environment.

Action research: A mechanism for active engagement of clinical nurses in a program of research.

This study aimed to explore the outcomes of active participation in an action research project on building the research capacity of clinical nurses. In this qualitative research study, six registered nurses volunteered to participate in the action research team. None of the nurses reported having any prior research experience. This study was part of a larger three-phase project. The nurses were required to reflect on the data about their medication practice of phase 1, develop and implement a bundle of interventions in phase 2 to improve medication safety, and evaluate the effectiveness of these interventions in phase 3. We report the nurses' participation in Action Research during phase 2. Meeting minutes and six semistructured interviews were thematically analyzed. The results showed that after receiving support to enhance their research skills from the research team, the nurses were empowered to perform and lead clinical nursing research project. Nurses were able to take ownership of the research process and outcomes and were then able to translate their new research knowledge and skills into their clinical practice by building their own research capacity.