Surgical counting interruptions in operating rooms.

BACKGROUND: Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions. METHODS: A retrospective observational study was carried out to examine the occurrence of the first surgical counting interruptions between 1st August 2023 and 30th September 2023. The data were collected using the "Surgical Counting Interruption Event Form", which was developed by the researchers specifically for this study. RESULTS: A total of 66 circulating nurses (CNs) and scrub nurses (SNs) were observed across 1015 surgeries, with 4927.8 min of surgical count. The mean duration of the first surgical count was 4.85 min, with a range of 1.03 min to 9.51 min. In addition, 697 interruptions were identified, with full-term interruptions occurring an average of 8.7 times per hour. The most frequent source of interruption during the first surgical counts was instruments (N = 144, 20.7%). The first surgical counting interruptions mostly affected the CN (336 times; 48.2%), followed by the ORNs (including CNs and SNs) (243 times; 34.9%) and the SN (118 times; 16.9%). Most of the outcomes of interruptions were negative, and the majority of the nurses responded immediately to interruptions. CONCLUSIONS: The frequency of the first surgical counting interruption is high. Managers should develop interventions for interruptions based on different surgical specialties and different nursing roles.

Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic.

BACKGROUND: According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). METHODS: A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal-Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. RESULTS: There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. CONCLUSIONS: Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses' well-being based on their experience and the needs of specific practice areas.

Association between organizational justice and serious psychological distress among hospital nursing staff during the COVID-19 pandemic: A cross-sectional study.

AIM: Amidst the COVID-19 pandemic, the association between organizational justice and psychological distress among hospital nursing staff is underexplored. Thus, this cross-sectional study, conducted in Fukuoka Prefecture, Japan, examined the relationship between organizational justice and serious psychological distress (SPD) among hospital nursing staff during COVID-19. METHODS: The study surveyed 783 hospital nursing staff using the Organizational Justice Questionnaire and Effort-Reward Imbalance Questionnaire. The Kessler K6 scale was used to measure SPD. Sociodemographic and occupational characteristics were controlled for as potential confounders. RESULTS: The prevalence of SPD was 14.4%, with a mean K6 score of 6.5. Moderate procedural justice (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.14-4.94, p = .021) and low distributive justice (effort-reward imbalance) (OR = 3.66, 95% CI = 2.01-6.67, p < .001) were associated with SPD, even after adjustment for confounders. Interactional justice showed significance only in the crude model. Effort-reward imbalance had the strongest association with SPD. CONCLUSIONS: The findings showed that moderate procedural justice and low distributive justice were associated with SPD, highlighting the need for organizational interventions to address these factors. Imbalances in effort/reward had the greatest impact, highlighting the critical role of distributive justice in mental health. Thus, in the context of a pandemic, extreme procedural justice is not necessarily associated with mental health, and efforts to ensure distributive justice are critical to improving the mental health of hospital nursing staff. Moreover, organizational stressors should be addressed during disruptive conditions such as infectious disease outbreaks.

Nurses' compliance to standard precautions prior to and during COVID-19.

AIMS: To measure nurses' compliance with standard precautions during the COVID-19 pandemic, compare findings with previous assessments and describe the barriers affecting nurses' compliance. BACKGROUND: Healthcare providers' compliance with standard precautions is still limited worldwide. Implementation of infection control policies in hospitals is needed internationally, especially during a pandemic. Surprisingly, studies exploring nurses' compliance with standard precautions are lacking during COVID-19. METHODS: A multicenter cross-sectional study was adopted in two Italian hospitals. Nurses' compliance with standard precautions was measured through The Compliance with Standard Precautions Scale (Italian version). An open-ended question explored the barriers to nurses' compliance with standard precautions. Reporting, followed the STROBE guidelines. RESULTS: A total of 201 nurses were enrolled in 2020. Nurses' compliance with standard precautions was suboptimal. A statistically significant improvement in the compliance rate with standard precautions was observed between pre- and during COVID-19 assessments. High compliance was found in the appropriate use of surgical masks, gloves and sharps disposal. Nurses perceived personal, structural and organizational barriers to standard precautions adherence. CONCLUSION: Nurses' compliance with standard precautions was not 100%, and different factors impeded nurses to work safely. Our findings provide institutional leaders and educators with the basis for implementing policies to optimize nurse safety, well-being and patient care. IMPLICATIONS FOR NURSING AND HEALTH POLICIES: Nurses have the right to work safely, and when the shortage of personal protective equipment and nurses during an emergency threatens healthcare quality worldwide, policymakers are challenged to act by establishing an effective allocation of resources for consistent compliance with standard precautions. Moreover, nurses should actively engage in the implementation of infection control policies to improve safe behaviours among citizens and students accessing hospitals.

Percepción del personal de enfermería sobre la cultura y seguridad del paciente / Perception of the nursing staff about the culture and patient safety

Introducción: La seguridad del paciente es la disminución del riesgo en la presentación de lesiones, incapacidad o muerte en el cuidado asistencial. La complejidad de los sistemas de salud, el entorno laboral, las situaciones propias del paciente, la infraestructura de los hospitales predispone la presentación de eventos adversos (EA). Objetivo: Determinar la relación entre cultura de seguridad del paciente, las horas por semana trabajadas y los incidentes en el último año del personal de enfermería de un hospital público de segundo nivel de atención de la ciudad de Saltillo, Coahuila. Métodos: Descriptivo correlacional, muestra de 113 enfermeras (os). Recolección a través de un enlace digital, para el personal de enfermería que cumpla con los criterios de inclusión. Se aplicó cédula de datos sociolaborales y el instrumento Hospital Survey on Patient Safety Culture. El análisis fue con estadística descriptiva e inferencial. Resultados: La cultura de seguridad del paciente en la mayoría de las dimensiones carece de fortaleza, con oportunidad de mejora: expectativas y acciones de la dirección (60.8%), aprendizaje organizacional (68.1%), feed-back y comunicación sobre errores (58.9%) y solo el trabajo en equipo refiere fortaleza (76.3%). Dimensiones con menor puntuación: franqueza en la comunicación (42.4%), apoyo a la gerencia 42.7%, dotación de personal 37.8 y la respuesta no punitiva a los errores 35.9%. Conclusiones: Es importante tomar en cuenta esta información para que se planten y se desarrollen estrategias que permitan ofrecer una atención hospitalaria segura. La acción gerencial es importante en la continuidad de acciones de seguridad del paciente. (AU)

Introduction: Patient safety is the reduction of risk in the presentation of injury, disability or death during health care. The complexity of health systems, the work environment, the patient's own situations and the hospital infrastructure predispose to the occurrence of adverse events (AE). Objective: To determine the relationship between patient safety culture, hours worked per week and the incidents in the last year of the nursing staff of a second level public hospital in the city of Saltillo, Coahuila. Methods: Descriptive correlational, sample of 113 nurses. Collection through a digital link, for the nursing staff that met the inclusion criteria. A social and labor data questionnaire and the Hospital Survey on Patient Safety Culture instrument were applied. The analysis was based on descriptive and inferential statistics. Results: The patient safety culture lacks strength in most of the dimensions, with opportunities for improvement: management expectations and actions (60.8%), organizational learning (68.1%), feedback and communication about errors (58.9%) and only teamwork refers strength (76.3%). Lower scoring dimensions: openness in communication (42.4%), management support 42.7%, staffing 37.8 and non-punitive response to errors 35.9%. Conclusions: It is important to take this information into account so that strategies can be planted and developed to provide safe hospital care. Management action is important in the continuity of patient safety actions. (AU)

Patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis: A cross-sectional survey.

The study aimed at analyzing patients and nursing-related factors associated with switching from peritoneal dialysis to hemodialysis. A telephone survey with 574 patients receiving care at six peritoneal dialysis centers of the Mexican Institute of Social Security was conducted: 64.3% were on peritoneal dialysis, and 35.7% had transitioned from peritoneal dialysis to hemodialysis. Data were collected on participants' sociodemographic and clinical characteristics, peritoneal dialysis center size, and nursing workload. Descriptive, bivariate, and multiple Poisson regression analyses were performed. Factors associated with an increased probability of switching from peritoneal dialysis to hemodialysis were a history of catheter dysfunction, peritonitis, and being treated in a large peritoneal dialysis center with a low (<50 patients per nurse per month) or high nursing workload (>70 patients per nurse per month) located in the State of Mexico, compared to a medium-size peritoneal dialysis center with a moderate workload (50-70 patients per nurse per month). To decrease the odds of switching from peritoneal dialysis to hemodialysis, improvement programs should aim to limit nurses' workload to 50-70 patients per nurse per month and implement evidence-based nursing interventions to prevent, detect, and manage peritonitis and peritoneal catheter dysfunction.

Entorno laboral de enfermería en un hospital de Bogotá, 2022 / Nursing Work Environment at a Hospitalb in Bogota, 2022 / Ambiente de trabalho da enfermagem em um hospital de Bogotá, 2022

Introducción: La preocupación por el entorno laboral en enfermería se ha hecho aun mayor desde la pandemia Covid-19, que afectó la cantidad y calidad del personal de enfermería alrededor del mundo. Objetivo. Describir el entorno laboral de los enfermeros que desempeñan funciones asistenciales en un hospital de Bogotá, Colombia. Método: Estudio descriptivo exploratorio, con un componente correlacional. Se remitió el cuestionario ENLASA a todos los enfermeros asistenciales del hospital objeto de estudio a través de RedCapÒ. Resultados. El cuestionario completo fue respondido por el 50% de los enfermeros asistenciales (49 enfermeros) de la institución e invitados a participar en el estudio. El 57,1% de los respondientes consideró el entorno laboral no saludable. La dimensión de elementos estructurales se consideró no saludable (64,49/100), y la de procesos organizacionales como saludable (71,18/100). Las subdimensiones no saludables fueron, en estructura, la planeación del recurso de enfermería, (54,66/100) y políticas de recursos humanos (58,91/100) y en procesos, la interacción enfermero-organización (63,10/100) y autonomía (66,07/100). No se encontró asociación entre las variables sociodemográficas y el entorno laboral de enfermería. La única asociación estadísticamente significativa entre entorno laboral y resultados fue la relativa a la motivación para trabajar. (Phi 0,362, p=0,040). Conclusiones. Se sugiere intervenir las dimensiones y subdimensiones identificadas como no saludables, y continuar monitoreando este fenómeno.

Introduction: concern for the work environment in nursing has become even greater since the COVID-19 pandemic, which affected the quantity and quality of nursing personnel around the world. Objective: to describe the work environment of nurses performing care functions in a hospital in Bogota, Colombia. Method: exploratory descriptive study. The Enlasa -Nursing Questionnaire was sent to all the nurses in the hospital under study through RedCap. Results: 50% of the nurses (49 nurses) of the institution invited to participate in the study answered the complete questionnaire. The work environment was considered unhealthy by 57.1% of the respondents. The dimension of structural elements was seen as unhealthy (64.49/100), and that of organizational processes as healthy (71.18/100). The sub-dimensions considered unhealthy in structure were nursing resource planning (54.66/100) and human resources policies (58.91/100). With respect to processes were nurse-organization interaction (63.10/100) and autonomy (66.07/100). No association was found between sociodemographic variables and nursing work environment. The only statistically significant association between work environment and results was the one related to motivation to work (Phi 0.362, p=0.040). Conclusions: it is suggested to intervene in the dimensions and subdimensions identified as unhealthy and to continue monitoring this phenomenon.

Introdução: a preocupação pelo ambiente de trabalho dos enfermeiros tornou-se ainda maior desde a pandemia de COVID-19, que afetou a quantidade e qualidade do pessoal de enfermagem em todo o mundo. Objetivo: descrever o ambiente de trabalho dos enfermeiros que desenvolvem funções assistenciais em um hospital de Bogotá, Colômbia. Método: estudo descritivo exploratório. O questionário Enlasa-Enfermagem foi enviado a todos os enfermeiros assistenciais do hospital objeto de estudo através de RedCap®. Resultados: 50% dos enfermeiros assistenciais (49 enfermeiros) da instituição convidados a participar do estudo respondeu ao questionário completo. 57,1% dos entrevistados considerou o ambiente laboral não saudável. A dimensão de elementos estruturais foi vista como não saudável (64,49/100), e a de processos organizacionais como saudável (71,18/100). As subdimensões consideradas não saludáveis em estrutura foram planejamento do recurso de enfermagem (54,66/100) e políticas de recurso humano (58,91/100). Quanto aos processos, foram interação enfermeiro-organização (63,10/100) e autonomia (66,07/100). Não foi encontrada associação entre as variáveis sociodemográficas e o ambiente laboral de enfermagem. A única associação estatisticamente significativa entre ambiente de trabalho e resultados foi relacionada à motivação para trabalhar. (Phi 0,362, p=0,040). Conclusões: sugere-se intervir nas dimensões e subdimensões identificadas como não saudáveis e continuar monitorando esse fenômeno.

Characteristics of elderspeak communication in hospital dementia care: Findings from The Nurse Talk observational study.

BACKGROUND: Elderspeak communication is typically viewed as patronizing and infantilizing by older adults and can lead to resistive behaviors in persons living with dementia. Little is known about the presence of elderspeak communication in hospitals in the United States. Understanding this phenomenon in the hospital setting is needed in order to improve hospital dementia care. OBJECTIVES: The purpose of the Nurse Talk study was to (1) describe attributes of elderspeak use in hospital dementia care and to (2) determine what characteristics are associated with nursing staff use of elderspeak communication with hospitalized patients with dementia. DESIGN: A cross-sectional observational study design was used to collect and analyze audio-recordings of nursing staff during care for hospitalized patients with dementia. SETTING: Three hospital units in one Midwestern university hospital in the United States. PARTICIPANTS: A convenience sample of 53 staff nurses and nursing assistants that provided direct care to 16 patients with mild or more severe dementia recruited from October 2019 through mid-March 2020. METHODS: Eighty-eight care encounters were audio-recorded and coded for elderspeak communication using the Iowa Coding of Elderspeak scheme to determine the frequency and characteristics of elderspeak communication. A linear mixed effects model was used to determine what characteristics were associated with elderspeak and the frequency of elderspeak use by nursing staff to hospitalized patients with dementia. RESULTS: Over a quarter (28.7%) of all nursing staff speech directed towards patients with dementia constituted elderspeak and nearly all (96.6%) care encounters included some elderspeak. Particularly common attributes of elderspeak were minimizing words and mitigating expressions, childish terms and phrases, and collective pronoun substitution. A statistically significant interaction was identified between staff role and age (95% CI: -0.02, -0.00, p = .008) in predicting the frequency of elderspeak use, indicating that elderspeak was used more often by older staff nurses, whereas the age of nursing assistants remained constant across elderspeak use. Statically significant effects for delirium and length of stay were also demonstrated. Elderspeak use was 12.5% higher with patients with delirium (95% CI: 0.02, 0.23, p = .025) and increased 1.5% for each additional day the patient with dementia was hospitalized (95% CI: 0.00, 0.03, p = .035). CONCLUSIONS: Elderspeak is present and pervasive in the acute care setting. Interventions targeted towards older staff nurses and nursing staff from hospital units that care for patients with delirium and longer lengths of stay are needed. TWEETABLE ABSTRACT: This study identified that nursing staff are frequently using elderspeak (infantilizing speech) with hospitalized patients with dementia. @claireshaw_phd @IowaNursing.

Surgical nurses' responses to worry: A qualitative focus-group study in the Netherlands.

BACKGROUND: Hospital nurses observe and respond to deterioration using the 'National Early Warning Score 2'. Surgical nurses are highly engaged in the early recognition of and response to deterioration. Responses to deterioration are based on deviating vital signs, while nurses also act on subjective indicators like worry. Scientific literature and (inter)national guidelines do not mention any information about acting upon worry. OBJECTIVE: To gain an in-depth understanding of the actions nurses on surgical wards undertake to generate an appropriate response to nurses' worry when the 'National Early Warning Score 2' does not indicate deterioration. METHOD: A qualitative focus-group study with surgical nurses working at a hospital in the Netherlands. Data was collected by focus-group interviews supported by vignettes and analysed thematically. FINDINGS: Four focus-group interviews with a total of 20 participants were conducted between February and April 2020. Two sequential themes emerged: 'Searching for explanation and confirmation' and 'Responding by actively applying nursing interventions'. Nurses gathered additional information about the patient and searched for a reference point to place this information in perspective. Nurses also approached others for co-assessment and verification. However, nurses faced barriers in calling for medical assistance. They felt physicians did not take them seriously. After gathering additional information, nurses responded by applying nursing interventions to comfort the patient. CONCLUSION: Nurses mainly try to formalise an in-depth understanding of their feeling of worry to convince a physician to accurately treat the patient. Spending much time on a search to this understanding leads to delays in escalating care.

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.

Principales etiquetas diagnósticas enfermeras y diagnósticos médicos en una unidad hospitalaria de enfermedades infecciosas / Main nursing diagnostic labels and medical diagnoses in a hospital unit of infectious diseases

Objetivo: identificar las principales etiquetas diagnósticas de Enfermería (EDE) y los principales diagnósticos médicos motivo de ingreso en una Unidad de Enfermedades Infecciosas, y establecer la asociación de las EDE con el sexo, la edad y los días de ingreso en el momento de recogida de datos.Método: estudio descriptivo transversal. Se anotó la edad, el sexo, el número de días de ingreso en el momento de la recogida de datos, el diagnóstico médico motivo de ingreso y las EDE presentes en el momento de la recopilación de datos. Dicha recogida de datos se realizó un día aleatorio al mes durante 11 meses. Se emplearon las pruebas de U de Mann-Whitney, T de Student y Chi cuadrado para analizar diferencias.Resultados: se identificaron las EDE tras la valoración de 136 pacientes: un 58,1% era hombre, la edad media fue 57,9 (DE: 18,1) años. Las EDE más habituales fueron: Riesgo de infección (66,2%) y Déficit de autocuidado: baño (40,4%). Se observaron diferencias según sexo en la Disposición para mejorar el autocuidado (p= 0,028) y la Incontinencia urinaria (p= 0,032), entre otros. Se observaron diferencias con la edad en el Déficit de autocuidado: baño y en el Deterioro de la movilidad física entre otros (p< 0,05). Al inicio del ingreso se dio más Riesgo de confusión aguda (p= 0,003) y, en los más prolongados, Riesgo de úlcera por presión (p= 0,003). Los diagnósticos médicos más frecuentes fueron: celulitis (10,3%) y neumonía (8,8%).Conclusiones: las EDE tienen una baja asociación con el sexo y la duración del ingreso, pero tienen una gran asociación con la edad.(AU)

Objective: to identify the main Nursing diagnostic labels (NDLs) and the main medical diagnoses that lead to admission at an Infectious Diseases Unit, and to determine the association of said NDLs with gender, age, and days of hospitalization at the time of data collection.Method: a descriptive cross-sectional study; the data collected were: age, gender, number of hospitalization days at the time of data collection, the medical diagnosis leading to the admission, and the NDLs present at the time of data collection. Said data collection was conducted on a random day per month for 11 months. The Mann-Whitney U, Student’s T and Square Chi tests were used to analyze the differences.Results: NDLs were identified after assessing 136 patients: 58.1% were male, and their mean age was 57.9 (SD: 18.1) years. The most common NDLs were: Risk of infection (66.2%) and Self-Care Deficit: bathing (40.4%). Differences by gender were observed in: Willingness to improve self-care (p= 0.028) and Urinary Incontinence (p= 0.032), among others. Differences with age were observed in Self-Care Deficit: bathing, and in Deterioration in Physical Mobility, among others (p< 0.05). At the start of the hospitalization there was a higher Risk of Acute Confusion (p= 0.003), and in the longer hospital stays, Risk of Pressure Ulcers (p= 0.003). The most frequent medical diagnoses were: cellulitis (10.3%) and pneumonia (8.8%).Conclusions: NDLs have a low association with gender and hospital stay duration, but a high association with age.(AU)

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.

Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals.

OBJECTIVES: This study was conducted to investigate the current status of handoffs, perception of patient safety culture, and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation. METHODS: This is a descriptive study. 425 nurses who work at small and medium-sized hospitals in South Korea were included in our study. They completed a set of self-reporting questionnaires that evaluated demographic data, handoff-related characteristics, perception of patient safety culture, and handoff evaluation. RESULTS: Results showed that the overall score of awareness of a patient safety culture was 3.65 ± 0.45, the level was moderate. The score of handoff evaluation was 5.24 ± 0.85. Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward. Handoff evaluation differed significantly according to the level of education, work patterns, duration of hospital employment, handoff method, degree of satisfaction with the current handoff method, errors occurring at the time of handoff, handoff guidelines, and appropriateness of handoff education time (P < 0.05). CONCLUSION: For handoff improvement, guidelines and standards should be established. It is necessary to develop a structured handoff education system. And formal handoff education should be implemented to spread knowledge uniformly.

Frequency and barriers of reporting workplace violence in nurses: An online survey in China.

OBJECTIVES: This study aimed to explore the reporting of workplace violence against nurses and the reasons why they did not reported. METHODS: A self-designed questionnaire regarding workplace violence and reporting was used to conduct a cross-sectional survey on nurses who submitted a manuscript to a Chinese nursing journal from 2016 to 2017. A total of 324 nurses agreed to participate in this study and 266 participants from 165 hospitals in 72 cities returned questionnaires. RESULTS: A total of 172 nurses (64.7%) experienced violent incidents during the past year. Of these incidents, 45.5% were reported; and the reporting rate of physical assaults (69.0%) was higher than those of verbal abuse (36.9%), threatening behavior (51.7%), and sexual harassment (60.0%). Formal reporting accounted for 25.4% (15.4% in written form and 10.0% through a computer-assisted reporting system). Almost half of the nurses (49.6%) stated that the hospital had no reporting system or they were uncertain about the reporting system. For reasons of not reporting, 51.9% of the nurses were unware of how and what types of violence to report, and 50.6% of the nurses believed that the hospital paid greater attention to patients rather than staff. CONCLUSIONS: A clear definition of workplace violence and reporting procedures, establishment of a facile system for reporting, and supervisory support following a reporting are urgently required.

Development and validation of the Japanese version of the team job crafting scale for nurses.

Team job crafting, which refers to designing the task, relational, and cognitive aspects of a job, is thought to be beneficial for nurses working in the ward. There are no scales to assess team job crafting among nurses. This study aimed to develop and examine the reliability and validity of a scale to measure team job crafting. Based on literature reviews and interviews, potential items were created. A total of 293 nurses working on 19 wards in two hospitals in Japan were asked to complete a questionnaire twice. A series of exploratory factor analyses (EFAs) were conducted to select the final items. For convergent validity, multilevel correlations were calculated. Cronbach's α and intra-class correlation coefficients (ICCs) were calculated for reliability. A total of 190 participants responded to the baseline survey and 152 responded to the retest. The EFAs yielded a three-factor structure comprising 13 items. The three factors are task crafting considering the team's growth, cognitive crafting for members' respect and reflection of meaningfulness of work, and relational crafting for smooth information sharing. Cronbach's α ranged from .810 to .831, and test-retest ICCs ranged from 0.571 to 0.710. At the individual level, team job crafting had small-to-moderate correlations with individual levels of job crafting, job control, supervisor support, co-worker support, job satisfaction, workplace social capital, and work engagement. The ICC of the team job crafting scores of 0.125 indicated meaningful variation across wards. At the ward-level, nonsignificant but strong correlations were found with workplace social capital, job satisfaction, and psychological distress. This scale showed acceptable levels of reliability and validity. It would be useful in monitoring and improving team job crafting to increase team members' well-being and performance.

A study of the relationship between professional values and ethical climate and nurses' professional quality of life in Iran.

OBJECTIVE: To explore the relationship between nursing professional values and ethical climate and nurses' professional quality of life. METHODS: The present study is a descriptive, cross-sectional work in which 400 nurses from various wards of hospitals in the south-east of Iran were studied. Data were collected using a questionnaire consisting of four sections: demographics, Nurses' Professional Values Scale-Revised (NPVS-R), the Hospital Ethical Climate Survey (HECS), and the Professional Quality of Life Scale (ProQOL). RESULTS: The total mean scores for professional values were 105.29 ± 15.60. The total mean score for the ethical climate was 100.09 ± 17.11. The mean scores for the indexes of compassion satisfaction, burnout, and secondary traumatic stress were 45.29 ± 8.93, 34.38 ± 6.84, and 32.15 ± 7.02 respectively. The relationships between professional values and the indexes of compassion satisfaction (r = 0.56), burnout (r = 0.26), and secondary traumatic stress (r = 0.18) were found to be positive and significant (P < 0.001). Also, the relationships between ethical climate and the items of compassion satisfaction (r = 0.60, P < 0.001), burnout (r = 0.15, P = 0.002) were found to be positive and significant. CONCLUSION: An understanding of nurses' perception of professional values and improving the ethical climate at work can help nursing administrators identify more effective strategies toward increasing compassion satisfaction and lessening burnout and work-related stress.

The experience of transition from nursing students to newly graduated registered nurses in Singapore.

OBJECTIVES: To investigate the experience of newly graduated registered nurses (NGRNs) in Singapore following their initial 6-12 months of transition from nursing student to registered nurse. METHODS: This mixed-methods study consisted of two phases. In the first phase, data were collected via the administration of the online survey to 30 NGRNs. The questionnaire contained 42 items of the four-point Likert scale survey. In the second phase, a focus group interview was conducted with 5 NGRNs to gather complementary information regarding the major findings from the first phase. RESULTS: The survey revealed despite most NGRNs (80%) in this study expressed overall satisfied with their transition, the item score was (2.97±0.61) out of 4, the majority (83.3%) also perceived their transition to professional practice being stressful, the item score was (3.07±0.74) out of 4.Three themes emerged from the interview, 'personal transition experience', 'professional transition experience', and 'organizational transition experience', which are entwined to construct overall NGRNs' transition experiences. CONCLUSIONS: This study reaffirms the theory-practice gap phenomenon. This signifies the need for closer collaboration between educational, healthcare industry and regulatory stakeholders to examine and address factors that influence their transition experience to better support them for workforce readiness.

Supervisor Support and Affective Organizational Commitment: The Mediator Role of Work Engagement.

The aim of the study was to verify the mediator role of work engagement between supervisor social support and affective organizational commitment. A cross-sectional and correlational study using questionnaires was conducted. We obtained a convenience sample of 267 participants from 403 nurses from two public hospitals (66.25% response rate). Participants were required to be registered nurses without a supervisor position and to have worked for at least 1 year in the same ward in a public hospital. The mediator role of work engagement was examined using path analysis and bootstrapping method (bias-corrected confidence intervals). Results showed that affective organizational commitment was positively and significantly predicted by supervisor support, vigor, and absorption. Supervisor support had both a direct effect and an indirect effect, through vigor and absorption, on affective organizational commitment. Social support from supervisors allows an increase both in nurses' engagement and their desire to remain in the organization.

A blueprint to establish a four-bed obstetric critical care unit in the labor ward of a central hospital.

Patients at risk of organ dysfunction or with established organ dysfunction should be referred to central or tertiary-level hospitals. However, even in central hospitals, intensive care unit (ICU) beds are often unavailable, which may contribute to maternal deaths. One pragmatic solution is to establish obstetric critical care units (OCCUs) in the labor wards of central hospitals; however, specific guidance on how to do this is limited. In addition, globally applicable standards of care are lacking, with uncertainty regarding who should lead obstetric critical care. In this article the specific OCCU infrastructure, equipment and human resources required to establish such units in central hospitals in low- and middle-income countries are described in sufficient detail for easy replication. Admission and discharge guidelines and operational recommendations that include quality indicators are also provided.

The ethical climate in paediatric oncology-A national cross-sectional survey of health-care personnel.

OBJECTIVE: To describe health-care personnel's (HCP's) perceptions of the ethical climate at their workplace in paediatric oncology. METHODS: A cross-sectional survey was conducted using the Swedish version of the shortened Hospital Ethical Climate Survey (HECS-S). HCP at all six paediatric oncology centres (POCs) in Sweden were invited to participate. Analysis included descriptive statistics, the Mann-Whitney U test (differences between groups) and Spearman's rank correlation. Informed consent was assumed when the respondents returned the survey. RESULTS: A high response rate was achieved as 278 HCP answered the questionnaire. Medical doctors perceived the ethical climate to be more positive than registered nurses and nursing assistants. At the POC with the significantly lowest values concerning immediate manager, no significant correlation with the other items was found. At the POC with the poorest ethical climate, HCP also had the lowest perception of the possibility of practicing ethically good care. CONCLUSIONS: Differences between centres and professional groups have been demonstrated. A negative perception of the immediate manager does not necessarily mean that the ethical climate is poor, but the manager's ability to provide the conditions for an open dialogue within the health-care team is key to achieving an ethical climate.