The holistic nursing competence and transition shock of newly graduated nurses as the determinants of missed nursing care: The mediation analysis.

AIMS AND OBJECTIVE: To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. BACKGROUND: Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. DESIGN: Descriptive and correlational design. METHODS: The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1-12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. RESULTS: The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. CONCLUSIONS: Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. RELEVANCE TO CLINICAL PRACTICE: The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education.

The positioning of nursing in Turkish mass media: Before and after the COVID-19 outbreak.

AIM: To explore the way the nursing profession was portrayed in online news coverage before and after the COVID-19 pandemic. BACKGROUND: The power of the media can be used as a tool to introduce nursing services to society, make nursing visible, and influence the public perception of nursing. INTRODUCTION: Analyzing the image of nursing as portrayed in the news can be a guide for more effective management of the media as a tool for positioning nursing in the future and presenting the right message. METHODS: A qualitative design was applied. Three online newspapers published in the Turkish language-the most widely read newspapers in Turkey-were analyzed. The sample for this research consisted of 505 news articles containing the keywords "nurse" and "nursing" published before and after the COVID-19 outbreak. The MAXQDA2022 software was used for data management. RESULTS: The articles selected were themed as news reflecting the nursing profession negatively, positively, and neutrally. When the negative and positive themes were compared, the two most repeated subthemes included (1) working conditions and being unprofessionalism; (2) impact on health, social recognition, and neutral included only subtheme that happens to you as a citizen/individual. CONCLUSION: Compared with the pre-COVID-19 period, there was an increase in news coverage reflecting portrayed nursing positively on the nursing profession in the post-COVID-19 period. Mass media, which are indispensable in social communication, can be used as an effective tool to improve the image of nursing in society. IMPLICATIONS FOR NURSING: From nursing students to policymakers, all professionals must act in a planned and purposeful manner to present nursing professionals positively as leaders in public healthcare.

Systematic Review on Characteristics and Effects of Leadership Development Interventions for Nursing Students.

BACKGROUND: Effective nursing leadership improves health care quality, patient well-being, and nursing staff outcomes. Newly graduated nurses face challenges in transitioning into leadership roles. Thus, examining the leadership development interventions for nursing students is critical. PURPOSE: This systematic review examined the characteristics and effectiveness of leadership development interventions designed for and implemented with undergraduate nursing students. METHODS: A comprehensive search covered Scopus, CINAHL Ultimate, ScienceDirect, MEDLINE, WOS Core Collection, Journals@Ovid, JSTOR Journals, and ERIC databases. Included studies were assessed using the Mixed Methods Appraisal Tool. RESULTS: The final review comprised 19 studies showcasing positive impacts on leadership development. The interventions varied in leadership approach, design and content, structure, qualifications, student involvement, and outcomes. CONCLUSIONS: Leadership development interventions are effective in enhancing nursing students' leadership. Nevertheless, future interventions should prioritize well-structured content, and studies must incorporate robust methodologies.

Turkish Version of the Perceived Future Decent Work Securement Scale: Validity and Reliability for Nursing Students.

Background: The aim of the study was to test the validity and reliability of the Perceived Future Decent Work Securement Scale for Turkish nursing students. Methods: A cross-sectional, methodological study design was used. The study was carried out at three nursing undergraduate programs in Turkey during the academic year of 2020-2021 with 336 senior nursing students. Language validity and content validity analyses were performed for the scale adaptation, followed by confirmatory factor analysis (CFA) for construct validity. The reliability of the scale was determined using the test-retest and Cronbach's alpha internal consistency coefficient. Results: The scale-content validity index score was 0.988. In CFA, all goodness-of-fit indices verified the acceptable fit of the model; its root mean square error of approximation was 0.076; the normed fit index was 0.909; the standardized mean square residual was 0.097; the relative fit index was 0.881; the goodness-of-fit index was 0.915; the adjusted goodness-of-fit index was 0.872 and χ2/df = 2.932. The overall reliability was α = 0.86. The item-total correlations of the scale were above the acceptable level, and the test-retest analysis had a high correlation. The access to healthcare (14.68, SD 3.53) obtained the highest average score, and the adequate compensation (8.52, SD 3.76) was the lowest rated by the senior nursing students. Conclusion: The Perceived Future Decent Work Securement Scale is a valid and reliable scale to assess nursing students' future decent work securement.

Speak-Up Behavior of Oncology Nurses: Organizational Trust and Structural Empowerment as Determinants.

OBJECTIVE: The aim of this study is to examine the mediating roles of organizational trust and structural empowerment on the speak-up behavior of oncology nurses. BACKGROUND: Organizational trust can create opportunities for a good working environment. Structural empowerment is an important factor affecting the speak-up behavior of nurses. The intermediary roles of organizational trust and structural empowerment on speak-up behavior are not specific. METHODS: A correlational descriptive research design was used, and 232 nurses from 2 different hospital levels (the Ministry of Health hospital and university hospital) responded to 4 questionnaires. RESULT: The results reflect that organizational trust and structural empowerment are a factor on nurses' speak-up behavior. CONCLUSION: The findings demonstrate that a work environment where organizational trust is developed and a structural empowerment framework is in place contributes to nurses' speak-up behavior among oncology nurses.

Relationship between Structural Empowerment and Nurse and Patient-Reported Outcomes: The Mediating Role of Control over Nursing Practices.

Practices that strengthen nurse work environments and enable them to have control over nursing practices have gained importance in recent years as they increase nurses' retention and patient care quality. This study aimed to examine the relationships between structural empowerment and nurse and patient-reported outcomes and the mediating role of control over nursing practices in these relationships. This correlational and cross-sectional study was carried out from September 2018 to May 2019 at two public hospitals in Turkey. We recruited staff nurses (n = 319) working in the inpatient units of these hospitals and their patients (n = 319). Data were collected using self-report measures from staff nurses and patients. It was determined that structural empowerment and control over nursing practices had a positive relationship with job satisfaction and nursing care quality, as well as a negative relationship with intention to turnover; however, there was no relationship with patient-reported outcomes. Control over nursing practices partially mediated the relationship between structural empowerment and outcomes of job satisfaction and nursing care quality. This study indicates that promoting the structural empowerment of nurses and ensuring that they have control over practice will increase job satisfaction and quality of care. Nurse managers can increase nurses' job satisfaction and quality of care by creating supportive work environments and ensuring they have control over nursing practices.

University Students' Risk Perception, Protective Measures, and General Health During the COVID-19 Pandemic in Turkey.

OBJECTIVE: This study aimed to investigate university students' risk perception, protective measures, and general health during the coronavirus disease 2019 (COVID-19) pandemic in Turkey. METHODS: The research sample consisted of 1920 university students. The data were collected through an online questionnaire. RESULTS: A total of 56.6% of the students considered their risk of being infected with the COVID-19. The number of measures taken by students was lower than expected. Students' increased anxiety perceived individual risk level, insufficient social support perceptions, and their perceptions of the current pandemic more serious than previous epidemics affect the number of measures they take. Students had sleep and study problems, and suicidal thoughts in the social isolation period. Sex, studying in medicine, anxiety related to COVID-19, feeling unconfident in coping with the pandemic, social support, were determined to be risk factors regarding general health, sleep and study problems, and suicidal thoughts. CONCLUSIONS: The results of the study showed that the measures taken by university students were insufficient and the precautions were affected by many factors. It was determined that their health was adversely affected by the pandemic. University administrations and decision-makers should consider the risk factors to improve the students' experiences in such pandemics and emergencies.

The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey.

BACKGROUND: Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs. METHODS: This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018-2019. A self-report questionnaire was used to collect data about students' sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used. RESULTS: The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% (n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration. CONCLUSION/APPLICATION TO PRACTICE: The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.

The effects of Nurse Led Transitional Care Model on elderly patients undergoing open heart surgery: a randomized controlled trial.

AIMS: Rate and number of successful cases in open heart surgery has been increasing due to the advances in medical technology and surgery. To improve patient convalescence results and reduce rate of post-discharge readmission to hospital and unplanned post-discharge rehospitalization, home-care and follow-up process of patients should be managed successfully. To evaluate the effectiveness of Nurse Led Transitional Care Model on the functional autonomy, quality of life, readmission, and rehospitalization rates of elderly patients undergoing open heart surgery. A randomized controlled trial was conducted from November 2017 to December 2018 and performed according to the CONSORT Guidelines. METHODS AND RESULTS: Sixty-six elderly patients were randomly allocated to the intervention (n: 33) and control (n: 33) groups. Patients in intervention group were given care based on the Transitional Care Model until the post-discharge 9th week starting from date of hospitalization. Patients in control group were given standard care services. Functional autonomy, quality of life levels, and repeated admission/re-hospitalization rates to the clinic were evaluated. The Functional Autonomy Measurement System and SF-36 Quality of Life Scale scores of the intervention group were higher than that of the control group at the 9th week (P < 0.05). In addition, rate of readmission and rehospitalization during the follow-up period (6 months) of patients in the intervention group was found to be lower than the patients in the control group (P < 0.05). CONCLUSION: Care services offered under the Transitional Care Model improved functional autonomy and quality of life and decreased post-discharge hospital readmission and rehospitalization rates of patients. TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov (ID: NCT04384289).

The reliability and validity of the Turkish version of the MISSCARE Survey-Patient.

AIM: This methodological study aimed to adapt the MISSCARE Survey-Patient, which evaluates patients' experiences regarding nursing care based on their reports, and to test it for validity and reliability in Turkish. BACKGROUND: Identifying the missed care interventions on the basis of nurse and patient reports are important to ensure an objective evaluation and develop solutions to the causes behind the failure to meet care needs. METHODS: The study sample consisted of 267 inpatients in the internal and surgery services in a university hospital (n = 267). The Turkish version of the survey was subjected to language and content validity analyses and to confirmatory factor analysis for construct validity. The reliability of the survey was tested through test-retest method and the Cronbach's alpha internal consistency coefficient. RESULTS: It was determined that the original construct was preserved in the Turkish version of the MISSCARE Survey-Patient. The findings indicated that the scale was stable and reliable. CONCLUSION: The Turkish version of the MISSCARE Survey-Patient was found to be valid and reliable. IMPLICATIONS FOR NURSING MANAGEMENT: The survey can be used to determine the frequency and duration of nursing care based on patients' reports and is a valid and reliable instrument for cross-cultural studies.

Turkish nurses' assessments of their power and the factors that affect it.

AIM: To explore nurses' self-assessments of power and their opinions regarding factors affecting power in Turkey using a cross-sectional, descriptive study. BACKGROUND: In order to safely and cost-effectively care for patients, nurses must perceive themselves as powerful and have the use and control of power resources. METHOD: The study sample consisted of 297 nurses in six hospitals: two government hospitals, two university hospitals and two private hospitals. Data were collected using the Demographic Data Form and Power Question Form. RESULTS: Nurses regarded themselves as 'quite powerful' regarding persuasion (53.2%) and referent power (43.4%). Many nurses also regarded themselves as having positional power and 'quite powerful' regarding, reward (44.1%) and legitimate power (34.7%). Nurses saw themselves as least powerful in resource power (48.1%). Individual, educational and organisational factors were the main factors affecting personal and positional power sources. CONCLUSION: Turkish nurses regarded themselves as above average on being powerful in both the personal and positional power base but not in resource power. IMPLICATIONS FOR NURSING MANAGEMENT: We recommend that nurses, educators and managers develop strategies to support nurses' power as a way to enhance the patient care outcomes.

Turkish nursing students' views on practice assessments and service user involvement.

This descriptive study at one university in Turkey aimed to document nursing students' views on involvement of service users in clinical practice assessments. The study sample was comprised of 179 baccalaureate degree nursing students in their second, third, and fourth years of study. Data were collected using a questionnaire developed by the researchers. Participants indicated they had some problems with the present clinical practice assessment methods (73.2%) and that most of these stemmed from the clinical educators (68.2%). Sixty-eight percent of the participants responded positively to service user involvement in clinical practice assessments. However, some noted that this involvement might have some drawbacks. Results of the present study suggest that future studies on service user involvement in clinical practice assessment process are needed to further clarify this issue.

The MISSCARE Survey-Turkish: psychometric properties and findings.

One measure of the process of nursing care is missed nursing care, which refers to any aspect of required care that is omitted either in part or in whole or delayed. Little is understood about how the quality and processes of nursing care differs among countries around the world. The aims of this study were (a) to test the psychometric properties of the MISSCARE Survey-Turkish and (b) to compare the extent and type of missed care as well as reasons for missing care between Turkey and the United States. There was less missed care reported by Turkish nurses as compared to U.S. nurses (p < 0.0001). Turkey nurses identified more problems with inadequate staffing resources (p < 0.0001), materials resources (p < 0.0001), and communication/teamwork (p < 0.0001) as reasons for missed nursing care than did U.S. nurses. Missed nursing care is a critical problem that needs to be addressed in both countries.

Nursing students' leadership and emotional intelligence in Turkey.

The purpose of this study was to determine nursing students' leadership and emotional intelligence. The study was conducted as a descriptive study in a nursing school in 2008. The sample comprised 69 junior and 85 senior nursing students and was based on voluntary participation. Data were collected through a data sheet, a leadership style questionnaire, and the Bar-On Emotional Intelligence Quotient Inventory. There were no statistically significant differences in leadership orientations and emotional intelligence between junior and senior students (p > 0.05). Although there was a significant relationship between emotional intelligence and task-oriented leadership (r = 0.427, p = 0.001), there was no significant relationship between emotional intelligence and people-oriented leadership (r = 0.076, p = 0.367). Students' emotional intelligence score was average, and their people-oriented leadership score was approximately half of the total score. It is recommended to develop strategies for improving nursing students' people-oriented leadership skills during their nursing education.

Transformational leadership training programme for charge nurses.

AIM: This paper is a report of an evaluation of the effects of a transformational leadership training programme on Unit Charge Nurses' leadership practices. BACKGROUND: Current healthcare regulations in the European Union and accreditation efforts of hospitals for their services mandate transformation in healthcare services in Turkey. Therefore, the transformational leadership role of nurse managers is vital in determining and achieving long-term goals in this process. METHOD: The sample consisted of 30 Unit Charge Nurses with a baccalaureate degree and 151 observers at two university hospitals in Turkey. Data were collected using the Leadership Practices Inventory-Self and Observer (applied four times during a 14-month study process from December 2005 to January 2007). The transformational leadership training programme had theoretical (14 hours) and individual study (14 hours) in five sections. Means, standard deviations and percentages, repeated measure tests and two-way factor analysis were used for analysis. RESULTS: According the Leadership Practices Inventory-Self and Observer ratings, leadership practices increased statistically significantly with the implementation of the programme. There were no significant differences between groups in age, length of time in current job and current position. The Unit Charge Nurses Leadership Practices Inventory self-ratings were significantly higher than those of the observers. CONCLUSION: There is a need to develop similar programmes to improve the leadership skills of Unit Charge Nurses, and to make it mandatory for nurses assigned to positions of Unit Charge Nurse to attend this kind of leadership programme.