Servant leadership behaviour of head nurse assessment and its linkage with nurse work engagement in China.

AIM: To assess the servant leadership behaviour of head nurse and its linkage with nurse work engagement in China. DESIGN: A cross-sectional study. METHODS: A anonymous investigation with the stratified cluster randomized sampling of nurse was conducted in Hunan Province of China in December 2020. We administered the Perceived Head Nurse Service Leadership Behaviour Scale and the Chinese version of Utrecht work engagement scale to survey, and analyse its relationships by multiple linear regression. RESULTS: A number of 890 nurses participated in this study. The average score of the perceived servant leadership of head nurse reported by nurses was 78.90 ± 14.04, which was at a medium level. Among its six dimensions, the dimension of promote nurse development scored highest (16.04 ± 2.84), while the dimension of dedication scored lowest (11.39 ± 2.46). Official nurses reported higher perceived servant leadership scores of head nurses than those who were employed and temporary nurses (b = 1.727, 95% CI: 0.054-3.400); nurses in tertiary hospitals reported higher perceived servant leadership scores of head nurses than nurses in primary and secondary hospitals (b = 2.703, 95% CI: 0.305-5.100); and lower perceived servant leadership scores were associated with nurses' job overtime (b = -4.935, 95% CI: -6.891 to -2.978). Nurses' perceived servant leadership of head nurses were positively associated with nurses' work engagement (r = 0.336, p < .05). Multiple linear regression analysis indicated that the perceived servant leadership of head nurse affected nurses' work engagement strongly (b = 0.585, 95% CI: 0.479-0.691). CONCLUSION: The servant leadership behaviour of head nurse in China was at the medium level, which was positively associated with nurses' work engagement. Further research should improve the power of the servant leadership behaviour of head nurse by integrating additional training, policies and support. IMPACT: It is time to consider the servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China seriously, and address the policies, guidelines, curriculum, and practice culture. PATIENT OR PUBLIC CONTRIBUTION: The study was conducted to explore the situation of servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China, which did not include input from the public or the intended participants.

Programas de supervisión clínica para enfermeras de cuidados intensivos: protocolo de scoping review / Clinical supervision programs for critical care nurses: scoping review protocol

Introducción: La escasez global de enfermeras trajo consigo una mayor dificultad a la hora de contratar y retener a este tipo de profesionales durante la pandemia provocada por la COVID-19. La supervisión clínica en enfermería, por tratarse de un procedimiento sistemático y estructurado para el desarrollo de la práctica clínica en sus diferentes contextos, parece influir en los indicadores de resultados, en la formación continua y en la trayectoria profesional de las enfermeras. Objetivo: 1) Mapear los programas de supervisión clínica para la incorporación de enfermeras en cuidados intensivos. Método de revisión: método de scoping review definido por el Instituto Joanna Briggs a partir de la siguiente pregunta: ¿cuáles son las características de los programas de supervisión clínica para la incorporación de enfermeras en cuidados intensivos? A la hora de definir los criterios de inclusión, se utilizó la estrategia PCC (población, concepto y contexto), además de artículos escritos en portugués, inglés y castellano; estudios primarios de tipo cuantitativo, cualitativo y mixto; estudios secundarios que responden a la pregunta de la investigación; documentos de textos y de opinión, y estudios encontrados en las referencias bibliográficas secundarias. No se utilizan artículos sin el texto completo, fuera del ámbito de la pregunta de partida y cuyo contexto sean los cuidados intensivos pediátricos y neonatales. La búsqueda se realiza en PubMed/ MEDLINE, SCOPUS, LILACS, OpenGrey, Google Scholar, Web of Science y EBSCOhost, y en las bases de datos asociadas. Presentación e interpretación de los resultados: los dados analizados se presentarán de manera esquemática, tabular y narrativa. (AU)

Background: The global shortage of nurses, considered one of the priority areas of intervention by the World Health Organization, has exposed increased difficulties in recruiting and retaining nurses during the COVID-19 pandemic. Clinical supervision in nursing, as a systematized and structured process for the development of clinical practice in different contexts, seems to contribute to outcomes, in continuous training and in the course of nurses’ professional experience. Aim: 1) To map clinical supervision programmes for the integration of nurses in critical care. Review method: Joanna Briggs Institute method for Scoping review, starting from the question: what are the characteristics of clinical supervision programs for the integration of nurses in critical care? In the inclusion criteria definition, the PCC strategy (population, concept and context) was used; articles written in Portuguese, English and Spanish; quantitative, qualitative, mixed type studies, secondary studies which answer the research question, text and opinion documents and studies found in secondary bibliographic references. Articles without full text, outside the scope of the starting question, and whose context is pediatric and neonatal critical care will be excluded. The search will be carried out in PubMed/ MEDLINE, SCOPUS, LILACS, OpenGrey, Google Scholar, Web of Science and EBSCOhost, with associated databases. Presentation and interpretation of results: The analyzed data will be presented in a diagrammatic, tabular and narrative form. (AU)

Standardized and validated training to support the charge nurse: Research protocol.

AIM: To develop a standardized training for charge nurses. DESIGN: A developmental research design divided into three parts will be undertaken. METHODS: (1) A scoping review will be used to develop standardized training focusing on charge nurse skills and sub-skills; (2) a Delphi review with nurses, managers and researchers will validate the content of the training; content validity will be assessed over sufficient rounds of review to obtain a content validity index of over 0.7 and (3) a cross-sectional study will pilot test the training with 30 charge nurses. RESULTS: This study will describe the development of updated and empirically validated training to be systematically implemented in healthcare institutions and offered to charge nurses when they begin.

Relación de la supervisión a través del aprendizaje dirigido y el desempeño laboral de enfermería / Relationship of supervision through directed learning and nursing job performance

Introducción:La supervisión de enfermería juega un papel fundamental en la implementación de estrategias de aprendizaje dirigido que mejoren el desempeño laboral de los profesionales, garantizando así una atención de calidad. Objetivo:Evaluarla relación que existe entre la supervisión a través del aprendizaje dirigido y el desempeño laboral de enfermería. Metodología: estudio cuantitativo con diseño descriptivo, correlacional de corte transversal desarrollado en el área de urgencias deun Instituto Nacional de Salud de la Ciudad de México, en2022. El universo estuvo conformado por profesionales de enfermería del Instituto Nacional deNutrición, la muestra fue de 90profesionales seleccionados por muestreo aleatorio simple, Se utilizó un instrumento que mide el desempeño laboral y la supervisión a través de una escala tipo Likert que va de nunca a siempre, clasificando las variables en tres categorías: nivel bajo, nivel medio y nivel alto. Resultados:existe una correlación directamente proporcional entre la supervisión a través del aprendizaje dirigido y el desempeño laboral, es decir un nivel medio de la categoría del instrumento, a mayor supervisión mayor desempeño laboral; así como, cuando existe mayor capacitación, comunicación, supervisión programada, hay un mayor desempeño laboral. Conclusiones: Los resultados evidencian que al impulsar la implementación del proceso de supervisión mediante el modelo de aprendizaje dirigido es posible potencializar el desempeño laboral de los profesionales de enfermería. Asimismo, el desempeño laboral del profesional se beneficia mediante las estrategias de supervisión como son: la capacitación continua, la comunicación efectiva, la retroalimentación y la supervisión programada

Introduction:Nursing supervision plays a fundamental role in the implementation of directed learning strategies that improve the job performance of professionals, thus ensuring quality care. Objective: To evaluatethe relationship between supervision through directedlearning and nursing job performance. Methodology: quantitative study with a descriptive, correlational, cross-sectional, cross-sectional design in the emergency department of a National Health Institute in Mexico City, from March to May 2022. The universe was made up of nursing professionals from the National Instituteof Nutrition, the sample was 90professionals selected by simple random sampling. An instrument was used to measure job performance and supervision through a Likert-type scale ranging fromnever to always, classifying the variables into three categories: low level, medium level and high level. Results: there is a directly proportional correlation between supervision through directed learning and job performance, i.e. a medium level of the instrument category, the higher the supervision the higher the job performance; as well as, when there is more training, communication, programmed supervision, there is higher job performance. Conclusions: The results show that by promoting the implementation of the supervision process through the directed learning model, it is possible to enhance the work performance of nursing professionals. Likewise, the professional's work performance benefits from supervision strategies such as: continuous training, effective communication, feedback and programmed supervision

Scoping review protocol examining charge nurse skills: requirement for the development of training.

INTRODUCTION: The charge nurse (CN) holds a position in clinical-administrative management and is essential for improving the quality and safety of care in healthcare institutions. The position requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. The scientific literature has not widely examined the importance of providing these skills as part of initial training, nor when CNs begin their duties. This study aims to fill this gap through an exhaustive review of the literature with the aim of developing standardised training for the CN when they start in their position. METHODS AND ANALYSIS: A scoping review using the Joanna Briggs Institute framework will be conducted. The CINAHL, MEDLINE, Science Direct and Cairn, databases as well as grey literature from ProQuest dissertations and thesis global database, Google Scholar and the website of the Order of Nurses of Quebec will be queried using keywords. Relevant literature in French and English, published between 2000 and 2022 will be retained. The CN is the target population. Outcomes address at least one of the five CN skills, describe how they are operationalised and what their impact is on the organisation of work and quality of care. This analysis will identify essential and relevant elements for the development of standardised, up-to-date and appropriate training for the position of CN. ETHICS AND DISSEMINATION: Ethical approval is not required, as data does not include individual patient data. The results will be published in peer-reviewed journals, presented at conferences and presented to nursing managers and directors. SCOPING REVIEW REGISTRATION: Research Registry ID: researchregistry7030.

Development and psychometric appraisal of Head Nurse Research Leadership Scale.

AIM: To develop a Head Nurse Research Leadership Scale and evaluate its reliability and validity. DESIGN: A psychometric instrument validation study was conducted in two phases. METHODS: The item tool was generated based on a literature review, semi-structured interview and brainstorming. Twenty experts validated the content of the initial version for two rounds. Thirty-nine clinical nurses conducted the HNRLS-v3 to test the readability of the items in pilot study I. Items were screened based on the critical ratio, correlation coefficient analysis, Cronbach's α coefficient and factor analysis using the data collected from 265 nurses in pilot study II. A cross-sectional survey was conducted in six hospitals to evaluate the reliability and validity between 4 January 2022 and 15 January 2022. Three hundred and sixteen nurses participated in this survey, and 60 completed the questionnaire to validate the test-retest reliability between 1 February and 6 February. RESULTS: A 15-item Head Nurse Research Leadership Scale based on 5 dimensions was developed, and the content validity was satisfied. The 15 items accounted for 77.9% of the variance. Confirmatory factor analysis showed acceptable convergent validity and discriminant validity. The Cronbach's α coefficient, split-half reliability and test-retest reliability of the scale were 0.966, 0.9633 and 0.927, respectively.

Knowledge sharing behaviour among head nurses in online health communities: The moderating role of knowledge self-efficacy.

BACKGROUND: Head nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard. PURPOSES: This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan. METHOD: The data were obtained by using a self-reported survey from 283 head nurses in 22 private hospitals in Jordan. A moderation regression analysis using a structural equation modelling approach (i.e. Smart PLS-SEM, Version 3) was utilised to evaluate the study's measurement and structural model. RESULTS: Knowledge self-efficacy moderates the relationship between the three individual factors (i.e., Trust, Reciprocity, and Reputation) and knowledge-sharing behaviours. However, self-efficacy did not moderate the relationship between the ability to share and knowledge-sharing behaviours. IMPLICATIONS: This study contributes to understanding the moderating role of knowledge self-efficacy among head nurses in online healthcare communities. Moreover, this study provides guidelines for head nurses to become active members in knowledge sharing in OHCs. The findings of this study offer a basis for further research on knowledge sharing in the healthcare sector.

[Establishment of Administrative Core Competencies and Evaluation Indicators for Head Nurses].

BACKGROUND: The increasing complexity of the healthcare environment in recent years highlights the importance of cultivating in head nurses the leadership and management competencies necessary to effectively handle complicated administrative tasks and lead nurses in facing various challenges. Identifying the core administrative management competencies required of head nurses and evaluating competency level using behavioral indicators are fundamental to evaluating related training outcomes. PURPOSE: This study was designed to identify the core administrative management competencies required of head nurses as well as the associated job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. METHODS: This study was conducted in two phases using a qualitative method. The first phase identified the core administrative management competencies and their behavioral definitions. The second phase established competency-related job responsibilities, tasks, behavioral evaluation indicators, work outputs, and requisite knowledge and skills. Each phase consisted of (1) a qualitative interview (first stage) or focus group discussion (second stage) to establish the prototype content; (2) a head nurse workshop to obtain multiple perspectives to modify the prototype content; and (3) a focus group discussion to achieve consensus regarding the content. RESULTS: Nine core competencies related to head nurse administration were identified, including: strategic planning, care supervision, quality improvement, communication, crisis management, responsible leadership, evidence-based practice, digital technology application, and presentation persuasion. Corresponding to these competencies, four responsibilities and associated work tasks were identified. Finally, the related behavioral evaluation indicators, work outputs, and requisite knowledge and skills were confirmed. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study may be used as the basis for head nurse administrative management training programs, while the identified behavioral evaluation indicators may be used to evaluate head nurse work performance and training outcomes. We recommend other institutions apply the results of this study and develop their own administrative core competencies and evaluation indicators for head nurses.

Fenómeno techo de cristal en enfermería: revisión integrativa / Glass ceiling in nursing: An integrative review

Introducción: El fenómeno "techo de cristal", es un término denominado de esta forma por un movimiento feminista de los años ochenta en los Estados Unidos, el cual hace referencia a la barrera "invisible" que impide el progreso de las mujeres en su carrera laboral. Objetivo: Analizar en el estado del arte disponible, la presencia del fenómeno techo de cristal en enfermería. Materiales y métodos: Se realizó una revisión integrativa basada en las cinco etapas de Crossetti, utilizando descriptores (enfermería, consejo directivo, supervisión de enfermería, liderazgo, inequidad de género y sexismo) validados en el tesauro DeCS y unidas con el booleano AND, en las bases de datos WOS, PUBMED, SCOPUS, SCIELO y BVS. Resultados: Tras la aplicación de los descriptores y estrategias de búsqueda se localizaron 133 artículos, posterior a la aplicación de filtros se seleccionan 43 artículos, tras aplicar criterios de inclusión y exclusión se obtuvieron 6 artículos, luego se complementó con una búsqueda manual localizando 2 artículos, conformándose una muestra de 8 documentos, se aplicó una propuesta de escala que asegura la calidad de la muestra, quedando 7 artículos. Discusión: Todos los artículos seleccionados expresaban una escasa representatividad femenina de enfermería en puestos directivos, se destaca que los hombres son mejor recompensados en términos de remuneración, avance profesional, ocupación de puestos mejores y más prestigiosos. Conclusiones: Los artículos analizados muestran la presencia del fenómeno techo de cristal, donde las mujeres enfermeras presentan más dificultades que los hombres para acceder a cargos directivos, con una aparente etiología marcada meramente por el género.

Introduction: The glass ceiling effect is a term named after a feminist movement in the 1980s in the United States referring to an "invisible" barrier that impedes women's progress in their working careers. Objective: To analyze the presence of the glass ceiling effect in nursing in the available state of the art. Materials and Methods: An integrative review was conducted following Crossetti's five steps and using descriptors such as nursing, board of directors, nursing supervision, leadership, gender inequality and sexism, which have been validated in DeCS thesaurus and linked with the Boolean And operation on WoS, PubMed, Scopus, SciELO and BVS databases. Results: After applying descriptors and search strategies, 133 articles were initially retrieved of which, after applying filters, 43 articles were selected to finally obtain 6 articles after applying inclusion and exclusion criteria. After a manual search, 2 articles were found to make a sample of 8 articles on which a scaling proposal was applied to ensure sample quality, resulting in 7 articles. Discussion: Selected articles indicated limited female representation of nurses in managerial positions, emphasizing that men are better compensated in terms of remuneration, professional advancement, and better and more prestigious positions. Conclusions: Analyzed articles reflect the presence of the glass ceiling effect in which female nurses have more difficulties than men in accessing managerial positions by an apparent etiology merely marked by gender.

Introdução: O fenômeno do "teto de vidro", é um termo que leva o nome de um movimento feminista dos anos 80 nos Estados Unidos, que se refere à barreira "invisível" que impede o progresso das mulheres em suas carreiras profissionais. Objetivo: Analisar o estado da arte disponível sobre a presença do fenômeno do teto de vidro na enfermagem. Materiais e métodos: Uma revisão integrativa foi realizada com base nos cinco estágios de Crossetti, utilizando descritores (enfermagem, diretoria, supervisão de enfermagem, liderança, desigualdade de gênero e sexismo) validados no thesaurus DeCS e ligados ao booleano AND, nas bases de dados WOS, PUBMED, SCOPUS, SCIELO e BVS. Resultados: Após a aplicação dos descritores e estratégias de pesquisa, foram localizados 133 artigos, após a aplicação dos filtros foram selecionados 43 artigos, após a aplicação dos critérios de inclusão e exclusão foram obtidos 6 artigos, depois uma pesquisa manual foi realizada e foram encontrados 2 artigos, formando uma amostra de 8 documentos, uma escala proposta foi aplicada para garantir a qualidade da amostra, deixando 7 artigos. Discussão: Todos os artigos selecionados expressaram uma escassa representação feminina de enfermagem em cargos de direção, destacando-se que os homens são mais bem recompensados em termos de remuneração, ascensão profissional, ocupação de cargos melhores e mais prestigiados. Conclusões: Os artigos analisados mostram a presença do fenômeno do teto de vidro, onde as enfermeiras apresentam mais dificuldades do que os homens no acesso a cargos de gerência, com uma aparente etiologia marcada puramente pelo gênero.

The relationship between talent management and the efficiency of head nurses and senior and middle managers from the educational and medical centers in Tabriz, Iran - a case study.

Nowadays, organizations understand that they need the best talent to succeed in the complex world economy and survive in a competitive business environment. Therefore, talent management can ensure that each employee with a unique talent or ability will be placed in the correct position. This article aimed to study the relationship between talent management, senior and middle managers, and head nurses from educational health and research centers in Tabriz, in 2016. The target population included senior and middle managers and head nurses from Tabriz University of Medical Sciences, approximately 197 people. The sample for this study was selected based on Morgan's table, which rounds up to 123 people. The Kolmogorov-Smirnov test was used to analyze data, and if data were normal, correlation and regression analysis were performed. There was a significant relationship between talent management and the efficiency of senior and middle management and head nurses from the educational and medical centers in Tabriz. Therefore, when talent management increases, the efficiency level also rises to a noticeable degree. Also, the linear regression showed a linear relationship between talent management as an independent variable and efficiency as a dependent variable. Applying talent management strategies in the management selection process in organizations with demanding environments such as hospitals seems inevitable so that managers with the highest efficiency are hired.

Interprofessional clinical event debriefing-does it make a difference? Attitudes of emergency department care providers to INFO clinical event debriefings.

BACKGROUND: Debriefing is increasingly used in clinical environments. Surveys indicate staff support for debriefing clinical events, but little is known about the specific effects of debriefing on healthcare workers in the workplace. INFO (Immediate, Not for personal assessment, Fast facilitated feedback, and Opportunity to support and ask questions) is a charge nurse facilitated clinical event debriefing program implemented in 2016 and currently used in five Emergency Departments (ED) in Calgary, Alberta, Canada. There have been more than 840 documented INFO debriefings. METHODS: Thirty interprofessional ED healthcare workers were recruited through posters and email to take part in voluntary one-on-one interviews using a standardized question script that asked participants about their experience with INFO debriefing assessments. Specifically, participants were asked to provide demographic information, give feedback about their involvement in INFO clinical debriefings, impact of debriefings on their clinical practice, stress levels and wellbeing. Interviews were transcribed and analysed using NVivo software. RESULTS: Forty-five healthcare workers replied to the initial recruitment methods with fifteen not responding to follow-up communication. Overall, staff satisfaction with INFO debriefing was highly rated. A qualitative thematic analysis to saturation approach was used to analyse the data. Five main themes were identified: 1.Effect of debriefing on clinical practice and patient care. 2. Psychological safety and teamwork. 3. Emotional acknowledgment after critical events. 4. Managing work stress in the ED. 5. Barriers to debriefing. CONCLUSIONS: In this study, debriefing in the ED helped interprofessional healthcare workers manage stress, provide improved patient care and teamwork while acknowledging emotions. This study specifically involved INFO, however, there are similarities that make our findings applicable to other clinical event debriefing programs. We believe this study provides further evidence supporting debriefing in clinical care areas.

RéSUMé: CONTEXTE: Le débriefing est de plus en plus utilisé dans les environnements cliniques. Les enquêtes indiquent que le personnel est favorable au débriefing des événements cliniques, mais on sait peu de choses sur les effets spécifiques du débriefing sur les travailleurs de la santé sur le lieu de travail. INFO (Immediate, Not for personal assessment, Fast facilitated feedback, and Opportunity to support and ask questions) est un programme de débriefing d'événements cliniques animé par l'infirmière en chef, mis en œuvre en 2016 et actuellement utilisé dans cinq services d'urgence (SU) à Calgary, Alberta, Canada. Il y a eu plus de 840 débriefings INFO documentés. MéTHODES: Trente travailleurs interprofessionnels des services d'urgence ont été recrutés par le biais d'affiches et de courriels pour participer à des entretiens individuels volontaires à l'aide d'un script de questions standardisé qui demandait aux participants de parler de leur expérience des évaluations de débriefing INFO. Plus précisément, les participants ont été invités à fournir des informations démographiques, à donner leur avis sur leur participation aux débriefings cliniques INFO, sur l'impact des débriefings sur leur pratique clinique, sur leur niveau de stress et sur leur bien-être. Les entretiens ont été transcrits et analysés à l'aide du logiciel NVivo. RéSULTATS: Quarante-cinq travailleurs de la santé ont répondu aux méthodes de recrutement initiales, quinze n'ont pas répondu à la communication de suivi. Dans l'ensemble, la satisfaction du personnel à l'égard du compte rendu d'INFO a été très bonne. Une analyse thématique qualitative jusqu'à saturation a été utilisée pour analyser les données. Cinq thèmes principaux ont été identifiés : 1. l'effet du débriefing sur la pratique clinique et les soins aux patients. 2. La sécurité psychologique et le travail en équipe. 3. Reconnaissance émotionnelle après des événements critiques. 4. Gestion du stress au travail dans les services d'urgence. 5. Obstacles au débriefing. CONCLUSIONS: Dans cette étude, le débriefing aux urgences a aidé les travailleurs de la santé interprofessionnels à gérer le stress, à améliorer les soins aux patients et le travail d'équipe tout en reconnaissant les émotions. Cette étude a porté spécifiquement sur INFO, mais il existe des similitudes qui rendent nos résultats applicables à d'autres programmes de débriefing d'événements cliniques. Nous pensons que cette étude apporte des preuves supplémentaires en faveur du débriefing dans les domaines des soins cliniques.

The enfermeiro-mor (head-nurse) in Santas Casas in the province of Minas Gerais: between care and administration. / O enfermeiro-mor nas Santas Casas da província de Minas Gerais: entre a administração e a assistência.

This article focuses on the perception of nursing as a low-prestige occupation in the 19th century. The history of nursing produced by professionals in the area supported this understanding. However, the profile of the enfermeiro-mor (head nurse), a position in the Santas Casas, demonstrates that the nursing profession was present throughout a broader social spectrum. The authors support the hypothesis that the typical negative assessment is based only on the more visible patient care activities. The presence of the enfermeiro-mor exemplifies the limits of a generalization of the social undervaluation of nursing. The conclusion is that the generalized assumption that nursing was only about basic health care is not acceptable.

Este artigo trata da percepção da enfermagem como uma ocupação de baixo prestígio no século XIX. A história da enfermagem produzida pelos profissionais da área reforçou essa concepção. No entanto, o perfil do cargo de enfermeiro-mor, presente nas Santas Casas, indica um espectro social mais amplo para a profissão de enfermagem. As autoras defendem a hipótese de que essa avaliação negativa se baseia apenas em atividades de cuidado ao paciente que eram mais visíveis. A presença do enfermeiro-mor exemplifica os limites de uma generalização da desvalorização social da enfermagem. A conclusão é que a suposição generalizada de que a enfermagem se limitava a cuidados básicos de saúde não se sustenta.

Clinical supervisors' perceptions and use of the fundamentals of care framework in supervision of nursing students.

AIM: To explore clinical supervisors' perceptions and use of the Fundamentals of Care framework in supervising nursing students in clinical placement in hospital settings. DESIGN: A qualitative study using focus group interviews. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research. METHODS: Twelve clinical nurse supervisors working in medical, surgical or psychiatric wards in hospitals in Denmark participated in four focus groups conducted from September to November 2020. Data were analysed using thematic analysis. RESULTS: Clinical supervisor's perceptions and use of the framework are described in three themes: structuring students' clinical learning, supporting tool for learning what nursing care is and developing own supervision practice. CONCLUSION: Supervisors perceive the Fundamentals of Care framework positively and use it as a supporting tool to structure and facilitate students' reflection on what nursing is and requires. They perceive that having a shared framework across school and clinical setting contributes to a safe and positive learning environment. Furthermore, using the framework develops their own practice as clinical supervisors.

Nursing leadership in clinical practice, its efficacy and repercussion on nursing-sensitive outcomes: A cross-sectional multicentre protocol study.

AIM: The aim of this study to describe a research protocol for evaluating the relationship between nursing leadership, organisational well-being and nurse and patient outcomes. BACKGROUND: The head nurses' leadership style influences the organisational context. When an organisation promotes nurses' well-being, they perform better performances and are more satisfied and engaged with their job. This reduces stress levels, burnout and absenteeism and improves physical and psychological health. METHODS: A multicentre study will be conducted. A self-report questionnaire will be administered to head nurses and nurses they coordinate. Study findings will include nurse-sensitive outcomes (e.g., pressure injuries, infections and mortality). Descriptive and correlational analyses will be conducted, and a structural equation model will be tested. RESULTS: Results might verify that a correctly judged leadership style of the head nurse will enhance the organisational context experienced by nurses and improve nursing sensitive outcomes. CONCLUSION: This study will demonstrate the organisational role of middle managers and the direct repercussions on their staff and patients, understanding the relationship between organisational, process and outcomes variables. IMPLICATIONS FOR NURSING MANAGEMENT: If the results confirmed the hypothesis, health care managers would cultivate and stimulate the head nurses' leadership style, thus increasing nurses' organisational well-being and achieving better patient outcomes. No Patient or Public Contribution.