Daily experiences of non-psychiatric nurses in acute psychiatric wards.

AIM: To explore and describe the daily experiences of non-psychiatric nurses working in selected acute psychiatric wards in South Africa. DESIGN: A qualitative explorative and descriptive study design was used. METHODS: Individual face-to-face semi-structured interviews were used to gather data from fifteen non-psychiatric nurses with a minimum of one month of experience working in acute psychiatric wards in Limpopo Province, South Africa. Data were analysed using eight Tech techniques. The study is reported following consolidation criteria for reporting qualitative research. RESULTS: Findings on non-psychiatric nurses' daily experience revealed three themes: (1) Unsafe working environment, (2) Managing difficulties due to lack of skills and (3) Strategies to support non-psychiatric nurses in acute psychiatric wards. Findings suggested institutional and managerial interventions in the form of orientation, in-service training and workshops and resource provision. Future studies should be done to develop a model for supporting non-psychiatric nurses in Limpopo Province, South Africa's acute psychiatric wards.

Measuring operating theatre nurses' perceptions of safety culture using the SCORE questionnaire.

BACKGROUND: Tackling operating theatre waiting lists may focus healthcare organisations' attention on increased productivity while downplaying safety concerns. AIM: To explore safety culture in a perioperative department from operating theatre practitioners' perspective. METHOD: Cross-sectional pen-and-paper survey among nurses in an operating theatre department in Malta using the Safety, Communication, Operational Reliability and Engagement questionnaire. FINDINGS: The response rate was 71.2% (n = 146). Engagement domains and Organisational Safety Culture domains were perceived to be at an average level, apart from Unit Leadership which was perceived to be low. Burnout domains were perceived to be high or very high. Correlation analysis showed that leaders' recognition of staff feedback and input is associated with improved safety culture perceptions. CONCLUSION: An organisational win-win situation is achievable, whereby safety culture perceptions are improved, not necessarily by decreasing job demands such as tackling waiting lists, but by recognising operating theatre staff's input and involving them in work-related decisions.

Emotional intelligence and perceived social support as predictors of psychological well-being among nurses in hospitals in metro manila: Basis for psychological wellness program.

An important factor related to psychological well-being is emotional intelligence and perceived social support. Nurses are exposed to different stressors that are triggered by failing to meet personal needs, taking care of patients, heavy workloads, being exposed to dying patients, fear of committing errors in practice, and experiences of discrimination. Literature suggests that emotional intelligence and perceived social support are associated with psychological well-being. This study aimed to test whether emotional intelligence and perceived social support significantly predict psychological well-being among nurses working in hospitals in Metro Manila through multiple regression analysis. The result shows a high level of emotional intelligence and perceived social support among the respondents. Furthermore, it was also found that nurses have an average level of psychological well-being. There is also a positive relationship between the domains of emotional intelligence, perceived social support, and psychological well-being. Lastly, the results show that the domains of emotional intelligence and perceived social support significantly predict psychological well-being among nurses.

AMPlifying metabolic screening for inpatients on antipsychotic medications with a nurse-driven protocol.

INTRODUCTION: Patients on antipsychotic medications are at higher risk of developing metabolic syndrome; nevertheless, metabolic screening for patients on antipsychotics is suboptimal. METHODS: This project developed and implemented AMP (Antipsychotic Metabolic screening Protocol), a nurse-driven protocol on inpatient psychiatric units that allowed nursing staff to collect all components of a metabolic screening. Nurses working on units with AMP were surveyed pre- and post-implementation on perception of AMP and empowerment. RESULTS: AMP significantly increased overall metabolic screening as well as the most frequently missing component (lipid panel). The screening rates pre-intervention were similar to those found in the literature (on average, only two-thirds of patients were screened). However, AMP improved the rate such that nine out of every ten patients on the units were screened. Nurses had a negative perception and no change in empowerment from AMP implementation. CONCLUSIONS: AMP can be used to increase metabolic screening for patients on antipsychotics. Further research is needed to better understand adoptability of nurse-driven protocols in the psychiatric inpatient setting as well as other applications, such as smoking cessation or safety sitters.

Application of Within-Methods Triangulation to Analyze Hospital System Health.

Qualitative descriptive research can be used when researchers are seeking to find the "how," "what," or "when" of phenomena. The most common qualitative descriptive analysis methods are content and thematic analyses. Data triangulation through content analysis and natural language processing was first described in 2018 for the analysis of nurse-to-nurse communication in an acute care setting. The purpose of this article is to discuss a within-methods data triangulation of interviews done with nurses and nursing leaders in Magnet- and non-Magnet-designated hospitals through integration and application of content analysis, code quantification via the Goodwin statistic, and natural language processing.

Peripheral intravenous catheter failure, nurse staffing levels and care complexity individual factors: A retrospective multicentre cohort study.

INTRODUCTION: Short peripheral intravenous catheter (PIVC) failure is a common complication that is generally underdiagnosed. Some studies have evaluated the factors associated with these complications, but the impact of care complexity individual factors and nurse staffing levels on PIVC failure is still to be assessed. The aim of this study was to determine the incidence and risk factors of PIVC failure in the public hospital system of the Southern Barcelona Metropolitan Area. METHODS: A retrospective multicentre observational cohort study of hospitalised adult patients was conducted in two public hospitals in Barcelona from 1st January 2016 to 31st December 2017. All adult patients admitted to the hospitalisation ward were included until the day of discharge. Patients were classified according to presence or absence of PIVC failure. The main outcomes were nurse staffing coverage (ATIC patient classification system) and 27-care complexity individual factors. Data were obtained from electronic health records in 2022. RESULTS: Of the 44,661 patients with a PIVC, catheter failure was recorded in 2,624 (5.9%) patients (2,577 [5.8%] phlebitis and 55 [0.1%] extravasation). PIVC failure was more frequent in female patients (42%), admitted to medical wards, unscheduled admissions, longer catheter dwell time (median 7.3 vs 2.2 days) and those with lower levels of nurse staffing coverage (mean 60.2 vs 71.5). Multivariate logistic regression analysis revealed that the female gender, medical ward admission, catheter dwell time, haemodynamic instability, uncontrolled pain, communication disorders, a high risk of haemorrhage, mental impairments, and a lack of caregiver support were independent factors associated with PIVC failure. Moreover, higher nurse staffing were a protective factor against PIVC failure (AUC, 0.73; 95% confidence interval [CI]: 0.72-0.74). CONCLUSION: About 6% of patients presented PIVC failure during hospitalisation. Several complexity factors were associated with PIVC failure and lower nurse staffing levels were identified in patients with PIVC failure. Institutions should consider that prior identification of care complexity individual factors and nurse staffing coverage could be associated with a reduced risk of PIVC failure.

Caring touch as communication in intensive care nursing: a qualitative study.

PURPOSE: This article describes intensive care nurses` experiences of using communicative caring touch as stroking the patient`s cheek or holding his hand. Our research question: "What do intensive care nurses communicate through caring touch?" METHODS: In this qualitative hermeneutically based study data from two intensive care units at Norwegian hospitals are analysed. Eight specialist nurses shared experiences through individual, semi-structured interviews. RESULTS: The main theme, Communicating safety and presence has four sub-themes: Amplified presence, Communicating security, trust and care, Creating and confirming relationships and Communicating openness to a deeper conversation. Communicative caring touch is offered from the nurse due to the patient`s needs. Caring touch communicates person-centred care, invites to relationship while respecting the patient's dignity as a fellow human being. Caring touch conveys a human initiative in the highly technology environment. CONCLUSION: Caring touch is the silent way to communicate care, hope, strength and humanity to critical sick patients. This article provides evidence for a common, but poorly described phenomenon in intensive care nursing.

An examination of the usefulness of a quantitative appraisal method in nursing human resource management in primary hospital operating rooms: An example of integrated collaborative scheduling.

In recent years, China medical and health services have made great development. However, the management of nursing human resources in operating room of primary hospitals still faces a series of challenges. In the nursing work of operating room, high-quality nursing human resource management is important for improving the efficiency of operating room and ensuring the safety of patients. From January 2022 to December 2022, comprehensive collaborative scheduling and quantitative scoring evaluation methods were carried out in our hospital, and relevant data were collected. The flexible scheduling combined quantitative scoring performance appraisal system and the traditional scheduling plus average distribution performance appraisal system were statistically analyzed and compared in terms of annual surgical cases, annual overtime hours, annual back work hours, annual compensatory rest hours, and average daily working hours. This study was based on 30 medical staff (27 females and 3 males) in the operating room of a primary hospital. The annual operation volume increased by 387 cases compared with before, and the attitudes of patients to the service attitude and preoperative waiting time were significantly improved, reaching more than 95%. In addition, in the survey of surgeons, it was found that their satisfaction with preoperative preparation and operation time was significantly higher than that of the traditional scheduling method, and reached more than 95%. In the survey of nursing staff, it was found that the satisfaction with the traditional scheduling method was about 80%, and the satisfaction directly reached 100% after the comprehensive collaborative scheduling system. Based on the above survey, the satisfaction of nurses, doctors and patients with the new comprehensive collaborative scheduling system has improved compared with before. After the implementation of the comprehensive collaborative scheduling system, the annual surgical volume has increased significantly, and the average daily working hours of nursing staff have decreased. Comprehensive collaborative scheduling is an effective method of nursing human resource management in operating room, which can effectively improve the work efficiency of nurses and the satisfaction of patients, doctors and nurses. In practice, this method needs to be continuously explored and refined to adapt to different application scenarios and requirements.

Delegating care as a double-edged sword for quality of nursing care: a qualitative study.

BACKGROUND: Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS: This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS: In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS: The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.

Does improved nurse staffing impact patient outcomes in cancer? Association between chronic diseases and mortality among older adult patients with lung cancer in Korea.

BACKGROUND: Evidence regarding the impact of nurse staffing on the health outcomes of older adult patients with cancer is scarce. Therefore, this study aimed to evaluate the impact of nurse staffing on long-term and short-term mortality in elderly lung cancer patients. METHODS: This study analyzed data from 5,832 patients with lung cancer in Korea from 2008 to 2018. Nursing grade was considered to assess the effect of nursing staff on mortality in older adult patients with lung cancer. The Cox proportional hazards model was used to evaluate the effect of the initial treatment hospital's nursing grade on one- and five-year mortality. Additionally, economic status and treatment type of patients were analyzed. RESULTS: Approximately 31% of older adult patients with lung cancer died within one year post-diagnosis. Patients in hospitals with superior nursing grades (lower nurse-to-bed ratios) exhibited lower mortality rates. Hospitals with nursing grades 2 and 3 exhibited approximately 1.242-1.289 times higher mortality than grade 1 hospitals. Further, the lower the nursing grade (higher nurse-to-bed ratio), the higher the five-year mortality rate. CONCLUSION: Both short- and long-term mortality rates for older adult patients with lung cancer increased at inferior nursing grades. Treatment in hospitals having inferior nursing grades, upon initial hospitalization, may yield better outcomes. This study provides valuable insight into the quality of adequate staffing to improve the quality of care for elderly cancer patients.

Practice and factors associated with pediatrics pain management among nurses working in Bahir Dar city public hospitals: A mixed method study.

BACKGROUND: Pain is the most misunderstood, underdiagnosed, and undertreated/untreated medical problem, particularly in children. The main aim of this study was to assess practice and factors associated with pediatrics pain management among nurses working in Bahir Dar city public hospitals, Amhara region, North West Ethiopia, 2022. METHOD: An institutional-based cross-sectional concurrent mixed study design was conducted on randomly selected 421 nurses from November 1 to 30/2022. Purposively selected 8 nurses in different positions and qualifications were included in a qualitative study. A structured self-administered questionnaire and a semi-structured in-depth interview questionnaire were used for data collection. Epi info version 7.1 was used for data entry and SPSS version 25 was used for analysis. ATLAS ti version 7.0 and thematic analysis were used for qualitative study. Binary logistic regression was done to identify predictor variables associated with outcome variables at p <0.05 with a 95% confidence interval. Hosmer and Lemeshow's tests were checked for model goodness of fit, which was 0.71. RESULT: The good practice of pediatric pain management among nurses for hospitalized children was 216 (53.6%) (95% CI- 48.4% to 58.3%). Knowledge [AOR = 3.95; 95%CI: (2.30, 6.79)], attitude [AOR = 2.57; 95% CI: (1.53-4.30)], qualified in BSC pediatrics and child health nurses [AOR = 6.53; 95%CI: (1.56-27.25)], year of experience in pediatrics unit [(AOR = 1.92; 95% CI: (1.03-3.56)] and gating pain management training [AOR = 3.31; 95% CI: (1.73-6.33)] were significant factors. Four themes inadequate knowledge of pain assessment and management practice, inadequate professional commitment, organization-related factors, and impacts of family knowledge, culture, and economic status were explored. CONCLUSION: Only half of the participants had good practice. Knowledge, attitude, nurses qualified in BSC pediatrics and child health, years of experience in the pediatrics department, and pain management training were associated factors. From the qualitative findings, the unavailability of anti-pain drugs, lack of training, assessment tools, continuous monitoring and evaluation, updated protocols, shortage of resources, and others were the barriers to proper pain management. This study concludes that applying effective pain management practices to hospitalized children remains a challenge. Therefore, it is better to put further effort towards improving pediatric pain management practice.

Effect of authentic leadership on nurses' stress, burnout, presenteeism during COVID-19.

PURPOSE: The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who are working with COVID-19-positive patients. Burnout leads to decreased productivity and manifests as emotional exhaustion, depersonalisation (cynicism) and low personal accomplishment (professional efficacy). Authentic leadership is built on a humanistic value system, which is the core value of nurses and other health-care professionals. This study therefore used authentic leadership as the independent variable. DESIGN/METHODOLOGY/APPROACH: A cross-sectional quantitative research method was adopted by distributing validated online questionnaires to 1,334 nurses in a private pathology laboratory and 241 questionnaires were analysed with 93.4% female respondents. Multiple linear regression model testing was conducted. FINDINGS: Multiple regression analyses showed statistically significant negative correlations between authentic leadership and emotional exhaustion, cynicism, job stress and job-stress-related presenteeism, and a positive correlation between authentic leadership and professional efficacy. PRACTICAL IMPLICATIONS: This study provides empirical data to encourage organisations to focus on developing authentic leaders to decrease nurses' burnout, job stress and presenteeism. The health-care sector should strive to create an environment where nurses are valued and their talent is recognised to increase employee engagement and commitment. ORIGINALITY/VALUE: There were two contributions in this study: first, to determine whether there is a relationship between authentic leadership job stress and job-stress-related presenteeism. Second, to determine whether there is a relationship between authentic leadership and the three sub-constructs of burnout.

A cross-sectional study on turnover intention of nurses in eastern China.

BACKGROUND: This study aimed to investigate the turnover intention among nurses in eastern China and explore the association between turnover intention and personal characteristics, family factors, and work-related factors. METHODS: A total of 2504 nurses participated in a cross-sectional survey administered in 26 hospitals in Eastern China from October to November 2017. In December 2021, a survey was conducted on nurses who resigned between December 2017 and November 2021. RESULTS: The turnover intention score of in-service nurses was 15 (12-17), and 43% of nurses had a high turnover intention, which was mainly due to the following reasons: age < 40 years, raising two or more children, monthly income of USD786.10-1572.20 or < USD786.10, occupation was assigned or selected according to parental wishes, ≤ 1 or ≥ 2-night shifts per week, contractual or third-party personnel agents, full-time nurses with part-time jobs, and high job stress. Among 102 retired nurses, 80.4% reported family reasons for leaving, 39.2% for work reasons, and 21.6% for other personal reasons. CONCLUSION: Nurses' intention to leave their occupation is high in Eastern China. Age < 40 years old, > 1 child, low income, involuntary career selection, frequent night shifts, informal employment, part-time, and high job stress are significant factors associated with nurses' willingness to leave. Government and hospital administrators should consider ways to address these factors to retain nurses in hospitals in eastern China and improve the quality of nursing services.

The relationship between psychological capital, burnout and perceived stress in junior nurses: a latent profile analysis.

Background: Psychological capital, an intrinsic personal asset, enhances junior nurses' ability to navigate transition and sustain superior job performance. This study aimed to classify junior nurses into distinct psychological capital profiles and examine their associations with burnout and perceived stress levels. Methods: A cross-sectional study involving 480 junior nurses from three hospitals in Beijing assessed psychological capital, stress, and burnout using e-questionnaires, from July 2021 to August 2022. We employed exploratory latent profile analysis for psychological capital profiling and logistic regression with the best subset method to identify the influential factors. Results: The results of the latent profile analysis supported the models of two latent profiles, which were defined as low psychological capital (224, 46.5%) and high psychological capital (256, 53.5%). Logistic regression revealed that introverted nurses and those experiencing moderate to high levels of burnout and stress were more likely to exhibit low psychological capital. Conclusion: Nursing management should proactively identify and support junior nurses with low psychological capital, with a focus on introverted individuals, to mitigate the impact of stress and burnout.

Advancing Nursing Science: Deriving a Middle-Range Theory for System-Level Communication Research in Complex Hospital Environments.

Background: Millions of injuries and deaths occur yearly from preventable errors, despite interventions applied at the point of care. Although evidence suggests that system-level factors are responsible for hospital system health and patient safety, research has largely not accounted for hospital complexity. Prior to the authors' research regarding the communication of system-level events that influence hospital system health and patient safety, no nursing-specific communication theories that accounted for hospital complexity were identified. However, theory-guided research holds the potential to boost scientific knowledge through the provision of a robust foundational understanding of phenomena. Purpose: The purpose of this article is to discuss the concept derivation used to create a middle-range theory for the guidance of research involving system-level communication in complex healthcare environments as it relates to hospital system health and patient safety. Methods: Concept derivation as described by Walker and Avant (2018) was conducted using parent concepts from the Effective Nurse-to-Nurse Communication Framework, Symbolic Interactionism, Information Theory, Gerbner's Communication Model, and Complexity Theory. Results: Authentication of the derived Effective System-to-System Communication Theory (ESSCT) was confirmed through identification of coherent relationships between the concepts and conceptual statements, alignment with the nursing metaparadigm, and peer review by a subject matter expert from the nursing discipline. Additionally, research revealed an overall congruency between the research findings and the ESSCT's theoretical statements. Implications: The current healthcare climate necessitates that research involving communication be optimized by a germane theoretical underpinning that accounts for hospital complexity. The authors contend that the use of the derived theory may assist such endeavors.

Factors associated with the quality of dying and death and missed nursing care.

BACKGROUND: Patients in intensive care units need full nursing care due to the high mortality rate. However, some aspects of nursing care can be forgotten. AIMS: To investigate the quality of death and dying and its association with aspects of missed nursing care, alongside the overall perception of nurses in intensive care units about factors associated with missed nursing care. METHODS: This cross-sectional study used a census sampling method of 105 nurses working in intensive care units. In order to collect data, the Quality of Dying and Death Questionnaire (QODD), missed nursing care (MISSCARE survey) and factors associated with missed nursing care questionnaire were used. Data analysis was performed by using SPSS 16. FINDINGS: The quality of death and dying, as perceived by nurses, was found to be lower than the average (Range score: 0 to 100). The range of missed nursing care was average (Range of score: 24 to 96) and the most noticeable reason for this missed nursing care was the shortage of nursing staff. CONCLUSION: Managers should ensure that nurses provide complete nursing care for terminally ill patients in intensive care units and eliminate factors that lead to aspects of nursing care being missed, such as staffing levels, material resources and communication between staff members.

Nursing Staff Presenteeism Scale: Development and psychometric test.

BACKGROUND AND OBJECTIVES: Nurses tend to exhibit higher rates of presenteeism compared to other professions. Presenteeism can cause the work performance of nurses to suffer, jeopardizing their own and their patients' safety and leading to decreased quality of care and increased risks of errors. However, there is a lack of a validated assessment tool for presenteeism in Taiwan. Thus, the purpose of this study was to develop a Nursing Staff Presenteeism Scale (NSPS). METHODS: To develop questionnaire items, participants from three medical centers in Taiwan were recruited. Through convenience sampling, 500 nurses who met the selection criteria were recruited from November 1, 2022 to January 18, 2023. The scale was developed based on a systematic literature review, a previous study, and expert consultation, and 50 items were initially generated. After removing three items that lacked discriminative power, the reliability and validity of the remaining 47 items were evaluated. An exploratory factor analysis was used to establish the construct validity. A confirmatory factor analysis and structural equation modeling for cross-validation were used to assess relationships of factors with items and the overall NSPS. RESULTS: The final scale consisted of 44 items assessed on a five-point Likert scale that loaded onto three different factors of physical or mental discomfort (18 items), work performance (15 items), and predisposing factors (11 items). These three factors were found to explain 63.14% of the cumulative variance. Cronbach's alpha for the overall final scale was 0.953. The item-to-total correlation coefficients ranged 0.443 to 0.795. CONCLUSIONS: The NSPS exhibited satisfactory reliability and validity. It can be applied to assess the level of presenteeism among clinical nurses and provide medical institutions with information regarding the causes of presenteeism, predisposing factors, and the impacts of presenteeism on their work performance to enhance the safety and quality of clinical care.