Care quality and satisfaction at the cancer hospital - a questionnaire study of older patients with cancer and their family members.

BACKGROUND: The unique life situations of older patients with cancer and their family members requires that health care professionals take a holistic approach to achieve quality care. The aim of this study was to assess the perceptions of older patients with cancer and family members about the quality of care received and evaluate differences between their perceptions. A further aim was to examine which factors explain patients' and family members' levels of satisfaction with the care received. METHODS: The study was descriptive and cross-sectional in design. Data were collected from patients (n = 81) and their family members (n = 65) on four wards in a cancer hospital, using the Revised Humane Caring Scale (RHCS). Data were analysed using descriptive statistics, crosstabulation, Wilcoxon signed rank test, and multivariable Analysis of Covariance (ANCOVA). RESULTS: Family members had more negative perceptions of the quality of care than patients did. Dissatisfaction was related to professional practice (p < 0.001), interaction between patient and health care professionals (p < 0.001), cognition of physical needs (p = 0.024), and human resources (p < 0.001). Satisfaction with overall care was significantly lower among those patients and family members who perceived that they had not been involved in setting clear goals for the patient's care with staff (p = 0.002). CONCLUSIONS: It is important that older patients with cancer and family members receive friendly, respectful, individual care based on their needs and hopes, and that they can rely on professionals. Health care professionals need more resources and education about caring for older cancer patients to provide quality care.

Spiritual interventions: Improving the lives of colorectal cancer survivors-A systematic literature review.

AIM: To systematically review the types of spiritual interventions available for colorectal cancer survivors and determine if they improve their lives. DESIGN: Systematic review. DATA SOURCE: A thorough literature search was conducted in July 2023 using PRIMO, PubMed/Medline, Cochrane, CINAHL, Scopus, and EMBASE. REVIEW METHODS: As an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, the Synthesis Without Meta-Analysis reporting guideline was employed. A narrative synthesis was used to analyse the data. RESULTS: Thirty-five articles were analysed for this study. The findings suggest that psychoeducational intervention, cognitive behavioural therapy intervention, mindfulness intervention, social intervention, and spiritual counselling improved CRC survivor's coping skills, boosted self-esteem, lessened anxiety, instilled hope, enhanced daily functioning, improved survival rates, improved neurological functional status and quality of life (QoL). CONCLUSION: There is proof that spiritual interventions help CRC patients and improve their QoL. It has been discovered that spiritual intervention is helpful in the diagnosis, management, and treatment of CRC conditions. IMPACT: CRC survivors may have impairments in their physical ability and daily functioning as a result of many symptoms, such as pain, bowel dysfunction, and exhaustion. Furthermore, individuals may encounter difficulties in several aspects of their psychological, emotional, social, and role functioning due to the presence of dread symptoms. Therefore, these study will help CRC survivors To implement spiritual interventions in the management of their long-term care. To cultivate problem-solving abilities, foster self-assurance, and enhance self-awareness. To alleviate symptoms, enhance everyday functioning, and improve QoL. NO INDUCEMENT: No financial incentives were used to compensate patients or members of the public for this review.

Nurse leaders' interpersonal communication competence: A mixed-method systematic review.

AIM(S): To identify and synthesize evidence available on nurse leaders' interpersonal communication competence. DESIGN: Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. METHODS: The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used. DATA SOURCES: CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022. RESULTS: A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert. CONCLUSIONS: This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication. IMPACT: This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence. PROSPERO ID: CRD42023385058. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Organizational characteristics of nursing practice environments related to registered nurses' professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: structural equation modeling study.

BACKGROUND: Nurses are leaving their profession because of poor personal job satisfaction, heavy workload, and unfavorable work environments with low professional autonomy. Professional autonomy involves the possibility to influence one's work and have a sense of control - the ability to contribute to a workplace culture and influence how decisions are made. This study explores registered nurses' perceptions of the nursing practice environment, using the Nursing Work Index-Revised (NWI-R), and its relationships with professional autonomy and job satisfaction. METHODS: A cross-sectional study along with instrument re-validation was conducted using a web-based survey for nurses in two Magnet-aspiring hospitals in Finland in September 2021 (n = 586). Structural equation modeling was used to find out the relationships of the NWI-R components with professional autonomy and job satisfaction. RESULTS: Principal component analysis and confirmatory factor analysis supported seven components with 34 items. Collegial nurse-doctor relationships, organization's quality standards, and nursing involvement and expertise sharing (means of 3.23, 2.96, and 2.66, respectively) demonstrated a favorable nursing practice environment; professional nursing standards, nurse management and leadership, staffing and resource adequacy, and professional advancement (means of 2.38, 2.18, 2.15, and 2.13, respectively) demonstrated an unfavorable nursing practice environment. The presented model (RMSEA 0.068, CFI 0.987, TLI 0.946) indicated that nursing involvement and expertise sharing, organization's quality standards, nurse management and leadership, and collegial nurse-doctor relationships were related to professional autonomy. Nurse management and leadership, staffing and resource adequacy, and organization's quality standards were related to job satisfaction. Moreover, professional autonomy was related to job satisfaction. CONCLUSION: Nurses' professional autonomy is important due to its relationship with job satisfaction. When factors that increase professional autonomy are taken into account and attention is paid to the promotion of autonomy, it is possible to improve nurses' job satisfaction. These issues cannot be solved at the unit level; investment is needed at the organizational and political levels. The results introduce nurses, managers, researchers, and stakeholders to improvements in the nursing practice environment toward an organizational culture where nurses may utilize their professional autonomy to its full potential.

Patient satisfaction - results of cluster analysis of finnish patients.

BACKGROUND: Healthcare providers must understand patients' expectations and perceptions of the care they receive to provide high-quality care. The purpose of this study is to identify and analyse different clusters of patient satisfaction with the quality of care at Finnish acute care hospitals. METHODS: A cross-sectional design was applied. The data were collected in 2017 from three Finnish acute care hospitals with the Revised Humane Caring Scale (RHCS) as a paper questionnaire, including six background questions and six subscales. The k-means clustering method was used to define and analyse clusters in the data. The unit of analysis was a health system encompassing inpatients and outpatients. Clusters revealed the common characteristics shared by the different groups of patients. RESULTS: A total of 1810 patients participated in the study. Patient satisfaction was categorised into four groups: dissatisfied (n = 58), moderately dissatisfied (n = 249), moderately satisfied (n = 608), and satisfied (n = 895). The scores for each subscale were significantly above average in the satisfied patient group. The dissatisfied and moderately dissatisfied patient groups reported scores for all six subscales that were clearly below the average value. The groups significantly differed in terms of hospital admission (p = .013) and living situation (p = .009). Patients representing the dissatisfied and moderately dissatisfied groups were acutely admitted more frequently than patients in other groups and were more likely to live alone than satisfied and moderately satisfied patients. CONCLUSION: The results mostly demonstrated high levels of patient satisfaction; however, the perceptions of minority populations of dissatisfied patients should be assessed to identify shortcomings in the care provided. More attention should be paid to acutely admitted patients who are living alone and the pain and apprehension management of all patients.

Resilience, job satisfaction, intentions to leave nursing and quality of care among nurses during the COVID-19 pandemic - a questionnaire study.

BACKGROUND: The COVID-19 pandemic has challenged nurses and healthcare systems globally and raised major concerns for nurses' wellbeing and working conditions. This cross-sectional and correlational study design aims to describe nurses' resilience, job satisfaction, intentions to leave and quality of care, and explain their relationships during the COVID-19 pandemic. METHODS: Data were collected from Registered Nurses (N = 437) in Finland through an electronic survey between February 2021 and June 2021. The questionnaire covered background characteristics (seven questions), resilience (four questions), job satisfaction (one question), intention to leave nursing (two questions), quality of care (one question), and requiring factors of the work (eight questions). The background variables and dependent variables were analyzed and presented using descriptive statistics. Structural equation modeling was used to explain dependent variables relationships. The study followed procedures recommended in the STROBE Statement for cross-sectional studies in efforts to maximize the quality of reporting results. RESULTS: The surveyed nurses evaluated their resilience by mean score 3.92, more nurses had considered leaving nursing during the pandemic (16%) than before (2%). Nurses´ mean score of requiring factors of the work was 2.56 and overall job satisfaction 5.8. Structural equation modeling revealed that resilience affected their job satisfaction, which also influenced the quality of care, that was rated moderate (7.46 out of 10). Structural equation modeling indices of goodness of fit were NFI = 0.988, RFI = 0.954, IFI = 0.992, TLI = 0.97, CFI = 0.992, and RMSEA = 0.064. No direct relationship was found between resilience and intention to leave nursing. CONCLUSIONS: Good resilience promoted delivery of high-quality care by nurses during the pandemic and enhanced their job satisfaction, which reduced their intention to leave nursing. The results indicate that it is important to develop interventions that support nurses' resilience. IMPACT: The study highlights the importance of nurses' resilience during the pandemic, while job satisfaction may decrease and requiring factors of the work increase. Given the number of nurses who consider leaving nursing, there are clear needs to develop effective strategies to maintain quality healthcare with resilient, committed nursing staff.

Nurse managers' perceptions of nurses' professional autonomy-A qualitative interview study.

AIMS: To describe nurse managers' perceptions of nurses' professional autonomy in hospitals and their role in promoting it. DESIGN: A qualitative descriptive approach. METHODS: Fifteen nurse managers participated in semi-structured focus group interviews in two university hospitals in Finland between May and June 2022. The data were analysed using inductive content analysis. RESULTS: Nurses' professional autonomy in hospitals is perceived according to three themes: individual qualities behind independent actions, limited influencing opportunities in the organization and physicians' central effect. The nurse managers perceive that they enhance nurses' professional autonomy by promoting the nurses' independence at work, their sufficient and up-to-date competence, their expert role in multi-professional cooperation and joint decision-making and an open and appreciative work community. CONCLUSIONS: Nurse managers can enhance nurses' professional autonomy with shared leadership. However, there are still gaps in nurses' equal possibilities to influence multi-professional work, especially outside of patient care. Promoting their autonomy requires commitment and support from leadership at all levels of the organization. The results advise nurse managers and the administration of the organization to maximize the potential of nurses' expertise, along with encouraging nurses towards self-leadership. IMPACT: This study provides an innovative approach to nurses' roles through their professional autonomy from the perspective of nurse managers. These managers have an important role in enhancing nurses' professional autonomy, empowering and supporting them in their expertise, enabling necessary advanced training, and maintaining an appreciative work community where all have equal participation opportunities. Thus, nurse managers have the opportunity to strengthen high-quality multi-professional teams' ability to jointly develop the patient's care for better outcomes through their leadership. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Influence of perceived benefits, barriers and activities of family engagement in care on family nursing practice: A cross-sectional correlational study.

AIMS: To describe nurses' perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice. DESIGN: A cross-sectional correlational study. METHODS: In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t-test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data. RESULTS: Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family-related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice. CONCLUSION: The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice. IMPACT: Probabilistic factor-specific predictions of nursing practice with families are provided in this study - this addresses a gap in the evidence regarding the elements that should be optimized when designing well-informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study's findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care. REPORTING METHOD: The study adheres to the STROBE reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION: Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study.

Extending ageing nurses' working lives: A mixed-methods systematic review.

AIM(S): To identify, describe and assess research evidence on factors that promote working until and beyond the official retirement age among nurses. DESIGN: A mixed-methods systematic review. PROSPERO ID: CRD42022303890. DATA SOURCES: The CINAHL, PsycINFO, MEDLINE, Scopus, SocINDEX and Web of Science databases were searched in December 2021. REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals. Data-based convergent synthesis and thematic analysis were used. RESULTS: Eighteen studies were included, most of which were survey-based. Eleven studies were quantitative, six were qualitative and one used mixed methods. Our results reveal that willingness to continue in work increased with age. Six factors promoted working until and beyond the official retirement age among nurses: good health and work ability, the significance of work sufficient income, meaningful relationships and support in the working community, individually tailored work arrangements, and organizational support and recognition. CONCLUSION: To sustain experienced nurses in working life and promote their working beyond retirement age organizations urgently need to apply throughout working lives supporting age management schemes. Interventions should target supportive relations and individual and flexible arrangements at the workplace. Scarce studies investigated factors contributing to an extension of working life among nurses. Most published evidence on this topic is based primarily on nurses' subjective opinions and preferences: no intervention studies or objective evaluations of factors affecting retirement were found. IMPACT: The available evidence suggests the most critical factors for extending nurses' working lives are support and individual and flexible arrangements in the workplace. There is a need to test interventions and evaluate the effectiveness of measures encouraging nurses to extend their working lives. NO PATIENT OR PUBLIC CONTRIBUTION: Systematic review.

Continuing education for advanced practice nurses: A scoping review.

AIM: The aim of the study was to identify the nature and extent of scientific research addressing continuing education for advanced practice nurses. DESIGN: A scoping review. REVIEW METHODS: The Joanna Briggs Institute's methodology for scoping reviews. DATA SOURCES: Electronic search was conducted on 17 September 2023 via CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Cochrane Library and the Joanna Briggs Institute's Evidence-Based Practice Database for research articles published between 2012 and 2023. RESULTS: Nineteen papers were included in this review. Scientific research on continuing education for advanced practice nursing roles (i.e. nurse practitioner, clinical nurse specialist) has primarily been conducted in the United States and mostly addresses online-delivered continuing education interventions for clinical care competency. Most of the interventions targeted nurse practitioners. CONCLUSION: Continuing education has a pivotal role in supporting advanced practice nursing competency development. In addition to clinical care, future continuing education research should focus on other advanced practice nursing competencies, such as education, leadership, supporting organizational strategies, research and evidence implementation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Continuing education programmes for advanced practice nurses should be rigorously developed, implemented and evaluated to support the quality and effectiveness of patient care. IMPACT: Continuing education for advanced practice nursing roles is an understudied phenomenon. This review highlights future research priorities and may inform the development of continuing education programmes. REPORTING METHOD: PRISMA-ScR.

Polychoric Correlation With Ordinal Data in Nursing Research.

BACKGROUND: Measures in nursing research frequently use Likert scales that yield ordinal data. Confirmatory factor analysis using Pearson correlations commonly applies to such data, although this violates ordinal scale assumptions. OBJECTIVES: The aim of this study was to illustrate the application of polychoric correlations and polychoric confirmatory factor analysis as a valid alternative statistical approach using data on family members' perceived support from nurses as an exemplar. METHODS: A primary analysis of cross-sectional data from a sample of 800 participants using data collected with the Iceland-Family Perceived Support Questionnaire was conducted using polychoric versus Pearson correlations, analysis of variance, and confirmatory factor analysis. RESULTS: A two-factor measurement model was compatible with data from family members in the Ugandan care settings. Two contextual factors (cognitive and emotional support) constituted the family support measurement model. A factor correlation indicated that the two factors reflected distinct but closely related aspects of family support. Polychoric correlation revealed 13.8% (range: 5.5%-25.2%) higher correlations compared to Pearson correlations. Moreover, the polychoric agreed with the data, whereas the Pearson confirmatory factor analysis did not fit based on multiple statistical criteria. Analyses indicated a difference in emotional and cognitive support perception across two family characteristics: education and relationship to the patient. DISCUSSION: A polychoric correlation suggests stronger associations, and consequently, the approach can be more credible with an ordinal Likert scale than Pearson correlations. Hence, polychoric confirmatory factor analysis can address a larger proportion of variance. In nursing research, polychoric confirmatory factor analysis can confidently be utilized when conducting confirmatory factor analysis of ordinal variables in Likert scales. Furthermore, when a Pearson confirmatory factor analysis is used for ordinal Likert scales, the researcher should carefully evaluate the difference between the two approaches and justify their methodological choice. Even though we do not suggest dispensing with Pearson correlations entirely, we recommend using polychoric correlation for ordinal Likert scales.

Interventions improving well-being of adult cancer patients' caregivers: A systematic review.

AIM: The aim of this study was to determine what kind of psychosocial interventions aimed at improving the well-being of adult cancer patient caregivers were developed, and to describe the methodological characteristics and clinical effectiveness of the interventions which could be included in the nursing care plans. DESIGN: Systematic review DATA SOURCES: A systematic search of three databases (PubMed, CINAHL, and PsycINFO) was conducted to identify peer-reviewed papers published between years 2004-2019. REVIEW METHODS: The review was guided by the Joanna Briggs Institute manual for systematic reviews. Data were extracted and appraised by three reviewers using standardized checklists. Narrative synthesis was used to analyse the data. RESULTS: A total of 37 studies underwent analysis. Most of the studies described psychoeducational interventions, designed for patient-caregiver dyads, delivered face-to-face. There was a great variety in caregiver outcomes and measurement tools used. Even though most studies used a randomized controlled design and standardized intervention protocols, many reported problems with recruitment and attrition. Most studies reported that the intervention improved caregiver outcomes, yet the majority of them failed to report effect sizes. CONCLUSION: There are currently a plethora of successful interventions available for cancer patient caregivers which can be included to the nursing care plan. Psychoeducational online interventions which include a social support component may have the best potential in supporting caregivers. It is important to address specific caregiver needs at different cancer stages rather than general needs of caregivers in future interventions. IMPACT: This review suggests that despite a large number of different interventions which can be included in the nursing care plan to improve the support offered to caregivers, some issues should be addressed while designing an intervention study. The emphasis should be placed on reporting effect sizes, focusing on specific caregiver needs and improving recruitment, retention strategies and sustainability of caregiver interventions.

Nurses´ and nurse managers´ perceptions of sustainable development in perioperative work: A qualitative study.

AIMS AND OBJECTIVES: To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision-making in perioperative work. BACKGROUND: Sustainable development involves interpersonal social and cultural relations and long-term economic and ecological thinking in societal decision-making. These dimensions are well-suited for a foundation of decision-making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective. DESIGN: Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ). RESULTS: The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision-making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision-making process in perioperative work. CONCLUSIONS: Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision-making in perioperative work. RELEVANCE TO CLINICAL PRACTICE: Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision-making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely.

Professional governance in Finnish nursing - measured by the Index of Professional Nursing Governance.

AIM: To translate and validate the Index of Professional Nursing Governance (IPNG) 2.0 and assess the state of professional nursing governance in Finland. BACKGROUND: Raising and maintaining quality of care while retaining staff are common problems in healthcare globally. Professional governance is a modern way to tackle them, but a reliable instrument is needed to measure the state of nursing governance in Finland, and elsewhere. METHODS: The IPNG that was translated into Finnish by forward-backward translation, culturally adapted and pilot tested with 20 nurses. A sample of 419 nurses was utilised in a cross-sectional study to assess the state of professional governance in Finland 2018. RESULTS: Principal component analysis yielded six components with good Cronbach's α values. The results clearly indicate that the IPNG version developed and evaluated in this study has suitable psychometric properties for use in Finnish healthcare settings. The validated IPNG scores indicate that nursing governance in Finland is in the professional governance range. The staff have some input in the governance of Finnish healthcare organisations. However, this perception is strongest among the nurse leaders and experts; other groups do not perceive much change yet. CONCLUSION: Participants, particularly nurse leaders in Finland, had self-reported impact in decision-making. The translated IPNG has acceptable internal consistency and can be used to assess healthcare organisations' governance models in Finland and broader in Nordic countries and Europe.

A cross sectional study of nurses' perceptions of nurse leaders' internal crisis communication during the COVID-19 pandemic.

AIM: The aim of this study is to describe nurse perceptions of nurse leaders' internal crisis communication during the COVID-19 pandemic. BACKGROUND: Internal communication is a vital part of nurse leaders' work, even more so during crises such as the COVID-19 pandemic. METHOD: This is a cross-sectional study design. The data were collected from 204 Finnish nurses in February 2021. A questionnaire developed in this study consisted of 29 items measuring internal crisis communication and seven demographic variables. The relationships between the variables were examined with cross-tabulation, a chi-squared test and non-parametric tests. Factor structure was evaluated with exploratory factor analysis and reliability with Cronbach's alpha. RESULTS: Nurses perceived the timeliness of communication highest and interaction the lowest. Nurses from intensive care, acute care and operative rooms gave highest evaluations for the content of communication and timeliness. Nurses working with COVID-19 patients daily or weekly evaluated the highest level of false communication. CONCLUSION: Nurse leaders' internal crisis communication was timely, especially in the most critical units dealing with the pandemic. The study highlighted the importance of considering a unit's special needs for internal crisis communication. Interaction between nurse leaders and nursing staff during periods of crisis needs improvement. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders' successful and emphatic communication is important in supporting nurses in managing a crisis.

Nurse leaders' resilience and their role in supporting nurses' resilience during the COVID-19 pandemic: A scoping review.

AIM: To explore nurse leaders' resilience and their role in supporting nurses' resilience during the COVID-19 pandemic. BACKGROUND: The COVID-19 pandemic has challenged health care systems on a global level. Nurse leaders are tasked with ensuring high-quality care, even during crises, which requires active problem-solving and confidence in the future-resilience from leaders. METHOD: A scoping review was conducted using inductive thematic analysis and the PCC (Participants, Concept, Context) framework. The PubMed, Scopus, CINAHL, and PsycINFO databases, as well additional studies and grey literature, were searched from December 2019 to June 2021. RESULTS: The review included 12 studies. Nurse leaders' self-awareness, self-reflection, and coping strategies described their resilience during the pandemic. A relational leadership style, supportive and safe work environment, and adequate communication were found to support nurses' resilience. CONCLUSIONS: There is scarce research concerning nurse leaders' resilience during the COVID-19 pandemic. Future research needs to address nurse leaders' personal resilience due to the link with nurses' resilience. IMPLICATIONS FOR NURSING MANAGEMENT: A healthy work environment is essential for nurses' resilience. During crises, nurse leaders should adopt relational leadership styles and actively interact with nursing staff.

Nurses' critical reflections of working in unit practice councils-A qualitative interview study.

AIM: This study aimed to describe nurses' experiences of working as members of unit practice councils. BACKGROUND: Health care organisations worldwide want personnel to participate in decision-making. Unit practice councils promote unit-level decision-making over unit-specific issues. Despite extensive research on shared decision-making, few studies have examined the experiences of nurses serving as members of these councils. METHODS: A descriptive qualitative study design was used with semi-structured interviews of 16 nurses in two clinics of a Finnish university hospital. Interviews were analysed using thematic analysis. RESULTS: The analysis revealed two themes describing nurses' experiences as members of unit practice councils: (i) inchoate unit practice councils with insufficient allocated working time and (ii) partial empowerment of nurses through the organisation's evolving Magnet project. CONCLUSIONS: Unit practice councils in the studied organisations are inchoate and unable to effectively advance shared decision-making or support nurses' professional autonomy. In the future, the councils require constant support from all leadership levels of the organisation. IMPLICATIONS FOR NURSING MANAGEMENT: Sharing decision-making power could be a win-win situation where nurse leaders relinquishing power over certain matters gain time to immerse in wider issues. While acknowledging different organisational roles, there is room for trusting each other's professionality and respecting autonomous work.

Nurse leaders' work-related well-being-Relationships to a superior's transformational leadership style and structural empowerment.

AIMS: To describe how nurse leaders' work-related well-being is related to a superior's transformational leadership style and structural empowerment. BACKGROUND: The demanding role of nurse leader means that these professionals experience emotional exhaustion and challenges with work-life balance. They can also be influenced by the leadership style of their own superiors. METHODS: A cross-sectional questionnaire using two internationally validated scales, namely, the Transformational Leadership Scale and Conditions For Work Effectiveness Questionnaire-II, was used. Statistical methods were applied during data analysis. RESULTS: A total of 155 nurse leaders participated completed the questionnaire. The participants' work-related well-being scores ranged from 8 to 10. The participants felt that their superiors employ transformational leadership. The dimension of feedback and rewards received the lowest scores, whereas the nurse leaders reported moderate overall empowerment levels. A nurse leader's work-related well-being was positively correlated with structural empowerment and their superior's leadership style. CONCLUSIONS: Despite the fact that nurse leaders reported relatively high levels of work-related well-being, more attention should be paid on the feedback and rewards and on the support of superiors as they positively influence the work-related well-being. IMPLICATIONS FOR NURSING MANAGEMENT: Transformational leadership should be supported in organisations and through education as it strengthens work-related well-being and structural empowerment of nurse leaders.

Relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study.

BACKGROUND: Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse managers, who can be described as middle-managers at health care organizations, is complex and changes on a daily basis. Only a few studies have clarified how nurse managers divide their time across various work activities. This study aimed to describe the relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the hospital unit level. METHODS: A cross-sectional and correlational study design was used. The data were collected from nurse managers (n = 29), nursing staff (n = 306), and patients (n = 651) from 28 units across three Finnish acute care hospitals between April and November 2017. In addition, data concerning medication errors (n = 468) over one calendar year (2017) were acquired from the hospitals' incident reporting register. Analysis of covariance (ANCOVA) was used to estimate relationships between data from subareas of Nurse Managers' Work Content Questionnaire, Kuopio University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale, along with medication error reports. A significance level of 95% was applied when estimating the covariances between variables. Unstandardized regression coefficients (B) were used to explain the relationships between variables. RESULTS: Multiple relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors were identified. Nurse managers' work activities had both positive and negative relationships on the other studied variables. The Requiring factors of work (p < .001) subarea of nurses' job satisfaction, total patient satisfaction (p < .001), and medication errors (p < .001) were identified as the variables most significantly affected by other factors. CONCLUSIONS: The findings suggest that nurse managers should focus on improving nursing practices by managing and organizing nurses' work in a way that makes their employees feel supported, motivated and secure. Furthermore, nurse managers should adopt a leadership style that emphasizes safe and patient-centered care. The results also suggest that the administration of today's health care organizations should actively evaluate nurse managers' share of work activities to ensure that their daily work is in line with the organizational goals.

Quality of care and patient safety at healthcare institutions in Oman: quantitative study of the perspectives of patients and healthcare professionals.

BACKGROUND: Oman's healthcare system has rapidly transformed in recent years. A recent Report of Quality and Patient Safety has nevertheless highlighted decreasing levels of patient safety and quality culture among healthcare professionals. This indicates the need to assess the quality of care and patient safety from the perspectives of both patients and healthcare professionals. OBJECTIVES: This study aimed to examine (1) patients' and healthcare professionals' perspectives on overall quality of care and patient safety standards at two tertiary hospitals in Oman and (2) which demographic characteristics are related to the overall quality of care and patient safety. METHODS: A cross-sectional study design was employed. Data were collected by two items: overall quality of care and patient safety, incorporated in the Revised Humane Caring Scale, and Healthcare Professional Core Competency Instrument. Questionnaires were distributed to (1) patients (n = 600) and (2) healthcare professionals (nurses and physicians) (n = 246) in three departments (medical, surgical and obstetrics and gynaecology) at two tertiary hospitals in Oman towards the end of 2018 and the beginning of 2019. Descriptive statistics and binary logistic regression were used for data analysis. RESULTS: A total of 367 patients and 140 healthcare professionals completed the questionnaires, representing response rates of 61.2% and 56.9%, respectively. Overall, quality of care and patient safety were perceived as high, with the healthcare professionals rating quality of care (M = 4.36; SD = 0.720) and patient safety (M = 4.39; SD = 0.675) slightly higher than the patients did (M = 4.23; SD = 0.706), (M = 4.22; SD = 0.709). The findings indicated an association between hospital variables and overall quality of care (OR = 0.095; 95% CI = 0.016-0.551; p = 0.009) and patient safety (OR = 0.153; 95% CI = 0.027-0.854; p = 0.032) among healthcare professionals. Additionally, an association between the admission/work area and participants' perspectives on the quality of care (patients, OR = 0.257; 95% CI = 0.072-0.916; p = 0.036; professionals, OR = 0.093; 95% CI = 0.009-0.959; p = 0.046) was found. CONCLUSIONS: The perspectives of both patients and healthcare professionals showed that they viewed both quality of care and patient safety as excellent, with slight differences, indicating a high level of patient satisfaction and competent healthcare delivery professionals. Such perspectives can provide meaningful and complementary insights on improving the overall standards of healthcare delivery systems.