Workplace violence is a prevalent phenomenon in healthcare, particularly among nursing professionals. Exposure to workplace violence may be direct through firsthand involvement, indirect through ...secondhand witnessing, or both. Even though implications for victims of workplace violence have been well-studied, less is known about the various types of exposure and their effects on nurse mental health. The purpose of this study is to examine the impact of workplace-violence exposure types on the mental health of nurses, while accounting for the intensity of the incident/s. This study employs an exploratory correlational design with survey methods. Nurses from British Columbia (BC), Canada, were invited by the provincial nurses' union to complete an electronic survey in Fall 2019. A total of 2958 responses from direct-care nurses in acute-care settings were analyzed using logistic regression. The results showed that mental-health problems increased with cumulative exposure; even though nurses with solely indirect exposure to workplace violence did not report greater mental-health problems, those experiencing solely direct exposure, or both direct and indirect exposure, were two to four times more likely to report high levels of post-traumatic stress disorder (PTSD), anxiety, depression and burnout compared to their counterparts with no exposure. There is an urgent need for better mental-health support, prevention policies and practices that take into account the type of workplace-violence exposure.
Background
Workplace violence is a prevalent phenomenon in the health-care sector globally, but few studies have examined its impact on nurses’ use of prescribed and/or over-the-counter medications ...to manage signs and symptoms.
Purpose
The purpose of this study was to examine the direct and indirect effect of workplace violence, through the pathway of psychological stress responses, on nurses’ frequencies of medication intake. An occupational stress and health outcomes model was tested in this study.
Methods
A secondary analysis of cross-sectional survey data from 551 medical-surgical nurses in British Columbia was conducted. Both emotional and physical workplace violence were examined. Emotional exhaustion and posttraumatic stress disorder were psychological stress responses to workplace violence.
Results
Emotional and physical violence from patients and/or families were the most prevalent sources of workplace violence. Physical violence and psychological stress responses increased the frequency of medication intake after controlling for nurse characteristics. Emotional violence was not related to medication intake over and above the effect of psychological stress responses. Physical and emotional violence elicited psychological stress responses resulting in increased medication use.
Conclusion
Workplace violence triggers psychological stress responses with adverse outcomes on nurses’ health and well-being.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Among health workers, nurses are at the greatest risk of COVID-19 exposure and mortality due to their workplace conditions, including shortages of personal protective equipment (PPE), insufficient ...staffing, and inadequate safety precautions. The purpose of this study was to examine the impact of COVID-19 workplace conditions on nurses' mental health outcomes. A cross-sectional correlational design was used. An electronic survey was emailed to nurses in one Canadian province between June and July of 2020. A total of 3676 responses were included in this study. We found concerning prevalence rates for post-traumatic stress disorder (47%), anxiety (38%), depression (41%), and high emotional exhaustion (60%). Negative ratings of workplace relations, organizational support, organizational preparedness, workplace safety, and access to supplies and resources were associated with higher scores on all of the adverse mental health outcomes included in this study. Better workplace policies and practices are urgently required to prevent and mitigate nurses' suboptimal work conditions, given their concerning mental health self-reports during the COVID-19 pandemic.
Aims
To explore associations between specific violence prevention strategies and nurses’ perceptions of workplace safety in medical‐surgical and mental health settings.
Background
Workplace violence ...is on the rise globally. Nurses have the highest risk of violence due to the nature of their work. Violence rates are particularly high among USA and Canadian nurses. Although multiple violence prevention strategies are currently in place in public healthcare organizations in British Columbia, Canada, it is unknown whether these approaches are associated with nurses’ perceptions of workplace safety.
Design
This is an exploratory correlational design using secondary data.
Methods
Using data obtained from a province‐wide survey of nurses between March 2017 ‐ January 2018, this study included 771 nurses from medical‐surgical and 189 nurses from mental health settings. Data were analysed using ordinal logistic regressions.
Results
For medical‐surgical and mental health nurses, greater perceptions of workplace safety were related to employers listening to them with respect to violence prevention strategies. Nurses in both settings were more likely to feel safe when they were not expected to physically intervene during a code white situation. Medical‐surgical nurses were more likely to feel safe when code white incident reviews were conducted and fixed alarms were used. Mental health nurses were more likely to report feeling safe when they had enough properly trained code white responders on their unit.
Conclusion
Nurse‐employer engagement is critical to nurses’ perceptions of feeling safe at work. Engagement opportunities include nurses’ involvement in discussions about appropriate violence prevention strategies, collaborative debriefing after violent incidents and co‐development and updates of patients’ behavioural care plans.
目的
探讨特定暴力预防策略与护士对内科、外科和心理健康环境中工作场所安全的认知之间的关系。
背景
工作场所暴力在全球范围内呈上升趋势。由于护士的工作性质,她们遭受暴力的风险最高。美国和加拿大护士的暴力发生率特别高。尽管加拿大不列颠哥伦比亚省的公共医疗保健机构目前已经制定了多种暴力预防策略,但尚不清楚这些方法是否与护士对工作场所安全的认知相关联。
设计
这是一个使用次级数据的探索性相关设计。
方法
通过采用2017年3月至2018年1月期间的全省护士调查数据,本研究包括771名内外科护士和189名心理健康护理人员。使用了有序逻辑回归法来分析数据。
结果
对于内外科护士和心理健康护理人员来说,对工作场所安全的进一步认知与雇主在暴力预防策略听取他们的意见有关。因为在代码为白色的情况下,不需要他们采取身体上的干预措施,所以这两种情况下的护士更有可能感到安全。当进行白色代码事件审查和使用固定警报时,内外科护士才更有可能感到安全。当心理健康护理人员所在单位里有足够多训练有素的代码白色急救人员时,他们才更有可能报告感到安全。
结论
护士与雇主之间的接触对护士对工作安全的认知至关重要。接触机会包括,护士参与讨论适当的暴力预防策略、暴力事件后的协作任务报告以及共同制定和更新患者的行为护理计划。
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aims
This study examined the effect of two components of a model of nursing care delivery, the mode of nursing care delivery, and skill‐mix on: (a) quality of nursing care; and (b) patient adverse ...events, after controlling for nurse demographics, work environment, and workload factors.
Design
A cross‐sectional exploratory correlational study that drew on secondary data was conducted.
Methods
Survey data from 416 direct care registered nurses from medical‐surgical settings across British Columbia were analysed using hierarchical multiple regression. Larger study data were collected in 2015.
Results
Nurses working in a team‐based mode reported a greater number of nursing tasks left undone compared with those working in a total patient care. Nurses working in a skill‐mix with licensed practical nurses reported a higher frequency of patient adverse events compared with those working in a skill‐mix without licensed practical nurses. At higher levels of acuity, nurses in a team‐based mode reported a higher frequency of patient adverse events than did nurses in a total patient care.
Conclusion
Models of nursing care delivery components, mode and skill‐mix, influenced quality and safety outcomes. Some of the team‐based medical‐surgical nurses in British Columbia are not functioning as effective teams. Team building strategies should be used to enhance collaboration among them.
Impact
Research into redesigning care delivery has typically focused on only one care delivery component at a time. The study findings could have implications for nurses and patients, nursing leadership and policymakers particularly in medical‐surgical settings in British Columbia.
目的本研究探讨了护理服务模式的两个组成部分,护理服务模式和技能组合对以下方面的影响:(a)护理质量;以及(b)在控制了护士的人口统计、工作环境和工作量因素后,患者发生不良反应。设计利用二级数据进行了横断面探索性相关研究。方法采用分层多元回归分析了来自不列颠哥伦比亚省医疗‐外科机构的416名直接护理注册护士的调查数据。大多研究数据收集自2015年。结果在基于团队的模式下工作的护士报告说,与在整体病人护理中工作的护士相比,其还有更多的护理任务没有完成。与没有执照护士的职业技能组合相比,在有执照护士的职业技能组合中工作的护士报告的患者不良事件发生率更高。在较高的敏锐度水平下,以团队为基础的护士报告的患者不良事件发生率高于整体患者护理中的护士。结论护理服务提供组成部分、模式和技能组合的模型影响质量和安全结果。在不列颠哥伦比亚省,一些以团队为基础的医疗外科护士没有发挥有效的团队作用。应该使用团队建设策略来加强他们之间的协作。影响重新设计护理服务的研究通常一次只关注一个护理服务组件。研究结果可能对护士和患者、护理领导和政策制定者,特别是在不列颠哥伦比亚省的外科医疗环境中产生影响。
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Background: Although healthcare workers (HCWs) in long-term care (LTC) have experienced significant emotional and psychological distress throughout the pandemic, little is known about their unique ...experiences. Objective: This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Method: Following Arksey and O’Malley’s framework, data published between March 2020 to June 2022, were extracted from six databases. Results: Among 3808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Conclusion: Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Aim
To examine the relationships between workload factors at different systems levels (unit level, job level and task level), patients/family complaints and nurse reports of patient violence towards ...them using a human factors framework.
Design
This is a secondary analysis of cross‐sectional data.
Methods
Data from 528 nurses working in medical–surgical settings in British Columbia, Canada, were analysed. At the unit‐level workload factors included patient‐RN ratios, patient acuity and dependency; at the job‐level perceptions of heavy workload, undone nursing tasks and compromised professional standards due to workload; and at the task‐level interruptions to workflow.
Results
Workload factors at multiple levels were directly related to workplace violence. Nurses' increased reports of compromised standards (job level) and interruptions (task level) were related to increased reports of physical and emotional violence, and higher patient acuity (unit level) was related to increased reports of emotional violence. Patient/family complaints mediated the relationship between almost all the workload factors and workplace violence.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Background
Nursing is a high-risk profession and nurses’ exposure to workplace risk factors such as heavy workloads and inadequate staffing is well documented. The COVID-19 pandemic has exacerbated ...nurses’ exposure to workplace risk factors, further deteriorating their mental health. Therefore, it is both timely and important to determine nursing groups in greatest need of mental health interventions and supports.
Purpose
The purpose of this study is to provide a granular examination of the differences in nurse mental health across nurse demographic and workplace characteristics before and after COVID-19 was declared a pandemic.
Methods
This secondary analysis used survey data from two cross-sectional studies with samples (Time 1 study, 5,512 nurses; Time 2, 4,523) recruited from the nursing membership (∼48,000) of the British Columbia nurses’ union. Data was analyzed at each timepoint using descriptive statistics and ordinal logistic regression.
Results
Several demographic and workplace characteristics were found to predict significant differences in the number of positive screenings on measures of poor mental health. Most importantly, in both survey times younger age was a strong predictor of worse mental health, as was full-time employment. Nurse workplace health authority was also a significant predictor of worse mental health.
Conclusions
Structural and psychological strategies must be in place, proactively and preventively, to buffer nurses against workplace challenges that are likely to increase during the COVID-19 crisis.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Working in unhealthy environments is associated with negative nurse and patient outcomes. Previous body of evidence in this area is limited as it investigated only a few factors within nurses' ...workplaces.
The purpose of this study was to identify the most important workplace factors predicting nurses' provision of quality and safe patient care using a 13-factor measure of workplace conditions.
A cross-sectional correlational survey study involving 4029 direct care nurses in British Columbia was conducted using random forest data analytics methods.
Nurses' reports of healthier workplaces, particularly workload management, psychological protection, physical safety and engagement, were associated with higher ratings of quality and safe patient care.
These workplace conditions are perceived to impact patient care through influencing nurses' mental health. To ensure a high standard of patient care, data-driven policies and interventions promoting overall nurse mental health and well-being are urgently required.
This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses' workload demands ...at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands. (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction. (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes. (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.
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CEKLJ, IZUM, KILJ, NUK, ODKLJ, PILJ, SAZU, UL, UM, UPUK
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