Background
During the pandemic and with the growing shortage of nurses, the problem of how to retain existing nurses was of paramount importance. However, there is limited evidence on the ...relationship between nurses' self-acceptance and intention to stay.
Objectives
This study aimed to investigate the factors influencing nurses' intention to stay at work, and explore the relationship between self-acceptance and their intention to stay.
Methods
Convenience sampling was conducted to select nurses who worked in a clinical environment during June 2020, in hospitals in Shandong Province, China. Self-designed basic information and two questionnaires, namely, the “self-acceptance questionnaire” and “intention to stay” were adopted. Mean, median, related analysis, and regression analysis were adopted to describe the relationship of self-acceptance and intention to stay on part of Chinese nurses.
Results
A total of 1,015 clinical nurses participated in the survey. The mean score of intention to stay among participants was 22.00. The multiple regression analysis revealed various factors, such as age, family support the work, interest in work, job suitability, type of employment, professional level, weekly working hours, working department and self-acceptance influenced the nurse's intention to stay (β range from −1.506 to 2.249).
Conclusion
Our findings identified several factors that are significantly related to and impact the level of intention to stay among clinical nurses.
Aims
The aim of this study was to develop the advance care planning (ACP) practice preference scale and validate its psychometric properties among clinical nurses.
Design
An instrument development ...and validation study was completed in the following three phases: (a) the generation and revision of the item, (b) the preliminary exploration and evaluation of the item and (c) the psychometric evaluation of the scale.
Methods
A literature review was conducted to develop the indicator system. A total of 360 clinical nurses (for item analysis) and 688 clinical nurses (for psychometric evaluation) were recruited. The exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. The reliability was explored by internal consistency and test–retest reliability. The study was conducted from October 2021 to January 2022.
Results
A total of 24 items were finally retained by the item analysis from the initial 78‐item pool. In the exploratory factor analysis, the six‐factor model explained 79.933% of the total variation. After limiting to three factors, 59.305% of the total variation was explained. Above factor models supported by the confirmatory factor analysis were consistent with the theoretically structure, and the fitting indexes were all satisfactory. Also, the findings showed appropriate internal consistency and test–retest reliability.
Conclusions
ACP practice preference scale presents satisfactory psychometric properties among clinical nurses and can be adopted to evaluate the propensity of clinical nurses to practice ACP.
Impact
ACP practice preference scale can be adopted to understand the training needs of clinical nurses on ACP clinical practice.
Patient or Public Contribution
Clinical nurses participated in the pilot testing and validation of ACP practice preference scale.
Speaking up about patient safety concerns is critical when bedside nurses encounter unsafe situations. Training programs that encourage nurses' speaking up behavior have been introduced, but there is ...limited evidence regarding whether such training leads to behavior change or improves patient safety.
The aim of this review was to identify the effectiveness of speak-up training programs for clinical nurses, focusing on program content and outcomes.
A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to the Cochrane and Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines.
This study used bibliographic databases of PubMed, Embase, PsycINFO, Scopus, ProQuest Dissertations and Theses Global for the English language, and NDSL, KCI, RISS, KISS, and DBpia for the Korean language. The literature search used a combination of keywords and subject headings related to speak-up training programs for nurses or any type of nurse training program with an assertiveness component. Training outcomes were evaluated according to the 4-level Kirkpatrick model.
A total of 4808 references were retrieved, of which 21 articles were selected. These 21 studies were conducted in different parts of the world and published from 1981 to 2020. Speak-up training primarily increased some degree of nurses' levels of assertiveness and speak-up behavior, and also led to secondary outcomes such as job stress, work motivation, and communication conflicts. Most studies (n = 19) applied traditional training formats which consisted of multi-session lectures and practice, whereas three studies applied new methodologies such as high-fidelity simulations and online learning. According to the Kirkpatrick model, five studies assessed reactions to speak-up training (level 1), all studies evaluated learning as a result of training (level 2), two studies measured the effect of speak-up training on nurses' behavior (level 3), and one study evaluated nurses' results (level 4) while no studies evaluated patient-level outcomes.
Speak-up training for nurses can improve their levels of assertiveness or speak-up behaviors. Despite inconsistent or mixed findings, speak-up training has the potential to improve nurses' psychological well-being, leading to positive organizational performance. New training methods are directed at specialized education for clinical situations. Future speak-up training should consist of training programs based on real clinical situations in which team members participate together to comprehensively evaluate the effect of training on behavioral changes of health professionals as well as patient safety.
Numerous articles have sought to identify the impact of educational interventions for improving evidence-based practice (EBP) amongst nurses, most of these focus on skills and knowledge acquired. No ...systematic review has explored whether this educational input translates into improved patient outcomes.
To review the evidence on (1) The change in patient outcomes following educational interventions to support practising nurses in implementing EBP. (2) The instruments or methods used to determine whether EBP education improves patient outcomes.
A systematic review following PRISMA guidance was conducted. Literature was comprehensive searched including 6 databases, journal handsearching, citation tracking, and grey literature websites. Studies were included if they reported an EBP educational intervention aimed at practising nurses and contained objective or self-reported measures of patient related outcomes. The quality of the included studies was assessed using a modified Health Care Practice R&D Unit (HCPRDU) tool. Because of the poor homogeneity of the included studies, the data were analysed by narrative synthesis.
Of the 4284 articles identified, 18 were included: 12 pre–post studies, three qualitative studies, and three mixed-methods study designs. The level of quality was modest in the studies. The results of the EBP educational interventions on patient outcomes were assessed using three methods: individual projects to implement an evidence-based approach, qualitative approaches, and a questionnaire survey. The majority of the articles concluded there was a positive change in patient outcomes following an educational intervention to improve EBP; a wide range of context specific outcomes were described.
Educational interventions for clinical nurses to support the implementation of EBP show promise in improving patient outcomes. However, the direct impact of EBP interventions on clinical outcomes is difficult to measure. Further testing and development is needed to improve the quality of studies and evaluation instruments in order to confirm the current findings.
Aims
This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors ...analysis and classification system (HFACS).
Design
A nationwide cross‐sectional survey was conducted.
Methods
Multi‐stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors.
Results
A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs.
Conclusion
The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs.
Relevance to Clinical Practice
Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere.
No Patient or Public Contribution
Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.
The current lack of the number of nurses and high nurse turnover rate leads to major problems for the health-care system in terms of cost, patient care ability, and quality of care. Theoretically, ...burnout may help link emotional labor with turnover intention. The purpose of this study was to investigate the mediating effect of burnout in the association between emotional labor and turnover intention in Korean clinical nurses.
Using data collected from a sample of 606 nurses from six Korean hospitals, we conducted a multiple regression analysis to determine the relationships among clinical nurses' emotional labor, burnout, and turnover intention, looking at burnout as a mediator.
The results fully and partially support the mediating role of burnout in the relationship between the subfactors of emotional labor and turnover intention. In particular, burnout partially mediated the relationship between emotional disharmony and hurt, organizational surveillance and monitoring, and lack of a supportive and protective system in the organization. In addition, we found that burnout has a significant full mediation effect on the relationship between overload and conflicts in customer service and turnover intention. Although the mediating effect of burnout was significantly associated with the demands and regulation of emotions, no significant effects on turnover intention were found.
To reduce nurses' turnover, we recommend developing strategies that target both burnout and emotional labor, given that burnout fully and partially mediated the effects of emotional labor on turnover intention, and emotional labor was directly associated with turnover intention.
Principles of Clinical Pharmacology is a successful survey covering the pharmacologic principles underlying the individualization of patient therapy and contemporary drug development. This essential ...reference continues to focus on the basics of clinical pharmacology for the development, evaluation, and clinical use of pharmaceutical products while also addressing the most recent advances in the field. Written by leading experts in academia, industry, clinical and regulatory settings, the third edition has been thoroughly updated to provide readers with an ideal reference covering the wide range of important topics impacting clinical pharmacology as the discipline plays an increasingly significant role in drug development and regulatory science. The Third Edition has been endorsed by the American Society for Clinical Pharmacology and Therapeutics Includes new chapters on imaging and the pharmacogenetic basis of adverse drug reactions Offers an expanded regulatory section that addresses US and international issues and guidelines Provides extended coverage of earlier chapters on transporters, pharmacogenetics and biomarkers and also illustrates the impact of gender on drug response Presents a broadened discussion of clinical trials from Phase 1 to incorporate Phases II and III.
Aim & Objective
Explore leadership self‐perception of clinical nurses at the bedside and their perception of leadership on patient care and outcomes.
Background
According to Institute of Medicine ...Future of Nursing Report, nurses are called to exhibit leadership at every level. Published research on nursing leadership is primarily focused on formal leaders. Research examining leadership at the clinical nurse level has either tested application of a particular leadership model or studied nurses who have been identified as informal clinical leaders. We took an inductive approach without any prior knowledge if participating clinical nurses viewed themselves as leaders.
Design
Descriptive qualitative method was used.
Methods
Four focus groups were conducted with a total of 20 clinical nurses from 2 hospitals within an integrated health system using a convenience sampling method until saturation was reached. The Consolidated criteria for Reporting Qualitative research (COREQ) was used to report findings.
Results
All participants identified qualities they admired in leaders. Fifty percent did not initially view themselves as leaders until they realised that they often demonstrated those same leadership qualities in providing nursing care to patients and families. Participants struggled to make a connection between their leadership at the bedside and patient outcomes.
Conclusions
Clinical nurses assume a formal title is required to be a leader. Findings from this study imply that leadership attributes required at point of care are embedded in the nursing practice and look similar to servant leadership.
Relevance to clinical practice
Leadership is in the nature of nursing practice, and more work is required to increase awareness that every nurse is a leader. Further efforts need to be pursued to help clinical nurses become self‐aware they are leaders in order to impact patient outcomes and transform health care from bottom‐up and inside‐out.
The COVID-19 pandemic presented staffing challenges in providing care during the surge of critically ill patients. This qualitative descriptive study was conducted to obtain an understanding of ...clinical nurses' perspective of staffing in units during the first wave of the pandemic. Eighteen focus groups were conducted with registered nurses who worked on intensive care, telemetry, or medical-surgical units at 9 acute care hospitals. The focus group transcripts were thematically analyzed to identify codes and themes. The overarching theme was staffing, a bit of a mess, which sums up the general perception of nurses during the initial phase of the pandemic. The following additional themes underscore the overarching theme: challenging physical work environment; supplementing the frontline: buddies, helpers, runners, agency, and travel nurses; nurses do everything; getting through as a team; and emotional toll. Nurse leaders can utilize these findings to guide staffing decisions today and in the future, such as ensuring nurses are oriented to their deployed unit, keeping team members together when reassigned, and striving for consistency with staffing. Learning from the experience of clinical nurses who worked during this unprecedented time will assist in improving nurse and patient outcomes.
Aim
To examine the associations between compassion competence and missed nursing care, professional quality of life and quality of life among clinical nurses.
Background
Compassionate care has been ...demonstrated to have a positive impact on outcomes for patients, employees and organisations. However, little is known about the associations between compassion competence and missed nursing care, professional quality of life and quality of life among clinical nurses.
Methods
A survey was conducted with 1,556 Korean clinical nurses. The associations between compassion competence and missed nursing care, professional quality of life and quality of life were examined using multivariate linear regression.
Results
Compassion competence was negatively associated with missed nursing care and burnout but positively associated with compassion satisfaction, secondary traumatic stress and quality of life.
Conclusions
Our results extend the literature on the significant influence of compassionate care by providing evidence of its positive effects on missed nursing care, compassion satisfaction, burnout and quality of life in clinical nurses.
Implications for nursing management
Nursing managers should implement programmes to improve compassion competence in clinical nurses to address missed nursing care and burnout and improve compassion satisfaction and quality of life, thus improving quality of care, patient experience and patient safety.
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