Journal of Nursing Management最新文献

Aim: To analyze the existing evidence on the contribution of the nursing profession to efficiency and healthcare sustainability in the hospital setting.

Background: Promoting economic efficiency in hospital centers is a key factor in ensuring their long-term sustainability. In this regard, nursing professionals with caregiving roles could emerge as valuable contributors to the survival of the existing hospital model.

Design: A systematic review was conducted following PRISMA guidelines. This review has been registered with PROSPERO under the registration number: CRD42023481140.

Method: A search was conducted across four international databases (CINAHL, PubMed, Scopus, and WOS) from 2013 to the present for studies in English and Spanish. Primary studies on economic evaluations and systematic reviews were included. The study selection was carried out in three stages, with two reviewers independently analyzing the data and resolving disagreements through discussion and consensus. The quality assessment utilized the CASP tool, the CHEERS checklist, and the STROBE statement.

Results: Out of 3058 records identified, nine were deemed eligible, comprising one longitudinal study, four descriptive studies, two systematic reviews, two randomized controlled trials, one cohort study, and two case-control studies, with a total of 333,597 patients. The studies varied in sample size, intervention strategy, content, measurement scales, and statistical analysis of the primary outcome. The studies indicate that health education provided by hospitals is cost-effective, potentially generating costs below 100,000 dollars per quality-adjusted life year. Investing in nursing specialty, advanced practice nurses, and clinical safety reduces the number of admissions and decompensations.

Conclusions: This review highlights that health education and clinical safety are the areas where nursing tasks have the most significant economic impact. Nursing specialty and the inclusion of advanced practice nurses are proving to be fields towards which health systems should focus to promote a more economically sustainable model.

Background: Acquired competencies, skills, and abilities can lead professionals into an overqualification situation that is associated with absenteeism, desire to abandon the respective profession, negative work performance, and interpersonal conflicts.

Aim: To develop and validate the Italian version of Maynard’s Scale of Perceived Overqualification (SPOQ).

Method: The SPOQ was linguistically and culturally adapted to develop and validate an Italian version (SPOQ-IT), calculating a content validity index and testing the scale validity with a cross-validation approach using Cronbach’s alpha, exploratory, and confirmatory factor analyses (CFAs).

Results: The SPOQ-IT had a good content validity index. Two dimensions (“overqualification” and “underemployment”) emerged from the exploratory and CFA. Age, gender, and working years affected the overqualification and underemployment perception in the Italian nursing profession.

Conclusion: The SPOQ-IT has good psychometric properties and demonstrated that acquired competencies, skills, and abilities are often underexploited in the Italian nursing profession, leading to overqualification and underemployment perceptions.

Implications for Nursing Management: Nursing managers should govern and monitor the overeducation and its effects on organizational and patients’ outcomes because the implementation of acquired competencies, skills, and abilities improves work performance and the quality of nursing care and avoids underemployment condition.

Background: The mental health of nursing students directly affects their future performance, quality of patient care, and personal development. Therefore, an in-depth understanding of research in this area can assist in implementing effective measures to improve the mental health of nursing students.

Aim: This study used bibliometric analyses to identify and analyze articles, authors, journals, and research institutes investigating nursing students’ mental health in terms of thematic structure and topic evolution, aiming to provide direction and guidance for future research.

Methods: In this retrospective bibliometric analysis, data were downloaded from the Web of Science Core Collection on August 15, 2024. Subsequently, CiteSpace software was employed to analyze the annual number of publications and citations, explore relationships between authors, institutions, countries, and keywords, and summarize research hotspots and frontiers in the field of nursing students’ mental health.

Results: Articles published from database inception to August 15, 2024, were screened, leading to the retrieval of 3803 relevant articles. The United States of America was the leading country in terms of research output on the mental health of nursing students, with 982 (25.79%) published articles, while the United States Department of Health and Human Services provided the most funding. Furthermore, Happell, B was the most productive author in this field, with 80 published papers. Lastly, Nurse Education Today was the most prolific journal in nursing education.

Conclusion: The main recent research trends include the psychological profile of nursing students, intervention strategies for improving the mental health of nursing students, and the influence of educational methods, clinical experience, and humanistic care on the mental health of nursing students. These trends imply that researchers should develop targeted training programs, apply information technology, and implement personalized teaching to enhance the psychological resilience of the nursing student population. Moreover, higher education institutions should provide nursing students with more comprehensive and effective mental health support by maintaining mental health files, strengthening mental health education, providing psychological counseling services, and establishing social support systems.

Objective: The purpose of this study was to retrieve, evaluate, and summarize the evidence for the prevention of deep vein thrombosis (DVT) in adult hip fracture patients and to provide an evidence-based basis for clinical practice.

Methods: Based on the top-down principle of the “6S model” of evidence-based resources, we systematically searched the relevant databases and websites for the prevention and treatment of DVT in adult hip fracture patients at home and abroad. The types of literature included clinical decision-making, clinical guidelines, evidence summary, systematic review, and expert consensus. The search range is from January 2014 to January 2024. Two review authors graded the evidence according to the Joanna Briggs Institute Center for Evidence-Based Health Care Pre-Grading System (2014 Version) in Australia.

Results: A total of 12 articles were included, including 2 clinical decisions, 3 guidelines, 1 evidence summary, 1 systematic review, and 5 expert consensus. We summarized 4 categories with a total of 28 best pieces of evidence, covering DVT risk assessment, diagnosis and screening, nursing intervention, and health education.

Conclusion: This study comprehensively summarizes the best available evidence for the prevention of perioperative DVT in adult patients with hip fracture and provides evidence-based basis for clinical nurses. The application of the best evidence to scientifically manage and prevent perioperative DVT can improve patient satisfaction and perioperative nursing quality.

Background: Nurses experiencing second victimization after a patient safety incident face challenges in developing effective coping strategies. Active coping can lead to constructive practice changes within a just culture. However, no theoretical model has yet tested the relationships among a just culture, second victim variables, coping strategies, and practice changes.

Methods: A nationwide online survey was conducted using proportional quota sampling based on region, representing 0.7% of nurses in tertiary hospitals across various Korean regions as of August 2022. Partial least squares structural equation modeling (PLS-SEM) was used to develop the hypothesized model, determine the model fit, and test research hypotheses. Descriptive statistics, model fit, and path analysis were performed using SPSS and Smart-PLS.

Results: The final analysis included 461 clinical nurses. Six significant pathways were identified: A just culture positively influenced constructive changes in nursing practice through second victim experience and avoidant coping (B = 0.07, p < 0.001). In the absence of a just culture, constructive changes decreased (B = −0.12, p < 0.001). The just culture negatively influenced defensive changes in nursing practice through second victim experience (B = −0.24, p < 0.001). The just culture negatively influenced defensive changes in nursing practice through second victim experience and avoidant coping (B = −0.10, p < 0.001). Without the just culture, defensive changes in nursing practice increased (B = 0.19, p < 0.001). The just culture reduced avoidant coping through second victim experience (B = −0.25, p < 0.001).

Conclusions: This study provides pathways to increase constructive nursing practice changes and decrease defensive nursing practice changes in nurses who have experienced a patient safety incident.

Implications for Nursing Management: The just culture needs to be established in a nursing practice setting and healthcare organizations. This study, using a representative sample through proportional quota sampling, provides reliable and valid evidence for nursing practice and healthcare organizations regarding the just culture, second victim experiences, and patient safety.

Aim: This study is a secondary analysis aimed at verifying the relationship between organizational learning activities for evidence-based practices (EBPs) in hospital wards and nurses’ internalization of those EBPs and analyzing the contextual effects.

Methods: This study used data from a previous study which was conducted to develop the group organizational learning activity inventory and used the same sampling method. The participants were asked about the extent of their internalization of EBPs, the organizational learning activities in their ward, and individual and ward characteristics. This study employed two-level hierarchical linear modeling with nurses’ internalization of EBPs as the objective variable, eight factors of the Group Organizational Learning Activity (GOLA) Inventory as the explanatory variable, and individual and ward characteristics as control variables. Nurses’ individual scores for the eight factors of the GOLA Inventory were analyzed by centering within clusters, and the wards’ mean GOLA Inventory scores were also examined. To show the effectiveness of concrete activities for the internalization of EBPs, we calculated the contextual effects of the wards’ organizational learning activities on the internalization of EBPs.

Results: As in the primary analysis, a total of 422 nurses from 56 wards in 12 hospitals responded to the survey and 360 nurses from 48 departments were included in this secondary analysis. Although the mean scores of all eight factors of the GOLA Inventory (ward level) were significantly positively associated with the internalization of EBPs, the contextual effect of each factor differed.

Conclusion: Rather than creating an EBP team, specific ward-level activities, such as those designed to ensure that the staff can understand why EBPs are implemented and encourage them to take ownership of EBPs, are necessary for nurses’ internalization of EBPs. Based on the results of this research, hospital or ward managers, as well as staff involved in introducing new practices, can implement efforts to promote nurses’ internalization of EBPs.

Aim: To understand how migrant nurses perceive their needs for autonomy, competence and relatedness are satisfied and relate how these contribute to regional workplace retention.

Design: A qualitative descriptive study.

Methods: Data were collected through semistructured interviews among 17 migrant nurses employed at a hospital in regional Australia. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. The self-determination theory provided a framework for the study.

Results: One overarching theme, facing challenges with determination to make oneself at home, was identified, with themes: migration and relocation to a regional area, commencing and adjusting to the workplace and integrating with the community. These are further explained with subthemes: experiencing personal vulnerabilities, experiencing familial challenges and adjustment, building connections, finding one’s feet, finding meaningful work through nurse empowerment, valuing relationships at work, and embracing the regional lifestyle.

Conclusion: An unfamiliar work environment and culture may challenge migrant nurses’ needs for autonomy, competence and relatedness, potentially impacting their integration. Supportive work environments, valued workplace relationships, community support and networking with peers from similar backgrounds can assist migrant nurses successfully transition, which may impact long-term retention.

Healthcare organizations aim to achieve excellence in their services while meeting the needs of their staff. A common strategy is to invest in international standards or accreditation models such as ISO, HCAC, or Magnet. This research seeks to examine the impact of the Magnet Model and Accreditation on healthcare organizations and their transformational journey toward nursing excellence and patient-centered care. The paper explains the Magnet Model’s five key tenets—transformational leadership, structural empowerment, exemplary professional practice, fresh knowledge and innovations, and empirical results. The research examines the importance of Magnet status and highlights its significant benefits. Achieving Magnet status positively impacts nurse satisfaction, patient outcomes, and overall organizational success. However, there are a number of implementation challenges in the United Arab Emirates, and this study is to answer this research question “What are the challenges in implementing Magnet Accreditation in the United Arab Emirates on a wider scale?” As such, qualitative research began by conducting a literature review, complemented by input from fifteen (15) subject matter experts operating within the healthcare industry. By examining a wide range of published articles and existing literature, this review aims to provide a comprehensive understanding of patients’ perspectives. The significance of this research lies in its ability to consolidate and analyze existing knowledge in the field. By synthesizing the available literature, it offers valuable insights into the pros and cons of Magnet Accreditation in general and in the UAE market in particular. The findings of this review suggest 5 key challenges for an effective Magnet Model implementation: (1) misalignment with local regulatory environments, (2) minimal improvement to nurses’ working conditions, (3) claims of no real change to nurses or patients, (4) significant financial investment yet questionable ROI, and (5) numerous workforce considerations.

Aims: This study aims to investigate the association between workplace violence and mental wellbeing of long-term care nursing assistants (LTC-NAs) based on work locations.

Background: The increasing global elderly population is elevating the demand for LTC services. The LTC-NA population is expanding, highlighting the necessity to create a secure work environment. However, little is known about how workplace violence poses a threat to the mental wellbeing of LTC-NAs across different work locations.

Methods: This observational cross-sectional study was conducted from October 2022 to July 2023, involving a survey of 937 certified LTC-NAs recruited through convenience sampling from various Taiwanese LTC units. Participants were evaluated for experiences of four types of workplace violence (physical, psychological, verbal, and sexual harassment) using a disseminated questionnaire. Mental health was assessed using the 5-item Brief Symptom Rating Scale, and client-related burnout was evaluated with the 6-item scale from the Chinese version of Copenhagen Burnout Inventory. Logistic regression identified the association between workplace violence and mental wellbeing. In addition, the relationship among participants working in residential facilities or home settings were examined.

Results: The completion rate of the questionnaire was 86%. Psychological violence was associated with poor mental health (adjusted odds ratio [OR] = 2.38 and 95% CI = 1.40–4.05), while verbal violence and sexual harassment were associated with client-related burnout (adjusted OR = 2.03 and 1.75, respectively). All types of workplace violence were more prevalent in residential facilities than home settings; however, the associations of workplace violence with poor mental wellbeing were more prominent among those working in home settings. Among violence victims, a higher proportion of LTC-NAs working in home settings reported experiencing physical and psychological violence from patients’ families compared to those working in residential facilities. Client-related burnout was found to mediate the relationship between violence from patients’ families and poor mental health.

Conclusion: Nonphysical workplace violence and sexual harassment were associated with poor mental wellbeing among LTC-NAs, especially in homecare settings. Violence from patients’ families posed a notable risk to homecare LTC-NAs. Therefore, protective policies and organizational training programs should be tailored to address the unique challenges of each work setting.

Background: The escalating complexity of healthcare environments underscores the importance of nurse managers’ ethical competency, which impacts organizational culture, work climate, and healthcare outcomes.

Objective: The purposes of this study were to identify and describe the characteristics of nurse managers’ competency in ethical principles in healthcare settings.

Methods: A systematic search was conducted across the Web of Science, Scopus, and PubMed databases, covering the literature from January 1, 2014, to April 1, 2024. Articles were selected based on specific inclusion criteria, and data were extracted and analyzed using a frequency analysis of the identified characteristics. This systematic review adhered to the PRISMA guidelines and the Joanna Briggs Institute assessment tools. The review protocol was registered in PROSPERO (ID: CRD42024542594).

Results: The review analyzed 22 studies, each focusing on nurse managers and their ethical competencies. Fourteen distinct characteristics of ethical competency were identified, with ethical leadership, ethical decision-making, and conflict resolution being the most prominent. Key ethical problems included conflicts between personal values and organizational policies, pressures to compromise ethical standards, and management of limited resources. These problems often led to significant consequences such as decreased staff morale, increased stress and burnout, and compromised patient care quality.

Conclusions: The development of ethical leadership and the ability to make ethical decisions are fundamental for nurse managers to create supportive work environments and reduce burnout. Promoting continuous professional development and fostering an ethical culture is essential for maintaining high ethical standards. Future research should explore how cultural, organizational, and environmental differences influence ethical decision making and leadership.

Implications for the Nursing Management: The development of ethical leadership and the ability to make ethical decisions are fundamental characteristics of ethical principles competency, as they facilitate the achievement of an adequate work environment and reduce burnout and emotional overload.