Journal of Nursing Management最新文献

Background: Burnout not only affects the health and work efficiency of nurses but also poses a potential threat to patient safety. The relationship and longitudinal mechanisms between inclusive leadership and nurse burnout in nursing work environments are unclear.

Objective: To analyze the pathways and mechanisms by which inclusive leadership influences nurse burnout through a longitudinal study and to explore the mediating role of professional identity and workplace social capital in this association.

Method: A two-wave study was conducted among 360 Chinese nurses from Baoding No. 4 Central Hospital in March 2024 and October 2024, respectively. The self-report questionnaire consisted of inclusive leadership scale, professional identity scale, workplace social capital scale, and Maslach Burnout Inventory. Pearson’s correlation analysis was employed to explore the relationships among study variables. The structural equation modeling was applied to test the proposed model.

Results: The scores for inclusive leadership, professional identity, workplace social capital, and burnout among nurses were 36.35 ± 7.04, 37.80 ± 6.96, 33.22 ± 5.31, and 30.03 ± 14.23, respectively. There is a significant correlation between the above study variables (p < 0.001). Inclusive leadership negatively influenced burnout directly and indirectly through professional identity and workplace social capital (all p < 0.001). The indirect effects accounted for 65.58% of the total effect, with significant mediation through both pathways.

Conclusions: Inclusive leadership contributed to the elimination of burnout in nurses at work. In addition, professional identity and workplace social capital had chain mediation roles between the effects of the inclusive leadership and burnout.

Implications for Nursing Management: Nursing mangers should actively adopt an inclusive leadership to improve nurses’ professional identity and workplace social capital to ameliorate burnout among clinical nurses.

Background: The mobility of outpatients, frequent treatment sessions, and varying illness severity challenge nursing care and hinder quality improvement efforts. The Donabedian model effectively evaluates nursing quality and is widely used in operating rooms, intensive care units and oncology wards. However, its application in outpatient nursing remains unclear.

Aim: To overview the Donabedian model’s application in outpatient care quality.

Methods: A scoping review was conducted using the Arksey and O’Malley framework, adhering to PRISMA-ScR. Searches for eligible papers were performed on PubMed, OVID, Web of Science, Embase, CNKI, CBM, and Wan Fang in June 2024. Data were analyzed narratively using an inductive approach, with visual mapping done through ArcGIS and Origin.

Results: A total of 18 studies were included in the review. Literature review, Delphi and semistructured interview were widely used in the mixed method studies. The primary settings involved dental clinics and health examination centers, followed by traditional Chinese medicine clinics and pediatric clinics. The studies spanned various regions: 2 in Canada, 3 in Germany, and 13 in China. Structural indicators evaluate outpatient care systems and resources, while process indicators emphasize specialty nursing practice, safety, infection control, and humanistic care. Satisfaction, adverse events, and quality care serve as key secondary indicators for outcome assessment.

Conclusions: The research on outpatient care quality based on the Donabedian model is primarily mixed, with a need to expand interventional and qualitative studies. The structure-process-outcome quality indicators have varying focuses that require further verification and coordination. Structural indicators offer more policy and resource support, while process indicators differ across outpatient specialties, leading to heterogeneous specialist nursing practice metrics. Satisfaction and adverse events are crucial components in evaluating outpatient nursing quality outcomes.

Implications for Nursing Management: The application of the Donabedian model offers care managers practical ideas and references for outpatient care quality improvement.

Background: As the largest workforce in health, it is critically important that the principles of planetary health are incorporated into nursing education to have a significant influence on reducing the environmental impacts of health practices and address health inequities. Despite the adoption of sustainability principles by the higher education sector, the translation into nursing curriculum has been challenging. The increased integration of digital technologies in health contributes towards both sustainability in health and the United Nations Sustainable Development Goals (SDG). Electronic health records (EHRs) are well documented in reducing the reliance on paper-based records and improve the efficiency of health delivery, including accessibility to health where information sharing barriers are reduced. The incorporation of digital health training, and specifically the use of simulated EHRs, into nursing curriculum will increase the application of the principles of planetary health into graduate practice.

Aims: This study explored if the use of an EHR in a simulated learning environment (SLE) in a Bachelor of Nursing (BN) program can lead to tangible reduction in paper consumption.

Methods: A nonexperimental, pre- and postdesign was used to audit the paper consumption, specifically paper-based manuals, within the SLE pre- and postimplementation of the HealthiERSim®, an in house developed simulated EHR system. The study was held across multiple campuses with different BN cohorts.

Results: The study reported an overall reduction paper consumption by 12.59% post-implementation of HealthiERSim® and a reduction in pages per SLE manual, with a significant (p < 0.001) difference in paper consumption between the subjects.

Conclusion: The results of this study indicate an effective implementation of an EHR solution can decrease paperconsumption within an SLE, contributing to reducing the environmental footprint of an educational institution. Where adopted with curriculum content about sustainable practices, this will increase graduate awareness and practice of planetary health principles and the SDGs.

Background: Clinical leadership is vital in improving nurses’ performance and healthcare services.

Aim: This study examined the relationship between clinical leadership behaviors, flourishing, and extra-role behavior among nurses in Jordan.

Methods: A descriptive correlational design was used, which enrolled a convenience sample of 260 registered nurses working at governmental hospitals in Jordan.

Results: The mean score of clinical leadership behaviors was moderate (M = 138.01, SD = 7.82). Nurse flourishing had a mean total score of (M = 31.76, SD = 5.49), indicating positive well-being. Extra-role behavior had a mean score of (M = 23.96, SD = 3.93), indicating moderate participation in extra-role behaviors. There was a significant moderate positive correlation between clinical leadership behaviors and nurse flourishing (r = 0.489, p = 0.047) and extra-role behaviors (r = 0.359, p = 0.004). Factors that significantly predicted nurse flourishing and extra-role behavior were clinical leadership behaviors, age, duration of nursing experience, income, and hospital number of beds.

Conclusion: Effective clinical leadership behaviors can significantly improve nurses’ flourishing and extra-role behavior.

Implication for Nursing Management: The results emphasize the importance of training nurses on positive leadership behaviors to enhance flourishing and involvement in extra-role behavior.

Aim: This study used bibliometric indicators to provide an overview of research on nurse managers’ innovative behaviors.

Background: Encouraging nurses’ innovative abilities leads to improved care quality and work efficiency and reduced healthcare costs. For these reasons, the innovative behaviors of nurse managers are crucial for both their personal development and the success of their teams.

Method(s): Bibliometric methods were employed to investigate the innovative behaviors of nurse managers. Data were collected from the Web of Science (WoS) database through mid-September 2024. A query string search yielded 478 articles, of which 44 met the inclusion criteria and were analyzed using bibliometric techniques. Microsoft Excel and the VOSviewer software were used to analyze the distribution of publications by year, leading countries, prominent journals, contributing authors, coauthor networks, and keyword co-occurrence.

Results: There has been a recent increase in publications on the innovative behaviors of nurse managers, with the United States leading in publication output. The Journal of Nursing Management and the Journal of Nursing Administration were identified as the most prolific journals in this area. In the coauthorship analysis, nine authors emerged as the most linked, forming a cluster with a total of 36 links. Furthermore, the most used keywords were “nurses,” “psychological empowerment,” and “innovative behavior.” Additionally, 56.8% of the articles employed quantitative methods, 31.8% used qualitative methods, and 11.4% applied mixed-method research designs.

Conclusion(s): The analysis of articles indexed in the WoS database suggests that research on the innovative behaviors of nurse managers is still in its developmental stages.

Implications for Nursing Managers: Future research should explore the innovative behaviors of nurse managers and the factors influencing these behaviors further. Both qualitative and quantitative studies should examine how and to what extent these behaviors impact the nurses under their supervision.

Background: Leadership of nurse education and research has become increasingly challenging over the last decade and remains a global issue affecting nurse managers working in the higher education (HE) sector. Nursing faculties have not been immune from the effects of funding constraints, policy reforms and organisational restructures.

Aim: This scoping review explored what is currently known about the qualities, behaviours and characteristics (core attributes) of nurse disciplinary leads that manage nursing faculties in HE.

Method: Five research questions were identified, and a scoping review method was used to map a wide-ranging set of literature and concepts. Databases were searched using a prospective protocol tool, and an extraction table was created to facilitate content analysis.

Findings: Ten articles that addressed one or more of the research questions were identified. While the literature described a range of core attributes required to lead nursing faculties in HE, clarity and definition of terms used were lacking, and articles were primarily opinion-based and nonevidential.

Discussion: Whilst key leadership core attributes may be transferable, nurse disciplinary leads require specific knowledge of the HE sector to operate effectively in this environment. Mentorship was reported to have a highly positive impact on academic nurse leadership skill development.

Conclusion: Further research is needed to identify opportunities to support the growth and readiness of future generations of nurse disciplinary leads and challenge the current deterrents inhibiting nurse academic career pathways in the Australian and New Zealand HE sectors.

Background: Primary nurses hesitated to communicate directly with leaders about safety concerns due to apprehension about confrontation, fear of blame, and their undervalued opinions. Affective leadership’s impact on voice behaviors was characterized by top–down impression management and an absence of upward management. This study aimed to validate the mediating role of workplace upward networking between affective leadership and employee voice behaviors.

Methods: This study was a cross-sectional survey, using purposive sampling to select 639 nurses from all primary hospitals in Hangzhou X district. Measurement tools included the demographic information questionnaire, affective leadership scale, employee safety voice scale, and workplace upward networking scale.

Results: The relationship between affective leadership and employee safety voice mediated by workplace upward networking was confirmed. Affective leadership affected workplace upward networking (B = 0.70, p < 0.0001), with an explained variation of 37%. Affective leadership and workplace upward networking affected employee safety voice (B = 0.45 and 0.21, p < 0.001), with an explained variation of 71%. Workplace upward networking’s total, direct, and indirect effects were 0.65, 0.20, and 0.45, respectively.

Conclusions: The study offers a theoretical basis for enhancing the safety management framework in primary care. It highlights the importance of affective leadership, improving upward management systems and establishing a supportive safety culture to bolster nurse engagement and initiative in patient safety.

Background: Value-based healthcare (VBHC) aims to improve the quality of healthcare delivery while reducing costs and also aims for outcomes that are of utmost importance from patients’ perspectives. Despite a growing interest in VBHC, a significant knowledge gap persists within the existing literature in the absence of a clear conceptualization of VBHC itself.

Aim: The aim of the present study was to develop a comprehensive understanding of the concept of VBHC in order to arrive at a definition based on the evidence in the existing literature.

Method: A concept analysis approach was used to identify the concept’s defining attributes, its antecedents, consequences, and its empirical referents.

Results: The analysis of the concept yielded three defining attributes: monetary value of health service, quality of care, and patient-centered care. The analysis also identified several crucial antecedents for transitioning traditional fee-for-service models to those focused on value; it also identified key interrelated consequences: improved patient outcomes, cost reduction, and increased patient satisfaction.

Conclusion: The concept analysis of VBHC provides a comprehensive framework for understanding its key components and challenges. By aligning healthcare delivery with the values and needs of patients, VBHC represents a promising avenue toward achieving high-quality, sustainable healthcare. The findings from this analysis call for a collaborative effort among healthcare leaders, researchers, and policymakers to further refine and implement VBHC models, ensuring healthcare systems are both patient-centered and cost-effective. These findings also have implications for nursing management.

Aim: To investigate the current state of work-related quality of life among Chinese nurses and to explore the mediating effect of clinical leadership between psychological empowerment and quality of work life.

Background: The quality of work-life significantly affects nursing team stability and the provision of high-quality care. Psychological empowerment and clinical leadership are considered influential factors in nurses’ work-life quality. However, there is a lack of large-scale studies investigating the relationships between these variables.

Methods: This nationwide cross-sectional study utilized a multistage stratified proportional sampling approach to select 2633 registered nurses with more than one year of work experience from 17 tertiary general hospitals in China. The data were analyzed using descriptive analysis, Pearson correlation analysis, and structural equation modeling.

Results: The quality of work-life score for nurses was 3.38 ± 0.67. Positive correlations were observed between clinical leadership and quality of work life (r = 0.470, p < 0.01). Psychological empowerment was also positively associated with quality of work life (r = 0.570, p < 0.01). The structural equation model revealed that psychological empowerment had a positive direct effect on the quality of work life (β = 0.587, p < 0.001), with clinical leadership playing an intermediary role, accounting for 8.42% of the total effect.

Conclusion: Nurses’ psychological empowerment was positively associated with the quality of work life and was partially mediated by clinical leadership. These results suggest that psychological empowerment and clinical leadership are key facilitators improving nurses’ work-life quality.

Implications for Nursing Management: Hospital managers should further raise awareness of empowerment among nurse managers, implement scientifically sound empowerment and clinical leadership programs for nurses, enhance nurses’ clinical leadership skills, and promote the quality of nurses’ work-life.

Background: Confidence in ethical decision-making is a critical factor for the success of nurse leaders. This confidence impacts the quality of nurse care and influences the work environment and the morality of health workers as a team.

Aims: This study aimed to determine the relationship between the ethical decision-making confidence of nursing managers and the ethical behavior of nurses.

Methods: This study used a cross-sectional and correlational design. In total, 532 nurses and 178 nursing managers from 12 hospitals affiliated with Ardabil University of Medical Sciences in Northwestern Iran participated in the study. The measuring tools used were Birkholz et al.’s Ethical Decision-making Scale and Orathai’s Ethical Behavior Scale.

Results: The mean values of ethical decision-making confidence in nurse managers and ethical behavior in nurses were 75.51 ± 7.27 and 130.56 ± 29.16, respectively. Additionally, 62.4% of nursing managers and 74.1% of nurses reported their ability to make ethical decisions and ethical behavior at a high or average level. There was a significant positive relationship between managers’ ethical decision-making confidence and nurses’ ethical behavior (r = 0.9, p = 0.001). The regression model indicated that the managers’ ethical decision-making confidence could predict 81% of nurses’ ethical behavior variance. Furthermore, female nurses and participants in an ethics workshop demonstrated higher ethical decision-making confidence and behavior (p < 0.001).

Conclusion: The confidence of nursing managers in their ethical decision-making significantly influences the ethical behavior of nurses on these managers’ respective units. Continuous training in ethical strategies is essential for managers, as decisions in true ethical dilemmas require a team approach. Managers should serve as role models and not make independent decisions when the choices lack clear right and wrong options.