Journal of Nursing Management最新文献

Object. To explore nurses’ experiences and perceptions of implementing pharmaceutical technical assistants on hospital wards for medication dispensation. The study focuses on implementation, role development, and impact on safety and quality of care, identifying critical success factors and improvement opportunities. Methods. In a qualitative descriptive study, between December 2022 and March 2023, 16 semistructured interviews were carried out with a stratified purposive sample of nurses across internal, surgical, and geriatric wards. The inclusion criteria required a minimum of six months of work experience and experience working both day and night shifts. Inductive thematic analysis was performed in NVivo 1.6.1. Results. Semistructured interviews revealed three main themes: (1) patient safety and quality of care, (2) organization of care, and (3) role development and collaboration. The implementation of pharmaceutical technical assistants on nursing wards was perceived to reduce the risk of medication errors without compromising care quality, allowing nurses to spend more time on direct patient care. Clear communication procedures were vital for successful implementation, highlighting the need for collaboration and information exchange between pharmaceutical technical assistants and nurses. Continuity in assigning pharmaceutical technical assistants was highlighted as crucial to improve medication safety and quality of care. This is considered an important aspect to ensure a smooth and optimal cooperation between nurses and pharmaceutical technical assistants. Nurses expressed that working with pharmaceutical technical assistants challenged their supervisory role and teamwork dynamics. Conclusions. Nurses confirmed the added value of pharmaceutical technical assistants in medication management. Critical factors included dedicated assignments to hospital wards, clear roles, and mutual expectations in collaboration with ward nurses.

Aim. The current study investigated the levels and predictors of leaders’ humble leadership, participants’ psychological safety, knowledge sharing in the team, and followers’ creativity in nursing. Background. Humble leadership, psychological safety, knowledge sharing, and followers’ creativity are non-nursing research fields, and humble leadership has recently been examined in nursing. Methods. A cross-sectional research design was employed via an online survey. A nonprobability convenience snowball sample of 245 nursing academics (n = 85, 34.70%), nurses (n = 140, 57.10%), and nursing leaders (n = 20, 8.20%) was recruited from three universities and three hospitals. Results. The participants rated “high” the leaders’ humble leadership, knowledge sharing in the team, and followers’ creativity in nursing. However, participants’ psychological safety was precarious. The four variables’ predictors were assessed based on the sample’s characteristics. Leaders’ humble leadership did not predict participants’ psychological safety; the sole predictor of the variable was the organization’s quality initiatives. The predictors of knowledge sharing in the team were leaders’ humble leadership, age, level of education, and accreditation initiatives in the organizations. The predictors of followers’ creativity were leaders’ humble leadership, level of education, and quality initiatives in the organizations. The lowest means of the four variables should be immediately managed. Conclusion. Quality initiatives in organizations and the number of tenures were the most influential predictors of the four variables evaluated. Leaders’ humble leadership predicted knowledge sharing in the team and followers’ creativity, but not participants’ psychological safety. As followers’ psychological safety contributes to trustful relationships within the team, workplace boundaries and conducive work environments should be promoted. Training programs are required to develop humble nurses and leaders’ leadership.

Background. Nurses represent the largest occupational group within the health care system, comprising half of the global health workforce. Health care settings are facing severe shortages in countries worldwide, with nurse turnover being identified as the primary reason for this shortage. However, estimates of nurse turnover rates vary widely in the relevant literature. Objective. This meta-analysis aimed to investigate the global nurse turnover rate since 2000 and provide evidence-based assistance to health policy makers and hospital managers. Methods. A systematic search of the PubMed, Web of Science, Embase, CINAHL, and Cochrane Library databases was conducted for relevant articles from January 1, 2000, to February 1, 2023. This study included cross-sectional, cohort, and longitudinal studies. In the meta-analysis, further risk of bias, heterogeneity, and subgroup analyses were conducted. Stata 17.0 was used for all of the statistical analyses. Results. In total, 48,157 records were scrutinized in this study, and 21 investigations encompassing 213,314 nurses across 14 countries were eventually included. The global nurse turnover rate ranged between 8% and 36.6%, and the combined nurse turnover rate was 16% (95% confidence interval: 14%–17%). Subgroup analysis demonstrated that the turnover rate was 19% (95% CI: 14%–23%) in Asia and 15% (95% CI: 13%–17%) in North America. Conclusions. This meta-analysis analysed the literature published from January 2020 to February 2023 and demonstrated that the global nurse turnover rate was 16%. It is suggested that all medical and health institutions actively adopt relevant systems that can reduce the turnover of nurses and promote a more harmonious, healthy, and safe occupational environment for nurses to strengthen the sustainable development capacity of the nurse workforce.

Introduction. Shifting care from hospitals into community-based settings is a major policy goal internationally. Community health services in England currently face the greatest workforce shortages of all sectors, threatening the feasibility of this policy. Moreover, little is known about the extent of variation in community workforce provision regionally and how this relates to determinants of need. Aim. To analyse regional variation in the community services workforce in England between 2010 and 2021. Methods. We obtained NHS workforce statistics data on the number of nurses and nursing support staff providing community services at each NHS organisation in England, from March 2010 to November 2021. We aggregated the organisation-level data to both regional and national levels, which enabled us to maintain consistent units of analysis across the decade. To examine longitudinal trends and regional variation in workforce provision, we calculated the number of staff per 100,000 population aged 65+ in each region and each period. We then graphed and summarised the variation and examined the correlations with levels of deprivation and rurality. Results. There was a twofold variation in community services workforce provision between English regions. In November 2021, the number of staff per 100,000 people aged over 64 ranged from 300 in the South West to 697 in the North West. Most regions experienced a reduction in provision between 2010 and 2021, with a 21.2% reduction nationally. East of England experienced the largest reduction of 39.3%, whilst London experienced a 2.1% increase. In November 2021, regions with more deprived populations had higher workforce provision and regions with a larger proportion of residents living in rural areas had lower workforce provision. Conclusions. The size of the community services workforce has fallen relative to population needs, contradictory to the policy priority to enhance care in the community. There was substantial regional variation in the size of the workforce, which has persisted throughout the decade. Workforce provision was higher in more deprived areas but lower in rural areas, potentially impacting equitable access in rural areas.

Aim. The aim of this study was to understand the current status of knowledge-attitude-practice of ICU nurses in tertiary care hospitals regarding swallowing disorders after extubation of tracheally intubated patients and to analyse the influencing factors. Design. A cross-sectional study. Background. Most patients admitted to the ICU have an endotracheal tube, which may be the cause of acute and/or chronic problems after extubation. Therefore, training of ICU nurses and early extubation are essential to prevent these problems. Methods. A convenience sample of clinical nurses (n = 627) was selected from Grade A Hospitals in Northwest, North, and Central China as the study population. Survey instruments included the Questionnaire on ICU Nurses’ Knowledge, Attitude, and Practice of Postextubation Swallowing Disorders in Patients with Tracheal Intubation. Data Sources. Data were sourced from structured questionnaire responses. Results. A total of 647 ICU nurses participated in this survey, with 627 valid questionnaires. The three dimensions of knowledge, attitude, practice, and the total score of the questionnaire on ICU nurses′ knowledge, attitude, and practice of postextubation swallowing disorders in patients with tracheal intubation were (6.46±3.09), (7.53±1.69), (4.89±2.00), and (18.88±5.18), respectively. Multiple linear regression analysis showed that the factors affecting the total score of PED among ICU nurses were age, nationality, professional title, job satisfaction, and mode of employment. Gender, age, nationality, and job satisfaction were the factors that influenced the score of knowledge. The influencing factors of attitude score include gender, age, nationality, section, professional title, job satisfaction, and mode of employment. The influencing factors of the score of knowledge include professional title and job satisfaction. Conclusion. The current status of ICU nurses’ knowledge-attitude-practice regarding postextubation dysphagia in tracheally intubated patients is generally at a moderate to low level, and the level of knowledge-attitude-practice needs to be further improved. Implications for Nursing Management. The results of the study showed that the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients’ postextubation dysphagia were in the lower middle level. Therefore, it is necessary to improve the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients’ postextubation dysphagia. This may include, but is not limited to, the development of tools for assessing PED, systematic and professional training, and the development of multidisciplinary collaborative models.

Introduction. The COVID-19 pandemic has had a significant impact on healthcare professionals globally, with nurses facing diverse challenges at the forefront. Despite their resilience, nurses are experiencing emotional burdens, which have contributed to a growing intention to abandon the profession. Understanding these factors is crucial for addressing the global nursing shortage. Methods. A qualitative descriptive approach was utilized for this study. Nurses who were actively working during the last waves of the pandemic in Catalonia, Spain, were intentionally recruited through social media and personal contacts, and data were collected through online semistructured interviews until data saturation was reached. Data were analyzed using Braun and Clarke’s thematic analysis method. Results. Fourteen nurses, with an average of 22.8 years of work experience, were interviewed. Thematic analysis revealed three main themes: (1) the impact of COVID-19 on health, (2) factors influencing the decision to stay, and (3) recommendations to improve crisis management. Conclusion. Nurses faced significant emotional impacts but demonstrated dedication and resilience. Their decision to persevere was influenced by factors such as responsibility, guilt, and economic stability. Urgent measures are necessary to provide tailored mental health support and recognize emotional challenges in crisis preparedness.

Aims. This study aimed to analyze the effects of the surgery preparation time on patient outcomes. Background. Postoperative complications have a decisive effect on postoperative survival. The anesthesia time is a crucial determinant of such complications. Competent operating room nurses can shorten the surgery preparation time, which is the time from when anesthesia is first administered to the making of the surgical incision. The shortening of this preparation time can shorten the anesthesia time and may reduce postoperative complications. However, discussion of this preparation time is insufficient. Therefore, this study analyzed the effect of the surgery preparation time on patient outcomes. Methods. From electronic health records data, this retrospective cohort study used the data of 1,944 patients who had been immediately admitted to the ICU after their surgery between 2017 and 2020. The patients were divided into two groups: ≥30 minutes preparation time and <30 minutes preparation time groups. We performed chi-squared tests and t-tests to determine differences in preoperation, intraoperation, and postoperation characteristics of the patients and patient outcomes based on the surgery preparation time. Furthermore, we performed a multiple logistic regression by including 12 adjusted variables to determine the influence of the surgery preparation time on patient outcomes. Results. Among the 1,944 patients, 820 were in the ≥30 minutes preparation time group and 1,124 in the <30 minutes preparation time group. The multiple logistic regression analysis showed that the surgery preparation time affects alertness (OR = 1.44; 95% CI: [1.09, 1.90]), ventilator application (OR = 1.32; 95% CI: [1.03, 1.70]), and length of stay in the ICU (OR = 1.69; 95% CI [1.16, 2.47]). Conclusions. The surgery preparation time affects postoperative patient outcomes. The competence of operating room nurses is the most essential aspect of the surgery preparation time. Implications for Nursing Management. It is important to analyze operating room nurses’ tasks, standardize the tasks, and educate nurses according to their experience level to reduce the surgery preparation time and improve patient outcomes.

Aims. (i) To evaluate the scope and quality of nurse-patient interactions recorded in the clinical notes of inpatient mental health units and (ii) to identify nursing interventions recorded in the context of the nurse-patient relationship in the clinical notes of inpatient mental health units. Design. A multimethod approach was use. Methods. Employing a quantitative cross-sectional design for the first aim, and a qualitative content analysis design of secondary data for the second aim. In total, 1,714 clinical notes were examined from 44 randomly selected patients who were hospitalized in five mental health units over the years 2022-2023. Results. The patient’s experience of the interaction was present in 69.9% (n = 1,198) of the notes. However, only 12.0% (n = 205) of the notes reached a sufficient standard of quality in terms of describing the nurse-patient interactions. Specifically, more than half of the notes did not reflect any type of nursing intervention (n = 723; 60.4%). Thirty interventions compatible with the nursing intervention classification were identified, of which more than 70% corresponded to domains in the physiological area. Conclusion. This study shows that the quantity and scope of patients’ clinical notes in mental health units do not sufficiently reflect the interventions performed by nurses, nor the quality or impact of these interventions in the context of the nurse-patient therapeutic relationship. Implications for the Profession and/or Patient Care. Improving the quality of clinical notes by integrating interventions and their impact can increase the quality of nursing care. Impact. The use of standardized nursing terminologies would contribute to the understanding of the extent and quality of nurse-patient interactions recorded in clinical notes. Thus, standardized documentation would also help to improve these interactions and their recording, which will facilitate decision-making. Reporting Method. Findings were reported using COREQ and STROBE guidelines. Patient or Public Contributions. There were no patient or public contributions.

Background. Although retaining new nurses is imperative for the future of the nursing profession, it remains a challenging task in the healthcare industry. Understanding the career journey of new graduates as they transition from students to nurses is vital. However, longitudinal studies investigating the factors influencing retention during this period are lacking. Aim. The aim of this study is to identify the influencing factors and develop a longitudinal prediction model for new graduate nurse retention. Methods. A secondary data analysis was conducted using the New Nurse e-Cohort Study dataset from two survey periods, November–December 2020 and February–March 2022. The participants were categorized into either retention or turnover groups based on their turnover experiences. A decision tree based on classification and regression tree (CART) analysis was utilized. Results. Of the total 586 participants, 463 (79%) were in the retention group. The CART model highlighted that new nurses’ retention was significantly associated with younger age, higher readiness for practice (clinical problem-solving) during the nursing program, lower transition shock (such as confusion in professional values, loss of social support, and conflicts between theory and practice), and a higher person-environment fit (person-job fit). The predictive accuracy of the CART model was 79.7%. Conclusion. To retain new nurses, nursing educators and hospital managers should collaborate to prepare nursing students for actual practice, offer support during organizational socialization, and foster healthy professional values for competence in the workplace. Implications for Nursing Management. Transforming the educational strategies of nursing programs and hospital management policies is imperative to ultimately enhance the retention of new graduate nurses.

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts.