Journal of Nursing Management最新文献

Background: Change is prevalent in nursing environments and often leads to change fatigue among nurses while aiming to improve service quality and efficiency. Change fatigue is a significant stressor affecting nurses’ work and psychology, and it is a crucial factor influencing organizational change. However, the concept of change fatigue among nurses has not yet been clearly defined or analyzed.

Aim: This analysis aims to differentiate, clarify, and clearly identify the specific concept of change fatigue among nurses, which will provide nursing administrators and researchers with a comprehensive understanding of the concept of change fatigue among nurses, ultimately facilitating relevant measurements and interventions.

Methods: This study employed Walker and Avant’s concept analysis method.

Results: A total of 29 papers were included in the study. The four defining attributes of change fatigue among nurses were identified as nurses’ exposure to constant change, exhaustion, decreased agency, and passive acceptance of change. Antecedents were categorized into nurses’ personal factors and those related to the organizational environment. The consequences of change fatigue were distinguished between individual-level and organizational-level impacts.

Conclusions: This study provides a clearer understanding of the concept of change fatigue among nurses by outlining its antecedents, attributes, and consequences. An operational definition and conceptual understanding of change fatigue will aid future research in developing effective prevention strategies.

Aim: This study aimed to elucidate the relationship between digital competence (DC), nurses’ career sustainability (CS), and the moderating role of family-supportive supervisory behavior.

Background: Nurses’ CS is crucial in promoting medical digital transformation in China. Thus, clarifying the influencing factors of nurses’ CS has become a priority.

Methods: This cross-sectional investigation was carried out in Anhui Province, China. Eight hundred and fifty-four nurses received self-administered questionnaires, which included the Digital Competence Questionnaire, Career Self-Efficacy Scale, Career Sustainability Scale, and Family-Supportive Supervisory Behavior Scale. A hierarchical regression analysis was used to test a hypothesized model.

Results: Nurses’ CS is significantly predicted by DC (r = 0.52, p < 0.01), and career self-efficacy (CSE) mediates this association (β = 0.682, p < 0.01). In addition, family-supportive supervisor behavior (FSSB) moderates the relationship between DC and CSE (β = 0.146, p < 0.01).

Conclusions: Our study investigates the positive impact of DC on nurses’ CS at both the individual and organizational levels, identifies potential boundary conditions, and advances theoretical research on nurses’ CS while providing a solid foundation for developing effective strategies to improve nurses’ CS.

Implications for Nursing Management: Hospital managers and leaders should focus on organizational support for nurses and their families, formulate intervention measures to increase nurses’ DC and CSE, and improve their CS.

Objective: To estimate the efficiency of a nurse-led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE-DD program).

Design: Secondary analysis of cost-consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment.

Method: The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost-effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed.

Results: The number of controlled patients is higher in the TELE-DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE-DD group than in the control group at 6 months (€160.31 vs. €49.79), but lower at 12 (€150.09 vs. €179.59) and 18 months (€209.22 vs. €376.88). The incremental cost-effectiveness ratio at 6, 12, and 18 months was €254.47, €143.65, and €177.46, respectively. The budget impact analysis revealed that implementing the TELE-DD program would result in a reduction of €721,940.68 in expenditure for the funder in the first year of application.

Conclusions: A nurse-led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources.

Trial Registration: ClinicalTrials.gov Identifier: NCT04097483.

Background: Patient safety is paramount in healthcare, and effective communication is a cornerstone of preventing adverse patient events. Despite nurses’ crucial role in improving patient safety, they often keep silent about their concerns. This study investigated links among hierarchical unit culture, nurses’ power distance orientation, perception of futility, and silence behavior in healthcare environments. Moreover, we aimed to determine whether nurse-perceived hospital management support for patient safety moderated the association between nurses’ perceived futility and silence behavior.

Methods: This cross-sectional, correlational study utilized survey data from 730 direct-care nurses working in 88 medical, surgical, or medical–surgical units across 34 hospitals in South Korea. Validated psychometric scales measured the study variables, and data were analyzed using a 2-1-1 type of multilevel structural equation model.

Results: Hierarchical unit culture and power distance orientation showed significant positive associations with nurses’ perception of futility (b = 0.62, p < 0.001, and b = 0.37, p < 0.001, respectively) and subsequently with their silence behavior (b = 0.22, p < 0.01, and b = 0.31, p < 0.001, respectively). Futility was found to mediate the relationship of both hierarchical unit culture (indirect effect = 0.222, 95% confidence interval (CI) [0.006, 0.438]) and power distance orientation (indirect effect = 0.132, 95% CI [0.003, 0.261]) to silence behavior. Hospital management support for patient safety significantly moderated the relationship between futility and silence behavior (b = 0.04, p < 0.05); nurses were less likely to remain silent when they perceived high management support as opposed to low support, regardless of their futility level.

Conclusion: Our findings highlight the crucial influence of organizational culture on nurses’ silence behavior. The findings also underscore the importance of hospital management support with respect to patient safety. Management support may be necessary to combat nurses’ perceived futility and to promote open communication.

Aim: The Organizational Learning Instrument–Development Stages (OLI-DS) measure hospital units’ readiness to engage in organizational learning. This study aimed to translate and evaluate the psychometric properties of the Persian version of this instrument.

Background: Organizational learning is crucial for nurses as it enables them to continuously develop their knowledge, skills, and abilities, enhancing the quality of patient care. However, validated instruments are needed to assess organizational learning in Persian-speaking healthcare settings.

Design: The research was carried out using a cross-sectional design.

Methods: This research study involved 319 clinical nurses selected using convenience sampling. The OLI-DS tool, consisting of 35 items, underwent a forward–backward translation process to Persian before being utilized for a psychometric analysis. The face, content, and construct validity were used to evaluate the tool’s effectiveness. The quality and accuracy of the measurements were determined by calculating internal consistency and stability reliability. The data were analyzed using SPSS and AMOS software.

Results: The intended meaning and clarity of the original English version were preserved in the Persian rendition of the OLI-DS instrument. The confirmatory factor analysis (CFA) further confirmed the consistency of the Persian version with the proposed four-factor model, indicating a good fit. The overall instrument had excellent values for Cronbach’s alpha coefficient (α = 0.931), McDonald’s omega (ω = 0.921), coefficient H (H = 0.979), and mean interitem correlation (ρ = 0.278). The convergent and discriminant validity of the four latent factors was found to be good. The stability of the overall OLI-DS instrument was ICC = 0.942 (95% CI, 0.902–0.955).

Conclusion: The Persian version of the OLI-DS has been validated to evaluate hospital units’ readiness for organizational learning processes. It is a robust tool for assessing their preparedness to participate in and benefit from organizational learning initiatives.

Implications for Nursing Management: The robust psychometric validation of the Persian version of the OLI-DS instrument equips nursing administrators and leaders with a reliable tool. This tool can assess and monitor organizational learning and development in healthcare settings, empowering them to make informed decisions in critical nursing management activities.

Background: Occupational stress is a significant challenge for healthcare systems worldwide. It compromises the quality of healthcare and jeopardizes patient safety. Globally, the estimated economic impact of occupational stress in the healthcare system ranges from US $221.13 million to US $187 billion. Emotional intelligence has been recognized as a behavioral buffer against occupational stress. Hence, this study investigated whether nurses’ perceptions of emotional intelligence impact their self-perceived occupational stress.

Design: A predictive correlational design was utilized.

Method: A prior power analysis using G ∗ Power 3.1 was conducted. A convenience sample of 734 nurses was recruited from Taif Health Cluster. Data were coded and analyzed using IBM® SPSS® Statistics for Windows v.25. Descriptive and inferential statistics were used. A hierarchical regression technique was used. The level of significance was established at p < 0.05. The process of data collection started at August 2022 and continued through October 2022.

Results: The results indicated that nurses’ age and working area predicted occupational stress perceptions in the first model (β = −0.28 and β = 0.21, p = 0.001, respectively). The second model showed a significant improvement (ΔF(7,727) = 162.35, p < 0.000, ΔR² = 0.226) and indicated a negative correlation between nurses’ perceptions of emotional intelligence and occupational stress (β = −0.45, t = −12.8, p < 0.000). The nurses’ sociodemographic characteristics in the first model explained 2.4% of the variance. The second model represented 25.0% of the variance when nurses’ emotional intelligence perception was included.

Conclusion: Our study shows a novel framework that indicates a positive perceived effect of emotional intelligence on nurses’ perceptions of occupational stress in Saudi Arabia. Our findings propose that emotional intelligence is a significantly effective mechanism against occupational stress.

Introduction: Using the COVID-19 pandemic as an example of a national and international crisis, it has been possible to show how critical care nurses (CCNs) were affected by their work situation with impact on health and wellbeing. This study sought out to investigate how CCNs stress was affected and to provide some answers as to how to react and organize care in a future crisis. The specific focus was CCNs’ stressors related supervision of nurses untrained in intensive care and how these were handled in a salutogenic perspective.

Aim: The aim of this study was to analyze CCNs’ experiences of supervision of nurses without training in intensive care during the COVID-19 pandemic, and to analyze these experiences with the help of the salutogenic concept sense of coherence.

Materials and Methods: The phenomena under study were explored during the years of 2021–2022 through in-depth interviews and interpreted using deductive content analysis.

Results: By analyzing CCNs experiences of supervising nurses without training in intensive care with the lens of sense of coherence, it was possible to show in what way these concepts influenced how to cope with the demanding situation. Sense of coherence was influenced by the inevitable prioritization of patient care and nursing interventions. This prioritization caused moral distress, but was also enhanced or decreased by CCNs sense of coherence.

Conclusion: When recruiting and introducing new personnel in a future crisis to any field of healthcare, but particularly to the intensive care, we would, on the basis of these findings, suggest that well-established plans are vital for how to move personnel throughout the organization, and for how to introduce the field of intensive care. Plans for how to model care with the help of RNs without specialist training should be put in place. A communication plan for the organization is also of importance to enhance transparency.

Introduction: Nurses, as frontline healthcare professionals, play a crucial role in ensuring patient safety, making their ability to speak up imperative. However, there are limited studies categorizing nurses based on their speaking-up behaviors and comparing their organizational characteristics. This study aimed to identify patterns of nurses’ speaking-up behaviors and examine differences in organizational cultures, teamwork climates, and working conditions according to these patterns.

Methods: A cross-sectional survey was conducted, involving 597 nurses directly participating in nursing care in Korean hospitals. The Speaking Up about Patient Safety Questionnaire (SUPS-Q), Nursing Organizational Culture Questionnaire, and Safety Attitude Questionnaire-Korean version (SAQ-K) were employed to measure nurses’ speaking-up-related behaviors, organizational culture, teamwork climate, and working conditions. Cluster analysis was used to identify clusters of nurses based on their speaking-up-related behavior. Differences in nursing organizational culture, teamwork climate, and working conditions among clusters were analyzed using one-way analyses of variance.

Results: Three clusters of nurses were identified based on their speaking-up-related behaviors. Cluster 1 (35%) showed high perceived concerns, moderate withholding, and speaking up, while Cluster 2 (37%) had moderate concerns, low withholding, and high speaking up. Cluster 3 (28%) had moderate concerns but low withholding and speaking up. Clinical experience significantly differed among clusters, with less experienced nurses predominantly in Cluster 1. Cluster 2 had the most collaborative culture, best teamwork climate, and working conditions.

Conclusion: Ensuring patient safety requires nurses to speak up about patient safety concerns. Creating safe working environments and fostering an organizational culture that prioritizes patient safety are essential steps in promoting nurses’ willingness to speak up about patient safety.

Aim: The present study aims to analyze the presence of gender stereotypes in the metaphors nurse clinicians use to describe their patients.

Methods: This study was conducted with 149 nurse clinicians working at a university hospital. Data were collected using a metaphor survey.

Results: The most common metaphors for female patients were “flower” (f: 23) and “mother/my mother” (f: 8), whereas the most common metaphors for male patients were “wood” (f: 10) and “cactus” (f: 7). These metaphors were more frequently produced by female nurses. Female patients were often described as “delicate, in need of attention and help, and fragile,” while male patients were described as “strong, authoritative, head of the family, and tough.” Female nurses likened a more delicate male patient to a “delicate woman,” and male nurses likened the strength of a male patient to a “man.” Furthermore, eight nurses, five male nurses and three female nurses, frequently used the metaphor of “patient” (f: 6) while stating that they did not view patients as female or male. Male nurses (f: 4) produced the metaphor of “patient” (f: 6) the most.

Conclusion: It is important not to overlook the factors underlying the metaphors produced by nurse clinicians. In this regard, extensive studies are needed to take into account additional factors such as cultural background, experience, or specific patient interactions that may have a major impact on how nurses perceive gender.

Implications for Nursing Management: This study evaluates nurse clinicians’ perceptions of patients in the context of gender stereotypes and highlights some important points in terms of nursing and patient care.

Introduction: The need for innovative technology in healthcare is apparent due to challenges posed by the lack of resources. This study investigates the adoption of AI-based systems, specifically within the postanesthesia care unit (PACU). The aim of the study was to explore staff needs and expectations concerning the development and implementation of a digital patient flow system based on ML predictions.

Methods: A qualitative approach was employed, gathering insights through interviews with 20 healthcare professionals, including nurse managers and staff involved in planning patient flows and patient care. The interview data were analyzed using reflexive thematic analysis, following steps of data familiarization, coding, and theme generation. The resulting themes were then assessed for their alignment with the modified technology acceptance model (TAM2).

Results: The respondents discussed the benefits and drawbacks of the proposed ML system versus current manual planning. They emphasized the need for controlling PACU throughput and expected the ML system to improve the length of stay predictions and provide a comprehensive patient flow overview for staff. Prioritizing the patient was deemed important, with the ML system potentially allowing for more patient interaction time. However, concerns were raised regarding potential breaches of patient confidentiality in the new ML system. The respondents suggested new communication strategies might emerge with effective digital information use, possibly freeing up time for more human interaction. While most respondents were optimistic about adapting to the new technology, they recognized not all colleagues might be as convinced.

Conclusion: This study showed that respondents were largely favorable toward implementing the proposed ML system, highlighting the critical role of nurse managers in patient workflow and safety, and noting that digitization could offer substantial assistance. Furthermore, the findings underscore the importance of strong leadership and effective communication as key factors for the successful implementation of such systems.