Journal of Nursing Management最新文献

Aim. This study explored and analyzed the characteristics of bystander types of workplace violence in hospital nurses experiencing horizontal (nurse-to-nurse) violence. The primary research question was “What are the behavioral patterns of bystander types in peer-to-peer violence situations among hospital nurses?”. Background. Workplace violence is a result of environmental and structural conflicts, rather than deviant individual perpetrators. Research examining workplace violence suggests that bystanders are not merely witnesses of acts of aggression but can play a substantial role in escalating or deflecting violence. Types of bystander influence power dynamics within a group, resulting in changes in the pattern of violence. Methods. Employing a qualitative design, this study conducted focus group interviews with nurses from three tertiary hospitals. The qualitative data collected was analyzed using inductive and qualitative content analysis methods. Results. Nine focus group interviews (n = 26) were conducted on bystanders’ experiences of workplace violence. A total of 185 analysis units were identified and categorized into three main themes, based on their impact on workplace violence (reinforcing, avoiding, and suppressing) with six subcategories (facilitative reinforcer, diffuse reinforcer, condoning avoider, powerless avoider, empathic suppressor, and interventional suppressor). Conclusions. This study delineates a typology of bystander roles in workplace bullying/horizontal violence among nurses, identifying three distinct types of bystanders. The outcomes of workplace violence vary, based on the type of bystander involved as well as the dynamics among bystanders, perpetrators, and victims. Implications for Nursing Management. Nursing organizations should educate nurses about the concept of bystanders as this will help nurses understand that even if they may not be perpetrators or victims of workplace violence, they are still implicated as bystanders. Additionally, nursing organizations and leaders should empower nurses to play a positive bystander role.

Background. Nurses, who comprise the largest proportion of healthcare professionals, must advocate for public health in a changing healthcare environment. Therefore, nurses have a social responsibility to be interested in politics, political participation, or healthcare policy interventions as leaders in healthcare policy reforms. However, previous research has reported that nurses’ political interests and participation are insufficient in most countries. Aim. This study systematically reviewed and synthesized qualitative data to identify the barriers and facilitators influencing nurses’ political participation and healthcare policy interventions. Methods. This study performed a systematic review and qualitative meta-synthesis. Literature searches were conducted using seven databases to comprehensively examine published journals, including doctoral dissertations, until December 31, 2023. The selection criteria for this study were articles analyzed using phenomenology, ethnography, qualitative research, and grounded theory, targeting nurses with extensive experience in healthcare policy intervention and political activities. Two researchers, professors in nursing with extensive experience in healthcare policy interventions and qualitative research screened the qualitative studies and extracted the data. Eighteen papers were analyzed, and the quality of each study was evaluated using the Critical Appraisal Skills Program Qualitative Checklist. Meta-ethnography was applied as the qualitative meta-synthesis method using ATLAS. ti. Results. Barriers include nurses’ lack of political interest and competence, nursing education, restrictive organizational cultures, and the nursing profession’s political activities. Facilitators include recognizing social responsibilities, enhancing political competence, innovating organizational environments, and strengthening nursing organizations’ political activities and policy interventions. Conclusions. This study could be used as data to enhance nurses’ political participation and to plan policy interventions and strategies. Implication for Nursing Management. To activate nurses’ political participation in the future, it is necessary to develop strategies, such as developing nursing political education programs and expanding opportunities for policy intervention.

Background. The worldwide pandemic of COVID-19 had put enormous pressure on frontline healthcare workers. In December 2022, China released its “10 new measures,” signaling the end of the “dynamic zero COVID-19 strategy.” This triggered a period of peak infection, which shocked China’s healthcare system and affected the mental health of nurses. Objective. To explore the anxiety, depression, and social support levels of frontline nurses during the peak period of COVID-19 infection and to identify the main needs and concerns of nurses during this period. Design. A multicenter cross-sectional study. Settings. 18 hospitals of different grades in three cities in Hunan Province from December 21, 2022, to January 10, 2023, the peak period of COVID-19 infection. Participants. A total of 4,160 nurses completed the survey. Methods. The questionnaire included general information, symptoms, the preparation for nurses, GAD-7, PHQ-9, PSSS, and two open-ended questions investigating nurses’ needs and concerns. General linear models were used to analyze the factors influencing anxiety. Hospital preparation for nurses, nurses’ needs, and nurses’ concerns were categorized and subjected to frequency counts. Results. The median (P25, P75) scores for anxiety and depression among nurses were 7.00 (3, 12) and 8 (3, 12), respectively. Type of hospital, professional title, family structure, isolation staff lounge preparation, ibuprofen preparation, health status of parents, fever, chest distress, dyspnea, cough, insufficient protective equipment, number of children, and PSSS others were the influencing factors of GAD grades. The top 3 needs were free drugs and treatments (78.71%), shift breaks and paid leave (77.66%), and understanding and supports from hospitals and families (75.99%). The first three concerns were the fear of spreading the disease to family members (83.89%), the after-effects of infection (65.67%), and cross-infection with colleagues and patients (61.70%). Conclusions. Nurses’ anxiety was more severe during peak infection period. Overloaded work schedules and insufficient sleep became a common situation. Worries about family members became the main concern of nurses. Managers should make contingency plans for public health emergencies and provide frontline nurses with protective equipment, stress-relieving measures, and a rotation system. More importantly, they should pay attention to the needs of nurses’ family members and provide medical and care support. The media should also explain how hospitals operate and carry out their duties during these extraordinary times in order for the public to comprehend the condition of frontline epidemic fighters.

Background. In the rapidly evolving healthcare management landscape, technology integration and artificial intelligence utilization play pivotal roles in shaping employee productivity. This research investigates these dynamics within Riyadh Province, Kingdom of Saudi Arabia, focusing on the relationships between technology integration, the use of artificial intelligence in nursing profession, nursing workforce competencies, technological leadership, and employee productivity. Methods. A quantitative approach was employed, involving 329 nurses from five hospitals in Riyadh Province. Partial Least Squares Structural Equation Modeling facilitated comprehensive analysis of direct and indirect relationships among variables. Results. Findings reveal that technology integration significantly enhances nursing productivity, while the use of artificial intelligence initially presents disruptions before yielding productivity gains. Nursing workforce competencies mediate these relationships, emphasizing the critical role of workforce readiness in harnessing technology’s benefits. Surprisingly, technological leadership did not significantly moderate these effects. Conclusions. This research offers vital insights for healthcare organizations, advocating strategic technology integration and workforce development. It underscores the significance of nursing competencies in navigating technological transformations and affirms the enduring importance of leadership in guiding these changes. As healthcare evolves, these findings provide guidance for optimizing technology and artificial intelligence to enhance employee productivity and patient care.

Background. Global nursing shortages have led to the recruitment of culturally and linguistically diverse nurses from various countries. However, nurses face integration challenges in their host countries. Objective. This systematic review aimed to find the most recent evidence of factors associated with integrational strategies and models to support the transition and adaptation of culturally and linguistically diverse nurses to the professional workforce in healthcare settings. Methods. This systematic review used the population, exposure, outcome framework to select studies according to JBI guidelines. Original peer-reviewed quantitative studies published between 2000 and 2021 were identified. Two researchers independently screened the studies based on eligibility criteria using title, abstract, and full text. The JBI critical appraisal tool assessed the methodology’s quality for analytical cross-sectional studies. Data were extracted, tabulated, and analysed narratively. PRISMA checklist was used in reporting. Data Sources. CINAHL (Ebsco), PubMed, Medic, ERIC (ProQuest), and Scopus. Results. The systematic review encompassed 19 articles and identified multiple factors associated with successful integration. These factors were classified into the following six categories: sociodemographic characteristics, discrimination, social support, organisational support, workplace environment, and acculturation. Conclusions. Comprehensive cultural competency training for healthcare staff, including managers, enhances cultural proficiency in work environments. Clear guidelines addressing bias and discrimination create a supportive environment where culturally and linguistically diverse nurses feel valued and respected, facilitating their adaptation and integration. Relevance to Clinical Practice. Patient care quality can be improved by ensuring sustainable culturally and linguistically diverse nurses’ integration into healthcare organisations. Cultural diversity is a unique opportunity to bring a diverse range and experience to clinical settings. The diversity can also help enhance the cultural competence of healthcare staff, allowing them to better understand and cater to the needs of culturally diverse patients. Patient or Public Contribution. Not required for study design.

Introduction. This study introduces the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE-PT), a pioneering instrument designed to assess leadership behaviours in multicultural nursing work environments, addressing gaps in current leadership assessment tools. Aim. This study aimed to develop and validate the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE-PT). Methods. It was conducted as a sequential exploratory mixed-method study, integrating DeVellis’s steps for instrument development. Items were formulated based on a literature review and a focus group study, and the content validity was evaluated by a panel of experts. A methodological approach involving nurses registered in the Portuguese Order of Nurses with leadership experience in multicultural nursing work environments was employed to further conduct an exploratory and a confirmatory factor analysis to assess the instrument’s structure and psychometric properties. Results. One hundred forty-five items were initially generated, of which 39 were included in the QLTE-PT following content validity assessment by a panel of experts. EFA revealed a factor structure of 25 items loading on six factors, explaining 64% of the total variance. The overall Cronbach’s α coefficient of the questionnaire was 0.90. This six-factor structure was tested by CFA, revealing a final model of 23 items and six factors, with a good quality of adjustment (CFI = 0.980, TLI = 0.976, SRMR = 0.078, and RMSEA = 0.070). Both convergent and discriminant validity were confirmed. Conclusions. The QLTE-PT demonstrates good psychometric properties and is suitable for assessing transcultural leadership behaviours of nurse managers and leaders in multicultural nursing work environments. Implications for Nursing Management. The QLTE-PT can assist nurse managers to improve their leadership behaviours, promote supportive working environments for their multicultural nursing staff, and improve the quality of care provided to patients from different cultural backgrounds.

Nursing and midwifery education in Malawi entails theoretical learning and clinical practice, essential for developing competent professionals. However, challenges such as staff shortages and limited resources hinder effective clinical teaching. Simulation-based education (SBE) offers a promising solution. This study aims to explore how SBE can enhance clinical teaching in Malawian nursing and midwifery education. Data were collected through in-depth interviews with lecturers, clinical instructors, and focus group discussion (FGD) with the final-year students. Thematic analysis revealed several key findings: SBE serves as a valuable gap-filler in clinical education, addressing complex needs while offering diverse learning opportunities. It also provides a platform for enhanced supervision and assessment strategies. The results indicate that SBE enables students to master various clinical skills without direct patient contact, reducing congestion at clinical sites while ensuring credit acquisition. Moreover, it proves effective as both a supervision and assessment tool for evaluating students’ clinical performance. In conclusion, the study advocates for the integration of SBE into Malawian nursing and midwifery education to alleviate the challenges associated with traditional clinical teaching. By leveraging SBE, institutions can mitigate overcrowding at clinical sites and provide students with diverse learning experiences. However, successful implementation requires adequate infrastructure, resources, and skilled lecturers. Ultimately, SBE holds the potential to significantly enhance the quality and outcomes of nursing and midwifery education in Malawi.

Aim. To explore the status of job crafting, leisure crafting, and burnout among nurses and to examine the impact of job crafting and leisure crafting variations on burnout using machine learning-based models. Background. The prevalence of burnout among nurses poses a severe risk to their job performance, quality of healthcare, and the cohesiveness of nurse teams. Numerous studies have explored factors influencing nurse burnout; however, few involved job crafting and leisure crafting synchronously and elucidated the effect differences of the two crafting behaviors on nurse burnout. Methods. Multicentre cross-sectional survey study. Nurses (n = 1235) from four Chinese tertiary hospitals were included. The Maslach Burnout Inventory-General Survey, the Job Crafting Scale, and the Leisure Crafting Scale were employed for data collection. Four machine learning algorithms (logistic regression model, support vector machine, random forest, and gradient boosting tree) were used to analyze the data. Results. Nurses experienced mild to moderate levels of burnout and moderate to high levels of job crafting and leisure crafting. The AUC (in full) for the four models was from 0.809 to 0.821, among which the gradient boosting tree performed best, with 0.821 AUC, 0.739 accuracy, 0.470 sensitivity, 0.919 specificity, and 0.161 Brier. All models showed that job crafting was the most important predictor for burnout, while leisure crafting was identified as the second important predictor for burnout in the random forest model and gradient boosting tree model. Conclusion. Even if nurses experienced mild to moderate burnout, nurse managers should develop efficient interventions to reduce nurse burnout. Job crafting and leisure crafting may be beneficial preventative strategies against burnout among nurses at present. Implications for Nursing Management. Job and leisure crafting were identified as effective methods to reduce nurse burnout. Nurse managers should provide more opportunities for nurses’ job crafting and encourage nurses crafting at their leisure time.

Aim. To determine Senior Nurse Managers’ perceptions of integration of Nurse Practitioner roles in Healthcare Organisations across Ireland and Australia. Background. Introduction of the Nurse Practitioner role in both countries is well established with national policies aimed at developing a critical mass in the health workforce. Current policy requires Senior Nurse Managers to be actively involved in the introduction of and oversight of the integration of Nurse Practitioners across healthcare settings. This is integral in the context of the success and sustainability of the services provided by the Nurse Practitioner. Methods. A quantitative, cross-sectional cloud-based survey of senior nurse managers across Ireland and Australia from April to September 2022. Results. Of 300 responses received, 122 were eligible for analysis. Of these, 77% expressed that there should be a specific role to support the integration of Nurse Practitioner roles at local level, and 61% recommended that this should occur at a national level, whilst 48% reported the absence of a standardised governance structure. Three reporting structures were identified: professional, clinical, and operational. Autonomous clinical decision making and prescribing were two Nurse Practitioner functions most identified. Fifty-five percent reported having performance indicators for Nurse Practitioner roles, with 24% agreeing that performance indicators captured the quality of care provided. Thirty-five percent of senior nurse managers indicated that there were agreed reporting timelines for performance indicators and a requirement for the provision of an annual report. Conclusion. Whilst some participants reported structure to guide and evaluate the work and value of Nurse Practitioners, the approach was inconsistent across organisations and countries. This paper demonstrates that integration is not broadly established across both countries. Implications for the Profession. The main findings were that Nurse Practitioners were misunderstood and the development of a structured framework to support the integration of Nurse Practitioners would provide long-term benefits.

Aim. This study examined the mental health of nurse managers in the Kingdom of Saudi Arabia. Background. The COVID-19 pandemic has affected the physical and mental health of senior nurses, including effects of shortages of staff and medical supplies. However, no study has examined this topic among nurse managers in the Kingdom of Saudi Arabia despite their exposure to mental stress during the pandemic. Methods. A cross-sectional design was used to investigate the levels of depression, anxiety, stress, and general psychological distress among nurse managers in Saudi Arabia. Data were collected August 2023 to February 2024. The main tool was the reliable and validated Arabic translation of the Depression, Anxiety, and Stress Scale (DASS-21). Data collection was performed using an online platform. IBM SPSS software was used for data analysis. The data was analysed using multiple regression to examine the relationship between the dependent (outcome) and independent (predictor) variables. A significant p-value was set at 0.05. Results. Stress and general psychological distress were the most common problems among nurse managers in the post-COVID-19 era. Individual educational attainment was the only significant predictor of anxiety, stress, and general psychological distress. Moreover, the nationalities of nurse managers were correlated with stress outcomes. Conclusions. Nursing managers are very likely to suffer from stress and general mental health problems in cases of exposure to crises. They may find the results of this study useful in understanding the factors that may play a role in the development of mental health problems during clinical work. Different strategies can be considered to alleviate depression, anxiety, and stress among managers, including the proper delegation of tasks. Top-level management and healthcare stakeholders should give special considerations to the nationality and education level upon selecting nurse mangers at different levels. Implications in Nursing Management. Policy makers involved in planning care for healthcare professionals may find this study valuable in planning for future pandemics by developing a strategy that could reduce stress and psychological distress.