Shift patterns influence nurses’ work and rest conditions. Limited information is available about the nurses' recovery, fatigue, and their associated factors considering shift patterns.
This study explored the association between fatigue and recovery and factors associated with recovery and chronic fatigue among nurses working a three-shift (8 hour shifts) or two-shift (more than 12 hour shifts) rotations in Japan.
This cross-sectional secondary analysis included 807 nurses from a previous questionnaire survey. Fatigue (acute and chronic) and intershift recovery were measured using the Occupational Fatigue Exhaustion Recovery Scale.
Intershift recovery was significantly lower among nurses working a three-shift rotations compared to nurses working a two-shift rotations. Nurses aged ≥40 years tended to experience severe chronic fatigue working in the two-shift rotations. In both shift patterns, overtime hours and low sleep quality were associated with lower intershift recovery and higher chronic fatigue. In the three-shift rotations, having children and being activity-oriented in leisure time were associated with higher intershift recovery and lower chronic fatigue. In the two-shift rotations, activity orientation was significantly associated with lower chronic fatigue.
The three-shift rotations influenced nurses’ intershift recovery more than the two-shift rotations. Regardless of shift patterns, managers must restrict overtime and encourage nurses to maintain sleep quality, family roles, and leisure activities. Moreover, considering nurses’ age while selecting and organising shift patterns may prevent chronic fatigue.
Fatigue management based on the characteristics and associated factors of fatigue and recovery for each shift pattern revealed in this study prevents chronic fatigue, which may contribute to the retention of nurses.
Transition to Practice Programs (TPPs) support graduate nurses and midwives during their first year of clinical practice. ‘Work readiness’ theory proposes specific skills, knowledge, and attributes are needed to successfully transition into the workplace.
To measure development of self-perceived work readiness among graduates undertaking a 12-month TPP.
Repeated measure, cross-sectional survey. Participants were a cohort of 160 graduate nurses and midwives (response rate 56.7%) commencing at a large tertiary hospital in Melbourne, Australia. Work readiness was measured using the Work Readiness Scale-graduate nurses at three timepoints: on commencement (T1), at 6 months (T2), and on completion (T3) of a 12-month TPP. Data were collected between 2018 and 2019.
Graduate’s Social Intelligence (p = 0.007) and Work Competence (WC) (p < 0.001) subscales had a significant increase from T1 to T3. On completion of the TPP (T3), participants reported significantly higher Personal Work Characteristics (p = 0.017) and WC (p < 0.001) scores compared with baseline (T1). Scores for the organisational acumen (OA) subscale were high across all three timepoints (p = 0.898).
Significant improvement in three of the four domains of work readiness was observed at timepoints across the TPP.
OA was consistently high at all timepoints, which may reflect the comprehensive orientation provided before commencement of the program.
Understanding graduate development of work readiness can inform cost-effective TPPs that deliver desired graduate outcomes.
Nurses’ quality of work life is a crucial factor in nurse, patient and organisational outcomes. Because work overload and leadership affect quality of work life, it is important to understand the relationship between them.
The aims of this study were to investigate the serial multiple mediation of transformational and clinical leadership in the relationship between work overload and quality of life among clinical nurses and to test a model designed to examine the fit and relations between these variables.
This study used a model-testing design with cross-sectional data. The sample consisted of 415 clinical nurses working in hospitals in Turkey. A questionnaire was used to collect data between August and September 2021. Data were analysed using descriptive and correlation analyses. Data analyses included model-testing approaches and were conducted using the Statistical Package for Social Sciences 26.0, Hayes’ PROCESS macro for SPSS v4.0, and Analysis of Moment Structures 24.0.
The serial–multiple mediation of transformational leadership perception and clinical leadership skills in the relationship between work overload and quality of work life was found to be statistically significant. The model fit indices were desirable.
The results of the study showed that decreased work overload perception was associated first with increased perception of transformational leadership, followed by increased clinical leadership skills, which in turn was related to increased quality of work life among clinical nurses.
The COVID-19 pandemic resulted in the implementation of social distancing measures, travel restrictions, and infection control measures that introduced a myriad of disruptions in the conduct of clinical research worldwide. As a result, many aspects of clinical research were variably impacted.
To explore the impact of the first 18 months of the COVID-19 pandemic on clinical research across accredited nursing, pharmacy, and medicine program providers in Australian and New Zealand universities.
Representatives from all program providers across Australian and New Zealand universities, with publicly available contact information, were invited to participate in this qualitative study, whereby semi-structured interviews were completed with participants who held senior research or leadership positions within their institution. Interviews were transcribed verbatim and inductively analysed using thematic content analysis.
Interviews were conducted with 16 participants between August and October 2021. Two major themes were identified (Immediate Research Impact and Broader Research Impact) with six subthemes: Prioritisation, Continuation, and Dissemination of Research; Modifications to Research; Funding and Changes to Research Focus; Collaboration; Research Workforce; Context-specific Impacts.
The impact on clinical research in Australian and New Zealand universities included changes to data collection methods, a perceived decreased quality of research, changes to collaboration, neglect of basic disease research, and loss of the research workforce.
This study highlights the impact of the COVID-19 pandemic on clinical research within the Australian and New Zealand university context. Implications of these impacts should be considered to ensure long-term sustainability of research and preparedness for future disruptions.
Peripheral intravenous catheters (PIVCs) are the most used invasive medical device. Unfortunately, PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, infection, delays in treatment, increased healthcare costs, and even death. In Australia, qualified nurses assess, manage, and remove a PIVC as part of their clinical role. To date, no study has described the current state of knowledge and confidence (self-efficacy) about PIVCs from the perspectives of qualified nurses working in Australian hospital settings.
To describe the current state of knowledge and confidence (self-efficacy) about PIVC management from the perspectives of qualified nurses working in Australian hospital settings. To explore how these related to the education received by these nurses.
An online cross-sectional survey.
Qualified nurses in Australia thought that education about PIVCs was important and that it should be underpinned by evidence-based guidelines. Knowledge Test score for the sample was 12.4/17 (SD 2.1), this equates to a mean grade of 73.0%. Respondents reported very high levels of confidence about caring for a patient with a PIVC in situ.
Despite the frequent and increasing use of PIVCs and importantly the documented adverse events associated with poor assessment, management and inappropriate removal, qualified nurses’ knowledge and confidence remain poorly reported. We demonstrated fundamental gaps in qualified nurses’ knowledge in relation to assessment, management, and removal of PIVCs.
The COVID-19 pandemic is a global health crisis that affected nurses’ professional values and competence.
Our study examined the relationship between nurses’ professional values and competence in Saudi Arabia during the COVID-19 pandemic.
This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data.
The emerging model showed acceptable model-fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong direct effect on activism. Justice had a moderate direct impact on trust, while activism had a weak direct impact on trust. Professionalism and caring had strong indirect effects on professional competence by mediating the dimension of activism.
The study’s findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence.
This study provides a structural model of the interaction between nurses’ professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses’ professional values and competence.
Missed nursing care (MNC) has gained increasing emphasis in nursing literature because of its association with nurse and patient outcomes in healthcare settings. While missed care has been widely studied, little evidence is available on the types and frequency of missed care, reasons for its occurrence, and predictors of missed care in Western Australia.
To determine nurses’ perceptions of the types of MNC, reasons for missed care and to identify factors predicting missed care occurrence in Western Australian acute care settings.
A cross-sectional study in medical and surgical wards was performed. The nurse MISSCARE survey tool was used to capture self-reported types and reasons for missed care and level of nurse job satisfaction from a sample of 204 nurses working in 16 acute care wards. Data analyses were carried out in International Business Machines Corperation located in Armonk, New York United States (IBM SPSS Statistics) (v 29).
The most common perceived missed activities included ambulation (87%), patient teaching (79%), interdisciplinary conference attendance (78%), mouth care (78%), intake and output (77%), and patient turning (75%). Labour resources ranked highest for reasons for missed care followed by material resources and communication. Significant relationships were observed between missed care and job satisfaction, role satisfaction, and teamwork.
Working overtime, job dissatisfaction, inadequate staffing, and heavy admissions and discharges were related to increased likelihood for missed care occurrence.
Although further studies examining the link between MNC and staffing methodologies are needed, this study provides evidence on nurse-reported missed care and the impact of missed care in Western Australia.
Aboriginal and Torres Strait Islander peoples experience disproportionate rates of heart failure. However, information regarding their use of hospital services in the last year of life is poorly delineated to inform culturally appropriate end-of-life health services.
To quantify hospital service use in the last year of life of Aboriginal and Torres Strait Islander peoples who died of heart failure or cardiomyopathy in Queensland, Australia.
A subgroup analysis of a larger retrospective linkage study using administrative health data in Queensland, Australia. Individuals that identified as an Aboriginal and Torres Strait Islander person from their first hospital admission in the last year of life, who died of heart failure or cardiomyopathy from 2008 to 2018, were included.
There were 99 individuals, with emergency department presentation/s recorded for 85 individuals. Over 50% of individuals presenting to the Emergency Department were from regional areas (n = 43, 51%). The 99 individuals had a total of 472 hospital admissions, excluding same day admissions for haemodialysis, and 70% (n = 70) died in hospital. Most admissions were coded as acute care (n = 442, 94%), and fewer were coded as palliative care (n = 19, 4%). Median comorbidities or factors that led to hospital contact = 5 (interquartile range 3–9).
Acute care hospital admissions in the last year of life by this population are common for those who died of heart failure or cardiomyopathy. Multimorbidity is prevalent in the last year of life, underscoring the importance of primary health care, provided by nurses and Indigenous health workers.
People experiencing homelessness have unmet healthcare needs often related to chronic health conditions and injury. Nurses are often the first and only point of contact for people experiencing homelessness accessing healthcare. However, education that prepares them to meet the needs of this vulnerable population is limited.
To qualitatively explore nurses’ perceptions on the skills, knowledge, and attributes required to provide healthcare to people experiencing homelessness in Australia that could underpin an educational pathway.
Semi-structured interviews with registered nurses and nurse practitioners.
Participants of a national survey were invited to undertake an interview. Interview data were analysed thematically and reported here in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
The registered nurses (n = 11) and nurse practitioners (n = 6) had varying levels of experience providing care for homeless Australians. Overarching themes that arose from the registered nurse and nurse practitioner participants included equitable access to care, knowledge around homelessness, contribution of nursing, and nurses’ role. However, nurse practitioners had a greater sense of agency and empowerment to enact care, while registered nurses perceived being underprepared and overwhelmed by the unmet needs of people experiencing homelessness.
The findings suggest that nursing practice holds opportunities to improve access and care provision for people experiencing homelessness. Capitalising on these opportunities requires that nurses are educationally prepared with the skills, knowledge, and attributes to meet the needs of this vulnerable population without necessarily becoming nurse practitioners. These findings will be used to underpin the development of an educational pathway for nurses to enhance their response to homeless populations.
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