Intensive & critical care nursing最新文献

Background: The job performance of intensive care nurses is critical to the treatment and recovery of critically ill patients. Inclusive leadership, self-efficacy and organization-based self-esteem (OBSE) are important psychosocial factors affecting job performance. However, few studies have explored the relationships among these factors in critical care nurses.

Aims: To examine the impact of inclusive leadership on the job performance of intensive care nurses and to explore the potential mediation through self-efficacy and OBSE.

Methods: A cross-sectional survey design was employed. Between November and December 2023, a total of 460 intensive care nurses from China completed the survey, which included standard assessments on inclusive leadership, self-efficacy, OBSE, and job performance. Mediation analysis was conducted using structural equation modeling. Indirect effects were evaluated through bootstrapping.

Results: The results indicated significant positive correlations among inclusive leadership, self-efficacy, OBSE, and job performance (all P < 0.01). Inclusive leadership not only directly affected the job performance of intensive care nurses but also influenced it through the partial mediating roles of self-efficacy and OBSE, with the mediating effects accounting for 14.29 % and 30.61 % of the total effect, respectively. Additionally, the analysis found that self-efficacy and OBSE played a chain mediating role in the relationship between inclusive leadership and the job performance, with the mediating effect accounting for 22.45 % of the total effect.

Conclusions: Inclusive leadership positively predict the job performance of intensive care nurses. Self-efficacy and OBSE act as mediating factors, further explaining how inclusive leadership improves the job performance of intensive care nurses.

Implications for clinical practice: Enhancing inclusive leadership can be achieved through targeted training programs that emphasize open communication, team collaboration, and recognition of diverse perspectives. For example, leadership workshops can include role-playing scenarios that promote active listening and constructive feedback. Furthermore, boosting self-efficacy and OBSE is essential, as these variables significantly mediate the relationship between inclusive leadership and job performance. Encouraging mentorship and providing opportunities for professional development can help nurses build their confidence and organizational identity, ultimately leading to improved performance and patient care outcomes.

Background: Within French intensive care units (ICUs), patients are treated with two levels of care (intensive or intermediate) with different nurse-to-patient ratios legally defined.

Objectives: We aimed to compare the nursing workload associated with these two levels of care.

Research methodology: A nationwide prospective observational study was conducted in France between April and July 2023. Each ICU was allowed to choose its own two-week period of data collection during which the Nursing Activities Score was collected by nurses at patients' bedside, during each shift. The Nursing Activities Score ranges from 20 to 177% and a 100% score represents a nurse per shift. The number of patients per nurse was collected and the Nursing Activities Score per nurse was assessed.

Results: One hundred and five ICUs participated. Overall, 21,665 measurements of Nursing Activities Score per patient and 9,885 Nursing Activities Score per nurse were collected. ICUs were composed by 2083 beds distributed into 1520 (73 %) intensive care beds and 563 (27 %) intermediate care beds. Among the participating units, 93 (89 %) of the teams worked in 2 shifts. Median [p25-p75] Nursing Activities Score per adult patient was 61 % [49-80] for intensive care patients and 47 % [38-61] for intermediate care patients (p < 0.001). Median Nursing Activities Score per nurse for adult population was 127 % [92-167], 143 % [92-198], and 164 % [126-213] for nurses only providing intensive care, only intermediate care or both levels of care, respectively (p < 0.001). A Nursing Activities Score per nurse value >100 % was observed in 71.4 %.

Conclusions: Nurses' workload was high in the ICU, especially when providing intermediate or mixed levels of care.

Implications for practice: In order to reduce nurses' workload, a review of the nurse-to-patient ratios is expected. Physically separating the two levels of care may be a valuable option.