Clinical Nursing Competence Research Articles

Clinical competency of nurses working at Intensive Care Units and its associated factors

Clinical competency of nurses working at Intensive Care Units and its associated factors

임상간호사의 공감능력과 간호조직문화인지가 임상의사결정능력에 미치는 영향

Objectives This study investigates the influence of clinical nurses' empathy ability and Cognition of nursing organizational culture on clinical decision-making ability.
 Methods Data collection was conducted on 198 clinical nurses at two general hospitals at P City from February10 to February 28th, 2023. The data responded to the survey were analyzed using descriptive analysis, t-test, One-way ANOVA, Pearson's correlation coefficient, and Hierarchical Multiple Regression Analysis.
 Results As results of this study, empathy ability scored 5.01 out of 7, Cognition of nursing organizational culture 3.47 out of 5, decision-making ability score was 3.56 out of 5. Empathy ability was significantly higher when the woker higher departmental experience (F=2.567, p<.05), the higher position (F=3.662, p<.05). Cognition of nursing organizational culture increased woker higher departmental experience (F=2.753, p<.05) and higher the position (F=3.234, p<.05). Clinical nurses' of clinical decision-making ability was correlated with empathy ability(r=.568, p<.001) and there was a correlation with Cognition of nursing organizational culture (r=.467, p<.001), there was a correlation with also correlated with empathy ability(r=.370, p<.001). Empathy ability(β=.457, p<.001) and Cognition of nursing organizational culture (β=.298, p<.001) had an effect on clinical decision-making ability, explaining 39.9% of the variance. In other words, it was results show that higher levels of empathy ability and Cognition of nursing organizational culture were associated with enhanced clinical decision-making ability.
 Conclusions Based on the results of this study, there is a need of the development and application of programs to clinical decision-making ability improvement program to strengthen clinical competency of Clincal nurses.

Clinical Competence of Nurses and the Associated Factors in Public Hospitals of Gamo Zone, Southern Ethiopia: A Cross-Sectional Study.

Nursing competency is an essential component for improving the quality of care in the healthcare system. However, assessing competency solely on the dimensions of skills and knowledge does not provide complete picture of a nurse ability to provide quality patient care. This is because it lacks focus on the nurse's attitudes and values, which are also important determinants of clinical competence. Therefore, this study aimed to assess the comprehensive clinical competence of nurses and its associated factors in public hospitals of Gamo Zone, Southern Ethiopia. A cross-sectional study was conducted using a census method to collect information from nurses through self-administered questionnaires. The data were entered into EpiData version 3.1 and exported to Stata version 15 for analysis. A linear regression model was used to identify factors associated with clinical competence. In this study, the average clinical competence of nurses was 177.32, with a standard deviation of 19.19, and 31.2% of the respondents had a high level of clinical competence. Associated factors identified with clinical competence include gender, age, marital status, qualification, position, work experience, unit, interest in their profession, critical thinking disposition, clinical self-efficacy, and emotional intelligence. The overall level of clinical competence among nurses in this study was moderate. As such, nurses improve their clinical competence by receiving training and development opportunities that focus on critical thinking, clinical self-efficacy, and emotional intelligence; working in a supportive work environment that encourages them to take risks and learn from their mistakes; and being monitored and coached on a regular basis.

임상간호사가 인식한 관리자의 변혁적 리더십, 안전분위기, 비판적 사고성향이 투약안전역량에 미치는 영향

Objectives This purpose of this study was to investigate the influences of transformational leadership of nurse manager, safety climate, and critical thinking disposition on clinical nurses’ medication safety competence.
 Methods A descriptive survey were conducted among 143 hospital nurses with more than 3months for work experiences in general hospitals . Data were collected from June 13 to June 22, 2022 and analyzed using the independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression using SPSS 26.0 program.
 Results Medication safety competence had significant correlation with transformational leadership of nurse manager(r=.23, p=.006), safety climate(r=.31, p<.001), critical thinking disposition(r=.55, p<.001). Critical thinking disposition(β=.59, p<.001), safety climate(β=.24, p=.017) were identified as factors influencing medication safety competence. This factors explained 38.4% of nurse’s medication safety competence(p<.001).
 Conclusions In oder to improve th medication safety competence of clinical nurses, it is considered necessary to make efforts to create a safety climate at the organizational level in medical institutions and to develop and apply eductional programs that can improve the critical thinking disposition.

Comparison of the clinical competency of nurses trained in competency-based and object-based approaches in the Democratic Republic of the Congo: A cross-sectional study.

In the Democratic Republic of the Congo (DRC), the object-based approach (OBA) still remains mainstream in the basic nursing education program, despite the intention of the Ministry of Public Health to expand the competency-based approach (CBA) nationwide. This study aimed to compare the clinical competency of nurses trained with CBA and OBA. A cross-sectional, mixed study was conducted. We developed a self-assessment questionnaire consisting of an individual demographic information, a clinical competency assessment scale and the General Self-efficacy Scale. Nurses trained with CBA or OBA and currently working in health facilities with two to five years of clinical experience were purposively selected from ten cities across nine provinces in the DRC. We also conducted key informant interviews with the clinical supervisors at health facilities. In a comparison of 160 nurses trained with CBA and 153 with OBA, 3 competency domains ("establishing professional communication", "making decisions about health problems", and "performing nursing interventions") of the 5 domains required for nurses had significantly higher scores in the CBA group. The key informant interviews supported these results while revealing various issues in the basic nursing education program. The results support the strategic direction of the Ministry of Public Health in the DRC to expand CBA. Collaboration among education institutions, health facilities, and administrative bodies is crucial for clinical nurses to fully engage their competencies for the population. Other low- and middle-income countries with scarce resources can refer to the developed and implemented competency assessment method applied in this study.

The effect of virtual reality on cognitive, affective, and psychomotor outcomes in nursing staffs: systematic review and meta-analysis

BackgroundIn the healthcare systems of the world, reinforcing the competence and professionalism of nurses has become a concern. Gaining clinical nursing competence in the healthcare system requires more effort, and additional training is required. Medical education and training have begun using digital technologies, such as virtual reality (VR). The purpose of this research was to examine the efficacy of VR in terms of cognitive, emotional, and psychomotor outcomes and learning satisfaction in nurses.MethodThe study searched eight databases (Cochrane library, EBSCOHost, Embase, OVID MEDLINE, ProQuest, PubMed, Scopus, and Web of Science) for articles that met these criteria: (i) nursing staff, (ii) any virtual reality technology intervention for education, all levels of immersion, [1] randomized control trial and quasi-experiment study, and (iv) published articles and unpublished theses. The standardized mean difference was measured. The random effect model was applied to measure the main outcome of the study with a significance level of p < .05. The I2 statistic assessment was applied to identify the level of heterogeneity of the study.ResultsA total of 6740 studies were identified, of which 12 studies with 1470 participants met the criteria for inclusion. The meta-analysis showed a significant improvement in the cognitive aspect (standardized mean difference [SMD] = 1.48; 95% CI = 0.33–2.63; p = .011, I2 = 94.88%), the affective aspect (SMD = 0.59; 95% CI = 0.34–0.86; p < .001, I2 = 34.33%), the psychomotor aspect (SMD = 0.901; 95% CI = 0.49–1.31; p < .001, I2 = 80.33%), and learning satisfaction (SMD = 0.47; 95% CI = 0.17–0.77; p = .002, I2 = 0%) aspects of the groups that received the VR intervention compared to the control groups. Subgroup analysis found that dependent variables (e.g., level of immersion) did not improve study outcomes. The quality of evidence was low which is affected by major methodological issues.ConclusionsVR may favorable as alternative method to increase nurse competencies. Randomized controlled trials (RCTs) on larger samples are needed to strengthen the evidence for the effect of VR in various clinical nurse settings. ROSPERO registration number: CRD42022301260.

Nurses’ clinical competency and its correlates: before and during the COVID-19 outbreak

BackgroundClinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses’ professional competence and its correlates before and during the COVID-19 pandemic.MethodsWe conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered.ResultsThe mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic.ConclusionThe clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Collaborative clinical facilitation in selected nursing and midwifery colleges in Northern Ghana.

Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana. To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana. The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana. A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically. Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication. This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students' clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment. This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students' clinical learning.

Clinical Competence and Clinical Performance of Nurses: A Cross-sectional Study

Background: In organizational analysis, competence and performance are fundamental issues. To ensure the quality of ‎nursing care, it seems essential to evaluate nurses’ clinical competence (CC) and clinical performance (CP) as the largest group ‎of professionals in the healthcare system. Objectives: This study aimed to examine the ‎CC and CP of nurses and other related factors. Methods: This cross-sectional study involved 220 nurses from various wards of Shahid Beheshti hospital in Kashan, Iran, in 2020. The samples were randomly selected based on the quota assigned to each section (coin toss). Then, 220 selected nurses filled out the CC questionnaire by self-reporting, and among them, the performance of 50 nurses was observed randomly (tossing a coin) in an entire work shift. The data collection tools included a personal information questionnaire and a checklist ‎for evaluating CC and CP. The data were analyzed using SPSS software (version 16; SPSS Inc., Chicago, IL, USA). Data analysis was carried out using descriptive statistical ‎methods, t-tests, analysis of variance, and Spearman and Pearson correlation coefficients. A P-value &lt; 0.05 was considered statistically significant in all tests. Results: The mean age of the participants was 31.15 ± 6.26 years. Moreover, the participants’ mean scores of work experience and work experience in the current ward ‎were 7.57 ± 5.73 and 4.02 ± 3.88 years, respectively. The nurses’ mean scores of CC and CP were 80.79 ± 12.09 (out of 100) and 70.30 ± 11.94 (out of 100), respectively. Female subjects had a significantly higher mean score in terms of CC than male subjects. Additionally, ‎married nurses had a higher mean score than single nurses (P &lt; 0.05). Nurses in the critical care wards and ‎emergency wards scored the highest (89.09 ± 12.09) and lowest (76.39 ± 12.65) regarding CC, respectively, ‏which was statistically significant (P &lt; 0.05). Furthermore, nurses with official employment had the ‎highest mean CC score; nevertheless, nurses with designated employment had the lowest mean CC score, which was statistically ‎significant (P &lt; 0.05). According to the correlation test, nurses’ CC and CP were ‎also associated with age, marital status, work experience in the current ward, and type of employment (P &lt; 0.05).‎ Conclusions: The CP and CC of the nurses participating in this study were satisfactory. Regarding the relationship between the CP score with marital status, workplace sector, employment status, age, ‎general work experience, and current work experience, it is suggested to consider the aforementioned ‎variables in programs for the improvement of nurses’ CP.

Effectiveness of an Educational Intervention on Clinical Competency among Mental Health Nurses Working at a Government Mental Health Hospital: A Quasi-experimental Study

Background: Mental health nurses play an important role in caring for patients with mental illnesses. In order to provide comprehensive mental health nursing care, it is important to establish periodic educational interventions about mental health and psychiatric nursing in any mental health institution. The presence of frequent educational programs can lead to improvements in mental health nurses' clinical competency. Aim: To evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses. Methods: A quasi-experiment study pretest and posttest with one group study design were conducted among 80 nurses in a large mental health hospital in Tabuk city, Saudi Arabia. Data were collected by using the clinical competence evaluation in mental health nurses scale to evaluate the effectiveness of an educational intervention on the clinical competency of mental health nurses by comparing the result of the pretest and posttest scores. Result &amp; Discussion: The total score for the pre-test was (74.83±14.25/Average), and then the score increased dramatically for the post-test (96.18±26.53/Good) also, the Wilcoxon signed-rank test indicated that Post-test (Mean rank=102) significantly higher than pre-test (Mean rank=59) (U=1480, p&lt;0.001). As a result of the current study, the program showed great effectiveness (p&lt;0.001) with an advantage for post-test. Conclusion: The collected data analysis revealed a statistically significant positive effect of educational programs on improving mental health clinical competency, hence, Healthcare organizations and senior decision-makers should develop well designed periodic mental health programs that involve nurses who have a master's and doctorate degrees in mental health nursing to enhance mental health clinical competency.

Relationship between Moral Intelligence and Clinical Competency of Nurses in Ilam Educational Hospitals

"In this descriptive-analytical study, 110 nurses working in educational hospitals of the Ilam University of Medical Sciences were included. Participants were selected using a random sampling method. The data collection tools were the demographic information form, the moral intelligence questionnaire of Lenik and Kiel (2005), and the standard clinical competency assessment questionnaire (CIRN). Data were analyzed using SPSS software, version 21. Descriptive and inferential statistical tests were used to analyze the data. The mean ± SD score of nurses' moral intelligence and clinical competency was estimated at 157.59 ± 26.60 and 136.65 ± 46.08, respectively. Fifty-one percent of participants had low clinical competency, and 46% had high clinical competency. There was a significant association between moral intelligence and clinical competency (p&lt;0.05). "

Effect of “Four Passes” Training and Assessment of Nurse Specialty Knowledge on the Cultivation of Core Competence of Clinical Nurses

Effect of “Four Passes” Training and Assessment of Nurse Specialty Knowledge on the Cultivation of Core Competence of Clinical Nurses

Current Situation and Influencing Factors of Post Competency of Undergraduate Nursing Students

<i>Objective:</i> To understand the status quo and influencing factors of undergraduate nursing interns' competency in clinical practice, and to provide scientific basis for the development of undergraduate nursing interns' training plan in clinical practice base. Methods a cross-sectional survey of 231 undergraduate nursing interns enrolled in the First Affiliated Hospital of Kunming Medical University from 2021 to 2022 was conducted using a self-designed general data questionnaire, a full-time undergraduate nursing internship job competency evaluation scale and a general self-efficacy scale. <i>Results:</i> The highest score of clinical nursing competence of undergraduate nursing interns was 76.99±10.95. The results of multi-factor analysis showed that age, class committee member at school, age, only child, education background, household registration, education background, voluntary choice of nursing major, gender, class committee member at school, voluntary choice of nursing major were all factors affecting the post competency of nursing students (P < 0.05). <i>Conclusion(s):</i> Undergraduate clinical nursing students have certain cognition of post competency, but there is a great difference in the post competency of nursing students, which is still a difficulty in the implementation of post competence-oriented teaching mode for undergraduate clinical nursing students.

Understanding the learning needs to enhance clinical competence of new professional nurses in public hospitals of South Africa: A qualitative study.

A competent nursing workforce plays an important role, as it will ensure effective management of the healthcare system by providing quality nursing care. However, from the literature, it is evident that the learning needs of new professional nurses are not well explored and documented. The objective of this paper was to report identified learning needs of new professional nurses to enhance their clinical competence to ensure that they are able to provide excellent quality nursing care to patients with confidence. A qualitative study design was used to understand the perceptions of operational managers regarding the learning needs of new professional nurses to enhance their clinical competence. The study was conducted at seven public hospitals in the three districts of the North West Province, South Africa, between September and November 2021. Data were analyzed thematic. Four themes emerged from data analysis: 1) Ethos and professional practice, 2) Management and leadership skills, 3) Assessment and observation skills, and 4) Documentation and record keeping. This study provides valuable information regarding the learning needs of new professional nurses. Understanding these learning needs can provide insight into how to better transition student nurses to registered nurses so that they are able to adequately and safely take care of a diverse patient population and work successfully as new nurses.

Effect of an Educational Intervention on Nurses’ Competency in the Neonatal Unit of a Teaching Hospital in Nigeria: A Pilot Study

Background: Clinical competency of nurses has been identified to be vital in making the difference between survival and death of neonates. Continuing education (CE) is essential to enhance the competency of nurses. This study aims to evaluate the effect of an educational intervention on nurses’ competency as regards their knowledge, attitude, and practices of neonatal care in a teaching hospital in Ogun State. Methods: A quasi experimental one (1) group pre- and postintervention design was used. Purposive sampling of all registered nurses working in the neonatal unit of Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu Ogun State was utilized. Two tools were used for data collection: a semi-structured questionnaire and nurses’ clinical performance observational checklist. Data were collected before and 2 weeks after educational intervention. Data collected was managed using Statistical Package for Social Sciences (SPSS), version 20 software. Descriptive statistics was used to analyze and present variables. Inferential statistics of student t test was employed for hypotheses testing at P ≤ .05. Result: Nurses’ knowledge and practice improved at postintervention. Knowledge mean score at pretest was 35.21 (±6.33) which increased to 43.74 (±3.30) in the posttest (t = −7.33, P = .000). Practice mean score at pretest was 32.7 (±6.04) which increased to 44.8 (±7.22) postintervention (t = 7.26, P = .000). However, no significant difference was observed between the attitude of nurses regarding care of neonates pretest 71.0 (±7.15) and posttest 71.1 (±13.5) (t = 0.04, P = .968). Overall, there is a significant difference in the nurses’ competency score at pretest 192.21 (±20.23) and posttest 203.79 (±4.78) (t = −2.21, P = .040). Majority (94.7%) of the nurses agreed that CE would facilitate their competent in the care of neonates in neonatal units while 31.6% established that financial constraint was a barrier to attending CE to improve themselves. Conclusion: Implementation of educational program for nurses working in the neonatal unit improved their competency toward neonatal care. It is recommended that CE and training programs should be organized for nurses on a regular basis to sustain their competency.

The Role and Function of Clinical Research Nurses in Anti-tumor Drug Clinical Trials for Lung Cancer Patients

抗肿瘤药物临床试验既是新药研发的必经之路，也是最前沿的恶性肿瘤治疗方法，给患者带来了更多生存机会。肺癌药物临床研究数目大，研究药物品种繁多，研究进展快，临床转化效率高，这些试验的成功开展离不开研究团队的共同努力，其中研究护士也发挥了不容小觑的作用。结合临床研究护士的工作内容，本文详细介绍了开展肺癌药物临床试验过程中研究护士的岗位管理、角色职能、核心能力及职业发展前景，以期为更多医疗机构开展相关工作提供参考，促进临床研究护士向规范化专业化深入发展。

Komparasi Kompetensi Kepemimpinan Klinis Perawat Primer Berdasarkan Perspektif Evaluasi Diri dan Evaluasi Kepala Ruangan

This study aims to examine the clinical leadership competence of primary nurses based on the perspective of self-evaluation and evaluation of the head of the room in the inpatient room at Immanuel Hospital, Bandung. This research method is a quantitative research using a comparative research design. The results showed that there was 1 component had an evaluation equation, namely the element of working together with other people both in the primary nurse self-evaluation and the evaluation of the head of the ward had good cooperation. Four components had different evaluation results between the primary nurse's self-evaluation and the evaluation of the head of the room, namely, self-quality, management of nursing care services, improving services, and determining direction. In conclusion, there are differences in the clinical leadership competence of primary nurses based on the primary nurse's self-evaluation with the evaluation of the head of the room.&#x0D; &#x0D; Keywords: Self Evaluation, Head of Room Evaluation, Clinical Leadership, Primary Nurse&#x0D;

Validity and Reliability of the Korean Version of the Holistic Nursing Competence Scale.

This methodological study aimed to verify the validity and reliability of the Korean version of the Holistic Nursing Competence Scale (HNCS), which comprises five dimensions and 36 items. The English version of the HNCS was forward and backward translated and administered to 251 participants with more than a year of work experience in a general hospital. Data were analyzed using SPSS WIN 24.0(Chicago, IL, USA), and AMOS program was used for confirmatory factor analysis. Additionally, the “Task Performance Evaluation Instrument for Clinical Nurses” was used for concurrent validity. Reliability assessed using Cronbach’s α was 0.969. Convergent, discriminant, and concurrent validity were good. Average variance extracted and construct reliability ranged from 0.845 to 0.932 and 0.980 to 0.987, respectively. The model was suitable with the chi-square value being 1216.563 (df = 584, p < 0.001), and Q value being less than three. Goodness-of-fit index, root mean square residual, and root mean square error of approximation were 0.784, 0.066, and 0.066, respectively. Moreover, comparative fit index, Tucker–Lewis index, and incremental fit index were 0.913, 0.906, and 0.913, respectively. Thus, this study verified the validity and reliability of the Korean version of the HNCS. Our findings suggest that the scale is helpful in measuring and developing the holistic nursing competence of clinical nurses.

The development and evaluation of a pediatric nurse education program to improve nursing competency for newly graduated nurses in a children’s hospital

Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation.Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program.Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children’s hospital. The categories derived from the focus group interviews were “getting special guidance,” “better care,” “becoming a nurse at a children's hospital” and “winning together.”Conclusion: It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.

Patient-level and organizational-level factors influencing in-hospital falls.

In-hospital fall is one key safety issue in a healthcare setting. Although healthcare providers apply several strategies for preventing falls, falls still occur in hospitals. The aim of this study was to investigate patient-level and organizational-level factors influencing in-hospital falls. A multicentre retrospective observational study. This study used the national healthcare database and supplemented with organizational data obtained through a survey. Data extraction and survey were conducted between July and August 2020. A mixed-effect logistic regression model was used to analyse factors influencing in in-hospital falls. A total of 43,286 patients admitted in 86 hospitals were included in this study. Fall rate was 0.85 per 1000 days. Length of stay was significantly longer for fall patients than for no-fall patients. Patient-level factors (including age, mobility impairment and surgery) and organizational-level factors (including nurse staffing and proportion of new nurses) were significant factors influencing in-hospital falls. Since in-hospital falls increase economic burden to patients, we should consider various fall prevention strategies to reduce falls. For a strategy to be applied stably to patients, organizational factors must be supported. Proactive fall management in acute settings is essential to ensure patient safety. Considering that the number of patients with fall risk is increasing due to ageing, organizational factors should be supported to provide quality nursing care for fall risk patients. Therefore, nurse leaders should primarily ensure an appropriate level of nurse staffing. They also need to make efforts to strengthen clinical competency of nurses.