Contract Nurses Research Articles

A Usability Survey of a Quality Improvement Data Visualization Tool among Medical Intensive Care Unit Nurses

Abstract Background Cognitive overload is prevalent among intensive care unit (ICU) clinicians. Data visualization may decrease cognitive load by assisting with data interpretation and task prioritization. We developed the Bundle Board to display real-time data from the electronic medical record (EMR), highlighting opportunities for action in standardized ICU patient care. This study evaluates the practical usability of this data visualization tool among nurses in the ICU. Methods The tool is offered as an application separate from the EMR and was available in the medical ICU for 8 months before we surveyed unit nursing staff. To evaluate usability of the tool, we adapted the Health-Information Technology Usability Scale and included an option to provide open-ended feedback. Survey data were analyzed using quantitative and qualitative methods. Results ICU nurses were invited to participate through email and verbal announcements. Of the potential participants, 38% (N = 47) responded. The survey demonstrated that the tool was perceived as usable. For each subscale, mean scores were as follows: Perceived Ease of Use 4.40, Impact 4.14, User Control 4.07, and Perceived Usefulness 3.61. There were no significant differences between core and contracted nurses or after stratifying by duration of Bundle Board use. Fifteen respondents completed the optional free-text portion of the survey. Qualitative analysis revealed six subthemes focusing on perceived impacts on quality and safety, cognitive burden and workload, and emotional impact of the Bundle Board. Conclusion The Bundle Board demonstrated good usability among ICU nurses, who provided substantive feedback for its improvement. These observations may be generalizable to other comparable interventions. Iterative feedback from end users is vital to developing and implementing a digital health intervention. Our study provides a framework for performing a usability analysis within a specific clinician population and environment.

THE IMPACT OF CONTRACT NURSE UTILIZATION ON NURSING HOME QUALITY

Abstract Nurse staffing intensity and skill mix have a significant impact on NH quality of care. For instance, higher staffing levels, particularly for registered nurses (RNs), have been associated with better resident outcomes. NHs have increasingly relied on contract nurse staffing to address pressing and persistent nursing shortages. Research suggests that contract nurses may be unfamiliar with institutional policies and procedures or organizational culture. They may require increased supervision, be less participatory in teamwork, and may increase the workload for the permanent staff. The objective of this study is to examine the association between contract nurse utilization and quality of care at US nursing homes.We used secondary data from PBJ nurse staffing, Nursing Home Compare, Healthcare Cost Report Information System (HCRIS) Dataset, and the American Community Survey (ACS) for the period 2017-2021. The dependent variable was CMS quality star rating, and the independent variables were contract nurse to total nurse proportions for each of RNs, LPNs, and CNAs. We employed multivariate random effects ordered logistic regression to test the hypothesis. We found that across all our three models (RNs, LPNs, CNAs), quality star ratings were negatively associated with contract nurse utilization. A 10% increase in contract nurse proportion was associated with a 10% decrease in the odds of reporting a higher quality star rating (OR=0.99, p<0.001). Our results suggest the increased utilization of contract nurse staffing may have a negative impact on US NH quality---an important issue that has agitated policymakers for nearly three decades.

CONTRACT NURSE UTILIZATION AND FACILITY AND COMMUNITY FACTORS

Abstract While NHs have long been plagued by nursing staff shortages, the situation has further deteriorated with the COVID 19 pandemic. The NH industry has attempted to address the persistent shortage of nursing staff by increasingly relying on contract nurse staffing. Research suggests that the increased utilization of contract nurses may have negative implications for NH quality and financial performance. However, all NHs are not equally likely to utilize nurse contract staffing. For instance, potentially, NHs with poorer quality of care and financial challenges may be forced to rely more on contract nurse staffing. The primary purpose of this paper is to explore the antecedents---facility and community factors---associated with increased utilization of nurse contract staffing. Employing a pooled cross-sectional observational study design, we extracted secondary data from the PBJ nurse staffing, Nursing Home Compare, Rural-urban commuting area (RUCA) codes, and the American Community Survey (ACS) for the period 2017-2021. To test the relationship between the ratios of contract nurses and facility/community factors, we employed multivariate mixed-effects maximum likelihood regression. We ran three separate regressions for RNs, LPNs, and CNAs. Our results suggest that among facility level factors, NHs with more beds, higher occupancy rates, and higher proportion of Medicare residents were generally more likely to employ contract nurse staffing with some minor differences across the three models (RNs, LPNS, CNAs). Among community factors, location in micropolitan/small town areas, higher poverty rates, and higher education levels were positively associated with nurse contract utilization. Policy and managerial implications are discussed.

EXPLORING THE ASSOCIATION BETWEEN CONTRACT NURSE STAFFING AND NURSE TURNOVER IN NURSING HOMES

Abstract NHs face a significant problem with nurse staffing---a critical factor in providing high-quality care to residents. Although contract nurse staffing in NHs may provide a relatively flexible option to address acute nurse shortages, it raises its own challenges including requirement of increased supervision, lower levels of teamwork, and increased workload for the permanent staff. This may lead to disenchantment of the remaining nursing staff, increased turnover---a perfect vicious cycle. Therefore, we examined whether higher ratios of contract nurse utilization were associated with higher nurse turnover rates (RNs, LPNs, and CNAs). Employing a pooled cross-sectional observational study design, we extracted secondary data from PBJ nurse staffing, Nursing Home Compare, Rural-urban commuting area (RUCA) codes, and American Community Survey (ACS) for the period 2017-2021. We employed multivariate mixed-effects maximum likelihood regression to estimate the relationship between the ratios of contract nurses and nurse turnover rates while controlling for organizational/community variables. We ran three separate regressions for RNs, LPNs, and CNAs. Our results suggest that NHs with a high proportion of contract nurses had higher nurse turnover rates for all the three types of staffing (RNs, LPNs, and CNAs). Moreover, NHs with high RN turnover rates had low RN staffing, higher CNA staffing, lower occupancy rates, and higher share of Medicaid residents. High nurse turnover can adversely affect resident outcomes—for instance, due to reduced continuity of care. As such, it is important to closely monitor contract nurse staffing levels and their implications on staffing and resident outcomes.

THE EFFECT OF EFFORT-REWARD IMBALANCE ON TURNOVER INTENTION MEDIATED BY BURNOUT AND WORK STRESS IN CONTRACT NURSES

This paper is motivated by the increasing number of nurse turnover at Bahteramas Hospital over the past 3 years. This incident is caused by factors that cannot be explained. In addition, there are inconsistencies in the findings of previous studies in the effect of effort-reward imbalance on turnover intention where one researcher and another researcher did not reach the same conclusion. This study will examine the model of the effect of effort-reward imbalance on turnover intention by presenting burnout and work stress as mediation. Therefore, this study aims to develop a model to analyze the effect of effort-reward imbalance on turnover intention mediated by burnout and work stress. The study was conducted with a quantitative approach and descriptive design utilizing the conservation of resources (COR) theory paradigm which is proven to be able to overshadow all research constructs. The respondents of the study were contract nurses at the Bahteramas Regional General Hospital in Kendari City, while data collection was carried out with digital instruments in the form of a google form that was distributed and managed to collect a sample of 125 respondents using the Slovin formula which was drawn by simple random sampling. The measurement scale is an ordinal scale. The analysis techniques in this study are descriptive statistics and multivariate analysis with the help of AMOS software.The results of the study proved that mediating variables in the form of burnout and work stress were the main triggers that caused turnover intention in contract nurses at the Bahteramas Regional General Hospital in Kendari City. The implications of this study can be used by hospital management to reduce burnout and work stress of contract nurses so that the presence of turnover intention can be avoided.

Mediating Effects of Organizational Commitment on Organizational Citizenship Behavior in Contract Nurses

Penelitian ini bertujuan untuk mengkaji dan menganalisis hubungan kasual antara kompensasi terhadap organizational citizenship behavior yang di mediasi oleh komitmen organisasi pada perawat kontrak. Menggunakan metode kuantitatif, sampel penelitian ini adalah seluruh perawat kontrak sebanyak 67 orang yang bekerja di RSUD Drs. Jacobus Luna MSI, di Bengkayang, Kalimantan Barat. Pengumpulan data dilakukan dengan penyebaran kuisioner. Data dianalisis mengunakan path analisis dan program SPSS versi 25. Penelitian ini memperlihatkan bahwa komitmen organisasi berpengaruh terhadap organizational citizenship behavior, kompensasi tidak berpengaruh secara langsung terhadap organizational citizenship behavior, tetapi akan berpengaruh ketika dimediasi olej komitmen organisasi. Penelitian ini juga membuktikan bahwa komitmen organisasi mampu memediasi organizational citizenship behavior. Perlu dikaji kembali kebijakan dalam pemberian kompensasi terhadap pegawai kontrak untuk meningkatkan organizational citizenship behavior serta meningkatkan kesejahteraan perawat kontrak

The Relationship Of Perceptions Of The Physical Work Environment, Workload And Wages With Contract Nurse Performance In Mataram City Hospital

Background: Nurses' performance as an integral part of the health care system is an important part that determines the quality of health services in hospitals. Nurses' performance in providing health services always gets special attention from patients. The perception of patients at the Mataram City Hospital shows that the performance of contract nurses is still considered low. There are several factors that can affect the performance of nurses in hospitals, including the physical work environment, workload and work wages.
 Objective: This study aims to determine whether there is a relationship between the physical work environment, workload and work wages with the performance of contract nurses at the Mataram City Hospital.
 Research Methods: The type of research used is quantitative research with a cross sectional approach. The research location is at the Mataram City Hospital. Data collection using a questionnaire. Respondents in this study were contract nurses at the Mataram City Hospital. The number of samples in this study were 80 respondents.
 Results: The results of the analysis showed that p < 0.05, this means that statistically the independent variables have an influence on the dependent variable, it can be concluded that there is a joint effect of perceptions of the work environment, workload and work wages with the performance of contract nurses at the Mataram City Hospital.
 Conclusion: this study concludes that there is a relationship between the physical work environment, workload and work wages with the performance of contract nurses at the Mataram City Hospital

Branded Care: The Policy Implications of Pharmaceutical Industry-Funded Nursing Care Related to Specialty Medicines.

An increasing proportion of new drugs approved for market worldwide are now high cost, specialty medicines. Pharmaceutical marketers face the challenge of convincing payers, prescribers, and patients that the cost and complexity of care associated with specialty medicines is worth the trouble, and now offer patient support programs, free of charge, to patients prescribed their drug. We conducted a secondary, qualitative, interpretive analysis of 24 interviews with leaders of patient groups and members of hospital formulary committees in Australia to describe the work of pharmaceutical company-employed or contracted nurses who provide support to patients prescribed specialty medicines, and to prompt discussion around the policy implications of relying on industry-funded nursing care within publicly funded health systems. Participants affirmed the value of specialist, holistic, person-centered nursing care, but perceived gaps within the public health system related to the availability and provision of nursing care for people living with chronic disease. Consequently, participants described the pharmaceutical industry as addressing health system gaps through sponsorship or direct provision of medication-related nursing care, but recognized that care was contingent on commercial interest. Participants highlighted a number of ethical and policy concerns stemming from industry-funded nursing care of people prescribed specialty medicines related to patient safety, continuity of care, inducement to prescribe, and health equity. This analysis suggests that outsourcing necessary medication-related care to pharmaceutical companies has implications for the health system and equitable, sustainable pharmaceutical policy that extend far beyond the care encounter.

Infection Prevention Resources to Respond to the Initial Coronavirus Disease Pandemic at an Academic Medical Center

BackgroundInfection prevention specialists (IPS) are relied on as subject matter experts, providing guidance and support within healthcare facilities. During the coronavirus disease (COVID-19) pandemic, infection prevention (IP) department resources were heavily taxed, creating an increased IP staffing need. The objective of this study is to quantify the additional IP resources needed to support pandemic response at a large, academic medical center.MethodsPre-pandemic, our IP department included 12 full-time IPS, providing support to a 1315-bed hospital, 138 outpatient clinics, and 2 ambulatory surgery centers. The increased level of organizational support needed for the COVID-19 pandemic response required more full-time employees (FTE) to assist in managing additional duties. Duties included: conducting employee cluster investigations and contact tracing; reviewing positive COVID-19 lab specimens reported each shift to ensure appropriate isolation and bed placement; developing and reviewing COVID-19 related protocols across multiple hospital areas; and instituting a clinical case review process with infectious disease (ID) physicians to respond to call questions about testing, isolation requirements, and discontinuation criteria in complex patients.ResultsThe first known COVID-19 positive patient was admitted on 3/17/2020. Department call volumes peaked between May 2020 and end of June 2020. Calls during that time frame totaled 2,825 with an average of 202 calls daily. In response our IP department added 6 additional FTE. These FTE consisted of 2 reassigned bedside nurses and 4 contract nurses, supporting the 24/7 on-call service from 3/31/2020- 4/6/2021. Physician support increased to 2 dedicated epidemiologists managing COVID-19 guidance and IPS escalation needs, and a 24/7 on-call clinical review team, involving 16 ID physicians was implemented.ConclusionsA pandemic response effort can have a major impact on infection prevention staffing resources. Repurposing and/or onboarding non-IP staff and training them to support concrete IP processes can be an effective strategy to reduce strain on department resources.

Leader Member Exchange (LMX) on Turnover Intention with Job Satisfaction as a Mediating Variable

The purpose of this study was to examine: (1) The effect of leader member exchange on turnover intention. (2) The effect of leader member exchange on job satisfaction. (3) The effect of job satisfaction on turnover intention. (4) The effect of leader member exchange on turnover intention through job satisfaction. The population in this study were all RST contract nurses. DR. Reksodiwiryo Padang totaling 152 people using proportional cluster random sampling. The analytical technique used is SEM analysis using smart PLS3. The results of this study indicate that: (1) leader member exchange has a negative and significant effect on turnover intention. (2) leader member exchange has a positive and significant effect on job satisfaction. (3) job satisfaction has a negative and significant effect on turnover intention. (4) Leader member exchange has a significant effect on turnover intention with job satisfaction as a mediating variable.

77 Fast Track Simulation-Based Education for COVID-19 Deployment

COVID-19 created pressure on healthcare institutions to quickly prepare for maximum capacities. To meet the critical care capacity challenges, non-critical care nurses and overseas short-term temporary contracted nurses needed to be urgently deployed to the critical care units. That quick deployment and recruitment process raised concern about competence and patient safety; therefore, the deployed nurses were upskilled using fast track simulation-based education (SBE). SBE is an effective method to manage quick, focussed upskilling training, helping to improve patient care and safety The aim of the study was to explore the effectiveness of the COVID-19 SBE upskilling program on perceived satisfaction, confidence and competence of deployed nurses.Upskilling of 1200 non-critical care nurses was conducted using SBE between 14 March and 1 June 2021 during the country’s second wave of COVID-19. Training consisted of completing a mandatory 2-hour online critical care introductory module that included information on COVID-19 (the disease, pathophysiology), the critical care environment, critical care scope of service and infection control strategies. The online module was followed by 4 hours of in-person SBE using a demonstration and return demonstration approach. Considering the urgency of the situation and time constraints, skills were selected and prioritized according to patient safety and included care of the patient receiving mechanical ventilation, invasive line monitoring and care, recognition of deterioration, proning, and assessment of patient response to interventions. Post SBE, a survey was administered to collect data on the perceived satisfaction, confidence and competence of the nurses being deployed.The majority of the nurses reported confidence in their new skills (97%), while 96% perceived themselves as competent after successful completion of SBEs. The nurses were highly satisfied with the training effectiveness (92%), and 99% believed that they were able to successfully achieve the learning objectives. Specifics about perceived competence and confidence per survey item will be reported in the presentation. The SBE upskilling programme was evaluated as an effective way to learn how to manage critically ill patients.Nurses perceived themselves as confident and competent after participating in SBE. However, competence confirmation will be evaluated either in further SBE or through actual competency assessment in the clinical setting by trained competency validators. Nurses could perceive themselves as confident and competent but still perform incorrectly. Fast track SBEs should not be used to confirm full competence due to the inability to provide repetition of skills practice.

Workplace spirituality and the affective commitment : emotional intelligence as moderator

The purpose of this study were to analyze the relationship between workplace spirituality and affective commitment when emotional intelligence is a moderat or variable to Nurses at the RST Dr. Reksodwiryo Padang. The population in this study were all contract nurses in the inpatient department at the RST Dr. Reksodiwiryo Padang as many as 108 people. The number of samples used in the study was 85 people using the clusters proportional random sampling technique. The research design used in this study is causality research. The data analysis technique used is the Structural Equational Model (SEM) with the help of the SmartPLS 3.0 . The results of this study revealed that the emotional intelligence moderates the relationship was found to be significant to Nurses at the RST Dr. Reksodwiryo Padang.

Effect of Ethical Leadership on Moral Sensitivity in Chinese Nurses: A Multilevel Structural Equation Model.

To explore the relationship between ethical leadership (a contextual factor at the higher organizational level) and nurses' moral sensitivity (the individual outcome at a lower level), a cross-sectional quantitative study design was used. Participants were 525 nurses at 65 various departments in public tertiary hospitals. These results showed that ethical climate played a mediating role in the relationship between ethical leadership and nurses' moral sensitivity. Moreover, nurses' employment type moderated the mediating effect of ethical leadership on their moral sensitivity. Additionally, the link between ethical climate and moral sensitivity of contract nurses was stronger than that of nurses employed by the state.

Knowledge, attitudes, practices, and related factors of low anterior resection syndrome management among colorectal surgery nurses: a multicenter cross-sectional study.

With the widespread development of low and ultra-low rectal sphincter-preservation surgery, low anterior resection syndrome, a new clinical challenge, has received increased attention. As the principal practitioners of this syndrome management, colorectal surgery nurses require sufficient relevant knowledge and skills, but few studies have been conducted of their actual ability and practice of managing the syndrome. The study adopted a knowledge, attitude, and practice model to evaluate low anterior resection syndrome management among colorectal surgery nurses. A multicenter cross-sectional study was conducted, in which 361 registered nurses in colorectal surgery from 6 hospitals in 4 cities were enrolled. A structured paper questionnaire was used to collect demographics, scale scores for knowledge, attitudes and management practice, and training needs. Participants scored poorly in knowledge, attitude, and practice. Whether training had been received or not was an important factor affecting the knowledge, attitude, and practice of nurses, and the majority of participants had not received training. Nurses with lower levels of education had worse knowledge and practice, and contract nurses scored lower than staff nurses in terms of knowledge and attitude. The critical role of nurses in patient management places high demands on their knowledge, attitude, and practice. However, the present study demonstrated that the current knowledge, attitude, and practice of colorectal surgery nurses regarding the syndrome gave cause for concern, and whether training had been received was a key factor affecting these three aspects. Therefore, training is a key strategy to eliminate the gaps identified.

Turnover Intention and Behavior Organizational Citizenship on Indonesian Hospital Case

Since the last 4 years the nurse turnover rate on Indonesian Hospital Case has shown an increase and reached the highest number (20.8%) in 2019 for contract nurses. If not anticipated it will disrupt the quality of service and reduce hospital performance. The high turnover rate also causes hospitals to incur additional costs for recruitment and training. Meanwhile, hospitals also need a lot of time to make nurses have the skills to provide quality care and meet the Patient Safety rules. The purpose of this study was to identify the influence of job satisfaction and organizational citizenship behavior on nurse turnover intention in hospital industry.
 This study uses quantitative methods, to determine the causality relationship between related variables. Data processing is done quantitatively using SEM statistical test methods, to prove the hypothesis. The research sample was saturated with 282 nurses, both organic and contract, conducted since November 2019 until January 2020. Data processing is done quantitatively using the SEM statistical test method, to prove the hypothesis. Research findings: increasing OCB is an important thing to do by Indonesian Hospital Case management, because OCB is proven to increase the effect of job satisfaction in order to reduce nurse turnover intention. The voluntary attitude of nurses is the lowest OCB behavior in contract and organic nurses, so efforts are needed to improve voluntary behavior so that nurse turnover intention can be significantly increased.
 The results showed nurse turnover Intention was influenced by Job Satisfaction and OCB. The indirect effect through OCB is 1.43 times greater than the direct effect of Job Satisfaction on Turnover Intention. Perceptions of turnover intention for contract nurses are moderate, organic is low, job satisfaction is moderate (organic nurses are more satisfied than contract nurses), and OCB is high (organic nurses are higher than contract nurses).

Association of Use of Contract Nurses With Hospitalized Patient Pressure Injuries and Falls

Hospital-acquired pressure injuries (HAPIs) and falls are outcomes sensitive to quality of nursing care. Use of contract (traveler) nurses varies among organizations, but there is little research on the effect of contract nurses on nurse-sensitive outcomes. To explore the relationship between use of contract nurses and two key nurse-sensitive outcomes, HAPIs and falls. This was a cross-sectional study of unit-level nursing, patient, and hospital factors versus HAPIs and falls from a national nursing data consortium from 2015 to 2016. We used cluster analysis to identify similar units, and compared outcomes between clusters. 605 nursing units in 166 hospitals, 3.2 patients per nurse, and 5.3% contract nurses. Prevalence and incidence of HAPIs and number of falls, adjusted by patient days. For both prevalence and incidence of HAPIs, there was a statistically significant difference between the five independent cluster groups (p = .012 and p = .001, respectively). The cluster with the highest percentage of nurse travelers (>7%) had the highest HAPI prevalence (0.84%) and incidence (0.055 per 1,000 patient days) despite higher nurse staffing, compared to HAPI prevalence of 0.32% and incidence of 0.017 per 1,000 patient days in the cluster with the lowest percentage of nurse travelers (<2%). We did not identify a consistent relationship between use of contract nurses and falls. Use of contract nurses was associated with higher HAPI prevalence and incidence, independent of staffing levels. Our results suggest that institutions should either minimize the use of contract nurses, or engage in extensive training to confirm that contract nurses have understanding of the institutional practices around HAPIs.

Fitting and its influencing factors in ICU nurses

Objective To explore the fitting and its influencing factors of ICU nurses. Methods There were 268 nurses recruited from the First Affiliated Hospital of Xi′an Jiaotong University, the Ninth Hospital of Xi′an, Shaanxi Provincial People′s Hospital by convenience sampling between April and June 2018. The Fitting Scale, Social Undermining Scale, Perceived Organizational Support Scale and Supportive Communication Scale were used in the investigation. Results The score of person-organization fit was (32.20±5.17). The score of person-job fit was (55.14±8.24), with the lowest score of supply-value fit subscale (2.58±0.48). The score of perceived organizational support, social undermining and supportive communication were (45.36±9.64), (46.27±7.48) and (68.47±11.25) respectively. Perceived organizational support, social undermining, contract nurses, and educational level could influence person- organization fit, which could explain 59.3% of the total variation. Working time, supportive communication and perceived organizational support could influence person- job fit, which could explain 47.6% of the total variation. Conclusions Nursing managers should improve the core value system of human resources management and organizational culture construction, enhance organizational support, construct humanities environment and coping strategy of undermining, provide the relevant training of interpersonal communication, and increase their organizational and job fitting. Key words: Intensive care units; Nurses; Fitting; Perceived organizational support; Social undermining; Supportive communication

Study on correlation between professional benefit and turnover intention of contract nurses in operating room from ClassIII Grade A hospitals in Shenyang

Objective To investigate the status of professional benefit and turnover intention among contract nurses in operating room from ClassⅢ Grade A hospitals, and to analyze the relationship between them. Methods A total of 258 contract nurses in operating room of 6 Class Ⅲ Grade A hospitals in Shenyang were investigated by nurses' professional benefit scale and turnover intention scale during September 2016 to October 2017, to investigate the status of professional benefit and turnover intention and analyze the relationship between them. Results The total score of professional benefit and turnover intention of contract operating room nurses in the third-class hospital was (47.89±7.59) and (12.12±3.06) respectively. The Pearson correlation analysis showed that there was a negative correlation between nurses' professional benefit and turnover intention in contract nurses of operating room in ClassⅢ Grade A hospitals (r=-0.537, P<0.01) . Hierarchical regression analysis showed that, after controlling demographic factors, professional benefit could independently explain 19.30% of the variation in turnover intention of contractual operating room nurses in Class Ⅲ Grade A hospitals. Conclusions Professional benefit of contract nurses in operating room of ClassⅢ Grade A hospitals is an important influencing factor of turnover intention. It is necessary to stabilize the working mentality by improving the sense of professional benefit and to promote the structural stability and sustainable development of the operating room nursing staff. Key words: Operating nursing; Professional benefit; Turnover intention; Correlation analysis

HUBUNGAN JOB INSECURITY DAN BEBAN KERJA MENTAL DENGAN STRES KERJA PERAWAT HONORER DI RSJD ATMA HUSADA MAKAHAM SAMARINDA

Stress is a dynamic condition of an individual faced with opportunities, limitations, or demands in accordance with expectations and results to be achieved in important and uncertain conditions. According to the National Institute for Occupational Safety and Health (NIOSH), nurses are professions that are very high risk of stress. Results of a survey by the Persatuan Perawat Nasional Indonesia (PPNI), where in 2006, approximately 50.9% of hospital nurses working in four provinces experienced work stress. This study aims to determine the relationship of job insecurity and mental workload with job stress contract nurses at RSJD Atma Husada Mahakam Samarinda. This research uses analytic survey method with cross sectional research design. The variables in this study are Job Insecurity, Mental Workload and Job Stress. The respondents of this research are contract nurses at RSJD Atma Husada Mahakam with total subject of this research is 74 respondents, sampling technique using Total Sampling. Data were analyzed by using Pearson Correlation test with ? = 0,05. The result showed that there was a relationship between job insecurity (p = 0.0001) and mental workload (p = 0,004) with work stress. The conclusion of this research is job insecurity and mental work load is the factor causing the occurrence of job stress on contract nurses at RSJD Atma Husada Mahakam. It is advisable to pay more attention to the nurse's need to reduce the level of job insecurity and mental workload by raising nurse staffing status for nurses with more than 5 years working period and providing pension guarantee and providing training to improve nurse's ability.

Health-promoting behaviours of Iranian nurses and its relationship with some occupational factors: A cross sectional study.

To assess the prevalence of health-promoting behaviours (HPBs) and their associations with some occupational factors among nurses. Health-promoting behaviours are significant indicators of health status. Nurses' HPBs may have a direct impact on patients' care and safety. A descriptive, questionnaire design was conducted among nursing staff (n=136) in a district hospital in Iran during 2015. Data was collected using a two-part questionnaire, which included the Health Promoting Lifestyle Profile II. Data was analysed using the Pearson correlation coefficient, and independent t and ANOVA tests (α=.05). The stress-management and physical activity dimensions had the lowest mean score and health responsibility had the highest. The HPBs of nurses with rotating/irregular shifts, contract employment, and low income were significantly lower. Nurses' HPBs should be promoted in the stress management and physical activity dimensions. In this regard, contract nurses, shift nurses, and low-income nurses are the priorities. Nurse managers should give more attention to promote nurses' HPBs especially in the areas of stress management and physical activity through implementation of healthy lifestyle programs. Nursing policy makers should give attention to permanent recruitment and improving salary as a strategy to improve nurses' HPBs.