Individual Nurses Research Articles

Effects of Personality Traits and Mentalization on Workplace Bullying Experiences among Intensive Care Unit Nurses

Aim. This study aimed to investigate the effects of intensive care unit nurses’ personality traits and mentalization on workplace bullying after controlling for organizational culture. Background. Nurses’ personality traits and mentalization may significantly influence workplace bullying. Methods. This cross-sectional study collected data from 416 nurses using an online survey in July 2022. Major variables were evaluated using the Pathological Narcissism Inventory, Perfectionistic Self-Presentation and Psychological Distress Scale, Short Dark Triad, Mentalization Scale, Positive Nursing Organizational Culture Measurement Tool, and the Negative Acts Questionnaire-Revised. . A multiple regression analysis was performed. Results. Narcissistic vulnerability, mentalization, and perfectionistic self-presentation significantly influence workplace bullying (victim aspect). Dark personality, mentalization, and perfectionistic self-presentation significantly influence workplace bullying (perpetrator aspect). Conclusions. Individual nurses could become either victims of bullying or perpetrators according to their personality traits. Therefore, it is necessary to determine their personality traits, so that they do not become influencing factors in workplace bullying. Implications for Nursing Management. Efforts at a nursing organization level are crucial to understand nurses’ personality traits, enhance their mentalization, minimize the manifestations of the negative aspects of their traits, and positively affect the prevention and alleviation of workplace bullying.

Nurses are background actors in medical reality television: A character network analysis and call for authentic action.

The aim of this study was to describe how nurses' dialogue compares with that of doctors in the Australian reality television program Emergency and to explain how this dialogue and the use of narration and direct-to-camera monologues contribute to the portrayal of nurses. The final aim was to outline how these findings can inform the actions of nurses, nursing organizations and writers and journalists. A descriptive study conducted in 2021 and 2022. Character network analysis was used to describe the verbal interaction of nurses and doctors and identify major, minor and background characters. Narration and direct-to-camera monologues were analysed through frequency counts. Cultivation theory was used to interpret the results. Fifty-four characters were identified, with 19 of these being nurses. Doctors spoke 87.9% of the dialogue. Most of the dialogue (43%) was monologue by doctors directly to the camera. All major characters were doctors, and only one nurse was a minor character. The mean number of mentions by the narrator of a nurse per episode was 4, and 30 for a doctor. The portrayal of nurses in Emergency is inaccurate and the production methods are used to privilege the role of doctors. This finding comes after decades of research showing inaccurate images of nursing in television. Drawing on recent Australian inquiries and the challenges experienced by mental health and aged care nursing, several approaches for collaborative action to improve these images are suggested. This is the first study of the portrayal of nursing in reality television. These results suggest that much effort is still required even in contemporary reality television to accurately reflect the work and contribution of nurses. It is the shared responsibility of individual nurses, nursing organizations and writers and journalists to accurately portray nurses in the media. This network analysis of a postproduction television program did not allow patient or public involvement in the design or analysis.

Social jetlag and body mass index among shift-working nurses in Korea: A cross-sectional study.

Shift-working nurses must function against their natural circadian system and are, thus, bound to be detrimentally affected by social jetlag. Circadian rhythms play a crucial role in regulating homeostasis, and social jetlag may increase one's risk for obesity. Therefore, this study aimed to identify associations between social jetlag and obesity among shift-working nurses. This cross-sectional study included 183 nurses working rotating shifts in South Korea. Chronotype and social jetlag were measured using the Morningness-Eveningness Questionnaire and the Munich Chronotype Questionnaire for Shift-Workers, respectively. Obesity was defined as a body mass index of 25.0 or higher, which was calculated using self-reported height and weight data. The associations between chronotype, social jetlag, and obesity were investigated using multiple logistic regression analysis. A total of 183 nurses were included in the analysis (81.4% women and 80.3% single, median age=27.00 years). Majority of the participants' (95.1%) chronotypes were moderate evening or intermediate type. The mean overall social jetlag was 3h and 31 min. The odds for obesity were 8.44 times higher among shift-working nurses whose social jetlag was over 3h and 31 min (95% confidence interval: 1.66-42.99) while controlling for chronotype, exercise time, and eating habits. Social jetlag may increase the likelihood of obesity among rotating shift-working nurses. To achieve positive outcomes for promoting nurses' health, upper nursing management should consider individual nurses' social jetlag when scheduling shifts. In addition, nursing managers should have the responsibility to educate nurses involved in shift work about the adverse effects of social jetlag.

Making more nurses, one minute at a time: an efficiency and quality improvement project in emergency triage.

Emergency triage is a short-duration, high-volume process so small reductions in the time taken to triage one patient can have large repercussions on the total amount of triage time. At the emergency department of a large inner-city hospital, an efficiency and quality improvement project was undertaken to reduce the time taken to safely triage patients and optimise the use of triage nurses' time. The project involved removing processes that did not contribute to the primary aim of triage, supporting individual triage nurses to improve their performance where needed, and optimising the triage process. A 44% reduction in mean triage episode time was seen, equating to 18,000 minutes of triage nurses' time saved every month. This near doubling of triage capacity was associated with an improvement in triage accuracy. The article describes the project, which used lean management principles and statistical process control methods, and discusses its implications for emergency triage.

Measuring Professional Identity: A Nursing Practice Perspective

In the past 20 years, professional identity in nursing and scales associated with the term have been difficult and confusing to define. In 2018, a group of nurse leaders sought to define professional identity in nursing and subsequently created a new scale based on that definition. This new Professional Identity in Nursing Scale is currently being psychometrically tested with practicing nurses. Nurse leaders can start to think innovatively about how to use the scale with individual nurses as well as with a group in the work environment.

Individualized Management of Quality of Care in Orthopedic Nurses Based on Sensitive Indicators.

Sensitive indicators of nursing quality focus on the core elements of nursing quality management. Nursing-sensitive quality indicators will play an increasingly important role in the macro and micro management of nursing quality in my country. This study were aimed at formulating the sensitive index management of orthopedic nursing quality based on individual nurses for improvement of the quality of orthopedic nursing. Based on the previous literature, the existing challenges in the early application of the orthopedic nursing quality evaluation index were summarized. Moreover, the management system of the orthopedic nursing quality-sensitive index based on individual nurses was devised and implemented, including monitoring the structure and result indices of individual nurses on duty and sampling the process indicators of patients managed by individual nurses. At the quarter-end, the data analysis was performed and fed back to determine the key points of the changes in the quality of specialized nursing affecting the individual, and the PDCA method was utilized for persistent improvement. The changes of sensitive indices of orthopedic nursing quality before (July-December 2018) and 6 months after implementation (July-December 2019) were compared. There were significant differences in other indices (accuracy of limb blood circulation assessment/accuracy of pain assessment/postural care pass rate/accuracy of rehabilitation behavioral training/satisfaction of discharged patients) (P < 0.05). The formulation of an individual-based orthopedic nursing quality-sensitive index management system modifies the traditional quality management model, improves the specialized nursing level, contributes to the accurate core competence training of specialized nursing, and improves the quality of specialized nursing of individual nurses. Consequently, there is an overall improvement in the specialized nursing quality of the department, and fine management is attained.

The therapeutic relationship at the heart of nursing care: Aparticipatory action research in acute mental health units.

To explore the process of change within the clinical practice of nurses in mental health inpatient units in the context of a participatory process to improve the nurse-patient therapeutic relationship. Participatory Action Research. Ninety-six nurses from 18 mental health units participated. Data were collected through focus groups and reflective diaries between March 2018 and January 2020. Data were analysed using inductive content analysis. The COREQ guidelines were used. The research process was carried out through two cycles of four stages each in which the nurses were able to identify the facilitating and limiting elements of their practice in relation to the therapeutic relationship. They then proposed two consensual improvement strategies for all the units, which they called reserved therapeutic space and postincident analysis. Finally, they implemented and evaluated the two strategies for change. This study has shown that, despite the different cultural and structural realities of the participating units, it is possible to implement a collaborative process of change, provided the needs and expectations of both the participants and the organisations are similar. The results obtained through Participatory Action Research were directly transferred to clinical practice, thus having an impact on individual nurses and patients, as well as on the collective dynamics of the teams and aspects related to the management of the units. Patient or public input is not directly applicable to this study. Patients were recipients of the changes that were occurring in the nurses as part of their daily clinical practice.

The Use of Electronic Health Record Metadata to Identify Nurse-Patient Assignments in the Intensive Care Unit: Algorithm Development and Validation.

Nursing care is a critical determinant of patient outcomes in the intensive care unit (ICU). Most studies of nursing care have focused on nursing characteristics aggregated across the ICU (eg, unit-wide nurse-to-patient ratios, education, and working environment). In contrast, relatively little work has focused on the influence of individual nurses and their characteristics on patient outcomes. Such research could provide granular information needed to create evidence-based nurse assignments, where a nurse's unique skills are matched to each patient's needs. To date, research in this area is hindered by an inability to link individual nurses to specific patients retrospectively and at scale. This study aimed to determine the feasibility of using nurse metadata from the electronic health record (EHR) to retrospectively determine nurse-patient assignments in the ICU. We used EHR data from 38 ICUs in 18 hospitals from 2018 to 2020. We abstracted data on the time and frequency of nurse charting of clinical assessments and medication administration; we then used those data to iteratively develop a deterministic algorithm to identify a single ICU nurse for each patient shift. We examined the accuracy and precision of the algorithm by performing manual chart review on a randomly selected subset of patient shifts. The analytic data set contained 5,479,034 unique nurse-patient charting times; 748,771 patient shifts; 87,466 hospitalizations; 70,002 patients; and 8,134 individual nurses. The final algorithm identified a single nurse for 97.3% (728,533/748,771) of patient shifts. In the remaining 2.7% (20,238/748,771) of patient shifts, the algorithm either identified multiple nurses (4,755/748,771, 0.6%), no nurse (14,689/748,771, 2%), or the same nurse as the prior shift (794/748,771, 0.1%). In 200 patient shifts selected for chart review, the algorithm had a 93% accuracy (ie, correctly identifying the primary nurse or correctly identifying that there was no primary nurse) and a 94.4% precision (ie, correctly identifying the primary nurse when a primary nurse was identified). Misclassification was most frequently due to patient transitions in care location, such as ICU transfers, discharges, and admissions. Metadata from the EHR can accurately identify individual nurse-patient assignments in the ICU. This information enables novel studies of ICU nurse staffing at the individual nurse-patient level, which may provide further insights into how nurse staffing can be leveraged to improve patient outcomes.

Effect of compassion rounds on nurses'professional quality of life on a COVID-19 unit.

Evidence suggests that support groups enhance nurses'professional quality of life (QOL), and positive professional QOL is associated with better patient and nurse outcomes. This study examined the effect of a unit-level support group on the professional QOL of nurses working on a progressive care unit-turned-dedicated-COVID-19 unit. We hypothesized that a professionally facilitated Compassion Rounds (CR) support group would improve compassion satisfaction (CS) and reduce compassion fatigue (CF) among COVID-19 unit nurses. For this pre/post, within-group trial we recruited an inclusive, convenience sample of 84 nurses on a COVID-19 unit within a 377-bed, Magnet®-designated hospital. The 10-week, CR consisted of biweekly meetings, and the ProQOL version 5 measured pre/post CS and CF. Paired t-testing showed that CS scores fell after CR (n = 10; p = .005), while scores rose for CF burnout (p = .05) and secondary traumatic stress (p = .008). Results were similar for unpaired analysis (N = 38; p < .05). Although pandemic-related challenges likely overwhelmed CR's potential to improve professional QOL, CR may have prevented worse deterioration of work-life quality. CR may also create clinically meaningful improvements for groups or individual nurses, and thus enhance nurse and patient outcomes.

How the reliability and validity of the patient classification system can be ensured in daily nursing work? A follow-up study.

This study aimed to determine the reliability and validity of the RAFAELA patient classification system (PCS) for qualified and efficient nurses. The number of patients per nurse or diagnosis-based determination of nursing workload are imprecise measures that do not consider the variation in patients' care needs. Ensuring the reliability and validity of the RAFAELA is important for the efficient allocation of nursing resources. In this study, we investigated how the maintenance (parallel classification measurement and professional assessment of optimal nursing care intensity level measurement) of the RAFAELA was done with 9 years of follow-up data. The results were analysed using quantitative methods supplemented with qualitative audit descriptions. The STROBE checklist was used. The RAFAELA was used continuously in 44 units (40%). The length of use of the RAFAELA influenced the success of parallel classification measurements. Six per cent of units passed parallel classification measurement over 75% after 1-3 years' use, 42% after 4-6 years and 83% after 7-9 years. Among the units that used the RAFAELA PCS continuously, only four (9%) passed the professional assessment of optimal nursing care intensity level measurement. This study shows that ensuring the reliability and validity of the use of the RAFAELA is laborious, requires several years of use and continuous investments in nurses' skills and motivation. Qualified use of PCS is challenging, and organisations should invest to maintenance, training, support and user motivation. Each patient should be classified comprehensively, and nursing resources should be calculated correctly. In addition, utilisation of the nursing intensity level should be maximised. Kuopio University Hospital organisation permit number 73/2014. Information regarding individual patients or nurses was not available to the researchers. All materials are in the form of summary tables.

Outcomes of a quality improvement project aimed at improving delivery of new anticancer drug education to nursing in an academic-community hybrid model.

50 Background: Educating staff on new anticancer medications is imperative for patient safety. Infusion nurses at Dana Farber Cancer Institute (DFCI) satellite infusion centers were surveyed on their comfort level administering newer oncology drugs. Results revealed only 57% of nurses were “extremely comfortable or somewhat comfortable,” while 32% of nurses were “somewhat uncomfortable or very uncomfortable.” This project aimed to increase percentage of nurses at the satellites indicating they are “extremely comfortable” or “somewhat comfortable” from baseline of 57% to ≥75%. Methods: An interdisciplinary team including pharmacy, medical oncology, and nursing was formed to analyze workflows around new drug onboarding, staff education, and satellite communication. The team utilized Plan-Do-Study-Act (PDSA) cycle methodology. Tools included process maps and fishbone to identify areas of improvement. Intervention development tools included a Pareto chart and a priority matrix. Results were analyzed using statistical process control charts. Results: PDSA cycle 1 consisted of making the pharmacy driven education sheet, At-A-Glance (AAG), more accessible for new drugs. AAGs for drugs approved by the FDA in the previous 18 months were posted on the DFCI pharmacy intranet page. Nurses were educated on how to access AAG weekly. For PDSA cycle 2, the survey was modified to target individual nurses administering new drugs rather than all nurses. A “Nursing consideration” section was added to the AAG template and workflow developed; Navigation and review of AAG was added to nursing competency. Monthly nursing/pharmacy huddles were established to optimize communication. These interventions increased the percentage of nurses indicating they are “extremely comfortable” or “somewhat comfortable” to ≥75% which was sustainable through PDSA cycle 2 (see Table). Conclusions: Making an easy-to-use nursing education resource accessible improved nursing comfort level. There were challenges with nursing survey due to COVID-19 surge and staff shortages. Routine huddles are essential for sustainability.[Table: see text]

Factors impacting delegation decision making by registered nurses to assistants in nursing in the acute care setting: A mixed method study

BackgroundHealthcare organisations have been redesigning care delivery models in an attempt to extend, expand and supplement the registered nurse workforce by including more unregulated healthcare workers, such as the assistant-in-nursing. As the number of assistants-in-nursing grows it is essential that nurses have the requisite skills and knowledge to effectively delegate and supervise this growing workforce. ObjectiveThe aim of this research was to explore the factors that impact the nurse's decision to delegate to assistant-in-nursing in the acute care environment. DesignThis study used a mixed-method explanatory sequential design. The participants were RNs in an acute public hospital in Western Australia. The surveys completed by the registered nurses (n = 100) included their attitude to delegation, the risk management process undertaken prior to delegation and the tasks that they delegated to the assistants-in-nursing. The survey data were analysed using descriptive statistics. The findings from these data informed the questions for the semi structured interviews which formed the second phase of this research. Interviews with registered nurses (n = 12) were conducted, transcribed verbatim and analysed using Braun and Clarke's thematic analysis. Results from both phases were triangulated to provide a richer understanding of the phenomena. ResultsOverall, approximately half have a ‘somewhat negative attitude’ (n = 45, 45%); and the other half have a ‘somewhat positive attitude’ (n = 48, 48%) towards delegation. Concerningly, many nurses do not complete a risk assessment prior to delegating to the assistant-in-nursing. This study identified a range of factors that impact nurses' decision to delegate to the assistant-in-nursing including their level of experience, level of education pertaining to delegation, the assistant-in-nursing skills, knowledge and attributes, and the individual nurses' personality traits. ConclusionsAs demand and financial constraints on healthcare systems increase, governments and health care providers are needing to reconsider how to deliver effective, cost efficient healthcare in the acute care environment. As models of care evolve to include more unregulated workers it is essential that safe, effective delegation practices occur between registered nurses and the assistant-in-nursing.

The relationships between organizational culture and thriving at work among nurses: The mediating role of affective commitment and work engagement.

Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work. Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross-level impact of organizational and individual characteristics. A cross-sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro. Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment. Our study confirmed the social embeddedness model of thriving at work by showing that both contextual and dispositional factors can influence nurses' thriving at work. Nurse leaders can foster nursing staff's thriving at work by building an inclusive work environment and by providing adequate resources to staff. Future research is needed to elaborate on employee and organizational outcomes associated with thriving at work. Nurse leaders should be the advocate for nurses to improve their organizational identification, fostering their thriving at work. Individual nurses can also take an active role in developing work-related resources to sustain their thriving through self-adaption processes. Collective thriving in the nursing workforce is needed to overcome adversity and hardship in the ever-changing and increasingly demanding health care industry and to further contribute to the vitality of the broader social and public environments. No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

The Role of Personality and Top Management Support in Continuance Intention to Use Electronic Health Record Systems among Nurses.

This study examines nurses’ Continuance Intention (CI) to use electronic health records (EHRs) through a combination of three conceptual frameworks: the Unified Theory of Acceptance and Use of Technology (UTAUT), the theory of expectation-confirmation (ECT), and the Five-Factor Model (FFM). A model is developed to examine and predict the determinants of nurses’ CI to use EHRs, including top management support (TMS) and the FFM’s five personality domains. Data were collected from a survey of 497 nurses, which were analyzed using partial least squares. No significant relationship was found between TMS and CI. The study revealed that performance expectancy significantly mediated the influences of two different hypotheses of two predictors: agreeableness and openness to testing CI. A significant moderating impact of conscientiousness was found on the relationship between performance expectancy and CI and the relationship between social influence and CI. The findings of this study indicated that rigorous attention to the personality of individual nurses and substantial TMS could improve nurses’ CI to use EHRs. A literature gap was filled concerning the mediating effects of performance expectancy on the FFM-CI relationship, and the moderation effects of Conscientiousness on UTAUT constructs and CI are another addition to the literature. The results are expected to assist government agencies, health policymakers, and health institutions all over the globe in their attempts to understand the post-adoption use of EHRs.

Meanings of troubled conscience in nursing homes: nurses' lived experience.

Troubled conscience among nurses and other healthcare workers represents a significant contributor to healthcare worker moral distress, burnout and attrition. While research in this area has examined critical care in hospitals, less knowledge has been obtained from long-term care contexts such as nursing homes, despite widely recognised challenges with regard to vulnerable patients, increasing workload and maintaining workforce sustainability among nurses. The aim of this study was to illuminate and interpret the meaning of the lived experience of troubled conscience among registered nurses (RNs) working in nursing homes. This qualitative research employed narrative interviews with eight nurses to obtain essential meanings of their lived experiences of troubled conscience. The interview texts were analysed using a phenomenological hermeneutic approach. Participation was voluntary, informed and was conducted with written consent. The Norwegian Centre for Research Data approved the data processing of personal data. The analysis uncovered two themes: (1) troubled conscience means abandoning ideals, with the subthemes: failing dependent patients; being disloyal to colleagues; being inadequate in the performance of work tasks and (2) troubled conscience means facing realities, with the subthemes: accepting being part of the system; responding to barriers. Troubled conscience meant experiencing continuous and simmering tension between one's ideals and realities and feeling a drive to preserve accountability and one's moral integrity. Endangered ideals were often under cross-pressure and included humanistic values, professional values, working life values and the values of the organisation. Nurses' troubled conscience refers to a struggle, but also a force that plays out at various levels and arenas in long-term care. Openness and dialogue about how professional values and the welfare state's intentions can be realised within the given framework are important for individual nurses' occupational health as well as the quality of care provided to patients.

Understanding the “alarm problem” associated with continuous physiologic monitoring of general care patients

Study AimThe aim of this study is to investigate the impact of alarm configuration tactics in general care settings. MethodsRetrospective analysis of over 150,000 hours of medical/surgical unit continuous SpO2 and pulse rate data were used to estimate alarm rates and impact on individual nurses. ResultsApplication of an SpO2 threshold of 80% vs 88% produced an 88% reduction in alarms. Addition of a 15 second annunciation delay reduced alarms by an additional 71% with an SpO2 threshold of 80%. Pulse rate alarms were reduced by 93% moving from a pulse rate high threshold of 120–140 bpm, and 95% by lowering the pulse rate low threshold from 60 to 50 bpm. A 15 second annunciation delay at thresholds of 140 bpm and 50 bpm resulted in additional reductions of 80% and 81%, respectively. Combined alarm frequency across all parameters for every 24 hours of actual monitored time yielded a rate of 4.2 alarms for the surveillance configuration, 83.0 alarms for critical care monitoring, and 320.6 alarms for condition monitoring. Total exposure time for an individual nurse during a single shift ranged from 3.6 min with surveillance monitoring, to 1.2 hours for critical care monitoring, and 5.3 hours for condition monitoring. ConclusionsContinuous monitoring can eliminate unwitnessed/unmonitored arrests associated with significant increased mortality in the general care setting. The “alarm problem” associated with these systems is manageable using alarm settings that signify severely abnormal physiology to alert responsible clinicians of urgent situations.

Impact of Rotating Shifts on Nurse’s Health Working in Public and Private Sector Hospitals of Peshawar

Background: Shift work refers to a work schedule that is performed in rotations, typically is divided into morning, evening, and nightshift or a set period of times by which different groups perform their duties accordingly. Little is known about shift work in Pakistan, especially in the Peshawar region. Implication for individual Nurses’ need to care for their own health as well as with patient care. The objective of this study was to identify the effects of shift work on the health of nurses working in public and private hospitals of Peshawar. Methods: The study design was cross-sectional study. In May 2017, 199 nurses participated in this study by completing a self-administered questionnaire which comprised of demographic data health outcomes after taking consent from the participants in 2 public and 1 private hospital in Peshawar. Results: The study found that Rotating shifts affect nurses physically as well as psychologically; there is a positive association between shift work and health problems such as sleep disturbances and sleep-related impairment, fatigue, anger, satisfaction with social roles outside of work, and lower cognitive abilities. Conclusion: Shift work is essential for any organization to provide 24 hours services to the patient. In nursing, shift work is mandatory and required to provide continuous quality care to the patients, but it has some adverse effects on the health of nurses as well as on patient safety.

Nurses' ethical leadership and related outcome variables: Systematic review and meta-analysis.

To investigate the outcomes and the effect sizes of ethical leadership in nursing practice. Many meta-analysis of ethical leadership have been conducted in other fields, but there are none for the effects of ethical leadership of nurse leaders and should be investigated. For a systematic literature review, we searched PubMed, EMBASE, the Cochrane Library, CINAHL, OVID, Web of Science and Korean databases for studies published in Korean or English. We used Comprehensive Meta-Analysis (CMA) 2.0 and R 3.6.2 for the meta-analysis. We divided the outcomes of ethical leadership into three categories and investigated the effect sizes: subordinates' perceptions of their leaders (ES = 0.65), subordinates' ethical behaviours (ES = 0.04) and job or organisational outcomes (ES = 0.45). In addition, we identified 14 outcome variables, and transformational leadership showed the greatest effect size (ES = 0.77) among them. This study confirmed the positive effects of ethical nursing leadership on individual nurses' perceptions about their leaders, their jobs and organisations. Nursing organisations and nurse administrators should make efforts to highlight ethical leadership of nurse leaders to improve outcomes of organisational performance including individual nurses' perceptions about their leaders, their jobs and organisations.

Factors influencing nurses' intent to provide care involved in coronavirus disease 2019: Theory of planned behaviour perspectives.

Aims and objectivesTo identify the factors influencing the intent to provide care among nurses involved in coronavirus disease 2019 (COVID‐19) care.BackgroundCOVID‐19 was first reported in Wuhan, China, in 2019. In 2020, the World Health Organisation declared it a pandemic, leading to 5,827,104 deaths and 421,203,495 confirmed cases as of 19 February 2022. The high transmissibility of COVID‐19 has prolonged the pandemic for over 2 years, resulting in deleterious effects on nurses' physical and mental health. The fear of infection and isolation may lead to negative experiences and perceptions among COVID‐19 frontline nurses, which may ultimately degrade the quality of patient care. Thus, it is essential to identify factors influencing of nurses' intent to provide care.DesignCross‐sectional study.MethodsData were collected from 169 nurses involved in direct COVID‐19 care at a hospital designated for infectious disease care in Korea from August to September 2021 using an online questionnaire. STROBE checklist was followed.ResultsNurses' intent to provide care significantly differed based on whether they lived with parents and had adequate availability of personal protection equipment. The correlation analysis indicated that the intent to provide care was significantly positively correlated with normative beliefs, control beliefs, attitude towards the behaviour, subjective norms and perceived behavioural control. Perceived behavioural control, control beliefs and attitude towards the behaviour were significant factors influencing nurses' intent to provide COVID‐19 care.ConclusionThis study showed that nurses perceived behavioural control and positive behaviour towards providing COVID‐19 care fundamentally influenced their intent to provide care.Relevance to clinical practiceIn clinical practice, the safety and rights of individual nurses who participated in COVID‐19‐related patient care are promoted, and ultimately, the quality of patient care is improved. Furthermore, active support at the organisation and government level is needed to strengthen the capabilities necessary for nursing patients with infectious diseases.

Factors preceding occupational distress in emergency nurses: An integrative review.

This integrative review aimed to synthesise current evidence on the factors that precede and contribute to the occupational distress of emergency nurses. Emergency nurses practice within an environment challenged by demand exceeding capacity, an inability of staffing to meet this demand in addition to limited resources which contribute to form a unique risk to clinician and patient safety. The risk of occupational distress, while demonstrated across specialties, is noted to be highest in emergency nurses with subsequent impacts for clinicians, organisations and patients being explored. While previous studies have examined singular outcomes or elements, a comprehensive review that considers the factors and components of the overarching occupational distress is not evident in the current published literature. Whittemore and Knafl's integrative review methodology enabled a structured format for synthesis and analysis of literature. A review of CINAHL, MEDLINE, Psych INFO, Embase, Australian Digital Thesis Network, University Microfilm International and Google Scholar between 2014 and 2021 was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Search terms explored the contributions of compassion fatigue, burnout, acute and post-traumatic stress disorder, and secondary traumatic stress/vicarious trauma to occupational distress. This search resulted in sixteen publications included for synthesis. Literature for inclusion was identified as quantitative (seven), qualitative (six) and mixed-methods (three) studies. Factors identified as contributing to the development of occupational distress arise from the characteristics and situations of individual nurses, local organisational governance and the inherent nature of the emergency nurse role. Consequentially, there are negative impacts on patients, clinicians and healthcare organisations. Emergency nurses experience exposure to several unique factors contributing to occupational distress which may originate from individual, organisational, occupational sources or a combination of these. Future research and strategies to address these factors could strengthen clinicians and organisations in the delivery of safe, holistic, high-quality nursing care. Emergency nurses practice in unique and challenging environments which place them at higher risk of occupational distress with subsequent negative impacts for the clinician, healthcare organisation and patients. Through the investigation and development of strategies such as the facilitation of knowledge of patient disposition, emergency nurses may experience an increase in their well-being, retention, job satisfaction and resiliency.