Nurses In Healthcare System Research Articles

The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students.

Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

'Nurses are seen as general cargo, not the smart TVs you ship carefully': the politics of nurse staffing in England, Spain, Sweden, and the Netherlands.

Nurse workforce shortages put healthcare systems under pressure, moving the nursing profession into the core of healthcare policymaking. In this paper, we shift the focus from workforce policy to workforce politics and highlight the political role of nurses in healthcare systems in England, Spain, Sweden, and the Netherlands. Using a comparative discursive institutionalist approach, we study how nurses are organised and represented in these four countries. We show how nurse politics plays out at the levels of representation, working conditions, career building, and by breaking with the public healthcare system. Although there are differences between the countries - with nurses in England and Spain under more pressure than in the Netherlands and Sweden - nurses are often not represented in policy discourses; not just because of institutional ignorance but also because of fragmentation of the profession itself. This institutional ignorance and lack of collective representation, we argue, requires attention to foster the role and position of nurses in contemporary healthcare systems.

Characterizing burnout and resilience among nurses: A latent profile analysis of emotional exhaustion, emotional thriving and emotional recovery.

To identify subgroups of nurses with distinct profiles of burnout (emotional exhaustion) and resilience (emotional thriving and emotional recovery) and describe nurse characteristics associated with each profile. Cross-sectional, correlational design. Data were collected via electronic survey from 2018 to 2019. Latent profile analysis was used to identify subgroups of nurses with distinct profiles of emotional exhaustion, emotional thriving and emotional recovery, with each measured on a 0-100 scale. Bivariate statistics were used to determine profile differences in nurse sociodemographic, professional and psychological characteristics. Four distinct profile subgroups were identified: (1) "exhausted" (14% with very high emotional exhaustion, low emotional thriving and moderate emotional recovery), (2) "exhausted with thriving" (6% with high emotional exhaustion, moderate-high emotional thriving and low emotional recovery), (3) "exhausted with thriving and recovery" (52% with moderate-high emotional exhaustion, emotional thriving and emotional recovery), and (4) "thriving and recovery" (27% with low emotional exhaustion and very high emotional thriving and emotional recovery). Nurses in the "exhausted" and "exhausted with thriving" profiles reported greater depression and poorer work-life integration. Nurses in "exhausted" profile were more likely to work in an inpatient setting. Nurses in the "exhausted with thriving and recovery" and "thriving and recovery" profiles reported more positive emotions, more well-being behaviours, and better work-life integration, with the "thriving and recovery" subgroup having the highest levels of these characteristics, lower depression scores and greater racial minority representation. Approaches designed to improve nurse well-being should be tailored to the nurses' profile of emotional exhaustion, thriving and recovery to maximize effectiveness. Given the growing shortage of nurses in healthcare systems, it is critical that multilevel strategies be investigated to retain nursing staff that consider the intersectionality and complexity of the different aspects of burnout and resilience experienced by the nurse. The aim was to assess burnout and resilience among nurses.

The Clinical Nurse Specialist.

These APRNs improve the workflow of nurses in health care systems.

The impact of ethical climate and the LMX relationship on nurses’ burnout in hospitals in Serbia

Burnout contributes to the emergence of numerous negative organisational phenomena. Nurses are exposed to high stress working conditions every day, making it important to study burnout among nurses in health care systems. The aim of the paper is to investigate the impact of ethical climate and the LMX relationship on burnout among nurses, as well as to examine the effects of the three moderators (gender, self-awareness and social skills among nurses) on the observed relationships. The sample consists of 326 nurses from 23 hospitals in Serbia. Standardised questionnaires were used, while correlation analysis and hierarchical regression analysis were employed for statistical processing. The dimensions of the ethical climate and LMX relationship have statistically significant impacts and predictive effects on the burnout dimensions. Raising the level of the ethical climate and LMX relationship positively affects burnout: it reduces emotional exhaustion and depersonalisation, and increases personal accomplishment and involvement. An adverse ethical climate and unfavourable LMX relationships among men cause greater emotional exhaustion. For nurses with high self-awareness and high social skills, a favourable ethical climate and positive LMX relationships reduce emotional exhaustion, and increase personal accomplishment. For nurses with low self-awareness and low social skills, a favourable ethical climate and positive LMX relationships reduce depersonalisation. Recommendations are made for improving the ethical climate and LMX relationships in hospitals in Serbia.

Neglected Concerns of Nurses and Their Unheard Voices; A Blind Spot in our Health System

The current scenario of nursing in India forces us to introspect if the nurses are equipped enough to bring out their best contribution towards the health of our country and if their voices are well heard in the healthcare system. Despite being highly skilled professionals, nurses are neither facilitated nor rewarded enough to sustain their motivation and inputs. To understand the struggles faced by nurses in India, we reviewed literature that addresses Indian nurses’ concerns and brainstormed about the major challenges that nurses encounter with key nursing personnel from nursing education, clinical services and administration from selected hospitals of India. The major challenges that negatively affect the contribution of nurses are shortage of nurses, poor working conditions and career opportunity, ineffective leadership roles, poor educational quality, low salary and state neglect. The COVID-19 pandemic has proven the vast contribution and sacrifice of nurses. The competency of nurses has gone up with specialization, and advanced nursing degrees. Enhancing nurses’ involvement in collaborative healthcare research would be a hallmark in improving the quality patient care. To efficiently utilize the contribution of the nurses in healthcare system, the society and state have to recognize the potentials and vulnerabilities of nurses, appreciate their strengths and reciprocate responsibilities to their neglected concerns.

1461P Development of a questionnaire to assess palliative care knowledge amongst nurses working in developing countries

Empowering nurses with knowledge is pivotal to development of palliative care. Tools like Palliative Care Quiz for Nursing are validated but differences in role of nurses in health care system makes locally developed and validated knowledge assessment questionnaire quintessential for educational programs A project was undertaken to develop such a questionnaire for developing countries.

Trend in the role of licensed practical nurses in health care system: A situational analysis.

Over the past hundred years, licensed practical nurses (LPN) have faced several challenges because of the changing situations in health care system. The current study addresses the role changing of LPNs in accordance with the context and new needs. This aim of situation analysis is to access what changes have occurred in the role of LPNs in the wake of changes in role of RNs over the past century and What factors and variables have influenced this process? This study used a Grounded Theory methodology called Situational Analysis. Data were collected through semistructured and in-depth interviews with 33 nurse. Researchers identify six themes that focus on how the role of LPNs has been changing and variables have influenced this process. In Iran, as in other countries of the world, the role of LPNs comes to fore when there are pressing needs and nursing shortage. Iranian policymakers have decided to eliminate LPNs, Although LPNs in other countries are working in community-based settings. Treatment-oriented and self-monitoring structure of the Iranian health care system, new nursing organizations and lack of clear role classification at the caring levels have made the nursing roles ambiguous.

Consequences of Presence of Forensic Nurses in Health Care System: A Qualitative Study.

Background:Nursing is a vital element in providing safe and effective care. Forensic nursing is one of the specialties in this discipline which, in addition to creating more satisfaction in nurses, is considered essential in holistic, quality, and safe care. This study aimed to describe the consequences of the presence of forensic nurses in the health system.Materials and Methods:This qualitative study was conducted between 2017 and 2018 in Iran. Semi-structured interviews were performed with 18 participant experts in the field of health and law. The interviews were analyzed using the inductive content analysis approach proposed by Graneheim and Lundman.Results:The consequences of the presence of nurses in the health system were summarized into two categories: positive and negative consequences. The positive consequences consisted of improved performance, better legality of nurses, the calmness of nurses, prevention of patients' rights violations, advancement comparable with developed countries, reduced costs, increased accuracy and speed in dealing with forensic cases, improved performance of Iranian Legal Medicine Organization and increased employment. On the other hand, the negative consequences were role conflict with other involved professionals and nursing shortage. Participants included nurses (with different specialties), nurse lawyers, forensic medicines, forensic midwives, a judge, and a medical lawyer.Conclusions:If planners and policymakers have a positive attitude toward the presence of forensic nurses, we can anticipate better forensic services for clients through the development of systematic educational programs, the formation of forensic teams, and the expertise of this profession can provide many benefits.

APPLICABILITY OF LEWIN'S CHANGE MANAGEMENT MODEL FOR OPTIMIZATION MANAGEMENT FUNCTION IN NURSING DELEGATION BETWEEN HEAD NURSE AND TEAM LEADER: A MINI PROJECT IN JAKARTA MILITARY HOSPITAL

The role of nurses in health care systems is diverse, included being a health care provider to clients, client advocates, educators for clients and families, and nursing service managers. One strategy that can be applied in managerial nursing is delegation. The goal of this study was to assess the applicability of Kurt Lewin's change management method to analyse the management function in nursing delegation between head nurse and team leader. This study was conducted in one of the Jakarta Military Hospital by conducting a mini project consisting of case reports using a fishbone diagram approach, solving problems using Plan-Do-Check-Action (PDCA) tools starting with Plan Of Action (POA), implementation, evaluation, and follow-up. The results of the identification showed that the head of the room in carrying out the delegation was not optimal, included documentation in the delegation book that was not optimal, delays in filling, non uniformity in the format of delegation books in the room, and not understanding due to lack of standardization and control from superiors. Guidelines are used as a reference in delegating nursing to the head of the hospital room, and the documentation of nursing delegates is done correctly because delegates work better when the reporting structure is clear. In conclusion, application fishbone diagram, lewin's change management model, and PDCA cycle can optimize management function in nursing delegation between head nurse and team leader in Jakarta Military Hospital. Recommendations are given to the nursing department, head of the room, team leader, and executive nurses to increase self-awareness, knowledge, and ability in delegating nursing.

The DNP Degree: Are We Producing the Graduates We Intended?

This study addressed how recently graduated doctor of nursing practice (DNP) nurses describe their current practice, how their supervisors describe the DNP's current practice, and whether nurse and supervisor descriptions of the practices reflect the American Association of Colleges of Nursing (AACN) DNP Essentials and, if so, how? Introduced in 2004, the goal of DNP programs was to educate advanced practice RNs for effective leadership in complex healthcare environments. The value of the DNP degree for nurses in healthcare systems is evolving. We used conventional content analysis to inductively describe how DNP graduates from 7 different schools and their supervisors described the practice of the recently graduated DNPs. Interviews were reviewed to assess whether the AACN DNP Essentials were enacted in practice. The overarching theme was "becoming more: re-envisioning self as an agent of change." Results support the claim that DNP education prepares advanced practice nurses for leadership across complex healthcare systems. Evidence of the DNP Essentials is realized when graduates perceive themselves as equal to other leaders and capable of driving change using evidence and effective collaboration.

Quality of life at work for nurses in the healthcare system of emergencies, 112 and 061, in Spain

Introduction: A high-quality professional life is associated with increased motivation and the ability to adapt to constant change. Objective: To enhance our knowledge concerning the quality of professional life as perceived by nurses in the emergency healthcare systems in Spain. Methods: The study population included 2,852 professionals, and we obtained 328 (11.5%) valid responses. The data indicate that 80% of respondents had been in their position for more than 10 years. The study used the specifically validated questionnaire CVP-35, which examines quality of life at work. Results: The global quality of life score was approximately 6.76 points. The highest scoring item was ‚My work is important for the lives of other people‛ (9.12), and the lowest score was ‚Possibility of promotion‛ (3.76). The evaluation of the various dimensions was heterogeneous. The most significant correlations were found for ‘management support’ with ‘intrinsic motivation’ and for ‘intrinsic motivation’ with ‘training’. The Spearman correlation coefficients were 0.521 and 0.439, respectively. There was a direct relationship between these score items. Conclusions: Nurses’ perception of the global quality of professional life tends to be good, and the best results are found for ‘intrinsic motivation’ and ‘training’. The worst areas were related to the items ‚possibility of promotion‛ and ‚my company tries to improve the quality of life of my post‛.

Quality of life at work for nurses in the healthcare system of emergencies, 112 and 061, in Spain

Introduction: A high-quality professional life is associated with increased motivation and the ability to adapt to constant change. Objective: To enhance our knowledge concerning the quality of professional life as perceived by nurses in the emergency healthcare systems in Spain. Methods: The study population included 2,852 professionals, and we obtained 328 (11.5%) valid responses. The data indicate that 80% of respondents had been in their position for more than 10 years. The study used the specifically validated questionnaire CVP-35, which examines quality of life at work. Results: The global quality of life score was approximately 6.76 points. The highest scoring item was ‚My work is important for the lives of other people‛ (9.12), and the lowest score was ‚Possibility of promotion‛ (3.76). The evaluation of the various dimensions was heterogeneous. The most significant correlations were found for ‘management support’ with ‘intrinsic motivation’ and for ‘intrinsic motivation’ with ‘training’. The Spearman correlation coefficients were 0.521 and 0.439, respectively. There was a direct relationship between these score items. Conclusions: Nurses’ perception of the global quality of professional life tends to be good, and the best results are found for ‘intrinsic motivation’ and ‘training’. The worst areas were related to the items ‚possibility of promotion‛ and ‚my company tries to improve the quality of life of my post‛.

Utilization of advanced practice nurses in healthcare systems and multispecialty group practice.

Cost-effective strategies for delivering primary care require the appropriate mix of healthcare providers. The authors define the scope of practice for the advanced practice nurse. Results of a nationwide survey of 26 large healthcare systems and multispecialty group practices are presented. Findings from these practice settings are contrasted with those previously reported in the literature. Implications for the future are discussed.