Hospital Nurses Research Articles

Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study.

To explore hospital staff experiences and perceptions of patient-perpetrated violence. Descriptive qualitative study. Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens. Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations. Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK. Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels. This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ). No patient or public contribution.

Environmental diseases, recognition for care: A qualitative study of nurses' perceptions.

This study aims to investigate hospital nurses' perceptions of illness due to environmental exposures. A qualitative exploratory study, designed in accordance with the specified reporting guidelines for qualitative research. Nurses working in Italian hospitals. Semi-structured interviews were used to collect data, then evaluated using the framework analysis methodology. Data collection was from January to June 2022 and analysed from July to September 2022. Forty-two nurses were interviewed. Data analysis revealed three themes: 1) the concept of disease in relation to environmental exposure; 2) the dangers of chemical and physical substances; 3) environmental changes cause concern and a sense of helplessness for the future. The results suggest the need for specific training on topics related to environmental disease types, environmental exposure, preventive measures, health promotion, and environmental impact to support professional development and support nurses in the management of this important aspect of health care.

Psychiatric Mental Health Nurses' Perceptions and Experiences of Inpatient Mental Health Care Safety Culture in Saudi Arabia.

Although patient safety culture is gaining attention globally, more studies are needed to investigate its relevance to the nursing care of mental health (MH) patients. This study aimed to illustrate the perceptions and experiences of nurses who work in inpatient mental health care (IMHC) concerning the patient safety practices that are employed to avert safety hazards encountered during the provision of care in IMHC settings. Eighteen postgraduate students working as MH nurses in nonprofit hospitals comprised the study sample. The participants had a minimum of 2 years' nursing experience in IMHC settings. Each participant was interviewed individually using a guided interview technique. The inductive data underwent thematic analysis. Patient protection and a safety perspective were the overarching themes that emerged from the data. Three principal themes and 9 subthemes were illuminated: (a) patient care safety knowledge and background, (b) improving MH care, and (c) development of MH nursing care. The findings of this investigation may assist in providing guidance for the further research into and development of a patient safety culture appropriate for IMHC nursing practice, including increased structured educational experiences, judicious risk assessment, assignment of staff to include a mixture of skills and experience levels during assignments, use of standardized handoff procedures, engagement with multidisciplinary care providers, blame-free reflective information sharing and mentoring, and attention to the built environment with consideration of patient and staff safety needs.

Identifying solutions to minimize meal tray waste: A mixed-method approach

Background & aimsOver $150,000 are lost annually due to meal tray waste in a large hospital in the United States. This study aims to explore the root causes of meal tray waste within a decentralized foodservice model and strategies to mitigate waste. MethodsA mixed methods sequential explanatory design was used by first identifying hospital units high and low in meal tray waste using recorded food management data from January 2021 through September 2022, then conducting observations, mobile-interviews (n=16), and in-depth interviews with hospital foodservice staff (n=6) and nurses (n=6) in each unit. Lastly, hospital and topic experts (n=10) were engaged in strategizing solutions to reduce meal tray waste. ResultsFindings indicate meal tray waste is increased when patients discharge and when standard trays (i.e., also known as house trays, which include items not requested by patients) are provided. Meal tray waste points to the unpredictability in a hospital that often arises due to patient circumstances, lack of coordination between nursing and foodservice staff, patients' food preferences, and the need for system and workflow improvements in a decentralized foodservice model. ConclusionsFindings highlight considerations that may be applicable across diverse medical institutions seeking to reduce meal tray waste. Hospitals should choose the best foodservice model that suits their institution to manage operations efficiently, focusing on reducing waste, cost optimization, patient satisfaction, and sustainability.

Impact of Telemedicine on Blood Glucose Control and Ophthalmic Screenings for Patients with Diabetes in Remote Areas During the COVID-19 Pandemic: A Real-World Study in Northern Taiwan.

Introduction: The purpose of this study was to assess the impact of telemedicine on ophthalmic screening and blood glucose control for patients with diabetes in remote areas of Northern Taiwan during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Telemedicine was implemented in Shiding and Wanli Districts using a 5G platform from April 2021 to December 2022. Patients with poorly controlled diabetes received real-time consultations from endocrinologists at Far Eastern Memorial Hospital, 50 km away, for medication adjustment, diet control, and lifestyle recommendations. The study also provided cloud-upload blood glucose meters for self-monitoring and regular medical advice from hospital nurses. Ophthalmic screenings included fundus imaging, external eye image, and intraocular pressure measurement, with instant communication and diagnosis by ophthalmologists through telemedicine. A satisfaction questionnaire survey was conducted. Results: The study enrolled 196 patients with diabetes. Blood glucose and glycosylated hemoglobin levels were significantly reduced after applying telemedicine (p = 0.01 and p = 0.005, respectively). Ophthalmic screenings led to hospital referrals for 16.0% with abnormal fundus images, 15.6% with severe cataract or anterior segment disorders, and 27.9% with ocular hypertension or glaucoma. Fundus screening rates remained high at 86.3% and 80.4% in 2022, mainly using telemedicine, comparable with the traditional screening rate in the past 5 years. The overall satisfaction rate was 98.5%. Conclusions: Telemedicine showed effectiveness and high satisfaction in managing diabetes and conducting ophthalmic screenings in remote areas during the COVID-19 pandemic. It facilitated early diagnosis and treatment of ocular conditions while maintaining good blood glucose control and fundus screening rates.

Health and Community Care workers' Knowledge and Perceptions of Social Prescribing in Singapore.

This study aimed to survey knowledge and perceptions of social prescribing (SP) amongst health and community care workers. Cross sectional online survey conducted in November 2023. The survey on basic demographics, awareness, knowledge, and practices of SP was completed by 123 health and community care workers. The mean age of respondents was 39.0 years. Nearly two-thirds had heard of SP. A lower proportion of acute hospital doctors (55.6%) and nurses (56.8%) had heard of SP compared with primary and subacute care doctors (75.0%). The majority agreed that SP is beneficial for patients' mental health and reducing healthcare utilisation. Primary care physicians, community nurses and active ageing centres were the top three professionals selected as most responsible for SP by survey respondents. The most commonly cited barriers to SP were seniors' reluctance (63.4%), lacking knowledge on how to refer (59.3%), lack of time (44.7%) and cost to seniors (44.7%). Overall, health and community care workers demonstrated positive attitudes toward SP and were keen to refer patients for SP. However, additional efforts are needed to improve knowledge about how to refer for and provide training on SP.

Analysis of Barriers to Medical Opioid Pain Medication Using the Japanese Version of the Barriers Questionnaire II (JBQ-II): Pharmacists and Nurses Perspective in Japan

Background Some Japanese patients with cancer pain have negative beliefs regarding opioid therapy. The Japanese version of the Barriers Questionnaire II (JBQ-II) determines barriers to cancer pain management. Few studies reported JBQ-II scores in Japan, and none focused on pharmacists. Accordingly, we aimed to explore the relationship between health care professionals’ knowledge of and willingness to use opioids, and their JBQ-II scores. Additionally, the variances in JBQ-II scores among nurses, hospital pharmacists, and pharmacy pharmacists were assessed. Methods This cross-sectional survey employed the JBQ-II for nurses and pharmacists in hospitals and pharmacies across Japan. Participants were requested to respond to the JBQ-II concerning their affiliation, knowledge of opioid analgesics, and willingness to utilize these drugs for medical practice. Results A total of 55 hospital pharmacists, 25 pharmacy pharmacists, and 24 nurses responded to the survey. The group-knowledgeable about medical use of narcotics had significantly lower total JBQ-II scores (25.43, standard deviation [SD]: 15.11) than those had by the group with insufficient knowledge (34.50, SD: 18.41). There was no statistically significant difference in total JBQ-II scores among those willing to use opioids medically. The total JBQ-II scores of hospital pharmacists, pharmacy pharmacists, and nurses were 31.00 (SD: 15.11), 33.96 (SD: 19.25), and 27.21 (SD: 15.56), respectively. However, the differences were not statistically significant. Conclusions Health care professionals in Japan with knowledge about opioids for medical purposes had a significantly lower total JBQ-II score than those with insufficient knowledge. Thus, health care professionals’ knowledge plays a crucial role in reducing barriers to using narcotic drugs.

Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis

PurposeThis study conducts a systematic review and meta-analysis to understand the characteristics and contents of studies on spiritual nursing education programmes and their effects.MethodsThe literature search included five databases (RISS, KISS, DBpia, Science ON, and KmBase) published in South Korea until September 30, 2021. Nine studies were included in the final review, with six for the meta-analysis using the RevMan 5.4. 1 programme. The programmes targeted nursing students and nurses in the RN-BSN course and employed methods such as lecturing, discussions, and case presentations. The contents focused on self-spirituality awareness, spirituality-related concepts, understanding others’ spirituality, and the process and application of spiritual nursing.ResultsThe meta-analysis revealed statistically significant effects on spiritual nursing competencies, spirituality, spiritual well-being, existential well-being, and spiritual needs, except self-esteem. Spiritual nursing education was effective in enhancing spiritual nursing competencies.ConclusionThe study confirmed that spiritual nursing education effectively improves spiritual nursing competency, indicating a need for increased focus and administrative and financial support for such education in schools and hospitals. Furthermore, future studies should employ randomised experimental designs to examine the effects of online education programmes with short training time on clinical nurses in hospitals.

Ethical climate and its relationship with attitude to teamwork in operating room nurses: A cross-sectional study

IntroductionIn the nursing profession, ethical climate is considered to be an important element of the work environment. Nurses are exposed to moral tension due to the volume and high work pressure; on the other hand, the stressful nature of this profession can have many negative effects on nurses and, as a result, the quality of care. Therefore, improving the conditions and ethical climate becomes very important. In the operating room, due to the special working conditions and the variety of available specialties, team work is of great importance among the operating room staff. Improving teamwork in the operating room reduces stress and anxiety, increases work efficiency, improves the quality of care, and increases the patient safety. ObjectiveThis study was conducted with the aim of determining the relationship between the ethical climate and the attitude towards teamwork of operating room nurses in hospitals affiliated with Shiraz University of Medical Sciences. MethodThis research was a cross-sectional study conducted in 2022. The study involved a sample of 310 operating room nurses from hospitals affiliated with Shiraz University of Medical Sciences, selected using convenient and purpose-based sampling methods. In order to collect data, the questionnaires of demographic information, Olsan's ethical climate and attitude towards teamwork baker were used. The collected data were analyzed by SPSS V20. FindingsThe average score of the operating room staff from the ethical climate was 94.12±14.96, and that of the overall attitude towards teamwork was 121.92±11.74, which indicates a favorable attitude towards teamwork. There was a significant relationship between the scores of the ethical climate and the attitude toward teamwork among the operating room personnel (r = 0.339,p < 0.0001). ConclusionThe results showed that there is a significant relationship between the attitude towards teamwork and the ethical climate of operating room nurses. Managers of hospitals and operating rooms can strengthen the spirit of teamwork and create a suitable atmosphere in the operating room by holding training courses and increase safety and productivity there.

Factors Associated With Job Fatigue In Outpatient Nurses In Hospital X

Work fatigue is a prevalent issue among public service workers, particularly nurses, impacting their performance and patient care. This study focuses on outpatient nurses at Hospital X in South Jakarta, aiming to identify factors associated with job fatigue. Using a quantitative cross-sectional design, data was collected from 100 outpatient nurses in 2023. Univariate and bivariate analyses, including the chi-square test, were conducted. Results revealed that 68.9% of nurses reported moderate fatigue, with significant associations found between high fatigue complaints and workload (p-value 0.000) and age (p-value 0.026). These findings underscore the need for Hospital X to address workload issues by considering additional personnel to mitigate fatigue among nurses. Such measures can enhance service quality and potentially improve nurse well-being, thereby benefiting patient care. Furthermore, implications suggest the importance of empathy training and holistic awareness of biopsychosocial components in addressing nurse fatigue and improving patient outcomes.

Patient Experience and Nurse Staffing Level in South Korea.

Patient experience has recently become a key driver for hospital quality improvement in South Korea, marked by the introduction of the Patient Experience Assessment (PXA) within its National Health Insurance (NHI) in 2017. While the PXA has garnered special attention from the media and hospitals, there has been a lack of focus on its structural determinants, hindering continuous and sustained improvement in patient experience. Given the relatively low number of practicing nurses per 1,000 population in South Korea and the significant variation in nurse staffing levels across hospitals, the staffing level of nurses in hospitals could be a crucial structural determinant of patient experience. This study examines the association between patient experience and hospital nurse staffing levels in South Korea. We used individual- and hospital-level data from the 2019 PXA, encompassing 7,250 patients from 42 tertiary hospitals and 16,235 patients from 109 non-tertiary general hospitals with 300 or more beds. The dependent variables were derived from the complete set of 21 proper questions on patient experience in the Nurse and other domains. The main explanatory variable was the hospital-level Nurse Staffing Grade (NSG), employed by the NHI to adjust reimbursement to hospitals. Multi-level ordered/binomial logistic or linear regression was conducted accounting for other hospital- and patient-level characteristics as well as acknowledging the nested nature of the data. A clear, positive association was observed between patient experience in the Nurse domain and NSG, even after accounting for other characteristics. For example, the predicted probability of reporting the top-box category of "Always" to the question "How often did nurses treat you with courtesy and respect?" was 70.3% among patients from non-tertiary general hospitals with the highest NSG, compared to 63.1% among patients from their peer hospitals with the lowest NSG. Patient experience measured in other domains that were likely to be affected by nurse staffing levels also showed similar associations, although generally weaker and less consistent than in the Nurse domain. Better patient experience was associated with higher hospital nurse staffing levels in South Korea. Alongside current initiatives focused on measuring and publicly reporting patient experience, strengthening nursing and other hospital workforce should also be included in policy efforts to improve patient experience.

Non-standard Working Practices and Nurses’ Job Performance: Experience from Public Hospitals in Tanzania

Non-standard working practices are common among nurses because they spend more time directly caring for patients than other healthcare professionals. Thus, nurses’ performance is impacted by how work is organized, whereas various component of the working practice may lead to a decrease in performance. The purpose of this study was to examine the influence of non-standard working practices on performance of nurses in public hospitals in Tanzania. Specifically, the study focused on assessing the influence of schedule variation, schedule uncertainty, and schedule intensity on performance of nurses in Tanzanian public hospitals. The study adopted descriptive survey research design using qualitative and quantitative methods. Stratified random sampling technique was used, whereas a sample size of 381 nurses was randomly chosen from a target population of 404. Quantitative data were analyzed through thematic analysis technique whereas qualitative data were analyzed by the use of multiple linear regression, one-way Analysis of Variance, independent t-test, and Pearson correlation. Qualitative data were entered, coded and analyzed using summative content analysis and presented in percentages, in tables, figures and charts. Correlation analysis was used to test the direction of relationship between the independent variables and dependent variable. Multiple regressions were used to test whether schedule variation, schedule uncertainty, and schedule intensity had any influence on nurses’ performance. The study established that schedule variation, schedule uncertainty, and schedule intensity contributed negatively to nurses’ performance. Furthermore, the study approved all three study hypothesis as it was found that all schedule variation, schedule uncertainty and schedule intensity had significant statistical influence on job performance of nurses. The study concluded that exposure to non-standard working practices were common among nurses in public hospitals in Tanzania. Further, the study concluded that nurses in the study area were more affected by schedule variation and schedule uncertainty. The study recommended the adoption of strategies aimed at minimizing the effects non-standard schedules to promote nurses’ performance.

The effect of nomophobic behaviors among nurses on their clinical decision-making perceptions

AimThis study aimed to explore the impact of nomophobic behaviors among hospital nurses on their clinical decision-making perceptions. This understanding can offer insights to enhance the work environment, improve the clinical decision-making ability of nurses and guide medical institutions in the management of related equipment and policy development. BackgroundThe term "nomophobia" refers to the anxiety and fear individuals experience when they cannot use their smartphones or when smartphones are not accessible. Nursing clinical decision-making is a complex process, including a meticulous assessment of the patient's pathological condition and medical history, alongside the application of nursing knowledge and experiential learning rooted in critical thinking. The concept of clinical decision-making perceptions is defined as a deliberate cognitive understanding of one's decision-making processes, which significantly influences the clinical decision-making capabilities of healthcare professionals, thereby impacting the quality of patient care. The factors influencing these clinical decision-making perceptions have been the subject of extensive research. However, there is no Chinese research on the impact of nurses ' nomophobic behaviors on their clinical decision-making perception. DesignA cross-sectional descriptive survey using online-based delivery modes was used. MethodsA descriptive cross-sectional survey design was employed. Using convenience sampling, we surveyed the nurses from a tertiary hospital in Nanjing in May 2023. Data were gathered using a sociodemographic data form, the Nomophobia Questionnaire and the Clinical Decision-Making in Nursing Scale. Techniques including the independent sample t-test, one-way ANOVA, Pearson correlation analysis and linear regression analysis were employed to probe the degree of nomophobia and its effects on their perception of clinical decision-making. Out of 284 questionnaires gathered, 272 were deemed valid, resulting in a 95.8% effective response rate. ResultsThe data revealed that participants exhibited a medium level of nomophobia (54.01 ± 24.09) and clinical decision-making perceptions (144.94 ± 20.08). A robust negative correlation was discerned between nomophobia and clinical decision-making perceptions (r: −0.365, P<0.001). This study highlighted that as the degree of nomophobia intensified, nurses' clinical decision-making perceptions decreased with the increase in nomophobia. ConclusionNomophobic behaviors can hamper nurses' perception of clinical decision-making, potentially leading to inaccuracies or errors. Nurses must use mobile phones judiciously, practice self-regulation and mitigate the disruptive effects of nomophobia on their decision-making. In addition, medical institutions should foster relevant education or craft policies to regularize mobile phone use, augmenting nurses' efficiency and decision-making prowess, enhancing patient care quality, diminishing medical errors and ensuring patient health and safety.

Cold sensitivity among female clinical nurses in Japan: A nationwide study

ObjectivesThis study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan. DesignA cross-sectional post survey research design. SettingsThe questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan. Participants1,138 female nurses MethodsThe survey captured participants’ characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits. ResultsOf the respondents, 44.3% were aware of daily cold sensitivity and 21.4% had a cold sensitivity disorder. The majority of respondents (63.1%) felt cold in their hands when providing nursing care, and 28.1% felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30% of the respondents experienced discomfort owing to cold hands. ConclusionsThe study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.

Effects of a dementia educational programme using virtual reality on nurses in an acute care hospital: A pre-post comparative study.

Poor awareness of dementia care by healthcare professionals affects the quality of care for people living with dementia in acute care settings. This study examined the effectiveness of a virtual reality-based educational programme for dementia for nurses working in acute care hospitals in Japan. A dementia education programme for nurses was designed. The programme comprised short movies, virtual reality videos based on the short movies, a lecture, discussions and role-playing based on the experimental learning model. Virtual reality video content was created to promote empathy for people living with dementia through a first-person experience of dementia. The educational programme involved nurses working in an acute care hospital in the Tokyo Metropolitan area. Before and after the programme, we employed structured questionnaires using validated instruments to assess participants' attitudes towards people living with dementia, their intentions of helping behaviour and their confidence in providing dementia care. Seventy-six nurses participated in and completed the pre- and post-tests. The mean age was 34.9 ± 9.2 years, and 90.8% of the participants were female. A paired t-test showed significant before-after improvement in the participants' attitudes towards people living with dementia (41.9 ± 5.1 vs. 44.5 ± 4.8), intentions of helping behaviour towards people living with dementia (10.8 ± 2.5 vs. 12.8 ± 2.1) and confidence in providing dementia care (25.9 ± 6.7 vs. 29.2 ± 6.0). The programme effectively improved nurses' attitudes towards people living with dementia and confidence in providing dementia care in acute care settings. Future research is important to explore the long-term effects of this programme and its effects on actual dementia care. The dementia education programme may promote person-centred care in acute hospitals. Future studies should consider the provision of more flexible programs so that nurses can more easily participate in them.

Development and Validation of a Knowledge Checklist of Cognitive Therapy for Nurses(KCCTN)

This study aimed to develop a Knowledge Checklist of Cognitive Therapy for Nurses (KCCTN) to assess theeffectiveness of cognitive-behavioral therapy-based training. Sixteen items were collected from the provisional KCCTN; four response choices were created for each item with one correct response. The reliability and validity study results showed that Cronbach’s alpha was 0.63. The intra-class correlation was calculated using the data on the number of correct answers before and after the training of nursing college students, and the reliability was confirmed at r=0.65 (p&lt;0.01). The uncorrelatedness of KCCTN and KBPAC helped establish discriminatory validity. Two-way analysis of variance with the dependent variable being the KCCTN score of the intervention group (nurses, N=30) and control group (nursing students, N=76) implementing cognitive-behavioral therapy, and pre-and post-intervention factors were calculated for hospital nurses. The results showed a significant interaction with a significant improvement in the intervention group.

Systematic Literature Review : The Correlation Between Head of Room Leadership Style and Work Motivation of Nurse in the Hospital

Leadership is the process of influencing or setting an example for followers through communication, with the aim of achieving organizational goals. The issue of nurse motivation in hospitals remains a current concern. This does not necessarily mean that nurses are underperforming, but it may be influenced by ineffective leadership, which can affect their level of work motivation. The objective of this research is to assess the correlation between the leadership style of ward heads and the work motivation of nurses in hospitals, as well as to identify the leadership styles commonly used by ward heads. The research method employed is systematic literature review. The research sample involves all practicing nurses in hospitals. The review of 11 research articles, spanning from 2018 to 2023 and originating from Indonesia, Timor-leste, and Jordan, indicates a correlation between the leadership style of ward heads and the work motivation of nurses in hospitals. The democratic leadership style is frequently used by ward heads in hospitals, as identified in the study.

Impact of clinical pathway implementation satisfaction, work engagement, and hospital-patientrelationship on quality of care in Chinese nurses.

This study aimed to investigate how clinical pathway implementation satisfaction, work engagement, and hospital-patient relationship impact the quality of care that is provided by nurses in public hospitals. Clinical pathways are recommended as a form of quality improvement by broader healthcare systems and are widely used in the world. Nurses are the most involved group of healthcare professionals in the implementation of clinical pathways in public hospitals. So, it is important to investigate how their satisfaction with the process affects the quality of care they provide and influencing factors. This descriptive cross-sectional study surveyed nurses practicing across seven tertiary public hospitals in Sichuan Province, China, online. The survey consisted of a questionnaire for the general characteristics of the participants and four Chinese maturity scales validated by previous studies: clinical pathway implementation satisfaction scale, work engagement scale, hospital-patientrelationship perception scale, and quality of care scale. The bootstrap method was used to test a moderated mediation model using Hayes' PROCESS macro models 4 and 8. We followed STROBE guidelines to prepare the study report. A total of 880 nurses filled out the questionnaires, 821 of which were regarded as valid. Clinical pathway implementation satisfaction had a positive effect on quality of care (B=0.873, P<0.001). Work engagement played a mediation role between nurses' clinical pathway implementation satisfaction and the quality of care (effect=0.080, Boot 95% CI=[0.023, 0.142]). This mediation model was moderated by the hospital-patientrelationship (P < 0.01). Clinical pathway implementation satisfaction may enhance the quality of care by work engagement of nurses. Moreover, a good hospital-patientrelationship can enhance the positive impact of nurses' satisfaction on work engagement and health service quality. Public hospital managers need to pay attention to nurses' evaluation of and perceptions toward clinical pathway implementation and then take corresponding measures to improve their satisfaction to enhance the quality of care. At the same time, the government, society, and hospitals also need to foster good hospital-patient relationships to ensure that nurses have a high level of work engagement that aids in providing high-quality care services.

Role of the addiction clinical nurse specialist in acute hospital settings.

The role of an addiction clinical nurse specialist (ACNS) is focused on individuals who misuse drugs and alcohol, and several benefits of the role have been identified in the literature. When people who misuse substances are admitted to acute general hospitals, there is an opportunity to engage with them and ensure they access support services to facilitate their recovery. To determine general nurses' experience of caring for patients who misuse substances, and to gauge nurses' views on the implementation of an ACNS role in an acute general hospital. This study used a qualitative design involving online interviews with 11 hospital nurses. Many participants felt that an ACNS could provide them with education and support around substance misuse, while also advocating for patients who misuse substances, reducing stigma and enhancing patient care. Participants indicated several benefits to implementing an ACNS role in their hospital, such as ensuring that patients who misuse substances experienced continuity of care which began at admission, was followed-up during inpatient stays and was maintained in the community.

The role of motivation in the initiation and maintening mentoring relationships among nurses and midwives.

To understand clinicians' motivations to engage in mentoring to support newly graduated nurses and midwives working in hospital settings. Nursing and midwifery literature has established the benefits of mentoring and challenges that affect the effectiveness of formal mentoring programmes. No studies have explored hospital nurses' and midwives' motivations to mentor in the absence of the obligatory status and associated rewards of institutionalised mentoring. A qualitative descriptive study with 35 nurses and midwives working in three public hospitals in the western, northern and northwestern parts of Uganda. Data were collected using semistructured interviews. Reflexive thematic analysis was applied to interpret the data. We have adhered to COREQ reporting guidelines. The study revealed three salient themes that capture nursing and midwifery professionals' mentoring perspectives. Participants expressed confidence in their inherent mentoring capacities and were often motivated by a desire to reciprocate prior mentoring experiences. Their mentoring approaches varied between self-focused and other-focused motivations, with some overlap in perspectives on hierarchical versus relational mentoring. Across the board, there was a strong consensus on the need of mentoring for individual clinicians, healthcare institutions and the broader profession. The study highlights five opportunities that can be harnessed to design future mentoring programmes. The findings delineate a complex interplay between self-centred and altruistic mentoring motivations, aligning with hierarchical or mutually beneficial mentoring paradigms. Nurse managers should tailor mentoring programmes to align with these intrinsic motivations, affirm the enduring need for mentoring, and leverage existing institutional resources to create both acceptable and efficient mentoring frameworks.