The objective of this review will be to evaluate the effectiveness of multilevel interventions, including communication strategies and other organizational measures targeting structures, processes, policies, and culture, compared to usual care or no intervention, in reducing the incidence and severity of verbal and physical workplace violence against registered nurses. Workplace violence against nurses includes verbal, physical, and psychological abuse, with lasting consequences on mental health, job satisfaction, and workforce retention. Although awareness of the phenomenon has increased, the existing evidence on prevention and management interventions remains fragmented and inconclusive. This review will synthesize the current evidence to identify effective strategies, thereby supporting institutional decision-making and protecting frontline nurses. This review will consider experimental, quasi-experimental, and observational studies that evaluate interventions aimed at preventing, managing, or mitigating workplace violence against registered nurses. The proposed review will follow the JBI methodology for systematic reviews of effectiveness. The main databases to be searched will include MEDLINE Ultimate (EBSCOhost), Embase (Embase.com), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, Web of Science Core Collection, Cochrane CENTRAL, ProQuest Dissertations and Theses Global, and Google Scholar (first 200 records). Additional records will be identified through forward and backward citation tracking. Two reviewers will independently review the studies, assess methodological quality, and extract data. Data synthesis will be performed using JBI SUMARI. The certainty of the evidence will be assessed using the GRADE approach. No date restrictions will be applied (from database inception to January 9, 2026). Studies published in English will be included, while studies in other languages will be considered with translation support at the title and abstract level. PROSPERO CRD420251125105.

Professional identity satisfaction among radiotherapy technologists and medical physicists in Morocco: A cross-sectional survey.

Academic medicine faces a workforce challenge. Experienced women physicians leave or disengage at disproportionate rates during their most productive years. We propose that the menopause transition, typically occurring between ages 40 and 55, converges with established sex inequities to create a predictable yet largely ignored driver of academic medicine attrition. Based on available data from meta-analyses, randomized trials, and longitudinal studies, we argue that menopause functions not merely as a symptom cluster to endure but as a catalyst for chronic disease that compounds workplace demands. Menopausal symptoms cost an estimated $1.8 billion annually in lost work time in the United States alone, with additional billions in medical expenses. Organizational interventions outperform individual-focused approaches in reducing burnout, with effect sizes nearly three times larger. Workplace-based cognitive behavioral therapy and coaching programs for women faculty have shown substantial benefits in randomized trials and cohort studies. We recommend universal design policies, coaching programs, structured mentorship, and systematic outcome tracking. With physician shortages projected to exceed 50,000 by 2033, supporting midcareer women through these natural biological transitions is both an ethical imperative and an institutional necessity.

This study aimed to identify cost-effective ergonomic interventions implemented for the prevention and management of work-related musculoskeletal disorders by systematically reviewing economic evaluation studies in this area. Randomized trials of workplace interventions with full economic evaluation were considered based on PRISMA 2020 guideline. All interventions were designed to manage and alleviate the adverse outcomes (of musculoskeletal disorders, particularly lower-back pain, and no preventive intervention had been considered, in healthcare workers in high-income countries. Among interventions with significant effectiveness, organizational interventions have shown the most promising results. Cost-effectiveness analysis was the most prevalent study type with a broad range of outcome measures. The most common outcome measure in cost-effectiveness studies was the number of days off work or the duration until recovery. Societal perspective was mostly selected to measure costs. The evidence on cost-effectiveness of ergonomic interventions is mixed and characterized by methodological heterogeneity. Current literature suggestsa trend where organizational interventions are frequently identified among the effective strategies, particularly for managing conditions like low-back pain.However, significant gaps remain, including narrow cost perspectives, short time horizons, and a predominant focus on curative rather than preventive measures in high-income settings. Future economic evaluations should adopt broader societal cost assessments, longer follow-ups, and model-based approaches to better capture long-term value. Urgently, more research is needed in low- and middle-income countries to understand context-specific economic impacts.

Emergency department operation depends on system-level efficiency and individual physician productivity. Although organizational interventions are well described, evidence on modifiable, clinician-level work practices remains limited. This systematic review aimed to identify and synthesize evidence on individual work practices associated with higher levels of physician productivity in emergency departments and to assess their potential transferability through training. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO. Eligible studies were primary studies involving physicians working in adult or pediatric emergency departments and examining budget-neutral, modifiable work practices attributable to individual physicians' behavior. Studies were required to report a quantifiable productivity outcome per unit time, such as patients per hour or relative value units per hour. Heterogeneity in methods and outcomes precluded meta-analysis. Findings were synthesized narratively and supplemented by an inductive process applied to extracted study findings to categorize and integrate heterogeneous evidence. Ten studies met the inclusion criteria: three direct observational studies, six retrospective observational studies, and one interventional study, all conducted in the United States. Two domains of productive work practices clearly emerged in the literature: controlled multitasking, which showed a nonlinear association with productivity, and team communication, which showed a consistent positive association with productivity. The only interventional study reported no measurable improvement in productivity after a lecture on evidence-based work practices. Controlled multitasking and team communication practices showed the strongest associations with productivity across studies. However, the evidence remains limited, underscoring the need for further investigation.

The persistent shortage of direct care workers across the long-term services and supports (LTSS) system has worsened since the onset of the COVID-19 pandemic. This shortage resulted in nursing homes (NHs) relying more heavily on agency staff to maintain a stable workforce. This study examines patterns of agency staff utilization and associated concerns reported by NH administrators. Data from the 2023 Ohio Biennial Survey of Long-Term Care Facilities were used to report utilization patterns and concerns related to the use of agency-provided certified nursing aides (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Analyses included 513 NHs in Ohio reporting the use of agency staff. Findings indicate that agency-provided CNAs and LPNs were utilized more frequently and for more extended periods than RNs. Agency staff were most often used for filling in last-minute call-offs, difficult-to-hire shifts, and vacancies following employee departures. Almost 90% of administrators identified cost as a severe problem with using agency staff, while two-thirds reported issues related to lack of dedication, accountability, or familiarity with facility policies and procedures. Agency staffing remains an important operational strategy for mitigating workforce instability in NHs. While agency staffing is an adaptive response to labor shortages, it also leads to financial and organizational strain. Addressing these challenges will require policy and organizational interventions through workforce investments aimed at strengthening the recruitment, retention, and support of directly employed staff to ensure sustainable and improved care outcomes in NHs.

Interventions for burnout among health profession students and trainees: Systematic review and implications for well-being work.

Gender equity for anaesthetists remains elusive, despite patient and clinician benefits. Many strategies have been proposed to promote gender equity, yet women remain under-represented in anaesthesia leadership compared with men. This review identifies contemporary implemented strategies to improve gender equity in anaesthesia leadership. We searched databases for studies published from January 2019 to March 2024, including reports of implementation. We employed state-of-the-art review methodology to provide a current understanding of this complex sociocultural problem, using Cook's and Stufflebeam frameworks for categorisation and deductive data extraction and analysis based on context, inputs, processes and outcomes. We screened 257 abstracts and identified 18 studies for analysis; 14 were conducted in the USA. The most prominent individual interventions were mentorship and sponsorship. These were supported by organisational interventions including professional development curricula; policies; and leadership roles supporting diversity. Two studies reported how programmes were iteratively developed. Reported success metrics included quantitative (increased diversity in leadership, achieving promotion) and qualitative outcomes (networks and wellbeing). Evidence for best practices to address gender equity in anaesthesia leadership is emerging. Prospective determination of key outcomes enables monitoring of success, including representation and wellbeing. Organisational support, in the form of policies and leadership roles linked to diversity outcomes, amplifies the benefits of mentorship and sponsorship. Future interventions should report the context in which the interventions were mobilised, associated costs and details of the iterative programme delivery and development process.

Abstract Income inequality is a structural feature in Argentina. This paper advances a relatively underexplored analytical framework that links sectoral disparities in profit rates to differences in union organisation and state intervention. We identify three interrelated dimensions: (a) uneven capital accumulation across sectors, captured by profit rates as an upper bound on wage growth; (b) workers’ collective organisation and bargaining capacity, which shape the extent to which this potential is realised; and (c) the role of the state as a contested arena in which distributive conflicts are mediated. Using panel data econometric models (2006–2019), we examine average wages across private economic sectors, accounting for sectoral profit rates, union strength, and minimum wage policies. Our findings reveal that wage inequality emerges from the interaction between capital’s drive for profit maximisation and workers’ responses through organisation, bargaining, and conflict.

Associate degree nurses constitute a substantial segment of the nursing workforce and play a crucial role in delivering frontline patient care across healthcare settings. Despite their importance, limited evidence exists regarding factors influencing their job satisfaction, particularly the quality of nursing work life (QNWL), within the Jordanian context. This study aimed to examine the relationship between QNWL and job satisfaction among associate degree nurses in Jordan. A cross-sectional study was conducted between March and April 2024 among 114 associate degree nurses working in 3 government hospitals in Jordan. Participants were recruited using purposive sampling. Eligible nurses held an associate degree in nursing, had at least one year of clinical experience, and were actively employed at the time of data collection. Nurses with less than one year of experience or those on extended leave were excluded. Data were collected using the Muller and McClosky Satisfaction Scale and Brooks' QNWL Scale. Descriptive statistics and Pearson correlation coefficient were applied for data analysis. The overall QNWL was low (mean (M) = 108.11, SD = 17.03). The lowest scores were observed in the work life/home life domain (M = 16.84, SD = 4.67) and the work design domain (M = 28.24, SD = 5.06), reflecting challenges related to workload and work-life balance. Job satisfaction levels were generally low, with mean scores ranging from 1.08 to 1.73 on a five-point scale, indicating dissatisfaction across multiple job dimensions. In contrast, relatively higher satisfaction was reported in interpersonal aspects, including satisfaction with coworkers (M = 2.67, SD = 0.42) and interpersonal interaction (M = 2.31, SD = 0.93). A strong and statistically significant positive correlation was identified between the work environment and job satisfaction (R = 0.746, P < .001). The findings reveal significant concerns regarding workload, work-life balance, and limited extrinsic rewards among associate degree nurses in Jordan. Implementing targeted organizational strategies and policy interventions aimed at improving the QNWL may enhance job satisfaction and ultimately contribute to improved quality of patient care.

This study examines workplace bullying within the middle-management tier of a large Gauteng-based retail organisation in South Africa, with a focus on structural organisational pressures and perceptual differences among managers. While traditional research often emphasises individual personality traits or victim demographics, this study explores how organisational conditions—particularly the “middle management squeeze” and performance-driven Key Performance Indicators (KPIs)—are reflected in workplace behaviours. Grounded in a positivist paradigm, a quantitative cross-sectional survey was conducted among a probability-based sample of 253 retail managers. Data were collected using the Negative Acts Questionnaire (NAQ-22) and analysed using Exploratory Factor Analysis (EFA) and nonparametric inferential tests. The findings indicate that task-related negative acts, such as micromanagement (M = 2.00) and persistent monitoring (M = 1.87), are frequently experienced. EFA identified two dimensions—General Harassment and Managerial Control—accounting for 62% of the total variance. Inferential results show that perceptions of General Harassment differ significantly across educational groups (p = 0.0268), whereas perceptions of Managerial Control remain consistent (p = 0.3378). These findings indicate that social forms of incivility are interpreted differently across educational cohorts, while task-related managerial practices are widely normalised. The study highlights the importance of understanding workplace bullying as both a structural and perceptual phenomenon and underscores the need for organisational interventions that address systemic pressures rather than relying solely on individual-level approaches.

Healthcare workers are exposed to sustained occupational stressors that may lead to heterogeneous patterns of psychological distress and resilience, with potential implications for job satisfaction. Person-centered approaches may help identify subgroups with distinct mental health profiles. We conducted a cross-sectional survey between December 2024 and March 2025 among healthcare workers employed in a single Italian Local Health Authority (ASL 1 Abruzzo). Participants completed measures of anxiety (GAD-7), depressive symptoms (PHQ-9), insomnia (ISI), resilience (RSA-11), perceived stress (PSS-10), and job satisfaction (JSS). K-means clustering on standardized mental health measures was used to identify profiles; the optimal number of clusters was selected using multiple internal validation indices (Gap statistic, average silhouette width, elbow method, and NbClust majority rule). Clusters were compared on sociodemographic variables and job satisfaction using non-parametric tests and chi-square tests. Of 383 respondents, five were excluded (n = 2 for invalid response patterns, n = 3 for incomplete data), yielding N = 378. A two-cluster solution emerged. Cluster 1 (n = 145) showed higher psychological distress and perceived stress and lower resilience; Cluster 2 (n = 233) showed lower anxiety, depressive symptoms, insomnia and perceived stress, alongside higher resilience. Job satisfaction was significantly higher in Cluster 2 than Cluster 1 (Wilcoxon W = 21521, p < 0.001, r = 0.23). Cluster membership also differed by gender and work site. Two distinct mental health profiles were identified within a single health authority, highlighting a subgroup characterized by high distress, low resilience and lower job satisfaction. Targeted psychosocial and organizational interventions may be warranted to support this vulnerable group and sustain workforce wellbeing.

Background/Objectives: Healthcare facilities are among the most energy-intensive public buildings, yet hospital decision-support models rarely integrate energy-related performance indicators alongside operational metrics. This study aims to address this gap by developing a discrete-event simulation framework capable of jointly evaluating clinical efficiency and energy consumption in elective orthopedic surgical pathways. Methods: A comprehensive discrete-event simulation model was developed to represent the diagnostic imaging and orthopedic surgical process. The model was parameterized using a hybrid data-collection approach that combined clinical activity data, scientific literature, and expert judgment. Energy consumption was modeled by differentiating fixed loads, such as heating, ventilation, and air-conditioning systems and lighting, from activity-dependent loads associated with diagnostic and surgical equipment. Baseline performance was assessed and compared with alternative scenarios for organizational and technological improvements. Results: The analysis showed that fixed infrastructural loads, particularly HVAC systems, were the main drivers of per-patient energy consumption, with inefficient space utilization and prolonged idle times. Scenario analysis demonstrated that organizational interventions, such as increasing operating room throughput and optimizing MRI scheduling, can substantially reduce energy intensity by diluting fixed loads and decreasing idle consumption. Technological interventions, such as replacing conventional surgical lamps with LED systems, produced smaller but still beneficial reductions. The combined implementation of organizational and technological strategies yielded the greatest overall improvement. Conclusions: Integrating energy metrics into discrete-event simulation provides effective support for hospital decision-making by revealing the interaction between workflow design, resource utilization, and environmental performance. The findings indicate that organizational redesign, particularly when combined with technological upgrades, can significantly improve both operational efficiency and sustainability in hospital settings. This study highlights discrete-event simulation as a promising tool for energy-aware healthcare planning.

Nurse leader burnout has intensified due to increasing operational demands, workforce shortages, and prolonged stressors amplified by the COVID-19 pandemic. Understanding contributors to burnout and protective factors is essential to sustaining leadership capacity and workforce stability. This article examines the prevalence, drivers, and outcomes of burnout among nurse leaders and explores changes in well-being, job satisfaction, and work-related stress over time. A repeated cross-sectional survey was administered to members of the Minnesota Organization of Leaders in Nursing in 2020, 2022, and 2024. The survey incorporated items from the Mini Z burnout tool and the Maslach Burnout Inventory, along with demographic and open-ended questions. Descriptive and comparative analyses were used to evaluate trends. Across 295 responses, nurse leaders reported improvements in job satisfaction, autonomy, and perceived time adequacy. Emotional exhaustion and depersonalization decreased over time; however, reports of workplace stress increased. Work-life balance and meaningful work consistently emerged as key factors for thriving. Although indicators of burnout have improved, persistent and rising stress highlights the need for sustained organizational and individual interventions. Ongoing investment in support, autonomy, and well-being strategies is critical to nurse leader resilience and retention.

Purpose The present study analyzes associations between organizational tolerance to workplace harassment, counterproductive work behavior and health complaints in organizations with more than 50 employees. This study also explores the mediating role of work engagement and the moderating impact of employee adaptability. Design/methodology/approach Data were collected from 434 active workers using a cross-sectional survey, and common method bias was assessed. The measurement model was validated in SmartPLS 4. Moderated mediation hypotheses were then tested with the PROCESS macro, which estimates indirect effects and confidence intervals. Findings Our findings support both the simple and conditional mediation hypotheses. Specifically, work engagement mediates the relationship between organizational tolerance and counterproductive work behavior, with the strength of this mediation varying in accordance with employee adaptability. Practical implications These findings point to the potential value of implementing organizational intervention programs aimed at reducing tolerance for workplace harassment. They also highlight the importance of developing personal coping skills to effectively manage undesirable behaviors in the workplace. Originality/value This study underscores the critical yet underexplored role of organizational tolerance of psychological harassment in the workplace. Drawing on Einarsen's framework, the proposed model links organizational tolerance with other critical variables, supporting a moderated mediation that clarifies how organizational factors shape individual reactions to harassment. This approach offers a novel basis for developing more effective organizational interventions.

Background: Workplace bullying constitutes a persistent psychosocial risk in public service settings, where hierarchical structures and limited exit opportunities may intensify employees’ psychological strain. Although previous research has documented associations between workplace bullying and burnout, less is known about the psychological processes through which bullying translates into emotional exhaustion and the contextual conditions under which these processes are activated, particularly in public sector contexts. Method: This study used survey data from 234 public service employees working in administrative, educational, and non-clinical healthcare institutions across three major cities in Türkiye (Istanbul, Ankara, and Izmir). Participants who were frequently exposed to workplace bullying were selected to examine the detrimental cycle that victims experience. A moderated mediation model (PROCESS Model 7) was tested to examine emotion-focused coping as a mediating mechanism between workplace bullying and burnout, operationalized through emotional exhaustion, and to assess whether this indirect effect was conditional on perceived bystander silence. Results: Findings indicated that workplace bullying was associated with increased reliance on emotion-focused coping only when perceived bystander silence was high. The conditional indirect effect of workplace bullying on burnout via emotion-focused coping was significant at higher levels of bystander silence, whereas no indirect effect emerged under low silence conditions. Conclusions: These findings suggest that burnout does not arise as an automatic consequence of bullying exposure but unfolds through coping processes that are activated in socially silent environments. By highlighting the conditional role of bystander silence, this study emphasizes the value of social context in shaping how public service employees respond to workplace bullying and how burnout develops. We discuss the practical implications for organizational interventions that aim to reduce bystander silence and support healthier coping processes in organizations.

Abstract Objectives Participatory organizational interventions (POIs) may improve workers’ mental health and work performance, but evidence from systematic reviews and meta-analyses of cluster-randomized controlled trials (cRCTs) remains limited: The meta-analysis has not been updated since 2015; a previous study focused on healthcare workers; and potential outcomes have not been adequately examined. This systematic review and meta-analysis aimed to investigate the effects of POIs on mental health and work performance among workers. Methods The current study searched PubMed, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society for papers published by November 11, 2022. Eligible studies were cRCTs assessing the effects of POIs on mental health or work performance. The risks of bias were evaluated by using the Cochrane risk-of-bias tool for cRCTs and performed meta-analysis using a random effects model. Results Fourteen cRCTs were included in the systematic review, and eight cRCTs in the meta-analysis. The meta-analysis showed non-significant beneficial effect on mental health conditions [the standardized mean differences (SMD) = -0.04, 95%CI; -0.10 to 0.03], positive mental health (SMD = -0.004, 95%CI; -0.077 to 0.068), and work performance (SMD = 0.01, 95%CI; -0.10 to 0.13). Conclusion This study did not confirm that POIs had a statistically significant effect on mental health or work performance. However, several studies that reported favorable results tended to emphasize active and structured participation, alignment with workers’ needs, and attention to organizational context. Further research is needed to identify the conditions under which the interventions are effective. Trial registration: The study protocol was registered at the UMIN registry (registration number: UMIN000049453).

Medication safety remains a critical concern in hospital settings, as medication errors continue to affect patient safety and the overall quality of healthcare delivery. Although prior studies have extensively examined clinical and technological determinants of medication safety, limited attention has been paid to human resource–related behavioral factors, particularly employee attribution. Drawing on attribution theory, this study aims to examine the antecedents of employee attribution and its impact on medication safety practices in hospitals through a secondary research approach. The study synthesizes existing empirical and conceptual literature to identify key organizational antecedents, including leadership support, organizational justice, training effectiveness, workload, and safety climate, and explores their influence on employee attribution among healthcare professionals. A systematic review of peer-reviewed journal articles, reports, and published studies related to employee behaviour, healthcare management, and medication safety was conducted. Relevant literature was analyzed and thematically synthesized to develop an integrative framework explaining the relationship between organizational antecedents, employee attribution, and medication safety practices such as adherence to drug administration protocols, error reporting, and compliance with safety guidelines. The findings highlight that positive employee attribution, shaped by supportive organizational and HR practices, plays a significant role in enhancing medication safety outcomes in hospital environments. This study contributes to the literature by conceptually linking attribution theory with medication safety and drug delivery practices. The proposed framework offers valuable insights for hospital administrators and policymakers to improve medication safety through strategic HR and organizational interventions.

Moral injury (MI) and post-traumatic growth (PTG) are critical psychological outcomes for healthcare workers who are frequently exposed to ethically challenging and traumatic situations. Thriving from work (TFW), characterized by vitality and learning at work, is proposed as a key contextual resource linking these constructs. The current cross-sectional study examined the mediating role of TFW in the relationship between MI and PTG among 4685 Chinese healthcare workers with an overall response rate of 36%. Measures included the Moral Injury Symptoms Scale-Health Professional (MISS-HP), Posttraumatic Growth Inventory-Short Form (PTGI-SF), and Thriving from Work Questionnaire (TFWQ). Correlation and mediation analyses revealed that TFW fully mediated the MI-PTG relationship, accounting for 91.67% of the total effect. MI negatively affected PTG by impairing TFW, while greater TFW reduced MI's adverse effects on PTG. These findings help to explain how healthcare professionals adapt to trauma in healthcare settings and suggest practical pathways to help safeguard healthcare workers' mental health through organizational and individual interventions targeting TFW.

The effects of mentoring on mentees have been well documented in research, but the effects of the mentoring interaction on the mentor are less well understood. This essay seeks to close that disparity. One important but little-studied topic is how mentoring initiatives affect the mentors. This research indicates that mentorship may be an essential component of an approach for cultural change when programme design is combined with deliberate mentor selection and targeting. The study aids in the conceptualization of mentoring as a fundamental component of a successful organisational change intervention by scholars and practitioners. Mentoring is becoming less predicated on a deficit model of the mentee. This training demonstrates how important actors in the company may become engaged in the necessary change process by focusing on what needs to change in the prevailing corporate culture, practices, and values.