Safe Nursing Care Research Articles

Designing and psychometric evaluation of safe nursing care instrument in intensive care units

BackgroundProviding safe care in a sensitive and high-risk unit such as the ICU is one of the most crucial tasks for nurses. One way to establish the criteria for safe care is by creating a instrument to assess it. Therefore, this study was conducted with the aim of designing and psychometrically evaluating an instrument for safe nursing care in the ICU.MethodsThe current study employed a sequential-exploratory mixed-method approach with two qualitative and quantitative phases. Based on the results of qualitative phase and the literature review, the primary instrument was designed. In the quantitative phase, the designed instrument underwent psychometric evaluation. Face, content and construct validity were assessed. Face validity was assessed by 20 nurses, and content validity was assessed by 26 experts. In the construct validity stage, the sample size for the exploratory factor analysis (EFA) included 300 nurses, and for the confirmatory factor analysis (CFA) included 200 nurses who work full-time in the ICUs of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran. EFA sampling was conducted in three hospitals, encompassing six ICUs, while CFA sampling was carried out in two hospitals, covering four ICUs. Sampling was done using the convenience method. The reliability of the instrument was also assessed. Finally, the interpretability, feasibility, weighting, and scoring of the instrument were evaluated.ResultsThe qualitative phase identified three themes, including professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment). The primary instrument was designed with 107 items rated on a five-point Likert scale. In the quantitative phase, the psychometrics of the instrument were conducted. First, the face and content validity were assessed, and the average scale content validity index (S-CVI) was 0.94. Then, a preliminary test was conducted to assess the initial reliability (α = 0.92) and the correlation of each item with the total score. After completing these steps, the number of items in the instrument was reduced to 52. The results of the EFA explained 58% of the total variance, with 4 factors identified: professional behavior by following guidelines, comprehensive care, accurate documentation, and pressure ulcer care. At the CFA stage, the results of the calculation of indices and goodness of fit showed that the model had a good fit. The reliability of the relative stability by examining the intraclass correlation coefficient (ICC) for the whole instrument in 20 samples was 0.92 with a confidence interval of 0.97 − 0.81. To measure absolute stability and determine the responsiveness of the instrument, the standard error of measurement (SEM) was 4.39 and the minimum detectable change (MDC) was 12.13.ConclusionThe instrument for safe nursing care in the ICU has favorable psychometric properties.

Components of safe nursing care in the intensive care units: a qualitative study

BackgroundPatient safety is a global health issue that affects patients worldwide. Providing safe care in the intensive care units (ICUs) is one of the most crucial tasks for nurses. Numerous factors can impact the capacity of nurses to deliver safe care within ICUs. Consequently, this study was undertaken with the aim of identifying the components of safe nursing care in ICUs.MethodsThe current research constitutes a qualitative conventional content analysis study conducted from January 2022 to June 2022. The study participants comprised nurses, intensivists, nurse responsible for patient safety, paramedic, patients, and patients’ family member, totaling 21 individuals selected through purposive sampling. Data collection involved individual, in-depth, and semi-structured interviews. Subsequently, data analysis was performed utilizing the approach outlined by Graneheim and Lundman (Nurse Educ Today 24(2):105–12, 2004), leading to the identification of participants’ perspectives.ResultsThree themes were identified as components of safe nursing care in ICUs. These themes include professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment).ConclusionsThe findings of this study underscore the significance of advocating for safe nursing practices in ICUs by emphasizing professional conduct, holistic care, and safety-focused organizational structures. These results align with existing research, suggesting that by introducing tailored interventions and tactics informed by these elements, a safer environment for nursing care can be established for ICUs patients.

The objectively structured clinical examination for safe nursing care: a scoping review

Introduction: The Objective Structured Clinical Examination (OSCE) has been utilized as an educational strategy in the training of health professionals. Its application in this context can enhance the development of both technical and non-technical skills, as well as safety in care.Objective: To map the patient safety skills developed by nursing professionals through the Objective Structured Clinical Examination as found in the literature.Method: This is a scoping review structured according to the JBI framework and guided by the Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The review is registered in the Open Science Framework with the DOI number 10.17605/OSF.IO/MESC3. A search was conducted in the following databases: PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the CAPES Catalog of Theses and Dissertations, and Google Scholar, between February and April 2023.Results: Twenty-five studies were selected, demonstrating that the OSCE is used to train nursing teams with a focus on safety skills such as communication, teamwork, decision-making, clinical care, and situational safety awareness.Conclusion: The OSCE has been used as an educational strategy to improve the quality and safety of care. It is applied from primary care to high-complexity settings to evaluate professional skills that are technical, attitudinal, or behavioral in nature. The use of OSCE aids in the development of professional skills related to patient safety.

The relationship between moral courage, team work, and safe nursing care in clinical nurses: a multicenter cross-sectional study in Iran

BackgroundMoral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses.MethodsThis descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson’s correlation coefficient. SPSS version 22 was used to analyze the data.ResultsThe participants’ mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p < 0.001), teamwork and moral courage (r = 0.49, p = 0.002), and moral courage and safe nursing care (r = 0.59 p < 0.001). According to the results, work experience, moral courage, and teamwork explained 44.4% of the variance in safe nursing care (R2 = 0.44, p < 0.001).ConclusionThe results indicated that the moral courage and teamwork of nurses were positively and significantly correlated with the participants’ safe nursing care. Accordingly, since moral courage and teamwork are the qualities that can contribute to improving the quality of care and ensuring safe nursing care, it is recommended that nursing managers pay special attention to these factors.

Operational nursing managers' experiences of clinical supervision at a Johannesburg Hospital.

Clinical supervision is pivotal in supporting nurses in rendering quality, safe patient care. Therefore, it is essential to understand clinical supervision from operational nursing managers' context to define existing challenges and propose suitable recommendations. This study aimed to explore and describe operational nursing managers' experiences of clinical supervision within the context of an academic hospital in Gauteng province and propose evidence-based practice recommendations to improve patient safety and the quality of clinical supervision. An exploratory, sequential, mixed-method design was used and implemented over two phases to take advantage of the strengths of both the qualitative and quantitative research designs. Unstructured individual interviews were conducted to collect data in phase one, and an adapted Manchester Clinical Supervision Scale (MCSS) questionnaire was used to collect data in phase two. Operational nursing managers work in stressful conditions and environments with a gross shortage of staff and tools of the trade while being expected to deliver high-quality and safe nursing care. Of the sampled respondents, 36% (n= 17) were dissatisfied with the supervision they received, while 64% (n= 30) were indifferent in the sense that they did not think it was adequate or inadequate. Clinical supervisors should be trained and supported in clinical supervision, with regular workshops on interpersonal relations.Contribution:A clearer understanding of clinical supervision within the hospital context and evidence-based practice recommendations to improve patient safety and the quality of clinical supervision.

The Future of Nursing Education: Necessary Elements and Implementation Strategies for Learning Artificial Intelligence

As populations age, average life expectancy increases and the complexity of diseases rises, leading to nursing care and healthcare systems facing severe challenges related to inadequate resources. Artificial intelligence (AI), including elements such as investigation, integration, learning, prediction, and decision-making, holds significant potential for application in clinical care not only to enhance care quality but also to help guide the future direction of healthcare. AI applications are already being increasingly utilized to improve the quality of clinical care and to streamline workflows. However, because nursing education has lagged behind in terms of adopting AI, greater attention must be given to training up nursing students with AI-related knowledge and application skills. AI technologies should be integrated into nursing curricula and clinical internships to adapt to the rapidly changing high-tech healthcare environment, enabling the more-effective use of AI technology in providing high-quality and safe nursing care.

Strategies for incorporating evidence-based practice into nurse residency programs: A scoping review.

The American Nurses Credentialing Center's (ANCC's) Practice Transition Accreditation Program (PTAP) establishes standards for nurse residency programs to elevate and optimize the skills, knowledge, and attitudes of new nurses participating in nurse residency programs. Evidence-based practice (EBP) is foundational to providing safe nursing care. One of the National Academy of Medicine's (NAM's) 2020 goals stated that 90% of clinical decisions would be supported by the best available evidence to attain the best patient outcomes. Nurse residency programs can benefit from evidence-based strategies to develop EBP competencies in new nurses. The purpose of this scoping review was to synthesize the literature around strategies for incorporating EBP into nurse residency programs across the United States. This scoping review was informed by the JBI (formerly known as the Joanna Briggs Institute) methodology for scoping reviews. Searches were conducted by a health science librarian in PubMed and CINAHL with Full Text. Keywords and their synonyms, Medical Subject Headings (MeSH; PubMed), and Subject Headings (CINAHL with Full Text) were used. Covidence, a literature review management program, was used to organize the literature and manage the review. Title, abstract, and full-text reviews were completed within Covidence using three teams of two independent reviewers. Four hundred and thirty-eight citations were imported into Covidence. Ten articles were retained for the final review. Three strategies for incorporating EBP into nurse residency programs emerged from the literature: (1) exposure of nurse residents to existing organizational resources, (2) completion of online EBP modules, and (3) completion of an EBP project. The incorporation of EBP competencies in nurse residency programs aligns with NAM's and ANCC's goals, yet a paucity of evidence exists to guide curriculum development in nurse residency programs. This scoping review corroborates the need for further research to inform best practices for implementing EBP into nurse residency programs.

Validation graphic protocol for assessing safe nursing care in hemodialysis

Validation graphic protocol for assessing safe nursing care in hemodialysis

Investigating safe nursing care and medication safety competence in nursing students: a multicenter cross-sectional study in Iran

BackgroundMedication safety competence is very important as one of the clinical skills among nursing students to provide safe nursing care. The lack of medication safety competence in nursing students leads to occurrence of medication errors subsequently jeopardizing patient safety. Thus, the present study was conducted to investigate safe nursing care and medication safety competence among nursing students in the south of Iran.MethodsA descriptive cross-sectional multicenter study was conducted from September to December 2022. The research population included nursing students of three universities of medical sciences in Fars Province, Southern Iran. A total of 310 nursing students who were selected through convenience sampling participated in the study. The data collection instruments consisted of a demographics survey, Medication Safety Competence Scale (MSCS), and a Safe Nursing Care Scale (SNCS). The collected data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and inferential statistics (Independent t-test, Analysis of variance and Pearson correlation coefficient). The data were analyzed in SPSS 23 and the level of significance was considered 0.05.ResultsThe mean age of the participants was 22.53 ± 1.69 years. The total mean scores for medication safety competence and safe nursing care were found to be 111.97 ± 11.85 and 105.12 ± 11.64, respectively. There was a statistically significant positive correlation between safe nursing care and medication safety competence (r = 0.084, P < 0.001).ConclusionThe mean scores of nursing students’ medication safety competence and safe nursing care were at an average level. To maintain patient safety, nursing instructors and managers are recommended to employ appropriate strategies to improve medication safety competence and safe nursing care in nursing students.

Moral Distress and Moral Resilience of Health Professionals in a Greek Public Hospital during the Second Wave of Pandemic

Moral distress is the situation in which nurses know the moral principles that should guide their actions but are not allowed by the constraints of the health system. Moral sensitivity is the ability of nurses to perceive the moral dimensions of certain situations or actions. Safe care is a range of services provided to patients by nurses and consequently nurses with the aim of monitoring, promoting, maintaining or restoring the health of patients. Moral distress negatively affects safe health care, and moral sensitivity is the solution to moral distress. This study investigates the relationship between both moral distress and moral sensitivity of nurses with safe nursing care. A total of 163 nurses from a General Greek Hospital participated in the research. The protocol included the Moral Resilience (RMRS), Moral Distress (MMD-HP) and Moral Sensitivity Control (Byrd's NEST) scales. For the RMRS scale, higher scores are recorded for the moral efficacy dimension. Moderate scores are recorded for the MMD-HP scale, so nurses are characterized by moderate moral sensitivity. None of the nurses had left or considered leaving the clinic due to moral distress, up to the time of the present study. Health professionals based on Byrd's NEST scale are characterized by moderate moral sensitivity. The greater the integrity of the relationships, the greater the reactions to moral adversity. The greater the moral distress, or the better the perceptions of the security offered by management, the greater nurses’ personal integrity. As relational integrity or distress decreased, moral efficacy increased. The higher the moral distress of the nurses, the greater the integrity of the relationships. Nurses who had children also felt more secure about working conditions than those who did not. The greater the dynamics of the clinic, the less reactions to moral adversity. Finally, greater moral deadlock was associated with both greater personal integrity and greater relational integrity, and less moral efficacy. Increased moral sensitivity prevents the occurrence of moral distress and has a positive effect on the provision of safe health care.

The Relation between Systems Thinking and Safe Nursing Care among Nurses at Menoufia University Hospital

The Relation between Systems Thinking and Safe Nursing Care among Nurses at Menoufia University Hospital

Patient-Safety Culture among Emergency and Critical Care Nurses in a Maternal and Child Department.

The quality of healthcare has multiple dimensions, but the issue of patient safety stands out due to the impact it has on health outcomes, particularly on the achievement of the Sustainable Development Goals (SDGs), expressly SDG3. In the services that we propose to study, the patient-safety culture had never been evaluated. To evaluate nurses' perceptions of the patient-safety culture in the Emergency and Critical Care Services of the Maternal and Child Department of a University Hospital and to identify strengths, vulnerabilities, and opportunities for improvement. This an exploratory, cross-sectional study with a quantitative approach, using the Hospital Survey on Patient Safety Culture as an instrument for data collection. The population were all nurses working in the emergency and critical care services of the maternal and child-health department, constituted, at the time of writing, by 184 nurses, with a response rate of 45.7%. Applying the guidelines from the Agency for Healthcare Research and Quality (AHRQ), only teamwork within units had a score greater than 75%. For this reason, it is considered the strength (fortress) in the study. The lowest-rated were non-punitive responses to errors and open communication. The overall average percentage score is below the benchmark of the AHRQ, indicating that issue of patient safety is not considered a high priority, or that the best strategies to make it visible have not yet been found. One of the important implications of this study is the opportunity to carry out a deep reflection, within the organization, that allows the development of a non-punitive work environment that is open to dialogue, and that allows the provision of safe nursing care.

Effectiveness of simulation-based case studies on knowledge acquisition and clinical judgment in undergraduate nursing students

BackgroundThe development of clinical judgment and nursing knowledge are essential in nursing. However, new graduate nurses do not possess the knowledge and clinical judgment needed to provide safe nursing care. Therefore, nurse educators must find ways to promote the development of clinical judgment and knowledge in nursing students. ObjectivesTo examine the effectiveness of simulation-based case studies as a classroom teaching strategy versus traditional lecture on the development of knowledge acquisition and clinical judgment in undergraduate nursing students. DesignQuasi-experimental two-group, pretest-posttest study. SettingThe study was conducted at a public university in the South-Central region of the United States. ParticipantsA total of 120 students enrolled in a medical-surgical course over two semesters. MethodsStudents in the control group (n = 54) attended a traditional lecture while students in the experimental group (n = 66) participated in simulation-based case studies. A knowledge quiz and the Lasater Clinical Judgment Rubric were completed before and after exposure to the teaching strategy. Data were analyzed using independent samples t-tests. ResultsThere was a significant increase in the knowledge quiz scores found in the experimental group. However, there was not a significant difference found in clinical judgment scores in the experimental group. There was a significant increase in knowledge and clinical judgment scores in both groups. ConclusionBoth attendance in traditional lecture and participation in simulation-based case studies in the classroom are effective in increasing knowledge and clinical judgment scores in undergraduate nursing students.

The Relationship Between Safe Nursing Care and Professional Commitment of Nurses in Iranian Educational-Therapeutic Hospitals

Background: Safe nursing care and professional commitment are known as two important components influencing the nursing service quality. Objectives: The present study aimed to assess the relationship between safe nursing care and nurses’ professional commitment. Methods: In the present cross-sectional correlational research, 263 nurses were selected from the intensive care unit/cardiac care unit (ICU/CCU), internal, surgery, pediatrics, gynecology and obstetrics, oncology, burn, orthopedics, infectious, and neurology wards of educational-therapeutic hospitals affiliated with Qazvin University of Medical Sciences by quota sampling method between May 2022 and September 2022. Data collection was performed using the nurses’ professional commitment scale (NPCS) and the assessment of safe nursing care (ASNC) questionnaire. Nurses were selected using a convenience sampling method. The collected data were analyzed using descriptive and inferential statistical tests (t-test, Pearson’s correlation, and one-way analysis of variance (ANOVA)) by SPSS software version 16. Results: The mean scores of nurses’ professional commitment and safe nursing care were 86.16 ± 4.92 and 134.57 ± 16.15, respectively. Pearson’s correlation test showed a significant relationship between nurses’ professional commitment and safe nursing care (r = 0.345, P ≤ 0.001). Also, the test results indicated that the level of nurses’ professional commitment varied among individuals with different employment types (P = 0.008). Conclusions: According to this study, safe nursing care and nurses’ professional commitment are two important components influencing each other. Therefore, these results have important implications for policymakers and healthcare systems involved in promoting the level of safe nursing care and nurses’ professional commitment.

NURSES’ KNOWLEDGE AND ADHERENCE TO CLINICAL PRACTICE GUIDELINE TO PREVENT EXTRAVASATION OF CHEMOTHERAPY IN ERBIL CITY

BackgroundKnowledge is the cornerstone of providing safe nursing care. However, to do so, they require access to the most recent clinical information and guidance.&#x0D; ObjectivesThis study aimed to determine the nurses’ knowledge and adherence to clinical practice guidelines to prevent chemotherapy-related extravasation&#x0D; Materials and MethodsDescriptive cross-sectional design was used, 70 oncology nurses who administer chemotherapeutic drugs were selected in both Rizgary Teaching Hospital and Nanakaly Hospital for blood disease in Erbil City, from June 2022 to May 2023, data was collected through a structured interview questionnaire consisting of demographic data of nurses, knowledge about extravasation of chemotherapy, adherence to clinical practical guideline and barrier adherence to clinical practical guideline, data analyzed by using mean, standard deviation, frequency, percentage, Chi-square and binary logistic regression were used to find out the result of the study, and, a p-value less than 0.05 is considered significant.&#x0D; ResultsConcerning the overall level of knowledge of oncology nurses 55.7% had inadequate knowledge, 61.4% of them had low adherence to clinical practice guidelines, and the factors associated with low adherence to clinical practice guidelines was lower level of education (P-value=0.007, OR= 0.63), inadequate knowledge, (P-value= 0.041, OR=6.48), and high perceived barrier (P-value=0.004, OR= 9.87), the most commonly reported barriers was lack of continuing education to update nursing information and poor applicability of clinical practice guideline in real-world practice.&#x0D; ConclusionThe clinical practice guideline adherence rate of nurses concerning chemotherapy administration was low because most oncology nurses had inadequate knowledge and high perceived barriers consequently the study highlighted the significance of continuing education to maintain oncology nursing staff with the updated evidence-based guidelines.

Pressure injury prevention measures in pediatric wards: nursing professionals' actions

Objective: to classify the quality of nursing care and analyze the association between professionals' characteristics and the implementation of preventive measures for pressure injuries in hospitalized children. Methods: this observational, cross-sectional study involved 235 nursing professionals. The Pressure Injury Prevention instrument comprised three domains with a total of 23 items: Preventive measures and early detection of pressure injuries (9 items), Pressure relief measures (8 items), and Assessment and reporting (6 items), analyzed using the Positivity Index for Quality of Care. Results: Most participants were females (98.7%), with a mean age of 38.83 ± 9.94 years, nursing technicians (57.4%), and had more than five years of experience (77.1%). Nursing care was predominantly inadequate across all three domains, with 82.6% of actions rated as poor. Significant associations were found between "participation in training courses" and "work-related exhaustion". There was a trend towards increased compliance with measurements among professionals aged 31-40. Conclusion: nursing care was predominantly poor and participation in training courses and the presence of exhaustion were associated with better adherence to preventive measures. Contributions to practice: the study highlights the pressing need for investments in professional training and the provision of necessary resources to support high-quality and safe nursing care.

Exploring Work-related Anxiety Among Newly Graduated Nurses in the Riyadh Region

Background: Work-related anxiety among nurses has been linked to various issues, including a heavy workload, work-related conflict, a lack of resources, and stress. This research aims to explore work-related anxiety among recently graduated nurses in Saudi Arabia’s Riyadh region.&#x0D; Methods: A descriptive, cross-sectional, and relational research design examined work-related anxiety among newly graduated nurses. A sample of 400 nurses was recruited from five Saudi hospitals in the Riyadh region. This study used the job anxiety scale ( JAS) as a study tool. The tool is a self-rating scale of 70 items for assessing job anxiety but only 25 items were applied to this research. A self-administered questionnaire was used to gather demographic information.&#x0D; Results: This study revealed that there was, overall, low work-related anxiety among the nurse participants. On the one hand, age, gender, educational qualification, job experience, workplace, and work scheduling (hours per week) were found to impact work-related anxiety substantially. On the other hand, work position, nationality, unit of care, and marital status were found to play no significant role in work-related anxiety.&#x0D; Conclusion: The study’s findings indicate the importance of paying more attention to workplace anxiety. As anxiety may affect nurses’ ability to attend to the needs of patients in their care units, addressing it can reduce burnout and the desire to quit. Changes in work processes, care models, and leadership may be effective in creating a supportive environment that decreases stress and anxiety, promote learning, and provides patients with optimal and safe nursing care. Health policymakers and nurse managers in Saudi Arabia should develop particular intervention programs to reduce work-related anxiety among newly graduated nurses. Managers must seek techniques that help to adapt the present environment to the needs of nurses, as well as approaches that offer newly graduating nurses essential assistance, such as clinical supervision.

The Relationship Between Perceived Organizational Support With Safe Nursing Care in Nurses Working in the Intensive Care Units of Selected Hospitals in Tabriz, Iran

Background &amp; Aims safe nursing care is the use of knowledge and skills by nurses to provide quality patient care and it is considered one of the health goals in intensive care units. The feeling of being supported by the hospital play a key role in achieving this goal; it can lead to job satisfaction, good job performance, and patient satisfaction. This study aims to determine the relationship between perceived organizational support and safe nursing care in nurses working in the intensive care units (ICUs) of public hospitals in Tabriz, Iran. Materials &amp; Methods This is a descriptive-correlational study with a cross-sectional design that was conducted on 200 nurses working in the ICUs of hospitals affiliated to Tabriz University of Medical Sciences in 2021-2022, who were selected using a quota sampling method. Eisenberger et al.’s perceived organizational support scale and Rashvand et al.’s safe nursing care questionaire were used to collect data. Data analysis was done in SPSS v.16 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson correlation test). Results The mean score of perceived organizational support was 23.20±9.57, which was lower than the cutoff point. Safe nursing care was at a favorable level with a mean score of 322.89±34.1. The perceived organizational support had no statistically significant correlation with safe nursing care and its dimensions. Conclusion Despite the unfavorable perceived organizational support of ICU nurses in Tabriz, their safe nursing care is favorable. There is no statistically significant relationship between their perceived organizational support and safe nursing care. This finding is probably due to the prevailing rules and professional beliefs in the work of nurses, which has caused the care provided to be safe despite the perception of low organizational support.

Carees Trends of Nursing Students in the Context of Career Preference planning

Objective: To find the career preferences of the selected group of students - nurses of the Master’s study program Nursing. Respondents and methodology: The data were collected in the months of September-October 2022. The selection of respondents was intentional, the conditions for inclusion in the study were consent to anonymous filling in of the questionnaire, performance of the profession of a nurse, current study in the Master’s degree Nursing program. A total number of 155 respondents took part in the survey. The collected data were processed with the aid of non-parametric statistical tests. Results: The average age of the nurses in our group was 27.7 years, and the average number of years of experience was 4.8 years. Almost 43.2% of nurses want to stay working in clinical practice; 38.7% of nurses are interested in a managerial position; 18% want to work as a teacher. Nurses are not interested in research in nursing. Within the career trends in nursing, the most preferred post was the school nurse. There was no statistically significant difference in the age of the respondents according to their field of career (p=0.41) or according to their preference of application (p=0.36). The perception of managerial and pedagogical skills of the respondents did not correlate with age or length of experience. Conclusion: Nursing students' career preferences change as they progress through their training: nursing career planning and management; career growth increase job satisfaction; provision of quality and safe nursing care. The students of the study program Nursing show great ambivalence in their ideas about their future career. This opens wide possibilities for educators, managers, mentors, and nurses in practice to significantly positively influence and formation the career preferences of students.

The Predictors of Clinical Competence among Hospital Nurses: A Cross-Sectional Study in Hamadan, West Iran.

Nurses' clinical competence (CC) is critical in providing high-quality and safe nursing care. Assessment of nurses' CC and its predictors is a key step to improve their CC and the quality of their services. The aim of this study was to determine the predictors of CC among hospital nurses in Iran. This analytical cross-sectional study was conducted from September 2020 to May 2021. Participants were purposively selected from four university hospitals in Hamadan, west of Iran. A demographic questionnaire and the 73-item Nurse Competence Scale were used for data collection. A total of 300 questionnaires were distributed and 270 questionnaires (response rate: 90%) were completed and returned to the researcher. Data were analyzed using the SPSS software (v. 16.0) and the one-way analysis of variance, the independent-sample t, the Mann-Whitney U, and the Kruskal-Wallis tests, the Pearson and the Spearman correlation analyses, and the linear regression analysis. The mean score of CC was 40.28±8.6 (in the possible range of 0-100) and the highest and the lowest dimensional mean scores were for the situation management (56.13±11) and the ensuring quality (25.3±8.1) dimensions, respectively. The mean score of CC had significant relationship with age, work experience, and ward of working and these variables significantly predicted 77% of the variance of CC (adjusted R = 0.778, P<0.05). According to the results of this study, age, work experience and ward of working weresignificant predictors of CC in hospital nurses. Nursing managers should employ strategies such as reducing nurses' workload, improving their employment status, and providing them with quality in-service education in order to improve their CC and the quality of their services.