Work engagement and perceived work ability: An evidence-based model to enhance nurses' well-being.

AIMS: The study aims are (a) to test a model developed to estimate the impact of work engagement on work ability as it is perceived by nurses; (b) to test the parameters between work ability and job satisfaction and between job satisfaction and turnover intention. DESIGN: Cross-sectional. METHODS: This study involved 1,024 nurses from January - May 2018. The response rate was 70.7%. The Work Ability Index and the Utrecht Work Engagement Scale were used. Path analysis was performed, both in the whole sample and in age categories (<45yy-≥45yy). Model's parameters and fit indexes were estimated. RESULTS: The comprehensive model was validated through the multi-group approach. Fit indexes were adequate in the general model and in the multi-group testing. Parameters confirmed the association between work engagement and work ability and between work ability and job satisfaction and turnover intention. Parameters highlighted different age-dependent patterns. CONCLUSION: This study states the contribution of work engagement to enhance work ability in nursing profession. Findings contribute in understanding motivational dynamics in nurses and they suggest the use of tailored strategies for different age categories. Further research could address the model to deepen generational patterns in work engagement, work ability, and organizational outcomes. IMPACT: The study highlights how to address nursing management to improve nurses' motivation and work ability and to improve organizational outcomes. Main findings point out different age-dependent patterns to tailor managerial strategies. Healthcare organizations have new elements to design human resources management and to improve job satisfaction and nurses' retention.

Randomized evidence for reduction of perioperative mortality.

OBJECTIVE: With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence. DESIGN AND SETTING: A web-based international consensus conference. PARTICIPANTS: More than 1,000 physicians from 77 countries participated in this web-based consensus conference. INTERVENTIONS: Systematic literature searches (MEDLINE/PubMed, June 8, 2011) were used to identify the papers with a statistically significant effect on mortality together with contacts with experts. Interventions were considered eligible for evaluation if they (1) were published in peer-reviewed journals, (2) dealt with a nonsurgical intervention (drug/technique/strategy) in adult patients undergoing surgery, and (3) provided a statistically significant mortality increase or reduction as suggested by a randomized trial or meta-analysis of randomized trials. MEASUREMENTS AND MAIN RESULTS: Fourteen interventions that might change perioperative mortality in adult surgery were identified. Interventions that might reduce mortality include chlorhexidine oral rinse, clonidine, insulin, intra-aortic balloon pump, leukodepletion, levosimendan, neuraxial anesthesia, noninvasive respiratory support, hemodynamic optimization, oxygen, selective decontamination of the digestive tract, and volatile anesthetics. In contrast, aprotinin and extended-release metoprolol might increase mortality. CONCLUSIONS: Future research and health care funding should be directed toward studying and evaluating these interventions.