Turnover intention and coronaphobia among frontline nurses during the second surge of COVID-19: The mediating role of social support and coping skills.

BACKGROUND: Turnover among frontline health care workers, particularly nurses, reached an alarming rate during the COVID-19 pandemic. This turnover has been attributed, in part, to excessive fear of the virus (a condition called coronaphobia). Studies have not yet been conducted examining whether social support and coping skills could act as buffers between coronaphobia and the intention to leave. AIM: To examine the relationship between coronaphobia and frontline nurses' organisational and professional turnover intention and to assess whether social support and coping skills can buffer this relationship. METHODS: A correlational research design was used to collect responses through an online questionnaire from a convenience sample of 687 frontline nurses from the Central Philippines. Data were analyzed using descriptive (mean, standard deviation and percentages) and inferential statistics (t test, Pearson r correlation coefficient, ANOVA and multiple linear regression). RESULTS: More than half of the frontline nurses experienced coronaphobia, while 25.8% reported a desire to leave their job and 20.7% reported a desire to leave their profession. Coronaphobia had direct significant effects on nurses' organisational (ß = .424, p < .001) and professional turnover intention (ß = .316, p < .001). Social support and coping skills partially mediated the relationship between organisational (ß = .365, p < .001; ß = .362, p < .001) and professional turnover intention (ß = .279, p < .001; ß = .289, p < .001). CONCLUSION: Frontline nurses who experienced coronaphobia were more likely to quit their job and the nursing profession. Increasing nurses' social support and enhancing their coping skills reduced the negative effects of coronaphobia, resulting in improved nurse retention. IMPLICATIONS FOR NURSING MANAGEMENT: Institutional approaches to reduce coronaphobia and turnover intention during the pandemic can be facilitated by improving social support through innovative approaches (e.g., use of technology and social media) and equipping nurses with positive coping skills through coping skills training and other empirically based coping skill-building interventions.

Factors associated with missed nursing care and nurse-assessed quality of care during the COVID-19 pandemic.

BACKGROUND: The coronavirus outbreak has brought unprecedented pressures to many health care systems worldwide, potentially compromising nursing care delivery and overall health care services. AIMS: This study identified factors that contributed to missed nursing care and nurse-assessed quality of care during the coronavirus pandemic. METHODS: This study employed a cross-sectional research design using an online survey. Survey respondents were 295 frontline nurses from the Central Region of the Philippines. RESULTS: Missed care occurred at a low level, with "adequate patient surveillance" as the most often missed nursing care activity. Hospital facility size, nurse staffing levels, and patient safety culture predicted missed nursing care. Personal protective equipment adequacy, nurse staffing levels, and patient safety culture were identified as predictors of quality of care. CONCLUSION: Frontline nurses tended to miss clinical aspects of nursing care during the pandemic. Modifying elements of the work environment, including nurse staffing levels, safety culture, and adequacy of protective equipment, may reduce care compromise and improve the quality of nursing care. IMPLICATIONS FOR NURSING MANAGEMENT: By addressing the identified predictors, nurse managers could effectively develop appropriate interventions to support the professional role of nurses and ensure the delivery of complete, safe, and quality nursing care during the pandemic.

Perceived COVID-19-associated discrimination, mental health and professional-turnover intention among frontline clinical nurses: The mediating role of resilience.

COVID-19-associated discrimination (CAD) is an important issue that may adversely affect frontline nurses' work effectiveness and well-being. This study examined the relationships between frontline nurses' perceptions of COVID-19-associated discrimination and their resilience, mental health, and professional-turnover intention. This cross-sectional descriptive study involved 259 frontline nurses in the Central Philippines and used four online self-report measures. The results revealed that frontline nurses perceived a moderate level of COVID-19-associated discrimination. Frontline nurses who perceived a higher level of discrimination during the coronavirus pandemic reported poorer mental health and higher professional-turnover intention. Resilience acted as a mediator and reduced the effects of COVID-19-associated discrimination on nurses' mental health and their professional-turnover intention. Proactive measures to reduce the negative consequences of discrimination during the pandemic, and efforts to foster resilience in nurses who are in the forefront of the fight against the highly transmissible virus, should be given high priority by hospital and nursing administrators to better support nurses' mental health and foster retention.

A Multicountry Study on Nursing Students' Self-Perceived Competence and Barriers to Evidence-Based Practice.

BACKGROUND: Nursing education and training are essential in the attainment of evidence-based practice (EBP) competence in nursing students. Although there is a growing literature on EBP among nursing students, most of these studies are confined to a single cultural group. Thus, cross-cultural studies may provide shared global perspectives and theoretical understandings for the advancement of knowledge in this critical area. AIMS: This study compared self-perceived EBP competence among nursing students in four selected countries (India, Saudi Arabia, Nigeria, and Oman) as well as perceived barriers to EBP adoption. METHODS: A descriptive, cross-sectional, and comparative survey of 1,383 nursing students from India, Saudi Arabia, Nigeria, and Oman participated in the study. The Evidence-Based Practice Questionnaire (EBP-COQ) and the BARRIERS scale were used to collect data during the months of January 2016 to August 2017. RESULTS: Cross-country comparisons revealed significant differences in EBP competence (F = 24.437, p < .001), knowledge (F = 3.621, p = .013), skills (F = 9.527, p < .001), and attitudes (F = 74.412, p < .001) among nursing students. Three variables including nursing students' gender (ß = .301, p < .001), type of institution, (ß = -0.339, p = .001), and type of nursing student (ß = .321, p < .001) were associated with EBP competence. Barriers to EBP adoption included having no authority to change patient care policies (M = 1.65, SD = 1.05), slow publication of evidence (M = 1.59, SD = 1.01), and paucity of time in the clinical area to implement the evidence (M = 1.59, SD = 1.05). LINKING EVIDENCE TO ACTION: Both academe and hospital administration can play a pivotal role in the successful acquisition of EBP competence in nursing students.

Predictors of evidence-based practice knowledge, skills, and attitudes among nursing students.

PROBLEM: Evidence-based practice (EBP) competence is one of the most desirable outcomes in nursing education. Assessment of knowledge, skills, and attitudes of nursing students regarding EBP is vital in examining the extent to which current approaches to EBP teaching is effective. PURPOSE: This study examined the predictors of knowledge, skills, and attitudes regarding EBP among Omani nursing students. METHODS: This study utilized a descriptive, cross-sectional approach. Two hundred and forty-eight nursing students enrolled in one of the universities in Oman participated in the study during the months of May 2016 to August 2017. The evidence-based practice questionnaire (EBP-COQ) was used for data collection. Descriptive and inferential statistical tools were used to analyze the data. FINDINGS: The mean values for the three EBP domains (knowledge, skills, and attitudes) were 3.41 (SD = 0.66), 3.62 (SD = 0.51), and 3.41 (SD = 0.68), respectively. Nursing students' sex (being female), classification (being a registered nurse to Bachelors of Science degree in Nursing nursing student), and access to the internet and to nursing journals strongly predicted the knowledge, skills, and attitudes regarding EBP. Overall, 79.0% of Omani nursing students intended to adopt EBP in the future. CONCLUSIONS: Omani nursing students possessed moderate knowledge, skills, and attitudes on EBP; however, more efforts are needed to ensure that future Omani nurses are competent and confident to apply EBP in the actual clinical area. Both academe and the hospital administration play a pivotal role in the acquisition and achievement of EBP competence in student nurses.

Interprofessional simulation in undergraduate nursing program: An integrative review.

OBJECTIVES: Interprofessional (IP) competencies are critical for successful collaborative practice. Nurse education, through interprofessional simulation, plays a critical role in preparing nursing students achieve these competencies. Although considerable research has been conducted on this topic, a broader perspective is lacking. This review systematically appraised and synthesized evidence examining the effects of interprofessional simulation on nursing students' outcomes. DESIGN: An integrative review method guided this review. DATA SOURCES: Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO, and MEDLINE) were searched to locate articles published from 2010 onwards. Search and MeSH terms included: interprofessional, interdisciplinary, simulation, nurse education, nursing, and student. Thirty (30) articles were included in this review. RESULTS: Findings of content analysis revealed five essential themes: interprofessional communication, appreciation of interprofessional team roles, interprofessional teamwork or collaboration, self-confidence or self-efficacy, and positive attitudes or readiness toward interprofessional learning. CONCLUSIONS: This review provides a current state of knowledge on the efficacy of interprofessional simulation in enhancing interprofessional learning and competencies in nursing students. However, more research should be done utilizing a more robust method of research and reliable assessment methods. Through interprofessional simulation experiences, nurse academe can adequately prepare nursing students for future collaborative practice. Inclusions of interprofessional simulation activities in all clinical nursing courses can help prepare nursing students achieve inter-professional learning.

Nursing students' perceptions of their instructors' caring behaviors: A four-country study.

BACKGROUND: Caring is the core and essence of the nursing profession. Nurse educators, are in a key position to role model for perspective nurses the role of caring while including caring as a vital component in a nursing curriculum. OBJECTIVES: This paper is a report on students' perceptions of instructors' caring behavior in four countries: India, Greece, Nigeria, and the Philippines. METHODS: This study utilized a quantitative, cross-sectional, comparative approach. A total of 450 nursing students participated with an almost equal nursing student frequency distribution. The main instrument used in this study was the Nursing Students' Perceptions of Instructor Caring (NSPIC). The study was conducted during the months of September 2013 to January 2014. Descriptive statistics, correlations analysis, linear regression model and one-way analysis of variance (ANOVA) were used to analyze the data collected. FINDINGS: The highest rated subscale in the NSPIC was "instills confidence through caring" (M=4.268, SD=0.964), while the lowest ranked subscale was for the subscale "Control versus flexibility" (M=3.609, SD=1.076). No significant correlations were found between the NSPIC scale and gender (F=0.060, p=0.807), age (F=3.220, p=0.073), educational level (F=0.100, p=0.752) and family status of students (F=1.417, p=0.235), except the country of origin (F=3.703, p=0.012, η(2)=0.024). CONCLUSION: With this study as an initial investigation into ascertaining nursing instructors caring focused on a cross-country approach, nurse educators can utilize this information to better portray their role as a nurse educator when being perceived by their nursing students.

Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses.

OBJECTIVES: This study aimed to determine the challenges encountered and strategies used by nurse preceptors to build effective professional relationships during the preceptorship of final year nursing students. METHODS: This study was conducted in November 2012 at the College of Nursing in Sultan Qaboos University, Muscat, Oman. A qualitative research design consisting of focus group discussions was used to investigate the challenges that preceptors encounter and the strategies that they use to build effective relationships with preceptees. A total of 21 preceptors from Sultan Qaboos University Hospital participated in the study as part of a training workshop for nurse preceptors. The interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS: The main challenges faced by preceptors included discrepancies in applying theory to practice; lack of trust; lack of time, and perceived lack of knowledge. The effective strategies identified by the preceptors to be used in building a healthy preceptor-preceptee relationship were proper orientation; effective communication; preparation for complex situations; appreciation and acknowledgment; positive feedback; assurance of support; spending time together; knowing preceptors personally; giving breaks, and encouraging self-commitment. CONCLUSION: Preceptors should be encouraged to identify challenges that hinder the building of effective relationships with preceptees early during their preceptorship. The incorporation of appropriate and evidenced-based strategies, such as those identified in this study, can transform the preceptorship experience into one that is fulfilling for both preceptors and preceptees. This may lead to greater job satisfaction, personal and professional growth as well as higher self-esteem levels for preceptors and the realisation of clinical objectives for preceptees.