Delegating care as a double-edged sword for quality of nursing care: a qualitative study.

BACKGROUND: Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS: This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS: In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS: The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.

[A Whole-Course Nursing Quality Evaluation System for Liver Transplantation in Children Based on Donabedian Theory].

Objective To build a whole-course nursing quality evaluation system for liver transplantation in children,so as to provide a basis for nursing quality evaluation and management. Methods With Donabedian's "structure-process-outcome" model as the theoretical framework,we employed literature analysis,Delphi method,and hierarchical analysis to determine the contents and weights of indexes in the whole-course nursing quality evaluation system for liver transplantation in children. Results The three rounds of survey based on questionnaires showed the questionnaire recovery rate of 100%,the expert authority coefficients of 0.95,0.96,and 0.98,and the Kendall's coefficients of concordance of 0.165,0.209,and 0.220,respectively(all P<0.001).The established nursing quality evaluation system included 3 first-level indexes,15 second-level indexes,and 67 third-level indexes. Conclusion The whole-course nursing quality evaluation system for liver transplantation in children that was built in this study can provide a basis for the evaluation of the nursing quality.

A cross-sectional study of the relationship between premenstrual syndrome and missed nursing care among female nursing staff.

Purpose: Premenstrual syndrome (PMS) is a cyclical psychosomatic disorder prevalent among women of reproductive age. However, research on the potential impact of PMS on routine nursing schedules and activities is limited. This study aims to identify the prevalence of PMS among female nursing staff and to examine the relationship between PMS and missed nursing care (MNC). Method: Between November 1, 2022, and April 30, 2023, this study was conducted among female nursing staff working in nine inpatient departments at Sun Yat-sen University Cancer Center. This study used a cross-sectional design. The participants were recruited through convenience sampling. Data were collected using the standardized Menstrual Distress Questionnaire, the Oncology Missed Nursing Care self-rating scale, and a sociodemographic questionnaire. One-way analysis of variance, Fisher's least significant difference test for post-hoc comparisons, and Spearman's correlation coefficient were utilized for data analysis. A trend test was also performed to explore patterns in the severity of PMS and MNC over time. Results: We collected a total of 224 questionnaires, with 154 (68.7%) female nursing staff reporting PMS. The most common symptoms were low back pain (91.1%), abdominal discomfort (90.6%), cold hands and feet (87.1%), and lethargy (87.1%). Moreover, 91.5% of the 224 female nursing staff reported at least one MNC activity. The nursing activities most frequently missed or left incomplete were liquid intake and output monitoring as ordered (43.3%), medication administration within 30 min before or after the scheduled time (43.3%), and electrocardiogram monitoring as ordered (42.9%). "Abdominal discomfort" from the Menstrual Distress Questionnaire was significantly correlated with the majority of MNC activities (p < 0.001). Conclusions: This study provides evidence for a strong association between PMS and MNC among female nursing staff, suggesting that administrators should take the premenstrual conditions of female nursing staff into consideration. It is necessary to provide appropriate understanding and support to mitigate the impact on patient care and safety.

Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care.

BACKGROUND: Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. METHODS: We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. RESULTS: Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety. CONCLUSIONS: The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units.

Patients' Perception Towards Quality of Nursing Care and Associated Factors at Agaro General Hospital, Southwest Ethiopia: A Cross-Sectional Study.

Introduction: Quality care is currently on the agenda of policy-makers at national and international levels. Patient-centeredness is considered an integral component of healthcare quality dimensions in addition to its effectiveness and safety. This indicates that healthcare should be viewed from a patient's perspective. Methods and Materials: An institution-based cross-sectional study was conducted with a total sample size of 422 using systematic random sampling among patients admitted to the Agaro General Hospital. SPSS software version 25.0 was used to enter and analyze the data. The relationship between the dependent variable and covariates was determined using multivariable binary logistic regression analysis. Results: A total of 405 patients participated in this study with a response rate of 96.0%. The overall percentage of positive perception was 76.3%. Clients aged 31-40 years were more likely [AOR: 2.191, 95% CI: 1.033-4.645, p-value: .041] and clients aged ≥ 51 years were less likely to perceive positively [AOR: 0.490, 95% CI: 0.271-0.886, p-value: .018]. Patients who had paid for receiving care were more likely to perceive it positively [AOR: 3.046, 95% CI 1.043-8.896, p-value: .042]. The odds of positive perception towards the quality of nursing care were higher among patients who thought the hospital cost was medium [AOR: 3.066, 95% CI: 1.286-7.311, p-value: .012], low [AOR: 13.859, 95% CI: 2.245-85.562, p-value: .005], and uncertain [AOR: 6.116, 95% CI: 1.988-18.809, p-value: .002]. Conclusion and Recommendations: Most patients had a positive perception of the quality of nursing care. Being elderly and feeling towards hospital costs have a negative influence whereas having paid for the treatment has a positive influence on the patients' perception of nursing care. Hence the need increases with age, and healthcare providers should pay great attention while providing care for elderly patients.

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic.

Purpose: This study explores the effect of working duration on nurses and their ill-being (ie, anxiety, depression, fatigue, and sleepiness), intention to leave, and the quality of nursing care. Methods: A questionnaire survey was employed for a convenience sample of 400 nurses at Malacca General Hospital in Malaysia who voluntarily participated in this cross-sectional study. The Statistical Package for the Social Sciences (SPSS) was used to treat and analyze the data. Descriptive statistics were generated, and Post Hoc analyses and ANOVA tests were conducted. Results: Findings indicated that working hours duration was significantly associated with nurses' anxiety (F (4, 394) = 10.362, p <0.001), depression (F (4, 395) = 23.041, p< 0.001), fatigue (F (4, 395) = 24.232, p< 0.001), sleepiness (F (4, 395) = 4.324, p < 0.002), quality of nursing care (F (4, 395) = 16.21, p <0.001) and intention leave their job, (F (4, 395) = 50.29, p <0.001). The results also revealed that working more than 14 hours was negatively associated with their perceived quality of nursing care and positively associated with their perceived ill-being and intention to leave. Conclusion: Shift length is an important issue, and nursing managers must consider shift length as it can adversely correlate with the nurses' perceptions of work and life.

Elements of patient satisfaction: An integrative review.

AIM: To summarize the scientific literature on the elements essential to understanding a nursing definition of patient satisfaction. DESIGN: Whittemore and Knafl's methodology was used for this integrative review. METHODS: Articles were included if the studies they explored patient satisfaction in patient populations and measured patient satisfaction using standardized, validated instruments. Elements in this review were defined as the essential components that create the complex concept of patient satisfaction. RESULTS: Thirty articles were found and analysed in full. Five definitions of patient satisfaction were used, all of which were at least 20 years old. Twenty-two different measures of patient satisfaction were used, six of which were nursing-specific. Sixty-eight elements of patient satisfaction were studied in the included articles. Forty-three elements were reported as having a significant relationship with patient satisfaction, 25 were reported as having no significant relationship. Eight elements had both significant and non-significant relationships.

High-Risk Symptom Cluster Groups for Work-Life Quality and Turnover Intention among Nurses.

This cross-sectional study aims to identify high-risk symptom cluster groups for assessing the quality of nursing work life (QNWL) and turnover intention among Korean nurses who have experienced workplace violence. Nurses were recruited for an online survey in May 2021 (n = 203). The following four symptom clusters are extracted: (a) depression-anxiety, (b) shame-somatization, (c) nightmare-loss of appetite, and (d) anger-shock. Three symptom cluster groups were identified. Group 1 had the highest score for the anger-shock symptom cluster, as well as the highest symptom scores and turnover intention. Group 2 had the highest score for the nightmare-loss of appetite symptom cluster and the lowest QNWL. Group 3 had a similar symptom cluster pattern to Group 1 but lower scores for all symptom clusters. Symptom monitoring and programs tailored to symptom cluster groups at the institutional level could be useful for managing QNWL and turnover intention.

Inpatient Satisfaction with Nursing Care and Its Impact Factors in Chinese Tertiary Hospitals: A Cross-Sectional Study.

AIMS: To evaluate the level of patient satisfaction with nursing care in China's major tertiary hospitals, and to explore patient and hospital level factors associated with patient satisfaction, in order to provide policy implications for the evaluation and improvement of nursing care, toward a patient-centered healthcare system. BACKGROUND: Patient satisfaction with nursing care has been designated as a key measure of the quality of nursing care and is one of the main focuses of the current healthcare improvement campaign in China. METHODS: We participated in the 2021 China National Patient Survey and designed and administered a survey instrument with five domains, to evaluate patient satisfaction with nursing care among 24,971 inpatients from 143 tertiary hospitals across 31 provinces in China. Descriptive analysis and binary logistic regressions were utilized to assess the level of satisfaction and identify key factors related to nursing satisfaction. RESULTS: The overall satisfaction level is high, but satisfaction with health guidance is relatively low. Patients' sociodemographic characteristics, including age, income, and education, are significantly associated with their satisfaction. Hospital characteristics, such as geographic location, type, and nurse-to-doctor ratio, significantly impact inpatient satisfaction with nursing care. Patients of hospitals in the eastern region, general hospitals, and hospitals with higher nurse-to-doctor ratios are more satisfied with nursing care. CONCLUSION: More attention should be paid to equitably allocating healthcare resources among different regions, improving the management and competence of non-general hospitals, and strengthening the recruitment and retention of the nursing workforce. Moreover, patient characteristics should be considered when evaluating patient satisfaction across hospitals. Patient and Public Contribution: These findings will help us better understand patients' satisfaction regarding nursing care in Chinese tertiary hospitals and develop targeted interventions, to establish a patient-centered healthcare system.

Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach.

BACKGROUND: Nursing workload and its effects on the quality of nursing care is a major concern for nurse managers. Factors which mediate the relationship between workload and the quality of nursing care have not been extensively studied. This study aimed to investigate the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and quality of nursing care. METHODS: In this cross-sectional study, 311 nurses from four different hospitals in center of Iran were selected by convenience sampling method. Six self-reported questionnaires were completed by the nurses. The data were analyzed by SPSS version 16. Structural equation modeling was used to determine the relationships between the components using Stata 14 software. RESULTS: Except direct and mutual relationship between workload and quality of nursing care (P ≥ 0.05), the relationship between other variables was statistically significant (P < 0.05). The hypothesized model fitted the empirical data and confirmed the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and the quality of nursing care (TLI, CFI > 0.9 and RMSEA < 0.08 and χ2/df < 3). CONCLUSION: Workload affects the quality of the provided nursing care by affecting implicit rationing of nursing care, job satisfaction and emotional exhaustion. Nurse managers need to acknowledge the importance of quality of nursing care and its related factors. Regular supervision of these factors and provision of best related strategies, will ultimately lead to improve the quality of nursing care.

[Construction of Nursing Quality Index System in Assisted Reproduction Hospitals Based on the Model of "Three-Dimensional Quality Structure"].

Objective To construct a nursing quality index system for the assisted reproduction hospitals integrating outpatient department,wards,and operating rooms and provide a reference for the application of the system in the quality control of clinical reproductive care. Method On the basis of Donabedian's health care quality model of structure-process-outcome,we established a nursing quality index system for assisted reproduction hospitals via literature retrieval,semi-structured interviews,Delphi method,and analytic hierarchy process. Results The two rounds of expert's questionnaire survey demonstrated the response rates of 100% and 92%,the expert authority coefficients of 0.911 and 0.919,and the Kendall coefficients of concordance of 0.228 and 0.253,respectively (all P<0.001).The nursing quality index system for assisted reproduction hospitals was established,which consisted of 3 first-level indicators,13 second-level indicators,and 39 third-level indicators. Conclusion The nursing quality index system of assisted reproduction hospitals is comprehensive,systematic and reasonable,which can be used as quality management standard and provide a reference for clinical application.

Iranian nurses' knowledge and attitude toward complementary and alternative medicines: Is there any relation with quality of nursing care?

Background: Nurses play an important role in advising and guiding patients on effective treatments, and in this situation, it is better to be aware of complementary and alternative medicine (CAM) as well as the effects and side effects of different procedures. In addition, the quality of nursing care is directly related to the nurse's knowledge of the different treatments and preventions of different diseases and conditions. The present study aimed to investigate Iranian nurses' knowledge and attitude toward complementary and alternative medicines (CAMs) as well as their correlation with the quality of patient care. Materials and methods: This cross-sectional study included 267 clinical nurses from three hospitals in southern Iran. The participants were recruited using convenience sampling methods in 2020-2021. A demographic questionnaire, knowledge and attitude toward CAM questionnaires, and the Quality Patient Care Scale were used to collect data. Results: The mean score of CAM knowledge was 26.51, which was less than the questionnaire midpoint of 39. The mean score of attitudes toward CAM was 63.84, which was more than the questionnaire midpoint of 57. The mean score of the quality of patient care was 197.80, which was more than the questionnaire midpoint of 130. There was no significant correlation between knowledge about CAM, quality of patient care, and its dimensions. In addition, there was no significant correlation between attitudes toward CAM, quality of patient care, and its dimensions (P > 0.05). Conclusion: The results of the present study showed that nurses' attitudes toward the use of CAM are positive and can be a sign of their readiness to use and further integrate clinically approved CAM in patient nursing care. Due to the role of nurses in patient care and treatment, there is a need to increase nurses' knowledge of CAM, and its training should be included in the nursing curriculum. More studies are needed to identify nurses' knowledge and attitudes toward CAM and its impact on the quality of nursing care.

The Relationship Between Nursing Care Delivery Models, Emotional Exhaustion, and Quality of Nursing Care Among Jordanian Registered Nurses.

Background: Inappropriately selected models of nursing care delivery and emotional exhaustion of nurses at work not only affect the nurses' health, but also the health of their patients. Purpose: To examine the relationship between nursing care delivery models, nurses' emotional exhaustion, and quality of nursing care. Methods: A cross-sectional survey that used a convenience sampling technique was employed. A total of 160 participants completed the study. Participants provided information about nursing care delivery models, nurses, emotional exhaustion, and quality of nursing care. Results: Participants had a moderate level of emotional exhaustion. No statistically significant difference in the scores of quality of nursing care and emotional exhaustion were found according to the type of care delivery model (P > .05). Emotional exhaustion was significantly and negatively correlated with the (nursing staff characteristics) subscale of quality of nursing care (r = -.183, P = .021). There was a significant difference in emotional exhaustion in regard to shift duty, marital status, education level, years of experience, salary, and working area). Only marital status significantly predicted emotional exhaustion (t = 2.57, B = -8.98, P = .011). Conclusions: Quality of nursing care was associated with nurses' emotional exhaustion rather than models of nursing care delivery. As nurses' emotional exhaustion could negatively affect the quality of nursing care, addressing the emotional exhaustion of nurses is important to improve patient outcomes.

Evidence of the Association between Nurse Staffing Levels and Patient and Nurses' Outcomes in Acute Care Hospitals across Japan: A Scoping Review.

We aimed to summarize the evidence of an association between nurse staffing and nursing sensitivity outcomes in Japanese hospitals. A scoping review was conducted and reported following the PRISMA-SR 2020 statement. The ICHUSHI and CiNii databases were searched for published articles written in Japanese and PubMed and CINAHL for those written in English. Out of the 15 included studies, all observational studies, 3 were written in Japanese and the others in English. The nurse staffing level measures were grouped into three categories: patient-to-nurse ratio, nursing hours per patient day, and nurse-to-bed ratio. The outcome measures were grouped into three categories: patient outcome, nursing care quality reported by nurses, and nurse outcome/nursing care quality. Some studies reported that the nursing staff increasingly favored positive patient outcome. Conversely, the findings regarding failure to rescue, in-hospital fracture, and post-operative complications were inconsistent. Although some studies indicated that more nurse staffing was favored toward better patient and nurse outcomes, due to the sparse accumulation of studies and heterogeneity among the findings, it is difficult to draw robust conclusions between nurse staffing level and outcomes in Japanese acute care hospitals.

Abuse and neglect of older people in health facilities from the perspective of nursing professionals: A cross-sectional study from Croatia.

BACKGROUND: Abuse and neglect of older people represent a salient public health issue that remains understudied in the current literature. However, most studies have focused on estimating the prevalence of mistreatment of older people, while litter priority has been put on healthcare professionals and their role in addressing this problem. OBJECTIVES: The aim of this paper was to determine nurses' perceptions of neglect and abuse of older persons within health facilities in Croatia. METHODS: A cross-sectional survey with convenience sampling approach was conducted on 632 nursing professionals between 26 March and 26 April 2020. Participation was voluntary and anonymous. A questionnaire from Drennan et al. (NCPOP, University College Dublin, Dublin, 2012), previously adapted by Neuberg et al. (Arch Ind Hyg Toxicol, 68, 2017, 190), was used as a survey instrument. Descriptive and inferential statistics has been used, as well as multivariable methods (reliability analysis). Significance was set at p < .05 (two-tailed). RESULTS: Abuse/neglect of older people was observed by 13.8% to 57.4% of nursing professionals, depending on the incident type. The most prevalent incidents observed were ignoring the call of an older person (57.4%), shouting at an older person in anger (41.1%) and force-feeding an older person (34.5%), while the least prevalent incidents observed were denial of food or some privileges as a form of punishment (13.8%). Male nursing professionals reported observing various forms of abuse significantly more often than their female counterparts (p = .038), without statistically significant age-related differences. Furthermore, mistreatment of older people was much more frequently observed in nursing homes (p = .013), with suboptimal the ratio of caregivers and care recipients, as well as by nursing professionals who work in shifts (p = .012). Reliability analysis demonstrated a satisfactory level of internal consistency for the used questionnaire. CONCLUSIONS: This study reinforces neglect and abuse of older people as a growing public health problem and puts the emphasis on its perception; hence, there is a need for systematic and continuous training of nursing professionals on preventing, identifying and responding to such mistreatment, with the aim of enhancing the quality of life in this vulnerable group. IMPLICATIONS FOR PRACTICE: This study contributes to the growing body of research on the quality of evidence-based nursing care of older people, most notably from providers' perspective - with direct implications for policy, practice, research and training.

Caregivers' perception of the quality of nursing care in child health care services of the University College Hospital, Nigeria.

The health care system has increasingly emphasized consumers' satisfaction in developing models of health care quality. Among health professionals, nurses spend more time with patients, hence, the measure of consumers' perception of quality nursing care is crucial. Children are vulnerable and unable to effectively express their views; hence, their caregivers often serve as their decision makers.This study aimed to assess caregivers' perception of the quality of nursing care in child health care services. A descriptive cross-sectional survey was conducted using a stratified sampling technique to recruit 308 caregivers attending Immunization and Child welfare clinics of University College Hospital, Nigeria. Participants were surveyed using an adapted version of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) which was analyzed using descriptive and inferential statistics at a 0.05 level of significance. A large percentage of the caregivers were female (86.9%)."Concern and caring by the nurses", "recognition of carers' needs", "coordination of care" and "privacy" were perceived to be fair (50.2%, 54.9%, 56.3%, 57%) while "clarity about instructions given", "helpfulness", "skill and competence" were perceived to be good (61.7%, 56.3%, 63.8%).The age, occupation, and marital status of the caregivers had a significant association with their perception of nursing care (p<0.05). The attitudes of nurses regarding concern, caring and privacy were perceived to be fair as compared with the skill and competence of nurses which were perceived to be good. Although caregivers had an overall average perception of quality of nursing care, more efforts should be geared towards improving on areas that were fair, like care and concern, courtesy, friendliness, and kindness, which are central to nursing as a caring profession. Good interpersonal relationships and acknowledgment of caregivers as decision-makers in health care which were perceived to be inadequate in this study are key factors that drive a good perception of quality nursing care. Nurses must continue to provide inclusive quality care where caregivers are seen as significant contributors to health care.

A systematic review: Unfinished nursing care and the impact on the nurse outcomes of job satisfaction, burnout, intention-to-leave and turnover.

AIM: To investigate the association of unfinished nursing care on nurse outcomes. DESIGN: Systematic review in line with National Institute for Health and Care Excellence guideline. DATA SOURCES: CINAHL, the Cochrane Library, Embase, Medline, ProQuest and Scopus databases were searched up until April 2020. REVIEW METHODS: Two independent reviewers conducted each stage of the review process: screening eligibility, quality appraisal using Mixed Methods Appraisal Tool; and data extraction. Narrative synthesis compared measurements and outcomes. RESULTS: Nine hospital studies were included, and all but one were cross-sectional multicentre studies with a variety of sampling sizes (136-4169 nurses). Studies had low internal validity implying a high risk of bias. There was also a high potential for bias due to non-response. Only one study explicitly sought to examine nurse outcomes as a primary dependent variable, as most included nurse outcomes as mediating variables. Of the available data, unfinished nursing care was associated with: reduced job satisfaction (5/7 studies); burnout (1/3); and intention-to-leave (2/2). No association was found with turnover (2/2). CONCLUSION: Unfinished nursing care remains a plausible mediator of negative nurse outcomes, but research is limited to single-country studies and self-reported outcome measures. Given challenges in the sector for nurse satisfaction, recruitment and retention, future research needs to focus on nurse outcomes as a specific aim of inquiry in relation to unfinished nursing care. IMPACT: Unfinished nursing care has previously been demonstrated to be associated with staffing, education and work environments, with negative associations with patient outcomes (patient satisfaction, medication errors, infections, incidents and readmissions). This study offers new evidence that the impact of unfinished nursing care on nurses is under investigated. Policymakers can prioritize the funding of robust observational studies and quasi-experimental studies with a primary aim to understand the impact of unfinished nursing care on nurse outcomes to better inform health workforce sustainability.

Association between work-related psychological empowerment and quality of nursing care among critical care nurses.

AIM: This study aimed to examine the association between work-related psychological empowerment and quality of nursing care in Jordanian critical care nurses. BACKGROUND: Nurses' work-related empowerment is the essential element to enhance nurses' quality of care. There are few studies about this area among critical care nurses. METHODS: A cross-sectional design was used, and data were collected from critical care registered nurses (N = 480) from different health sectors. RESULTS: The mean scores of work-related psychological empowerment and quality of nursing care were 5.22 (SD = 0.92) and 3.75 (SD = 0.62), respectively. The nurses had agreement level of psychological empowerment and very good level of quality of nursing care. There was a positive relationship between quality of nursing care and psychological empowerment. CONCLUSION: The need to enhance work psychological empowerment is necessary to improve quality of nursing care. IMPLICATION FOR NURSING MANAGEMENT: The results reflect the need for policy-makers and nursing managers to develop and implement strategies to promote psychological empowerment to provide high quality of nursing care among critical care nurses.

Adverse Events and Risk Management in Residential Aged Care Facilities: A Cross-Sectional Study in Hunan, China.

Purpose: Adverse events threaten residents' safety. Risk management is important to provide proper care and maintain quality in residential aged care facilities (RACFs). However, there is little data on adverse events, risk management, and risk early warning in RACFs in the Chinese mainland. This study aimed to fill this gap by investigating the prevalence of the aforementioned aspects and related factors in China. Participants and Methods: Using a cross-sectional design, a field survey of 272 RACFs in Hunan Province was conducted from January 25 to June 1, 2020. Data were collected using four main tools on prevalence of nursing adverse events, risk management, risk early warning, and general information. Descriptive statistics were described by frequency (percentage) and median (interquartile range). Mann-Whitney U-test and Kruskal-Wallis H-test, and Spearman coefficient were used for statistical analysis. Results: RACFs experienced an average of five (15) adverse events in 2019, with falls and pressure ulcers being the most common. The total average score of risk management in RACFs was 4.72 (0.98) out of 5, with the environment and personnel management dimensions scoring the highest with 4.75 (1) and the service management dimension scoring the lowest with 4.60 (1). Only 72.79% had trained their staff on ethical and legal knowledge and 84.56% had utilized pre-hospital first aid. Further, 30% to 40% were unprepared for contingency plans of suicide, electric shock, gas poisoning, and drowning. There were significant risk management differences among the following variables: facilities' locations, accreditation with the Practice Certificate of Social Welfare Facilities, bed-size, nursing hours per resident day, requirement for nursing staff with certificates, and payment for nursing staff (p < 0.05). Conclusion: RACFs are facing safety challenges with a high prevalence of nursing adverse events. These facilities need to improve risk early warning and management to ensure residents' safety.

Correlation between the quality of nursing handover, job satisfaction, and group cohesion among psychiatric nurses.

BACKGROUND: Nursing handovers are a critical component of patient safety. Researchers have performed many primary studies in this field, mainly reporting findings from changes in nursing handover patterns. However, few quantitative studies have explored the factors that influence handover quality. Therefore, this study aimed to investigate the quality of handovers and explore the associations between handover quality, job satisfaction, and group cohesion among psychiatric nurses. METHODS: This cross-sectional study included 186 registered psychiatric nurses from a Chinese hospital, who responded to the Handover Evaluation Scale, McCloskey/Mueller Satisfaction Scale, and Group Cohesion Scale. Bootstrap analyses were used to evaluate the mediating effect between variables. RESULTS: The average item score for handover quality was (5.85 ± 1.14), and job satisfaction and group cohesion could predict the variance of handover quality. Job satisfaction could partially mediate between group cohesion and handover quality, and the value of the mediating effect was 45.77%. CONCLUSION: The quality of psychiatric nursing handovers has enhanced space. Thus, hospital managers should take various measures to strengthen group cohesion and promote job satisfaction, both of which help improve the quality of psychiatric nursing handovers.