Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design.

AIM: To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops. DESIGN: A Quasi-experimental design. METHOD/SETTING/PARTICIPANTS: Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken. RESULTS: There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention. STUDY REGISTRATION: Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

A conflicted tribe under pressure: A qualitative study of negative workplace behaviour in nursing.

AIM: This study explored workplace interactions of Australian nurses in regional acute care hospitals through an examination of nurses' experiences and perceptions of workplace behaviour. DESIGN: This research is informed by Social Worlds Theory and is the qualitative component of an overarching mixed methods sequential explanatory study. METHODS: Between January and March 2019, data were collected from 13 nursing informants from different occupational levels and roles, who engaged in semi-structured, in-depth, face-to-face interviews. Data analysis was guided by Straussian grounded theory to identify the core category and subcategories. RESULTS: Theoretical saturation occurred after 13 interviews. The core category identified is A conflicted tribe under pressure, which is comprised of five interrelated subcategories: Belonging to the tribe; 'It's a living hell'; Zero tolerance-'it's a joke'; Conflicted priorities; Shifting the cultural norm. CONCLUSION: This study provides valuable insight into the nursing social world and the organizational constraints in which nurses work. Although the inclination for an individual to exhibit negative behaviours cannot be dismissed, this behaviour can either be facilitated or impeded by organizational influences. IMPACT: By considering the nurses' experiences of negative workplace behaviour and identifying the symptoms of a struggling system, nurse leaders can work to find and implement strategies to mitigate negative behaviour and create respectful workplace behaviours. PATIENT OR PUBLIC CONTRIBUTION: This study involved registered nurse participants and there was no patient or public contribution. CLINICAL TRIAL REGISTRATION: Study registration Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

Tröger's Base Network Polymers of Intrinsic Microporosity (TB-PIMs) with Tunable Pore Size for Heterogeneous Catalysis.

Heterogeneous catalysis plays a pivotal role in the preparation of value-added chemicals, and it works more efficiently when combined with porous materials and supports. Because of that, a detailed assessment of porosity and pore size is essential when evaluating the performance of new heterogeneous catalysts. Herein, we report the synthesis and characterization of a series of novel microporous Tröger's base polymers and copolymers (TB-PIMs) with tunable pore size. The basicity of TB sites is exploited to catalyze the Knoevenagel condensation of benzaldehydes and malononitrile, and the dimension of the pores can be systematically adjusted with an appropriate selection of monomers and comonomers. The tunability of the pore size provides the enhanced accessibility of the catalytic sites for substrates, which leads to a great improvement in conversions, with the best results achieving completion in only 20 min. In addition, it enables the use of large benzaldehydes, which is prevented when using polymers with very small pores, typical of conventional PIMs. The catalytic reaction is more efficient than the corresponding homogeneous counterpart and is ultimately optimized with the addition of a small amount of a solvent, which facilitates the swelling of the pores and leads to a further improvement in the performance and to a better carbon economy. Molecular dynamic modeling of the copolymers' structures is employed to describe the swellability of flexible chains, helping the understanding of the improved performance and demonstrating the great potential of these novel materials.

Adjustable Functionalization of Hyper-Cross-Linked Polymers of Intrinsic Microporosity for Enhanced CO2 Adsorption and Selectivity over N2 and CH4.

In this paper, we report the design, synthesis, and characterization of a series of hyper-cross-linked polymers of intrinsic microporosity (PIMs), with high CO2 uptake and good CO2/N2 and CO2/CH4 selectivity, which makes them competitive for carbon capture and biogas upgrading. The starting hydrocarbon polymers' backbones were functionalized with groups such as -NO2, -NH2, and -HSO3, with the aim of tuning their adsorption selectivity toward CO2 over nitrogen and methane. This led to a significant improvement in the performance in the potential separation of these gases. All polymers were characterized via Fourier transform infrared (FTIR) spectroscopy and 13C solid-state NMR to confirm their molecular structures and isothermal gas adsorption to assess their porosity, pore size distribution, and selectivity. The insertion of the functional groups resulted in an overall decrease in the porosity of the starting polymers, which was compensated with an improvement in the final CO2 uptake and selectivity over the chosen gases. The best uptakes were achieved with the sulfonated polymers, which reached up to 298 mg g-1 (6.77 mmol g-1), whereas the best CO2/N2 selectivities were recorded by the aminated polymers, which reached 26.5. Regarding CH4, the most interesting selectivities over CO2 were also obtained with the aminated PIMs, with values up to 8.6. The reason for the improvements was ascribed to a synergetic contribution of porosity, choice of the functional group, and optimal isosteric heat of adsorption of the materials.

Creating Respectful Workplaces for Nurses in Regional Acute Care Settings: Protocol for a Sequential Explanatory Mixed Methods Study.

BACKGROUND: Negative workplace behaviour among nurses is an internationally recognised problem, despite the plethora of literature spanning several decades. The various forms of mistreatments and uncaring attitudes experienced by nurses include workplace aggression, incivility, bullying, harassment and horizontal violence. Negative behaviour has detrimental effects on the individual nurse, the organisation, the nursing profession and patients. Multi-level organisational interventions are warranted to influence the "civility norms" of the nursing profession. OBJECTIVE: The aim of this study is to investigate the self-reported exposure to and experiences of negative workplace behaviours of nursing staff and their ways of coping in regional acute care hospitals in one Local Health District (LHD) in NSW before and after Respectful Workplace Workshops have been implemented within the organisation. METHODS: This study employs a mixed methods sequential explanatory design with an embedded experimental component, underpinned by Social World's Theory. This study will be carried out in four acute care regional hospitals from a Local Health District (LHD) in New South Wales (NSW), Australia. The nurse unit managers, registered nurses and new graduate nurses from the medical and surgical wards of all four hospitals will be invited to complete a pre-survey examining their experiences, perceptions and responses to negative workplace behaviour, and their ways of coping when exposed. Face-to-face educational workshops will then be implemented by the organisation at two of the four hospitals. The workshops are designed to increase awareness of negative workplace behaviour, the pathways to seek assistance and aims to create respectful workplaces. Commencing 3 months after completion of the workshop implementation, follow up surveys and interviews will then be undertaken at all four hospitals. RESULTS: The findings from this research will enhance understanding of negative workplace behaviour occurring within the nursing social world and assess the effectiveness of the LHD's Respectful Workplace Workshops upon the levels of negative workplace behaviour occurring. By integrating qualitative and quantitative findings it will allow for a dual perspective of the social world of nurses where negative and/or respectful workplace behaviours occur, and provide data grounded in individuals lived experiences, positioned in a macro context. CONCLUSIONS: It is expected that evidence from this study will inform nursing practice, and future policy development aimed at creating respectful workplaces. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; 14 December 2018). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/18643.

Negative workplace behavior and coping strategies among nurses: A cross-sectional study.

Negative workplace behavior affecting nurses is an internationally recognized problem. This study examines the types and extent of negative workplace behavior experienced by nurses in non-metropolitan, regional acute care settings and their ways of coping when subject to that behavior. A cross-sectional study was conducted involving 74 nurse participants in four regional hospitals in Australia. The structured questionnaire consisted of four parts: demographic questions, the Negative Acts Questionnaire - Revised, questions on exposure to bullying and/or incivility and policy awareness and use of pathways, and the Ways of Coping Questionnaire. Overall, 34% of participants were exposed to bullying and 49% to incivility over the previous month. The most common type of negative workplace behavior reported was "work-related bullying," which included exposure to excessive workloads, unrealistic deadlines, and information being withheld. Nurses reported the use of a variety of coping mechanisms, including problem-focused coping strategies and seeking social support. The findings imply that negative workplace behaviors occur not only at individual nurses' level but also derive from the broader contexts of organizational management and systemic factors.

New graduate registered nurses' exposure to negative workplace behaviour in the acute care setting: An integrative review.

BACKGROUND: Negative workplace behaviour among nurses is a globally recognised problem and new graduate nurses are at high risk for exposure. Negative behaviour has detrimental effects on new graduate nurses, the nursing profession and patients. OBJECTIVES: To synthesise evidence on negative workplace behaviour experienced by new graduate nurses in acute care setting and discuss implications for the nursing profession. DESIGN: An integrative review guided by Whittemore and Knafl's (2005) framework. DATA SOURCES AND REVIEW METHODS: A search of evidence-based research from five electronic databases (CINAHL, MEDLINE, ProQuest, JBI and Scopus) was conducted for the period of 2007-2017. Eligible articles were critically appraised using the Mixed Methods Appraisal Tool. RESULTS: Eight qualitative and eight quantitative studies were identified and reviewed. There was a variety of terms and definitions used to describe the disrespectful, unprofessional and uncivil targeted behaviour towards new graduate nurses. The incidence of negative workplace behaviour varied from 0.3% as a daily occurrence to 57.1% experiencing sporadic exposure. The precipitating factors included the new graduates' perceived lack of capability, magnifying power and hierarchy, leadership style and influence of management. The negative behaviour was identified as either a personal or professional attack, which left new graduates feeling emotional distress, anxiety or depression, which in turn impacted upon job satisfaction, cynicism, burnout, and intention to leave. The lack of a definitional consensus and the range of negative workplace behaviour make identification, seeking assistance and intervention difficult. Specific or ongoing organisational support to address negative behaviours towards new gradute nurses was not identified. Instead, the way they used to deal with these behaviours were personal. CONCLUSION: Negative workplace behaviour towards new graduate nurses continues to be an international problem. Available studies are descriptive and exploratory in nature and there have been few effective strategies implemented in acute care setting to address towards new graduate nurses. Multi-level organisational interventions are warranted to influence the 'civility norms' of the nursing profession. With a new understanding of the theoretical underpinnings of negative workplace behaviours towards new graduate nurses and the identification of limited intervention studies being undertaken, the nursing profession is provided with new directions in their future endeavours.

Coming ready or not! An integrative review examining new graduate nurses' transition in acute care.

AIMS: To synthesize the scientific evidence about new graduate nurses' transition to practice in the acute care setting and consider implications for nurses and nursing practice. BACKGROUND: Despite the vast amount of literature on new graduate nurses' transition to practice, the transition of new graduate nurses is a global issue and remains at the forefront of discussions within the nursing community. DESIGN: An integrative review. REVIEW METHODS: A search of evidence-based research from seven electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, Wiley, and Scopus) was conducted for the period of 2006-2016. Eligible articles were critically reviewed and scored using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Twenty-six articles were reviewed, which included 19 qualitative, five quantitative, and two mixed methods studies. "The Experiences" are described in three themes: Dominated by fear but feeling a sense of accomplishment and satisfaction; Reality vs Idealism; and Adjusting to nursing life. "The Factors" are described under three themes: Personal, Professional, and Organizational. CONCLUSION: The transition experience of new graduate nurses is complex and multidimensional and highlights that "it takes a village" to grow and support new graduate nurses.

Factors associated with prolonged anesthesia recovery following laparoscopic bariatric surgery: a retrospective analysis.

BACKGROUND: Phase I postanesthesia recovery is often prolonged after laparoscopic bariatric surgery. We hypothesized that postoperative respiratory depression is a major contributor to this delayed recovery. METHODS: Medical records of all patients who had a laparoscopic bariatric surgical operation from January 1, 2009, to December 31, 2012, were reviewed for clinical, anesthetic, and postanesthesia variables. Recoveries were defined as discharge from the recovery room in ≤90 min and in >90 min (prolonged postanesthesia recovery). We compared characteristics of patients without prolonged recovery to those with prolonged recovery. RESULTS: Of 781 bariatric patients, 304 (38.9 %) had prolonged recovery. These patients had more respiratory depression (29 vs 6 patients), more postoperative nausea and vomiting (106 vs 92 patients), more treatments of hypertension in the recovery room (49 vs 33 patients), and more opioid treatment (median intravenous morphine equivalents [interquartile range], 10.0 [3.0-15.0] vs 5.0 [0.0-10.5]) (P < 0.001 for all). On multivariable analysis, preoperative history of hypertension (P = 0.03), fewer prophylactic antiemetics received (P = 0.02), and longer surgical duration (P = 0.03) were associated with prolonged postanesthesia recovery. CONCLUSIONS: Inadequate antiemetic prophylaxis and the treatment of postoperative hypertension were associated with prolonged postanesthesia recovery. Surprisingly, diagnosis of obstructive sleep apnea was not associated with prolonged recovery, which may be attributable to use of continuous positive airway pressure devices following emergence from anesthesia. Prolonged recovery in patients treated for hypertension may be related to institutional guidelines that require additional monitoring time after these medications are administered.