Federated blockchain system (FBS) for the healthcare industry.

Blockchain is a distributed technology that introduced the well known Bitcoin cryptocurrency into action. Blockchain has been considered for research by many countries and industries. It is being applied in many fields such as the healthcare domain. Many companies started using Blockchain to increase the security and privacy of the Electronic Healthcare Records for their patients. The work in this paper discusses some existing healthcare problems and challenges. In addition, the paper reviews some related work models and provides a comparison that shows their objectives and limitations. Also, a proposed Federated Blockchain System (FBS) is introduced to provide solutions for these healthcare problems and elaborates the technical details of the system architecture. Moreover, the effectiveness of the system has been validated which showed an average of 68-100 ms for performing query operations and average of 0.944-19.041 s for performing writing operations on the system. Finally, a discussion of the system validation and future work are presented.

Influence of nurses' perception of organizational climate and toxic leadership behaviors on intent to stay: A descriptive comparative study.

Background: Nursing managers and leaders must fight to retain nurses in hospitals by constructing an inviting organizational climate that is attractive to work in, not toxic. The organizational climate is primarily affected by employees' internal work environment and behavior. Hence, nursing managers and leaders must implement effective strategies to increase nurses intention to stay by address the organizational climate. Aim: This study was designed to assess nurses' perception of the effects of organizational climate and toxic leadership behaviors on their intention to stay and the differences in these domains between the two hospitals studied. Methods: A descriptive comparative design was used. Data were collected in 2022 from 250 nurses working in the two largest hospitals in Assiut, an Egyptian city south of Cairo, using three self-administered questionnaires: the organizational climate questionnaire (42 items categorized into nine domains), the toxic leadership scale (30 items categorized into five domains), and the Chinese version of the intent-to-stay scale. Results: Most nurses reported their intention to stay as "normal." The nurse participants perceived that a positive organizational climate was not present, but toxic leadership was at a low level (13.6% and 25.6%, respectively). The model of regression analysis was significant, showing that the organizational climate represented by supportive systems impacted nurses' intention to stay in the hospitals under study. Meanwhile, toxic leadership behaviors, represented by authoritarian leadership, unpredictability in the university hospital, and self-promotion in the insurance hospital, affected nurses' intention to stay. Conclusion: Positive organizational climate played a significant role in retaining nurses through investing in incentives and providing supportive systems. Authoritarian leadership, unpredictability, and the self-promotion of leaders' behaviors impacted the nurses and the climate negatively. Hence, we recommend investing in potential strategies to improve the nurses' intention to stay through performance standards, increased pay and benefits, clear reward mechanisms, participation in decision making, and assessments of leaders' behaviors. Furthermore, decision and policy makers need to establish effective, supportive systems in hospitals to retain nurses. Hence, nursing managers and leaders must rethink how they can use their leadership skills and behavior in a positive manner to promote nurse retention. Study registration: Not registered.

Management of the COVID-19 pandemic: challenges, practices, and organizational support.

BACKGROUND: Health organizations currently face tremendous challenges in the management of the COVID-19 pandemic. To do this, successful and proven scientific practices and support are needed. AIM: This study aimed to explore the challenges, practices, and organizational support dealt with by nursing managers in the management of the COVID-19 pandemic. METHOD: A qualitative content analysis study evaluated 35 nursing managers in five university hospitals through a semi-structured interview. The Consolidated Criteria for Reporting Qualitative Research were used for this qualitative study. RESULTS: Three main themes emerged: Challenges include the development of a COVID-19 crisis management plan, a shortage in nursing staff, and psychological problems. Practices include; changes in work schedules for nursing staff, the exchange process, hospital preparation, and training and education. And organizational support includes both support at an organizational level and support at an individual level. CONCLUSION: This study revealed that nursing managers are faced with many challenges in the management of COVID-19, requiring good practices and organizational support. This study offers evidence for nursing managers to expect problems that may arise during the pandemic. RECOMMENDATIONS: The COVID-19 pandemic requires the development of an integrated plan, and this plan must be disseminated to the hospital's nursing and medical teams to better equip them for the current and future crises.

Studying nursing activities in inpatient units: a road to sustainability for hospitals.

BACKGROUND: Since the United Nations has adopted the Sustainable Development Goals in 2015, sustainability has been increasingly considered. Working time is an important resource (time is money), as well as the nurses inside hospitals. So, nursing activities must be studied and analyzed well. Consequently, the resulting information gives hospital managers a clear picture of the current status-the basics of developing plans for sustainability and keeping pace with developed countries. AIM: This study was designed to study nursing activities performed in inpatient units and to determine which types of nursing activities are the most frequent and time-consuming, how much time each category of nursing personnel spends in different activities, and how units divide their time between patient care and other activities. METHOD: A work sampling method was used on 36 nurses in six units for three successive years, using two tools: a demographic data sheet and guidelines for the level of activities and area of activities. RESULTS: There were 5,184 observations per year. According to area of activities, personal, and patient activities were the most time-consuming and frequent. According to the level of activities, unclassified and nursing activities were the most time-consuming among the intensive care, medical, and surgical units under study (44.1%, 41.6%, and 55.2%, respectively, and 28.2%, 34.8%, and 28.3%, respectively). The work of technical and diploma nurses was similar. CONCLUSION: Personal, unclassified, and patient activities consumed a large portion of nursing hours during the morning shift. Meanwhile, unit and personnel activities have consumed a minimal portion of hours. No significant differences in work were observed between technical and diploma nurses. RECOMMENDATIONS: Nursing managers and leaders should take a step to improve sustainability in their hospitals through study the nursing activities to gather data to develop plans for the future and rearrange the entire nursing staff in hospital units according to the needs of each shift.

Effect of nurses' perception to workplace civility climate on nurse-physician collaboration.

AIMS: To assess the effect of nurses' perception to workplace civility climate on nurse-physician collaboration and determine whether the largest contributor to changing the climate of the workplace are the employees or top management. DESIGN: This study used non-experimental descriptive cross-sectional study design, which using purposive sample (139 nurses) working at Health Insurance Hospital. METHOD: The current study data were collected by using self-administered questionnaires including three tools: (a) a structured interview questionnaire includes personal data; (b) perceived workplace civility climate scale (15 items); and (c) Nurse Physician Collaboration Scale (27 items). RESULTS: Main result of this study reveals that there was a positive statistically significant correlation between workplace civility climate and collaboration (0.208* ). Studied nurses were perceived top management with the high score (87.5) than employees (65.2). CONCLUSION: Workplace civility climate was demanded for well collaboration between nurses and physicians to provide high-quality services; when nurses and physicians have increase chance to work in civility climate, combining with response to incivility and low intolerance for it, they will be more collaborated. RECOMMENDATION: Policies and procedures are very important in healthcare settings to address uncivil actions and establish a civilized climate.

The attitudes of healthcare professionals towards nurse-physician collaboration.

AIMS: The current study aims to examine the attitudes of healthcare professionals towards nurse-physician collaboration and to explore the level of satisfaction concerning the quality of collaboration among them. DESIGN: A descriptive comparative study design was used to demonstrate attitudes of 338 participants (158 internship nurses, 139 nurses and 41 physicians) working in intensive care units, surgical department and medical department. METHODS: Two instruments were used, socio-demographic data sheet and Jefferson scale of attitude towards nurse-physician collaboration (JSANPC), it consisted of 15 items under 4 dimensions. RESULTS: The internship nurses have the high score (38.6%) in poor level of satisfaction regarding quality of collaboration between nurses and physicians comparing to staff nurses and physicians. Physicians are satisfied (61%) with the level of collaboration between them and nurses. Staff nurses have the high positive attitude (48.45 (4.03)) towards collaboration between nurses and physicians comparing to physicians and internship nurses. CONCLUSION: Internship nurses were not satisfied with the level of collaboration between nurses and physicians.