Relationship between Structural Empowerment and Nurse and Patient-Reported Outcomes: The Mediating Role of Control over Nursing Practices.

Practices that strengthen nurse work environments and enable them to have control over nursing practices have gained importance in recent years as they increase nurses' retention and patient care quality. This study aimed to examine the relationships between structural empowerment and nurse and patient-reported outcomes and the mediating role of control over nursing practices in these relationships. This correlational and cross-sectional study was carried out from September 2018 to May 2019 at two public hospitals in Turkey. We recruited staff nurses (n = 319) working in the inpatient units of these hospitals and their patients (n = 319). Data were collected using self-report measures from staff nurses and patients. It was determined that structural empowerment and control over nursing practices had a positive relationship with job satisfaction and nursing care quality, as well as a negative relationship with intention to turnover; however, there was no relationship with patient-reported outcomes. Control over nursing practices partially mediated the relationship between structural empowerment and outcomes of job satisfaction and nursing care quality. This study indicates that promoting the structural empowerment of nurses and ensuring that they have control over practice will increase job satisfaction and quality of care. Nurse managers can increase nurses' job satisfaction and quality of care by creating supportive work environments and ensuring they have control over nursing practices.

The relationship between nurses' perceived organisational, supervisor and coworker support, psychological well-being and job performance.

OBJECTIVE: To examine the relationship involving nurses' perception of organisational, supervisor and co-worker support, psychological well-being and job performance. METHODS: The cross-sectional, correlational study was conducted from June 2016 to January 2017 after approval from the ethics review committee of Istanbul Medipol University, Istanbul, Turkiye, and comprised nurses working in public or private sector and being in their current employment for at least one year. Data was obtained using Organisational Support, Co-Worker Support, Supervisor Support, Psychological Well-Being and Job Performance scales. Data was analyzed using SPSS 26. RESULTS: Of the 1056 nurses, 896(84.8%) were women and 160(15.2%) were men. The overall mean age was 30.69±7.53 years (range: 17-59 years) and mean professional experience was 9.31±7.66 years (range: 1-36 years). CONCLUSIONS: Organisational, supervisor and co-worker support increased psychological wellbeing. Supervisor and co-worker support had a positive effect on job performance, but organisational support did not. Psychological wellbeing also increased job performance. Psychological well-being had a mediating role in the effect of organisational, supervisor and co-worker support on job performance. There was a positive relationship between perceived support, psychological wellbeing and job performance of nurses.

Effect of Repeated Multipatient Simulations on Professional Readiness Among Senior Nursing Students.

BACKGROUND: Senior nursing students are expected to be ready in terms of professional decisions and practices as soon as possible after graduation. Quality and Safety Education for Nurses (QSEN) is a framework to prepare nursing students for practice in the health care system. PURPOSE: This study aimed to explore the effect of repeated exposure to multipatient simulations on senior nursing students' pregraduation transition views, QSEN knowledge level and self-competency, professional readiness, and postgraduation transition shock. METHODS: A randomized controlled trial of intervention and control groups with pretest, posttest, and a follow-up was conducted with 78 senior nursing students at a private, accredited, nursing program in Istanbul, Turkey. RESULTS: There was a statistically significant improvement in the intervention group between the pretest and the posttest for self-confidence ( P < .01), QSEN knowledge level ( P < .01), and professional readiness ( P < .01). The QSEN knowledge level ( P < .01) and professional competency ( P < .05) of the intervention group were higher than those of the control group. CONCLUSION: These results suggest that multipatient simulations may be an effective strategy to better prepare students for the health care system's demands.

The effect of talent management on the job satisfaction and organizational commitment of nurses.

AIM: To determine the effect of talent management on job satisfaction and organizational commitment of nurses and the mediating role of job satisfaction. BACKGROUND: Talent management plays a critical role in attracting, developing, and retaining nurses and is effective in the formation of job satisfaction and organizational commitment. METHODS: This correlational study sample consisted of 482 volunteering nurses who were selected through a convenience sampling method. Data were collected using an information form, the Talent Management Scale, the Minnesota Satisfaction Questionnaire, and the Organizational Commitment Scale. The data were analyzed using descriptive statistics, Pearson correlation analysis, single linear regression, and hierarchical regression analysis. The Baron and Kenny model was used to determine the mediation effect. FINDINGS: Talent management affected the intrinsic, extrinsic subdimensions of job satisfaction and the total score and the affective commitment, normative commitment, and continuance commitment significantly and positively. Job satisfaction had a full mediating role in the effect of talent management on affective commitment and continuance commitment and a partial mediating role in affecting normative commitment. CONCLUSION: Talent management in organizations can increase nurses' job satisfaction and organizational commitment and nurses' job satisfaction can play a mediating role in the effect of talent management on organizational commitment. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study demonstrates that nurse managers and decision-makers should adopt talent management practices in nursing. Desired results such as nurses' job satisfaction and organizational commitment can be achieved by focusing on the development of nurses' talents.

Atitudes de profissionais de enfermagem e produtividade em serviços de emergência em Istambul / Actitudes de los profesionales de enfermería y productividad en los servicios de urgencia en Estambul / Attitudes of nursing professionals and productivity in emergency rooms in Istanbul

Objetivo: analisar as atitudes em relação à produtividade de profissionais de enfermagem que atuam em serviços de emergência. Método: pesquisa transversal de abordagem quantitativa, realizada em fevereiro e março de 2020 com 204 profissionais de enfermagem de serviços de emergência de três hospitais em Istambul, Turquia. Os dados foram coletados por meio de questionário e Escala de Atitudes em Relação à Produtividade dos Profissionais de Enfermagem. Analisaram-se os dados com o programa Statistical Package for the Social Sciences. Resultados: as atitudes dos participantes em relação à produtividade ficaram parcialmente abaixo da média, sendo afetadas por fatores como escolaridade, escolha voluntária da profissão e satisfação com o trabalho. Conclusões: há necessidade de efetuar melhorias nos serviços de emergência para que os profissionais de enfermagem desenvolvam atitudes mais positivas em relação à produtividade, sendo sensibilizados à respeito da importância deste conceito.(AU)

Objective: to analyze attitudes towards the productivity of nursing professionals working in emergency rooms. Method: cross-sectional research with a quantitative approach carried out in February and March 2020 with 204 nursing professionals of emergency rooms from three hospitals in Istanbul, Turkey. Data were collected through questionnaire and Attitudes towards Nursing Professionals' Productivity Scale. Data were analyzed using the Statistical Package for the Social Sciences program. Results: participants' attitudes towards productivity were partially below average, and were affected by factors such as educational level, voluntary choice of the profession and job satisfaction. Conclusions: there is a need to make improvements in emergency rooms so that nursing professionals develop more positive attitudes towards productivity, being sensitized about the importance of this concept.(AU)

Objetivo: analizar las actitudes hacia la productividad de los profesionales de enfermería que trabajan en los servicios de urgencia. Método: investigación transversal con enfoque cuantitativo, realizada en febrero y marzo de 2020 con 204 profesionales de enfermería de los servicios de urgencia de tres hospitales en Estambul, Turquía. Los datos fueron recolectados a través de cuestionario y Escala de Actitudes hacia la Productividad de los Profesionales de Enfermería. Los datos se analizaron con el programa Statistical Package for the Social Sciences. Resultados: las actitudes de los participantes con relación a la productividad estuvieron parcialmente por debajo del promedio, y se vieron afectadas por factores como nivel escolar, elección voluntaria de la profesión y satisfacción laboral. Conclusiones: es necesario hacer mejoras en los servicios de urgencia para que los profesionales de enfermería desarrollen actitudes más positivas hacia la productividad, sensibilizándose sobre la importancia de este concepto.(AU)

Antecedents and Outcomes of Nurses' Subjective Career Success: A Path Analysis.

PURPOSE: This study aimed to test the hypothesis model showing the relationship between nurses' individual and working characteristics, nursing work environment, subjective career success, job satisfaction, intent to leave, and professional commitment. DESIGN AND METHODS: A cross-sectional and correlational design was utilized for the study. The study sample consisted of 604 nurses working in four hospitals in Istanbul, Turkey. Data were collected using the Nurse Information Form, Subjective Career Success Inventory, Practice Work Environment Scale of the Nursing Work Index, Job Satisfaction Global Item, Intent to Leave Subscale, and Professional Commitment Scale. Data were analyzed using descriptive and correlation analysis, and the hypothesis model was tested using structural equation modeling. FINDINGS: The hypothesis model that was established to test the antecedents and outcomes of subjective career success in nurses was acceptable and had a good fit. Having a master's degree, work schedule with rotating shifts (negative), good individual income, participation in hospital affairs, staffing and resource adequacy, and nurse-physician relations were significantly associated with the subjective career success of nurses. Subjective career success had a positive effect on job satisfaction and professional commitment and a negative significant effect on intent to leave in nurses. CONCLUSIONS: This study revealed that human capital, objective career success, and some characteristics of the nursing work environment were significantly associated with nurses' subjective career success, and that increased subjective career success produced positive professional and organizational outcomes. CLINICAL RELEVANCE: The results of this study, which revealed the antecedents and outcomes of nurses' career success, should be taken into consideration by managers who wish to retain a qualified nursing workforce.

Validity and reliability of Evidence-Based Practice Leadership Scale and Evidence-Based Work Environment Scale in Turkish.

PURPOSE: This study aims to evaluate the validity and reliability of the Evidence-Based Practice Leadership Scale (EBPLS) and Work Environment Scale (EBPWES) translated into Turkish so that they are used in nursing research. DESIGN AND METHODS: This methodological study was conducted with nurses. Language and content validity, item analyses were used to test the validity and reliability of the scales. FINDINGS: The confirmatory factor analysis results demonstrate that t values of each item in both scales are significant (P < .05). All model and data fit indices are higher than the acceptable level. Thus, CFA has shown that the scales with model-data fit are valid. PRACTICE IMPLICATIONS: The characteristics of nurse leaders and the suitability of the working environment are crucial for the maintenance of evidence-based practices. EBPLS and EBPWES will be effective and reliable tools in our country and an effective tool for contributing to the maintenance and development of evidence-based practices. The analyses indicate that the Turkish versions of the EBPLS and the EBPWES are acceptable, valid, and reliable for Turkish nurses.

The reliability and validity of the Turkish version of the MISSCARE Survey-Patient.

AIM: This methodological study aimed to adapt the MISSCARE Survey-Patient, which evaluates patients' experiences regarding nursing care based on their reports, and to test it for validity and reliability in Turkish. BACKGROUND: Identifying the missed care interventions on the basis of nurse and patient reports are important to ensure an objective evaluation and develop solutions to the causes behind the failure to meet care needs. METHODS: The study sample consisted of 267 inpatients in the internal and surgery services in a university hospital (n = 267). The Turkish version of the survey was subjected to language and content validity analyses and to confirmatory factor analysis for construct validity. The reliability of the survey was tested through test-retest method and the Cronbach's alpha internal consistency coefficient. RESULTS: It was determined that the original construct was preserved in the Turkish version of the MISSCARE Survey-Patient. The findings indicated that the scale was stable and reliable. CONCLUSION: The Turkish version of the MISSCARE Survey-Patient was found to be valid and reliable. IMPLICATIONS FOR NURSING MANAGEMENT: The survey can be used to determine the frequency and duration of nursing care based on patients' reports and is a valid and reliable instrument for cross-cultural studies.

Usage of a Bundle Application Process in Decreasing Ventriculoperitoneal Shunt Infections.

AIM: To determine the effect of using three concurrent measures (2% chlorhexidine gluconate +70% alcohol for skin cleaning, changing the dressing every 48 hours, and observing the operating room) for patients who had venriculoperitoneal shunt (VPS) implantations on the infection rate. MATERIAL AND METHODS: This was a prospective interventional study. Using infection prevention compliance control lists, patients who had a VPS implanted between November 2012 and November 2013 were compared to those who had a VPS implanted between October 2011 and October 2012. The data included information about the patients, follow-up, and infection prevention. These data were obtained for the pre-, peri-, and postoperative periods. RESULTS: Triple bundle prevention in the applied protocol significantly reduced the VPS infection rate in the study group compared to the control group (p < 0.005). CONCLUSION: These findings revealed the importance of creating a prevention protocol and following it regularly in a way for all surgery, operating room, and service teams fully comply to prevent VPS infections.

Socially Responsible Leadership: A study with nursing and medical students in Turkey.

This study determined the levels of Socially Responsible Leadership of students studying in the nursing and medical faculties of a public university as well as the influencing variables. The sample of this descriptive and correlational study consisted of the students studying in the nursing and medical faculties of a public university (n = 464). The data were collected using the Socially Responsible Leadership Scale. The total and all subscale scores obtained by the nursing and medical students from the Socially Responsible Leadership Scale were in the middle level. The effects of the department and participation in student clubs were statistically significant in the model when examining the variables affecting leadership level. The results of this study revealed the necessity of improving the Socially Responsible Leadership levels in the basic professional education programs for physicians and nurses.

The Correlations Between Nursing and Medical Students' Values and Social Innovation Tendencies.

AIM: This study aimed to determine the correlation between values and social innovation tendencies of nursing and medical students and examine the effect of values on social innovation tendencies. METHOD: This descriptive and correlational study consisted of 524 third-year students at nursing and medical faculties in a public university in Istanbul (response rate of 57.1%). The data of the study were collected using the information form, Portrait Values Questionnaire, and Social Innovation Scale. The data were collected between December 2015 and May 2016. The data were analyzed using descriptive and correlational analyses, and the factors affecting the score of social innovation were analyzed using linear regression analysis (backward). RESULTS: A positive significant correlation was determined between the total scores of Portrait Values Questionnaire and Social Innovation Scale (r=0.453). The subscale mean scores of Portrait Values Questionnaire had an effect of 26.6% in total score of Social Innovation Scale. In the regression model where significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. CONCLUSION: The value of universalism affected the social innovation for both groups at the most, which is an expected result by the nature of these occupations. The value of openness to innovation including self-direction and stimulation in medical students had a significant effect on the total score of social innovation, which is compatible with innovative behavior literature. These results are expected to guide educators and managers in developing socially innovative behaviors.

Organisational silence among nurses and physicians in public hospitals.

AIMS AND OBJECTIVES: To define the underlying reasons that lead physicians and nurses who provide patient care and treatment, to maintain silence in their work and how they perceive the consequences of such silence in public hospitals. BACKGROUND: The concept of organisational silence is described as employees' avoidance of stating his/her opinions, thoughts and suggestions, which would improve the organisation and enable it to provide better processes or services. This concept has been examined more frequently in the international literature in the past decade, and it has drawn attention as one of the most important barriers to employees' contributions to their organisation. DESIGN: Descriptive and cross-sectional study. METHODS: The study sample consisted of 601 physicians and nurses who work in five hospitals with bed capacities of 100 or more. The data were collected using a two-part form: an introductory information form and an organisational silence scale. RESULTS: Administrative and organisational topics were prominent among the reasons for employees of healthcare organisations to remain silent for both physicians and nurses. CONCLUSIONS: The results of this study should be considered by physicians and nurses to realise and improve themselves. Also, decision makers and managers of public hospitals might evaluate and remove organisational and communicative barriers to employees' contributions to their organisations based on these results. RELEVANCE TO CLINICAL PRACTICE: Physicians and nurses are responsible for the fulfilment of highly important tasks for their organisations. Their contributions help their organisations remain competitive, improve the health services, ensure and sustain patient safety. Hence, these results will provide information to facilitate an understanding of the topics, causes and consequences of organisational silence among physicians and nurses, two key healthcare professions, and will be helpful in the development of medical and nursing human resources in clinical settings.

Determination of nurses' mental workloads using subjective methods.

AIMS AND OBJECTIVES: To adapt the National Aeronautics and Space Administration Task Load Index scale into Turkish, to determine the nurses' mental workload using subjective methods and to identify the factors affecting the mental workloads of nurses. BACKGROUND: As the concept of safety gains prominence in healthcare services, the determination of employees' mental workloads using subjective methods is considered important in preventing errors caused by employees. DESIGN: Methodological and descriptive design. METHODS: The population of the study consisted of a total of 1900 nurses working at three hospitals and a dentistry faculty hospital affiliated with a public university in Istanbul. The sample of the study consisted of 1266 nurses who agreed to participate in the study (the rate of return was 66·6%). Language and content validity and reliability measurements were performed to adapt the National Aeronautics and Space Administration Task Load Index into Turkish, which was used as the data collection tool. RESULTS: It was found that the mean total mental workload score of the nurses was 80·48 (SD 11·76), and the weighted score of mental workload was 83·7. While the highest mean score was obtained on the subscale of mental demand (88·08, SD 16·12), the lowest mean score was obtained on the subscale of frustration (54·52, SD 29·96). The mean total mental workload score of the nurses showed a significant difference according to the units in which the nurses worked. CONCLUSION: The mean mental workload scores of nurses working at hospitals within the scope of the study were higher than the results of other studies. RELEVANCE TO CLINICAL PRACTICE: It is recommended that nurse managers perform mental workload measurements of nurses and compare the results with the quality indicators observed in units to determine and employ a labour force that is qualified for the profession and that may benefit more effectively from human resources.

Planning for the Size of the Nursing Staff at an Outpatient Chemotherapy Unit.

BACKGROUND: Use of a patient classification system particular to the unit, including size of nursing staff, is required for nurses to have adequate staffing and provide high-quality nursing care in oncology units. OBJECTIVES: The study was conducted to create a planning system for nursing staff size for an outpatient chemotherapy unit at a university hospital. METHODS: The study was conducted with the nurses working in an outpatient chemotherapy unit of a university hospital and patients who received five weeks of treatment. Patients were classified by using the Magnuson Model. Data related to job analysis were collected by two independent observers who made measurements with a stopwatch, in line with safety and quality standards on the chemotherapy units. FINDINGS: A total of 1,795 patients who received care at the outpatient chemotherapy unit were classified using the model. Based on the job analysis, on average, 17.12 nurses per day were needed to care for the patients.

What are the career planning and development practices for nurses in hospitals? Is there a difference between private and public hospitals?

AIM: The aim was to determine the opinions of nurse managers about career planning and development for nurses in hospitals. BACKGROUND: Career planning and development are defined as an important and necessary tool in the development of nurses as professionals and in retaining nurses in a facility. DESIGN: A descriptive survey. METHOD: The research population comprised nurse managers in 200+ bed hospitals on the European side of Istanbul province (n = 668). The entire population was targeted and 373 nurse managers were included in the study (55.8% return rate). Data were collected with a 32-item survey form that had three sections to determine the nurse managers' demographic characteristics, the career development practices at the facility where they worked, the nurse managers' responsibilities for career development and their expected competencies and recommendations. FINDINGS: The findings of this study suggest that the most common technique used for nurses for career development was education programs, the career development practices of private hospitals were more developed than public hospitals and the nurse managers' perceptions about career development were different according to their management level, age group and educational level (p < 0.05). RESULT: Although different practices were found in public and private hospitals in Turkey there were no effective career development practices identified and the nurse managers did not have agreement on the subject of career development. RELEVANCE TO CLINICAL PRACTICE: Hospitals which provide opportunity for horizontal and vertical promotion and have clear development policies will be successful hospitals which are preferred by high quality nurses. This study draws attention to the importance of career planning in nursing and the need for nurse managers to take an active role in career planning and development.

Mobbing in the workplace by peers and managers: mobbing experienced by nurses working in healthcare facilities in Turkey and its effect on nurses.

AIM: This research was conducted as a descriptive and cross-sectional study with the purpose of determining the mobbing experienced by nurses who work in healthcare facilities in Turkey, its emotional, social and physiological effects on the nurses and the actions that the individuals take to escape from the mobbing. BACKGROUND: The term 'mobbing', which includes workplace terrorizing, pressure, frightening, belittling and psycho-terror, is defined as the presence of systematic, directed, unethical communication and antagonistic behaviour by one or more individuals. These actions that occur frequently and continue for a long time are the most serious and effective causes of workplace stress. The person who is the target of the mobbing is left without help, without protection and alone in the workplace. Individuals who are exposed to psychological abuse experience physiological, psychological and social problems that are related to high levels of stress and anxiety. DESIGN AND METHOD: The research participants were 505 nurses of whom 325 (64%) worked in public and 180 (36%) in private hospitals. All of the participants were female. A questionnaire developed by the researchers in the light of information in the literature was used for data collection and had four sections including the participants' demographic characteristics and questions asking about mobbing behaviours, reaction to mobbing incidents and actions taken to escape from the mobbing. The data were collected between October and December 2005 by giving an envelope to the participants and then collecting the responses in the closed envelope. FINDINGS: The overwhelming majority (86.5%) of the nurses participating in the research reported facing mobbing behaviour in the workplace in the last 12 months. The nurses working at private hospitals faced statistically significantly more mobbing behaviours than those at public hospitals (p

Mobbing behaviors encountered by nurse teaching staff.

The term 'mobbing' is defined as antagonistic behaviors with unethical communication directed systematically at one individual by one or more individuals in the workplace. This cross-sectional and descriptive study was conducted for the purpose of determining the mobbing behaviors encountered by nursing school teaching staff in Turkey, its effect on them, and their responses to them. A large percentage (91%) of the nursing school employees who participated in this study reported that they had encountered mobbing behaviors in the institution where they work and 17% that they had been directly exposed to mobbing in the workplace. The academic staff who had been exposed to mobbing behaviors experienced various physiological, emotional and social reactions. They frequently 'worked harder and [were] more organized and worked very carefully to avoid criticism' to escape from mobbing. In addition, 9% of the participants stated that they 'thought about suicide occasionally'.