Factors affecting quality of nurse shift handover in the emergency department

Aim

The aim of this study was to explore and test factors hypothesized to influence quality of Emergency Department nurse‐to‐nurse shift handover communication.

Background

Nurse‐to‐nurse shift handover communication includes the transfer of information and responsibility for patients at shift change. The unique environment of the Emergency Department, where there is a high degree of patient unpredictability, increased patient volumes and rapid patient turnover, can create challenges for high quality handover communication. There is considerable literature addressing handover communication and factors that influence quality or effectiveness. However, few studies have empirically tested those factors.

Design

A quantitative, cross‐sectional design was used to test a conceptual model of factors hypothesized to influence quality of handover communication.

Methods

In 2014, data were gathered using surveys mailed to Emergency Department nurses across Ontario, Canada.

Results

The final eligible sample was 231 of 576 for an overall response rate of 40.1%. Analysis was performed using backwards elimination stepwise multiple linear regression. Four statistically significant explanatory variables were retained in the final multiple regression model, explaining 34% (p < .0001) of variance in handover quality. Handover quality was increased when patients flowed smoothly through triage, when nurses experienced positive intrusions, in the presence of a positive safety climate and when there were positive relationships between incoming and outgoing nurses.

Conclusions

By understanding those factors that contribute to handover quality, it is possible to develop targeted interventions aimed at improving the quality of Emergency Department nurse‐to‐nurse shift handover.     

Therapeutic alliance,relationship building,and communication strategies-for the schizophrenia population: An integrative review

Background

Schizophrenia is a chronic mental illness that affects the client, family, and community. Nurses are educated to use the nurse-patient relationship to provide health education and collaborative health decision-making. However, challenges abound for nurses and clients with schizophrenia to effectively utilize the relationship to reach these goals.

Capacity for care: meta‐ethnography of acute care nurses' experiences of the nurse‐patient relationship

Aims

To synthesize evidence and knowledge from published research about nurses' experiences of nurse‐patient relationships with adult patients in general, acute inpatient hospital settings.

Background

While primary research on nurses' experiences has been reported, it has not been previously synthesized.

Design

Meta‐ethnography.

Data sources

Published literature from Australia, Europe, and North America, written in English between January 1999–October 2009 was identified from databases: CINAHL, Medline, British Nursing Index and PsycINFO.

Review methods

Qualitative studies describing nurses' experiences of the nurse‐patient relationship in acute hospital settings were reviewed and synthesized using the meta‐ethnographic method.

Results

Sixteen primary studies (18 papers) were appraised as high quality and met the inclusion criteria. The findings show that while nurses aspire to develop therapeutic relationships with patients, the organizational setting at a unit level is strongly associated with nurses' capacity to build and sustain these relationships. The organizational conditions of critical care settings appear best suited to forming therapeutic relationships, while nurses working on general wards are more likely to report moral distress resulting from delivering unsatisfactory care. General ward nurses can then withdraw from attempting to emotionally engage with patients.

Conclusion

The findings of this meta‐ethnography draw together the evidence from several qualitative studies and articulate how the organizational setting at a unit level can strongly influence nurses' capacity to build and sustain therapeutic relationships with patients. Service improvements need to focus on how to optimize the organizational conditions that support nurses in their relational work with patients.     

Psychiatric Patients’ and Nurses' Opinions About Limit Setting Technique in Port-said City

Background

Limit setting facilitates the development of a therapeutic, caring and supportive relationships, it can also decrease patients' feelings of anxiety and uncertainty. It is a two-way process that should be delivered professionally by the nurse and perceived therapeutically by the patient, so patient considered a vital participant of the technique.

Revisiting the impact of job satisfaction and organizational commitment on nurse turnover intention: an individual differences analysis

Background

Nurse turnover is an important contributing factor to the worldwide nursing shortage. Many studies have examined the antecedents of nurse turnover to gain a better understanding of the problem and help hospitals reduce their turnover rates. However, an important shortcoming of this research stream is its exclusive focus on explaining turnover behavior of the “average nurse”, thereby disregarding individual differences between nurses and groups of nurses.

Objectives

To examine individual differences in the relationships between two crucial turnover antecedents – job satisfaction and organizational commitment – and nurse turnover intention.

Participants

A sample of 287 nurses working for a variety of Belgian hospitals participated in the study.

Methods

A survey method was used to collect quantitative data, which were analyzed through standard multiple linear regression, mixture regression models and t-tests.

Results

In the total sample of hospital nurses, both job satisfaction and organizational commitment significantly predicted nurse turnover intention. However, subsequent individual differences analyses revealed the existence of two subgroups of nurses. In the satisfaction focused group, only job satisfaction was found to predict nurse turnover intention, whereas in the satisfaction and commitment focused group both job satisfaction and organizational commitment were related to turnover intention. Furthermore, nurses in the latter group displayed stronger turnover intention, were significantly younger and had less job tenure and organizational tenure than nurses in the satisfaction focused group.

Conclusions

The debate on the antecedents of nurse turnover still continues, as the existing models fail to fully grasp nurse turnover. The present study identifies individual differences in nurse turnover antecedents among groups of nurses as a possible reason for the absence of one comprehensive turnover model that holds for the general nursing population. Further studies are needed in order to capture the total impact of the underlying individual differences in nurse turnover antecedents.     

Correlates of treatment satisfaction and well‐being among patients with type II diabetes

Aim

To examine the impact of patient characteristics, anthropometric measurement and patient clinical variables on their appraisal of treatment satisfaction and well‐being.

Background

Treatment satisfaction and well‐being are instrumental in achieving diabetes care goals. Nursing practices and healthcare policies may inform interventions in these areas.

Introduction

The prevalence of diabetes is high in the Middle East. An understanding of relationships between clinical and socio‐demographic variables and well‐being and treatment satisfaction is needed to improve care and patient outcomes.

Methods

A total of 1002 patients completed tools measuring well‐being, treatment satisfaction and socio‐demographic characteristics. A series of bivariate and multivariate analysis were conducted to identify factors associated with well‐being and treatment satisfaction.

Results

Males reported better treatment satisfaction and well‐being than females. Older participants, those who were compliant to diet, with controlled diabetes, and no neuropathy reported higher treatment satisfaction scores and well‐being scores. Insulin therapy was associated with better treatment satisfaction.

Discussion

Females, participants who were not prescribed diabetic diets and those with complications were more likely to be negatively impacted by diabetes. Individuals with diabetes who were treated with insulin had higher treatment satisfaction than those who used oral hypoglycaemic agents.

Conclusion and implication for nursing and health policy

These findings are important in assisting nurses and other healthcare professionals in identifying patients with diabetes with low treatment satisfaction who may present a greater risk for poor well‐being. Additionally, they lend support to developing policies for frequent screenings and special therapeutic interventions that are needed to maximize patients’ treatment satisfaction and well‐being in the Middle East and elsewhere.     

Ethical issues in practice: A survey of home‐visiting nurses in Japan

Aim: The purposes of this study were to identify specific components and frequencies of ethical issues that home‐visiting nurses encountered in their practice, relationships between ethical issues and demographic data, and experience of ethics education and workplace environment. Methods: A self‐administered questionnaire was distributed to home‐visiting nurses in Japan. Usable data (1961) were analyzed. Results: Item and exploratory factor analysis for the frequency of encountering ethical issues revealed: (i) concern about respecting client or relationships with relevant professionals; (ii) differences in treatment or care‐taking views among home‐visiting nurse and client and family, or relevant professionals; and (iii) discrepancy of intention between family and client or home‐visiting nurse. All factors were significantly positively related to the current position, duration of working experience as a home‐visiting nurse, and type of nursing education; age was significantly negatively related. Home‐visiting nurses noted that programmed continuing education systems and staff‐training programs were not sufficiently available. Conclusion: The findings of this study indicated the characteristics of ethical issues that home‐visiting nurses encountered in their practice and insufficient continuing education system including ethics education. Ethics education programs tailored to home‐visiting nurses ethical concerns and traits and continuing education systems are needed.     

Disaster preparedness among nurses: a systematic review of literature

Aim

This review explored peer‐reviewed publications that measure nurses’ preparedness for disaster response.

Background

The increasing frequency of disasters worldwide necessitates nurses to adequately prepare to respond to disasters to mitigate the negative consequences of the event on the affected population. Despite growing initiatives to prepare nurses for any disasters, evidence suggests they are under prepared for disaster response.

Methods

This is a systematic review of scientific articles conducted from 2006 to 2016 on nurses’ preparedness for disasters. SCOPUS, MEDLINE, PubMed, CINAHL and PsychINFO were the primary databases utilized for search of literature. Keywords used in this review were as follows: ‘emergency’, ‘disaster’, ‘disaster preparedness’, ‘disaster competencies’, ‘disaster nursing’, ‘disaster role’ and ‘nurse’. Seventeen (17) articles were selected for this review.

Findings

Factors that increase preparedness for disaster response include previous disaster response experience and disaster‐related training. However, it is widely reported that nurses are insufficiently prepared and do not feel confident responding effectively to disasters.

Conclusion

The findings of this review contribute to a growing body of knowledge regarding disaster preparedness in nurses and have implications for academia, hospital administration and nursing educators. The findings of this review provide evidence that could be used by nurse educators and nurse administrators to better prepare nurses for disaster response.

Implications for nursing and health policy

The findings from this review place an emphasis on hospitals to implement policies to address lack of preparedness among their employees. Furthermore, this review highlights the benefit of further research and provision of well‐grounded disaster exercises that mimic actual events to enhance the preparedness of the nursing workforce.     

Pediatric oncology nurses’ perceptions of prognosis-related communication

Background

Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described.

Empathic processes during nurse–consumer conflict situations in psychiatric inpatient units: A qualitative study

Empathy is a central component of nurse–consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was ‘my role as a nurse – the role of my nurse’. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers; consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses ‘being there’. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self‐reflection and building empathy skills in managing conflict.     

The relationship between nurse practice environment,nurse work characteristics,burnout and job outcome and quality of nursing care: A cross-sectional survey

Aim

To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment.

Background

Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community.

Design

Cross-sectional survey.

Method

Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N = 1201) in two independent hospitals and one hospital group with six hospitals in Belgium.

Results

Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses’ work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively.

Conclusion

The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses’ involvement in decision-making process and interdisciplinary teamwork are recommended.