A scale-development study: Exploration of intensive-care nurses’ attitudes towards futile treatments

The study was conducted to determine the validity and reliability of the tool used to assess nurses’ attitudes towards futility, and to explore intensive-care nurses’ attitudes towards futility. Principal components analysis revealed that 18item scale was made up of four subdimensions that assess Identifying(beliefs), Decision-Making, Ethical Principles and Law, and Dilemma and Responsibilities related to futile treatments. The internal consistency of the scale was in the acceptable range, with a total Cronbach’s alpha value of 0.72. Overall the results of study suggest that scale can be used as a valid and reliable assessment tool to assess nurses’ attitudes towards futility.     

A framework to support preceptors’ evaluation and development of new nurses’ clinical judgment

In today’s complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates’ learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses’ clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice.     

The reliability and validity of the Chinese version of nurses’ self-concept questionnaire

cao x.y., Liu X.H., tian l. & guo y.q. (2013) Journal of Nursing Management  21 , 657–667 The reliability and validity of the Chinese version of nurses’ self-concept questionnaire Aim To examine the reliability and validity of the Chinese version of nurses’ self-concept questionnaire. Background Nurses’ self-concept is important to alleviate the current shortage of nurses. Nurses’ self-concept questionnaire is an effective instrument to measure nurses’ self-perception of professional competencies. However, the psychometric properties of the Chinese version have not been tested. Methods A two-stage research design was used in this study. At Stage 1347 registered nurses were recruited to establish the psychometric properties of the Chinese version. At Stage 2, a confirmatory factor analysis was used to examine the extracted factor structure from Stage 1 with 1017 respondents as a sample. Results The internal consistency of the Chinese version was 0.95 and the test–retest reliability was 0.83. The exploratory factor analysis extracted six dimensions. The findings at Stage 2 showed an acceptable model fit and discriminant validity. The Chinese version was a significant predictor of Maslach Burnout Inventory (β = −0.58; P = 0.00). Conclusions This study verified the psychometric properties of the Chinese version of nurses’ self-concept questionnaire. Implication for nursing management The Chinese version of nurses’ self-concept questionnaire will facilitate the evaluation of professional self-concept among nurses and help to develop the individualized self-concept strategies.     

Neonatal nurses’ professional quality of life: An integrative review

BackgroundNurses working in critical care environments, such as intensive care units, are susceptible to impaired professional quality of life. Those caring for babies and children, even more so.AimTo appraise the extant literature regarding neonatal nurses’ professional quality of life and propose recommendations for neonatal nursing practice, policy, and research.MethodThis integrative review aligns with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and Whittemore and Knafl's five-stage methodology. A systematic search of the CINAHL, Medline, and PsychInfo electronic databases and grey literature was conducted. Peer reviewed articles referring to neonatal nurses’ work-related stressors and satisfiers which had been published in English language between 1990 and 2020 were included.FindingsNeonatal nurses of varying ages, experience levels and cultures, report burnout, secondary and post-traumatic stress; however, the cumulative impacts result in higher prevalence among experienced clinicians. Compassion fatigue is mitigated by compassion satisfaction.DiscussionNeonatal nurses’ report lower resilience and higher emotional exhaustion and sensitivity to organisational change than their medical colleagues. Despite workplace adjustments some nurses may remain disproportionately at risk due to factors associated with their personality traits, affect, and practice environments.ConclusionFurther research exploring the relationships between structural factors impacting neonatal nurses’ professional quality of life and organisational outcomes is required. The generalisability of future studies will be enhanced by longitudinal design, recruitment of heterogeneous samples, and use of scales with psychometric adequacy to capture complex interrelationships between variables.     

Factors influencing nurses’ attitudes towards healthcare information technology

Huryk l.a. (2010) Journal of Nursing Management 18, 606–612
Factors influencing nurses’ attitudes towards healthcare information technology Aim(s) This literature review examines the current trend in nurses’ attitudes toward healthcare information technology (HIT). Background HIT implementation and expansion are at the core of global efforts to improve healthcare quality and patient safety. As a large portion of the healthcare workforce, nurses’ attitudes towards HIT are likely to have a major impact on the electronic health record (EHR) implementation process. Evaluation A search of PubMed, CINAHL and Medline databases produced 1930 combined hits. Returned articles were scanned for relevancy and applicability. Thirteen articles met all criteria and were subsequently reviewed in their entirety. Key Issue(s) In accordance with two change theories, if HIT implementation projects are to be successful, nurses must recognize that incorporating EHRs into their daily practice is beneficial to patient outcomes. Conclusion(s) Overall, the attitudes of nurses toward HIT are positive. Increased computer experience is the main demographic indicator for positive attitudes. The most common detractors are poor system design, system slowdown and system downtime. Nurses are also fearful that the use of technology will dehumanize patient care. Implications for nursing management Involving nurses in system design is likely to improve post-implementation satisfaction. Creating a positive, supportive atmosphere appears to be instrumental to sustainability.     

Public health nurses’ views on quality measures: A cross-sectional study

BackgroundThe quality indicators program has intended and unintended consequences that may affect nurses’ professional performance and organisational outcomes.AimsTo explore public health nurses’ knowledge, attitudes, and perceptions of the nursing-sensitive quality indicators applied in mother–child health clinics and their associations with organisational quality outcomes: quality of care, burnout, and communication.MethodsA cross-sectional study with a convenience sample. In total, 177 public health nurses completed a self-administered questionnaire measuring their knowledge, attitudes, and perceptions of the quality indicators regarding their performance and organisational outcomes. A structural equation modelling analysis was performed to describe the associations between the variables and to identify the mediating variables.FindingsThe structural equation modelling analysis revealed that the intended (positive) impact on the nurse's professional level was the mediating variable between the nurses’ knowledge and attitudes towards the National Health Quality Measure program, their seniority, and the unintended (negative) impact on the nurse's professional level, and the organisational outcomes.Discussion and conclusionPublic health nurses perceive quality indicators as contributing to and improving their professional work, with a positive impact on organisational outcomes. Nursing leaders and policymakers may promote good organisational outcomes by developing methods that will emphasise the importance of quality indicators in nursing practice.     

Relationships between nurses’ empathy,self-compassion and dimensions of professional quality of life: A cross-sectional study

BackgroundJob stress and burnout are common among healthcare professionals, and nurses in particular. In addition to the heavy workload and lack of recourses, nurses are also confronted with emotionally intense situations associated with illness and suffering, which require empathic abilities. Although empathy is one of the core values in nursing, if not properly balanced it can also have detrimental consequences, such as compassion fatigue. Self-compassion, on the other hand, has been shown to be a protective factor for a wide range of well-being indicators and has been associated with compassion for others.ObjectivesThe main goal of this study was to explore how empathy and self-compassion related to professional quality of life (compassion satisfaction, compassion fatigue and burnout). In addition, we wanted to test whether self-compassion may be a protective factor for the impact of empathy on compassion fatigue.Methods and participantsUsing a cross-sectional design, 280 registered nurses from public hospitals in Portugal's north and center region were surveyed. Professional quality of life (Professional Quality of Life), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion Scale) were measured using validated self-report measures.ResultsCorrelations and regression analyses showed that empathy and self-compassion predicted the three aspects of professional quality of life. Empathic concern was positively associated with compassion satisfaction as well as with compassion fatigue. Mediation models suggested that the negative components of self-compassion explain some of these effects, and self-kindness and common humanity were significant moderators. The same results were found for the association between personal distress and compassion fatigue.ConclusionsHigh levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.     

Intensive care nurses’ perceptions of Inter Specialty Trauma Nursing Rounds to improve trauma patient care—A quality improvement project

BackgroundTrauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses’ knowledge.ObjectivesThe purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement.MethodsThe project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients’ care. The rounds were evaluated to assess the nurse’s perception of improvement.ResultsThere were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues.ConclusionsInter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge.     

Overseas qualified nurses’ sociocultural adaptation into the Australian healthcare system: A cross-sectional study

BackgroundOverseas qualified nurses (OQNs) face various challenges while adjusting to the Australian healthcare system. However, few studies to date have identified specific factors affecting their sociocultural adjustment, health and psychology.AimsThe primary aim was to examine factors associated with OQNs’ sociocultural adjustment to the Australian healthcare system. A secondary aim was to determine whether there was a correlation between OQNs’ sociocultural adjustment and their mental and physical health.MethodsA questionnaire was sent electronically to 2,250 randomly selected OQNs through the Australian Health Practitioner Regulation Agency, and later distributed to 50 OQNs in person through Western Health, Melbourne. Sociocultural adjustment was assessed using the Sociocultural Adaptation Scale-Revised. The Nurse International and Transition Questionnaire-2 was used to explore the factors involved in sociocultural adjustment: these were pull factors, push factors, initial experiences, job satisfaction, feeling at home, and reactions to the working environment. The Perceived Stress Scale and General Health Questionnaire-12 were used to assess psychological adjustment and general health, respectively.FindingsA total of 200 participants completed the questionnaire. The mean age (SD) of the participants was 32.79 (6.91) with 161 (80%) holding a bachelor degree. In the adjusted multivariate linear regression, job satisfaction (β = 0.24, 95% CI 0.13 to 0.36), current work environment (β = 0.27, 95% CI 0.05 to 0.49) and feeling at home (β = 0.32, 95% CI 0.13 to 0.50) were independently positively associated with sociocultural adaptation. Sociocultural adaptation was negatively related to PSS (r = −0.14, β = −0.16, p = 0.04) and GHQ12 (r = −0.36, p < 0.001, β = −0.59).DiscussionThree factors (job satisfaction, current work environment, and feeling at home in Australia) were found to be significant in measuring OQNs’ level of sociocultural adaptation. When the level of sociocultural adaptation was high, OQNs reported better general and psychological health.ConclusionJob satisfaction and feeling supported in the workplace are the most important factors influencing OQNs’ successful adjustment into the Australian healthcare system.     

What makes your day? A study of the quality of worklife of OR nurses

From data obtained in this study, the weak or negligible influences on the quality of worklife of OR nurses are: Organizational Structure Leadership, and Organizational Learning. Things that matter to OR nurses and that influence their quality of worklife are: Collaborative Decision-Making, Multiskilled Workers, Change, Organizational Culture, Locus of Control; and the most important influence of all- Teamwork. So, now when the question is asked "What Makes Your Day?" The answer is clear--at the end of the day, it all boils down to the most fundamental of all answers--People! People are involved in collaborative decision-making, multiskilled workers, change, organizational culture, locus of control, and teamwork. These People include the OR nurse, who is involved in collaborative decision-making and all the other items that affect your daily work environment. The people you collaborate with, the people you interact with in the organization, and the people that make up the team--you and everyone around you are responsible for that magic ingredient--Teamwork. What you say, what you do, and how you behave makes all the difference in the daily worklife of your colleagues. Each and every comment and interaction contributes to the efficiency and effectiveness of the team. Each and every day from this day forward, remember this--remember how important your role is in building a strong and effective team. At the recent AORN Congress, Joan Rivers shared a favourite saying with us: "The past is history, The future a mystery, Today is a gift from God, that is why it is called the present." Today is all that we really have--let us make the best of each and every day as we continue to respect and value each member of the team. Teamwork--our building block of the future--yours, mine, and every other member of the surgical team. Each member can make an enormous contribution--we only need to believe that the "best is yet to be--the best resides in me". Yes, we can do our part in making our workplace a good one. But we can only do so much. It's time for governments, administrators, and managers to examine the work environment, to identify the kinds of things that motivate nurses to get up in the morning and go to work, and what makes that workplace pleasant enough that they are happy to stay there. We are hearing about nursing shortages across Canada and the United States. Recruitment and retention strategies are returning to hospitals. Besides "sign-on" bonuses, it is time for governments and administrators to examine the culture of the workplace. Questions that must be answered: Are nurses included in decisions made? Do nurses have what they need to work with? Are they given a reasonable workload? Are nurses part of a team that values them and their unique contribution to patient care? In the words of Senator Lucie Pépin (1999): "We must turn our anger first, into passion, then into action. A hostile or unpleasant workplace must not be tolerated!" With confidence we must be assertive as we look to improve our work environment. Yes, we can do our part, but now it is time for the other stakeholders to pay attention!     

Novice nurses’ experiences from teamwork in the emergency department: A qualitative content analysis

Background and aimTeamwork is assumed crucial in nursing. Nevertheless, nursing shortages in medical centers have thus far compelled nurse managers to use novice nurses. The present study aimd to explaining the challenges and experiences of novice nurses regarding teamwork in emergency departments.Materials and methodsUsing qualitative content analysis, 11 novice nurses working at emergency department, participated in this study. Data were collected with semi structured interview and analyzed by Graneheim and Lundman.ResultsThe data analysis led to the emergence of four themes of “essential teamwork skills development”, “contradictory relationships between team members”, “unpleasant feelings and experiences”, and, “personal growth and maturation during teamwork”.ConclusionFostering different personal aspects as prerequisites for teamwork, novice nurses will be able to deal with unpleasant feelings and experiences as well as contradictory relationships between team members in an effective manner. This challenging experience will thus give rise to personal growth and maturation during teamwork among them in emergency department.