Quality of nursing care in Saudi's healthcare transformation era: A nursing perspective

Implementing the Clinical Nurse Specialist Role in Hospital Settings: A Scoping Review

PURPOSE/AIMS

To understand, based on the literature, how to implement the role of a clinical nurse specialist (CNS) in the hospital setting.

DESIGN

A scoping review was conducted following the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute.

METHOD

The search was conducted during March and April 2023 and was updated in November 2023. Electronic searches were conducted in the following major databases: PubMed, CINAHL, Web of Science, Scopus, PsycINFO, and Cochrane Library. Additionally, a "snowballing" strategy was used. A critical reading was conducted using the Joanna Briggs Institute methodological quality criteria. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for the Scoping Review guidelines were used.

RESULTS

Eleven relevant studies were included in this review. The primary results are presented in 4 sections related to the framework, process, components, and evaluation of the implementation of the CNS role. The findings of the reviewed studies suggest that the implementation process of the CNS is cyclical, variable, context-dependent, and multifactorial and can be assessed using the indicators of structure, process, and outcome.

CONCLUSIONS

This scoping review provides relevant information to support the design of implementation and evaluation strategies for the role of the CNS in the hospital context. Based on the findings of the reviewed studies, a comprehensive strategy is suggested for implementing the role of the CNS in a hospital setting.

Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety

BACKGROUND

In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives.

AIM

This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety.

RESEARCH DESIGN

A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale.

PARTICIPANTS AND RESEARCH CONTEXT

The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles.

RESULTS

Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making.

CONCLUSION

The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.

When nurses become ill, are they able to identify the predictors of the quality of care they received?

<b>Background</b>: Nurses are the most qualified judges for quality of nursing care (QNC) because they have the greatest experience with standard care. It is vital to examine QNC from the perspective of nurses who have experience as hospitalized patients or as caregivers in order to perform an accurate assessment of the nursing care that is delivered to meet the needs of patients.<br /> <b>Aims</b>: To examine the predictors of QNC from the perspective of nurses as patients and/or as caregivers for hospitalized relatives.<br /> <b>Methods</b>: This study aimed a cross-sectional correlational design that utilized a convenience sample of 231 registered nurses recruited from eight hospitals in three health care sectors in Jordan. Data were collected using caring behaviors inventory, nurse professional competence scale, and using a single item rating scale that asked nurses to respond to the overall QNC.<br /> <b>Results</b>: The hierarchical multiple regression showed that QNC scores was predicted with a high variance (61%) explained. The strongest predictive contribution was from nursing competencies. Only 34% of the participants gave positive scores for the overall QNC, and their perception was moderately positive.<br /> <b>Conclusion</b>: It is necessary to examine QNC from the perspective of nurses who have experience as hospitalized patients or as caregivers.