Work conditions influencing professional development of specialist nurses in surgical care explored using the Job Demand-Resources theory: A qualitative study

Evaluating the Implementation of Strategies to Improve Evidence-Based Surgical Care: A Focus Group Study

AIM

To evaluate healthcare professionals' perspectives on factors that lead to success in the implementation of strategies to strengthen evidence-based surgical nursing care.

DESIGN

A qualitative study design with focus group interviews, according to Krueger and Casey in a surgical department at a university hospital in Sweden.

METHODS

Four focus groups were conducted with 18 participants, including specialist nurses in surgical care, registered nurses and assistant nurses. Data were collected in February-March 2024. A semi-structured interview guide was used, and data were analysed using qualitative content analysis.

RESULTS

Three themes with seven subthemes were developed to capture the evaluation of health care professionals' perspectives of the implementation strategies to strengthen evidence-based surgical nursing care. The themes were (1) Roles and leadership, (2) Engagement in the implementation, and (3) Facilitators and barriers to implementation. The implementation has meant the transition from theory to practice and integrating new routines into the surgical department. It was a learning process where the health care professionals needed to familiarise themselves with new concepts and working methods. The positive outcome of the project and support from the nursing leadership were important facilitators in the implementation process.

CONCLUSIONS

The implementation of new ways of working was a complex process with both resistance and learning, but it ultimately led to positive changes in the surgical care environment.

IMPLICATIONS FOR THE PROFESSION AND IMPACT

The project has entailed that specialist nurses in surgical care have increased nursing power in the department and extended responsibilities. Support from the head of the department and the management team has been crucial to being able to carry out the project, and the implementation of activities in small steps has been successful.

REPORTING METHOD

Adhered to the SRQR guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Burnout and work engagement in advanced practice cancer nurses: A scoping review

PURPOSE

To explore the job demands, resources and outcomes of burnout and work engagement in advanced practice cancer nurses.

METHODS

A scoping review guided by Arksey and O'Malley's methodological framework. Six databases, including CINAHL (EBSCO), Cochrane Library, MEDLINE (Ovid), PsycINFO (Ovid), Scopus, and ProQuest Dissertations and Theses database and grey literature were searched for studies published in English between January 2000 and January 2024. A descriptive analysis and qualitative content analysis were conducted to analyse the data.

RESULTS

A total of 2344 articles were screened for eligibility, and 28 were selected for inclusion. Four broad themes were identified: (i) job demands, (ii) job resources, (iii) negative outcomes and (iv) positive outcomes in relation to the advanced practice cancer nurses' work environment and practices. A total of 31 job demands, 22 job resources, 9 negative and 12 positive outcomes were identified. Three studies reported higher burnout among advanced practice cancer nurses, while no studies provided data on work engagement.

CONCLUSION

Higher job demands lead to negative outcomes, which could affect advanced practice cancer nurses' overall performance and well-being. The evidence for the relationship of job demands and resources with burnout and work engagement is inconclusive. Further research is needed to address the influence of job demands and resources on burnout and work engagement of advanced practice cancer nurses.

Assessment of the Educational Needs of Spanish Nurses in the Care and Management of Patients with Diabetes

Introduction: The rising prevalence of chronic diseases such as diabetes poses significant challenges to healthcare systems globally, requiring specialized care and management. Nurses play an essential role in educating and caring for patients, but current continuing education programs often fail to meet the practical needs of clinical settings. Methods: This study used a qualitative descriptive-interpretative approach, conducting semi-structured interviews with 24 nurses working in primary care and hospital settings across Spain. The interviews focused on their experiences, perceptions, and educational needs in diabetes care. A thematic analysis was performed to identify key trends and insights. Results: Nurses emphasized the importance of ongoing education in building professional confidence and improving patient care outcomes. However, they reported significant barriers, including limited time, high costs, and a lack of practical focus in existing training programs. Participants favored hybrid learning models, which combine the flexibility of online training with the hands-on experience of in-person sessions. Nurses in rural areas highlighted the value of virtual training to overcome geographic constraints, while those in urban environments preferred hybrid approaches. Additionally, nurses called for accessible and concise resources, such as digital libraries and clinical simulations, to support decision making in real time. Conclusions: To be effective, diabetes- and ostomy-focused continuing education must align with nurses' clinical realities and individual needs. Combining digital tools with practical in-person learning can enhance accessibility and foster the practical application of skills. These findings provide actionable insights for designing education programs that advance both patient care and nurses' professional development.

Implementing coaching programmes for healthcare professionals-A review of the barriers and facilitators

BACKGROUND

The European Union faces severe and worsening personnel shortages in healthcare. Coaching has emerged as a human-centred strategy to enhance sustainable employment and retention. While the number of efficacy studies on coaching continues to grow, knowledge about the barriers and facilitators to implementing coaching interventions among healthcare professionals (HCPs) remains scarce.

OBJECTIVES

This systematic review aimed to describe common barriers and facilitators to the implementation of coaching interventions for HCPs.

METHODS

In April 2023, five databases were searched for eligible articles. Barriers and facilitators were systematically identified and mapped onto the constructs of the Consolidated Framework for Implementation Research (CFIR). Directed content analysis yielded thematic areas and a reporting frequency.

RESULTS

A total of thirty (n = 30) studies were included in this review, representing twenty-five (n = 25) distinct coaching programmes. Implementation determinants were clustered under two CFIR domains: the Inner Setting (8 facilitators, 5 barriers) and Implementation Process (6 facilitators, 1 barrier). Barriers included (i) limited organisational capacity, (ii) lack of psychological safety, (iii) competing work demands, and (iv) insufficient leadership buy-in, while facilitators were the (i) allocation of protected time for participants and coaches, (ii) promotion through opinion leaders, (iii) embeddedness in existing Continuous Professional Development programmes, and (iv) programme co-creation.

CONCLUSION

The findings of this study provide practical insights to guide the future implementation of coaching interventions at an organisational level. In particular, the identified barriers and facilitators suggest, for optimal efficacy and sustainment, coaching interventions must be implemented within a safe, supportive organisational climate.

Nurses' experiences of moral distress and how it affects daily work in surgical care-a qualitative study

AIM

To describe nurses' and specialist nurses' experiences of moral distress and how it affects daily work in surgical care.

DESIGN

A qualitative descriptive study design was used.

METHODS

A qualitative study with 12 interviews with nurses and specialist nurses working in surgical care. All interviews were conducted during October and November 2022 in two hospitals in southeastern Sweden. Data were analysed using conventional qualitative content analysis.

FINDINGS

Three categories and seven subcategories generated from the data analysis. The three categories generated from the analysis were Experiences that lead to moral distress, Perceived consequences of moral distress and Strategies in case of moral distress. The results show that a lack of personnel in combination with people with complex surgical needs is the main source of moral distress. Both high demands on nurses as individuals and the teamwork are factors that generate moral distress and can have severe consequences for the safety of patients, individual nurses and future care.

CONCLUSIONS

The results show that moral distress is a problem for today's nurses and specialist nurses in surgical care. Action is necessary to prevent nurses from leaving surgical care. Prioritizing tasks is perceived as challenging for the profession, and moral distress can pose a patient safety risk.

IMPACT

Surgical care departments should design support structures for nurses, give nurses an authentic voice to express ethical concerns and allow them to practice surgical nursing in a way that does not violate their core professional values. Healthcare organizations should take this seriously and work strategically to make the nursing profession more attractive.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.