Clinical nurse competence and its effect on patient safety culture: a systematic review

Professional competency and moral courage among staff nurses

BACKGROUND

Nurses must possess professional competency and moral courage to ensure the excellence of care and safety for patient, communicate effectively with other healthcare staff, and promote the establishment of consistent and universal care.

AIM

This study aimed to investigate the relationship between professional competency and moral courage among staff nurses.

METHODS

A descriptive correlational study design was conducted at Ain Shams University Hospital, affiliated with Ain Shams University Hospitals. The study included 172 out of 310 staff nurses. Three tools were used for data collection, namely: Personal Characteristics Sheet, The Nurse Professional Competency Scale-Short Form (NPC-Scale SF), and The Nurses' Moral Courage Scale (NMCS). Data were collected over a period of six weeks, starting from the second half of April 2024 until the end of May 2024.

RESULTS

This study revealed that 42.7% of the staff nurses were aged between 25 and 35 years, 61.4% were female, 28.7% held a nursing technical degree, and 51.5% had more than five years of experience. In addition, more than three-fifths of the participants reported a moderate level of professional competency, followed by a low level. Similarly, two-thirds of the participants reported a moderate level of moral courage, followed by a low level. Furthermore, there was a strong positive correlation between professional competency and moral courage among staff nurses (r = 0.637**, p = 0.000).

CONCLUSION

This study concluded that there was a strong positive significant relationship between professional competency and moral courage among staff nurses, which answered the research question. This study recommends that training and educational programs should be conducted regularly and continuously to update and expand nurses' knowledge and skills concerning professional competencies and the implementation of ideal models in clinical practice.

Exploring the impact of interaction dynamics and professional capacity and development on cognitive medical errors: a multiple-case study of healthcare professionals in Jordan

BACKGROUND

Addressing cognitve medical errors (MEs) and their contributing factors has emerged as a crucial factor in enhancing patient safety and attaining improved clinical outcomes. This study aimed to examine the impact of interaction dynamics and professional capability and development on cognitive MEs (i.e., mistakes, slips, or lapses) from the perspectives of healthcare professionals in Jordan.

METHODS

A multiple-case study design was employed with a cross-sectional approach. Our study investigated three prominent Jordanian hospitals in the northern region (government, private, and teaching) through a pretested, valid, and reliable survey. Using a convenience sampling, 400 participants from three occupational categories, including physicians, nurses, and clinical managers were invloved. The relationships among the study variables were examined through structural equation modeling (SEM) following Confirmatory Factor Analysis (CFA) conducted using AMOS software.

RESULTS

The results of CFA demonstrated that the model fit indices are acceptable (RMSEA = 0.069; CFI = 0.901; Chisq/df = 2.92; p <.05). The SEM analysis revealed a significant positive association between gaps in professional capacity and development, which comprises three subscales: training needs, continuous medical education, and skills, abilities, and competencies of healthcare professionals, and cognitive MEs (β = 0.40; p <.05). In contrast, a significant negative correlation was found between interaction dynamics among healthcare professionals, including two subscales: interpersonal communication, and teamwork and mutual support, and cognitive MEs (β = - 0.21; p <.05).

CONCLUSION

Our findings advocate for fostering a hospital culture that consolidates efforts to prioritize patient care coordination, and teamwork cohesion, while also minimizing gaps in unmet needs for training and continuing education, and addressing shortcomings in the skills and job competence of healthcare professionals as essential proactive steps to migirate cognitive MEs in Jordanian hospitals.

Cross-cultural Adaptation and Validation of the Italian Version of the Revised Perceived Perioperative Competence Scale

PURPOSE

The nurse's role in the operating room requires essential competencies throughout the care process, such as theoretical knowledge, technical skills, and problem-solving abilities assessed by the Revised Perceived Perioperative Competence Scale (PPCS-R). The study aims to translate, cross-culturally adapt, and validate the Italian version of the scale.

DESIGN

A cross-cultural adaptation and validation of the Italian version of PPCS-R.

METHODS

The revised English version of the 40-item scale PPCS-R was translated into Italian according to Beaton's guidelines. The scale's internal consistency was assessed using Cronbach's α coefficient, ensuring the instrument's reliability. An exploratory factor analysis was conducted, preceded by the Kaiser-Meyer-Olkin test and Bartlett's sphericity test. Statistical analyses were performed using SPSS version 29.1 (IBM Corp.).

FINDINGS

The exploratory factor analysis of the Revised Perceived Perioperative Competence Scale-Italian Version (PPCS-R ITA) (N = 509) confirmed the 6 factors served in the original version. The final Italian version of PPCS-R comprises 40 items grouped into 6 latent factors. Each latent component showed a high consistency per Cronbach's α. The statistical analyses of the study confirm the reliability and good consistency of the tool.

CONCLUSIONS

The statistical analyses of the study confirm the reliability and consistency of the tool (Revised Perceived Perioperative Competence Scale-Italian Version). By investigating the perception of Italian professionals working in the operating room through a translated and validated scale, specific training and professional development needs of a specific context can be better understood to identify appropriate learning and management strategies.

Relationship Between Perceived Psychological Empowerment, Clinical Leadership, and Quality of Work Life Among Chinese Nurses: A Correlational Study

Aim: To investigate the current state of work-related quality of life among Chinese nurses and to explore the mediating effect of clinical leadership between psychological empowerment and quality of work life. Background: The quality of work-life significantly affects nursing team stability and the provision of high-quality care. Psychological empowerment and clinical leadership are considered influential factors in nurses' work-life quality. However, there is a lack of large-scale studies investigating the relationships between these variables. Methods: This nationwide cross-sectional study utilized a multistage stratified proportional sampling approach to select 2633 registered nurses with more than one year of work experience from 17 tertiary general hospitals in China. The data were analyzed using descriptive analysis, Pearson correlation analysis, and structural equation modeling. Results: The quality of work-life score for nurses was 3.38 ± 0.67. Positive correlations were observed between clinical leadership and quality of work life (r = 0.470, p < 0.01). Psychological empowerment was also positively associated with quality of work life (r = 0.570, p < 0.01). The structural equation model revealed that psychological empowerment had a positive direct effect on the quality of work life (β = 0.587, p < 0.001), with clinical leadership playing an intermediary role, accounting for 8.42% of the total effect. Conclusion: Nurses' psychological empowerment was positively associated with the quality of work life and was partially mediated by clinical leadership. These results suggest that psychological empowerment and clinical leadership are key facilitators improving nurses' work-life quality. Implications for Nursing Management: Hospital managers should further raise awareness of empowerment among nurse managers, implement scientifically sound empowerment and clinical leadership programs for nurses, enhance nurses' clinical leadership skills, and promote the quality of nurses' work-life.

The Effects of Grit, Emergency Nursing Competency, and Positive Nursing Organisational Culture on Burnout Among Nurses in the Emergency Department

This descriptive cross-sectional study investigated the relationship between grit, emergency nursing competency, positive nursing organisational culture, and burnout among emergency department nurses and identified the factors influencing burnout. The study participants were 176 nurses from one tertiary and six general hospitals in Chungcheong-do, South Korea. Data were collected from 18 July to 10 August 2024 and analysed using hierarchical multiple regression. Burnout was negatively correlated with grit (r = -0.57, p < 0.001), emergency nursing competency (r = -0.41, p < 0.001), and positive nursing organisational culture (r = -0.60, p < 0.001). It was also negatively correlated with the subdomains of positive nursing organisational culture: active leadership of nurse managers (r = -0.46, p < 0.001), pursuit of shared values (r = -0.55, p < 0.001), trust-based organisational relationship formation (r = -0.62, p < 0.001), and fair management systems (r = -0.55, p < 0.001). The regression analysis showed two variables that significantly affected burnout-trust-based organisational relationship formation in positive nursing organisational culture (β = -0.31, p = 0.012) and grit (β = -0.29, p < 0.001); their explanatory power was 44.0% (F = 18.19, p < 0.001). Thus, positive nursing organisational culture and grit were major factors affecting burnout. Therefore, to prevent and effectively manage burnout among emergency department nurses, nursing organisations must create a positive organisational atmosphere based on mutual respect and trust, promoting active participation in work, decision-making, and collaboration.

Application of a training program system centered on job competency in the standardized training of new nurses

OBJECTIVE

This study investigates the effectiveness of a job competency-centered training system for newly hired nurses during their induction training.

METHODS

The control group included 41 nurses who underwent traditional teaching models from 2020 to 2021. The observation group consisted of 39 nurses trained from 2022 to 2024, focusing on job competency. This training covered basic theoretical knowledge, operational skills, professional conduct, communication, emergency response, and comprehensive nursing care skills. Post-training evaluations included competency, theoretical and practical examination scores, Nursing-Mini-CEX excellence rates, patient satisfaction, and humanistic care abilities.

RESULTS

The observation group achieved higher scores across all assessment areas compared to the control group. Theoretical examination scores were (95.987 ± 2.129) vs. (94.756 ± 2.773), practical scores were (96.987 ± 1.254) vs. (95.902 ± 1.855), and comprehensive scores were (96.487 ± 1.234) vs. (95.329 ± 1.841). Mini-Clinical Evaluation Exercise (Mini-CEX) scores were (8.795 ± 0.409) for the observation group and (8.439 ± 0.594) for the control group. In job competency dimensions, the observation group scored: professional quality (10), general work capability (34.718 ± 0.916), communication and coordination (13.949 ± 0.605), proactive management (13.974 ± 0.778), patient safety (14.128 ± 0.767), health education (8.564 ± 0.552), and overall competency (95.333 ± 1.420). Conversely, the control group scored: professional quality (10), general work capability (34.268 ± 0.708), communication and coordination (13.634 ± 0.733), proactive management (13.634 ± 0.733), patient safety (13.780 ± 0.725), health education (8.293 ± 0.599), and overall competency (93.610 ± 1.481). For humanistic care ability, the observation group had cognitive (66.41 ± 3.362), courage (65.923 ± 3.115), and patience dimensions (60.308 ± 3.686), totaling (192.641 ± 5.451). The control group's scores were cognitive (64.488 ± 3.543), courage (64.317 ± 3.446), and patience (57.902 ± 5.004), totaling (186.707 ± 8.143). Patient satisfaction rates were 100% in the observation group and 95.12% in the control group. Nurses trained under the competency-based model showed significant enhancements in job competency, patient satisfaction, and humanistic care compared to those trained under traditional methods.

CONCLUSION

The job competency-centered induction training model significantly enhances new nurses' job competence, theoretical and practical assessment scores, humanistic care abilities, and patient satisfaction compared to traditional models.

Enhancing the retention of newly qualified nurses

The retention of newly qualified nurses (NQNs) is a pressing issue in healthcare systems, particularly in high-pressure environments such as acute care. This article explores the key challenges faced by NQNs, including lack of career development opportunities, negative workplace cultures and burnout, all of which contribute to high turnover rates. Strategies such as structured preceptorship and mentorship programmes, emotional wellbeing initiatives, and leadership support are examined. The article underscores the importance of building a positive work environment to retain NQNs, thereby improving workforce sustainability and patient care. Additionally, recommendations are provided to enable a proactive approach to improving NQN retention.

Evaluating the outcomes of patient safety education programs in nursing education: a scoping review

PURPOSE

This study aimed to identify the trends in scholarly research related to patient safety education programs and outcome evaluations in the field of nursing education, focusing on providing a comprehensive overview of the current state of patient safety education and suggesting directions for future program development and evaluation.

METHODS

We conducted a scoping review using Arksey and O'Malley's 5-step framework and searched five databases; Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), PubMed, Science Direct, and Research Information Sharing Service (RISS) for Korean literature.

RESULTS

Of the 1626 articles retrieved, we identified 27 articles published between 2006 and 2023. The articles' educational content focused on comprehensive patient safety education using instructional methods such as lectures, discussions, simulations, and online education. The effectiveness of the programs was evaluated primarily via knowledge, skills, and attitudes toward patient safety, and behavioral and results-related outcomes were rarely evaluated at Kirkpatrick's evaluation., The most commonly used tools were the Health Professional Education in Patient Safety Survey and the questionnaire developed by the World Health Organization Patient Safety Program. The evaluation was conducted using quantitative and qualitative methods, but follow-up tests were rarely conducted.

CONCLUSION

Our review findings suggest that patient safety education programs for nursing students and clinical nurses should apply diverse teaching methods and comprehensive evaluation strategies to enhance their overall effectiveness and ensure the practical application of safety practices. It is essential to diversify program evaluation metrics, such as experiential learning and interprofessional education, by expanding performance indicators at both learner and institutional levels for long-term repeated assessments.

Exploring the hidden synergy between system thinking and patient safety competencies among critical care nurses: a cross-sectional study

BACKGROUND

Patient safety remains a global priority, with nurses playing a crucial role in minimizing errors and improving patient outcomes. System thinking, which involves understanding how various components of a healthcare system interact, is increasingly recognized as essential for enhancing patient safety competencies.

AIM

This study investigates the impact of systems thinking on patient safety competencies among nurses in critical care units, exploring the relationship between systems thinking and various subdomains of patient safety competencies.

METHODS

A cross-sectional study was conducted at all critical care units of Alexandria Main University Hospital, Egypt. Data were collected from a convenience sample of 289 nurses using the system thinking scale and the patient safety competency self-evaluation questionnaire. Correlation and regression analyses were performed to examine the relationship between systems thinking and patient safety competencies, controlling for demographic factors such as age, qualifications, and years of experience.

RESULTS

Nurses demonstrated moderate to high levels of systems thinking (mean = 82.36 ± 12.14) and patient safety competencies (mean = 162.74 ± 23.56). Strong positive correlations were found between systems thinking and patient safety competencies (r = 0.605, p < 0.05), particularly in areas such as error reporting, communication, and infection prevention. Regression analysis revealed that systems thinking significantly predicted patient safety competencies, increasing the explained variance from 58.8 to 67.7%.

CONCLUSION

The findings highlight the critical role of systems thinking in enhancing nurses' patient safety competencies. Nurses with higher systems thinking skills are better equipped to prevent errors and improve communication, ultimately enhancing patient care quality.

IMPLICATIONS

Nursing schools should integrate system thinking into nursing curricula to prepare future nurses for complex healthcare environments. Healthcare organizations should incorporate system thinking into professional development programs to enhance the competencies of practicing nurses. Nurse managers can foster a culture of safety by promoting interdisciplinary collaboration and reflective practice. Broader adoption of system thinking can improve patient outcomes, especially in resource-constrained environments.

CLINICAL TRIAL NUMBER

Not applicable.

Compassion Competence and Patient Safety Competency in psychiatric nurses

BACKGROUND

Compassion Competence and the ability to strive to understand the suffering of patients in psychiatric ward is essential for nurses to establish effective therapeutic communication in the process of their recovery. Patient Safety Competency is of great importance for nurses to prevent adverse events and minimize errors. This study aimed to investigate the relationship between Compassion Competence and Patient Safety Competency in nurses working in psychiatric wards of Shiraz University of Medical Sciences affiliated hospitals in 2024.

METHOD

This descriptive-analytical study was conducted on 184 nurses working in the psychiatric wards of Shiraz University of Medical Sciences affiliated hospitals from January 2024 to April 2024 as a census. Data were collected using the Compassion Competence, Patient Safety Competency and Demographic Survey questionnaires and were then analyzed using descriptive and analytical statistics. The analyses were performed using SPSS 22 statistical software.

RESULTS

The results showed that the compassion competence score of psychiatric nurses was 3.98 ± 0.46, with subscales of sensitivity (4.05 ± 0.56), insight (3.79 ± 0.62), and communication (4.04 ± 0.48). Additionally, the patient safety competency score of psychiatric nurses was 3.56 ± 0.44, with subscales of attitude (3.67 ± 0.34), knowledge (3.06 ± 0.77), and skill (3.63 ± 0.58). A statistically significant correlation was also found between Compassion Competence and Patient Safety Competency (r = 0.458, p < 0.001). Regression results showed that the sensitivity (p = 0.012) and insight (p = 0.026) dimensions predict Patient Safety Competency. Among the demographic variables, only the completion of a communication skills course was significantly associated with both Compassion Competence (p = 0.04) and Patient Safety Competency (p = 0.02).

CONCLUSION

The findings of this study revealed a statistically significant correlation between Compassion Competence and Patient Safety Competency among psychiatric nurses. It is recommended that educational programs be designed to consider these two components and their dimensions to help enhance the competencies of nurses.

CLINICAL TRIAL NUMBER

Not applicable.

Fostering Caring Attributes to Improve Patient Care in Nursing Through Small-Group Work: Perspectives of Students and Educators

Background: Nursing relies on the development of caring attributes to uphold exceptional standards of care. While small-group work is a common practice in nursing education, its pivotal role in nurturing these attributes often remains underexplored. Aim: This study explored how caring attributes emerge in small-group settings from the perspectives of nursing students and educators. Methods: This qualitative study conducted semi-structured group interviews separately for students and educators. Thirteen nursing students and ten educators at a professional educational institution were interviewed. Results: Through the interviews, four key sets of caring attributes nurtured through small-group work were identified: interpersonal communication with respect; compassion and empathy; competence and confidence; and accountability to commitment. These findings, based on the perspectives of students and educators, underscore the essential role of caring in nursing. They emphasize how collaborative group work can serve as a catalyst for the development of these vital attributes through meaningful interpersonal interactions. Notably, the cultivation of respectful communication skills among students emerged as pivotal for enriching interactions with healthcare professionals, patients, and families, ultimately enhancing the quality of care provided. By providing a platform for interactive learning and continual practice, small-group work facilitates the internalization of these caring attributes, nurturing nursing professionalism over the course of students' careers. Conclusions: This study offers invaluable insights into the profound impact of small-group work in fostering caring attributes and propelling advancements in nursing education and practice. By enhancing the development of these attributes, small-group work contributes to the delivery of compassionate and high-quality patient care.

Trends in patient safety education research for healthcare professional students over the past two decades: a bibliometric and content analysis

Research and practice in patient safety education have garnered widespread attention; however, a comprehensive bibliometric analysis is lacking. This study aimed to provide a comprehensive understanding of the research focus and research trends in the globalization of the field of patient safety education and to describe the general characteristics of publications. Data on articles and reviews about student safety education were extracted from Web of Science. Microsoft Excel 2019, CiteSpace 6.1.R3, VOSviewer 1.6.18, SATI 3.2, Scimago Graphica, and Pajek were used for quantitative analysis. Collaboration networks of countries, institutions, journals, authors, and keywords were visualized based on publications from January 2000 to September 2022. A total of 573 papers were published between 2000 to 2022, showing an overall increasing trend. The USA, England, and Australia are the top three most prolific countries; Johns Hopkins University, the University of Technology Sydney, and the University of Toronto are the top three most productive institutions; Nurse Education Today, Journal of Nursing Education, and BMC Medical Education are the most productive journals; Based on content analysis five research hotspots focused on: (1) Quality Improvement of Patient safety Teaching and Learning; (2) Patient safety Teaching Content; (3)Specialized Teaching in Patient Safety; (4) Integrating Patient Safety and Clinical Teaching; (5)Patient Safety Teaching Assessment Content. Through keyword clustering analysis, five research hotspots and relevant contents were identified. According to this study, simulation, communication, collaboration, and medication may attract more attention from researchers and educators, and could be the major trend for future study.

What are the training needs of emergency department resuscitation nurses? A scoping review

BACKGROUND

The emergency resuscitation nurse is a challenging and specialised role at the forefront of critical care practice in the emergency department. Despite their extensive specialist knowledge and skill requirements, in Australia there is no state-wide or nationally agreed approach to how to best provide training that meets a set of fixed objectives and requisite skills for resuscitation nurses. Due to an ageing nursing population and increasing workforce attrition, an efficacious accelerated pathway to acquire specialist resuscitation nursing knowledge, is necessary.

AIM

The aim of this review is to identify, consolidate and summarise the available evidence on the training needs for the requisite clinical and non-technical skills of emergency resuscitation nurses ELIGIBILITY CRITERIA: Papers about nurses currently working in the emergency department; including Nurse Unit Managers (NUMs), Clinical Nurse Educators (CNEs), Clinical Nurse Consultants (CNCs), Clinical Nurse Specialists (CNSs), Registered Nurses (RNs) and Enrolled Nurses (ENs) were included. The review included primary and non-primary research, including papers addressing how emergency nurses are trained. There was no date limitation set to ensure all results could be reviewed. Papers that were not published in English, included nurses who were not working in the ED, or included doctors, allied health, and other staff where population cohorts could not be distinguished, were excluded. Abstract only, editorials, conference posters or oral presentations, were also excluded.

SOURCES OF EVIDENCE

Searches were conducted in MEDLINE, CINAHL and EMCARE. The authors conducted extensive hand-searching of the included study reference lists as well as the grey literature to ensure that all relevant literature was captured.

METHODS

A scoping literature review was conducted.

RESULTS

Data extraction was conducted on the final 33 articles (23 peer reviewed studies and 10 competency and practice standards documents). Specific training requirements to achieve competence in the requisite clinical and non-technical skills in resuscitation nursing do not exist. A decline in competency without regular reinforcement was reported. Multi-modal approaches, incorporating diverse teaching methods, show potential in enhancing knowledge retention and skill acquisition.

CONCLUSION

Resuscitation nursing lacks a standardised training approach in Australia, leading to a gap in ensuring consistent skill acquisition and knowledge among nurses. Research is required to identify what resuscitation nursing skills and training are necessary to ensure practice effectively meets the needs of patients.

Nursing core competencies and educational needs in the low- and middle-income country: A cross-sectional study

BACKGROUND

The government of the Kyrgyz Republic is committed to improving healthcare worker education, and as nurses comprise the majority of healthcare workers, improving nursing education and competency is a critical policy strategy. However, insufficient understanding of nurses' duties and competencies, low levels of professional education and motivation, and the poor reputation of the profession have negatively impacted the development of nursing in the Kyrgyz Republic.

AIM

This study aimed to identify the core competencies of nursing that are necessary for improving healthcare in the Kyrgyz Republic.

DESIGN

The research design was a cross-sectional study.

SETTING

The study was conducted from June to November 2022 across the Kyrgyz Republic.

PARTICIPANTS

A total of ten focus group interviews were conducted with 54 participants, and 289 individuals responded to the survey.

METHODS

A job analysis was conducted to identify nursing core competencies, followed by focus group interviews. Educational needs were assessed and analysed for importance and performance using the Competency Inventory for Registered Nurses and the Borich Needs Assessment Model.

RESULTS

Of the 289 participants, 97.9 % were female, the mean age was 43.22, and the mean nursing career length was 19 years. Eleven duties were identified as nursing core competencies. Educational needs were highest for teaching-coaching, followed by clinical care and critical thinking and research aptitude, with interpersonal relations being the lowest. Critical thinking and research aptitude, clinical care, and professional development were identified as topics with high importance and educational needs.

CONCLUSIONS

The nursing core competencies reflect the emphasis on primary health care in the Kyrgyz Republic, while the educational needs were related to international nursing standards and national nursing education characteristics. The findings can be used to develop a bachelor's-level nursing curriculum in the Kyrgyz Republic to improve nursing care and contribute to improving the health status of the population.

Challenges in Clinical Training for Nursing Students during COVID-19: Examining Its Effects on Nurses' Job Satisfaction

Introduction

Nursing education involves a robust blend of theory and hands-on practice, crucial for cultivating the intricate abilities required to safely progress from being a student to becoming a proficient nursing professional. This training process was disrupted by the COVID-19 pandemic when the imposition of lockdowns compelled the transition of classes from in-person to online formats.

Aim

This study aimed to assess the challenges in clinical training for nursing students during the COVID-19 pandemic, specifically examining how reductions in hands-on clinical practice have impacted their job satisfaction upon entering the workforce.

Methods

It was an exploratory, descriptive, and cross-sectional study, using the Font Roja Questionnaire on job satisfaction as an instrument for data collection. The population was made up of Spanish nurses who graduated in 2020, 2021, and 2022.

Results

The sample consisted of 390 nurses, 81.5% female, averaging 24.35 years old, with 76% having missed at least one month of clinical practice during their training. We found significant levels of dissatisfaction with job pressure and professional competence (52.3% and 40.8%, respectively). Statistically significant differences were found between gender, job pressure, year of graduation, and professional competence.

Conclusion

The loss of clinical practice periods, a vital element in nursing education, has influenced the early careers of these nurses, particularly affecting certain aspects of their job satisfaction such as job pressure and professional competence.

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.

Development and validation of a new satisfaction scale for objective structured clinical assessments (S-OSCA): A multicenter cross-sectional study

BACKGROUND

Nursing clinical competence assessment has acquired a special relevance at the undergraduate and postgraduate levels in recent years. In this context, the Objective Structured Clinical Assessment (OSCA) has emerged as a valid and feasible method of assessing nursing competence. The Satisfaction with Nursing Skill Examination: Objective Structured Clinical Assessment (SINE-OSCA) scale is a valid and reliable 10-item measure that has been developed to evaluate nursing students' satisfaction with the OSCA in the Australian context. Given the importance that OSCA has gained in Spain, it is necessary to validate this tool to be used in one of the most spoken languages in the world.

OBJECTIVES

The purpose of the study was to carry out a modification of the SINE-OSCA, cross-cultural adaptation and a psychometric analysis of the new S-OSCA with Spanish nursing students.

DESIGN

A multicenter study of questionnaire development and validation was carried out in 2023 in four Spanish university nursing centers. The study was carried out in 3 phases: design, pilot implementation, and construct validation.

PARTICIPANTS/SETTING

The total population of students from these centers amounted to 1350 students. The final sample consisted of 364 nursing students, selected by convenience sampling.

METHODS

The process of translation and cultural adaptation of SINE-OSCA to the Spanish population was carried out following the guidelines proposed by Beaton et al. Content validation, Internal consistency and temporal reliability were evaluated.

RESULTS

The S-OSCA presents values in the psychometric indicators (V AIKEN, Bland-Altman diagram, and IVC Lawshe) that exceed the cut-off values established even considering the lower limit of the confidence intervals. This spanish version of the SINE-OSCA has a Cronbach's alpha value that is slightly higher than that reported for that original version (0.928 CI 95 % (0.913-0.94)). Regarding temporal reliability, the S-OSCA scale was completed in 40 nursing students at two times separated by an interval of 15 days. The Intraclass Correlation Coefficient (ICC) obtained was 0.974 CI 95 % (0.952-0.986).

CONCLUSIONS

The S-OSCA instrument proves to be robust enough to guarantee the quality of its results up to 15 days post-OSCA.

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing, China: A cross-sectional study

Objectives

This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City, China, and provide suggestions to enhance these competencies.

Methods

This study was conducted in 204 hospitals in Southwest China from December 24, 2022 to January 7, 2023. The "Geriatric Nursing Competence of Clinical Nurse Investigation Tool" was used to explore factors that influence geriatric nurses' competencies via stratified sampling. The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.

Results

A total of 10,692 nurses answered the questionnaires. Of these questionnaires, 9,442 were valid. The total geriatric nursing competence score of the clinical nursing staff was 2.29 ± 0.81, the secondary hospital score was 2.23 ± 0.78, and the tertiary hospital's overall mean score was 2.33 ± 0.83. The factors that influenced secondary hospitals included the department of medicine, age of nurses and total length of career (P < 0.05). The factors that influenced tertiary hospitals included the department of medicine, age of nurses, nurses' professional title, and geriatric practical advanced nurses' certification (P < 0.05).

Conclusions

Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors. The findings highlight the need for further clinical training in geriatric nursing. The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

Service demand analysis and optimization strategy construction of emergency observation patients based on the Kano model

Background

Emergency observation unit in China are characterized by a high number of patients, complexity of diseases, and instability of patient conditions, leading to low patient satisfaction. The Kano model is an effective method widely used to identify customer demands and improve service quality to enhance customer satisfaction. However, its application in emergency observation unit has been studied less. This study aims to design a questionnaire based on the Kano model and identify the demands of emergency observation patients to determine priorities for improvements in the emergency observation unit and improve patient satisfaction.

Methods

A cross-sectional study was conducted in Guizhou Provincial People's Hospital from March 21st, 2023, to May 20th, 2023. A convenient sampling method was used to recruit 100 patients from the emergency observation unit, who completed a questionnaire designed based on the Kano model to assess their demands for care service. Data were analyzed using IBM SPSS Statistics 28.0 software. The element selection line and sensitivity analysis were used to determine factors for patient service demand improvement.

Results

A total of 13 patient service demands for improvement were screened out from 19 service demands, including 1 item of must-be quality (M), 11 item of one-dimensional quality (O), and 1 item of attractive quality (A), These attributes showed significant differences in patients' sociodemographic characteristics.

Conclusion

The Kano model is a valuable tool for identifying the characteristics of patients' service demands, and the element screening method can be employed to establish the hierarchy of these demands. These results offer crucial direction for creating forthcoming nursing management initiatives in emergency observation unit.

Exploring the perception of safety culture among nurses in Saudi Arabia

BACKGROUND

Medical errors and adverse events pose a serious challenge to the global healthcare industry. Nurses are at the frontline in implementing safety measures and protecting patients. This study aimed to investigate nurses' perceptions of the patient safety culture in Saudi Arabia.

METHODS

This cross-sectional descriptive study used convenience sampling to survey 402 nurses from various hospitals in Jazan, Saudi Arabia. The Hospital Survey on Patient Safety Culture was used for the data collection.

RESULTS

Nurses reported a moderate perception of safety culture, with 60% positive responses. Teamwork had the highest safety culture rating at 77.8%, while responses to error and staffing were the lowest at 39.75% and 46.17%, respectively. Qualifications significantly predicts nurses' safety culture rating (B = -0442, t = -4.279, p < 0.01). Positive correlations were found between event reporting frequency and communication openness (r = 0.142, p < 0.01), and patient safety grades with communication about errors (r = 0.424, p < 0.01) and hospital management support (r = 0.231, p < 0.01).

CONCLUSIONS

Nurses in Saudi Arabia demonstrated a strong sense of teamwork and commitment to organizational learning. However, critical areas such as staffing and error response require attention to improve patient safety.

Assessing nurses' professional competency: a cross-sectional study in Palestine

BACKGROUND

Evaluating nurses' professional competence is critical for ensuring high-quality patient care. Therefore, this study aimed to evaluate the nurses' professional competence level and to identify differences based on demographics in three West Bank hospitals.

METHODS

A cross-sectional design was used, and a convenient sample of 206 nurses participated in the study. The Nurse Professional Competence (NPC) Scale was used to assess the competency level. The investigator distributed the questionnaire and explained the aim of the research. Consent forms were signed before the data collection.

RESULTS

The average competency level was 79% (SD = 11.5), with 90% being professionally competent nurses. The average "nursing care" competency was 79% (SD = 12.98), and the competency level in providing value-based care was 80% (SD = 13.35). The average competency level in technical and medical care was 78% (SD = 13.45), whereas 79% (SD = 12.85) was the average competence level in "Care Pedagogics" and "Documentation and Administration ". The average competence level in the development and leadership subscale was 78% (SD = 12.22). Nurses who attended three to five workshops had a higher level of Nursing Care Competency, (H = 11.98, p = 0.003), and were more competent in value-based care (H = 9.29, p = 0.01); in pedagogical care and patient education (H = 15.16, P = 0.001); and in providing medical and technical care (H = 12.37, p = 0.002). Nurses attending more than five workshops were more competent in documentation and administration (H = 12.55, p = 0.002), and in development and leadership subscale ( H = 7.96, p = 0.20).

CONCLUSION

The study revealed that participants lacked development and leadership skills. Engagement in workshops positively impacted the level of competencies among nurses. Notably, those attending more than five workshops exhibited greater competence in documentation, administration, development, and leadership in nursing care.

IMPLICATIONS

This study emphasized the role of continuing education in improving nurses' competencies and highlighted the need to conduct the study at a wider aspect to involve more hospitals with various affiliations to help structure more sensitive professional development and adopt the competencies as an integral part of staff development.

Exploring the consequences of nurses' involvement in disaster response: findings from a qualitative content analysis study

BACKGROUND

The presence of nurses during disasters can lead to many consequences. Understanding the nurses' experiences of these consequences can provide valuable insights. Therefore, this study was conducted to explore the experiences of Iranian nurses regarding the consequences they faced when being present during disasters.

METHODS

This qualitative descriptive study employed a content analysis approach to examine the topic at hand. 20 nurses working in the emergency units of Kerman hospitals were selected through purposive sampling. In-depth semi-structured interviews were conducted to collect the data. The data were analyzed using qualitative content analysis proposed by Graneheim and Lundman. MAXQDA 10 was used to manage data.

RESULTS

After analysis of the interviews, two main categories were identified: overlapping of job frustrations and acquiring experience in difficult conditions. The main category of acquiring experience in difficult conditions comprised the following subcategories: improved quality of care, experience and dedication in fulfilling the role, reduced stress, occupational motivation and enthusiasm, increased self-confidence, and improved social status. On the other hand, the category of overlapping of job frustrations also consisted of the subcategories of physical strength deterioration, psychological and emotional distress, discontinued from supports, feelings of hopelessness, increased exposure to violence and aggression, and occurrence of family problems.

CONCLUSION

Being present during disasters and obtaining the necessary competencies can have positive consequences that serve as turning points in the personal and professional growth of nurses. Additionally, favorable outcomes can help nurses cope with adverse circumstances. Managers can utilize the findings of this study to develop strategies aimed at reducing negative outcomes and enhancing positive ones among nurses during disasters.

Effects of burnout and work engagement in the relationship between self-efficacy and safety behaviours-A chained mediation modelling analysis

AIMS

To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety.

DESIGN

An anonymous cross-sectional survey.

METHOD

A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self-efficacy by the General Self-efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self-efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self-efficacy, occupational burnout and work engagement.

RESULTS

The total score of safety behaviour of nurses was 55.45 ± 6.879, the total score of general self-efficacy was 31.39 ± 5.729, the total score of occupational burnout was 44.99 ± 26.587, and the total score of work engagement was 38.48 ± 13.433; the scores of the Nurse Safety Behaviour Scale, Self-Efficacy Scale, and Work Engagement Scale were positively correlated (all p < .001); the occupational burnout scale was negatively correlated with the scores of self-efficacy scale, work engagement scale and nurse safety behaviour scale (all p < .001); Structural equation model analysis shows that self-efficacy and work engagement have a direct positive impact on nurse safety behaviour(β = .103, β = .096, all p < .001); Occupational burnout has a direct negative impact on self-efficacy, work engagement and nurse safety behaviour(β = -.371, β = -.413, β = -.328 all p < .001). Bootstrap analysis showed that occupational burnout and job involvement had a significant chain mediating effect between self-efficacy and the safety behaviour of nurses (95% CI: 0.148-0.21). The total effect of self-efficacy on the safety behaviour of nurses was 0.283 (p < .001, 95% CI: 0.225-0.301), the direct effect was 0.096 (p < .001, 95% CI: 0.042-0.15), and the indirect effect was 0.179 (p < .001, 95% CI: 0.085-0.215), The mediating effect accounted for 63.3% of the total effect size.

CONCLUSION

Occupational burnout and work engagement play a partial mediating role between self-efficacy and nurse safety behaviour. It is necessary to strengthen training on nurse safety culture awareness, improve the nurse self-efficacy and work engagement, reduce nurse occupational burnout, and thereby improve the level of nurses' safety behaviour.

Specialized nurses' role in ensuring patient safety within the context of telehealth in home care: A scoping review

Objectives

Specialized nurses are uniquely positioned to implement innovative telehealth solutions to improve the quality and safety of home care, and this has become a focal point of contemporary healthcare research. This review aimed to identify the nature and scope of specialized nurses' roles in ensuring patient safety within the context of telehealth in home care.

Methods

A scoping review of the international literature was carried out from January 1, 2013, to August 29, 2024. The review employed Levac et al.'s framework to delineate the research phenomenon and consolidate existing empirical research findings. Through a comparative analysis, the review integrated findings from selected studies, highlighting both similarities and differences related to this phenomenon, which led to the development of distinct categories.

Results

The search yielded 1127 articles, from which 23 studies met the inclusion criteria for research synthesis and subsequent reporting of results. These studies spanned specialized nurses' roles in telehealth and various fields in which specialized nurses utilized telehealth to deliver high-quality and safe home care. The findings highlighted key outcomes linked to the improvement of patient safety in home care encompassing continuity of care, confidence in care, monitoring and early intervention, medication safety, engagement and adherence, and healthcare costs.

Conclusions

The review revealed the crucial role played by specialized nurses in harnessing telehealth in healthcare to meet the highest care standards, creating an environment that prioritizes the well-being and patient safety in home care.