Work-related Communication Mediates the Relationship between Perceived Diversity Climate and Psychological Empowerment among Part-time Nurses: A Cross-sectional Study

AIM

This study investigates which work-related communication mediates the relationship between diversity climate and psychological empowerment among part-time nurses.

BACKGROUND

Part-time nurses' high psychological empowerment is desirable because it may lead to high quality nursing practice.

METHODS

Anonymous self-report questionnaires or web-based surveys were used to measure diversity climate (Climate for Inclusion Scale), psychological empowerment (Japanese version of the Psychological Empowerment Scale), and work-related communication (scale developed in this study). The respondents were part-time nurses from departments with shift work in six Japanese hospitals having over 200 beds. The surveys were conducted from September to October 2020. Multiple regression analyses and a significance test of indirect effects were then conducted.

RESULTS

Among the work-related communication components, "expressing thoughts about their work" fully mediated the relationship between diversity climate and psychological empowerment.

CONCLUSIONS

It is important for part-time nurses to be actively "expressing thoughts about their work" to enhance their psychological empowerment. Positive diversity climate is also important because it allows part-time nurses to express their thoughts regarding work.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can enhance part-time nurses' psychological empowerment by encouraging them to express their work-related opinions based on the diversity climate.

A comparison of middle managers' and paediatric nurses' satisfaction with organisational communication

AIMS

To explore the differences in organisational communication satisfaction between ward paediatric nurses and middle managers, and to assess whether there is a difference in organisational communication satisfaction between paediatric nurses and middle managers with different educational levels, years of nursing and managerial experience, contracted hours, area of work, age and gender.

BACKGROUND

Previous studies reported a connection between job satisfaction, work commitment and organisational communication; however, nurses' and nursing middle managers' satisfaction with organisational communication has not been extensively studied in recent years and not at all among paediatric nurses.

METHODS

A cross-sectional quantitative research design using online and hard copy self-reported questionnaires was used. Data were collected at one point in time from paediatric nurses and middle (nursing) managers working in a tertiary paediatric hospital in Australia. Statistical methods were employed for data analysis.

RESULTS

The middle management group were significantly more dissatisfied with organisational communication than the paediatric ward nurse group. Middle managers were found in this study to effectively manage and maintain communication lines with the personnel who reported to them; however, communication within the management cohort itself was found to be suboptimal.

CONCLUSION

Further research to understand how horizontal and vertical communications at the nurse manager and executive level can be optimised is required.

IMPLICATIONS FOR NURSING MANAGEMENT

It is anticipated that the findings from this study may increase the understanding of communication satisfaction between paediatric nurses and middle managers. The study has highlighted the need for improvement with information flow in the management cohort with the addition of extra managerial support and empowerment.

Research progress of “shared nurses” under the family community hospital integrated management mode

In order to meet the diverse and multilevel health service needs of the people, following the implementation of the “multi-point practice” of registered physicians by the government in 2009, many pilot projects on the legality of “shared nurses” have been carried out, but there are many difficulties in the process. Through reviewing and researching the relevant literature inland and abroad, this study explores the application of family-community-hospital integrated medical and nursing management model in order to provide a reference for the development and management of “shared nurses” in China.

What do we know about our agency nurse population? A scoping review

BACKGROUND

Nurse staffing shortages are often managed by using temporary staff. This review discovers what is known about nurses who choose to work in this way.

PROCEDURE

A literature search found eight international studies investigating the lived experience of agency nurses.

RESULTS

Nurses actively choose agency nursing to work flexibly and avoid office politics or as a career stop-gap. However, respondents describe feeling isolated, working difficulties with permanent staff and fewer opportunities for training.

CONCLUSIONS

Though participants described positive reasons for choosing agency nursing, there were significant downsides. The findings must be viewed in the context of the continued feminized nature of the nursing profession as care responsibilities were cited as a reason for choosing this study pattern. However, the lack of security and provision of adequate pensions and career advancement are considerable issues. The costs of using agency staff are high and consideration must be given to encouraging these nurses into substantive contracts. These individuals show considerable resilience, flexibility, and varied expertise. Such qualities are vital for health care in the 21st century and understanding why they opt out of permanent nursing will enable employers to adapt practices to harness this. Suggestions for practice and further research are presented.

The influence of effective communication, perceived respect and willingness to collaborate on nurses' perceptions of nurse-physician collaboration in China

BACKGROUND

Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China.

AIMS

To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration.

METHODS

A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used.

RESULTS

Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ± 0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ± 0.68, mean = 3.87 ± 0.75, mean = 4.50 ± 0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R² = 0.573, F = 435.563, P < 0.001). Perceived respect (β = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (β = 0.315), and the weakest factor among these three factors was willingness to collaborate (β = 0.160).

CONCLUSION

Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information; however, improvements need to be made regarding Joint participation in the cure/care decision-making process. Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate.

Utilisation and costs of nursing agencies in the South African public health sector, 2005-2010

BACKGROUND

Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals.

OBJECTIVE

The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector.

DESIGN

A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6-2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices).

RESULTS

Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year, a total of 5369 registered nurses could have been employed in lieu of nursing agency expenditure.

CONCLUSIONS

The study findings should inform workforce planning in South Africa. There is a need for uniform policies and improved management of commercial nursing agencies in the public health sector.

Factors influencing agency nursing and moonlighting among nurses in South Africa

Background

In South Africa, nurses are the largest category of the health care providers. Their optimal performance is critical for the successful implementation of impending health sector reforms.

Objective

This paper examines the occurrence of agency nursing, moonlighting, and overtime among nurses in South Africa, and the factors influencing moonlighting.

Design

This cross-sectional survey was a one-stage cluster random sample of 80 hospitals in four South African provinces, selected with stratification from the public and private health sectors. On the survey day, all nurses working in critical care, theatre, emergency, maternity, and general medical and surgical wards completed a self-administered questionnaire after giving informed consent. In addition to demographic information, the questionnaire elicited information on the frequency of agency nursing, moonlighting, and overtime, and the nurses’ reasons for doing moonlighting. Survey data were weighted and analysed using STATA version 12.

Results

The majority of survey participants (n=3,784) were South African (98.0%), female (92.7%), and employed in government (52.8%). Their mean age was 41.5 years (SD 10.4). The occurrence of moonlighting among nurses in the 12 months preceding the survey was 28.0% [95% CI: 24.2–32.1], the frequency of agency nursing was 37.8% [95% CI: 32.4–43.6], while 56.0% of nurses did overtime [95% CI: 51.4–60.4]. In the multiple logistic regression analysis, predictors of moonlighting were province, sector of primary employment, unit of work, category of nurse, and having children. The odds of moonlighting was 1.51 [95% CI: 1.03–2.21] times higher for private sector nurses than for public nurses, while the odds ratio for auxiliary nurses was 0.61 [95% CI: 0.47–0.79] compared to professional nurses. The odds of moonlighting was 1.49 [95% CI: 1.18–1.89] for nurses with children, compared to those without.

Conclusions

Agency nursing, moonlighting, and overtime are common among South African nurses, but have received insufficient policy attention. These issues need to be addressed as part of the implementation of comprehensive health workforce strategies.

Nursing clinical handover in neonatal care

BACKGROUND

Clinical handover ensures continuity of care, providing the opportunity to transfer responsibility and accountability for the care of a patient from nurse to nurse.

AIM

The aim of this study was to examine afternoon nursing clinical handover from the perspective of nurses, exploring the quality of information, the interactions and support, the efficiency and the involvement of parents in a private neonatal unit.

METHODS/DESIGN

An exploratory, descriptive, prospective quantitative survey with qualitative elements was undertaken using The Handover Evaluation Scale (O'Connell, MacDonald, & Kelly, 2008). All nurses working in the Neonatal unit who attend afternoon handover, were invited to participate in the study (N = 22), with N = 16 responses received.

RESULTS/FINDINGS

The quantitative and qualitative results indicate that the quality of the information handed over in neonatal care units can be maintained despite intrinsic limitations. Additionally, high levels of support and interaction between nursing staff in this stressful practice environment occur during the handover period.

CONCLUSION

Given the vulnerability of neonates it is important that accurate information is efficiently handed over. In order to do this distractions should be minimised. Finally, parental involvement in handover should be actively encouraged whenever feasible.

Barriers to information exchange during older patients' transfer: nurses' experiences

AIMS AND OBJECTIVES

To describe nurses' experiences of barriers that influence their information exchange during the transfer of older patients between hospital and home care.

BACKGROUND

The successful transfer of an older patient across health organisations requires good communication and coordination between providers. Despite an increased focus on the need for cooperation among providers across healthcare organisations, researchers still report problems in the exchange of information between the hospitals and the healthcare systems in the municipalities.

DESIGN

A qualitative study using focus group methodology.

METHODS

Three focus group interviews using topic guides were conducted and interpreted. The study included registered nurses (n = 14) from hospital and home care. The data were analysed through content analysis.

RESULTS

Three main themes were identified: barriers associated with the nurse, barriers associated with interpersonal processes and barriers associated with the organisation. These themes included several subthemes.

CONCLUSIONS

The findings highlight the challenges that nurses encounter in ensuring a successful information exchange during older patients' transfer through the healthcare system. The barriers negatively influence the nurses' information exchange and may put the patients in a vulnerable and exposed situation. In order for nurses to conduct a successful exchange of information, it is critical that hospital and home care systems facilitate this through adequate resources, clear missions and responsibilities, and understandable policies.

RELEVANCE TO CLINICAL PRACTICE

Recognition of the barriers that affect nurses' exchange of information is important to ensure patient safety and successful transitions. The barriers described here should help both nurses in practice and their leaders to be more attentive to the prerequisites needed to achieve a satisfactory nursing information exchange and enhance informational continuity.

Full-time work for nurses: employers' perspectives

AIM

To examine an employer response to a government employment policy, the Nursing Graduate Guarantee (NGG), over a 2-year period (2008-2009 and 2009-2010).

BACKGROUND

Healthcare organizations rely on a stable supply of nurses to meet their staffing needs. However, employment trends have indicated a propensity for part-time employment. The NGG was created to stimulate full-time employment of new graduate nurses in Ontario, Canada.

METHODS

A mixed methods design was used, which included online surveys and focus groups. All healthcare providers (n = 1198) were surveyed in 2008-2009 and 2009-2010. Each year, a sample of NGG employers participated in sector-specific focus groups.

RESULTS

Approximately 20% of potential healthcare employers participated in the NGG. Reasons for non-participation included lack of awareness of the initiative and lack of full-time jobs. Barriers to offering full-time employment to new graduates included lack of full-time vacancies and budget constraints.

CONCLUSIONS

Employers perceive flexible staffing practices as a way to contain personnel costs but often at the expense of a stable full-time nursing workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

This research contributes to an understanding of employers' perspectives on full-time hiring and participation in a government employment policy.