Determinants of Nurse Managers' Transformational Leadership: The Role of Individual Unit and Organizational Characteristics

OBJECTIVE

The aim of this study was to examine the relationship between various factors and self-perceived transformational leadership among a sample of Filipino nurse managers (NMs).

BACKGROUND

Transformational leadership plays a crucial role in promoting positive outcomes in healthcare settings, particularly for NMs. Understanding the factors that influence NMs' self-perceived transformational leadership is essential for improving leadership practices and enhancing organizational effectiveness.

METHODS

A cross-sectional research design was used to collect data from 260 NMs using standardized measures.

RESULTS

Employment status, the number of units managed, the type of hospital employment, psychological distress, and job satisfaction were factors that significantly influenced their leadership perceptions.

CONCLUSION

By addressing the identified factors, nursing organizations can create an environment that promotes effective leadership practices, ultimately enhancing patient outcomes, staff satisfaction, and overall organizational performance.

Stress as a mediator between abusive supervision and clinical nurses' work outcomes

AIMS

This study aimed to test whether stress could mediate the association between abusive supervision and nurses' work engagement, absenteeism, and turnover intention.

BACKGROUND

Abusive supervision has been attributed to suboptimal work performance and reduced productivity among employees in different sectors. While existing nursing literature links abusive supervision to a wide range of work-related outcomes in the nursing workforce, little is known regarding the mechanism underlying this relationship.

DESIGN

Data for this descriptive study were collected from 770 direct-care nurses from seven acute care hospitals in the Philippines, utilizing five standardized scales.

RESULTS

Abusive supervision had direct positive effects on absenteeism (β = .189, p < .001) and intent to leave (β = .138, p < .001) and a direct negative effect on job engagement (β = -.131, p < .001). The relationships between abusive supervision and absenteeism (β = .175, p < .001), intent to leave (β = .131, p < .001), and work engagement (β = -.122, p < .001) were partially mediated by stress.

CONCLUSIONS

Stress mediated the relationship between abusive supervision and nurses' work outcomes, including turnover intention, absenteeism, and work disengagement.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The evident connection between abusive supervision, stress, and work-related outcomes underscores the importance of focusing on enhancing managerial supervisory styles as a potential organizational strategy to enhance staff retention and well-being.

Relationship between transition shock in novice emergency room nurses, quality of nursing care, and adverse patient events: The mediating role of emotional exhaustion

BACKGROUND

Transition shock, experienced during the first two years of employment, has been attributed to decreased clinical performance and an overall decrease in work productivity among newly graduated nurses, as well as compromised patient safety outcomes. This study tested the intermediary effect of emotional exhaustion on the association between transition shock in novice emergency room (ER) nurses, adverse patient events, and nursing care quality.

METHODS

A descriptive study was carried out involving 303 novice ER nurses from various emergency units in five different hospitals in Central Philippines, utilizing four standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).

RESULTS

Transition shock in novice ER nurses was associated with an increased incidence of adverse patient events (β = 0.3897, p = 0.0005) and poorer nursing care quality (β = -0.2146, p = 0.0021). Furthermore, emotional exhaustion partially mediated the association between transition shock and the two patient-related outcomes: adverse patient events (β = 0.0477, 95 % CI = 0.0078-0.0997) and nursing care quality (β = -0.0142, 95 % CI = -0.0412 to -0.0095).

CONCLUSIONS

Transition shock in novice ER nurses contributed to heightened emotional exhaustion, which subsequently led to an increased incidence of adverse patient events and a decline in the quality of nursing care.

Relationship between transformational leadership, adverse patient events, and nurse-assessed quality of care in emergency units: The mediating role of work satisfaction

BACKGROUND

Effective leadership plays a pivotal role in healthcare settings, particularly in the fast-paced and high-pressure environment of the emergency room, as it is closely linked to patient safety and the overall quality of care. This study assessed the mediating role of work satisfaction in the relationship between nurses' perceptions of their nurse managers' transformational leadership, reported adverse patient events, and the nurse-assessed quality of care in the emergency units.

METHODS

A cross-sectional survey design was carried out involving 283 emergency room nurses from the Philippines, utilizing standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).

RESULTS

Emergency room nurses perceived their nurse managers as highly transformational. Nurses' perceptions of transformational leadership in their nurse managers were associated with a reduction in reported adverse patient events and an increase in nurse-assessed nursing care quality. Work satisfaction partially mediated the relationship between transformational leadership and nurse-assessed nursing care quality, but it did not serve as a mediator between transformational leadership and reported adverse patient events.

CONCLUSION

The results suggested that enhancing transformational leadership behaviors among nurse leaders can foster work satisfaction in ER nurses, which, in effect, contributes to enhanced nursing quality of care provision in emergency settings.

Nurses' adherence to patient safety protocols and its relationship with adverse patient events

INTRODUCTION

Ensuring patient safety is a critical component of healthcare delivery, and nurses play a vital role in adhering to patient safety protocols to prevent adverse events. However, studies linking nurses' adherence to these protocols with patient outcomes is scarce. This study has two-fold purposes: (1) to examine determinants of nurses' adherence to patient safety protocols, and (2) to investigate the relationship between nurses' adherence to patient safety protocols and adverse patient events.

DESIGN

A cross-sectional design.

METHODS

A total of 343 clinical nurses from five hospitals in the Philippines were included in this study. Two standardized scales were used to collect data, including the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Data collection took place from April 2022 to August 2022.

RESULTS

Adherence to patient safety protocols was generally moderate to high (M = 4.483), while nurse-reported adverse events occurred at a lower frequency (M = 1.150). Lower adherence rates were identified in areas such as reporting safety errors (M = 3.950), conducting fall risk assessments (M = 4.299), and adhering to pressure ulcer prevention guidelines (M = 3.979). Patients' and their families' complaints (M = 2.129) and abuses (M = 1.475) were the most frequently reported adverse events. Increased adherence to safety protocols was associated with higher reporting of adverse patient events (β = 0.115, p < 0.001).

CONCLUSION

Higher adherence to patient safety protocols resulted in an increased reporting of adverse patient events. The factors identified that contributed to nurses' adherence to patient safety protocols can be utilized in the development of strategies aimed at improving compliance, especially in areas where adherence is currently low.

CLINICAL RELEVANCE

Healthcare organizations should prioritize efforts to enhance adherence to patient safety protocols, particularly in areas with lower compliance rates, through relevant trainings, resource provision, and support systems. Promoting a culture of open communication and reporting can significantly contribute to reducing adverse events and improving patient safety.

Umbrella Review: Stress Levels, Sources of Stress, and Coping Mechanisms among Student Nurses

Prelicensure nursing students face significant stress from their education and clinical placements, highlighting the crucial need for the development of effective coping mechanisms with which to manage both academic and clinical responsibilities, ultimately enhancing the wellbeing and academic performance of these students. This umbrella review aims to evaluate and synthesize existing review articles that examine stress levels and coping mechanisms among student nurses during their education and training. Five databases (PsycINFO, PubMed, CINAHL, Scopus and Web of Science) were searched for review articles published from 2010 onwards. This review includes twelve articles, encompassing 189 studies. The review findings demonstrate that student nurses experience moderate-to-high levels of stress during their nurse education. Major sources of stress include academic demands, patient care responsibilities, and interactions with nursing staff and faculty. Commonly utilized coping skills involve problem-solving behaviors, transference, and maintaining an optimistic outlook. Given the adverse consequences of stress, nurse educators play a critical role in the development of strategies with which to reduce stress and enhance coping skills among student nurses. This study was not registered.

Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study

INTRODUCTION

Nurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department.

AIM

This study has two-fold purposes: (a) to examine the association between nurses' demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses' caring ability and nursing care quality, as well as its impact on adverse patient events and missed care.

METHODS

This cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data.

RESULTS

A total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (β = 0.259, p <.001), a reduction in adverse events (β = -0.169, p <.05), and a decrease in instances of missed care (β = -0.158, p <.01).

CONCLUSION

This study emphasizes the significance of nurses' characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.

Reality shock in newly graduated critical care nurses and its association with missed nursing care: The mediating role of caring ability

OBJECTIVES

This study is a report assessing the intermediary role of caring ability in the association between reality shock in newly graduated nurses and missed nursing care.

RESEARCH METHODOLOGY/DESIGN

This descriptive study involved 286 newly graduated nurses working in various critical care units. Three standardized scales were used to collect data, including the Missed Nursing Care Scale, the Environmental Reality Shock-Related Issues and Concerns (ERS-RIC) Scale, and the Caring Ability Inventory (CAI). The Hayes' PROCESS macro in SPSS (Model 4) was utilized to perform mediation testing. The data was collected from March 2022 to July 2022.

SETTING

Critical care units in seven Philippine hospitals.

RESULTS

Newly graduated critical care nurses reported moderate levels of reality shock (mean = 50.31). Reality shock was directly associated with missed nursing care (β = 0.0493, p = 0.0066). Caring ability partially mediated the association between reality shock and missed nursing care through caring ability (β = 0.0042, SE = 0.0027).

CONCLUSIONS

Newly graduated critical care nurses experience reality shock during the initial two years of employment. Reality shock diminishes the caring abilities of the newly graduated nurses, leading to a higher incidence of missed nursing care.

IMPLICATIONS FOR CLINICAL PRACTICE

Institutional strategies aimed at facilitating a smooth transition for newly graduated nurses should be prioritized to prevent a decline in their caring abilities and ultimately reduce compromises in nursing care.

A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review

The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.

Abusive Supervision and Its Relationship With Nursing Workforce and Patient Safety Outcomes: A Systematic Review

Despite efforts to improve management and leadership behaviors among nurse managers, studies have shown the pervasive nature of abusive supervision in nursing practice, with strong evidence linking this type of behavior to reduced work productivity among nurses. This systematic review aimed to appraise and synthesize peer-reviewed studies that examine nurse-related and patient safety outcomes associated with abusive supervision. The review searched nursing literature from five databases (PubMed, CINAHL, Scopus, Web of Science, and PsycINFO) between August and November 2022. A total of 21 relevant studies were identified, with the Abusive Supervision Scale being the most frequently used measurement tool. Through content analysis, the review identified 29 outcomes which were categorized into six groups: (a) affective-based, (b) behavior/performance-based, (c) relationship-based, (d) cognitive-based, (e) health and well-being, and (f) nursing care. In addition, 10 mediators were identified and grouped into three categories: (a) affective-based, (b) motivation-based, and (c) health and well-being. The review findings provide compelling evidence regarding the detrimental effects of abusive supervision in the nursing workforce. Moreover, the review emphasizes the need for further research to explore how such behavior can impact patient safety outcomes. To address abusive supervision, it is crucial to promote positive behaviors among nurse managers through human resource mechanisms, relevant rules and policies, and theory-driven leadership development programs.

Student nurses' attitudes, perceived utilization, and intention to adopt artificial intelligence (AI) technology in nursing practice: A cross-sectional study

AIM

The aim of this study was to investigate the attitudes and intentions of student nurses towards Artificial Intelligence (AI) in the context of nursing practice and to explore the relationship between their attitudes towards AI, their perceptions of AI utilization in nursing practice, and their intentions to adopt AI technology. The study hypothesized that perceived utilization of AI in nursing practice would positively influence the intention to use AI and that attitudes towards AI would mediate this relationship.

BACKGROUND

AI has the potential to revolutionize various aspects of healthcare, including nursing practice. As AI technology continues to advance, it becomes increasingly important for nurse education to prepare student nurses to leverage AI technology and be willing to adopt it in their nursing practice.

DESIGN

Cross-sectional design.

METHODS

A total of 200 student nurses from two government-owned nursing schools participated in the study. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).

RESULTS

Perceived AI utilization in nursing practice had a significant positive effect on student nurses' attitudes towards AI (β = 0.450, p < 0.001) and their intention to adopt AI technology (β = 0.458, p < 0.001). Attitudes towards AI partially mediated the relationship between perceived AI utilization in nursing practice and the intention to adopt AI technology (β = 0.255).

CONCLUSION

The findings suggest that student nurses had favorable perceptions of AI utilization in nursing practice, expressed high intentions to adopt AI technology, and held positive attitudes towards AI. Furthermore, student nurses' perceptions of AI utilization in nursing practice influenced their attitudes towards AI, which, in turn, affected their intentions to adopt AI technology. Nursing education programs should incorporate AI-focused coursework, training, and experiential learning to further enhance students' readiness and proficiency in utilizing AI technology. Additionally, healthcare institutions should consider creating a supportive environment for nursing students to explore and embrace AI, ultimately preparing them for the evolving landscape of AI-enhanced healthcare practice.

TWEETABLE ABSTRACT

Student nurses' attitudes towards AI technology were influenced by their perceptions of AI utilization in nursing practice, which subsequently influenced their intentions to adopt AI technology.

Factors influencing student nurses' readiness to adopt artificial intelligence (AI) in their studies and their perceived barriers to accessing AI technology: A cross-sectional study

BACKGROUND

With the projected significant increase in the use of AI in nursing education, it becomes vital for nurse faculty to adequately equip student nurses with the necessary competences to effectively utilize AI in their studies. Ensuring that student nurses are prepared and ready to embrace AI technology is imperative for their successful integration into the healthcare workforce.

OBJECTIVE

This study aimed to examine student nurses' readiness to embrace AI technology, explore associated factors, and identify perceived barriers to accessing AI technology.

DESIGN

Cross sectional study.

SETTINGS

One public-owned nursing school in the Philippines.

PARTICIPANTS

Three hundred twenty-three student nurses.

METHODS

Data were collected using structured questionnaires. Descriptive statistics and multivariable analysis were performed to analyze the data.

RESULTS

The results revealed that student nurses demonstrated moderate readiness to embrace AI in their studies (M = 2.906, SD = 0.692) and perceived moderate barriers to accessing AI technology (M = 2.336, SD = 0.719). Factors associated with students' readiness to embrace AI included self-rated technological proficiency (β = 0.170, p = 0.014), understanding of AI-powered technologies (β = 0.260, p < 0.001), and perceived AI use in nursing practice (β = 0.153, p = 0.022). The study also identified potential barriers to accessing AI technology, such as lack of computer skills to navigate AI, lack of AI knowledge and awareness, and time constraints.

CONCLUSION

The findings of this study provided valuable insights into the factors influencing student nurses' attitudes towards AI and shed light on their perceived barriers to accessing AI technology. By enhancing technological proficiency, increasing AI understanding, and providing practical experiences, nurse faculty can better prepare future nurses to effectively navigate the AI-driven healthcare environment and contribute to improved patient care outcomes.

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman

Objectives

This study aimed to explore the relationships between nurses' work environment, job stress and job satisfaction, along with the moderating effects of work environment and empowerment on the relationship between job stress and job satisfaction.

Methods

A descriptive correlational design was utilised for this study. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. Moreover, a self-report questionnaire that included a set of instruments was used to collect the data.

Results

Nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment and perceived their work environment as less favourable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction, whereas no support was found for indirect or moderating effects. Furthermore, the hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables.

Conclusion

The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment and tackle job stress to enhance levels of job satisfaction.

The impact of job burnout on nurses' caring behaviors: Exploring the mediating role of work engagement and job motivation

AIM

To investigate the influence of job burnout on nurses' caring behaviors, with a specific focus on the serial mediating role of work engagement and job motivation.

BACKGROUND

Job burnout is a prevalent issue among nurses and poses significant challenges to their ability to deliver compassionate care. However, the underlying mechanisms that explain the relationship between job burnout and nurses' caring behaviors, which could provide valuable insights for developing targeted interventions and strategies to support nurse well-being and ensure the consistent provision of compassionate care, remain underexplored.

METHODS

A cross-sectional design was used to gather data from 520 clinical nurses working in various acute healthcare settings in the Philippines. Mediation analyses were conducted using the PROCESS Macro with Model 6.

RESULTS

Nurses exhibited high levels of caring behaviors (M = 4.219); however, they experienced moderate levels of job burnout (M = 2.342). Job burnout had a negative effect (β = -0.0603, p = 0.0482) on nurses' caring behaviors. Work engagement and job motivation sequentially mediated the relationship between job burnout and nurse caring behaviors (β = -0.0126, p < 0.05).

CONCLUSIONS

Higher levels of job burnout were associated with a decreased demonstration of nurses' caring behaviors. Job burnout among nurses led to a decrease in their level of work engagement and job motivation, ultimately impacting their ability to provide caring behaviors to patients.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Organizations should prioritize creating a positive work environment and implementing theory-driven strategies to address job burnout, which can foster work engagement and job motivation among nurses, thereby providing crucial support for them in delivering high-quality, compassionate care to patients.

Factors associated with millennial nurses' intention to pursue formal leadership roles: a cross-sectional study

PURPOSE

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

DESIGN/METHODOLOGY/APPROACH

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

FINDINGS

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses' intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

ORIGINALITY/VALUE

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses' intentions to pursue formal leadership roles.

Toxic leadership and its relationship with outcomes on the nursing workforce and patient safety: a systematic review

PURPOSE

This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

DESIGN/METHODOLOGY/APPROACH

This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes.

FINDINGS

The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies.

PRACTICAL IMPLICATIONS

Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy.

ORIGINALITY/VALUE

The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.

Problematic internet use and psychological distress among student nurses: The mediating role of coping skills

Problematic internet use has become a growing concern among student nurses, posing potential risks to their well-being and academic performance. Yet, the extent to which coping skills can help alleviate the adverse effects of problematic internet use on the psychological well-being of student nurses remains largely understudied. This study examined the mediating role of coping skills in the relationship between problematic internet use and psychological distress among student nurses. This cross-sectional study was conducted to collect data from 279 student nurses enrolled in a public-funded nursing school. Mediation analyses were conducted using the PROCESS Macro with Model 4. Findings showed that student nurses reported moderate levels of problematic internet use with a mean score of 2.233 (SD = 0.765). Several factors strongly predicted problematic internet, including being on the 3rd year of education (β = -0.261, p < 0.001), having an average academic performance (β = 0.184, p = 0.006), and using the internet for <3 h per day (β = -0.304, p < 0.001). Problematic internet use was significantly associated with increased psychological distress (β = 0.1791, p < 0.01). Coping skills were found to mediate the relationship between problematic internet use and psychological distress (β = 0.0160, SE = 0.0095). Overall, this study sheds light on the determinants of problematic internet use among student nurses and its negative impact on psychological well-being. By addressing problematic internet use and promoting healthy coping mechanisms, nursing education can better prepare student nurses to maintain their well-being and academic performance in the digital age.

Leadership Styles and Nurses' Innovative Behaviors: A Systematic Review

OBJECTIVE

In an increasingly competitive healthcare climate, ensuring an innovative nursing workforce is essential for organizational success and survival.

BACKGROUND

The authors aimed to evaluate the literature examining the association between leadership styles and innovative behaviors in the nursing workforce.

METHODS

A systematic review of articles from 5 databases was conducted from August 2022 to October 2022.

RESULTS

A total of 21 articles published in the English language were included in the review. This study provides evidence for the vital role of "relationship-oriented" leadership styles in fostering innovative behaviors among nurses. However, more research is needed to examine how "task-oriented" leadership styles contribute to innovativeness in nurses. Twelve mediators linking leadership styles to healthcare workers' innovative behaviors were identified and clustered into motivation-based, relation-based, and affective mediators.

CONCLUSION

Organizational strategies to foster relationship-based leadership styles among healthcare leaders are vital to support nurses' innovative behaviors.

Disaster preparedness among nurses in disaster-prone countries: A systematic review

BACKGROUND

Disaster preparedness is crucial for mitigating the impact of disasters and saving lives. Ensuring preparedness for disaster response and management, particularly among nurses in disaster-prone countries, is essential due to the serious threats disasters pose to affected populations. This study was conducted to appraise and synthesize the literature examining preparedness for disaster management and response among nurses in countries with the highest disaster risks.

METHODS

A systematic review of the literature published from 2000 onwards was conducted using five databases: SCOPUS, PubMed, MEDLINE, PsychINFO, and CINAHL. Twenty-one relevant articles were identified for this review.

RESULTS

The findings revealed that nurses in countries at high risk of disasters had inadequate disaster knowledge and skills, leaving them ill-prepared to respond to such situations. Previous experience in disaster relief, disaster-related education and training, and higher academic qualifications were associated with increased readiness for disaster response and management.

CONCLUSION

The review's findings provide insight into the current state of disaster preparedness among nurses in disaster-prone nations. The review identified evidence highlighting the value of disaster-related education and training, as well as disaster response experience, in fostering preparedness among nurses. These results can inform policymakers, hospital administrators, and nurse administrators in developing strategies for promoting disaster preparedness in nurses through evidence-based training programs and interventions.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses

BACKGROUND

Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses.

OBJECTIVE

To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses.

METHODS

A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables.

RESULTS

Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (β = - 0.481, p = 0.031), ethical/moral conduct (β = - .408, p = 0.043), managerial ability and support (β = - 0.497, p = 0.018), and adequate staffing and resources (β = -.068, p = 0.028) were all associated with lower job burnout.

CONCLUSIONS

Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

COVID-19 phobia, loneliness, and dropout intention among nursing students: the mediating role of social support and coping

The coronavirus outbreak led to many students' experiencing tremendous fear, resulting in numerous psychological and mental health issues, and potentially impacting academic outcomes. The purpose of this study was to examine the mediating role of coping and social support on the relationships between COVID-19 phobia, loneliness, and the intention to abandon nursing education in students. An online survey using a cross-sectional research design was used. A total of 301 full-time student nurses from the Philippines who were currently registered in a nursing programme were included. Nearly half 40.8% (n = 127) of the nursing students were found to experience COVID-19 phobia. COVID-19 phobia had direct positive effects on loneliness (β = 0.210, p < .001) and intention to abandon nursing education (β = 0.293, p < .001). Social support and coping had partial mediating effects on the association between COVID-19 phobia and loneliness and the intention to abandon nursing education. COVID-19 phobia was associated with increased loneliness and greater desires to abandon nursing studies in students. However, by providing adequate social support and coping, the negative effects of the pandemic on nursing students' outcome were reduced, resulting in decreased loneliness and improved student retention.

Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well-being among student nurses during the second wave of the COVID-19 pandemic

PURPOSE

To identify specific coping skills that contribute to relieving anxiety and stress while supporting student nurses' mental health and psychological well-being.

DESIGN AND METHOD

This is a cross-sectional online survey involving 261 students nurses from private and government-owned nursing schools in the Central Philippines.

RESULTS

Resilience was associated with reduced stress and anxiety and better mental health and psychological well-being. Mental disengagement was associated with lower anxiety and stress levels. Spiritual and not scientific sources of support were associated with lower stress and increased psychological well-being and mental health.

PRACTICE IMPLICATIONS

Nurse faculty should foster functional coping skills in student nurses to enhance their ability to endure negative psychological and mental health outcomes related to the pandemic.

Determinants of Physicians’ Job Satisfaction

Objectives: Physician satisfaction with their job can lead to a better quality of care, fewer chances of making errors, and better patient outcomes. The purpose of the study was to examine physician satisfaction; and to assess job satisfaction across several factors, such as quality of care, ease of practice, relationship with leadership, and inter-professional collaboration. Method: A descriptive cross-sectional design was used. Data were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician satisfaction (13-item Likert type items on a scale from 1 to 5), and inter-professional collaboration (15-item, 4-point Likert scale, ranging from 1 for “strongly disagree” to 4 for “strongly agree”). Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of 396 physicians who were contacted, 354 responded (response rate = 89.4%). The median age was 40 years, and there were 208 male and 124 female physicians. The vast majority (238/354 = 62%) were expatriates. Seventy percent had a post-graduate degree. The vast majority (308 = 87%) worked in government hospitals. Results showed that 15 (5%) of the physicians were not satisfied with their job (<3.00), 179 (40%) expressed a moderate level of satisfaction (3.00 – 3.75), and 129 (55%) were highly satisfied (>3.76). There was no difference in mean job satisfaction score among different groups of study participants, except for gender, and the working grade (p < 0.05). The overall job satisfaction rates were higher for the quality of care (M = 3.93, SD = 0.61), and for ease of practice (M = 3.89, SD = 0.55) and lower for the relationship with leadership (M = 3.67, SD = 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (p = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility, and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care, and for ease of practice, and lower for relationship with the leadership. Relationship with the leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates. Keywords: Interprofessional relations; Job Satisfaction; Leadership; Oman; Physician; Quality of health care

Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout

BACKGROUND

Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship.

AIM

To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout.

METHODS

A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout.

RESULTS

Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout.

CONCLUSION

Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.

Nurses' job burnout and its association with work environment, empowerment and psychological stress during COVID-19 pandemic

AIM

The aim of this study was to assess the influence of perceived work environment, empowerment and psychological stress on job burnout among nurses working at the time of the COVID-19 pandemic.

BACKGROUND

Nurses experienced high levels of job burnout during the pandemic, which impacted their mental health and well-being. Studies investigating the influence of work environment, empowerment and stress on burnout during the time of COVID-19 are limited.

DESIGN

The study utilized a cross-sectional design.

METHODS

Data were collected from 351 nurses in Oman between January and March 2021. The Maslach Burnout Inventory, the Practice Environment Scale of the Nursing Work Index, the Conditions of Work Effectiveness Questionnaire and the Perceived Stress Scale were used to assess study variables.

RESULTS

About two-thirds of the nurses (65.6%) reported high levels of job burnout. Nurse managers' ability, leadership and support; staffing and resources adequacy; and nurses' access to support were significant factors associated with a reduced level of burnout.

CONCLUSION

Supporting nurses during the crisis, ensuring adequate staffing levels and providing sufficient resources are critical to lower job burnout. Creating a positive and empowered work environment is vital to enhance nurses' retention during the pandemic.

Reverse Mentoring and Intergenerational Learning in Nursing

Covid -19 pandemic urged technical competency and knowledge sharing among the diverse multigenerational workforce. Reverse mentoring is where a technically competent younger employee mentors the senior experienced employee and reciprocally exchanges the work culture and soft skills. Diverse intergenerational learning spurs innovation through sharing knowledge, skills, competencies, norms, and values. The ever-changing nursing practice and education with a multigenerational workforce demand a reverse mentoring approach for intergenerational knowledge sharing to enhance technical competency. Reverse mentoring is known to have benefits on quality of education, better practice outcomes, and employee development. A reverse mentoring strategy is proposed as a sustainable cost-effective intergenerational knowledge-sharing tool in the current era of economic crisis due to the Covid -19 pandemic. This paper aimed to discuss the scope of reverse mentoring and intergenerational learning in nursing. This paper provides an overview of reverse mentoring characteristics, significance, benefits, conceptual framework, implementation strategy, and application in nursing. Keywords: Mentoring; Covid-19; Cultural Diversity; Learning; Nursing; Preceptorship; Intergenerational learning; Multigenerational Workforce.

TURNOVER INTENTION AND CORONAPHOBIA AMONG FRONTLINE NURSES DURING THE SECOND SURGE OF COVID-19: THE MEDIATING ROLE OF SOCIAL SUPPORT AND COPING SKILLS

BACKGROUND

Turnover among frontline healthcare workers, particularly nurses, reached an alarming rate during the COVID-19 pandemic. This turnover has been attributed, in part, to excessive fear of the virus (a condition called coronaphobia). Studies have not yet been conducted examining whether social support and coping skills could act as buffers between coronaphobia and the intention to leave.

AIM

To examine the relationship between coronaphobia and frontline nurses' organizational and professional turnover intention and to assess whether social support and coping skills can buffer this relationship.

METHODS

A correlational research design was used to collect responses through an online questionnaire from a convenience sample of 687 frontline nurses from the Central Philippines. Data was analysed using descriptive (mean, standard deviation, percentages) and inferential statistics (t - test, Pearson r correlation coefficient, ANOVA, and multiple linear regression).

RESULTS

More than half of the frontline nurses experienced coronaphobia, while 25.8% reported a desire to leave their job and 20.7% reported a desire to leave their profession. Coronaphobia had direct significant effects on nurses' organizational (β=.424, p<.001) and professional turnover intention (β=.316, p<.001). Social support and coping skills partially mediated the relationship between organizational (β=.365, p<.001; β=.362, p<.001) and professional turnover intention (β=.279, p<.001; β=.289, p<.001).

CONCLUSION

Frontline nurses who experienced coronaphobia were more likely to quit their job and the nursing profession. Increasing nurses' social support and enhancing their coping skills reduced the negative effects of coronaphobia, resulting in improved nurse retention.

IMPLICATIONS FOR NURSING MANAGEMENT

Institutional approaches to reduce coronaphobia and turnover intention during the pandemic can be facilitated by improving social support through innovative approaches (e.g., use of technology, social media) and equipping nurses with positive coping skills through coping skills training and other empirically based coping skill-building interventions.

Fear of COVID-19, poor quality of sleep, irritability, and intention to quit school among nursing students: A cross-sectional study

PURPOSE

This study aims to assess the fear of coronavirus disease 2019 (COVID-19) and its influence on the students' fear of COVID-19 and intention to leave nursing school.

DESIGN AND METHODS

This study employed a cross-sectional design using self-report questionnaires distributed to 261 nursing students from the Philippines.

FINDINGS

The first-year nursing students are found to be the most fearful among the group. The students' fear of COVID-19 is associated with their high irritability, poor sleep quality, and desire to quit nursing school.

PRACTICE IMPLICATIONS

Students are perturbed by the pandemic and teachers should implement supportive, teaching-learning strategies to address the student's needs.

Linking nurse practice environment, safety climate and job dimensions to missed nursing care

AIM

This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care.

BACKGROUND

Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established.

METHODS

This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines.

RESULTS

Patient safety climate (β = -0.148, p = 0.001), decision authority (β = -0.101, p = 0.018) and staffing/resource adequacy (β = -0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care.

DISCUSSION

Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.

Perceived COVID-19-associated discrimination, mental health and professional-turnover intention among frontline clinical nurses: The mediating role of resilience

COVID-19-associated discrimination (CAD) is an important issue that may adversely affect frontline nurses' work effectiveness and well-being. This study examined the relationships between frontline nurses' perceptions of COVID-19-associated discrimination and their resilience, mental health, and professional-turnover intention. This cross-sectional descriptive study involved 259 frontline nurses in the Central Philippines and used four online self-report measures. The results revealed that frontline nurses perceived a moderate level of COVID-19-associated discrimination. Frontline nurses who perceived a higher level of discrimination during the coronavirus pandemic reported poorer mental health and higher professional-turnover intention. Resilience acted as a mediator and reduced the effects of COVID-19-associated discrimination on nurses' mental health and their professional-turnover intention. Proactive measures to reduce the negative consequences of discrimination during the pandemic, and efforts to foster resilience in nurses who are in the forefront of the fight against the highly transmissible virus, should be given high priority by hospital and nursing administrators to better support nurses' mental health and foster retention.

Transformational leadership as a mediator between work-family conflict, nurse-reported patient safety outcomes, and job engagement

PURPOSE

Work-family conflict (WFC) is an important issue in nursing administration and management that is associated with reduced work effectiveness and patient safety issues. To date, very few studies have attempted to explain the mechanisms underlying these relationships. The aim of this study was to determine the influence of work-family conflict (WFC) on patient safety outcomes and job engagement via the intermediary role of transformational leadership (TL).

DESIGN

Cross-sectional study.

METHODS

Seven hundred fifty-four nurses from 10 acute care hospitals in the Philippines were included in this cross-sectional study.

FINDINGS

A higher perception of WFC was associated with increased adverse events, reduced quality of care and decreased job engagement. WFC was indirectly associated with quality of care, adverse events and job engagement through the intermediary of TL.

CONCLUSIONS

The results of this study underscore the important role of nurse managers' TL in sustaining work-family balance and, in turn, improving patient safety outcomes and enhancing job engagement among nurses.

CLINICAL RELEVANCE

Institutional measures to foster patient safety outcomes and sustain the nursing workforce should involve enhancing nurse managers' leadership behaviors through theory-driven interventions, periodic leadership assessment, and implementation of leadership development activities. WFC may be addressed by creating empowering work conditions, providing adequate coaching and mentorship to nurses, and implementing work-family friendly policies in the workplace.

Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses

BACKGROUND

As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored.

AIM

This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction.

METHODS

This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman.

RESULTS

Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations.

CONCLUSION

Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes.

IMPLICATIONS FOR NURSING MANAGEMENT

Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.

Lockdown fatigue among college students during the COVID-19 pandemic: Predictive role of personal resilience, coping behaviors, and health

OBJECTIVES

This study was conducted to examine the levels of lockdown-induced fatigue and its association with personal resilience, coping skills, and health in college students.

DESIGN AND METHODS

This is an online cross-sectional study involving 243 college students in the Central Philippines during the 6th month of the lockdown measure implementation.

FINDINGS

College students experience moderate levels of fatigue during the mandatory lockdown period. Increased personal resilience and coping skills were associated with lower levels of lockdown fatigue.

PRACTICE IMPLICATIONS

Lockdown fatigue may be addressed by formulating and implementing interventions to enhance personal resilience and coping skills among college students.

Social and emotional loneliness among college students during the COVID-19 pandemic: The predictive role of coping behaviors, social support, and personal resilience

OBJECTIVE

To determine the influence of coping behaviors, resilience, and social support on students' emotional and social loneliness during the COVID-19 pandemic.

DESIGN AND METHODS

A cross-sectional research design was used to gather data from 303 college students from the Central Philippines using four standardized scales through an online survey.

FINDINGS

Loneliness among students was high during the coronavirus pandemic. Resilience, coping behaviors, and social support were identified as protective factors against loneliness.

PRACTICE IMPLICATIONS

Interventions directed toward increasing resilience, social support, and coping behaviors may help decrease emotional and social loneliness caused by the mandatory lockdown during the COVID-19 pandemic.

Factors associated with missed nursing care and nurse-assessed quality of care during the COVID-19 pandemic

Background

The coronavirus outbreak has brought unprecedented pressures to many health care systems worldwide, potentially compromising nursing care delivery and overall health care services.

Aims

This study identified factors that contributed to missed nursing care and nurse‐assessed quality of care during the coronavirus pandemic.

Methods

This study employed a cross‐sectional research design using an online survey. Survey respondents were 295 frontline nurses from the Central Region of the Philippines.

Results

Missed care occurred at a low level, with “adequate patient surveillance” as the most often missed nursing care activity. Hospital facility size, nurse staffing levels, and patient safety culture predicted missed nursing care. Personal protective equipment adequacy, nurse staffing levels, and patient safety culture were identified as predictors of quality of care.

Conclusion

Frontline nurses tended to miss clinical aspects of nursing care during the pandemic. Modifying elements of the work environment, including nurse staffing levels, safety culture, and adequacy of protective equipment, may reduce care compromise and improve the quality of nursing care.

Implications for Nursing Management

By addressing the identified predictors, nurse managers could effectively develop appropriate interventions to support the professional role of nurses and ensure the delivery of complete, safe, and quality nursing care during the pandemic.

Use of Simulation in Teaching Nursing Leadership and Management Course: An integrative review

Nursing education is strategically positioned to prepare nursing students for management and leadership skills necessary for future professional nursing roles. This review appraised and synthesised the outcomes of using simulation in pre-licensure nursing management and leadership courses. This is an integrative review of original articles published between 2008 and 2018. In January 2019, PsychINFO, CINAHL, PubMed and SCOPUS were searched to identify relevant articles using the following terms: ‘management’, ‘leadership’, ‘simulation’, ‘nursing’, ‘education’ and ‘student’. A total of 10 articles were included in the review. Four essential themes were identified from the content analysis: acquisition of skills or understanding of delegation, enhanced teamwork or collaboration capacities, improved decision-making and problem-solving skills and increased communication skills. Incorporation of simulation in the nursing management and leadership courses has the potential to enhance nursing students’ skills regarding delegation, problem-solving capacities, decision-making and communication and teamwork.

Resilience as a mediator in the relationship between stress-associated with the Covid-19 pandemic, life satisfaction, and psychological well-being in student nurses: A cross-sectional study

Aim

This study examined the direct and indirect effects of stress associated with the pandemic on student nurses’ life satisfaction and psychological well-being through the intermediary role of resilience.

Background

The coronavirus disease 2019 (COVID-19) outbreak has brought additional stress to those in nursing programs, who were already under high pressure. This has resulted in increased mental and psychological issues in student nurses. The role of resilience as a mediator reducing the effects of pandemic-associated stress on student nurses’ outcomes remains unexplored.

Design

Cross-sectional study.

Methods

This was an online survey that used four standardized scales and was completed by 301 student nurses in the Philippines. The data were collected from September 2020 to October 2020.

Results

Filipino student nurses experienced stress associated with the pandemic at a high level; however, their resilience, life satisfaction and psychological well-being were found to be moderate to high. Increased pandemic-associated stress was associated with reduced life satisfaction and poorer psychological well-being. Further, resilience was found to reduce the negative effects of pandemic-associated stress on the life satisfaction and psychological well-being of student nurses.

Conclusions

This study highlights the importance of building resilience in student nurses during the coronavirus pandemic to sustain their mental and psychological well-being and improve their life satisfaction.

AUTHENTIC LEADERSHIP AND NURSES' MOTIVATION TO ENGAGE IN LEADERSHIP ROLES: THE MEDIATING EFFECTS OF NURSE WORK ENVIRONMENT AND LEADERSHIP SELF-EFFICACY

BACKGROUND

Leadership styles of a nurse manager have a profound influence on staff nurses' motivation to engage in formal nursing leadership roles; however, the mechanism underlying this pattern of influence remains unknown.

AIM

To assess the direct and indirect effect of nurse managers' authentic leadership on staff nurses' motivation to engage in formal leadership roles, through the intermediary role of nurse work environment and leadership self-efficacy.

METHODS

This cross-sectional study involved 1534 nurses from 24 acute care hospitals in the Sultanate of Oman.

FINDINGS

Nurse managers' authentic leadership was associated with staff nurses' motivation to engage in formal leadership roles. Nurse practice environment and leadership self-efficacy mediated partially the association between authentic leadership and motivation to engage in formal leadership roles.

CONCLUSION

Results of this study underscore the value of authentic leadership in creating a healthy work environment and fostering nurses' leadership self-efficacy, resulting in greater motivation to engage in nursing leadership roles.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizational strategies to attract nurses to undertake leadership roles should include measures to bolster authentic leadership behaviours in nurse managers through theory-driven leadership development programmes or interventions, continuing education, effective succession planning, and creating a supportive work environment.

The impact of perceived nurses' work environment, teamness, and staffing levels on nurse-reported adverse patient events in Oman

BACKGROUND

Fostering a healthy work environment becomes a necessity in health care institutions that value quality care and patient safety. However, limited studies investigated the impact of work environment characteristics including staffing and teamness among healthcare teams on adverse patient events in Oman.

AIMS

To examine the (1) impact of work environment, interprofessional teamness, staffing levels on adverse patient events and (2) predicting factors of perceptions of work environment among nurses in the Sultanate of Oman.

METHOD

A cross-sectional descriptive design was utilized to collect data from 2113 nurses. Participants completed a self-report questionnaire that included a set of instruments.

RESULTS

The results showed a strong positive relationship between work environment and teamness (r = 0.59, p < 0.001). Nurses working in a favorable environment that has positive teamwork reported a reduction in adverse events including patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medication errors (p < 0.001). There was a nonsignificant correlation between staffing and adverse patient events.

CONCLUSION

Fostering a healthy and supportive work environment continue to be crucial for ensuring patient safety. Nurse administrators should strive to improve work environment through creating a culture that values interprofessional teamwork and collaborative relationships.

Job engagement and satisfaction are associated with nurse caring behaviours: A cross-sectional study

BACKGROUND

There is a scarcity of literature assessing the impact of job engagement and satisfaction in the nurse's caring behaviours. This study aims to identify how these factors affect the caring behaviours of nurses.

METHODS

This study used a cross-sectional design and employed self-report questionnaires. A total of 549 nurses from private and government hospitals participated in the survey conducted in the year 2019. Descriptive and inferential statistics were utilized to analyse the data.

RESULTS

Results revealed that the nurses display high caring behaviours and job engagement and moderate sense of satisfaction. Remarkably, there are no profile variables significantly related to the nurse's caring behaviours. Findings suggest that job engagement and satisfaction are significantly associated with the nurses' caring behaviours.

CONCLUSION

Factors such as job engagement and satisfaction affect nurses' caring behaviours.

IMPLICATIONS TO NURSING MANAGEMENT

Health organisations must provide strategies to increase job engagement and satisfaction of nurses to yield high caring behaviours, which is vital to the achievement of patient safety.

Pandemic fatigue and clinical nurses' mental health, sleep quality and job contentment during the covid-19 pandemic: The mediating role of resilience

Aim

This study examined the influence of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment, with resilience as a mediator.

Background

Pandemic fatigue is an emerging health concern among frontline clinical nurses as a consequence of the ongoing coronavirus pandemic and the various measures implemented to slow the spread of infection. As yet, no studies have investigated the link between pandemic fatigue and resilience, mental health, sleep quality and job contentment in frontline clinical nurses.

Methods

This was a descriptive, cross‐sectional study involving 255 frontline clinical nurses in the Philippines. The Pandemic Fatigue Questionnaire, Brief Resilience Scale, Job Contentment Scale and the Sleep Quality Scale were used to collect data through an online survey.

Results

The mean pandemic fatigue score was 3.086 (out of 5). Being vaccinated (β = 0.231, p < .001) and increased staffing levels (β = −0.488, p < .01) were associated with decreased pandemic fatigue in clinical nurses. Resilience partially mediated the relationships between (a) pandemic fatigue and mental health (β = −0.488, p < .001), (b) pandemic fatigue and sleep quality (β = −0.326, p < .001) and (c) pandemic fatigue and job contentment (β = −0.395, p < .001).

Conclusion

Clinical nurses who received a COVID‐19 vaccine and those who perceived sufficient staffing in their units reported lower levels of pandemic fatigue. Resilience reduces the effects of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment.

Implications for Nursing Management

By providing frontline nurses with access to COVID‐19 vaccines and ensuring sufficient staffing levels, nurse managers could effectively reduce or prevent pandemic fatigue and improve their mental health. Implementing resilience‐promoting measures are essential to support nurses’ mental health, promote their sleep quality and foster job satisfaction.

Authentic leadership, nurse-assessed adverse patient events and quality of care: The mediating role of nurses' safety actions

BACKGROUND

Authentic leadership has been consistently cited as a strong precursor of sustained job performance and work effectiveness in nurses; however, studies linking authentic leadership with nurses' safety actions, nurse-assessed adverse patient events and nursing care quality are scarce.

AIM

To examine whether nurses' safety actions mediate the relationship between authentic leadership, nurse-assessed adverse events and nursing care quality.

METHODS

A multi-centre, cross-sectional study involving 1,608 nurses employed in acute care facilities in Oman. Multi-stage regression analysis was conducted in testing for the mediation model.

FINDINGS

Nurse managers in Oman were perceived to be highly authentic by their staff nurses. Authentic leadership significantly predicted nurses' safety actions (β = 0.168, p < .001), decrease in nurse-assessed adverse events (β = -0.017, p = .024) and increase in care quality (β = 0.121, p < .001). Further, the association between authentic leadership and nurse-assessed adverse events (β = -0.063, p = .057) and care quality (β = 0.038, p = .002) was mediated by nurses' safety actions.

CONCLUSION

Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' safety actions and reduce adverse patient outcomes and promote nursing care quality.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizational efforts to address patient safety issues should be directed towards developing authentic leadership in nurse managers through leadership programmes, periodic evaluation of leadership competencies (e.g., 360-degree or a bottom-up performance evaluation), and a creation of a safe culture in which nurses can openly report safety concerns for corrective action.

Prevalence and predictors of coronaphobia among frontline hospital and public health nurses

OBJECTIVES

To determine the prevalence as well as the predictors of coronaphobia in frontline hospital and public health nurses.

DESIGN

This study used a cross-sectional research study involving 736 nurses working in COVID-19 designated hospitals and health units in Region 8, Philippines. Four structured self-report scales were used, including the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Perceived Social Support Questionnaire, and the single-item measure for perceived health.

RESULTS

The prevalence of coronaphobia was 54.76% (n = 402): 37.04% (n = 130) in hospital nurses and 70.91% (n = 273) in public health nurses. Additionally, nurses' gender (β = 0.148, p < .001), marital status (β = 0.124, p < .001), job status (β = 0.138, p < .001), and personal resilience (β = -0.167, p = .002) were identified as predictors of COVID-19 anxiety. A small proportion of nurses were willing (19.94%, n = 70) and fully prepared (9.40%, n = 33) to manage and care for coronavirus patients.

CONCLUSION

Coronaphobia is prevalent among frontline Filipino nurses, particularly among public health nurses. Interventions to address coronaphobia among frontline nurses in the hospital and community should consider the predictors identified. By increasing personal resilience in nurses through theoretically driven intervention, coronaphobia may be alleviated.

Psychological resilience, coping behaviours and social support among health care workers during the COVID-19 pandemic: A systematic review of quantitative studies

Aim

To appraise and synthesize studies examining resilience, coping behaviours and social support among health care workers during the coronavirus pandemic.

Background

A wide range of evidence has shown that health care workers, currently on the frontlines in the fight against COVID‐19, are not spared from the psychological and mental health‐related consequences of the pandemic. Studies synthesizing the role of coping behaviours, resilience and social support in safeguarding the mental health of health care workers during the pandemic are largely unknown.

Evaluation

This is a systematic review with a narrative synthesis. A total of 31 articles were included in the review.

Key Issues

Health care workers utilized both problem‐centred and emotion‐centred coping to manage the stress associated with the coronavirus pandemic. Coping behaviours, resilience and social support were associated with positive mental and psychological health outcomes.

Conclusion

Substantial evidence supports the effectiveness of coping behaviours, resilience and social support to preserve psychological and mental health among health care workers during the COVID‐19 pandemic.

Implications for Nursing Management

In order to safeguard the mental health of health care workers during the pandemic, hospital and nursing administrators should implement proactive measures to sustain resilience in HCWs, build coping skills and implement creative ways to foster social support in health care workers through theory‐based interventions, supportive leadership and fostering a resilient work environment.

Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses

AIM

To examine the relative influence of fear of COVID-19 on nurses' psychological distress, work satisfaction and intent to leave their organisation and the profession.

BACKGROUND

The emergence of COVID-19 has significantly impacted the psychological and mental well-being of frontline health care workers, including nurses. To date, no studies have been conducted examining how this fear of COVID-19 contributes to health, well-being and work outcomes in frontline nurses.

METHODS

This is a cross-sectional research design involving 261 frontline nurses in the Philippines. Five standardized scales were used for data collection.

RESULTS

Overall, the composite score of the fear of COVID-19 scale was 19.92. Job role and attendance of COVID-19-related training predicted fear of COVID-19. An increased level of fear of COVID-19 was associated with decreased job satisfaction, increased psychological distress and increased organisational and professional turnover intentions.

CONCLUSIONS

Frontline nurses who reported not having attended COVID-19-related training and those who held part-time job roles reported increased fears of COVID-19. Addressing the fear of COVID-19 may result in improved job outcomes in frontline nurses, such as increased job satisfaction, decreased stress levels and lower intent to leave the organisation and the profession.

IMPLICATIONS FOR NURSING MANAGEMENT

Organisational measures are vital to support the mental health of nurses and address their fear of COVID-19 through peer and social support, psychological and mental support services (e.g. counselling or psychotherapy), provision of training related to COVID-19 and accurate and regular information updates.

Influence of nurse managers' toxic leadership behaviours on nurse-reported adverse events and quality of care

AIM

To assess the impact of toxic leadership behaviours among nurse managers on nurse-reported adverse events and quality of care.

BACKGROUND

Toxic leadership, a form of ineffective leadership, is increasingly becoming rampant in the field of nursing and has been strongly linked to poor nurse job outcomes including job dissatisfaction, higher stress levels, and increased turnover intention. To date, no studies have been conducted to examine how this type of leadership behaviours affects patient outcomes and care quality.

METHODS

A multicentre, cross-sectional study. This study involved a sample of 1,053 registered nurses working in 20 hospitals in the Philippines. Three standardized scales were deployed, including the Toxic Leadership Behaviors of Nurse Managers Scale, the Adverse Patient Events Scale and the single-item quality-of-care-measure.

RESULTS

Overall, nurses (96.2%) appraised the quality of care of their respective units as 'good to excellent' and cited complaints from patients and their families as the most commonly reported adverse events. Toxic leadership behaviours in nurse managers were strongly associated with increased nurse-reported adverse events including reports of complaints (β = .619; p < .001) and verbal mistreatment from patients and their families (β = .407; p < .001), patient falls (β = .834; p < .001), health care-associated infections (β = .629; p < .001) and errors in administering medication (β = .708; p < .001) and with decreased quality of care (β = -.216; p < .001).

CONCLUSION

Nurses who experience working under a nurse manager exhibiting toxic behaviours reported an increased frequency of nurse-reported adverse events and poorer quality of care in the unit.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizational measure to reduce the occurrence of adverse events and enhance the quality of care provided in medical units may include intervention to develop positive leadership practices among nurse managers.

Predictors and outcomes of work-family conflict among nurses

BACKGROUND

Work-family conflict, an issue important to nursing management, has been examined extensively worldwide. With an increasing number of nurses leaving and intending to leave the country, and considering the traditional family arrangement, it is increasingly relevant to examine the precursors and outcomes of work-family conflict among Filipino nurses.

AIM

To identify the predictors of work-family conflict and its relationship to Filipino nurses' work outcomes and perceived quality of care.

METHODS

A descriptive research design was utilized to collect data from one thousand one hundred (n = 1010) registered nurses with more than three months of experience working in the hospital using the Work-Family Conflict Scale, Job Satisfaction Index, Perceived Stress Scale, the two single-item measures of turnover intention, and a single-item measure of care quality.

RESULTS

Filipino nurses experience moderate levels of work-family conflict. Nurses' age, education, facility size, and hospital location predicted work-family conflict. Work-family predicted job satisfaction, job stress, intention to leave the organization, and perceived quality of care.

CONCLUSIONS

In accordance with international studies, Filipino nurses experience significant levels of work-family conflict. Addressing work-family conflict may result in improved work outcomes and increased care quality rating.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Organizational measures to address work-family conflict in nurses should take into account the different predictors identified, particularly those that are modifiable. Nurses' work outcomes and care quality can be improved by employing empirically based measures to effectively address work-family conflict.

Capability beliefs and the intention to adopt evidence-based practices in the future among nursing students: An international study

BACKGROUND

Capability beliefs and the intention to adopt EBP in future nursing practice have been identified as strong antecedents of subsequent utilization of EBP. Despite this, a multicountry comparison may yield interesting findings that can be useful in designing empirically based and culturally tailored strategies to facilitate and enhance students' capability beliefs as well as their intentions to integrate evidence into nursing practice.

AIMS AND OBJECTIVES

This report sought to compare capability beliefs and intentions to adopt EBP in the future among student nurses from four countries-specifically, Oman, India, Nigeria, and Saudi Arabia-and to identify specific variables that predict the intention to adopt EBP.

METHODS

This study employed a descriptive, cross-sectional, comparative research design to gather data from a convenience sample of 1387 nursing students from four countries using self-report questionnaires that captured their EBP capability beliefs and their intention to adopt EBP in clinical practice upon graduation. This study adhered to STROBE guideline for cross-sectional studies.

RESULTS

Overall, nursing students reported a high intent to adopt EBP in their future nursing practice; however, the exact rate varied according to the country of origin. Students' gender, student track, education, country of origin, access to the internet, and capability beliefs were seen as important in explaining the likelihood of future implementation of evidence in clinical nursing practice. Capability beliefs among students were moderate, with large differences observed between countries.

CONCLUSIONS

Although the surveyed nursing students reported moderate capability beliefs, their intention to adopt and integrate EBP in their future nursing practice was relatively high.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study highlight the critical role of nurse educators and nurse administrators in fostering EBP capability beliefs and future intentions to adopt among students through curricular review, implementation of evidence-based strategies, and the promotion of EBP culture within the clinical learning sites.

Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses

AIM

To examine the relative influence of fear of COVID-19 on nurses' psychological distress, work satisfaction and intent to leave their organisation and the profession.

BACKGROUND

The emergence of COVID-19 has significantly impacted the psychological and mental well-being of frontline health care workers, including nurses. To date, no studies have been conducted examining how this fear of COVID-19 contributes to health, well-being and work outcomes in frontline nurses.

METHODS

This is a cross-sectional research design involving 261 frontline nurses in the Philippines. Five standardized scales were used for data collection.

RESULTS

Overall, the composite score of the fear of COVID-19 scale was 19.92. Job role and attendance of COVID-19-related training predicted fear of COVID-19. An increased level of fear of COVID-19 was associated with decreased job satisfaction, increased psychological distress and increased organisational and professional turnover intentions.

CONCLUSIONS

Frontline nurses who reported not having attended COVID-19-related training and those who held part-time job roles reported increased fears of COVID-19. Addressing the fear of COVID-19 may result in improved job outcomes in frontline nurses, such as increased job satisfaction, decreased stress levels and lower intent to leave the organisation and the profession.

IMPLICATIONS FOR NURSING MANAGEMENT

Organisational measures are vital to support the mental health of nurses and address their fear of COVID-19 through peer and social support, psychological and mental support services (e.g. counselling or psychotherapy), provision of training related to COVID-19 and accurate and regular information updates.

Predictors of toxic leadership behaviour among nurse managers: A cross-sectional study

AIM

To identify the predictors of toxic leadership behaviour in nurse managers.

BACKGROUND

Toxic leadership is becoming increasingly prevalent in nursing; however, the literature provides very limited evidence of the different factors that promote toxic leadership behaviour in nurse managers.

METHODS

A descriptive, cross-sectional design was used. Two hundred and forty nurse managers from ten hospitals in the Central Philippines were included in the study. Data were collected using the Nurse Information Form and the Toxic Leadership Behaviours of Nurse Managers Scale (ToxBH-NM). Hierarchical multiple regression was used to analyse the data collected.

RESULTS

The mean of average item score of the ToxBH-NM was 1.250 (SD = 0.470). Multiple regression analyses identified the years of experience in a managerial role (β = -0.165, p = .031), job status (part time) (β = 0.177, p = .002), ward census (30 patients, 40 patients and above 40 patients) ([β = 0.231, p = .005]; [β = 0.345, p < .004]; [β = 0.262, p = .012]), number of units managed (2 units and > 3 units) ([β = 0.292, p < .001]; [β = 0.235, p < .001]), hospital type (private hospital) (β = 0.271, p = .007) and hospital level (secondary hospitals) (β = 0.226, p = .036) predicted toxic leadership behaviour in nurse managers.

CONCLUSIONS

Overall, nurse managers were appraised as non-toxic leaders. Nurse managers who held a part-time job status, those who had lower experience in the managerial role and those who were assigned to wards or units with high patient admission numbers reported increased toxic leadership behaviours. Further, nurse managers who managed more than 2 units, those who were employed in private hospitals and those who worked in secondary hospitals reported increased toxic leadership behaviours.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse administrators can consider the different predictors identified when planning and developing leadership interventions and organisational strategies (e.g. limiting the number of units per nurse manager, provision of full-time job employment, assignment of assistant nurse managers, formulation of policy specific to managing toxic behaviours), which may assist in the determent of toxic behaviours in nurse managers.