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Nursing Open Mar 2023This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses.
DESIGN
This study applied a systematic review design.
METHODS
Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review.
RESULTS
Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.
Topics: Humans; Hospitals; Job Satisfaction; Nursing Staff, Hospital; Workforce
PubMed: 36303066
DOI: 10.1002/nop2.1434 -
Human Resources For Health Jun 2020Workforce studies often identify burnout as a nursing 'outcome'. Yet, burnout itself-what constitutes it, what factors contribute to its development, and what the wider...
BACKGROUND
Workforce studies often identify burnout as a nursing 'outcome'. Yet, burnout itself-what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients-is rarely made explicit. We aimed to provide a comprehensive summary of research that examines theorised relationships between burnout and other variables, in order to determine what is known (and not known) about the causes and consequences of burnout in nursing, and how this relates to theories of burnout.
METHODS
We searched MEDLINE, CINAHL, and PsycINFO. We included quantitative primary empirical studies (published in English) which examined associations between burnout and work-related factors in the nursing workforce.
RESULTS
Ninety-one papers were identified. The majority (n = 87) were cross-sectional studies; 39 studies used all three subscales of the Maslach Burnout Inventory (MBI) Scale to measure burnout. As hypothesised by Maslach, we identified high workload, value incongruence, low control over the job, low decision latitude, poor social climate/social support, and low rewards as predictors of burnout. Maslach suggested that turnover, sickness absence, and general health were effects of burnout; however, we identified relationships only with general health and sickness absence. Other factors that were classified as predictors of burnout in the nursing literature were low/inadequate nurse staffing levels, ≥ 12-h shifts, low schedule flexibility, time pressure, high job and psychological demands, low task variety, role conflict, low autonomy, negative nurse-physician relationship, poor supervisor/leader support, poor leadership, negative team relationship, and job insecurity. Among the outcomes of burnout, we found reduced job performance, poor quality of care, poor patient safety, adverse events, patient negative experience, medication errors, infections, patient falls, and intention to leave.
CONCLUSIONS
The patterns identified by these studies consistently show that adverse job characteristics-high workload, low staffing levels, long shifts, and low control-are associated with burnout in nursing. The potential consequences for staff and patients are severe. The literature on burnout in nursing partly supports Maslach's theory, but some areas are insufficiently tested, in particular, the association between burnout and turnover, and relationships were found for some MBI dimensions only.
Topics: Burnout, Professional; Health Status; Humans; Internal-External Control; Job Satisfaction; Leadership; Nurse's Role; Nurses; Patient Safety; Personnel Turnover; Quality of Health Care; Sick Leave; Time Factors; Workload; Workplace
PubMed: 32503559
DOI: 10.1186/s12960-020-00469-9 -
Worldviews on Evidence-based Nursing Apr 2022Falls and their consequences are particularly common in older adults in hospitals and long-term care (LTC) facilities. (Review)
Review
BACKGROUND
Falls and their consequences are particularly common in older adults in hospitals and long-term care (LTC) facilities.
AIM
To avoid falls and their consequences, and provide nurses with an overview of all relevant research literature on fall prevention, and a practice guideline on fall prevention in older adults was developed.
METHODS
The development process included a systematic literature review to identify systematic reviews and primary studies on the topic of fall prevention, an assessment of the study quality, the preparation of meta-analyses to summarize the results, and the application of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to grade the scientific literature. The guideline panel and an external multidisciplinary team graded the recommendations using the Delphi method. In addition, the panel and team formulated expert opinions.
RESULTS
A total of 79 randomized controlled trials on fall prevention were identified, which formed the basis of the recommendations. Strongly recommended measures for both settings included multifactorial interventions, professionally supported body exercise interventions, and education and counselling interventions. The panel and team did not recommend the use of a specific assessment tool for fall risk assessment, low-floor beds in hospitals, or body exercise interventions in frail residents.
LINKING EVIDENCE TO ACTION
During the development of this guideline, particular attention was paid to collecting evidence-based knowledge relevant to practice. By applying the recommendations, the outlined nursing care is justified, enabling healthcare personnel to achieve the overriding goal of providing optimal care to persons at risk of falling. Evidence for several fall prevention interventions was graded as very low. Sound intervention studies are necessary to strengthen the confidence in the evidence for low-floor beds, alarm sensor systems, medication review, and staff education in hospitals.
Topics: Aged; Hospitals; Humans; Nursing Homes; Risk Assessment
PubMed: 35262271
DOI: 10.1111/wvn.12571 -
Patient Education and Counseling Mar 2021Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the... (Review)
Review
OBJECTIVE
Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers.
METHODS
A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists.
RESULTS
48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions.
CONCLUSION
Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload.
PRACTICE IMPLICATIONS
This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.
Topics: Allied Health Personnel; Communication Barriers; Delivery of Health Care; Humans; Quality of Health Care; Workload
PubMed: 32994104
DOI: 10.1016/j.pec.2020.09.017 -
Nursing Open May 2021To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. (Review)
Review
AIM
To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators.
DESIGN
A qualitative design with a deductive approach was used.
DATA SOURCES
Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature.
REVIEW METHODS
Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
RESULTS
A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators.
CONCLUSION
This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators.
IMPACT
This review provides evidence-based results that health organizations can benefit from nursing care quality.
Topics: Cross-Sectional Studies; Humans; MEDLINE; Nursing Care; Nursing Research; Nursing Staff
PubMed: 34482649
DOI: 10.1002/nop2.654 -
Nursing Reports (Pavia, Italy) Sep 2023With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective... (Review)
Review
BACKGROUND
With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective leadership; particularly, transformational leadership (TFL) is shown to scientifically be the most successfully recognized leadership style in healthcare, focusing on relationship building while putting followers in power and emphasizing values and vision.
AIM
To examine how transformational leadership affects nurses' job environment and nursing care provided to the patients and patients' outcomes.
DESIGN
A systematic literature review was conducted. From 71 reviewed, 23 studies were included (studies included questionnaire surveys and one interview, extracting barriers and facilitators, and analyzing using qualitative synthesis).
RESULT
TFL indirectly and directly positively affects nurses' work environment through mediators, including structural empowerment, organizational commitment, and job satisfaction. Nurses perceived that managers' TFL behavior did not attain excellence in any of the included organizations, highlighting the necessity for additional leadership training to enhance the patient safety culture related to the non-reporting of errors and to mitigate the blame culture within the nursing environment.
CONCLUSION
Bringing more focus to leadership education in nursing can make future nursing leaders more effective, which will cultivate efficient teamwork, a quality nursing work environment, and, ultimately, safe and efficient patient outcomes. This study was not registered.
PubMed: 37755351
DOI: 10.3390/nursrep13030108 -
Journal of Advanced Nursing Apr 2021The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to... (Review)
Review
AIM
The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research.
DESIGN
Discussion Paper.
DATA SOURCES
Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR).
IMPLICATIONS FOR NURSING AND MIDWIFERY
Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency.
CONCLUSION
This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery.
IMPACT
With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.
Topics: Female; Humans; Midwifery; Pregnancy; Research Design; Research Personnel; Students
PubMed: 33543511
DOI: 10.1111/jan.14743 -
Nursing Open May 2022Nurses' burnout might affect their quality of life, productivity and nursing care services. (Review)
Review
BACKGROUND
Nurses' burnout might affect their quality of life, productivity and nursing care services.
AIM
The aim of this systematic review was to systemically review the relationship between nurses' burnout and quality of life and to introduce practical recommendations to reduce nurses' BO and improve their QOL.
METHODS
In April 2021, MeSH terms (("Nurses"[Mesh]) AND "Burnout, Professional"[Mesh]) AND "Quality of Life"[Majr] were used to search five electronic databases: CINAHL, PubMed, Medline, Psychology and Behavioral Sciences Collection and Google Scholar.
RESULTS
The search produced 21 studies exploring nurses' burnout and their quality of life within the last ten years (2009-2021). Most of these studies found significant relationships between the burnout dimension(s) and quality of life dimension(s) among the nurses.
CONCLUSION
Nurses have moderate to high levels of burnout and were negatively associated with poor quality of life. Interventional programs are needed to decrease nurses' burnout and improve their quality of life.
Topics: Burnout, Professional; Burnout, Psychological; Humans; Nurses; Nursing Staff, Hospital; Quality of Life
PubMed: 33991408
DOI: 10.1002/nop2.936 -
Journal of Advanced Nursing Oct 2022To map the nursing skills required for different types of disasters. (Review)
Review
AIMS
To map the nursing skills required for different types of disasters.
DESIGN
This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute.
DATA SOURCES
A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review.
REVIEW METHODS
The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized.
RESULTS
We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills.
CONCLUSION
This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing.
IMPACT
This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.
Topics: Clinical Competence; Disasters; Earthquakes; Humans; Nurses; Triage
PubMed: 35989672
DOI: 10.1111/jan.15337 -
International Journal of Environmental... Aug 2019: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct...
: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct adherence and perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with consequent complications. The aim here was to analyze hand hygiene training and the effectiveness of different methods and educational strategies among nurses and whether they maintained correct adherence over time. : A systematic review was conducted in the sources CINAHL (Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline, SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject Headings (MeSH) descriptors was "Nurs* AND (handwashing OR hand hygiene) AND clinical trial". The review was performed following the recommendations of the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. : = 17 clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as reminder sounds, practical simulations, videos, and audiovisual media improved handwashing compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the use of povidone-iodine, which reduced colony formation compared Hand hygiene teaching strategies among nursing staff: a systematic review to soap. : The strategies that go beyond teaching techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility, and repetition.
Topics: Education, Nursing; Hand Disinfection; Hand Hygiene; Nursing Staff; Students, Nursing
PubMed: 31443355
DOI: 10.3390/ijerph16173039