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

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          Abstract

          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.

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          Most cited references49

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          Fear of Covid‐19, psychological distress, work satisfaction and turnover intention among frontline nurses

          Abstract 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 healthcare 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 standardised 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.
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            Is Open Access

            The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

            Background There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture). Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire. Methods Six cross-sectional surveys of health care providers (n = 10,843) in 203 clinical areas (including critical care units, operating rooms, inpatient settings, and ambulatory clinics) in three countries (USA, UK, New Zealand). Multilevel factor analyses yielded results at the clinical area level and the respondent nested within clinical area level. We report scale reliability, floor/ceiling effects, item factor loadings, inter-factor correlations, and percentage of respondents who agree with each item and scale. Results A six factor model of provider attitudes fit to the data at both the clinical area and respondent nested within clinical area levels. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. Scale reliability was 0.9. Provider attitudes varied greatly both within and among organizations. Results are presented to allow benchmarking among organizations and emerging research is discussed. Conclusion The Safety Attitudes Questionnaire demonstrated good psychometric properties. Healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions.
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              Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

              Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80
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                Author and article information

                Contributors
                Role: Lecturer, Adjunct Facultyleo7_ci@yahoo.com
                Role: Associate Professor
                Role: Lecturer
                Journal
                J Nurs Manag
                J Nurs Manag
                10.1111/(ISSN)1365-2834
                JONM
                Journal of Nursing Management
                John Wiley and Sons Inc. (Hoboken )
                0966-0429
                1365-2834
                19 October 2021
                19 October 2021
                : 10.1111/jonm.13483
                Affiliations
                [ 1 ] College of Nursing Sultan Qaboos University Muscat Sultanate of Oman
                [ 2 ] College of Nursing Visayas State University Baybay City Philippines
                Author notes
                [*] [* ] Correspondence

                Leodoro J. Labrague, Sultan Qaboos University, Muscat, Sultanate of Oman.

                Email: leo7_ci@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0003-0315-4438
                https://orcid.org/0000-0003-0291-0801
                Article
                JONM13483
                10.1111/jonm.13483
                8646803
                34590383
                af0507ff-fd42-4e9b-b353-671c1ada36b3
                © 2021 John Wiley & Sons Ltd

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 01 July 2021
                : 03 June 2021
                : 24 September 2021
                Page count
                Figures: 0, Tables: 4, Pages: 9, Words: 7280
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:06.12.2021

                covid‐19,missed nursing care,nurse staffing,quality of care,safety culture

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