J Nurs Manag [JOURNAL]
Sun
200 papers
The Impact of Communication Competence on Job Performance Among Registered Nurses: A Cross-Sectional Analysis.
Al-Zawahreh H, Eshah N, Rayan AH … +4 more , Oweidat I, Al-Mugheed K, Baghdadi NA, Abdelaliem SMF
J Nurs Manag · 2026 · PMID 41923494 · Full text
INTRODUCTION: Effective communication in nursing practice is directly influencing job performance, patient outcomes, and teamwork. As the healthcare landscape becomes increasingly complex, understanding the specific comm...
INTRODUCTION: Effective communication in nursing practice is directly influencing job performance, patient outcomes, and teamwork. As the healthcare landscape becomes increasingly complex, understanding the specific communication competencies that contribute to professional development and interpersonal effectiveness is essential. PURPOSE: to investigate the relationship between communication competence and job performance among Jordanian nurses. METHODS: A quantitative, cross-sectional study examined the link between communication competence and job performance among 113 registered nurses at Al-Bashir and Zarqa Governmental Hospitals. Data were collected during one month, using a self-administered questionnaire with two validated English-language scales: The Interpersonal Communication Competence Scale (ICCS, 30 items, α = 0.840) and the Six-Dimensional Scale of Nursing Performance (6-D Scale, 52 items, α = 0.903). Validity was confirmed through face and construct validation and reliability via Cronbach's alpha. SPSS v26 was used for analysis, including multiple linear regression and Kruskal-Wallis H tests to assess relationships and demographic differences. RESULTS: The study confirmed a statistically significant and positive relationship between communication competence and job performance. In particular, the dimensions of empathy (B = 0.318, p < 0.01), self-disclosure (B = 0.349, p < 0.01), social relaxation (B = 0.362, p < 0.01), and environmental control (B = 0.328, p < 0.01) had the most substantial impact. Demographic variables (gender, educational level, years of experience, type of unit, and shift pattern) were found to significantly influence both communication competence and job performance. CONCLUSIONS: Communication competence boosts nursing performance. Key skills like empathy and self-disclosure enhance relationships and growth. Tailored training and further research are recommended.
The Moderating Role of Confucian Coping in the Job Demands-Resources Model in Chinese Tertiary Hospitals.
Deng M, Ferreira AI
J Nurs Manag · 2026 · PMID 41915299 · Full text
BACKGROUND: Medical staff in Chinese tertiary hospitals experience excessive workloads, increasing burnout vulnerability. Traditional cultural resources may influence their job attitudes, but this area remains unexplored...
BACKGROUND: Medical staff in Chinese tertiary hospitals experience excessive workloads, increasing burnout vulnerability. Traditional cultural resources may influence their job attitudes, but this area remains unexplored. PURPOSE: Based on the job demands-resources model, this study investigates how Confucian coping, as a personal culture resource, moderates the relationships among job demands, resources, engagement and burnout in Chinese medical staff. METHODS: Using an online self-administered survey, we collected data from 1653 medical staff members across 14 tertiary hospitals in China. Structural equation modelling was used to test the hypothesised moderating pathways. RESULTS: Confucian coping demonstrated a significant positive moderating effect on the job resources-job engagement relationship and a significant negative moderating effect on the job demands-job burnout relationship. CONCLUSION: Confucian coping serves as a significant personal resource for medical staff, mitigating burnout by buffering job demands and enhancing engagement by amplifying job resources. ORIGINALITY: By employing empirical analysis with the job demands-resources model, this study unravels how medical staff draw on Confucian coping functions and provides a new theoretical perspective for further study of the influence of cultural and psychological factors.
Nurses' Perception of the Hospitals' Spiritual Climate and Its Influence on Their Organizational Commitment: A Cross-Sectional and Correlational Study.
Nagórska M, Martin Červený, Rękas M … +6 more , Lesiak A, Chmiel Z, Zamboriová M, Danková S, Hrindová T, Cruz JP
J Nurs Manag · 2026 · PMID 41914979 · Full text
BACKGROUND: The spiritual climate in the workplace has become more important in recent years, especially regarding organizational performance and employee well-being. However, its effect on nurses' organizational commitm...
BACKGROUND: The spiritual climate in the workplace has become more important in recent years, especially regarding organizational performance and employee well-being. However, its effect on nurses' organizational commitment in Poland and Slovakia has not yet been studied. AIM: This study aimed to examine the influence of hospital's spiritual climate on organizational commitment as perceived by nurses in Slovakia and Poland. DESIGN: Cross-sectional and correlational study. METHODS: The research involved a convenience sample of 390 nurses from Poland and Slovakia. The online questionnaire consisted of three parts: sociodemographic characteristics of respondents, Spiritual Climate Scale (SCS), and Three-Component Model (TCM) Employee Commitment Survey. A standard multiple linear regression model was performed to investigate the influence of spiritual climate and sociodemographic variables on each of the TCM survey subscales. RESULTS: Over half of the respondents (53.3%) experienced positive sensations according to the spiritual climate at their hospitals, but only one in three (33.1%) felt encouraged to express their spirituality at work. Affective commitment scored highest among nurses, followed by normative and continuance commitment. Regression models showed significant predictors, with managerial role, age, education, nationality, and perceived spiritual climate influencing commitment levels across subscales. CONCLUSION: The study showed that a positive hospital spiritual climate leads to higher organizational engagement, according to nurses from two European countries. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital policymakers, administrators, and nursing leaders should consider integrating interventions and policies that promote a favorable spiritual climate in hospitals to ensure more committed nurses.
Family Socioeconomic Status and General Self-Efficacy in Nursing Students: A Moderated Mediation Model of Family Relationship Quality and Institutional Type.
Wang A, Zhu L, Dong X … +5 more , Wen L, Chang W, Zhu Y, Jin Y, Wan J
J Nurs Manag · 2026 · PMID 41914264 · Full text
BACKGROUND: Nursing students face significant psychological challenges, with general self-efficacy (GSE) serving as a critical protective factor. Although family socioeconomic status (SES) and family relationship quality...
BACKGROUND: Nursing students face significant psychological challenges, with general self-efficacy (GSE) serving as a critical protective factor. Although family socioeconomic status (SES) and family relationship quality (FRQ) have been linked to GSE, their underlying pathways and the moderating role of institution type (vocational vs. undergraduate colleges) remain unclear. This study aimed to examine the association between SES and GSE among nursing students, focusing on FRQ as a mediator and institution type as a moderator. METHODS: A cross-sectional survey of 1461 nursing students from two Chinese medical institutions was conducted. SES was derived from five socioeconomic indicators using principal component analysis. FRQ was constructed as a latent variable from three observed items using confirmatory factor analysis. GSE was measured using the General Self-Efficacy Scale. Mediation and moderated mediation analyses were performed using PROCESS macros. RESULTS: SES was positively associated with GSE (B = 0.313, p = 0.004). FRQ partially mediated the relationship between SES and GSE in the total sample (β = 0.060, 95% CI [0.009, 0.115]). However, this mediation was only significant among undergraduates (β = 0.118, 95% CI [0.043, 0.201]) and not among vocational students (β = -0.005, 95% CI [-0.060, 0.051]). Institution type moderated both the direct effect of SES on GSE and the indirect effect via FRQ, with stronger associations among undergraduate students. Specifically, simple slope test showed that SES was associated with GSE among undergraduates (β = 0.455, 95% CI [0.191, 0.720]) but not among vocational students (β = 0.021, 95% CI [-0.324, 0.367]). CONCLUSIONS: Family SES was positively associated with nursing students' GSE directly and indirectly via FRQ, and these associations were stronger among undergraduate than among vocational students. These findings suggest that considering both family resources and educational context may be useful when designing targeted interventions to foster GSE among nursing students.
Cultural Differences in the Relationship Between Negative Leadership Behaviours and Nurses' Emotional Exhaustion: A Systematic Review.
Chen S, Zhang X, Chen H … +3 more , Zhang F, Tung TH, Chen H
J Nurs Manag · 2026 · PMID 41914260 · Full text
AIMS: Nurses face the risk of emotional exhaustion due to high-intensity work, resource shortages and multiple stressors. Negative leadership behaviours exacerbate emotional exhaustion through the abuse of power and psyc...
AIMS: Nurses face the risk of emotional exhaustion due to high-intensity work, resource shortages and multiple stressors. Negative leadership behaviours exacerbate emotional exhaustion through the abuse of power and psychological oppression. Therefore, this study aims to summarise the current evidence on the relationship between negative leadership behaviours and nurse emotional exhaustion in different cultures. METHODS: Databases such as PubMed, Web of Science, Embase, the Cochrane Library, Scopus, CINAHL, APA PsycInfo, CNKI, Wanfang and VIP were searched for related studies, from inception until 20 November 2025, without any language restrictions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to review these studies. The PEO (population, Exposure and outcome) framework was followed with nurses as the population, negative leadership behaviour as the exposure and emotional exhaustion as the outcome. The final studies were reviewed and selected using EndNote 21, with information extracted according to specific criteria. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of the included studies. RESULTS: The initial search yielded 1990 records, and after duplicate removal and screening, 11 studies published between 2007 and 2025 were included. Of these, four were longitudinal studies and seven were cross-sectional studies. Eight of the 11 articles included in this systematic review were conducted in Asia. The correlation coefficients between negative leadership behaviour and emotional exhaustion ranged from 0.18 to 0.76, indicating moderate to strong positive associations, and other variables were found to play a role in the relationship between them. CONCLUSION: This systematic review summarises that negative leadership behaviours are significantly positively correlated with nurses' emotional exhaustion, and this correlation shows significant cultural differences. Future research should conduct cross-cultural longitudinal studies and develop targeted intervention strategies.
Organizational Silence as a Mediator Between Ethical Nursing Competence and Perceptions of Open Disclosure in Patient Safety Incidents.
Kim Y, Son YJ, Jang SJ … +1 more , Lee H
J Nurs Manag · 2026 · PMID 41906650 · Full text
BACKGROUND: Open disclosure of patient safety incidents (PSIs) is essential for patient safety, but organizational silence may inhibit nurses from speaking up. However, the influence of ethical competence on the percepti...
BACKGROUND: Open disclosure of patient safety incidents (PSIs) is essential for patient safety, but organizational silence may inhibit nurses from speaking up. However, the influence of ethical competence on the perception of open disclosure and the role of organizational silence remain unclear. This study aimed to examine the relationships among nurses' ethical competence, organizational silence, and perceptions of open disclosure in PSIs and whether organizational silence mediates the effect of ethical competence on perceptions of open disclosure. METHODS: A cross-sectional survey of 303 nurses in South Korea measured their ethical competence, organizational silence, and perceptions of open disclosure. Data were collected between October 14 and November 8, 2024, via an online nursing community. Multiple regression and mediation analyses were used to test for direct and indirect effects while adjusting for covariates. RESULTS: Ethical competence was significantly associated with lower organizational silence and higher open disclosure perception, whereas organizational silence was associated with lower open disclosure perception. Mediation analysis confirmed that organizational silence had a significant indirect effect. CONCLUSIONS: Higher ethical competence is linked to lower organizational silence and greater support for the perception of open disclosure. Enhancing nurses' ethical competence and reducing silence may foster a more transparent patient safety culture. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should strengthen nurses' ethical competence, encourage open communication to reduce silence, and promote transparent disclosure of PSIs.
Workplace Barriers to Nursing Autonomy in Saudi Hospitals: Implications for Management and Policy Under Vision 2030.
Alenezi IN
J Nurs Manag · 2026 · PMID 41902794 · Full text
AIM: This study explored how nurses perceive and navigate professional autonomy in Saudi hospital settings, with particular attention to the organisational and cultural barriers that shape autonomous practice. BACKGROUND...
AIM: This study explored how nurses perceive and navigate professional autonomy in Saudi hospital settings, with particular attention to the organisational and cultural barriers that shape autonomous practice. BACKGROUND: Vision 2030 provides the strategic framework for transforming healthcare systems in Saudi Arabia, placing nursing autonomy at the centre of efforts to deliver safe, patient-centred care. Nursing autonomy influences clinical decision-making, job satisfaction and workforce retention. METHODS: A qualitative descriptive design was employed across two referral hospitals in northern Saudi Arabia. Purposive sampling was used to recruit staff nurses and nurse managers with direct experience of clinical autonomy in practice. Twenty-four semistructured interviews were conducted in Arabic with staff nurses (n = 16) and nurse managers (n = 8). Data were analysed using Braun and Clarke's reflexive thematic analysis. RESULTS: Three themes were constructed through analysis: (1) structured dependency, reflecting how hierarchical systems restrict independent decision-making; (2) navigating interprofessional dynamics, addressing collaborative practice and role negotiation and (3) communication and professional identity, capturing how nurses' sense of agency is shaped by confidence, visibility and perceived professional status. DISCUSSION: The findings indicate that nursing autonomy is variably supported and is shaped by the interplay of hierarchical structures, interprofessional dynamics and communication-based professional identity work. CONCLUSIONS: A substantive misalignment exists between the strategic aims of Vision 2030 and nurses' day-to-day experiences of hierarchical control and structured dependency. Addressing this gap requires targeted interventions, including leadership development and sustained institutional commitment to shared governance models.
The Mechanism of Ethical Leadership's Influence on Nurses' Voice Behavior: An Empirical Study Based on a Chain Mediation Model.
Jing JT, Ma ZY, Liu DR … +4 more , Qiu HN, Fu YK, Liu J, Chen CR
J Nurs Manag · 2026 · PMID 41894140 · Full text
BACKGROUND: Nurses' voice behavior plays an irreplaceable role in optimizing nursing practices, improving healthcare quality, and fostering organizational innovation. However, existing research on the influencing factors...
BACKGROUND: Nurses' voice behavior plays an irreplaceable role in optimizing nursing practices, improving healthcare quality, and fostering organizational innovation. However, existing research on the influencing factors and underlying mechanisms of nurses' voice behavior remains limited and requires further exploration. OBJECTIVE: This study aims to examine the relationship between ethical leadership and nurses' voice behavior and further investigate the potential mediating roles of psychological contract and organizational commitment. METHODS: From August to October 2024, a questionnaire survey was conducted, collecting valid data from 1357 nurses in China. The survey included the Ethical Leadership Scale, Psychological Contract Scale, Organizational Commitment Scale, and Voice Behavior Scale. Data were statistically analyzed using SPSS 25.0, and structural equation modeling (SEM) was performed using Amos 26.0 to examine the mediating roles of psychological contract and organizational commitment in the relationship between ethical leadership and nurses' voice behavior. RESULTS: Ethical leadership, psychological contract, organizational commitment, and voice behavior were significantly correlated (p < 0.001). Ethical leadership had a direct impact on voice behavior (effect = 0.360, 95% CI = [0.319, 0.399]). Psychological contract and organizational commitment played partial mediating roles in the relationship between ethical leadership and voice behavior (effect = 0.101, 95% CI = [0.086, 0.118], and effect = 0.010, 95% CI = [0.004, 0.016]). Additionally, a significant chain mediation effect of psychological contract and organizational commitment was found in the relationship between ethical leadership and voice behavior (effect = 0.024, 95% CI = [0.018, 0.031]), accounting for 4.848% of the total effect (0.024/0.495). CONCLUSION: Ethical leadership not only directly promotes nurses' voice behavior but also indirectly enhances this effect through the chain mediation of psychological contract and organizational commitment. Strengthening ethical leadership can optimize nurses' psychological contracts and enhance their organizational commitment, thereby effectively stimulating voice behavior. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators should recognize the critical role of ethical leadership in nursing management and adopt multilevel strategies to foster a positive organizational climate, optimize nurses' psychological contracts, and strengthen their organizational commitment. These efforts will encourage nurses to actively voice their opinions, thereby enhancing team effectiveness and stability.
A Qualitative Exploratory Study of Patient Safety and Nurses' Body Awareness Using Motion-Capture-Linked Avatars.
Fujii C
J Nurs Manag · 2026 · PMID 41887198 · Full text
This study aimed to explore the ongoing possibilities of motion-capture-linked avatars in patient safety education, with the goal of enhancing nurses' body awareness, thereby improving patient safety and nontechnical ski...
This study aimed to explore the ongoing possibilities of motion-capture-linked avatars in patient safety education, with the goal of enhancing nurses' body awareness, thereby improving patient safety and nontechnical skills. Six nurses with an average experience of 29.0 ± 4.8 years participated in this pilot, exploratory qualitative study. Actual situations using avatars were initially demonstrated through video. Participants subsequently wore mobile motion-capture devices, with responses obtained through interviews and questionnaires based on their experience using the avatars. Qualitative content analysis was conducted, and the responses were organized into the following three themes: usability of the avatars as a new technology, promoting body awareness, and patient safety using avatars. The findings showed that avatars enabled nurses to learn about body movements without the need to identify specific individuals, while protecting their privacy and surroundings. However, using avatars alone was insufficient to fully convey the situation. Verbalizing the avatar's movements was also found to be important. This study indicates that motion capture and avatars can contribute to new patient safety education through physical awareness when employed in nursing situations. The movement-based knowledge sharing gained through this new approach (avatars) can contribute to improving nursing management quality.
Exploring the Role of the Advanced Nurse Practitioner (ANP) Older Persons From the Perspective of the Interdisciplinary Team.
Mullally A, Doolan M, Brennan C … +10 more , Burke L, Farrelly A, Flynn G, Heduvan K, Keena G, Lynch O, Mannion J, Moore F, Nolan M, McDonnell-Naughton M
J Nurs Manag · 2026 · PMID 41882951 · Full text
BACKGROUND: Advanced Nursing Practice is well established in Irish healthcare; these nurses are educated to practice at higher levels of competency as Advanced Nurse Practitioners (ANPs). Nurses working as ANP Older Pers...
BACKGROUND: Advanced Nursing Practice is well established in Irish healthcare; these nurses are educated to practice at higher levels of competency as Advanced Nurse Practitioners (ANPs). Nurses working as ANP Older Persons are relatively new and offer a unique skillset that facilitates the delivery of holistic person-centred care. To date, this represents novel research, as the ANP role in Older Persons' care has not previously been explored from the perspective of the interdisciplinary team. AIM: The aim of this research was exploring the role of the ANP Older Persons from the perspective of the interdisciplinary team. The objective of this study was to gain a greater insight of the IDT's perception of the ANP Older Persons' role. METHODS: A total of 40 participants were interviewed in 11 focus groups using semistructured interviews. Participants included representation from health and social care professionals, nurses and medical staff. FINDINGS: Data were collected and analysed using Braun and Clarke (2021) theoretical framework, and results are presented in three themes: Contribution of the ANP Older Persons' Role to Clinical Practice and Patient Care, Contribution of the ANP Older Persons' Role to the Interdisciplinary Team and Barriers to the Development of the ANP Older Persons Role are the three emerging themes. CONCLUSION: The findings indicate that the ANP Older Persons is a valuable resource in the IDT providing education, leadership, clinical expertise and enhancing patient care. Ambiguity exists around defining advanced practice nursing in older person's services, and there are barriers to the development of the ANP Older Persons' role.
Artificial Intelligence Attitudes and Time Management Among Undergraduate Nursing Students: A Cross-Sectional Study.
Bozkurt R, Özdoğan MC
J Nurs Manag · 2026 · PMID 41879090 · Full text
BACKGROUND: Artificial intelligence (AI) has emerged as an innovative technology that is increasingly used in healthcare. In the nursing profession, AI offers several advantages, including time savings through accelerate...
BACKGROUND: Artificial intelligence (AI) has emerged as an innovative technology that is increasingly used in healthcare. In the nursing profession, AI offers several advantages, including time savings through accelerated care processes, reduced error rates, and enhanced patient safety. AIM: This study aimed to describe undergraduate nursing students' attitudes toward AI and their time management skills and to examine the relationship between these variables. METHODS: This cross-sectional study was conducted with 360 undergraduate nursing students enrolled at a state university in northwestern Turkey. The data were collected between September and December 2024 using the Individual Identification Form, the General Attitude Scale Towards AI, and the Time Management Questionnaire. The study was conducted in accordance with the principles of the Declaration of Helsinki. RESULTS: Among participants, 58.9% were aged 21 years and above, 83.3% were female, and 32.5% were first-year students. The mean score on the General Attitudes Toward AI Scale was 68.92 ± 9.21, while the mean score on the Time Management Questionnaire was 85.02 ± 12.61. A statistically significant positive correlation was found between attitudes toward AI and time management skills (r = 0.119, p < 0.05). CONCLUSIONS: Nursing students demonstrated high levels of positive attitudes toward AI and strong time management skills. As students' attitudes toward AI increased, their time management skills also improved. Further controlled and longitudinal studies are needed to confirm the mechanisms and long-term effects of AI-based time efficiency. Integrating AI literacy and ethical use modules into undergraduate nursing curricula is recommended to promote the responsible and effective use of AI tools in the context of patient safety and academic integrity.
A Systematic Review of Multivariate Models for Predicting Fall-Related Injuries in Older Adults.
Cai Y, Zhu W, Zhang X … +3 more , Wang C, Liu S, Jiang Y
J Nurs Manag · 2026 · PMID 41877399 · Full text
AIM: To evaluate the quality, risk of bias, and clinical applicability of prediction models for fall-related injuries in older adults. BACKGROUND: Numerous prediction models for fall-related injuries in older adults have...
AIM: To evaluate the quality, risk of bias, and clinical applicability of prediction models for fall-related injuries in older adults. BACKGROUND: Numerous prediction models for fall-related injuries in older adults have been developed, but their quality and applicability in clinical practice and future research remain uncertain. METHODS: We systematically searched Medline (via OVID), Embase (via OVID), Cochrane Library, CINAHL (via EBSCO), Web of Science, and Scopus from inception to May 23, 2024, for English-language publications. All observational and experimental studies reporting the development or validation of any multivariable prediction model for fall-related injuries in older adults were included. The risk of bias and applicability was assessed using the PROBAST, and the reporting quality was measured based on the TRIPOD + AI checklist. Data were synthesized using a narrative synthesis approach. RESULTS: Thirty-one models from 15 studies were included. Twelve studies focused on the development and/or internal validation of a model, two studies dealt with development and external validation using a nonrandom split-sample, and one study externally validated existing models. The reported model discriminative statistics exhibited a broad range, from 0.54 to 0.89, in internal or external validation contexts. The risk of applicability was low for all studies, while the overall risk of bias was high in all studies (100.0%). High bias risk was notably prevalent in the analysis domain (100% of studies) and observed in the predictors (33.3%), participants (26.7%), and outcome (6.7%) domains. Median adherence to TRIPOD + AI reporting items was 56.4%. CONCLUSION: The discriminative ability in the prediction models of fall-related injuries in older adults varied widely, with all models exhibiting a high risk of bias according to the PROBAST. Upcoming research should focus on developing high-quality and reproducible models that undergo proper external validation, followed by studies on implementation. IMPLICATIONS FOR NURSING MANAGEMENT: Existing fall-related injuries prediction models exhibit high bias and inconsistent accuracy, limiting clinical utility. Nursing leaders should advocate for future models that undergo thorough internal and external validation, ensure sufficient events per variable, properly handle missing data, and adopt transparent reporting practices. This will underpin data-driven clinical decisions and enable targeted fall prevention strategies in vulnerable older adults.
Employee Net Promoter Score Links Nursing Satisfaction to Quality of Care Before and During the COVID-19 Pandemic.
Chou JS, Shah NT, Weiseth A … +2 more , Woodbury SR, Edmonds JK
J Nurs Manag · 2026 · PMID 41873696 · Full text
AIM: To measure the association between job satisfaction and perceived quality of care among nurses on labor and delivery (LD) units. BACKGROUND: Nurses constitute the largest segment of the US healthcare workforce. Low...
AIM: To measure the association between job satisfaction and perceived quality of care among nurses on labor and delivery (LD) units. BACKGROUND: Nurses constitute the largest segment of the US healthcare workforce. Low job satisfaction is a critical factor in nurse turnover and quality of care. METHODS: A web-based survey was distributed across LD units in the United States. We used logistic regression to assess the association between job satisfaction, as measured by the employee net promoter score (eNPS), and perceived indicators of quality of care. RESULTS: Among 1021 LD nurses who responded, those characterized as passive or detractors had greater odds of rating that the quality of care on their LD unit was fair or good rather than excellent (adjusted odds ratio [aOR] 3.45, 95% CI: 2.44-4.88 and aOR 6.58, 95% CI: 4.08-10.75, respectively, with both p < 0.0001), agreeing that nurses were spending less time with laboring patients suspected or confirmed to have COVID-19 (aOR 1.42, 95% CI: 1.04-1.95, p = 0.0288; aOR 2.08, 95% CI: 1.33-3.28, p = 0.0014) and reporting that professional labor support was frequently or always missed during the pandemic (aOR 2.19, 95% CI: 1.49-3.20, p < 0.0001; aOR 1.82, 95% CI: 1.09-3.03, p = 0.0217) compared to respondents characterized as promoters. CONCLUSIONS: Higher nursing job satisfaction as measured by the eNPS is associated with higher perceived quality of care on the LD units. IMPLICATIONS FOR NURSING MANAGEMENT: eNPS is a one-question survey that is easy to deliver, simple to interpret, and is associated with perceived quality of care. Nursing management can use it to track progress over time and understand reasons for job dissatisfaction on their units.
Factors Associated With the Usability and Adoption of Continuous Monitoring Devices With Deterioration Alerting Systems in Acute Hospital Non-ICU Settings: A Mixed Methods Study.
Pan JF, Wong D, Liao K … +1 more , Dowding D
J Nurs Manag · 2026 · PMID 41873534 · Full text
AIM: To identify factors associated with usability and adoption of continuous monitoring with deterioration alerting systems (CM-DAS) in non-ICU wards from clinicians' perspectives. BACKGROUND: Patient deterioration is a...
AIM: To identify factors associated with usability and adoption of continuous monitoring with deterioration alerting systems (CM-DAS) in non-ICU wards from clinicians' perspectives. BACKGROUND: Patient deterioration is a safety concern on general wards; intermittent vital sign checks can miss early decline. CM-DAS can help, but impact depends on usability and clinician adoption, which remain variably achieved. METHODS: Convergent mixed methods using the unified theory of acceptance and use of technology (UTAUT) model to guide data collection: An online UTAUT-based survey (n = 111 clinicians, 20 countries; April-August 2023) and semistructured interviews (n = 10) were conducted. Quantitative data were analysed with nonparametric tests and composite PLS-SEM (3000 bootstraps); qualitative data underwent thematic analysis; findings were integrated narratively. RESULTS: Perceived usefulness and ease of use were positively associated with the intention to adopt CM-DAS. In the multivariable PLS-SEM, only intention to use the system (β ˜ 0.29, p ˜ 0.01) and prior CM-DAS experience (β ˜ 0.28, p ˜ 0.01) were associated with routine bedside use; other constructs did not retain independent associations, and variance explained was modest (R_use≈0.15). Interviews corroborated benefits (patient safety and workflow) and highlighted barriers-false alarms, reliability/connectivity issues, technical language/user interface and gaps in support and training. Peer practices and patient/family responses shaped the climate for adoption. CONCLUSIONS: This study suggests that ensuring reliable infrastructure (signal stability, hospital Wi-Fi and integration with EHR) is foundational for safe and sustained CM-DAS operation. Routine use was most closely associated with clinicians' intention to use the system and accumulated experience. Factors such as how easy a system is to use and how individuals perceived its usefulness strengthened an individual's intention to use the system. IMPLICATIONS FOR NURSING MANAGEMENT: Management should prioritise reliable infrastructure, implement tiered alarm governance to reduce nonactionable alerts, designate ward super-users supported by vendor service-level agreements and deliver brief, recurring, practice-embedded training so that intention translates into sustained, safe bedside use.
Risk Factors, Health Consequences, and Professional Work of Problematic Mobile Phone Use Among Nurses: A Systematic Review.
López-Gutiérrez G, Gutiérrez-Puertas V, Gómez-Guerrero B … +3 more , Fernandes HJ, Mantzoukas S, Gutiérrez-Puertas L
J Nurs Manag · 2026 · PMID 41873504 · Full text
BACKGROUND: Problematic mobile phone use is an emerging public health issue, the prevalence of which has increased among nurses. AIM: To synthesize and describe knowledge on problematic mobile phone use by nurses, its co...
BACKGROUND: Problematic mobile phone use is an emerging public health issue, the prevalence of which has increased among nurses. AIM: To synthesize and describe knowledge on problematic mobile phone use by nurses, its consequences, and strategies for addressing this phenomenon. DESIGN: A systematic review was conducted following the checklist Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. This systematic review has been registered in PROSPERO (CRD420251052591). METHODS: Four electronic databases were systematically searched from their inception to September 2025. The article's reference lists were also manually searched. The study selection was carried out in three stages, with two reviewers independently analyzing the data and resolving disagreements. The quality assessment utilized the Mixed Method Appraisal Tool, considering the criteria established for each study design. RESULTS: Sixteen studies from four online databases were selected, the majority of which were cross-sectional and descriptive. The risk factors for problematic mobile phone use, the negative consequences for mental and physical health, and the clinical work of nurses were highlighted, such as a combination of strategies to prevent and mitigate problematic mobile phone use in the clinical setting. CONCLUSION: The problematic mobile phone use of nurses negatively affects their mental and physical health, as well as their performance in the clinical setting. IMPLICATION FOR NURSING MANAGEMENT: The findings of this study may inform the need for nursing managers to develop and implement strategies to prevent and mitigate the problematic use of these devices among nurses and ensure the appropriate use of mobile phones in the clinical setting.
Network Analysis of Burnout and Safety Competence Among Oncology Nurses: A Secondary Study to Identify Bridge Targets for Precision Interventions.
Ma F, Luo Z, Zhu Y … +4 more , Liu L, Chen H, Liu Y, Zhang F
J Nurs Manag · 2026 · PMID 41870377 · Full text
BACKGROUND: Occupational burnout poses a persistent threat to nurses' mental health and the quality of patient care. Emerging evidence indicates that burnout is not a uniform phenomenon but manifests in distinct psycholo...
BACKGROUND: Occupational burnout poses a persistent threat to nurses' mental health and the quality of patient care. Emerging evidence indicates that burnout is not a uniform phenomenon but manifests in distinct psychological patterns. Yet, how these diverse burnout experiences interact with safety-related factors is insufficiently understood. Network analysis offers a systems-level perspective to uncover interconnections among psychological and safety variables and to pinpoint potential bridge nodes for targeted interventions. AIM: This study sought to map the network architecture linking psychological and safety-related factors among nurses across different burnout profiles, to identify profile-specific central and bridge nodes, and to examine their associations with safety behaviors. METHODS: A total of 2092 nurses were included. This study was a secondary analysis based on a previously established dataset in which three distinct burnout profiles were identified using latent profile analysis: the High Achievement Stable Group (Class 1, 70.3%), the High Efficiency Contradictory Group (Class 2, 6.6%), and the High Pressure Adaptive Group (Class 3, 23.1%). Psychological-safety networks were estimated for both the overall sample and each subgroup using the EBICglasso model. Centrality and bridging indices were computed via expected influence and bridge expected influence, followed by network comparison tests to evaluate structural variations across profiles. RESULTS: In the overall network, "skills" (B4) exhibited the greatest centrality, whereas "personal accomplishment" (A3) and "knowledge" (B1) consistently functioned as pivotal bridge nodes across profiles. Although bridge configurations differed slightly among classes, A3 and B1 remained the principal connectors integrating psychological and safety communities. Significant structural differences were detected between Classes 2 and 1 (M test, p < 0.001) and between Classes 3 and 1 (M test, p < 0.001; S test, p = 0.002), with pronounced discrepancies in the edge patterns surrounding A3 and B1. CONCLUSIONS: The burnout-safety networks revealed distinct structural configurations across nurse subgroups. Identifying profile-specific bridge nodes offers practical guidance for precision interventions that enhance safety behaviors and foster occupational resilience.
The Impact of High-Fidelity Simulation and Curriculum Integration on Nursing Students' Competence and Satisfaction: A Quasiexperimental Study.
Ismail A, Al-Modallal H, Aldardeir N … +2 more , Gomma N, Eltohamy NAE
J Nurs Manag · 2026 · PMID 41870306 · Full text
BACKGROUND: Curriculum integration and high-fidelity simulation (HFS) were used separately in nursing education. Little is known about their combined effect on undergraduate nursing students' competence. AIM: To assess t...
BACKGROUND: Curriculum integration and high-fidelity simulation (HFS) were used separately in nursing education. Little is known about their combined effect on undergraduate nursing students' competence. AIM: To assess the impact of HFS and curriculum integration on nursing students' competence and satisfaction. METHODS: A quasiexperimental study design was employed. Using convenience sampling, two groups of undergraduate nursing students were compared in their management of pregnant women undergoing normal vaginal delivery and immediate newborn care. The intervention group (n = 30) received the HFS/curriculum-integrated session, while the control group (n = 30) received the traditional curriculum. The HFS/curriculum-integrated intervention consisted of five three-hour sessions, with six students participating in each session. The intervention was conducted in the simulation laboratory of Fakeeh College for Medical Sciences in December 2023 over one week, and study data were collected two weeks after the completion of the educational intervention. Students' competence was assessed using a structured written examination and an objective structured clinical examination (OSCE), while satisfaction was evaluated using a self-reported questionnaire. Independent t-tests were used to examine differences in competency between the two groups. RESULTS: Students who participated in the HFS/curriculum-integrated sessions demonstrated significantly higher performance in both written knowledge examinations and clinical skills assessments compared to the control group. Knowledge scores were higher for management of normal vaginal delivery (86% vs. 46%) and immediate newborn care (80% vs. 54%), and OSCE scores were also significantly greater for vaginal delivery management (81% vs. 50%) and immediate newborn care (95% vs. 56%) (p ≤ 0.05). Students' satisfaction with the integrated session using HFS was high (91% ± 7.6). CONCLUSION: The use of HFS and curriculum integration significantly enhanced nursing students' competency and satisfaction levels. These findings underscore the value of incorporating HFS and curriculum integration as an effective strategy in nursing education. However, further large-scale and longitudinal studies are warranted to more comprehensively evaluate the long-term impact of HFS and curriculum integration on diverse nursing learning outcomes. IMPLICATION FOR NURSING MANAGEMENT: Nursing management should facilitate the use of HFS and curriculum integration in nursing education, as this approach significantly enhances students' clinical competence while bridging the gap between theory and practice.
Nursing Leadership in Practice: A Qualitative Scoping Review of Framework Implementation Experiences in Public Healthcare Systems.
Marks L, Biles J, Kornhaber R
J Nurs Manag · 2026 · PMID 41863094 · Full text
AIM: To explore how nurse leaders in public healthcare systems experience the implementation of professional practice and leadership frameworks and to identify contextual factors that influence their practical applicatio...
AIM: To explore how nurse leaders in public healthcare systems experience the implementation of professional practice and leadership frameworks and to identify contextual factors that influence their practical application. BACKGROUND: Leadership frameworks are widely promoted to enhance nursing leadership capability, yet their translation into practice remains inconsistent. Understanding how nurse leaders experience these frameworks is essential to inform leadership development and organisational strategy. METHODS: A qualitative scoping review was conducted using Braun and Clarke's reflexive thematic analysis. Fourteen qualitative studies published between 2015 and 2024 were identified through systematic searches of CINAHL, Scopus and MEDLINE. The review followed the Arksey and O'Malley framework and PRISMA-ScR guidelines. RESULTS: Five themes were identified: leadership skills, leadership development, leadership challenges, evidence-based practice and workplace culture. Leadership was described as a responsive practice shaped by clinical credibility, strategic management and interprofessional influence. A conceptual model, the Clinical-Administrative-Research Nexus, emerged reflecting the concurrent demands placed on nurse leaders. Systemic barriers such as hierarchical constraints, limited resources and inconsistent organisational support contributed to a persistent 'knowing-doing' gap. Workplace culture was the most influential factor, shaping leadership development, evidence translation and team cohesion. CONCLUSION: Leadership frameworks were experienced as contextual tools rather than standalone solutions. Their implementation depends on structural support, mentorship and alignment with clinical realities. Leadership success was shaped more by the conditions in which it is enacted than by individual capability alone. IMPLICATIONS FOR NURSING MANAGEMENT: The findings highlight the need for integrated system-level support to enable nurse leaders to navigate the complexities of their clinical, administrative and research responsibilities. Organisational strategies must move beyond individual skill building to address structural barriers and foster cultures that support leadership development and evidence-based practice.
Psychological Recovery of "Second Victims" After Adverse Events: Experiences From Generation Z Emergency Nurses.
Liu Y, Zhang Y, Zhu X … +6 more , Zou J, Zheng J, Liu S, Chi C, Zeng L, Jiang J
J Nurs Manag · 2026 · PMID 41862225 · Full text
BACKGROUND: The second victim (SV) phenomenon is common among nurses in emergency departments. SVs may experience positive changes and achieve psychological recovery due to new insights or gains, even while enduring seco...
BACKGROUND: The second victim (SV) phenomenon is common among nurses in emergency departments. SVs may experience positive changes and achieve psychological recovery due to new insights or gains, even while enduring second victim syndrome (SVS). Generation Z emergency nurses (ENs) in China possess distinct life experiences compared with previous generations, and their work characteristics influence their psychological recovery experiences. OBJECTIVE: This study aimed to investigate the psychological recovery experiences of Generation Z ENs who served as SVs after adverse events. METHODS: This study employed a descriptive phenomenological approach. From April to May 2024, semistructured in-depth interviews were conducted with eleven Generation Z ENs from a tertiary hospital in Shanghai. The Colaizzi seven-step framework was employed for data analysis. RESULTS: Three themes and eight subthemes emerged: shock and stress, reconstruction and remodeling, and gain and growth. CONCLUSION: As SVs, positive introspection, resilience mobilization, and the receipt of emotional first aid facilitated the reconstruction and growth of Generation Z ENs. To create effective strategies, managers should prioritize the work characteristics and needs of Generation Z ENs at various stages of psychological recovery, emphasizing self-efficacy, collective agency, and social capital. The findings of this study are relevant to the development and implementation of future SV support programs.
Exploring the Concept of Nurses' Healthcare Policy Competence: A Systematic Review and Qualitative Meta-Synthesis.
Han NK, Kim JG
J Nurs Manag · 2026 · PMID 41860586 · Full text
BACKGROUND: Nurses' competence in healthcare policy is crucial for policy intervention to strengthen public health equity and resolve health problems through healthcare policy reforms. Previous studies conducted systemat...
BACKGROUND: Nurses' competence in healthcare policy is crucial for policy intervention to strengthen public health equity and resolve health problems through healthcare policy reforms. Previous studies conducted systematic reviews, scoping reviews, or meta-syntheses related to the political competence of nurses, factors affecting nurses' policy interventions, and barriers and facilitators of policy intervention, but the concept of healthcare policy competence was not examined. AIM: This study explored nurses' competence in healthcare policy through a systematic review and meta-synthesis of previous qualitative studies. METHODS: A systematic review of English-language journal articles in databases including Medline, Embase, PubMed, CINAHL, Web of Science, and Scopus published up to December 31, 2023, generated 17,810 identified articles, of which 27 individual studies were used for analysis. Researchers with rich experiences in healthcare policy interventions and qualitative research analysis extracted data using ATLAS.ti and meta-synthesized it. RESULTS: Nurses' competence in healthcare policy was synthesized into five factors: intrinsic motivation, healthcare expertise, policy development, political skills, and policy intervention. Fifteen themes and 34 subthemes were derived as subattributes. CONCLUSIONS: This study provides a conceptual framework for nurses' competence in healthcare policy and for developing political or policy education or programs to strengthen this competence.
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