Journal of Nursing Regulation最新文献

{"title":"Work Organization Factors Associated With Nurses’ Stress, Sleep, and Performance: A Pre-pandemic Analysis","authors":"Amy Witkoski Stimpfel PhD, RN,&nbsp;Lloyd Goldsamt PhD,&nbsp;Eva Liang MA,&nbsp;Deena K. Costa PhD, RN, FAAN","doi":"10.1016/S2155-8256(22)00085-0","DOIUrl":"10.1016/S2155-8256(22)00085-0","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic put extreme stress on an already strained healthcare workforce. Suboptimal work organization, exacerbated by the pandemic, is associated with poor worker, patient, and organizational outcomes. However, there are limited qualitative studies exploring how the interconnections of work organization factors related to shift work, sleep, and work stress influence registered nurses and their work performance in the United States.</p></div><div><h3>Purpose</h3><p>We sought to understand how nurses perceive work organization factors that impact their performance. Knowledge in this area could direct efforts to implement policies and design tailored interventions to support nurses in the post-pandemic period.</p></div><div><h3>Methods</h3><p>We used a qualitative descriptive design with the <em>Work, Stress, and Health</em> framework as an overarching guide to understand the interconnectedness of work organization factors, work stress, and outcomes. Participants were randomly assigned to one of two anonymous, asynchronous virtual focus groups (i.e., threaded discussion boards) in 2019. Registered nurses (<em>N</em> = 23) working across the United States were recruited and engaged until data saturation was achieved. Directed content analysis was used to analyze the data.</p></div><div><h3>Results</h3><p>Findings aligned with the <em>Work, Stress, and Health</em> framework and revealed three themes: (1) “Our Voice Should Matter” (nurses’ desire to have their voices heard in staffing policies); (2) “Tired But Wired” (the harmful cycle of work stress, rumination, and poor sleep); and (3) “We’re Only Human” (nurses’ physical, emotional, and mental exhaustion linked to critical performance impairments).</p></div><div><h3>Conclusion</h3><p>These findings underscore that high work stress and poor sleep were present before the pandemic and impacted nurses’ perceptions of their performance. As leaders look forward to recovery and work redesign efforts, these findings can guide decision-making and resource allocation for optimal nurse, patient, and organization outcomes.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Pages 4-12"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9581500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Factors Impacting New Graduate Registered Nurses and Their Passage to Becoming Competent Professional Nurses: An Integrative Review","authors":"Peter David Mellor RN, DipT (NEd), BEd (NursSt), Grad Dip Ed Admin, MClinEd, PhD,&nbsp;Anita De Bellis RN, BN (Man), MN, PhD,&nbsp;Amanda Muller BA, PhD, Grad Cert PH, Grad Cert Ed, Grad Cert TESOL","doi":"10.1016/S2155-8256(22)00081-3","DOIUrl":"10.1016/S2155-8256(22)00081-3","url":null,"abstract":"<div><h3>Background</h3><p>Health services offer new graduate registered nurses (NGRNs) employment primarily via specialized transition programs. However, findings continue to indicate that these programs are mostly counterproductive in the provision of a supportive environment. As a consequence, the health of graduates and safety of their patients is often at risk.</p></div><div><h3>Purpose</h3><p>The specific aim of this integrative review was to review, critique, and synthesize the existing literature with regard to the spectrum of factors and perceptions that have an impact on NGRNs and their passage to becoming competent professional nurses. The overall aim was to reconceptualize the approach to NGRN transition and develop new frameworks or perspectives.</p></div><div><h3>Methods</h3><p><span>This study used an integrative review of qualitative, quantitative, and mixed methods research guided by the Preferred Reporting Items for </span>Systematic Reviews<span> and Meta-Analyses (PRISMA) guidelines and the McGill Mixed Methods Appraisal Tool. The CINAHL, PsycInfo, Google Scholar, and Ovid MEDLINE databases were searched for relevant quantitative, qualitative, and mixed methods studies published in English in an academic journal between 2015 and 2021. Eligible studies were categorized conceptually in accordance within a recognized framework for integrative reviews.</span></p></div><div><h3>Results</h3><p>A total of 41 studies were included in the review. This review found that healthcare organizations are primarily solipsistic and provision of consistent quality support, or any support at all, for NGRNs was not assured. As a consequence, purposive psychosocial preparation of nursing students for self-support during transition is needed.</p></div><div><h3>Conclusion</h3><p>An intense focus on psychosocial preparation of nursing students in order to scaffold the transition to practice experience and thus ensure patient safety is advocated. Proposals for change are recommended at the undergraduate level, which includes comprehensive curriculum development in both theory and practice.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Pages 24-51"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41974323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the United Kingdom’s Nursing and Midwifery Council Applies Guidance When Exercising Its Disciplinary Functions","authors":"Cathal T. Gallagher PhD,&nbsp;Fatima Saleem MPharm","doi":"10.1016/S2155-8256(22)00080-1","DOIUrl":"10.1016/S2155-8256(22)00080-1","url":null,"abstract":"<div><h3>Background</h3><p>The Nursing and Midwifery Council (NMC) is responsible for addressing concerns about UK-registered nurses and midwives through its fitness-to-practice process.</p></div><div><h3>Purpose</h3><p>To assess whether the NMC considers relevant factors at all stages of its deliberations into nurse misconduct, as required by the determinations in the appeal cases of <em>Cohen v. General Medical Council</em> (GMC), <em>Zygmunt v. GMC</em>, and <em>Azzam v. GMC</em>, and to assess whether the circumstances described in its <em>Sanctions Guidance</em> warranting the suspension or removal of a nurse from the practice register lead to that outcome.</p></div><div><h3>Methods</h3><p>Cases between July and September 2021 that highlighted aggravating circumstances deemed as serious enough to warrant removal were identified and included in this study. Specific factors, including patient safety and dishonesty, included when determining impairment of fitness to practice were compared with their subsequent consideration when determining the severity of sanction. Pearson’s χ2 and Fisher’s exact tests were used to detect any variation from the expected distribution of data.</p></div><div><h3>Results</h3><p>Fifty-nine cases met the inclusion criteria. Each of the four factors considered was more likely to be heard when determining a sanction after first being factored into the consideration of impairment. Where the aggravating factors of dishonesty or risk of harm to patients or the public were identified as an aspect of a nurse’s misconduct, the sanctions of suspension or removal were no more likely to be imposed than when they were absent.</p></div><div><h3>Conclusion</h3><p>The NMC does, in general, factor the rulings of High Court appeal cases into their deliberations on the impairment of fitness to practice; however, we were unable to demonstrate that dishonesty or risk of harm were more likely to result in suspension or removal of a nurse from the practice register.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Pages 52-59"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42183708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thematic Analysis of Health Professions Sunset Reports: Foci, Gaps, Impacts, and Best Practices","authors":"David C. Benton PhD, RN, FRCN, FAAN,&nbsp;Alyson S. Brenton RN, MSN, CNL,&nbsp;Peggy Seller Benson MSN, RN, MSHA, NE-BC,&nbsp;Katherine Stansfield MN, RN,&nbsp;Phyllis Johnson DNP, MSN, RN, FNP-BC","doi":"10.1016/S2155-8256(22)00094-1","DOIUrl":"10.1016/S2155-8256(22)00094-1","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Sunset reviews, along with performance audits&lt;span&gt; and judicial reviews, orientate regulatory boards to act in the public interest and to address any weaknesses in the boards’ efficiency. Although sunset reviews gained popularity after their introduction in the 1970s and 1980s, their limited success in terminating agencies, along with the resources needed to conduct the reviews, have led to sunset legislation being repealed in several jurisdictions in favor of broader program evaluation or general audit processes. Increased interest in trying to limit the growth of the number of professions requiring a license to practice has seen a revival of interest in both sunrise and sunset reviews over the past decade.&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;To review existing sunset reports related to nursing and other health professions licensing boards and identify the foci, best practices, and criteria used by states in their evaluations.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A review and systematic examination of existing literature was performed with a mixed-methods approach and a range of analytical techniques. Manual and computer-based qualitative analyses were used to identify themes. Documents were analyzed for thematic content, the centrality of various themes, and how they may inform the development of more standardized approaches to assess the performance of regulatory bodies.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;A total of 329 reports were identified from 24 US states. The 329 reports were analyzed and varied in length from 3 to 727 pages with an average report length of 68 pages. Collectively, 22,420 pages were analyzed. The review identified that many evaluations were based on opinion or survey responses rather than quantifiable or empirical evaluations. As a result, objective analysis of the approaches is difficult to assess, both within and across jurisdictions. The study identified 26 themes with considerable overlaps and connections between them. By coding various themes to the content of the reports, researchers identified groups of the most strongly related themes. The most connected group, &lt;em&gt;main areas of performance scrutiny,&lt;/em&gt; relates to the major responsibilities and functions of licensing boards. The next most connected group encompasses the administrative and &lt;em&gt;operational concerns&lt;/em&gt; involved in the conduct of the review. The least connected group is those elements that delineate the &lt;em&gt;authority and focus&lt;/em&gt; of the review and encompass the basis of the legislative authority used to enable the review. Best and promising practices were also identified, including the following: (a) information provision (e.g., guidance notes that explain the process and provide public input); (b) comparative data sets (e.g., conducting reviews on a range of boards simultaneously); (c) accountability and publication of responses (e.g., improvement recommendations or commendation for best practices are made available).","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Pages S1-S68"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48324020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building the Future of Regulation on the Steps From Our Past 45 Years","authors":"Maryann Alexander PhD, RN, FAAN (Editor-in-Chief)","doi":"10.1016/S2155-8256(22)00078-3","DOIUrl":"10.1016/S2155-8256(22)00078-3","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Page 3"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48278073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legislative Highlight: Indiana House Bill 1003","authors":"Nicole Livanos JD, MMP","doi":"10.1016/S2155-8256(22)00083-7","DOIUrl":"10.1016/S2155-8256(22)00083-7","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Pages 60-62"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42442593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Advisory Board","authors":"","doi":"10.1016/S2155-8256(22)00093-X","DOIUrl":"https://doi.org/10.1016/S2155-8256(22)00093-X","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 3","pages":"Page C2"},"PeriodicalIF":2.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138198369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrections to Lavin et al. (2022)","authors":"","doi":"10.1016/S2155-8256(22)00064-3","DOIUrl":"10.1016/S2155-8256(22)00064-3","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Page 64"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2155825622000643/pdfft?md5=eb77529d8472011f2f865d467860d097&pid=1-s2.0-S2155825622000643-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42702739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Shortage of Bills to Reverse Workforce Trends","authors":"Nicole Livanos JD, MPP","doi":"10.1016/S2155-8256(22)00065-5","DOIUrl":"10.1016/S2155-8256(22)00065-5","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Pages 61-63"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48992846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Review of NCLEX Candidates’ Testing Behavior: Examining the Relationship Between Repeat Testing, Time-to-Test, and Discipline","authors":"Nicole Kaminski-Ozturk PhD,&nbsp;Richard Smiley MS,&nbsp;Elizabeth Zhong PhD,&nbsp;Brendan Martin PhD","doi":"10.1016/S2155-8256(22)00062-X","DOIUrl":"10.1016/S2155-8256(22)00062-X","url":null,"abstract":"<div><h3>Background</h3><p>Concerns about the competence of repeat NCLEX test takers have persisted, resulting in a patchwork of regulatory policies that limit the number of test attempts or the conditions under which a candidate can retest in certain U.S. jurisdictions.</p></div><div><h3>Purpose</h3><p>To examine possible corrolaries between repeat test-taker status and future practice discipline and to investigate the relationship between time-to-test and repeat testing.</p></div><div><h3>Methods</h3><p>Data were collected on nearly a quarter of a million registered nurse (RN) and practical nurse (PN) NCLEX candidates who passed the examination between 2013 and 2017. Multivariable generalized estimating equation models were used to assess the likelihood of discipline (0, 1) and the need for repeat testing (0, 1). Propensity score matching was employed to address initial group imbalance on all available covariates for models assessing discipline.</p></div><div><h3>Results</h3><p>The rate of discipline among the RN (1.0%, <em>n</em> = 2,029) and PN (1.8%, <em>n</em> = 749) samples was low. After applying propensity score matching, repeat test-taker status was found to be weakly aligned with practice discipline for RNs (<em>p</em> = .047) but was not correlated for PNs (<em>p</em> = .13). In contrast, adjusting for sex, race, ethnicity, and age, RN candidates who delayed taking the test for 60 days were 5% more likely to need to retake the NCLEX (<em>p</em> &lt; .001). For PN candidates, a delay of 90 days was associated with a 9% increase in the likelihood of needing to retake the NCLEX (<em>p</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>Empirical evidence supports the comparable safety profile of single– and multi–test-taker groups, underscoring the need to revaluate restrictions that limit the conditions under which candidates can retest. Furthermore, ongoing outreach to nursing programs to emphasize the importance of prompt NCLEX testing and the possible deleterious effects of delays, by even a few months, is important.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Pages 4-9"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41425240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}