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Enumeration	Reference	Cover	Find
1.	Allard, Karin, 1972, et al. (author) Gender equality and managers’ work in elderly and social care: A structural equation modelling approach 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:8, s. 2689-2696 Journal article (peer-reviewed)
2.	Amritzer, Maria A, et al. (author) Nursing staff ratio and skill mix in Swedish emergency departments : A national cross-sectional benchmark study. 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:8, s. 2594-2602 Journal article (peer-reviewed)abstract AIM: To describe ratio and skill mix for nursing staff in Swedish emergency departments over a specific 24-hour period.BACKGROUND: The link between number of patients per nursing staff and missed nursing care is well described within the in-hospital setting, showing association with negative outcomes such as increased mortality. Potential association within the emergency department setting is still unexplored.METHOD: A national descriptive cross-sectional benchmark study.RESULTS: The majority (n=54; 89%) of Swedish emergency departments participated. The patients-per-registered nurse ratio varied between the shifts, from 0.3 patients to 8.8 patients (mean 3.2). The variation of patients per licensed practical nurse varied, from 1.5 to 23.5 patients (mean 5.0). The average skill mix was constant at around 60% registered nurses and 40% licensed practical nurses.CONCLUSION: The varying ratios for patient per registered nurse and licensed practical nurse in Swedish emergency departments is noteworthy. Furthermore, the patient flow and nursing staff numbers did not match one another, resulting in higher nursing staff ratios during the evening shift.IMPLICATIONS FOR NURSING MANAGEMENT: Findings can be used to improve rosters in relation to crowding, to manage the challenging recruitment and retention situation for nursing staff and to improve patient safety.
3.	Arakelian, Erebouni, 1973-, et al. (author) Nurse managers in perioperative settings and their reasons for remaining in their jobs : A qualitative study 2020 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 28:6, s. 1191-1198 Journal article (peer-reviewed)abstract AIM: The study describes what helps nurse managers maintain the strength to keep going as leaders.BACKGROUND: Good leadership is important for the quality of patient care, patient satisfaction in care and efficiency. Many nurse managers stay on despite challenges at work.METHODS: Twelve nurse managers were interviewed. Data were analysed by systematic text condensation according to Malterud.RESULTS: The results were as follows: A-Walking side by side with my employees; B-Knowing that I mean something to my employees; C-Talking to myself-asking myself tough questions; D-Having someone to talk to, to decrease the feeling of being alone; E-Leading and managing in my own way-the fear of not succeeding is my motivation.CONCLUSION: The nurse managers built their own strategies to get through and get on when difficult situations arose. In order to succeed in leading their employees, the nurse managers gathered their inner strength through moving caritatively back and forth between the 'secret room' and the 'staff room' in the house of leadership.IMPLICATIONS IN NURSING MANAGEMENT: The manuscript gives insights into where nurse managers found sources of strengths in their everyday work. To realize their employees' strengths and motivation made a difference for nurse managers as a driving force. By having someone to talk to and by asking themselves tough questions, they were prepared for the challenges that came.
4.	Arakelian, Erebouni, 1973-, et al. (author) Reaching a tipping point : perioperative nurse managers' narratives about reasons for leaving their employment - a qualitative study. 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:4, s. 664-671 Journal article (peer-reviewed)abstract AIM: To describe reasons why nurse managers in perioperative settings decide to leave their employment.BACKGROUND: Current literature has shown that perioperative nurse managers' reasons to leave their positions are formed through an interaction of factors.METHODS: Individual in-depth interviews were performed with seven nurse managers, all women, in perioperative settings in Sweden. Data were analysed using Systematic Text Condensation.RESULTS: Five key themes were identified: a- To end where I started, as a front-line nurse; b- I wanted to develop further to the next level in my career; c- I ran out of ideas; d- I lost trust in my head manager and did not believe in the new organization, and e- I had had enough of being offended by my superior manager and my employees.CONCLUSION: Nurse managers experienced feeling forced into a decision to leave because of being offended by their superiors or their employees. Furthermore, the findings indicate that nurse managers should be offered support from superior managers and the organization together with time for discussions.IMPLICATIONS IN NURSING MANAGEMENTS: The most essential element should be the influence of caritative leadership and the obvious expectation of being treated with dignity, respect, and appreciation.
5.	Arakelian, Erebouni, 1973-, et al. (author) Success factors when implementing a structured support model for systematic work environment management in operating departments : A case study from Sweden 2022 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 30:7, s. 3618-3627 Journal article (peer-reviewed)abstract Aim The study aimed to investigate how departments in a Swedish hospital worked with a structured support model between the sessions and what they identified as success factors. Background To improve the work environment in a Swedish hospital, a structured support model for systematic work environment management was implemented in operating departments. The structured work starts with sending a web-based, open-ended, anonymous questionnaire to all employees. In response, employees describe how they perceive their work environment 'right now'. Next, a session is held where employees' viewpoints are discussed, and areas of improvement are agreed upon. Action plans are created between the sessions, and the employees start working with their plans with support from their managers. Implementing new models takes time and requires efforts from employees and managers. Method A case study was conducted, including three operating departments within a perioperative organization in a university hospital in Sweden. The participating departments had used the model without interruption during the Covid-19 pandemic 2 years after implementation, and they had created a customized working method. Three first-line managers were interviewed, and 22 action plans, 21 workplace meeting notes and two presentations were analysed using thematic analysis. Results The results are sorted under three main thematic headings: Experience of results and benefits, Marketing and cheering on and Making adjustments and making the model one's own. The results from the action plans and workplace meetings indicated that the employees had discussed problems with cooperation, work organization and how to treat each other. Conclusion Human factors, such as support, encouragement, seeing the benefits, allowing for time and respecting each other can facilitate and contribute to the implementation and success of a new model. Implications for Nursing Management The main finding of the study indicates that with a structured way of working, and with the participation of the employees in the systematic work environment work, the employees contributed with constructive suggestions for improvement. This, in turn, contributed to reducing the workload for first-line managers. In addition, when working with a structured model, deficiencies in the workplace were identified, which triggered an improvement process in the participating hospital departments.
6.	Avallin, Therese, et al. (author) Using communication to manage missed care : A case study applying the Fundamentals of Care framework 2020 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 28:8, s. 2091-2102 Journal article (peer-reviewed)abstract AimTo explore, through the patient's perspective, how patient–provider communication is linked to missed nursing care vs. meeting patients’ fundamental care needs.BackgroundMissed nursing care causes severe consequences for patients. Person-centred fundamental care, in which communication is central, provides an approach to manage this challenge. However, the specific patient–provider communications linked to care outcomes are unknown.MethodsCase study using secondary analysis of observations and interviews. A purposeful sample of 20 patients with acute abdominal pain collected using ethnographic methodology at one emergency department and two surgical wards. The Fundamentals of Care framework guided the analysis.ResultsCommunications that included the patient as an equal member of the care team were observed to make a difference between adequate and missed nursing care. Four categories were identified: interpersonal respect, humanized context of care, available and accessible communication channels, and mutual holistic understanding of the care needs and care plan.ConclusionCommunication can be an essential tool to avoid missed nursing care and address the critical need for nursing managers to restore the fundamentals of care.Implications for Nursing ManagementNursing managers can use this new knowledge of communication to facilitate person-centred fundamental care and thereby avoid missed nursing care.
7.	Bry, Anna, 1984, et al. (author) Organizational climate and interpersonal interactions among registered nurses in a neonatal intensive care unit: A qualitative study 2022 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:6, s. 2031-2038 Journal article (peer-reviewed)abstract Aim The aim of this work is to describe the organizational climate and interpersonal interactions experienced by registered nurses in a level III neonatal intensive care unit. Background Neonatal nurses have a demanding task in caring for a varied, highly vulnerable patient population and supporting patients' families. Nurses' psychosocial work environment affects quality of care as well as nurses' job satisfaction and organizational commitment. Method Semistructured interviews with 13 nurses, covering numerous aspects of their psychosocial work environment, were analyzed using thematic analysis. Results High staff turnover and a preponderance of inexperienced nurses were described as stressful and detrimental to group cohesion. Work at the unit was considered overly demanding for newly qualified nurses, while senior nurses expressed frustration at the work of training new nurses who might not stay. While some were very satisfied with the group climate, others complained of a negative climate and incivilities from some experienced nurses toward new recruits. Conclusions High turnover and variable competence among staff present challenges for maintaining a positive organizational climate. Implications for Nursing Management Management should communicate a clear sense of the nature of neonatal intensive care when recruiting, foster group cohesion (e.g., by creating stable work teams) and reward commitment to working at the unit.
8.	Bujacz, Aleksandra, et al. (author) Psychosocial working conditions of shiftworking nurses : A long-term latent transition analysis 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:8, s. 2603-2610 Journal article (peer-reviewed)abstract Aim: This study aimed to identify profiles of working conditions to which nurses were exposed to over time and investigate how changes in working conditions relate to shiftworking and health.Background: Previous studies rarely addressed the issue of working conditions development over long periods and the effects of such development on nurses' health.Methods: Data from a national cohort of nurses in Sweden (N = 2936) were analysed using a person-centred analytical approach-latent profile and latent transition analysis.Results: Nurses report better psychosocial working conditions as they progress into mid-career. Shiftworking nurses experience poorer working conditions than their dayworking counterparts and tend to move from shiftwork to daywork as they progress into mid-career. In mid-career, nurses in work environments characterized by low autonomy and support tend to report poorer health outcomes.Conclusion: Current analyses suggest that shiftworking nurses are particularly in need of interventions that address poor work environments. Not only do they experience more negative psychosocial working conditions than their dayworking counterparts, but they do so while having to contend with demanding schedules. Implications for Nursing Management The findings highlight that organisational interventions should target different aspects of the work environment for nurses in diverse stages of their careers.
9.	Bäckström, Josefin, Med dr, 1977-, et al. (author) I Was Merely a Brick in the Game : A Qualitative Study on Registered Nurses' Reasons for Quitting Their Jobs in Hospitals 2024 In: Journal of Nursing Management. - : Hindawi Publishing Corporation. - 0966-0429 .- 1365-2834. ; 2024 Journal article (peer-reviewed)abstract The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession.
10.	Engström, Maria, et al. (author) What relationships can be found between nurses' working life and turnover? - A mixed-methods approach 2022 In: Journal of Nursing Management. - : Wiley. - 0966-0429 .- 1365-2834. ; 30:1, s. 288-297 Journal article (peer-reviewed)abstract AIM: to describe why registered nurses decide to leave their work and to investigate relationships between registered nurses' working life and turnover (leaving the unit versus the profession).BACKGROUND: Much research has explored nurses' intention to leave, while less research has looked at turnover and especially leaving the profession.METHODS: Data were collected using questionnaires and interviews.RESULTS: The three most common reasons for both groups (leaving the profession, n=40; leaving unit but not profession, n=256) were high workload, low salary and applied for and got a new job. Multivariate logistic regression analysis revealed statistically significant relationships between turnover and empowering structures, such as access to resources and informal power as well as the factor learning in thriving.CONCLUSIONS: Structural empowerment, such as good access to resources and informal power, is important to keeping nurses in the profession, while learning seems to increase the risk of leaving the profession when variables such as vitality, resources, informal power and age are held constant.IMPLICATIONS FOR NURSING MANAGEMENT: To counteract nurses leaving the profession, managers must provide nurses with good access to resources, informal power, such as networks within and outside the organization, and focus on nurses' vitality.
11.	Epstein, Majken, et al. (author) Managing Sustainable Working Hours within Participatory Working Time Scheduling for Nurses and Assistant Nurses : A Qualitative Interview Study with Managers and Staffing Assistants 2023 In: Journal of Nursing Management. - : Hindawi Publishing Corporation. - 0966-0429 .- 1365-2834. ; 2023 Journal article (peer-reviewed)abstract Aim. To bring insights into how healthcare managers and staffing assistants work to achieve sustainable working hours within a participatory scheduling system. Background. Hospital nurses and assistant nurses often work on rotating shifts, which affects their opportunities for sleep, recovery, and work-life balance. In Sweden, a participatory scheduling approach is commonly used, where working hours are planned in collaboration between employees, managers, and staffing assistants. Influence over working hours is related to positive outcomes among shift workers. However, it also places responsibility on the employee to schedule working hours that promote health and patient safety, i.e., sustainable working hours. Accordingly, the organisation has responsibilities to support the employee in this regard. Methods. Semistructured individual interviews were conducted with 11 managers and 9 staffing assistants from four Swedish regions and analysed using thematic analysis. Results. Several key factors for achieving sustainable working hours within the context of participatory scheduling were described: distribution and clarity of responsibilities, allocating time for scheduling, establishing shared responsibility, considering fairness, fostering an individual relationship with the employee, managing dissatisfaction, providing support, clarifying guidelines for sustainable scheduling, managing inconsistencies between employee requests and sustainable working hours, and considering recovery opportunities and the competence mix on shifts. Additionally, contextual factors, such as staffing levels, working procedures, working time arrangements for night work, and technological support, were highlighted as important. Conclusion. Achieving sustainable working hours within participatory scheduling involves considering the interactions between factors at the levels of the organisation, the individual, and the technological systems. Implication for Nursing Management. Nurse managers and staffing assistants must work closely with their employees during participatory scheduling to ensure sustainable working hours. Key goals in this regard include establishing a shared responsibility, clarifying responsibilities and guidelines for sustainable scheduling, and allocating time for the scheduling process.
12.	Fallman, Sara L., et al. (author) Managerial approaches for maintaining low levels of sick leave: A qualitative study 2022 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:7, s. 3546-3552 Journal article (peer-reviewed)abstract Aim The aim of this study was to identify first-line managers' approaches for maintaining low levels of sick leave among health care employees. Introduction One challenge in health care is the high level of sick leave among employees. High work demands and conflicting pressures characterize the work situation of both employees and first-line managers, with potential negative effects on work-related health. Method First-line managers at units with low and/or decreasing sick leave were interviewed. Thematic analysis was used to analyse the data. Results The managers took a holistic approach in meeting their employees' broader needs, and they were balancing high organisational demands through insubordination. To keep sick leave rate low, they created possibilities for the employees to influence their own working life through a present, visible and trustful leadership. Conclusion Managers responsible for units with low sick leave seemed to utilize a holistic approach with focus on their employees and prioritized needs of their employees before organisational demands from top management. Implications for nursing management First-line managers in health care can have impact on sick leave among their employees and create good working conditions, despite pressure from their superiors.
13.	Gadolin, Christian, 1987, et al. (author) Managing health care under heavy stress: Effects of the COVID-19 pandemic on care unit managers’ ability to support the nurses—A mixed-methods approach 2022 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:8, s. 4080-4089 Journal article (peer-reviewed)abstract Aim(s): This study aims to investigate care unit managers’ perceptions of how the COVID-19 pandemic influenced their ability to support the nurses. Background: The COVID-19 pandemic placed extreme pressure on health care organizations. More knowledge regarding how the pandemic influenced care unit managers’ ability to support nurses is central to ensuring high-quality health care in future crises. Method(s): A mixed-methods study in Swedish hospitals with a survey (n = 128) and interviews (n = 20) with care unit managers. Results: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care and strong professional and social support were important job resources. Conclusion(s): For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers’ perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management: This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.
14.	Gadolin, Christian, 1987-, et al. (author) Managing Healthcare under Heavy Stress : Effects of the COVID-19 Pandemic on Care Unit Managers' Ability to Support the Nurses - A Mixed Methods Approach. 2022 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:8, s. 4080-4089 Journal article (peer-reviewed)abstract AIM: Investigate care unit managers' perceptions of how the COVID-19 pandemic influenced their ability to support the nurses.BACKGROUND: The COVID-19 pandemic placed extreme pressure on healthcare organizations. More knowledge regarding how the pandemic influenced care unit managers' ability to support nurses is central to ensuring high-quality healthcare in future crises.METHOD: A mixed-methods study in Swedish hospitals with a survey (n=128) and interviews (n=20) with care unit managers.RESULTS: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care, and strong professional and social support were important job resources.CONCLUSION: For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers' perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.
15.	Gillberg, Nanna, et al. (author) Resilience Capability and Capacity in Unexpected Crises: Experiences and Lessons Learned in a Healthcare Organisation during the COVID-19 Pandemic 2023 In: Journal of Nursing Management. - 0966-0429 .- 1365-2834. Journal article (peer-reviewed)abstract Aim. The current article aims to gain insight into (a) what characterises organisational resilience during an unexpected crisis such as COVID-19 and (b) how organisations respond to developments in their environments. Background. In times of societal crises, such as the COVID-19 pandemic, the resilience of the healthcare organisation is tested. Method. This research is based on a case study in a university hospital and a county hospital in Sweden using surveys with both structured and open answers. Results. The result shows ambiguity and “polarised” experiences, emphasising flexibility vs. structure, clear hierarchical information vs. spaces for peer learning through dialogue, and focus on acute care vs. determination to continue with core operations. Conclusion. The article concludes that the pandemic resulted in paradoxes, tensions, and new experiences in organisational processes and interactions. These create opportunities for learning not only during crises but also for improving nursing management in both acute and planned care. Three relations are important in building organisational resilience in crises: resilience capability, resilience capacity, and sustainable resilience practices. Implications for Nursing Management. Organisational resilience under extraordinary circumstances, such as a pandemic, as well as enhancing the previous literature on nursing management that offer a more individually oriented perspective.
16.	Hamdan Alshehri, Hanan, et al. (author) Managerial and organisational prerequisites for the integration of palliative care in the intensive care setting: A qualitative study. 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 29:8, s. 2715-2723 Journal article (peer-reviewed)abstract To explore the association of organizational structures when integrating palliative care in intensive care units.Palliative care within intensive care settings has been widely recognized as an area requiring improvement when caring for patients and their families. Despite this, intensive care units continue to struggle to integrate palliative care.A qualitative descriptive methodology was used. Data were collected through research interviews with 15 managers and 36 health care professionals working in intensive care. The data were analysed adopting constant comparative analysis.This study provides insight into a diverse range of perspectives on organizational structure in the context of facilitation and the challenges posed. Three themes were identified: Do not resuscitate policy as a gateway to palliative care, facilitating family members to enable participation and support and barriers for palliative care in intensive care unit as a result of intensive care organization.In fostering a sustainable organizational culture and practice development in intensive care, the findings indicate the need for specific palliative care policies and implementation strategies tailored according to context.Management has a responsibility to facilitate dialogue within any multidisciplinary team regarding palliative care and, in particular, to focus on 'do not resuscitate' policies as a gateway into this conversation.
17.	Hörberg, Anna, et al. (author) Experienced Nurses’ Motivation, Intention to Leave, and Reasons for Turnover : A Qualitative Survey Study 2023 In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 2023 Journal article (peer-reviewed)abstract There is a global nurse shortage, and researchers have made great efforts in trying to unveil the reasons for turnover and how to increase retention. However, such research has had a tendency to study variables related to intention to leave (ITL) or turnover as isolated phenomena. Objective. To simultaneously explore what factors motivate experienced nurses in the workplace and the underlying reasons for strong ITL and high staff turnover within the profession. Design. An inductive qualitative content analysis was used based on data from open-ended survey questions. The data originated from the longitudinal analyses of nursing education/employment/entry (LANE) in work-life study. The qualitative data analyzed in this study were distributed in October 2017-January 2018, to all nurses in three cohorts corresponding to 11-, 13- and 15-year postgraduation. Of the 2,474 nurses answering the survey, 1,146 (46%) responded to one or more of the open-ended questions. Results. The result showed that what motivates experienced nurses, their intention to leave (ITL), and reasons for turnover could be described in the form of five broad categories, namely, organizational characteristics, work characteristics, relationships at work, work recognition, and health issues. There was rarely a one single reason described, rather several reasons needed to be experienced over time for nurses to stay motivated or leave the profession. Conclusions. There is no single reason that makes nurses leave the profession, nor is there one single reason that makes them motivated to stay. Retention and turnover are complex processes and need to be addressed as this, not as a single isolated phenomenon. © 2023 Anna Hörberg et al.
18.	Jakobsson, Jenny, 1975-, et al. (author) Workplace violence from the perspective of hospital ward managers in Sweden : A qualitative study 2022 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 30:6, s. 1523-1529 Journal article (peer-reviewed)abstract AIM: The aims of the study are to explore workplace violence perpetrated by patients or visitors from the perspective of hospital ward managers and to describe how ward managers perceive their leadership role and manage related incidents.BACKGROUND: Few studies focus on workplace violence from the perspective of ward managers even though they are the closest managers to the operational staff.METHOD: Fifteen semistructured interviews were analysed using qualitative content analysis.RESULTS: Four categories emerged: the face of workplace violence, a two-fold assignment, strive towards readiness to act, and managing incidents.CONCLUSION: While the most common acts of workplace violence are considered less serious and related to patients' medical conditions or dissatisfied visitors, hospital organizations focus on serious but rarely occurring incidents. Consequently, ward managers have limited opportunities to ensure a safe work environment on an everyday basis.IMPLICATIONS FOR NURSING MANAGEMENT: To support ward managers' occupational safety and health management, workplace violence prevention and management should be acknowledged as an important responsibility for senior management in hospitals. It is important to identify incidents that most likely will occur at the wards and to create strategies related to those incidents. Strategies could include risk assessments, prevention, evaluation, education and reflection combined with, for example, scenario training.
19.	Jönsson, Sandra, et al. (author) Preceptorship as part of the recruitment and retention strategy for nurses? : a qualitative interview study 2021 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 29:6, s. 1841-1847 Journal article (peer-reviewed)abstract AIM: The aim of this study was to explore aspects that are important for the integration of preceptorship and processes for recruitment and retention of nurses.BACKGROUND: Shortage of nurses is a global concern that has a major impact on healthcare systems around the world. However, earlier research has not considered whether preceptorship of nursing students can be an integral part of recruitment and retention of nurses.METHOD: A descriptive design with a qualitative approach was used. Semi-structured interviews were conducted with ten preceptors and six ward managers in different healthcare specialties in Sweden.RESULTS: Three aspects were found central for integrating preceptorship with recruitment and retention: perceptions of preceptorship, the organization of preceptorship, and the way preceptorship operates in relation to recruitment and retention strategies.CONCLUSION: The findings suggest that preceptorship and recruitment strategies could both benefit from being integrated.IMPLICATIONS FOR NURSING MANAGEMENT: It is central for nursing managers to develop organizational practices that enable the integration of preceptorship with recruitment and retention of nurses. This could increase the quality of both preceptorship and the work environment in general.
20.	Klarare, Anna, et al. (author) Leadership in specialist palliative home care teams : A qualitative study 2020 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 28:1, s. 102-111 Journal article (peer-reviewed)abstract AimThe aim of this study was to describe team leaders' experiences of facilitators and barriers of leadership in specialist palliative home care teams.BackgroundFor effective teamwork in specialist palliative care, leadership is crucial; however, defining and agreeing on what leadership comprises may be challenging. In palliative care, teamwork is recognized as imperative for multiprofessional perspectives to meet dying patients' and families' needs.MethodsQualitative interviews with 13 team leaders in specialist palliative home care were performed, using the Pettigrew and Whipp framework, and analysed with directed content analysis.ResultsTeam leaders' experiences of conditions influencing the organisation and delivery of specialist palliative home care is multifaceted and leaders seem conflicted in their approach to the multiple levels of leadership, vision and responsibilities.ConclusionTeam leaders in specialist palliative home care described goals of care on differing levels and, for some, fiscal restraints and external pressures influenced their vision and leadership. Team leaders experienced challenges of leadership in relation to organisational issues, feeling burdened by responsibilities, budget restraints and team size.Implications for Nursing ManagementTeam leadership is demanding and complex. In specialist palliative home care, affirming values and enabling vision during times of fiscal strain and external pressures, is challenging. For successful leadership that develops both individuals and the health care team, leaders are recommended to adapt the leadership style to the present situation surrounding the team.
21.	Lundin, Karin, et al. (author) Staff structural empowerment - observations of first-line managers and interviews with managers and staff 2022 In: Journal of Nursing Management. - : Wiley. - 0966-0429 .- 1365-2834. ; 30:2, s. 403-412 Journal article (peer-reviewed)abstract AIM: The aim was to study how first-line managers act to make structural empowerment accessible for nursing staff. Furthermore, to relate these observations to the manager's and their nursing staff's descriptions regarding the staff's access to empowering structures.BACKGROUND: Staff access to empowering structures has been linked to positive workplace outcomes. Managers play an important role in providing the conditions for structural empowerment.METHOD: Five first-line managers were observed for two workdays. Managers and staff (n=13) were thereafter interviewed. Field notes and interviews were analyzed using directed content analysis.RESULTS: The managers displayed intentional actions that could enable their staff access to empowering structures. Managers and staff described the importance of staff's access to empowering structures.CONCLUSION: Staff who perceive to have access to structural empowerment have managers who are present and available. Unanimity among managers and staff existed in regard to the importance of staff having access to structural empowerment. The managers work continually and intentionally, doing many things at the same time, to provide the staff access to empowering structures.IMPLICATIONS FOR NURSING MANAGEMENT: The study shows the importance of promoting managers' awareness of staff's access to structural empowerment and maximizing managers' presence and availability to their staff.
22.	Nordin, Anna, et al. (author) Intensive Care Managers' Experiences of the COVID-19 Pandemic: A Dramatic Change of the Intensive Care Landscape 2023 In: Journal of Nursing Management. - : Wiley-Hindawi. - 0966-0429 .- 1365-2834. Journal article (peer-reviewed)abstract Aim. To describe intensive care managers' experiences of premises and resources of care in intensive care units during the COVID-19 pandemic.Background. Intensive care units (ICUs) were enormously pressured during the COVID-19 pandemic from many ill patients, requiring advanced care. Hospital and community volunteers increased staff strength. Obligatorily, recruitments were also conducted using transfer of staff from different hospital departments. However, there is little knowledge about intensive care managers' (ICMs) experiences of leadership during the COVID-19 pandemic.Methods. A qualitative descriptive study was conducted from March to April 2022. Semistructured interviews were held with 12 ICMs who were purposively sampled from the ICU in ten Swedish hospitals. Data were analysed using qualitative content analysis.Results. Two themes emerged: a dramatic change of the intensive care landscape and we could handle more than we thought, but at a steep price. Participants described that the ICUs had to perform extraordinary changes at a very fast pace, which initially created a sense of cohesion. Training and introduction to war-like conditions associated with uncertainty meant that ICMs had to support ICU staff in prioritising interventions. Participants described how ICUs stood strong against a pandemic, but stress, worries, and anxiety took a heavy toll on ICU staff and ICMs. The pandemic eroded the resilience in ICUs. Participants described a deterioration in health and said that sick leaves and resignations occurred.Conclusion. Our findings show ICMs' experiences as a field of tension between resources and demands, whereby the changes created a heavy burden that left intensive care weakened.Implications for Nursing Management. Findings emphasised the importance of creating working conditions using human resources and materials in order to rebuild resilience in intensive care with the ability to conduct safe patient care.
23.	Pavlidis, George, et al. (author) A survey on the training needs of caregivers in five European countries 2020 In: Journal of Nursing Management. - : WILEY. - 0966-0429 .- 1365-2834. ; 28, s. 385-398 Journal article (peer-reviewed)abstract Aim This survey explored caregivers perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy). Background Training can enhance the professional capacity of caregivers; however, caregivers training needs within Europe have not been examined recently. Methods A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open-ended items and by conducting statistical and content analysis. Results The results indicated basic nursing skills and specialization, as well as training in psychology-related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas. Conclusions It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology-related skills could add to the professional capacity of European caregivers employed in health and social care. Implications for nursing management The findings inform about employed caregivers training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care.
24.	Ropponen, A, et al. (author) A case-crossover study of age group differences in objective working-hour characteristics and short sickness absence 2020 In: Journal of nursing management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 28:4, s. 787-796 Journal article (peer-reviewed)
25.	Rose, Anna-Karin, et al. (author) Newly graduated Nurses' experiences of the intervention graduate guidance nurses : A qualitative interview study. 2022 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 30:7, s. 3200-3207 Journal article (peer-reviewed)abstract AIMS: Describing newly graduated nurses' experiences of the intervention graduate guidance nurses.BACKGROUND: Newly graduated nurses need support to become established in the profession. The intervention was initiated to empower and support in the professional role.METHODS: A qualitative case study conducted with semi-structured interviews, using a thematic content analysis.RESULTS: One overarching theme "Organizational prerequisites, consisting of three themes occurred: "Activator" involved that the graduate guidance nurse was the activator creating a clear structure and the wards became more attractive workplaces. "Supportive nursing" meant that the graduate guidance nurse constituted an important support function which ensured patient safety. "Professional development" created the opportunity for professional growth.CONCLUSION: Newly graduated nurses' experiences shows that the creation of an organizational structure enabled the graduate guidance nurses to be an important support and contributed to professional development.IMPLICATIONS FOR NURSING MANAGEMENT: In healthcare organizations, strategic decisions, management support, and clear goals are important to create the organizational conditions to improve safer care. Support from experienced nurses is a large enabler in supporting newly graduated nurses developing in their profession. The results of the current study can be transferred to other similar healthcare organizations and can be supporting managers who plan to initiate support to newly graduated nurses.
26.	Scammell, Janet, et al. (author) Learning to lead: A scoping review of undergraduate nurse education 2020 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 28:3, s. 756-765 Research review (peer-reviewed)abstract Aim To explore undergraduate student's preparation for leadership roles upon registration. Background Effective leadership is vital when promoting positive workplace cultures and high‐quality care provision. However, newly registered nurses are not always well‐prepared for leadership roles. Evaluation A scoping review of primary research published in English between 2009 and 2019 was undertaken. Data were analysed using an adapted version of Arksey and O'Malleys' (2005. International Journal of Social Research Methodology: Theory and Practice, 8, 19) framework. Nine papers met the review eligibility criteria. Key issues Findings revealed three themes: leadership education content; positioning of leadership education within the nursing programme; and teaching and learning delivery. Conclusions The review highlighted some agreement about the knowledge, skills and behaviours to be addressed in leadership education. What varied more was the pedagogical methods used to deliver this, the extent of its integration throughout the programme and the nature of collaborative academic–practice working to ensure good quality clinical supervision. Implications for Nursing Management (a) Students must be exposed to positive leadership practices during clinical placements to facilitate theory–practice integration. (b) Bullying negatively impacts on students' self‐efficacy whereas positive role modelling from registered nurses supports development of leadership competence. (c) Leadership theory and competence should be introduced early and revisited throughout the programme.
27.	Tønnessen, Siri, et al. (author) Visibility of nursing in policy documents related to healthcare priorities. 2020 In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 28:8, s. 2081-2090 Journal article (peer-reviewed)abstract To explore the visibility of nursing in policy documents concerning healthcare priorities in the Nordic countries.Nurses at all levels in healthcare organizations set priorities on a daily basis. Such prioritization entails allocation of scarce public resources with implications for patients, nurses, and society. Although prioritizations in healthcare has been on the political agenda for many years, prioritization in nursing seems to be obscure in policy documents.Each author searched for relevant documents from their own country. Text analyses were conducted of the included documents concerning nursing visibility.All the Nordic countries have published documents articulating values and criteria relating to healthcare priorities. Nursing is seldom explicitly mentioned but rather is included and implicit in discussions of healthcare prioritization in general.There is a need to make priorities in nursing visible to prevent missed nursing care and ensure fair allocation of limited resources.To highlight nursing priorities, we suggest that the fundamental need for nursing care and what this implies for patient care in different organizational settings be clarified and that policymakers explicitly include this information in national policy documents.
28.	von Vogelsang, Ann-Christin, et al. (author) Missed nursing care during the COVID-19 pandemic : A comparative observational study 2021 In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:8, s. 2343-2352 Journal article (peer-reviewed)abstract AIM: To evaluate frequencies, types of, and reasons for missed nursing care during the COVID-19 pandemic at inpatient wards in a highly specialized university hospital.BACKGROUND: Registered nurse/patient ratio and nursing competence is known to affect patient outcomes. The first wave of the COVID-19 pandemic entailed novel ways for staffing to meet the expected increased acute care demand, which potentially could impact on quality of care.METHODS: A comparative cross-sectional study was conducted, using the MISSCARE Survey. A sample of nursing staff during the first wave of the COVID-19 pandemic (n=130) was compared with a reference sample (n=157).RESULTS: Few differences between samples concerning elements of missed care, and no significant differences concerning reasons for missed care were found. Most participants perceived the quality of care and the patient safety to be good.CONCLUSION: The results may be explained by three factors: maintained registered nurse/patient ratio, patients' dependency levels and that nursing managers could maintain the staffing needs with a sufficient skill mix.IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers impact on the occurrence of MNC; to provide a sufficient registered nurse/patient ratio and skill mix when staffing. They play an important role in anticipatory planning, and during infectious diseases outbreaks.
29.	Willman, Anna, 1970-, et al. (author) Professional development among newly graduated registered nurses working in acute care hospital settings : A qualitative explorative study 2022 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 30:7, s. 3304-3312 Journal article (peer-reviewed)abstract Aim To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. Background Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. Methods An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. Results One theme emerged: 'Clarity and security in one's own nursing role despite facing challenges that hinder professional development' and three categories: 'Independency due to one's own efforts and experience', 'Well-functioning teamwork' and 'Challenges in the work situation'. Conclusion After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. Implication for Nursing Management Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.
30.	Zhang, Min, et al. (author) Multidimensional factors affecting care needs in daily living among community-dwelling older adults : A structural equation modelling approach 2021 In: Journal of Nursing Management. - : John Wiley & Sons. - 0966-0429 .- 1365-2834. ; 29:5, s. 1207-1219 Journal article (peer-reviewed)abstract Aims: To develop a model illustrating the factors that can influence care needs in daily living (CNDL) of older adults and the pathways between these. Background: The care needs in community-dwelling older adults have increased sharply. A better understanding of the elderly's CNDL would thus help policymakers define which types of support and services should be given. Methods: A multicentre study with structural equation modelling was conducted in this study. We recruited 3,448 community-dwelling older adults in China by using a stratified random cluster sampling technique. Results: Physical and mental health was the strongest predictor of CNDL. Both age and living situation had positive effects on CNDL, while economic factors, social support and family support were the major risk factors for CNDL. Conclusion: The presented model provides a better understanding of how to address CNDL in the targeted population. The older adults who are the oldest, low-income, non-empty nesters, and with poor self-rated health or the signs of loneliness should be firstly targeted for daily assistance. Implications for Nursing Management: Using this model could provide health authorities and managers with the information of distinguishing between the priority group and the strategies for easing the caregiving burden in older adults care, and thus improving resource utilization.

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