Association between ethical leadership, ethical climate and organizational citizenship behavior from nurses' perspective: a descriptive correlational study

Background:Ethical leadership plays an important role in improving the organizational climate and may be have an effect on citizenship behavior. Despite the growing emphasis on ethics in organizations, little attention to has been given this issue. The purpose of this study was to identify ethical leadership, an ethical climate, and their relationship with organizational citizenship behavior from nurses' perspective. Methods:In this descriptive correlational study, 250 nurses in twelve teaching hospitals in Tehran were selected by multistage sampling during 2016-2017. The data were collected using Ethical Leadership Questionnaire, Hospital Ethical Climate Survey, and Organizational Citizenship Behavior Scale. Results:The findings showed a significant correlation between ethical leadership in managers, organizational citizenship behavior (P = 0.04, r = 0.09) and an ethical climate (P < 0.001, r = 0.65). There was a significant correlation between an ethical climate and nurses' organizational citizenship behavior (P < 0.001, r = 0.61). The regression analysis showed that ethical leadership and an ethical climate is a predictor of organizational citizenship behavior and confirms the relationship between the variables. Conclusion:Applying an ethical leadership style and creating the necessary conditions for a proper ethical climate in hospitals lead to increased organizational citizenship behavior by staff. To achieve organizational goals, nurse managers can use these concepts to enhance nurses' satisfaction and improve their performance

Effect of community-based education on undergraduate nursing students’ skills: a systematic review

Abstract: Background: Community-based education, as an effective approach to strengthen nurses’ skills in response to society’s problems and needs has increased in nursing education programs. The aim of this study was to review the effect of community-based education on nursing students’ skills. Methods: For this systematic review, ProQuest, EMBASE, Scopus, PubMed/ MEDLINE, Cochran Library, Web of Science, CINAHL and Google Scholar were searched up to February 2021. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Seventeen studies were included in this systematic review. Inclusion criteria included articles published in English and were original articles. Results: In all studies, undergraduate nursing students’ skills were improved by participation in a community-based education program. Community-based education enhances professional skills, communication skills, self-confidence, knowledge and awareness, and critical thinking skills and teamwork skills in undergraduate nursing students. Conclusions: Community-based education should be used as an effective and practical method of training capable nurses to meet the changing needs of society, to improve nurses ‘skills and empower them to address problems in society

Unwanted isolation: An obstacle to constructive interaction between oncology nurses and their patients

Aim The current study was carried out to investigate the obstacles faced by oncology nurses in their interactions with their patients. Design This research is a descriptive qualitative study. Methods In this study, conventional content analysis was used for analysing the data collected from 26 oncology nurses. The participants were selected through purposive sampling. Semi‐structured interviews were used for collecting data. Data analysis was conducted with Elo and Kyngäs's approach. Results The results included three categories: “role conflict,” “role overload” and “inefficient interaction,” and 10 subcategories

A comparative study of patient safety in the intensive care units

Aim This study aimed to assess patient-safety principles in ICUs. Design This is a descriptive-comparative study. Methods The research environment includes ICUs of hospitals affiliated to the two universities of medical sciences in Tehran. Sampling was done by census using Time and Event Sampling methods. Research instrument was “Patient Safety Principles Checklist”. Data analysis was performed using SPSS-20 and descriptive-inferential statistics with a significance level of 0.05. Results There is no significant difference (p-value = .15) in the level of observance of patient-safety principles in two university-affiliated hospitals A (133.26 ± 9.14) and B (128.16 ± 18.01). Evaluation of the mean scores obtained in each dimension and in each of the ICUs was showed that only in dimension No.3 the difference was significant (F[68,2] = 5.20, p-value = .008) and in the AICUs (16.13 ± 1.8) (p-value = .04), it was significantly lower than other ICUs. Identifying risk factors for the patient’s immunity reduces the side effects of patient care

United Kingdom National Register Study of Anti-Epileptic Medications:Suspected Foetal Congenital And Pregnancy-Associated Side Effects

Objective: There continue to be concerns regarding exposure during pregnancy to anti-epilepsy drugs (AEDs). The study aims were to determine the suspected adverse drug reactions (ADRs) associated with AEDs and potential mechanistic hypotheses. Methods: Suspected ADR profiles for 8 AEDs were data-mined from the MHRA Yellow Card scheme (January 2018-August 2022) together with prescribing data from OpenPrescribing (August 2017-July 2022). The physicochemical, pharmacokinetic, and pharmacology of the AEDs were datamined from public databases. Results: The suspected ADRs per 1,000,000 Rx identified across all AEDs are statistically significant (χ2 test, P &lt; .05). Pregnancy, puerperium &amp; perinatal conditions associated with lamotrigine (1.51 per 1,000,000 Rx, χ2 test, P &lt; .05, d = 2.720, 95% CI [1.656, 4.469]) had a larger size effect than valproic acid (2.28 per 1,000,000 Rx, χ2 test, P &lt; .05, d = 1.846, 95% CI [1.150, 2.964]). The large size effect associated with valproic acid for congenital and hereditary disorders (d = 9.069, 95% CI [5.807, 14.163]) and foetal exposure during pregnancy (d = 6.632, 95% CI [4.894, 8.988]) were notable amongst the AEDs. Valproic acid, a known teratogen, had the unique and clinically achievable targeting of histone deacetylase (HDAC 1 IC50 = 54.4, HDAC2 IC50 = 82.4 micromolar, HDAC3 IC50 = 148 micromolar, HDAC8 IC50 = 144 micromolar, Cmax = 184.3 micromolar) associated with teratogenicity. Significance: There is renewed discussion about the management of epilepsy in pregnancy, and the risks of different AEDs. Whilst 1 in 250 women have epilepsy, they account for 1 in 10 of women who die in childbirth or postpartum. Fears about ADRs impact on adherence to medication, whilst pregnancy itself reduces the serum level of AEDs. As a result of this women are at increased risk of seizures during pregnancy and childbirth. There has been a doubling of Sudden and Unexpected Death in Epilepsy (SUDEP) in mothers between 2013-2015 and 2019-2021 in the UK and Ireland. The AEDs studied have diverse modes of action, and the unique polypharmacology of AEDs influences their ADR profiles. Lamotrigine had a larger size effect than valproic acid (d =2.720 vs 1.846) for suspected pregnancy, puerperium and perinatal ADRs. As noted in other studies, there is a suspected association between valproic acid exposure and 1) congenital and hereditary disorders (d = 9.069), and 2) foetal exposure during pregnancy (d = 6.632) compared to other studied AEDs. Pregnancy-related ADRs with levetiracetam and topiramate did not reach statistical significance, however neurological ADRs in children who were exposed to lamotrigine and levetiracetam continue to be the subject of scrutiny

Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

Background Witnessing or experiencing of incivility affected the nurses’ perception of the ethical climate and quality of their work life. The aim of this study was to investigate the effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses. Method This study was conducted as a randomized controlled parallel group clinical trial. Eighty emergency nurses participated in this study and were randomly assigned to intervention and control groups during December 2019—March 2020. Cognitive rehearsal program (include of definitions of incivility, ten common incivilities and appropriate practice methods for responding to each and role-plays) was delivered in five two-hour sessions over three weeks on different working days and shifts. The control group received only written information about what incivility is and how to deal with it before the implementation of intervention and one month after the completion of the training sessions, the demographic information form and the incivility scale were completed by the nurses. Results The results showed that there was a significant effect on overall incivility, general incivility, and supervisor incivility between the intervention and control groups. However, these significant reductions were seen in control group who received only written education. There were no significant differences in nurse's incivility towards other nurses, physician incivility, and patient/visitor incivility between the two groups. Conclusion The cognitive rehearsal program did not decrease perceived incivility among emergency department nurses in the short term

Improving nurses' organizational commitment by participating in their performance appraisal process

AIMS: To promote the nurses' organizational commitment by their participation in the improvement of the performance appraisal process. BACKGROUND: Organizational commitment is one of the factors that secures safe and high-quality care of patients. It also enhances motivation among nurses, which affected by various factors such as performance appraisal. METHOD: A participatory action research study was undertaken (March 2015 to February 2018) with 39 intensive critical care nurses and nurse managers in Social Security Hospital in Iran, using a complete enumeration sampling method. The data were collected using organizational commitment and job satisfaction questionnaires, focus groups, semi-structured interviews and Delphi technique. RESULTS: Three major themes emerged including inappropriate performance appraisal system, inefficient instruments and unskilled evaluators. There were significant differences between organizational commitment and job satisfaction with performance appraisal process before and after the change in appraisal process. CONCLUSIONS: Nurses' involvement in revising and improving the process of their performance appraisal leads to higher commitment. IMPLICATIONS FOR NURSING MANAGEMENT: Maintaining a committed nursing workforce is vital for high-quality health care. Nurse Managers can improve the process of nurses' appraisal to make more motivation among them and prevent some problems such as job dissatisfaction. © 2020 John Wiley & Sons Ltd