Nicholas Raposo, Johan Vamstad, Dabin Hwang, Yayoi Saito, Anna Klarare
Aim
To examine the associations of interpersonal justice with work engagement and burnout among hospital nurses in Japan, and to test whether job satisfaction moderates these relationships.
Design
A cross-sectional study using structural equation modeling (SEM), grounded in job demands–resources framework.
Methods
Survey data were collected between 2016 and 2017 from 2773 nurses across 10 Japanese hospitals. Interpersonal justice was operationalized using workplace fairness and gender equality indicators. Work engagement and burnout were measured using study-specific indicators. SEM was used to test direct and moderated pathways, with theoretically justified modifications to the measurement model resulting in acceptable fit (RMSEA = 0.052; CFI = 0.987; TLI = 0.976; SRMR = 0.023).
Results
Interpersonal justice was independently associated with higher work engagement (β = 0.28, p < 0.001) and lower burnout (β = −0.28, p < 0.001). Job satisfaction also predicted both outcomes but did not moderate the effects of interpersonal justice. These findings suggest that fair and equal work environments support nurse well-being regardless of overall job satisfaction.
Conclusion
Interpersonal justice represents an important component of healthy work environments that may inform management interventions aimed at strengthening the nursing workforce in Japan and similar contexts.
Implications for Nursing Management
Nurse managers and healthcare leaders can help promote nurse well-being by fostering fair and equal workplace interactions through transparent decision-making, equitable workload allocation and promotion practices, inclusive leadership, and mechanisms for addressing discrimination and unfair treatment. Such efforts may support higher work engagement, lower burnout, and a more sustainable nursing workforce.
{"title":"Exploring Interpersonal Justice via the Job Demands–Resources Framework: A Structural Equation Model of Nurse Work Engagement and Burnout in Japan","authors":"Nicholas Raposo, Johan Vamstad, Dabin Hwang, Yayoi Saito, Anna Klarare","doi":"10.1155/jonm/8900636","DOIUrl":"https://doi.org/10.1155/jonm/8900636","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the associations of interpersonal justice with work engagement and burnout among hospital nurses in Japan, and to test whether job satisfaction moderates these relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional study using structural equation modeling (SEM), grounded in job demands–resources framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Survey data were collected between 2016 and 2017 from 2773 nurses across 10 Japanese hospitals. Interpersonal justice was operationalized using workplace fairness and gender equality indicators. Work engagement and burnout were measured using study-specific indicators. SEM was used to test direct and moderated pathways, with theoretically justified modifications to the measurement model resulting in acceptable fit (RMSEA = 0.052; CFI = 0.987; TLI = 0.976; SRMR = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interpersonal justice was independently associated with higher work engagement (<i>β</i> = 0.28, <i>p</i> < 0.001) and lower burnout (<i>β</i> = −0.28, <i>p</i> < 0.001). Job satisfaction also predicted both outcomes but did not moderate the effects of interpersonal justice. These findings suggest that fair and equal work environments support nurse well-being regardless of overall job satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Interpersonal justice represents an important component of healthy work environments that may inform management interventions aimed at strengthening the nursing workforce in Japan and similar contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>Nurse managers and healthcare leaders can help promote nurse well-being by fostering fair and equal workplace interactions through transparent decision-making, equitable workload allocation and promotion practices, inclusive leadership, and mechanisms for addressing discrimination and unfair treatment. Such efforts may support higher work engagement, lower burnout, and a more sustainable nursing workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/8900636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Objective</h3> <p>To explore the intention to use large language models (LLMs) among clinical nurses with prior familiarity with or experience using LLMs, and to examine how relevant facilitators, constraints, perceived risks, and professional boundary considerations were reflected in such intention.</p> </section> <section> <h3> Methods</h3> <p>Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT), this descriptive qualitative study employed semistructured interviews with 17 clinical nurses from different hospital levels, specialties, and roles. Data were analyzed using directed content analysis.</p> </section> <section> <h3> Results</h3> <p>Six themes were identified: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived risk, and professional boundaries and identity. Participants expressed a positive but conditional intention to use LLMs. Performance expectancy, effort expectancy, social influence, and facilitating conditions were reflected in participants’ accounts as perceived enabling conditions, whereas perceived risk and professional boundaries and identity were described as important sources of caution. Participants acknowledged the potential supportive value of LLMs in standardized and relatively low-risk tasks, such as documentation, knowledge support, and teaching-related work, but emphasized that LLMs should not replace nurses’ clinical judgment, accountability, or humanistic communication.</p> </section> <section> <h3> Conclusion</h3> <p>Among clinical nurses with prior familiarity with or experience using LLMs, intention to use these tools was reflected in participants’ accounts of perceived value, usability, organizational conditions, risk appraisal, and professional boundaries. Conditional intention should be understood as an interpretive finding rather than as a validated new construct or a formal extension of UTAUT. These findings provide context-specific insights for cautious pilot testing, governance, and implementation of LLM-supported nursing applications.</p> </section> <section> <h3> Implications for Nursing Management</h3> <p>Nurse managers may consider cautious pilot testing of LLM-supported nursing applications in low-risk and standardized tasks. Priorities include defining appropriate-use boundaries, data security, and accountability requirements, ensuring human review, providing tiered training, and evaluating usability, workflow fit, safety concerns,
{"title":"Intention to Use Large Language Models Among Clinical Nurses in China With Prior Familiarity With or Experience Using LLMs: A Qualitative Study","authors":"Xu Li, Xu Hu, Huiting Xu, Jingjing Guo, Hailing Ju, Pin Yu","doi":"10.1155/jonm/7972792","DOIUrl":"https://doi.org/10.1155/jonm/7972792","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the intention to use large language models (LLMs) among clinical nurses with prior familiarity with or experience using LLMs, and to examine how relevant facilitators, constraints, perceived risks, and professional boundary considerations were reflected in such intention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT), this descriptive qualitative study employed semistructured interviews with 17 clinical nurses from different hospital levels, specialties, and roles. Data were analyzed using directed content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six themes were identified: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived risk, and professional boundaries and identity. Participants expressed a positive but conditional intention to use LLMs. Performance expectancy, effort expectancy, social influence, and facilitating conditions were reflected in participants’ accounts as perceived enabling conditions, whereas perceived risk and professional boundaries and identity were described as important sources of caution. Participants acknowledged the potential supportive value of LLMs in standardized and relatively low-risk tasks, such as documentation, knowledge support, and teaching-related work, but emphasized that LLMs should not replace nurses’ clinical judgment, accountability, or humanistic communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among clinical nurses with prior familiarity with or experience using LLMs, intention to use these tools was reflected in participants’ accounts of perceived value, usability, organizational conditions, risk appraisal, and professional boundaries. Conditional intention should be understood as an interpretive finding rather than as a validated new construct or a formal extension of UTAUT. These findings provide context-specific insights for cautious pilot testing, governance, and implementation of LLM-supported nursing applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>Nurse managers may consider cautious pilot testing of LLM-supported nursing applications in low-risk and standardized tasks. Priorities include defining appropriate-use boundaries, data security, and accountability requirements, ensuring human review, providing tiered training, and evaluating usability, workflow fit, safety concerns,","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/7972792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pauline Calleja, Jenny Kelly, Stephen Yu, Colleen Ryan, Matthew Hiskens, Burton Linda Roszak, Lynette Graham, Marree Porch, Caroline Laker, Pamela Knight-Davidson, Michelle Cleary
<div> <section> <h3> Aim</h3> <p>To explore nurses’ perceptions of the strategies used to support their mental health and well-being during a recent public health crisis.</p> </section> <section> <h3> Design</h3> <p>A pragmatic, qualitative, exploratory design was employed.</p> </section> <section> <h3> Methods</h3> <p>Semistructured interviews were conducted with a purposive sample of 20 nurses working in two large, regional public hospitals and health services in Queensland, Australia, between July and October 2023.</p> </section> <section> <h3> Results</h3> <p>Three main themes were constructed from the data: (i) management and leadership approaches, (ii) connection to others and (iii) self-care practices. Eight subthemes support the three themes.</p> </section> <section> <h3> Conclusion</h3> <p>Although nurses and healthcare leaders could not control the broader impact of the crisis, the prolonged and evolving nature of the situation brought significant challenges to workforce management. Amidst the uncertainty, adaptability emerged as essential. The crisis also created space for innovations in flexibility and revealed the central role of peer support and teamwork in coping. Moreover, the importance of self-care, particularly through maintaining boundaries between professional and personal life, was widely recognised as crucial to sustaining well-being.</p> </section> <section> <h3> Implications for Nursing Management</h3> <p>Nursing management has an important role in sustaining staff well-being during prolonged crisis conditions. Given the centrality of peer support and teamwork as coping strategies, nursing managers should prioritise team cohesion through structured opportunities for connection and debriefing. Organisational approaches should also move beyond short-term gestures and embed accessible, proactive well-being supports that enable boundaries and recovery over time.</p> </section> <section> <h3> Reporting Method</h3> <p>The study adheres to the COREQ reporting guidelines.</p> </section> <section> <h3> Patient or Public Contribution</h3> <p>Participants in this study were registered nurses employed in two regional public hospitals in Queensland,
{"title":"Leading, Connecting and Coping: Nurses’ Responses to Sustaining Well-Being During the COVID-19 Crisis—A Qualitative Study","authors":"Pauline Calleja, Jenny Kelly, Stephen Yu, Colleen Ryan, Matthew Hiskens, Burton Linda Roszak, Lynette Graham, Marree Porch, Caroline Laker, Pamela Knight-Davidson, Michelle Cleary","doi":"10.1155/jonm/8830477","DOIUrl":"https://doi.org/10.1155/jonm/8830477","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore nurses’ perceptions of the strategies used to support their mental health and well-being during a recent public health crisis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A pragmatic, qualitative, exploratory design was employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semistructured interviews were conducted with a purposive sample of 20 nurses working in two large, regional public hospitals and health services in Queensland, Australia, between July and October 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes were constructed from the data: (i) management and leadership approaches, (ii) connection to others and (iii) self-care practices. Eight subthemes support the three themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although nurses and healthcare leaders could not control the broader impact of the crisis, the prolonged and evolving nature of the situation brought significant challenges to workforce management. Amidst the uncertainty, adaptability emerged as essential. The crisis also created space for innovations in flexibility and revealed the central role of peer support and teamwork in coping. Moreover, the importance of self-care, particularly through maintaining boundaries between professional and personal life, was widely recognised as crucial to sustaining well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>Nursing management has an important role in sustaining staff well-being during prolonged crisis conditions. Given the centrality of peer support and teamwork as coping strategies, nursing managers should prioritise team cohesion through structured opportunities for connection and debriefing. Organisational approaches should also move beyond short-term gestures and embed accessible, proactive well-being supports that enable boundaries and recovery over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Reporting Method</h3>\u0000 \u0000 <p>The study adheres to the COREQ reporting guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Participants in this study were registered nurses employed in two regional public hospitals in Queensland,","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/8830477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karin Berggren, Mirjam Ekstedt, Patrik Lynga, Peter Sackey, Lena Swedberg, Eva Joelsson-Alm, Anna Schandl
<div> <section> <h3> Objectives</h3> <p>The COVID-19 pandemic placed extraordinary demands on intensive care units (ICUs), posing significant challenges to patient safety and underscoring the critical role of healthcare managers. Although leadership has been widely studied during the pandemic, little is known about how first-line ICU managers experienced their work supporting staff and shaping organisational and relational preconditions for patient safety. This qualitative study aimed to address this gap by exploring first-line ICU managers’ descriptions of their work during the pandemic.</p> </section> <section> <h3> Methods</h3> <p>Individual interviews were conducted with 15 first-line managers (nurses and physicians) who had operational responsibility for ICU staff, including nurses, physicians and assistant nurses, during the first wave of the COVID-19 pandemic (1 March–30 September 2020). Participants were recruited from five ICUs across three Swedish hospitals. Data were analysed using thematic analysis.</p> </section> <section> <h3> Results</h3> <p>The first-line managers’ experiences were described in three themes: Balancing resources, workload and the well-being of ICU staff; fostering a responsive and adaptive work environment; and building trust and collaboration. According to the first-line managers, they experienced conflicts between maintaining efficiency and ensuring preconditions for patient safety, often struggling to balance care with limited resources. They explained how flexibility, continuous learning and mutual trust contributed to an adaptable healthcare environment that enabled the identification of safety risks.</p> </section> <section> <h3> Conclusions</h3> <p>This study highlights the unique role of first-line managers in shaping organisational preconditions for patient safety in ICUs during the COVID-19 pandemic. Their leadership was enacted in real time, embedded in clinical care, shaped by ethical complexity, resource constraints and the need to support staff well-being. The findings reveal how adaptive leadership, characterised by flexibility, continuous learning and trust, enabled managers to respond effectively to rapidly changing conditions and maintain patient safety under pressure.</p> </section> <section> <h3> Implications for Nursing Management</h3> <p>The results underscore the importance of equipping first-line managers with leadership competencies that promote adaptability, trust-building, and continuous learning, espec
{"title":"First Line Managers’ Experiences of Shaping Organisational and Relational Preconditions for Patient Safety in Swedish Intensive Care Units During the COVID-19 Pandemic: A Qualitative Study","authors":"Karin Berggren, Mirjam Ekstedt, Patrik Lynga, Peter Sackey, Lena Swedberg, Eva Joelsson-Alm, Anna Schandl","doi":"10.1155/jonm/2665196","DOIUrl":"https://doi.org/10.1155/jonm/2665196","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The COVID-19 pandemic placed extraordinary demands on intensive care units (ICUs), posing significant challenges to patient safety and underscoring the critical role of healthcare managers. Although leadership has been widely studied during the pandemic, little is known about how first-line ICU managers experienced their work supporting staff and shaping organisational and relational preconditions for patient safety. This qualitative study aimed to address this gap by exploring first-line ICU managers’ descriptions of their work during the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individual interviews were conducted with 15 first-line managers (nurses and physicians) who had operational responsibility for ICU staff, including nurses, physicians and assistant nurses, during the first wave of the COVID-19 pandemic (1 March–30 September 2020). Participants were recruited from five ICUs across three Swedish hospitals. Data were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first-line managers’ experiences were described in three themes: Balancing resources, workload and the well-being of ICU staff; fostering a responsive and adaptive work environment; and building trust and collaboration. According to the first-line managers, they experienced conflicts between maintaining efficiency and ensuring preconditions for patient safety, often struggling to balance care with limited resources. They explained how flexibility, continuous learning and mutual trust contributed to an adaptable healthcare environment that enabled the identification of safety risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the unique role of first-line managers in shaping organisational preconditions for patient safety in ICUs during the COVID-19 pandemic. Their leadership was enacted in real time, embedded in clinical care, shaped by ethical complexity, resource constraints and the need to support staff well-being. The findings reveal how adaptive leadership, characterised by flexibility, continuous learning and trust, enabled managers to respond effectively to rapidly changing conditions and maintain patient safety under pressure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>The results underscore the importance of equipping first-line managers with leadership competencies that promote adaptability, trust-building, and continuous learning, espec","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/2665196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Choon Ean Ooi, Angelita Martini, Rebecca Walton, Brigid McInerney, Lakkhina Troeung, J. Simon Bell
<div> <section> <h3> Background</h3> <p>Telehealth can increase access to medical and allied health services in residential aged care facilities (RACFs).</p> </section> <section> <h3> Objectives</h3> <p>This study investigated the feasibility of a telehealth collaborative care model involving on-site nurse practitioner and off-site clinical pharmacist to simplify complex medication regimens in RACFs.</p> </section> <section> <h3> Methods</h3> <p>This was a pragmatic, nonrandomized pilot and feasibility study in three Western Australian RACFs. A nurse practitioner and an off-site clinical pharmacist applied a validated five-step regimen simplification tool. The nurse practitioner identified residents who may benefit and had a desire to simplify their regimen. The nurse practitioner and pharmacist then conducted video case conferences to discuss simplification opportunities. The nurse practitioner decided which simplification opportunities to implement in consultation with residents and general medical practitioners (GPs). The primary outcome was feasibility (recruitment and retention, protocol adherence, and stakeholder acceptability). Secondary outcomes included change in the number of medication administration times per day, medication and behavioral incidents, falls and fractures, and hospitalization at 4 months.</p> </section> <section> <h3> Results</h3> <p>Telehealth collaborative care was delivered according to the protocol, with one or more simplification opportunities identified for 18 of 21 residents. The most frequent simplification opportunities involved changing a dose time or formulation. The intervention was well received by the interviewed stakeholders. At the 4-month follow-up, 47% of residents had at least one simplification recommendation implemented and one-third had a reduced number of regular daily medication administration times. Compared to the previous quarter, there was a non-significant decline in medication incidents (24%–18% of residents), behavioral incidents (48%–35%), and falls and fractures (48%–41%). No hospitalizations were reported among residents who completed follow-up.</p> </section> <section> <h3> Conclusions</h3> <p>This nurse practitioner–pharmacist telehealth intervention was feasible and acceptable. Further adequately powered trials to detect clinical outcomes are warranted.</p> </section> <section> <h3> Implications for Nursing Management</h3>
{"title":"Nurse Practitioner–Pharmacist Collaboration for Medication Regimen Simplification: Pilot and Feasibility Study of a New Telehealth Model of Care","authors":"Choon Ean Ooi, Angelita Martini, Rebecca Walton, Brigid McInerney, Lakkhina Troeung, J. Simon Bell","doi":"10.1155/jonm/1321189","DOIUrl":"https://doi.org/10.1155/jonm/1321189","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Telehealth can increase access to medical and allied health services in residential aged care facilities (RACFs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigated the feasibility of a telehealth collaborative care model involving on-site nurse practitioner and off-site clinical pharmacist to simplify complex medication regimens in RACFs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a pragmatic, nonrandomized pilot and feasibility study in three Western Australian RACFs. A nurse practitioner and an off-site clinical pharmacist applied a validated five-step regimen simplification tool. The nurse practitioner identified residents who may benefit and had a desire to simplify their regimen. The nurse practitioner and pharmacist then conducted video case conferences to discuss simplification opportunities. The nurse practitioner decided which simplification opportunities to implement in consultation with residents and general medical practitioners (GPs). The primary outcome was feasibility (recruitment and retention, protocol adherence, and stakeholder acceptability). Secondary outcomes included change in the number of medication administration times per day, medication and behavioral incidents, falls and fractures, and hospitalization at 4 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Telehealth collaborative care was delivered according to the protocol, with one or more simplification opportunities identified for 18 of 21 residents. The most frequent simplification opportunities involved changing a dose time or formulation. The intervention was well received by the interviewed stakeholders. At the 4-month follow-up, 47% of residents had at least one simplification recommendation implemented and one-third had a reduced number of regular daily medication administration times. Compared to the previous quarter, there was a non-significant decline in medication incidents (24%–18% of residents), behavioral incidents (48%–35%), and falls and fractures (48%–41%). No hospitalizations were reported among residents who completed follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This nurse practitioner–pharmacist telehealth intervention was feasible and acceptable. Further adequately powered trials to detect clinical outcomes are warranted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 ","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/1321189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>With an aging population, increasing patient complexity, and rising health care burdens in the postpandemic era, ICU nursing personnel research is growing in importance. However, systematic analyses of its knowledge structure, thematic evolution, and international collaboration models remain lacking.</p> </section> <section> <h3> Objective</h3> <p>In this study, we used bibliometric methods to analyze trends, knowledge structures, and collaborative networks in global ICU nursing personnel research from 2001 to 2025.</p> </section> <section> <h3> Methods</h3> <p>We searched PubMed, Web of Science Core Collection, and Scopus for ICU nursing literature from 2001 to 2025. We used descriptive bibliometric analysis to assess the distribution of countries, institutions, authors, journals, and highly cited articles. We constructed an institutional collaboration network and performed topic clustering using the Leiden algorithm based on keyword co-occurrence networks. We used Holt’s linear exponential smoothing model to predict future publication trends.</p> </section> <section> <h3> Results</h3> <p>We ultimately included 44,011 articles. Global ICU nursing personnel publications showed a steady upward trend, with the United States dominating in terms of publication volume and international collaboration. In a co-occurrence network analysis using the Leiden algorithm, we identified five core research themes: health care provider attitudes and management (C0), clinical management and patient outcomes (C1), evidence-based nursing and infection control (C2), pediatric intensive care (C3), and neonatal care (C4). Trend projections indicated that the annual publication output in this field will approach 5000 articles by 2030.</p> </section> <section> <h3> Conclusion</h3> <p>Global ICU nursing personnel research has expanded rapidly, with research attention shifting from clinical-practice-oriented topics toward workforce sustainability, organizational support, and nursing management. These bibliometric findings provide a knowledge map of the field and highlight the need for future empirical research and cross-regional collaboration.</p> </section> <section> <h3> Implications for Nursing Management</h3> <p>Nursing managers may use these mapped trends to inform ICU nursing workforce planning, staffing allocation, organizational support, an
{"title":"Global Research Trends in ICU Nursing Personnel: A Bibliometric Analysis (2001–2025)","authors":"Yadong Song, Ximing Chen, Cen Wu, Yang Shao","doi":"10.1155/jonm/7601256","DOIUrl":"https://doi.org/10.1155/jonm/7601256","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With an aging population, increasing patient complexity, and rising health care burdens in the postpandemic era, ICU nursing personnel research is growing in importance. However, systematic analyses of its knowledge structure, thematic evolution, and international collaboration models remain lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, we used bibliometric methods to analyze trends, knowledge structures, and collaborative networks in global ICU nursing personnel research from 2001 to 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Web of Science Core Collection, and Scopus for ICU nursing literature from 2001 to 2025. We used descriptive bibliometric analysis to assess the distribution of countries, institutions, authors, journals, and highly cited articles. We constructed an institutional collaboration network and performed topic clustering using the Leiden algorithm based on keyword co-occurrence networks. We used Holt’s linear exponential smoothing model to predict future publication trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We ultimately included 44,011 articles. Global ICU nursing personnel publications showed a steady upward trend, with the United States dominating in terms of publication volume and international collaboration. In a co-occurrence network analysis using the Leiden algorithm, we identified five core research themes: health care provider attitudes and management (C0), clinical management and patient outcomes (C1), evidence-based nursing and infection control (C2), pediatric intensive care (C3), and neonatal care (C4). Trend projections indicated that the annual publication output in this field will approach 5000 articles by 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Global ICU nursing personnel research has expanded rapidly, with research attention shifting from clinical-practice-oriented topics toward workforce sustainability, organizational support, and nursing management. These bibliometric findings provide a knowledge map of the field and highlight the need for future empirical research and cross-regional collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>Nursing managers may use these mapped trends to inform ICU nursing workforce planning, staffing allocation, organizational support, an","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/7601256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Introduction</h3> <p>The ward atmosphere in closed psychiatric wards significantly influences nurses’ well-being and quality of care. However, the formation mechanisms of ward atmosphere perceptions remain underexplored, and previous research has largely overlooked individual heterogeneity in how nurses perceive different dimensions of the ward environment. This study aims to identify distinct profiles of ward atmosphere among psychiatric nurses in closed wards and examine the predictive effects of physical environmental factors and workplace violence on profile membership.</p> </section> <section> <h3> Materials and methods</h3> <p>This quantitative, cross-sectional study adopted mixed nonprobability sampling combining purposive and convenience sampling and collected data via online questionnaires. A total of 1037 psychiatric nurses from 34 hospitals in China completed self-report questionnaires between July and August 2024. Ward atmosphere was measured using the Chinese-version Essen Climate Evaluation Schema. Physical environment characteristics were collected using a self-developed questionnaire. Workplace violence was measured using the Workplace Violence Scale. Latent profile analysis was conducted using Mplus 8.3 to identify distinct ward atmosphere profiles. Multinomial logistic regression (R3STEP) was used to examine predictors of profile membership. All respondents provided electronic informed consent, and the study was approved by the institutional ethics committee.</p> </section> <section> <h3> Results</h3> <p>Three distinct profiles of ward atmosphere were identified: “Triple-High group” (10.8%), “Safety-Deficient group” (77.1%), and “Support-Depleted group” (12.1%). Compared with nurses in the Triple-High group, those in the Safety-Deficient and Support-Depleted groups reported poorer ventilation, smaller ward size, less adequate safety measures, more frequent workplace violence, and higher rates of permission for smartphone use. Greenery, video surveillance, tidiness, and larger ward size differentiated the Safety-Deficient group from the Support-Depleted group.</p> </section> <section> <h3> Conclusion</h3> <p>Psychiatric nurses’ perceptions of ward atmosphere are heterogeneous, with the majority experiencing safety deficits. Both physical environmental features and exposure to workplace violence are important predictors of these perceptions. Hospital administrators should implement targeted modifications to the physical environment of the wards and reduce workplace violence to enhance the ward atmosphere.</p>
{"title":"Ward Atmosphere and Its Predictive Factors Among Psychiatric Nurses in Closed Psychiatric Wards: A Latent Profile Analysis","authors":"Deyu Liu, Liping Zhao, Jianjian Wang, Linjing Zhang, Yuan Luo, Haiye Ran, Junyu Liu","doi":"10.1155/jonm/1251723","DOIUrl":"https://doi.org/10.1155/jonm/1251723","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The ward atmosphere in closed psychiatric wards significantly influences nurses’ well-being and quality of care. However, the formation mechanisms of ward atmosphere perceptions remain underexplored, and previous research has largely overlooked individual heterogeneity in how nurses perceive different dimensions of the ward environment. This study aims to identify distinct profiles of ward atmosphere among psychiatric nurses in closed wards and examine the predictive effects of physical environmental factors and workplace violence on profile membership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>This quantitative, cross-sectional study adopted mixed nonprobability sampling combining purposive and convenience sampling and collected data via online questionnaires. A total of 1037 psychiatric nurses from 34 hospitals in China completed self-report questionnaires between July and August 2024. Ward atmosphere was measured using the Chinese-version Essen Climate Evaluation Schema. Physical environment characteristics were collected using a self-developed questionnaire. Workplace violence was measured using the Workplace Violence Scale. Latent profile analysis was conducted using Mplus 8.3 to identify distinct ward atmosphere profiles. Multinomial logistic regression (R3STEP) was used to examine predictors of profile membership. All respondents provided electronic informed consent, and the study was approved by the institutional ethics committee.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three distinct profiles of ward atmosphere were identified: “Triple-High group” (10.8%), “Safety-Deficient group” (77.1%), and “Support-Depleted group” (12.1%). Compared with nurses in the Triple-High group, those in the Safety-Deficient and Support-Depleted groups reported poorer ventilation, smaller ward size, less adequate safety measures, more frequent workplace violence, and higher rates of permission for smartphone use. Greenery, video surveillance, tidiness, and larger ward size differentiated the Safety-Deficient group from the Support-Depleted group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Psychiatric nurses’ perceptions of ward atmosphere are heterogeneous, with the majority experiencing safety deficits. Both physical environmental features and exposure to workplace violence are important predictors of these perceptions. Hospital administrators should implement targeted modifications to the physical environment of the wards and reduce workplace violence to enhance the ward atmosphere.</p>\u0000 ","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/1251723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>The role of generative artificial intelligence (GenAI) in nursing is increasingly shifting from a support tool toward a collaborative partner. However, the mechanisms underlying nurse–GenAI value co-creation (N-GAIVC) remain undertheorized.</p> </section> <section> <h3> Aim</h3> <p>To develop a theoretical framework for N-GAIVC.</p> </section> <section> <h3> Methods</h3> <p>This study used a Straussian grounded theory approach. Between January and April 2026, 27 clinical nurses and nurse managers from hospitals across China were recruited using purposive, snowball, and theoretical sampling. Semistructured in-depth interviews and online textual data from Chinese social media platforms were analyzed. Data analysis followed the constant comparative method, with iterative open, axial, and selective coding conducted to generate and refine categories. Theoretical saturation was assessed through supplementary interviews and considered achieved when no new categories or relationships emerged.</p> </section> <section> <h3> Results</h3> <p>A theoretical framework of nurse–GenAI value co-creation was developed, comprising three integrative domains. Situated engagement conditions included engagement drivers, appraising GenAI fit, and safe-use scaffolding. Professional orchestration in practice involved selective delegation, prompting, verification, contextualization, feedback, peer diffusion, and implementation embedding. Conditional value outcomes encompassed both co-creation and destruction and recursively shaped subsequent engagement, safeguards, and nurse–GenAI co-evolution.</p> </section> <section> <h3> Conclusions</h3> <p>Nurse–GenAI value co-creation is a situated, professionally orchestrated, and adaptive process. Value arises not from GenAI use alone, but from nurses’ appraisal of task fit and risk, active orchestration of GenAI contributions, and alignment with nursing expertise, human-centered care, and organizational safeguards.</p> </section> <section> <h3> Implications for Nursing Management</h3> <p>The framework provides a practical roadmap for responsible GenAI integration in nursing practice. Nurse managers should assess task suitability and risk; strengthen nurses’ GenAI literacy and critical evaluation; establish training, governance, accountability, and validation mechanisms; and support nurse-led feedback and wor
{"title":"Value Co-Creation Between Nurses and Generative Artificial Intelligence: A Grounded Theory Study","authors":"Yingying Jia, Wei Zhu, Yan Cai, Yan Jiang","doi":"10.1155/jonm/8980490","DOIUrl":"10.1155/jonm/8980490","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The role of generative artificial intelligence (GenAI) in nursing is increasingly shifting from a support tool toward a collaborative partner. However, the mechanisms underlying nurse–GenAI value co-creation (N-GAIVC) remain undertheorized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop a theoretical framework for N-GAIVC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used a Straussian grounded theory approach. Between January and April 2026, 27 clinical nurses and nurse managers from hospitals across China were recruited using purposive, snowball, and theoretical sampling. Semistructured in-depth interviews and online textual data from Chinese social media platforms were analyzed. Data analysis followed the constant comparative method, with iterative open, axial, and selective coding conducted to generate and refine categories. Theoretical saturation was assessed through supplementary interviews and considered achieved when no new categories or relationships emerged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A theoretical framework of nurse–GenAI value co-creation was developed, comprising three integrative domains. Situated engagement conditions included engagement drivers, appraising GenAI fit, and safe-use scaffolding. Professional orchestration in practice involved selective delegation, prompting, verification, contextualization, feedback, peer diffusion, and implementation embedding. Conditional value outcomes encompassed both co-creation and destruction and recursively shaped subsequent engagement, safeguards, and nurse–GenAI co-evolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nurse–GenAI value co-creation is a situated, professionally orchestrated, and adaptive process. Value arises not from GenAI use alone, but from nurses’ appraisal of task fit and risk, active orchestration of GenAI contributions, and alignment with nursing expertise, human-centered care, and organizational safeguards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>The framework provides a practical roadmap for responsible GenAI integration in nursing practice. Nurse managers should assess task suitability and risk; strengthen nurses’ GenAI literacy and critical evaluation; establish training, governance, accountability, and validation mechanisms; and support nurse-led feedback and wor","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/8980490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leanna G. Santostefano, Kurt Lushington, Siobhan Banks, Grant R. Tomkinson, Justin J. Lang, Kristin Graham, Hayley Ruf, Kiriaki Stewart, Kirstie Howland, Michelle Headland, Michael Musker, Lisa Matricciani
Aim
To examine temporal trends in nurses’ sleep duration and quality.
Background
In recent decades, the nursing workplace demands have intensified. This is thought to have contributed to a decline in nurses’ sleep duration and quality. Despite concerns, it remains unclear if nurses’ sleep has changed.
Method
A systematic database search was used to identify studies reporting nurses’ total sleep time or sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Trends in mean sleep duration and global PSQI scores were analysed using generalised linear regression models adjusted for age, sex, geographic region, shift type and measurement method (self-report vs. actigraphy).
Results
Data were extracted from 280 studies representing 219,245 nurses. A significant decline of 28.7 min was observed in sleep duration (95% CI: 26.2, 33.1, standardised effect size [ES]: 0.43) between 1985 and 2022, while a 1.6-point increase in global PSQI scores was observed between 1990 and 2023, indicative of poorer sleep quality (95% CI: 1.47, 1.77, ES: 0.49).
Conclusion
These findings suggest a decline in nurses’ sleep duration and quality over recent decades. These trends suggest that targeted interventions may be needed to improve nurses’ sleep health.
Implications for Nursing Management
Temporal declines in nurses’ sleep duration and quality may reflect an increased risk of fatigue, impaired clinical performance, staff burnout and work-related accidents. This study provides important insights into workforce well-being and highlights the need for nurse managers to recognise staff susceptibility to poor sleep and proactively develop and implement strategies that promote healthy sleep.
{"title":"Trends in Nurses’ Sleep: A Meta-Regression Involving 219,245 Nurses From 45 Countries","authors":"Leanna G. Santostefano, Kurt Lushington, Siobhan Banks, Grant R. Tomkinson, Justin J. Lang, Kristin Graham, Hayley Ruf, Kiriaki Stewart, Kirstie Howland, Michelle Headland, Michael Musker, Lisa Matricciani","doi":"10.1155/jonm/9051680","DOIUrl":"10.1155/jonm/9051680","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine temporal trends in nurses’ sleep duration and quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In recent decades, the nursing workplace demands have intensified. This is thought to have contributed to a decline in nurses’ sleep duration and quality. Despite concerns, it remains unclear if nurses’ sleep has changed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic database search was used to identify studies reporting nurses’ total sleep time or sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Trends in mean sleep duration and global PSQI scores were analysed using generalised linear regression models adjusted for age, sex, geographic region, shift type and measurement method (self-report vs. actigraphy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were extracted from 280 studies representing 219,245 nurses. A significant decline of 28.7 min was observed in sleep duration (95% CI: 26.2, 33.1, standardised effect size [ES]: 0.43) between 1985 and 2022, while a 1.6-point increase in global PSQI scores was observed between 1990 and 2023, indicative of poorer sleep quality (95% CI: 1.47, 1.77, ES: 0.49).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest a decline in nurses’ sleep duration and quality over recent decades. These trends suggest that targeted interventions may be needed to improve nurses’ sleep health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Management</h3>\u0000 \u0000 <p>Temporal declines in nurses’ sleep duration and quality may reflect an increased risk of fatigue, impaired clinical performance, staff burnout and work-related accidents. This study provides important insights into workforce well-being and highlights the need for nurse managers to recognise staff susceptibility to poor sleep and proactively develop and implement strategies that promote healthy sleep.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/9051680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muzelfe Biyik, Ensar Durmuş, Perihan Ersoy, Manar Aslan
<div> <section> <h3> Background</h3> <p>Evaluating the nursing workforce solely on the basis of nurse numbers leads to the neglect of critical workload determinants, such as indirect nursing activities and care intensity. This limitation may result in inaccuracies in workforce planning and pose risks to the quality of care. The combined use of time–motion analysis and patient classification systems enables a more comprehensive and objective assessment of nursing workload.</p> </section> <section> <h3> Aim</h3> <p>This study aimed to analyse the workload of nurses working in the chest diseases and urology wards of a teaching and research hospital in Türkiye using time–motion analysis and to determine the optimal number of nurses (ONN) based on a patient classification system.</p> </section> <section> <h3> Methods</h3> <p>This study employed a cross-sectional, observational design based on time–motion analysis. Between June and July 2025, the workload of nurses working in the chest diseases and urology wards of a tertiary teaching hospital in Türkiye was evaluated. A total of 20 nurses were observed during morning and evening shifts over a 5-week period. The ONN was calculated using three key indicators derived from the patient classification system: patient classification score, nursing intensity coefficient, and total care time.</p> </section> <section> <h3> Findings</h3> <p>The calculated ONN was consistent with the current staffing levels in both wards. Higher care intensity (nursing intensity score: 9.44) in the chest diseases ward and patient volume (patient classification score: 55.75) in the urology ward emerged as the primary determinants of workload. Time–motion analysis showed that 22.8%–26.6% of nurses’ working time was allocated to direct care, 31.1%–32.9% to indirect care, and 34.6%–42.3% to personal tasks. Direct care time per patient was 12.60, 18.77, and 34.52 min for Group 1, 2, and 3 patients in the chest diseases ward and 11.18, 21.91, and 36.89 min, respectively, in the urology ward.</p> </section> <section> <h3> Results</h3> <p>These findings indicate that nursing workload is shaped by different dynamics across clinical settings and that nurses allocate a limited proportion of their working time to direct patient care. The combined use of time–motion analysis and a patient classification system highlights the need for more accurate nurse staffing planning and workflow redesign to increase direct care time.</p> </section>
{"title":"Nursing Workload and Optimal Staffing in Medical and Surgical Wards: A Time–Motion Study Using a Patient Classification System","authors":"Muzelfe Biyik, Ensar Durmuş, Perihan Ersoy, Manar Aslan","doi":"10.1155/jonm/3918250","DOIUrl":"10.1155/jonm/3918250","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evaluating the nursing workforce solely on the basis of nurse numbers leads to the neglect of critical workload determinants, such as indirect nursing activities and care intensity. This limitation may result in inaccuracies in workforce planning and pose risks to the quality of care. The combined use of time–motion analysis and patient classification systems enables a more comprehensive and objective assessment of nursing workload.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to analyse the workload of nurses working in the chest diseases and urology wards of a teaching and research hospital in Türkiye using time–motion analysis and to determine the optimal number of nurses (ONN) based on a patient classification system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study employed a cross-sectional, observational design based on time–motion analysis. Between June and July 2025, the workload of nurses working in the chest diseases and urology wards of a tertiary teaching hospital in Türkiye was evaluated. A total of 20 nurses were observed during morning and evening shifts over a 5-week period. The ONN was calculated using three key indicators derived from the patient classification system: patient classification score, nursing intensity coefficient, and total care time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The calculated ONN was consistent with the current staffing levels in both wards. Higher care intensity (nursing intensity score: 9.44) in the chest diseases ward and patient volume (patient classification score: 55.75) in the urology ward emerged as the primary determinants of workload. Time–motion analysis showed that 22.8%–26.6% of nurses’ working time was allocated to direct care, 31.1%–32.9% to indirect care, and 34.6%–42.3% to personal tasks. Direct care time per patient was 12.60, 18.77, and 34.52 min for Group 1, 2, and 3 patients in the chest diseases ward and 11.18, 21.91, and 36.89 min, respectively, in the urology ward.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>These findings indicate that nursing workload is shaped by different dynamics across clinical settings and that nurses allocate a limited proportion of their working time to direct patient care. The combined use of time–motion analysis and a patient classification system highlights the need for more accurate nurse staffing planning and workflow redesign to increase direct care time.</p>\u0000 </section>\u0000 ","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2026 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/3918250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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