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To examine the relationship between nurse managers' empowering leadership, nurses' resilience and organisational learning from incidents.
Cross-sectional observational study.
Secondary data from a study conducted in June–July 2022 was used. The sample included 1049 nurses working in three special-functioning hospitals. The self-administered questionnaires assessed nurse managers' empowering behaviours, nurses' resilience and attitudes and behaviours fostering organisational learning from incidents. The analysis employed multilevel analysis with hierarchical linear modelling.
Nurse managers' empowering behaviours and nurses' resilience were significantly positively associated with attitudes and behaviours fostering organisational learning from the following incident subscales: make efforts to identify the problem, discuss safety in the workplace, identify and give feedback to address the at-risk behaviour. The interaction of empowering behaviours and resilience was not significant.
Nurse managers' empowering behaviours and nurses' resilience can contribute to attitudes and behaviours that foster organisational learning, even when nurses face stressful incidents.
Fostering empowering leadership in nurse managers and resilience in nurses enhances organisational learning and improves safety and care quality.
The reporting is based on the STROBE guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To summarise the type of medication administration errors associated with nurse staffing and workload, and identify how nurse staffing, workload and medication administration data were measured and captured in existing studies.
A scoping review.
We conducted a literature search across four electronic databases, including Embase, CINAHL, Ovid Medline and Scopus, from inception to June 2024. The search was limited to articles published in English and primary studies examining nurse staffing, workload and medication administration errors in hospital settings.
Of the 1141 articles retrieved, 36 articles met the inclusion criteria. The majority were conducted using a Cohort (n = 15) or Cross-sectional (n = 16) study design. Most studies (n = 21) used self-reported data to evaluate nurse staffing, workload and medication administration errors. We found limited studies used objective data sources, such as barcode medication administration (BCMA) systems (n = 5) and electronic staffing systems (n = 5), to assess the impact of staffing on medication errors involving the administration of time-critical medications. There was a fair amount of heterogeneity in how nursing workload and medication administration errors were measured and analysed, complicating nurse leaders' ability to allocate staffing resources that meet the patient's needs.
This review found a heavy reliance on self-reported data across different study designs. While self-reported data offer valuable insights, the emerging use of objective data sources, such as BCMA, can minimise bias and capture more nuances in administration errors during high-demand periods.
The review highlights the emerging use of real-world data to examine the influence of nurse staffing and workload on medication administration errors. As nursing care becomes increasingly complex, future studies utilising subjective and objective data sources can assist nurse leaders in making informed, data-driven staffing decisions to reduce medication errors.
The review followed the PRISMA-Scr reporting guidelines.
No patient or public contribution.
To clarify how public health nurses allocate their time across various tasks and compare time-use patterns between prefectural and municipal public health nurses in Japan, where distinct administrative mandates define their roles.
A self-reported, prospective time study.
Public health nurses from two municipalities and one prefecture recorded their daily practices and time allocations using Kintone. Time allocation differences by administrative level and job position were analysed using linear mixed-effects models.
Overall, 121 participants contributed 9502 person-days of data. Participants spent an average of 463.6 min/workday on work-related activities. Municipal public health nurses dedicated more time to application paperwork (64.0 min), health examinations (57.6 min), and individual coordination (48.3 min). Prefectural public health nurses allocated more time to business management and organisational operations (69.0 min) and traveliing, particularly in rural contexts. Managers spent less time on direct care and more on administrative tasks.
This study provides the first quantitative, self-reported evidence of task distribution among public health nurses across administrative levels and positions. The findings reflect structural differences in role expectations and underscore the need to reallocate workloads to better align with each level's mandate.
Task prioritisation, information and communication technology tool integration, and administrative support are essential in optimising public health nurses' contributions to community health. These strategies can reduce non-clinical workload and enable public health nurses to focus on high-impact, value-added public health services that promote health equity.
This study closes a longstanding gap by quantifying PHNs' time allocation, revealing the hidden burden of administrative work, and providing critical insights for workforce planning and sustainable public health service delivery.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guideline.
No Patient or Public Involvement.
UMIN Clinical Trials Registry; UMIN000051509 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000058761; August 1, 2023)
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