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The effects of clinical learning environment and career adaptability on resilience: A mediating analysis based on a survey of nursing interns

Abstract

Background

The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience.

Aims

To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience.

Methods

The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals.

Results

The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01).

Conclusion

Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.

Effectiveness of Interventions for Reducing Interruptions During Medication Administration: A Systematic Review

ABSTRACT

Background

Medication errors, particularly during administration, are a major threat to patient safety, with interruptions being a key contributor. Nurses are the most affected by these disruptions, and various interventions have been proposed to reduce interruptions.

Aims

This review evaluates the effectiveness of preventive and responsive interventions aimed at reducing interruptions during medication administration.

Methods

A systematic search of multiple databases identified 14 eligible studies on interventions targeting nurse interruptions. The review includes randomized controlled trials and quasi-experimental studies, focusing on interruption and medication error rates. Significant heterogeneity prevented meta-analysis.

Results

Preventive strategies, like no-interruption vests and awareness campaigns, may reduce interruptions from external sources, but nurse-to-nurse interruptions remained common. Responsive strategies showed limited success in reducing interruptions but improved nurses' ability to manage them. The impact on medication errors was inconclusive.

Linking Evidence to Action

Preventive strategies help reduce interruptions, but more targeted interventions are needed for nurse-to-nurse disruptions. A combined approach of preventive and responsive strategies can enhance medication safety.

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