The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross sectional survey',

Background Healthcare emergency can increase work-related stress and reduce nurses’ job satisfaction and quality of life. Managerial decisions and proactive interventions implemented to react to the emergency ensure the best patient outcomes. Purpose Verify whether a proactive organizational approach can limit nurses’ work-related stress and help preserve their job satisfaction and quality of life during a health emergency. Method A longitudinal mixed methods study was conducted. Data were collected before and after the transformation into a SARS-CoV-2 Hospital and the implementation of organizational interventions. Focus groups were conducted to investigate quantitative data. Findings After the implementation of interventions and as the pandemic progressed, work-related stress decreased and job satisfaction and quality of life increased. Discussion Through proactive organization, even during an emergency, nurses are prepared for working, and work-related stress due to changes is reduced. Nurses are motivated and satisfied with their organization and management, and quality of life increases.

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Aims and objectives:To describe and synthesise current knowledge on the maintenance and preservation of vessels in patients who need the placement of a vascular access device.Introduction: To administer drugs, blood or intravenous fluids, nurses or doctors insert a peripheral vascular access device on the arm using the traditional approach.This approach implies that devices are blindly inserted until flow is satisfactory and all possible sites have been exhausted. A proactive approach would ensure at the outset that the best device is used for each patient, eliminating repeated attempts at cannulation.Design: An integrative review was conducted using data recorded until July 2017.Searches were conducted in PubMed, Cochrane Library, CINAHL and Scopus.Review method: A modified version of Cooper's five-stage method and the PRISMA guidelines were used to perform the integrative review.Results: Nine papers were included in this review. The patients were active participants in a proactive approach to vessel health and preservation. The involvement of each healthcare professional in vessel health and preservation improves outcomes and expands the use of a proactive approach to vascular device management.Because nurses are directly involved in the use of such devices and support patients during the decision-making process, they should take the lead in the use of the proactive approach.Conclusion: Despite the many documented advantages of the proactive approach to preserving vessels in many settings and healthcare systems, it has not been widely tested. Future research is needed to guarantee high-quality vessel health and preservation care, thus contributing to the development and dissemination of the proactive approach.Relevance to clinical practice: The proactive approach preserves vessels for future needs, improves the delivery of the treatment plan and reduces length of stay, costs, risk of infection, complications and pain perceived by patients. This approach also ensures better use of nurses' time and vascular access device material. K E Y W O R D Sproactive approach, vascular access, vessel health and preservation SUPPORTING INFORMATIONAdditional supporting information may be found online in the Supporting Information section at the end of the article.

Aims and objectives To summarise the evidence about patient‐related risk factors for difficult intravenous access in adults, and at identifying nurses' beliefs and their consistency with evidence. Background Peripheral intravenous cannulation is a common procedure for nurses, but rates of failure at first attempt of peripheral intravenous cannulation range 10%–40%. Nurses' beliefs about difficult intravenous access factors might influence their clinical practice more than current evidence. Design The study included a literature review of the evidence on patient‐related risk factors for difficult intravenous access, the development of an instrument to investigate nurses' beliefs about this topic and a cross‐sectional multicentre survey on clinical nurses. Methods The quality of the studies included was evaluated through the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. A synthesis of evidence for each risk factor was produced. A survey instrument was developed including 26 risk factors, which were then rated by nurses as perceived predictors of difficult intravenous access. The STROBE guidelines for study reporting were followed. Results Four hundred and fifty clinical nurses working in four hospitals in Italy were surveyed. Nurses' beliefs were in line with evidence in considering body mass index, drug abuse, lymphadenectomy and chemotherapy as difficult intravenous access factors. Beliefs about difficult intravenous access factors were influenced by nurses' work experience and frequency of peripheral intravenous cannulation. Nurses also identified as risk factors for difficult intravenous access oedema, thrombophlebitis, hypovolaemia, skin lesions and irritant therapies, which have been minimally investigated by research. Conclusions An overall congruence between nurses' beliefs and evidence about risk factors for difficult intravenous access was found. With their expertise, nurses may fill the knowledge gap of clinical evidence and open new paths for clinically meaningful research. Relevance to clinical practice Nurses' beliefs about difficult intravenous access factors can be influenced by their work experience and clinical setting. Integrating nurses' beliefs with scientific evidence can increase the quality of care.