A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.

(1) Background: In Portugal, no accurate and reliable predictive instruments are known that could assist healthcare professionals in recognizing patients with difficult venous access. Thus, this study aimed to translate and validate the Modified A-DIVA scale to European Portuguese. (2) Methods: A methodological and cross-sectional study was conducted in two phases: translation of the Modified A-DIVA scale to European Portuguese following six stages proposed by Beaton and collaborators, and assessment of its psychometric properties in a non-probability sample of 100 patients who required peripheral intravenous catheterization in a Portuguese hospital. (3) Results: The European version of the Modified A-DIVA scale (A-DM scale) showed excellent inter-rater accordance scores, k = 0.593 (95% CI, 0.847 to 0.970), p < 0.0005. The A-DM scale’s criterion and construct validity was assessed through predictive, convergent, and correlational analysis with variables identified in the literature as associated with difficult peripheral intravenous access, with moderate to large magnitudes and statistical significance. (4) Conclusions: The A-DM scale is a reliable and valid instrument that can support healthcare professionals and researchers in the early identification of patients at risk of difficult peripheral intravenous access. Future validation studies are needed to test the A-DM scale’s applicability across clinical settings and in different patient cohorts.

Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment and intention to leave; (ii) analyzes the relationship between structural factors (such as, work environment and nurse staffing), individual factors (age), and nurses’ organizational commitments and intention to leave; and (iii) analyzes the differences in the intention to leave and in the organizational commitment according to service specialty, nurses’ specialization, and contractual relationship in Portuguese public hospitals. A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals units. The results show a high affective and continuance commitment of nurses with the hospital, and a reduced tendency of the intention to leave. A significant positive association was also found between the intent to leave and individual/structural factors. Organizational commitment and intention to leave levels are satisfactory, despite the influence of several factors, such as nurse staffing, work environment, or other opportunities for professional development. The results identify particularly sensitive areas that, through adequate health and management policies, can reduce nurses’ intentions to leave and promote the sustainability of the health system.

Aim: To describe the organizational structure and resources for strategic mediacommunication of nursing professional associations and trade unions in Portugal.Design and Methods: Quantitative study, with a cross-sectional, exploratory/ descriptive design. From October to November 2017, a questionnaire was sent to 21 nursing professional associations and trade unions in Portugal. Eleven (52.4%) organizations replied: nine professional associations and two trade unions.Results: The participating organizations rely on basic structures regarding strategic communication: 54.5% of them have less than 500 members; 63.6% of them have no communication budget; 54.5% of them have no formal communication structure, and only 27.3% of them hold events for the purpose of media coverage. Consequently, most of these organizations have occasional interactions with journalists, create messages about nursing problems, and directed mostly to nurses, perpetuating a circular communication.Conclusion: Nursing professional organizations have limited resources and lack of formal communication structures. The restricted interaction with the media and the "echoing" voice that propagates within the profession may hinder citizens' full understanding of its contribution. Nursing organizations must develop a nation-wide strategy that promotes transversal collaboration and resources optimization, with the purpose of increasing their media visibility and strengthening their Public Health mission. K E Y W O R D S media visibility, nursing professional associations, nursing trade unions, public communication, strategic communication 1 | BACKGROUND Nurses are the largest occupational group in the health sector and play a key role in promoting the well-being and quality of life of the populations they care for. They integrate multidisciplinary teams which work in a variety of settings (hospitals, outpatient departments, conflict scenarios, etc) and provide more than 80% of primary health care in some countries. 1 They promote public health and health literacy by ensuring vaccination and education for selfmanagement in areas such as diabetes, obesity, and cardiovascular Nurs Forum. 2019;54:291-297. wileyonlinelibrary.com/journal/nuf are co-authors.problems. 2 In addition to direct patient care, nurses are also responsible for quality improvement programs, management development, teaching, and audit activities, and are actively involved with health policy.Despite nurses' major contribution to the economic and social development of a country, they are usually missing from the media coverage of the health sector and, consequently, kept away from public discussion. [3][4][5][6] Mason et al 4 analyzed 537 articles from 13American health publications and concluded that nurses were identified as sources of only 2% of quotes in the articles, were mentioned in 13% of stories, and were identified in 4% of images in the articles. The authors concluded that 20 years after the initial study, which found the profession was almost invisible, there were no significan...

Aim To assess the impact of safe nurse staffing on the quality of care, based on the structure‐process‐outcome approach, in Portuguese hospitals. Background Safe nurse staffing is essential for the quality of care in hospital settings, together with work environment, organisational commitment and nursing practices. However, there is little evidence of its analysis in the Portuguese context. Method A cross‐sectional survey study was conducted using a sample of 850 nurses from 12 public hospital units in the central and northern regions of Portugal. Results The proposed structural equation model for quality assessment has a good fit (χ2/df = 2.37; CFI = 0.88, PCFI = 0.83; PGFI = 0.77, RMSEA = 0.04), showing the impact of safe nurse staffing, work environment, and affective and normative organisational commitment on the quality of care (mortality rate and adverse events). The mediating effect of nursing practices was also found. Conclusion Safe nurse staffing, which is compromised in 90% of the units, is a predictor of the quality of care through the mediating effect of nursing practices. Implications for Nursing Management The results not only highlight the need for urgent intervention but also support political decision‐making with a view to improving the access to quality care.