Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world.

Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage.

Aim: This study aimed to illustrate the relationship between nurse staffing and missed care, and how missed care affects quality of care and adverse events in Thai hospitals.Background: Quality and safety are major priorities for health care system. Nurse staffing and missed care are associated with low quality of care and adverse events.However, examination of this relationship is limited in Thailand.Methods: This cross-sectional study collected data from 1188 nurses in five university hospitals across Thailand. The participants completed questionnaires that assessed the patient-to-nurse ratio, adequacy of staffing, missed care, quality of care and adverse events. Logistic regression models were used to estimate associations.Results: Higher patient-to-nurse ratio, poor staffing and lack of resource adequacy were significantly associated with higher odds of reporting missed care. Higher nurse-reported missed care was significantly associated with higher odds of adverse events and poor quality of care.Conclusions: Poor nurse staffing was associated with missed care, and missed care was associated with adverse events and lower quality of care in Thai university hospitals.

Nurse administrators can use the results of this study to develop policies, improve work empowerment programmes and decrease burnout so that staff nurses can work more effectively.

Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review 64, 22-32Background: A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Aim: Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. Design: A qualitative study employing Longest's model to examine policy-making processes. Methods: Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Findings: Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Study limitations: Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Conclusion: Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand.Correspondence address: Wipada Kunaviktikul, Faculty of Nursing, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai 50200, Thailand; Tel: 66-81-2877232; Fax: 66-53-225425; E-mail: wipada1111@hotmail.com. FundingGraduate school, Chiang Mai University; faculty of Nursing, Chiang Mai University under the support of China Medical Board; and The Thailand Nursing and Midwifery Council. Conflict of interestThere is no conflict of interest. © 2016 International Council of Nurses Original ArticleImplications for Nursing/Health Policy: Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments. Like governments in other countries, The Royal Thai Government has made a number of efforts to address the nursing shortage through national policies and the quality of nursing education, including its first specific policy on this: the Plan for Increasin...

The findings add to increasing international evidence that favourable nurse working conditions, low nurse-to-patient ratio and richer skill mix result in positive patient outcomes. Health systems can foster nurses to perform high-quality care by improving work conditions, and providing sufficient nurses and resources.

Aim To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID‐19. Background Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID‐19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments. Methods A cross‐sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses. Results Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment. Discussion The COVID‐19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses’ organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential. Conclusion and implications for the field of nursing and health policy Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID‐19.

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