Missed nursing care is a universal phenomenon threatening the quality of care and patient safety across hospitals, countries and cultures (Jones, Hamilton, & Murry, 2015; Kalisch et al., 2011). A literature review showed that 55% to 98% of nurses reported missing at least one nursing task (Jones et al., 2015). The antecedents of missed nursing care are also universal across hospitals and countries (Kalisch et al., 2011). Some known

The kidney plays a critical role in fluid homeostasis, glucose control, and drug excretion. Loss of kidney function due to drug-induced nephrotoxicity affects over 20% of the adult population. The kidney proximal tubule is a complex vascularized structure that is particularly vulnerable to drug-induced nephrotoxicity. Here, we introduce a model of vascularized human kidney spheroids with integrated tissue-embedded microsensors for oxygen, glucose, lactate, and glutamine, providing real-time assessment of cellular metabolism. Our model shows that both the immunosuppressive drug cyclosporine and the anticancer drug cisplatin disrupt proximal tubule polarity at subtoxic concentrations, leading to glucose accumulation and lipotoxicity. Impeding glucose reabsorption using glucose transport inhibitors blocked cyclosporine and cisplatin toxicity by 1000- to 3-fold, respectively. Retrospective study of 247 patients who were diagnosed with kidney damage receiving cyclosporine or cisplatin in combination with the sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin showed significant (P < 0.001) improvement of kidney function, as well as reduction in creatinine and uric acid, markers of kidney damage. These results demonstrate the potential of sensor-integrated kidney-on-chip platforms to elucidate mechanisms of action and rapidly reformulate effective therapeutic solutions, increasing drug safety and reducing the cost of clinical and commercial failures.

ObjectivesTo examine the association between listening and disruptive behaviors and the association between disruptive behavior and the wellbeing of the nurse. To test whether constructive and destructive listening has an incremental validity.MethodsA structured questionnaire survey that measured the (constructive & destructive) listening climate at work, exposure to disruptive behaviors, well-being and feeling as a victim. We presented this survey using the Qualtrics software.ResultsOf the final sample of 567 respondents who reported that they were nurses, MAge = 38.41, 67% indicated that they were exposed to some form of disruptive behavior. Experiencing listening in the ward was associated with low levels of exposure to disruptive behaviors; exposure to disruptive behaviors, in turn, predicted reduction in the nurses’ wellbeing; the reduction in wellbeing was especially pronounced among nurses who felt like a victim. Each of the facets of the listening measure—constructive listening and destructive listening—had incremental validity in predicting exposure to disruptive behaviors. Finally, the effect of exposure to disruptive behavior on wellbeing was curvilinear.ConclusionsDisruptive behavior is a major challenge to the workplace well-being for nurses. The victim mentality has an adverse impact on nurses. Preventive efforts aimed at reducing disruptive behaviors among nurses and decreasing their sense of victimization are crucial for the well-being of nurses.

BackgroundNurse managers and team co‐workers' disruptive behaviors (DBs) are negatively associated with a perceived safe climate. Moreover, DBs are a risk factor for patients' safety. Yet, it remains unknown whether and to what extent these effects were prevalent in COVID‐19 wards and among witnesses of DBs.DesignA cross‐sectional study.MethodsA questionnaire was distributed on social networks and completed by nurses in various Israeli healthcare organizations using snowball sampling between October and December 2021. The questionnaire included seven previously published measures and a question checking whether the participants had worked in a COVID‐19 ward. The minimal sample size for any analysis was 236. Hypotheses were tested with correlations and structural equation modeling.ResultsDBs of nurse managers and team co‐workers toward nurses were higher in COVID‐19 teams. As hypothesized, DBs were negatively correlated with a safe climate and positively with patient safety (fewer errors). The data were consistent with a model suggesting that a safe climate is related to fewer DBs and DBs largely mediate the effects of safe climate on errors. Surprisingly and importantly, the strongest predictor of errors, including preventable mortality, is witnessing DBs and not being a victim of DBs.ConclusionsDBs may impede open communication and collaboration among co‐workers, particularly in COVID‐19 teams. This study shows the links between nurse shaping of a safe climate, DBs toward nurses, and patient safety.Clinical relevanceNurse managers who create a safe climate and show zero tolerance for DBs could reduce the risk of errors in care.