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Nurses play a critical role in providing evidence-based, high-quality care to optimize patient outcomes. Models from implementation science suggest social networks may influence the adoption of evidence-based practices (EBPs). However, few studies have examined this relationship among hospital nurses. Social network analysis (SNA) mathematically evaluates patterns of communication, a critical step in implementation. Exploring hospital nurses' communication networks may provide insight into influences on the adoption of EBPs.
This study aimed to describe complete communication networks of hospital nurses for practice changes on inpatient units, including upper level nursing administrators.
This descriptive, exploratory, cross-sectional study used SNA on two inpatient units from one hospital. A sociometric survey was completed by nurses (unit to executive level) regarding communication frequency about practice changes. Network-level density, diameter, average path length, centralization, and arc reciprocity were measured. Attribute data were used to explore subnetworks.
Surveys from 148 nurses on two inpatient adult intensive care units (response rates 90% and 98%) revealed high communication frequency. Network measures were similar across the two units and among subnetworks. Analysis identified central (charge nurses and nurse leaders) and peripheral members of the network (new-to-practice nurses). Subnetworks aligned with the weekend and shift worked.
Established communication channels, including subnetworks and opinion leaders, should be used to maximize and optimize implementation strategies and facilitate the uptake of EBPs. Future work should employ SNA to measure the impact of communication networks on promoting the uptake of EBP and to improve patient outcomes.
Nurses experience various health-related issues due to the nature of their work.
This study aimed to examine the effect of a mindfulness-based intervention on stress overload, depression and mindfulness among nurses. A secondary objective was to examine the role of the setting (i.e., in and out of the hospital as a natural setting) on mindfulness-based intervention effectiveness.
A randomized controlled trial with three groups' pretest–posttest design was used in this study. A total of 195 nurses were recruited—65 intervention-inside hospital, 60 intervention-outside hospital, and 63 control. The mindfulness-based intervention was delivered by a certified mindfulness practitioner over 4 weeks in Jordan. Data were collected using a demographics questionnaire, the Stress Overload Scale Short, the Center for Epidemiologic Studies Depression Scale-Revised, and the Five Facet Mindfulness Questionnaire.
Multivariate analysis showed a statistically significant effect of the intervention on the linear combination of the dependent variables V = 0.44, F[6, 368] = 17.56, p < .001. Follow-up analyses showed that a mindfulness-based intervention significantly decreased stress overload, depression, and increased mindfulness levels among nurses in intervention groups compared with the control group. In addition, conducting a mindfulness-based intervention outside the hospital has a better effect on mindfulness levels than the inside hospital.
The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness should be considered when planning for nurses' well-being and the quality of care provided. Nurse managers are encouraged to use the study's findings to promote nurses' well-being.
During the COVID-19 pandemic, acute care nurse managers functioned in a critical role by helping to advance the mission and goals of their organization while navigating a rapidly evolving healthcare landscape. This resulted in high levels of ongoing job-related stress which is linked to negative physical, psychological, and job-related outcomes. Little is known about the perceptions regarding their own professional well-being during this time.
The aim of this study was to qualitatively describe acute care nurse managers' perceptions of and barriers to their professional well-being.
Using a qualitative descriptive approach, nurse managers from a hospital system in the southwestern United States responded to two short-answer, survey-based questions in 2022: (1) “Describe the definition of nurse-manager well-being in your own words” and (2) “What do you feel is your biggest barrier to professional well-being?” Reflexive thematic analysis was utilized to analyze participant responses (N = 80).
Professional well-being is a complex concept influenced by the nurse manager's ability to navigate work–life balance; care for their own physical, emotional, and spiritual selves; give and receive support from stakeholders; and manage feelings of thriving vs. struggling in the role. Barriers most cited as influencing well-being included having too little time to get things done coupled with increasing workloads, feeling stuck in the middle among stakeholders, and coping with ongoing staffing challenges.
The definition of and barriers to well-being are influenced by the specific needs and experiences of the nurse manager. While not all barriers can be immediately removed, the identification of individual and organization-specific barriers needs to be taken seriously, reviewed by those who can promote change, and evidence-based solutions for improvement piloted or implemented when feasible.
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