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Residents in under-resourced/high-Medicaid (85% or higher) nursing homes on average receive care from relatively lower quality providers and have worse health outcomes, which may increase the risk of higher COVID-19 incidence. This study aims to evaluate if having a culture that encourages employee empowerment results in better quality (lower COVID-19 deaths) in times of crisis, such as the current pandemic. The study combined primary survey data from 391 Directors of Nursing (response rate of 37%), with Centers for Medicare and Medicaid Services’ (CMS) Nursing Home COVID-19 Public File, LTCFocus, Area Health Resource File, and Nursing Home Compare. The dependent variable consisted of the number of COVID-19 death as of November 25, 2021. The independent variables consisted of Likert scale for employee empowerment (Cronbach alpha= 0.82). Control variables consisted of organizational factors (e.g., size, location, and ownership), as well as community factors (e.g., poverty, unemployment, and competition). The results indicated that one unit increase in employee empowerment was associated with 6% lower likelihood of having COVID-19 deaths. Nursing homes, particularly those under-resourced, face difficulty improving the quality of care due to financial constraints. However, the results suggest that adopting a culture that fosters employee empowerment may give nursing homes an edge in improving quality outcomes in crises.

The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub‐scales from the Nursing Work Index – Revised (NWI‐R) to assess the nursing work environment and the performance of these sub‐scales across different units in a hospital. Data were derived from a cross‐sectional survey of 243 nurses from 13 units of a 300‐bed university‐affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five sub‐scales were confirmed; three of the sub‐scales had greater ability to discriminate between units. Using hierarchical regression models, “resource adequacy” was the sub‐scale most strongly associated with the perceived quality of care at the last shift. The NWI‐R sub‐scales are potentially useful for comparison of work environments of different nursing units at the same hospital.

States Canadian governments have, after a decade of health care downsizing, started to focus on issues of health human resources. Posits that nurses in particular experience higher rates of absenteeism and injury than other types of Canadian workers. Advocates that this study’s findings offers numerous ideas to managers of the system, unions, nurses, government and other parties on how to manage the system better for all involved and the improvement of the health care system.

In this paper, the authors situate existing scholarship about men in nursing within the broader gendered landscape of the profession and society. As a consequence, the need to reframe the discourse about men in nursing from the current emphasis on personal or collective experiences to collective action becomes apparent. The paper aims to discuss these issues.

A critical synthesis of scholarship addressing men in nursing serves as the basis for a conceptual paper which challenges the existing discourse on men in nursing.

The experiences and careers of men in nursing are profoundly shaped by patriarchal power structures that situate caregiving within the realm of the feminine. Although men generally benefit in the context of patriarchal society, men in nursing are subject to a patriarchal paradox that marginalizes their performance of masculinity and situates them as unlikely caregivers. Therefore, men in nursing are preoccupied with balancing the contradictions and tensions in their lives associated with enacting a contextual performance of masculinity depending on the social context of their gender performance.

A comprehensive synthesis of the existing men in nursing literature is presented and these findings are situated within a broader discussion of gender in nursing and society. This analysis provides the impetus for a “call to action” for nursing to comprehensively and meaningfully address the negative consequences of patriarchal forces on the profession of nursing.

Federal and state governments collaborate on state Medicaid nursing facility long-term care (SMNF-LTC) programs. These programs are increasingly expensive as the baby-boomers retire. Yet serious resident outcome problems continue in spite of the Centers for Medicare and Medicaid Services’ (CMS) extensive process-focused regulatory efforts. This study identifies a promising and simpler auxiliary path for improving resident outcomes.

Drawing on a longitudinal (1997–2005), 48-state data set and panel-corrected, time-series regression, we compare the effects on resident outcomes of CMS process-focused surveys and four minimally regulated program structural features on which the states vary considerably.

We find that each of these four structural features exerts a greater effect on resident outcomes than process quality.

We suggest augmenting current process-focused regulation with a less arduous approach of more extensive regulation of these program features.

To date SMNF-LTC program regulation has focused largely on member facility processes. While regulating processes is appropriate, we show that regulating program structural features directly, an arguably easier task, might well produce considerable improvement in the quality of resident outcomes.

The purpose of this paper is to examine the effectiveness of an emotional intelligence (EI) and leadership development education program involving 20 nurse leaders at nursing homes. Also, it investigates the relationship between EI and transformational leadership.

Three research questions are posed. Correlation analysis and t-tests were conducted to answer the questions posed.

The findings of this paper indicate that the EI educational development was effective, while the personal leadership development was not. The data also showed a positive significant relationship between EI and transformational leadership.

This paper is limited by the small sample size; thus, a causal relationship between EI and leadership could not be investigated. Additionally, the sample was not randomly selected because of the commitment needed from the participants. Furthermore, the paper was focused on nurse leaders in nursing homes, so it may not be generalizable to other populations.

With the increasing need for nursing home facilities and the limited training generally provided to nurses who move into managerial roles in these facilities, it is critical for organizations to understand the effectiveness of educational programs that exist. Moreover, the findings of this paper may provide information that would be useful to others who wish to develop EI and/or leadership education for nurses.

While much research exists on EI and transformational leadership, little of this research focuses on nurses in nursing home facilities. Thus, this paper fills a gap in the literature.

The purpose of this paper is to provide an overview of published literature on behavioural and psychological symptoms of dementia (BPSD) nursing in Japan and to highlight challenges that need to be resolved.

The criteria for retrieval of literature were as follows: a BPSD study conducted by a nurse in Japan, and it must have been published. Papers without conference proceedings and peer reviews and literature without English titles and abstracts were excluded. The PRISMA (preferred reporting items for systematic reviews and meta-analyses) was referenced.

Based on the analysis of 20 studies meeting the criteria, nurses tended to manage BPSD when all three of the following were clearly defined: attempts to understand BPSD, the provision of nursing intervention to improve the quality of care and clarification of the perception of BPSD. There were eight studies that implemented surveys considered to be helpful for nurses to understand BPSD with the aim of clarifying the symptomatic factors, meaning of each behaviour, etc. In the eight studies, nurses directly coped with BPSD in various ways. Four studies reported on how nurses perceive the associated behaviours and symptoms of BPSD patients.

This study suggests that not only implementing interventions but also aiming at improving nurses’ understanding of BPSD and their level of knowledge are crucial to promote BPSD nursing in Japan.

This research aims to explore the fine-grained relationships between nurse staffing and hospital operational performance with respect to care quality and operating costs. The authors also investigate the moderation effect of competition in local hospital markets on these relationships.

A six-year panel data is assembled from five separate sources to obtain information of 2,524 USA hospitals. Fixed-effect (FE) models are used to test the proposed hypotheses.

First, nurse staffing is initially associated with improved care quality until nurse staffing reaches a turning point, beyond which nurse staffing is associated with worse care quality. Second, a similar pattern applies to the relationship between nurse staffing and operating costs, although the turning point is at a much lower nurse staffing level. Third, market competition moderates the relationship between nurse staffing and care quality so that the turning point of nurse staffing will be higher when the degree of competition is higher. This shift of turning point is also observed in the relationship between nurse staffing and operating costs.

The study identifies three ranges of nurse staffing in which hospitals will likely experience simultaneous improvements, a tradeoff or simultaneous decline of care quality and operating costs when investing in more nursing capacity. Hospitals should adjust nurse staffing levels to the right directions to achieve better care or reduce operating costs.

Nurses constitute the largest provider group in hospitals and profoundly impact care quality and operating costs among all health care professionals. Optimizing the level of nurse staffing, therefore, can significantly impact the care quality and operating costs of hospitals.

This paper reflects on changes to end-point assessment (EPA) brought about as a result of the COVID-19 pandemic and considers how proposed future change will impact on training providers and employers of health apprentices.

The paper provides an analysis of apprenticeship policy, the role of EPA and consideration of assessment strategies used in higher education and health professions. Implications for policy, training providers and clinical practice are proposed.

These changes will bring the completion of EPA closer to education providers and allow them to take a more direct role within the process. Education providers will need to be issued with clear guidance to ensure regulatory compliance. The pedagogical value of EPA is questioned.

Training providers and policymakers will need to review their processes and guidance appropriately. This paper provides a summary of salient points needing consideration.

This study investigates national trends in students’ science, technology, engineering, and mathematics (STEM) occupational expectations by using Program for International Student Assessment (PISA) 2000, 2003, and 2006 data. The analyses in this study revealed several noteworthy national trends in STEM occupational expectations. In many countries students’ computing or engineering (CE) occupational expectations changed between PISA 2000 and PISA 2006, while students’ health service (HS) occupational expectations remained constant. In particular, many developed countries experienced downward national trends in CE occupational expectations among top performers in science. This study also found gender differences in national trends in STEM occupational expectations. In many countries boys’ CE occupational expectations decreased between PISA 2000 and PISA 2006, while girls’ occupational expectations remained unchanged in both CE and HS fields. Finally, the gender gaps in CE occupational expectations converged in many countries, but this convergence was not due to increases in CE occupational expectations among girls, but rather decreases in expectations among boys. Because one of the policy goals in many countries is to promote engagement in STEM education and occupations among students, especially academically talented students, the current findings – national declines in CE occupational expectations among top academic performers – will most likely be viewed as problematic in several countries. Future research should use data collected over longer periods to investigate whether students’ interest in STEM education and occupations increased or decreased in a variety of countries, and whether these patterns varied by student characteristics and performance levels. Moreover, future research must focus on factors that can explain the national trends in student interest in STEM education and occupations.