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This study aims to make visible the dynamic nature of leader–member exchange (LMX) in the changing realm of health-care leadership.

The qualitative study used an open questionnaire, which was distributed amongst nursing staff and managers at a Finnish public university hospital.

The participants described partly LMX theory, but the leader-member relationship was also influenced by the organizational culture and the existing management practices. Nursing staff were found to have a more variable and dynamic role in the LMX relationship than has previously been reported. The research therefore provided novel information for the field of health-care research.

The presented research was limited by the content of the data, as the collected single narratives were rather short; however, the fact that a large number of narratives were collected from diverse participants strengthened the ability to reliably answer the research questions.

Although the participants described partly LMX theory, the leader–member relationship is also influenced by the organizational culture and existing management practices; the finding that nurses have more variable roles in LMX relationships in the health-care context was new insight in this field. Therefore, the presented findings can help decision-makers change the current, perhaps antiquated, leadership practices at health-care organizations.

This study provides new insight into the field of LMX research in terms of the important role of nursing staff, the organizational factors that influence the LMX relationship and the dynamic nature of LMX relationships.

This viewpoint article discusses and analyses the need and benefits of a patient safety definition within the context of nursing.

This viewpoint article is supported by literature review, statutory documents and expert knowledge evidence. All these sources provided a unified narrative of the background, current aspects and future needs of patient safety.

The need for strengthening patient safety and the nurses' role within healthcare's actions towards patient safety are discussed. The predominant role of nurses due to the proportionate size and significant role along with the need for clarification of patient safety in nursing terms is recognised. Research evidence of nursing areas with safety issues and relevant nursing interventions are presented. Based on all findings, a research-based nursing specific patient safety definition is proposed. This definition includes three axes: what is patient harm, how this harm can be eliminated or reduced and which are the areas of nursing practice that are identified to provide opportunity for patient harm. These axes include nursing specifications of the patient safety definition.

It is the first time that a nurse specific patient safety definition is proposed. This definition strives to enhance nurse practitioners' understanding and engagement with patient safety by clarifying aspects of patient safety within everyday nursing practice.

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

• This is one of the first studies on the relationship between provision models of nursing care and patient experience.

• Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

• Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

• Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

The purpose of this paper is to share insights, research findings and discuss key issues related to graduate experiences with transnational nursing education (TNE).

The authors used a qualitative approach and sampled national and international nurse graduates to identify challenges and best operating practices in cross-border nursing program facilitation.

This research paper has provided a platform for graduates to lend their voices to the promotion of effective cross-border nursing education delivery and suggests that although international collaborations endeavor to maintain high academic standards in TNE, there is still a need to re-engineer, revise and adapt curricular content, learning, teaching and assessment practices to aid the nursing student.

Identified challenges affecting the facilitation and delivery of cross-border nursing education programs can act as levers to improving service quality of present and future cross-border programs to the nursing student. This will assist future nursing students to recognize culture shock and embrace their decision to pursue nursing.

The experience of being involved in TNE for nursing students may not be that much different than students of other disciplines. While not able to be generalized to the entire population, the reports by the nursing students in this sample appear to be valuable and worthwhile to continue supporting and encouraging other TNE opportunities.

This paper explores cross-border nursing education experiences from national and international perspectives. The authors were able to explore inherent TNE challenges from diverse population and cultural backgrounds.

Cambodia has one of the highest death rates for children under five years of age in Southeast Asia. The high mortality rate of children under five years of age, especially the neonate is 35 per 1,000 for the period zero to four years. There are no neonatal nursing standards of practice to guide nurses providing neonatal nursing care. Some general guidelines are currently being implemented for both doctors and nurses. The Minister for Health officially launched the Cambodian Council of Nurses’ Guideline for the Standard of Nursing Care in December 2015. In the absence of specific neonatal nursing standards of practice, the purpose of this paper is to develop the Neonatal Nursing Standard of Practice for Cambodia.

The Delphi technique was selected as being appropriate for this study. The snowball with purposive sampling was used. The identified experts were located across Cambodia so the e-Delphi approach was considered appropriate and applicable according to the study context. Four experts preferred to be interviewed face-to-face, while 16 experts were confident to use e-mail to respond to the questionnaire in Round 1. In total, 19 experts provided responses via e-mail to the Rounds 2 and 3 questionnaires.

A Standard for Neonatal Nursing Practice for Cambodia which consists of ten standards was found as a result of this study: assessment, nursing diagnosis, planning, implementation, evaluation, ethics, evidence-based practice and research, health teaching and health promotion, continuing education, and communication.

All items and sub-items achieved consensus as either being at the most significant level and therefore, could be key indicators for neonatal nursing standards of practice. The results of this study can be incorporated into a focused discussion led by the Nursing and Midwifery Bureau of the Ministry of Health to develop national standards of practice for neonatal nurses in Cambodia.

The purpose of this paper is to investigate aspects related to difficulty to retain nursing assistants at nursing homes in Sweden related to perceived work environment characteristics.

To reveal aspects related to difficulty to retain nursing assistants, the paper uses the BIKVA model, sense of coherence and New Public Management (NPM). In total, three focus groups with nursing assistants at three nursing homes are interviewed with corresponding individual interviews with their senior managers and users. The purpose is to analyze the situation from the affected group of nursing assistants. The focus of this study is how nursing assistants discuss related to recruit and retain nursing assistants at nursing homes and elderly care and the response from senior management related to those aspects.

The main conclusions are that nursing assistants consider their job as meaningful, but limited latitude and direct involvement in managing their daily tasks in a continuous communication with management affect negatively. Furthermore and combined with wage levels, aspects related to scheduling, working hours, shift work, split shifts and understaffing generate a burdensome and stressful environment affecting the possibility to retain staff in a negative direction.

The research uses a new approach utilizing the BIKVA model, sense of coherence and NPM. The study shows that central in retaining nursing assistants at nursing homes relates to aspects such as wages, staffing, shift work and split shifts and continuous communication between nursing assistants and management.

The purpose of this study is to investigate factors surrounding low Emirati student recruitment and retention within a nursing programme in the Abu Dhabi Emirate. A sequential explanatory mixed methods research design was used to collect data from 140 Emirati students at different levels of the nursing program. Questionnaires, semi-structured interviews and related document analyses were used to collect information for this study. Quantitative analysis revealed that overall participants perceived the Emirati society as holding a positive image of nursing, though a majority of them indicated that nursing as a profession, would be a third or last choice of career for them. Inferential analysis on the reasons to choose or not choose nursing, revealed an opportunity to work as part of the team; and as a stepping stone to other professions as significant reasons, versus perceived program difficulty level, and perceived unpleasant tasks. Thematic analysis of interviews highlighted: 1) personal interest; 2) parental support; 3) awareness of the profession; 4) perceived barriers; 5) potential benefits, and 6) policies at the local and national levels. The study has several implications for nursing education and policy in the United Arab Emirates and the region.

.يبظوبأ ةرامإ يف ضيرمتلا جمانرب نمض مهب ظافتحﻻاو نييتارامﻹا ةبلطلا ددع ةلقب ةطيحملا لماوعلا ةسارد وه ةساردلا هذه نم ضرغلا نم تانايبلا عيمجتل ةطلتخم قرط يف لسلستم يثحب ميمصت مادختسا مت دقو 140 .ضيرمتلا جمانرب تايوتسم فلتخم ىلع ايتارامإ ابلاط تسﻻا تلمعتسا ةيبلغأ نأ يمكلا ليلحتلا فشك و .ةساردلا هذهل تامولعملا عمجل ةلصلا تاذ قئاثولا تﻼيلحتو ةمظنملا هبش تﻼباقملاو تانايب ضيرمتلا نأ ىلإ تراشأ مهتيبلغأ نأ نم مغرلا ىلع ،ضيرمتلل ةيباجيإ ةروص لمحي هنأ ىلع يتارامﻹا عمتجملا ىلإ نورظني نيكراشملا مهرايخ نوكيس ،ةنهمك ضيرمتلا رايتخا مدع وأ رايتخا بابسﻷ يلﻻدتسﻻا ليلحتلا يف و .مهل ةبسنلاب ةيفيظولا ةايحلا نم ريخﻷا وأ ثلاثلا ةماه ةيباجيإ بابسأك ،ىرخأ نهمل قﻼطنا ةطقنك وأ ؛قيرفلا نم ءزجك لمعلل ةصرف نع جئاتنلا تفشك ،ةيبلسلاو ةيباجيﻹا بابسﻷا لباقم ا يف و،ضيرمتلا رايتخﻻ رايتخا مدعل ةريبك ةيبلس بابسأ اهنأ ىلع ، اهيف بوغرملا ريغ ماهملاو ،جمانربلا ةبوعص ىوتسم ىلإ رظنلا ،لباقمل :تﻼباقملل يعيضاوملا ليلحتلا زربأو .ةنهمك ضيرمتلا 1 ( ؛ةيصخشلا ةحلصملا 2 ( ؛نيدلاولا معد 3 ( ةنهملاب يعولا ؛ 4 ( ؛ةعقوتملا زجاوحلا 5 ( و ،ةلمتحملا دئاوفلا 6 ( ةلود يف هتاسايسو ضيرمتلا ميلعت ىلع تاروصت ةدع ةساردلا هذهلو .ينطولاو يلحملا نييوتسملا ىلع تاسايسلا ةقطنملاو ةدحتملا ةيبرعلا تارامﻹا .

The purpose of this paper is to synthesize the existing evidence on leadership that best matches nursing home care, with a focus on behaviors, effects and influencing factors.

A narrative review was performed in three steps: the establishment of scope, systematic search in five databases and assessment and analysis of the literature identified.

A total of 44 articles were included in the review. The results of the study imply that a stronger focus on leadership behaviors related to the specific context rather than leadership styles could be of added value in nursing home care.

Only articles applicable to nursing home care were included. The definition of “nursing home care” may differ between countries. This study only focused on the academic literature. Future research should focus on strategies and methods for the translation of leadership into behavior in practice.

A broader and more conceptual perspective on leadership in nursing homes – in which leadership is seen as an attribute of all employees and enacted in multiple layers of the organization – could support leadership practice.

Leadership is considered an important element in the delivery of good quality nursing home care. This study provides insight into leadership behaviors and influencing contextual factors specifically in nursing homes.

The purpose of this paper is to explore the influence of peer mentoring on critical care nursing students’ learning outcomes in critical care units.

A qualitative exploratory research design was used to conduct the study. Ten critical care nursing students were recruited from critical care units in the five private and two public hospitals. Descriptions of their experiences were gained through individual face-to-face interviews.

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes. However, peer mentoring was not consistent in all hospitals and there were no structured support systems to ensure that peer mentoring was formalized. Making peer mentoring a vital component in the registered nurses core competencies would enable efficiency and guarantee the viability of peer mentoring.

Mentors for the critical care nursing students were not included in the study.

The study identified a need for incorporating a formalized mentorship programme into the core competencies of all qualified critical care nurses, the unit mentor to familiarise themselves with the prescribed learning objectives of the critical care nursing student and an allocation of supernumerary time for the critical care nursing student and mentors to allow for formal mentoring responsibilities to take place.

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes and conscietises registered nurses of their responsibility as mentors.

The purpose of this study is to describe council structure, its benefits, supportive and obstructive factors and developmental needs as a part of shared governance in a university hospital.

This is a descriptive study, where semi-structured interviews with 12 nurses was conducted in 2014 and documents from 75 council meetings from 2009 to 2014 were gathered and analyzed. Qualitative content analysis method was used on the data.

The study hospital has been developing nursing shared governance with unique structure and processes of councils. Professors and university researchers act as chair and members are voluntary nursing staff. The factors supporting the councils are nurse managers’ support, enthusiastic personnel and neighboring university. The factors obstructing the councils are lack of time, understanding and skills. The work of the councils benefits the organization by improving patient care, harmonizing nursing practices and informing decision-making. The council’s developmental needs were more visibility, concentration into everyday problems and interprofessionality.

Applying nursing shared governance structures into an organization improves the professional practice environment of nursing personnel.

The study hospital has its own, unique council structure. It did not cover the whole hospital or all of the nursing personnel, but it is already producing promising results. It should be given an official status and more support from nurse managers, and it should be developed into an inter-professional discussion. The results presented here indicate that shared governance, even, in its early stage, contributes positively to the quality of care, harmonizes nursing practices and informs decision-making. Applying shared governance structures into an organization improves the professional practice environment of nursing personnel. The study showed concrete supporting and obstructing factors that should be notified in nursing leadership.

Despite the extensive empirical studies on nursing shared governance, there is very little research on councils in the Scandinavian countries.