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    The effect of problem-solving and decision-making education on problem-solving and decision-making skills of nurse managers: A randomized controlled trial
    (Elsevier Sci Ltd, 2024) Kusakli, Berra Yilmaz; Sonmez, Betul
    Objectives: This study was conducted to determine the effect of an education program developed to improve the problem-solving and decision-making skills of nurse managers through both self- and subordinate evaluations and to compare it with a control group without training. Background: The most basic skill that managers should have is effective problem-solving and decision-making skills. Nevertheless, studies indicate that nurse managers' problem-solving and decision-making skills are at a moderate level and need to be improved. Design: Randomized controlled, pre-test-post-test, intervention and control group design. The study was conducted at a tertiary hospital in Istanbul, T & uuml;rkiye. The sample consisted of 60 nurse managers (30 intervention and 30 control groups) and 300 nurses or nurse managers working as subordinates. Methods: After assessing the problem-solving and decision-making skills of nurse managers in the intervention and control groups by themselves and their subordinates, educational intervention was provided to the intervention-group. The problem-solving and decision-making education consists of two full days of interactive training based on case studies. Subsequent to the training, nurse managers in the intervention-group underwent a second follow-up. The third follow-up for the intervention-group, as well as the second follow-up for the controlgroup and all subordinates, were conducted in the third month after the training. Data were analysed using descriptive tests, independent sample t-test and dependent sample t-test for comparisons and repeated measures analysis of variance for the effectiveness of the training program. Results: Significant differences were found between the mean scores of the intervention-group nurse managers in problem-solving and decision-making pre and post-test (t=-11.005, p<.001) and case evaluations (t=-10.03, p<.001). Moreover, significant differences were identified in the assessment of pre-training, post-training and 3month post-training average scores of overall problem-solving (F=93.643, p<.001) and rational (F=7.331, p=.007), dependent (F=13.607, p<.001), avoidant (F=11.543, p<.001) and spontaneous decision-making style (F=4.393, p<.001). When evaluated by the subordinates of the nurse managers in the intervention-group, there was a notable difference in the mean scores of overall problem-solving (t=-16.237, p=.001) and rational (t=3.472, p=.001) and dependent decision-making styles (t=4.161, p=.001) before and 3-months after the training. Conclusions: The study uncovered that the problem-solving and decision-making training provided to nurse managers led to enhancements in their respective abilities, a progression that was also noted by their subordinates. The findings underscore the significance of case-based training programs tailored to enhance the problem-solving and decision-making competencies of nurse managers.
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    Öğe
    The Relationship Between Work Environment and Missed Nursing Care in Nurses: The Moderator Role of Profession Self-Efficacy
    (Lippincott Williams & Wilkins, 2024) Yildiz, Cennet Ciris; Oz, Seda Degirmenci; Kusakli, Berra Yilmaz; Korkmaz, Irem
    Aims: This study aimed to examine the relationship between work environment and missed nursing care (MNC) in nurses and determine whether profession self-efficacy has a moderator role in this relationship. Design: A quantitative, cross-sectional, correlational study design was used to test the study model. Methods: The study was conducted with 433 nurses in 2 city hospitals in Istanbul, Turkey. Data were collected between November 2022 and February 2023 using the MISSCARE Survey-Turkish, the Work Environment Scale, and the Nursing Profession Self-Efficacy Scale. Results: The participants had a mean Nursing Profession Self-Efficacy Scale score of 66.67 +/- 14.37, a mean Work Environment Scale score of 84.96 +/- 13.62, a mean elements of MNC score of 1.30 +/- 0.73, and a mean reason for MNC score of 3.18 +/- 0.78. Nursing profession self-efficacy was determined to be positively related to the work environment of the participants and their reasons for MNC (respectively, r = 0.276 and r = 0.114) and negatively related to elements of MNC (r = -0.216) (P < 0.05). There was also a negative relationship between the work environment and elements of MNC (r = -0.249; P < 0.05). Profession self-efficacy had a significant moderator role in the relationship between the work environment and elements of MNC. Having low or moderate levels of profession self-efficacy moderated the negative effects of the work environment on elements of MNC. Conclusions: There is a need for interventions to reduce elements of missed nursing care in nurses. Especially nurses and/or nurse managers may have difficulties in improving their work environment, considering its multifaceted structure. In such cases, administrators can reduce missed nursing care by increasing the profession self-efficacy of nurses. Therefore, profession self-efficacy should be considered in addition to interventions for the work environment to improve care.