Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
http://www.sciepub.com/author/signin

To unsubscribe from our mailing list, please click on the following link: unsubscribe

I am looking forward to hearing from you.

Kind regards,

David Rain
Email:join@sciepub.com
Science and Education Publishing (http://www.sciepub.com)

Label_Title

Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
http://www.sciepub.com/author/signin

To unsubscribe from our mailing list, please click on the following link: unsubscribe

I am looking forward to hearing from you.

Kind regards,

David Rain
Email:join@sciepub.com
Science and Education Publishing (http://www.sciepub.com)

The Need for Nursing Administrative Support for Primary Health Care Nurses as Leaders in Improving the Quality of Nursing Work in Primary Health Care Centers

Ms. Areej Ibrahim Almalki*, Dr. Awatif Mansoor Alrasheeday

Senior-Nurse Educator, Khobar Health Network -Eastern Health Cluster, Khobar, Saudi Arabia

Abstract: Background: the problem lies in the pivotal role that nurses play within primary healthcare centers as frontline caregivers and leaders in care delivery. emphasizing the importance of providing high-quality and accessible care. nurses often face challenges in fulfilling their responsibilities effectively due to various factors, one prominent issue is the lack of adequate administrative support tailored to the unique needs of nursing professionals in primary healthcare settings. Aim: the purpose of this study is to investigate and highlight the critical importance of nursing administrative support within primary healthcare settings and its impact on the quality of nursing work and patient outcomes. Methods: a quantitative cross-sectional research design used, gathering data at a single point in time from a diverse sample of PHCs nurses, sample size was 264 nurses working in the 11 primary healthcare centers located in the city of Al-Khobar – Saudi Arabia. Finding: results indicated significant positive associations between nursing administrative support for nursing leaders & nursing staff and the level of nursing service for clients. The results show that health organizations have become of high quality in providing nursing health services when they receive appropriate support from all aspects of nursing management. Conclusion: the study confirms a positive link between nursing administrative support, quality of nursing work, and patient outcomes in primary health care. This underscores the need for healthcare organizations to prioritize supportive management structures, which can enhance job satisfaction, reduce burnout, and improve quality of care for nursing staff. Ultimately, these efforts contribute to improved patient satisfaction, clinical outcomes, and safety.

Keywords: primary health care, Nursing Administrative Support, nursing quality, patient outcomes

Received March 05, 2025; Revised April 07, 2025; Accepted April 14, 2025

Citation: Ms. Areej Ibrahim Almalki, Dr. Awatif Mansoor Alrasheeday, The Need for Nursing Administrative Support for Primary Health Care Nurses as Leaders in Improving the Quality of Nursing Work in Primary Health Care Centers. American Journal of Nursing Research, 13 (2). 25-31. January 2025. doi:10.12691/ajnr-13-2-2

1. Introduction

The provision of high-quality healthcare services is a fundamental objective of healthcare systems worldwide, with primary healthcare centers serving as the cornerstone of accessible and comprehensive care delivery. Within these centers, nurses play a pivotal role as frontline caregivers, providing a wide range of essential services to individuals and communities. As leaders in the delivery of primary healthcare services, nurses are tasked with ensuring the delivery of safe, effective, and patient-centered care while navigating increasingly complex healthcare environments. However, the ability of nurses to fulfill their leadership roles effectively is contingent upon a supportive and enabling organizational infrastructure [1]. Nursing administrative support, encompassing strategic planning, resource allocation, and operational management, is instrumental in facilitating the optimal functioning of nurses within primary healthcare settings. This support is particularly crucial in the context of enhancing the quality of nursing work and ultimately improving patient outcomes [2,3]. The need for nursing administrative support in primary healthcare settings arises from various challenges and complexities inherent in contemporary healthcare delivery. These challenges include, but are not limited to, evolving regulatory requirements, financial constraints, workforce shortages, and technological advancements [4]. In the absence of adequate administrative support, nurses may encounter barriers that impede their ability to deliver high-quality care consistently. The need for nursing administrative support for primary healthcare nurses as leaders in improving the quality of nursing work in primary healthcare centers is undeniable [1]. By addressing challenges related to resource allocation, facilitating quality improvement initiatives, fostering a supportive work environment, and promoting effective communication and collaboration, administrative support empowers nurses to fulfill their leadership roles and deliver high-quality care to patients in primary healthcare settings.

1.1. Statement of the Problem

The provision of high-quality healthcare services within primary healthcare centers is essential for promoting population health and well-being [5]. However, nurses, who serve as frontline caregivers and leaders in these settings, face numerous challenges that hinder their ability to deliver optimal care. One significant problem is the lack of adequate nursing administrative support, which encompasses issues such as resource allocation, quality improvement initiatives, and fostering a supportive work environment. Without enough administrative support, nurses may encounter obstacles in effectively managing their workload, accessing necessary resources, and implementing evidence-based practices, ultimately compromising the quality of nursing work and patient outcomes within primary healthcare centers.

1.2. Purpose of Study

The purpose of this study is to investigate and highlight the critical importance of nursing administrative support within primary healthcare settings and its impact on the quality of nursing work [6]. This study aims to contribute to a better understanding of how administrative support can be optimized to empower nurses as leaders in primary healthcare.

1.3. Literature Review Related to Study

The purpose of this literature review is to clarify the current state of knowledge regarding the effect of nursing administrative support on nursing work quality in primary healthcare settings. This review aims to provide a thorough understanding of the opportunities, challenges, and implications related to nursing administrative support in primary healthcare by synthesizing and analyzing the existing literature. This understanding helped inform the development of strategies and interventions to improve patient care delivery and enhance nursing practice.

Nursing Leadership Theory emphasizes the essential role of nursing leaders in fostering quality care delivery and positive patient outcomes. Within this framework, nursing administrative support acts as a catalyst for nursing leadership, providing necessary resources, guidance, and organizational structures to empower nurses as leaders within primary healthcare. By embracing principles of transformational leadership, where leaders inspire and motivate others toward common goals, nursing administrative support fosters a culture of excellence, collaboration, and continuous improvement among frontline nurses, ultimately enhancing the quality of nursing work and patient care outcomes [7].

Systems Theory provides a holistic lens through which to understand the complex interactions within healthcare systems. In this study, primary healthcare centers serve as the system within which nursing administrative support operates to influence nursing work quality and patient outcomes. Nursing administrative support serves as a critical component of this system, impacting various subsystems such as staffing, resource allocation, communication, and quality improvement initiatives. By examining the interconnectedness and feedback loops within this system, the study aims to elucidate how changes in nursing administrative support can affect the overall functioning and effectiveness of primary healthcare delivery [8].

Donabedian's Framework for Healthcare Quality offers a comprehensive model for evaluating healthcare quality based on three domains: structure, process, and outcomes. In this study, nursing administrative support represents a structural component of primary healthcare delivery, influencing care processes and ultimately contributing to patient outcomes. By assessing the adequacy of nursing administrative support in terms of staffing, resource allocation, leadership support, and organizational culture, the study seeks to identify opportunities for improving the nursing work and enhancing patient outcomes within primary healthcare centers [9].

The Institute of Medicine's Framework for Quality Healthcare identifies six dimensions of quality care: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. This framework serves as a comprehensive lens through which to evaluate the impact of nursing administrative support on various aspects of healthcare quality. By examining how nursing administrative support influences these dimensions, the study aims to identify areas for improvement and develop targeted interventions to enhance nursing practice and improve patient care delivery within primary healthcare settings [10].

[11] conducted a cross-sectional survey to explore the relationship between nurse managers' leadership style and patients' perception of the quality of care provided by nurses. With a sample of 479 registered nurses and 829 hospitalized patients from five hospitals across Italy, the study aimed to test a model examining how nurse managers' leadership style influences patient perception of care quality through the mediation of the working environment's quality. Using two separate questionnaires for nurses and patients, the researchers employed multilevel analysis to analyze the data. Their findings revealed that nurses who were satisfied with leadership experienced lower burnout and interpersonal strain, engaged less in counterproductive work behavior, and ultimately contributed to higher patient satisfaction with the care provided by nurses. The study underscores the importance of organizational context, leadership, and nurse behavior in shaping patients' perceptions of care quality, emphasizing the need for healthcare managers to consider these factors seriously to enhance patient care outcomes.

Hence, [12], conducted a cross-sectional survey aiming to explore the effects of resonant leadership, leader exchange relationships, and perceived organizational support on work engagement and patient outcomes. Data were collected from 252 nurses and clerical staff, along with institutional patient safety (falls rates) and patient satisfaction measures in New Zealand. Structural equation modeling (SEM) was employed for data analysis. The results indicated that resonant leadership positively correlated with relationships at work, perceived unit care quality, reduced falls rates, and better patient satisfaction. Additionally, perceived organizational support and leader-member exchange were identified as antecedents of work engagement, which, in turn, influenced nurses' perception of unit care quality. The study underscores the importance of relational leadership styles in promoting quality care and enhancing both staff experience and patient outcomes, providing valuable insights for improving healthcare practices.

1.4. Significance of Study for Nursing

This study holds significant implications for the nursing profession by shedding light on the critical role of nursing administrative support in enhancing the quality of nursing work within primary healthcare settings [13]. As frontline caregivers and leaders in patient care, nurses play a central role in promoting health, preventing illness, and managing chronic conditions. Understanding the impact of adequate administrative support on nursing practice and patient outcomes is crucial for advancing nursing excellence and improving healthcare delivery. By identifying barriers, challenges, and opportunities related to administrative support, this study provides valuable insights that can inform policy development, organizational strategies, and professional development initiatives aimed at empowering nurses to thrive in their roles, deliver high-quality care, and ultimately contribute to better health outcomes for individuals and communities.

2. Methodology

2.1. Study Design, Target Population and Setting

This study is a quantitative cross-sectional research design, gathering data at a single point in time from a diverse sample of PHCs nurses. The target population for this study comprises all nurses working in the 11 primary healthcare centers except new staff less than 1 year nursing experience (exclusion criteria) located in the city of Al-Khobar-Saudi Arabia. The total population consists of 310 nurses, and the sample size was 172 as determined using the RASoft website. These nurses represent a diverse group of healthcare professionals who play a vital role in delivering primary healthcare services to the community.

2.2. Study Instrument

The Practice Environment Scale of the Nursing Work Index (PES-NWI) was developed by Lake in 2002 to measure the quality of the nursing work environment, including aspects such as administrative support, nurse manager support, and teamwork. The aim of this tool is to capture the organizational context in which nursing care is delivered. The PES-NWI comprises a total of 25 items, distributed across five subscales: staffing and resource adequacy, nurse manager ability, leadership, and support, collegial nurse-physician relations, quality of nursing care, and foundation for quality of care. Scoring involves (Strongly agree- Agree- Disagree- Strongly disagree) to each item within the subscales, which (Strongly agree-Agree) indicating a more favorable practice environment, The PES-NWI has demonstrated good internal consistency and validity across various healthcare settings [14,15,16] .

3. Data Analysis /Findings

264 primary health nurses participated from 11 primary healthcare facilities in Khobar-Saudi Arabia revealed how important administrative assistance to creating a positive work atmosphere. Most participants were female (87.8%), with males comprising (12.2%), taking into consideration difference in age, years of experience, educational level. (Table 1).

The questionnaire used in this study showed that the nursing leaders& nursing staff receive appropriate administrative nursing support in all its aspects based on the five categories (dimensions) shown in the tool, which enable them to provide high quality nursing services. 90% of participants voted that there is enough staff nurses to handle the workload effectively (Figure 1), 76% voted the nurses managers advocate for nurse's needs (Figure 2),68% from nurses feel comfortable expressing suggestions to physicians that support effective communication between team members in primary care settings (Figure 3), 73%from nurses provide individualized patient care (Figure 4), 78% from nurses have access to continue education opportunities like bachelors and master degrees also 78% ensures that the nursing practice environment supports professional growth and development. (Figures 5).

Table 1. Demographic information of study participants

Figure 1. percentage of each item from Staffing and resource adequacy dimension

Figure 2. percentage of each item for Nurse manager ability, leadership and support dimension

Figure 3. percentage of each item from Collegial Nurse-Physician Relations dimension

Figure 4. percentage of each item from Quality of Nursing Care dimension

Figure 5. percentage of each item from (Foundation for Quality-of-Care dimension

4. Discussion

This study demonstrates the importance of providing administrative nursing support to nursing leaders and nursing staff and how it affects the quality of nursing services provided to the beneficiary. Through the results of the participants’ votes on the items of the sent questionnaire, it became clear that the nursing staff of Khobar Health Network has high and professional nursing administrative support that helps nursing staff to provide and meet all the needs of the beneficiary and receive high-quality service.

Which supports the results of this study and considers real evidence of the quality of health care provided by Khobar primary health centers is: Obtaining the ideal work environment certificate from the organization of "GREAT PLACE TO WORK"-2024.

Nursing Administrative Support for nursing leaders and nursing staff appears in many forms and from many aspects in Khobar primary health care, such as:

Nursing workforce: The nursing administration provided an average of 11-12 nurses in each primary health care center, in line with the population area and the number of scope of services such as vaccination& immunization program, and healthy child program - pregnant women and breastfeeding program – blood collection clinic - urgent care program - chronic disease care program - dressings and treatment room, as there is in each center sufficient coverage of nursing in each program or clinic with training and continuous rotation among nursing throughout the year under supervision of nursing professional development department of nursing administration through safe nurse rotation program . Resources: Providing all medical supplies, equipment, computers and accessories with internet access, as the work system in primary health centers relies on the electronic system and electronic health files. A unique account is created for each nurse in the approved medical program. It enables faster service to patients while reducing risks, whether by calling the patient by name and ID number, or by entering vital signs correctly and accurately, such as calculating body mass index electronically, or making a referral between the doctor and nurse by entering all the patient's basic data, or administering treatment with the dosage calculated electronically according to the patient's age and weight. Administrative nursing support for the nursing leaders and staff is also shown through an official partnership with the Elsevier platform, which allows the nurse to be trained and evaluated on clinical skills on a regular basis according to in-service training plan and annual continuous educational plan through creating a single account for each nurse which can print training manuscript at the end of year.

The nursing administrative leader also provides a consulting and mentorship program (experienced individuals) for each leader in the health centers, which helps them to continue the workflow efficiently, develop improvement plans, and find solutions to obstacles that disrupt the workflow. Through this program, nursing needs are identified and how to meet nursing demands. In addition, this administrative nursing support for nursing is evident through the establishment of programs accredited by the Eastern Health Cluster affiliated with the Saudi Ministry of Health, such as nursing leadership programs for each nurse leader, in addition to other specialized programs such as the health coach program, care coordinator program, and nursing mental health program, chronic care nurse program, clinical nurse educator program so that nursing becomes more efficient in a specific scope of service. There are some mandatory programs included for nursing, such as the medication safety program, which requires annual renewal, and basic infection control skills program, which is renewed every two years. All these programs aim to ensure the provision of comprehensive, highly efficient services. In addition to the forms of administrative nursing support provided by the nursing administration, along with other individuals from different specialties, there is the presence of professional respect and effective communication with the nursing staff, as communication is considered the key to the smooth running of work among the team. It is worth noting that the nursing staff of the Al-Khobar Health Network has a voice when expressing an opinion on patient care or work policies and procedures in healthcare centers.

Patient satisfaction tends to improve because patients see medical staff as professional and competent. This has a direct impact on quality of patient care and the patient’s likelihood of continuing self-care upon discharge. Team satisfaction also improves, which improves job satisfaction, reduces turnover and improves patient rapport

Encouraging the nursing staff to continue developing the educational and academic level of nursing through the external and internal scholarship programs, where a file is included annually for the required nursing specializations, and the nurse has the freedom to choose the program she wants, while covering the tuition fees and devoting to study.

In addition, there is a Nursing Research Department under the Nursing Administration, which aims to develop, promote and disseminate a culture of nursing research that uses evidence-based nursing practices to achieve excellence in the quality of nursing care, Nurses who are interested in the field of nursing research are free to join and participate in the research study, present and discus of journal clubs. These ideas agree with study results, studies that confirm the importance of nursing administrative support in enhancing nursing work quality and patient outcomes provide valuable evidence for healthcare practice and policy. When research findings align with theoretical expectations, it strengthens the understanding of the underlying mechanisms and reinforces the significance of investing in supportive administrative structures within healthcare organizations. The delivery of primary care occurs across varied settings but is most frequently provided in a clinic and, increasingly, by interprofessional teams that may consist of family physicians, registered nurses (RNs), nurse practitioners, pharmacists, and other health professionals [17].

Studies have shown that a healthy nursing work environment is satisfying, empowering, and safe [18]. Such work environments contribute to increasing job satisfaction, performance of nurses, and the quality of patient care [19]. Notably, the quality of care provided to patients is directly linked to the quality of the nurse’s working environment [20]. The importance of prioritizing administrative support as a critical component of healthcare management. By acknowledging and addressing the needs of nursing staff through effective administrative practices, healthcare organizations can foster a positive work environment, improve care quality, and ultimately enhance patient outcomes in primary healthcare settings.

5. Recommendation and Implications for Practice

Based on the results of the study, the following recommendations are suggested to ensure the continuity of the nursing administrative support for nursing leadersand nursing staff:

1. Opening internal and external scholarships for a doctorate degree in nursing sciences to increase efficiency and professionalism in the nursing profession at a high level of education.

2. Holding accredited programs for the rest of the scope of services that provided in primary health care centers such as the vaccination and immunization program, the maternity care program, and the urgent care program.

3. Giving nursing staff the option for overtime hours compensation between financial and leave compensatory.

6. Conclusion

The study's findings highlight the pivotal role of nursing administrative support in primary healthcare settings, revealing a positive association between administrative support, nursing work quality, and patient outcomes. These results underscore the importance of healthcare organizations investing in administrative structures that facilitate high-quality nursing care. By allocating resources and implementing policies that prioritize administrative support, organizations can create a positive work environment for nursing staff, leading to increased job satisfaction, reduced burnout, and improved morale among healthcare professionals. Moreover, supportive administrative practices empower nurses to deliver care more efficiently and effectively, thereby enhancing overall care quality. Importantly, the benefits of such administrative support extend beyond the workforce to positively impact patient outcomes, including improved satisfaction, better clinical outcomes, and increased safety during healthcare encounters. These conclusions have significant implications for healthcare policy, urging policymakers to consider the importance of administrative support in healthcare delivery and to support initiatives that prioritize such support within healthcare organizations.

Ethical Considerations

Participation was voluntarily. Take informed consent before taking responds. Privacy and confidentiality of data was protected. Approval of the Institutional Review Board was taken prior to conducting the study.

References

[1]   | Labrague, L. J., & de Los Santos, J. A. A. (2021). Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic. Applied nursing research, 61, 151476.
[2]   | Sherwood, G., & Barnsteiner, J. (Eds.). (2021). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.
[3]   | Al-Hamdan, Z., & Bani Issa, H. (2022). The role of organizational support and self‐efficacy on work engagement among registered nurses in Jordan: A descriptive study. Journal of Nursing Management, 30(7), 2154-2164.
[4]   | Lavoie‐Tremblay, M., Gélinas, C., Aubé, T., Tchouaket, E., Tremblay, D., Gagnon, M. P., & Côté, J. (2022). Influence of caring for COVID‐19 patients on nurse's turnover, work satisfaction and quality of care. Journal of nursing management, 30(1), 33-43.
[5]   | Kakemam, E., Chegini, Z., Rouhi, A., Ahmadi, F., & Majidi, S. (2021). Burnout and its relationship to self‐reported quality of patient care and adverse events during COVID‐19: A cross‐sectional online survey among nurses. Journal of nursing management, 29(7), 1974-1982.
[6]   | Brown, J., Pope, N., Bosco, A. M., Mason, J., & Morgan, A. (2020). Issues affecting nurses' capability to use digital technology at work: an integrative review. Journal of clinical nursing, 29(15-16), 2801-2819.
[7]   | Fernandez, R., Lord, H., Halcomb, E., Moxham, L., Middleton, R., Alananzeh, I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International journal of nursing studies, 111, 103637.
[8]   | Mo, Y., Deng, L., Zhang, L., Lang, Q., Liao, C., Wang, N., ... & Huang, H. (2020). Work stress among Chinese nurses to support Wuhan in fighting against COVID‐19 epidemic. Journal of nursing management, 28(5), 1002-1009.
[9]   | Lyman, B., Gunn, M. M., & Mendon, C. R. (2020). New graduate registered nurses’ experiences with psychological safety. Journal of nursing management, 28(4), 831-839.
[10]   | Baskin, R. G., & Bartlett, R. (2021). Healthcare worker resilience during the COVID‐19 pandemic: An integrative review. Journal of nursing management, 29(8), 2329-2342.
[11]   | Zaghini, F., Fiorini, J., Piredda, M., Fida, R., & Sili, A. (2020). The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross sectional survey. International journal of nursing studies, 101, 103446.
[12]   | Parr, J. M., Teo, S., & Koziol‐McLain, J. (2021). A quest for quality care: Exploration of a model of leadership relationships, work engagement, and patient outcomes. Journal of Advanced Nursing, 77(1), 207-220.
[13]   | Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2021). Fundamentals of nursing-e-book. Elsevier health sciences.
[14]   | Lake, E. T. (2002). Development of the practice environment scale of the nursing work index. Research in nursing & health, 25(3), 176-188.
[15]   | Montgomery, A. P., Campbell, C. M., Azuero, A., Swiger, P. A., & Patrician, P. A. (2023). Using item response theory to develop a shortened practice environment scale of the nursing work index. Research in Nursing & Health.
[16]   | Skela-Savič, B., Sermeus, W., Dello, S., Squires, A., Bahun, M., & Lobe, B. (2023). How nurses’ job characteristics affect their self-assessed work environment in hospitals—Slovenian use of the practice environment scale of the nursing work index. BMC nursing, 22(1), 100.
[17]   | National Academies of Sciences, Engineering, and Medicine. (2021), Implementing high-quality primary care: rebuilding the foundation of health care. The National Academies Press. https://www.nap.edu/read/25983.

[18]  
Wei, H., Oehlert, J. K., Hofler, L., & Hill, K. N. (2020). Connecting patients' perceptions of nurses' daily care actions, organizational human caring culture, and overall hospital rating in hospital consumer assessment of healthcare providers and systems surveys. JONA: The Journal of Nursing Administration, 50(9), 474-480.

[19]   | Moisoglou I., Yfantis A., Galanis P., Pispirigou A., Chatzimargaritis E., Theoxari A., Prezerakos P. (2020). Nurses work environment and patients’ quality of care. International Journal of Caring Sciences, 13(1), 108–116.
[20]   | Al-Dossary R. N. (2022). The effects of nursing work environment on patient safety in Saudi Arabian hospitals. Frontiers in Medicine, 9, 872091.