Purpose: This study aimed to examine the effect of nurse clinical educators’ coaching leadership on the nursing performance of novice and advanced beginner nurses, and to verify the mediating role of grit in this relationship. Methods: A descriptive cross-sectional survey was conducted among 142 nurses with less than 36 months of clinical experience at three general hospitals in D city, South Korea. Data were collected from June 20 to July 5, 2025, using self-reported online questionnaires measuring coaching leadership, grit, and nursing performance. Statistical analyses included descriptive statistics, correlation analysis, and a mediation analysis using PROCESS macro Model 4. Results: Coaching leadership was positively associated with both grit and nursing performance. Grit was also positively correlated (r=.71, p<.001) with nursing performance and was found to partially mediate (β=.30, 95% CI=0.20, 0.41) the relationship between coaching leadership and nursing performance. The findings indicate that coaching leadership not only directly enhances nursing performance but also indirectly improves it by increasing the nurses’ grit. Conclusion Nurse clinical educators’ coaching leadership directly and indirectly enhanced the nursing performance of novice and advanced beginner nurses through the mediation of grit. Strengthening the coaching leadership competencies of nurse clinical educators and implementing educational programs that foster grit among early-career nurses may optimize nursing performance.

Purpose: This study aimed to identify the effects of knowledge about the elderly and ethical awareness on elderly care attitudes among nursing assistants working in comprehensive nursing care service wards. Methods: A descriptive cross-sectional survey design was used with 121 nursing assistants working in comprehensive nursing care service wards. recruited through an online nursing assistant community and direct visits to hospitals operating such wards. Data were collected from March 30 to May 2, 2025 using a self-administered online questionnaire including the knowledge about the elderly, ethical awareness and elderly care attitudes scales.Data were analyzed using descriptive statistics, t-tests, analysis of variance (ANOVA), Pearson's correlation coefficients, and hierarchical regression analysis. Results: The mean scores were 9.60±1.55 points for knowledge about the elderly, 3.85±0.45 points for ethical awareness, and 4.63±0.38 points for elderly care attitudes. Knowledge about the elderly and ethical awareness showed positive correlations with elderly care attitudes (r=.26, p=.004; r=.70, p<.001, respectively). In hierarchical regression analysis, ethical awareness (β=.66, p<.001) was significantly associated with elderly care attitudes, explaining 50.0% of the variance, while knowledge about the elderly did not show a significant association (β=.06, p=.416). Conclusion The findings indicate that ethical awareness is a significant predictor of elderly care attitudes among nursing assistants. Systematic ethical education programs and structured mentoring for novice nursing assistants are essential for improving the quality of elderly care in comprehensive nursing care service wards.

Purpose: This study examined the association between nursing organizational culture and near-miss reporting intention and explored the relationships among these variables, focusing on the mediating effect of ethical nursing competence and the moderated mediating effect of psychological safety. Methods: This cross-sectional descriptive correlational study included 216 nurses working at three general hospitals with more than 200 beds in B metropolitan city. Data were collected from January 17 to February 20, 2025. The data were analyzed using IBM SPSS/WIN Statistics 29.0 and Hayes’ PROCESS macro (Models 4 and 7). Indirect effects were estimated using bootstrapping with 5,000 resamples and 95% confidence intervals. Results: Clan culture and market culture showed direct associations with near-miss reporting intention, whereas adhocracy culture and hierarchy culture were indirectly associated with near-miss reporting intention through ethical nursing competence. Moderated mediation by psychological safety was identified in the pathways of clan culture and adhocracy culture. In the clan culture pathway, conditional indirect effects were not significant but were significant within a specific range. In contrast, in the adhocracy culture pathway, conditional indirect effects were significant, and the magnitude of the indirect effect increased as psychological safety increased. Conclusion Structural relationships between near-miss reporting intention and nursing organizational culture, ethical nursing competence, and psychological safety were identified. The findings may serve as baseline data for understanding relationships among variables related to near-miss reporting intention.

This study was conducted to identify educational needs for infection prevention and control (IPC) among staff in long-term care hospitals and to determine education priorities using the Borich model, importance-performance analysis (IPA), and the Locus for Focus (LFF) model. Methods: A descriptive crosssectional survey was conducted with 162 staff members from two long-term care hospitals in Gyeongsangbuk-do, Republic of Korea (January 5 to 16, 2026). A 32-item instrument across eight IPC domains was developed and refined based on the fourth cycle long-term care hospital accreditation standards and the national healthcareassociated infection surveillance manual. Participants rated the importance and perceived performance of each item. Data were analyzed using descriptive statistics, paired t-tests, Borich need scores, IPA, and LFF, with crosshairs based on the overall mean values. Results: Across all eight IPC domains, importance scores exceeded performance scores in both healthcare professionals and allied health personnel. At the domain level, priorities varied by occupation: overall, standard precautions and transmission-based precautions were the highest priorities. Among healthcare professionals, transmission-based precautions ranked first, followed by standard precautions, whereas among allied health personnel, standard precautions and multidrug-resistant organisms (MDRO) and antibiotic stewardship were identified as top priorities. Conclusion: IPC education in long-term care hospitals should be delivered as an integrated, role- and competency-based training system that standardizes facility-wide core practices-particularly standard precautions and transmission-based precautions-while providing job-specific advanced modules aligned with occupational scope and work processes, and should be supported by organizational measures such as monitoring, feedback, and ensuring access to IPC resources.

This study aimed to identify factors associated with medication near-misses among nurses. Methods:This cross-sectional study included 146 nurses with at least 3 months of clinical experience at a tertiary hospital or general hospital in B metropolitan city. Data were collected from June 17 to July 5, 2024, using self-reported questionnaires assessing medication safety competence, organizational communication satisfaction, safety climate, and medication near-miss frequency within the past 3 months. IBM SPSS/WIN 29.0 program was used for analysis; negative binomial regression was applied to address overdispersion in medication near-miss frequency. Results: Within the past 3 months, 72.6% of the participants reported at least one medication near-miss. Higher medication safety competence (Incidence Rate Ratio, IRR=0.98, 95% Confidence Interval, CI=0.96~0.99), higher safety climate (IRR=0.98, 95% CI=0.96~0.99), and longer total clinical experience (IRR=0.93, 95% CI=0.89~0.98) were significantly associated with lower medication near-miss frequency.Medication near-miss frequency varied significantly by work unit, highest among nurses in medical wards.However, organizational communication satisfaction showed no significant association with medication near-miss frequency. Conclusion: Medication near-misses were found to be highly prevalent among nurses in clinical settings. To reduce medication near-misses, it is essential to enhance medication safety competence and safety climate and to implement organizational strategies tailored to nurses’ experience level and work unit.

Purpose: This study aims to identify the impact of nurses' ethical dilemmas and ethical sensitivity on psychological empowerment. Methods: A descriptive correlational study was conducted with 126 registered nurses working in general wards of a tertiary hospital in Seoul who had at least one year of clinical experience.Data were collected using a structured online questionnaire from July 30 to August 10, 2025. The data were analyzed using IBM SPSS/WIN 27.0, including descriptive statistics, independent t-tests, one-way analysis of variance (ANOVA), Pearson’s correlation coefficients, and multiple linear regression analysis. Results: Factors influencing nurses’ psychological empowerment were ethical sensitivity (β=.36, p<.001) and day duty work schedule (three-shift rotation as the reference group) (β=.18, p=.041). The regression model explained 17.0% of the variance in nurses‘ psychological empowerment. Conclusion To enhance psychological empowerment among hospital nurses, healthcare institutions should implement ethics education programs that promote nurses’ ethical sensitivity. In addition, organizational strategies are needed to strengthen psychological empowerment among nurses working in shift-based schedules.

Purpose: This study aimed to examine the effects of nurses' job esteem and positive psychological capital on their intention to stay and to investigate the mediating effect of organizational commitment in these relationships. Methods: A cross-sectional survey was conducted among 107 nurses employed at two general hospitals in Daejeon and Sejong, South Korea, between March and June 2023. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson's correlation coefficients, hierarchical multiple regression, and PROCESS macro (Model 4) with bootstrapping. Results: Nurses' intention to stay was positively correlated with job esteem (r=.52, p<.001), positive psychological capital (r=.47, p<.001), and organizational commitment (r=.60, p<.001). After controlling for gender and total clinical experience, job esteem, positive psychological capital, and organizational commitment explained 48.0% of the adjusted variance in intention to stay (adjusted R2 =.48), with organizational commitment being the strongest predictor. Mediation analysis showed that job esteem had a significant indirect effect on intention to stay through organizational commitment, while its direct effect was not significant, indicating full mediation. In contrast, positive psychological capital did not show a significant indirect effect through organizational commitment but had a significant direct effect on intention to stay. Conclusion These findings suggest that job esteem influences intention to stay primarily through organizational commitment, whereas positive psychological capital exerts a direct effect. Therefore, nurse retention strategies should prioritize organizational interventions that strengthen organizational commitment, along with efforts to enhance job esteem.

Purpose: This study aimed to develop and implement an antimicrobial stewardship education program for physician assistant nurses and to evaluate its effects on their knowledge and clinical performance. Methods: A quasi-experimental, single-group pre-post design was conducted with 50 physician assistant nurses at a university hospital in Seoul, Republic of Korea. The antimicrobial stewardship education program, developed using the ADDIE model, consisted of 12 sessions including lectures and case-based learning (CBL)-based discussions.Knowledge was measured before and immediately after the intervention, while performance was assessed pre-intervention and four weeks post-program. Data were analyzed using paired t-tests, Wilcoxon signed-rank tests, and analysis of covariance (ANCOVA). Results: Knowledge scores significantly improved from 44.65±7.45 to 58.50±10.11 (p<.001), and all subdomains showed significant increases (p<.001). Performance scores increased from 3.68±0.77 to 4.28±0.68 (p<.001). Knowledge gain did not differ significantly between the medical and surgical departments (p=.710). Likewise, after adjusting for pre-test scores, no significant difference in performance improvement was observed between the two departments (ANCOVA, p=.170). These results indicate that the program was effective across both departments regardless of their characteristics. Conclusion The antimicrobial stewardship education program improved both knowledge and performance among physician assistant nurses. This program may contribute to the standardization of antimicrobial stewardship education and to appropriate antimicrobial use and the reduction of antimicrobial resistance.

Purpose: This study aimed to develop a digital multimedia-based educational intervention for hematopoietic stem cell (HSC) donors and to evaluate its effects on anxiety, knowledge, attitudes toward hematopoietic stem cell donation, and educational satisfaction. Methods: This quasi-experimental study employed a nonequivalent control group non-synchronized pretest-posttest design. Participants were 60 HSC donors admitted to a general hospital in Seoul, Republic of Korea, between April and December 2024. The participants were assigned to an experimental group (n=30) and a control group (n=30). The experimental group received a digital multimediabased educational intervention in addition to the usual education using a standardized handout, whereas the control group received the usual education only. The intervention was provided in three sessions: on the day of admission (20 minutes), on the day of stem cell collection (10 minutes), and on the day of discharge (10 minutes). Data were collected at admission and discharge using structured questionnaires. Anxiety was analyzed using generalized estimating equations (GEE), knowledge and attitudes using mixed ANOVA, and educational satisfaction using an independent t-test. Results: The experimental group showed significantly lower anxiety (p=.048) and higher knowledge levels (p=.005) than the control group. No significant differences were found between the groups in attitudes toward donation or educational satisfaction. Conclusion The digital multimedia-based educational intervention was effective in reducing anxiety and improving knowledge among HSC donors. This intervention may enhance donors’ understanding of the donation process and support a more positive donation experience. Further multicenter studies with larger samples and longitudinal follow-up measurements are needed to verify the long-term effects and generalizability of the intervention.

Purpose: This study aimed to compare work-life balance, turnover intention, and teamwork between nurses in wards participating in a shift work improvement pilot program and those in non-participating wards. Methods: In this comparative descriptive study, 201 nurses working at D University hospital located in B city, including 71 participants in the pilot program and 130 non-participants. Data were collected from August 1 to August 31, 2025, using a structured questionnaire. The collected data were analyzed using IBM SPSS Statistics 29.0 including descriptive statistics, t-tests, χ2 tests, and one-way ANOVA. Results: The results of this study indicated that participation in the shift improvement pilot program significantly enhanced nurses' work-life balance (t=2.03, p=.044), particularly in the work-leisure (t=2.42, p=.016) and work-growth (t=2.00, p=.047), whereas no significant differences were found in turnover intention or teamwork between the groups. Regarding individual characteristics, work-life balance was significantly higher among unmarried and male nurses (t=2.23, p=.029). Turnover intention was notably higher among those with a bachelor’s degree or lower (t=2.56, p=.012) and those with 3 to 5 years of experience in their current department (F=4.63, p=.012). Teamwork was reported at higher levels by nurses with less than 3 years of experience (F=3.45, p=.035). Conclusion Participation in the shift work improvement pilot program was associated with higher work-life balance, particularly in relation to leisure and professional growth. However, participation was not associated with differences in turnover intention or teamwork, suggesting that these outcomes may be influenced by factors beyond shift work arrangements.