Effective Communication of System-Level Events for Hospital System Health and Nurse Well-Being: A Qualitative Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

In this paper, authors analyzed the perceptions of Magnet® and nonMagnet® nurses and nursing leaders about system-level factors affecting hospital system health and patient safety, as well as how these factors are communicated.

Although it is difficult to generalize the research results with a very small number of participants in this study, it provided good insights into the environment and perceptions of nurses about the US hospital system after the corona pandemic.

-To improve the completeness of this paper, please revise the following.

-In Chapter 1, describe a more accurate definition of the 'system-level' factor.

-Describe in more detail the difference between Magnet-designated Hospital and Non-Magnet Hospital in Chapter 1. 

-Is there a source of 'definition' in Table 2 or is it the author's idea? Some definitions (e.g., hierarchy, processes, etc.) are very abstract.

-The limitations of this study described in Chapter 4 are inherent, so it is recommended to delete them.

-Isn't the implication of this study described in lines 294 to 297 too obvious? Describe it more specifically if possible.

-Most of what is described in the conclusion of Chapter 6 should be described in Chapter 5, and Chapter 6 should be described more simply.

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses attached and the corresponding revisions/corrections highlighted in the re-submitted files.

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The article is interesting and important from the point of view of nursing safety.

It is necessary to develop patient care even safer than it currently is. In this study, treatment units with magnet or non-magnet status were examined. Although the setting is important, it is somehow incomplete because there were only a few participants from both statuses examined.

Fortunately, the purpose of the study has been left very open, because such small data does not justify drawing conclusions about the differences between the two types of staff of magnet and non-magnet hospitals. The study question was coherent and clear, but still, as a reader, I cannot fully understand where this described result can be used for and how to utilize it.

Two types of technical aids have been used in the analysis of the research, which seem to work well in classifying qualitative data. Still, one gets the impression that the analysis process has remained unfinished, because the results are not summarized and clear upper and main categories are not presented. Sandelowski and Kyngäs, who are respected condensers of qualitative research and presenters of results, have been used as method sources. It would have needed to go a little further in this study analysis as well, so that the reader could have been presented with a summary of the categories/factors that weaken and increase the safety of magnet hospitals and non-magnet hospitals.

I suggest that the analysis is continued and a concise presentation of the results and a figure of the condensed results. Now a description of long and abstract phenomena or lists of words e.g. in lines 216-219 and 237-240 that are not qualitatively connected. Without a summary, the results are left very very open. 

 

 

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses attached and the corresponding revisions/corrections highlighted in the re-submitted files.

 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Many thanks for the opportunity to revise this article. The article is consistent with the Journal aim, is original and methodologically sound. Numerosity limitations are disclosed and properly weighed by thematic saturation. 

Title: probably could be better to relate with nurse/nuerse leader profiles

line 226 reference typo to be revised

Conclusions are properly focused on study questions. However, it could be useful for readers to provide a comprehensive and critical summary of the study. This could also make the comparison with other Countries with specific nurses’ and overall healthcare professionals’ organisations easier.

references 50-51 very outdated. Please revise.

Author Response

Thank you very much for taking the time to review this manuscript. Please find the detailed responses attached and the corresponding revisions/corrections highlighted in the re-submitted files.

 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The revised paper was prepared by reflecting all the opinions of the reviewer.

Reviewer 2 Report

Comments and Suggestions for Authors

Ok Now. Congratulations

   

 

 

Reviewer 3 Report

Comments and Suggestions for Authors

Many thanks!