Background: Nurse managers face great challenges in responding to organizational demands. There exists a general mismatch between managerial span of control and the demands of the job post, which can lead to overburdening and attrition. The aim of this review was to identify the effects of the nurse manager span of control on hospital organizations. Methods: An integrative literature review was carried out on nurse manager span of control using the Medline, Embase and Web of Science databases. Results: 21 articles were included. Our findings indicate that the span of control of nursing managers influences outcomes in inpatients, professionals, nurse managers, and the organization. Conclusions: The span of control of each nurse manager must be assessed and adjusted to each case. An appropriate span of control will lead to improved outcomes for stakeholders and the organization as a whole. Implications for nursing management: Tools must be developed and implemented to measure and evaluate the span of control of nurse managers. This study was not registered.

The objective has been to develop and validate a questionnaire to know patient experience in relation to nursing care during their hospital stay in the Spanish healthcare setting. To know patient experience will improve the quality of care of the healthcare system; therefore, we must count on validated tools so it can be evaluated in an accurate way. Method: a questionnaire containing 29 items alongside socio-demographic questions was developed. It was distributed to 158 patients admitted to a tertiary hospital. The psychometric properties were assessed through principal components analysis and confirmatory factor analysis to evaluate construct validity, employing Cronbach’s alpha to test reliability. Results: The final tool contains 17 items grouped into 5 dimensions: interrelations, nursing care, information during hospital stay, information about patient’s rights, and discharge information. Two additional questions related to pain were added. The questionnaire showed adequate validity and reliability. Conclusions: we describe a new tool validated and adapted to the Spanish healthcare setting with adequate validity and reliability to assess patient experience with nursing professionals during hospital stay. This tool will serve to identify areas for improvement in hospital nursing care and as an instrument in the management and supervision of nursing teams.

Aims: The main goal of this research is to identify, through expert consensus, the key factors that determine the span of control (SOC) of first‐line nurse managers (FLNMs) in the Spanish healthcare system.Background: The SOC is a management concept which has usually been defined as the number of subordinates reporting to a superior. In nursing, however, it is much more complex. This complexity is shaped by various factors related to patients, healthcare professionals and organisational structures. Nursing leaders must thoroughly consider these factors and their determinants, which necessitate a comprehensive assessment. Given the significant impact an inadequate SOC can have on patients, professionals and the organisation, it would be beneficial to address this issue. In nursing, studies on this subject are practically nonexistent and focus solely on the number of subordinates, highlighting the need for research in this area.Methods: Between September and December 2022, a Delphi study was conducted. Forty‐five experts were invited to participate. The study involved nurse administrators, FLNMs, university professors, renowned researchers and other non–health professionals related to health management. The participants completed an online survey over three phases. Factor analysis was performed on the items for which consensus was reached. The jamovi software version 2.3.15 was used for data analysis.Results: A total of 35 experts participated in at least one of the three phases of the Delphi study. Following a comprehensive analysis of the identified factors, a consensus was reached on 31 of them. These were subsequently grouped into four categories: unit category (16 items, including complexity, resource management, conflicts and protocolisation and monitoring of activities), professional category (five items: number of staff, staffing stability and skill level and diversity of staff), FLNM category (four items: autonomy, experience and education and leadership style) and organisation category (six items: digitisation and information systems, education, research and implementation evidence‐based practice and performing guards).Conclusions: Our research shows a high degree of consensus amongst participants in identifying the determinants and degree of relevance of SOC‐related aspects. Although SOC is not currently assessed, all stakeholders agree that there are a large number of variables that should be considered when appointing a FLNM.Implications for Nurse Managers: Nursing managers can better assess the health of the organisation and improve performance by understanding the factors that influence the SOC of FLNMs. Due to the lack of previous studies, understanding these factors will allow the development of methods and tools tailored to the characteristics of different health systems.

Background: First-Line Nurse Managers (FLNMs) have been recognised as key contributors to achieving organisational objectives, serving as vital intermediaries between management, staff, and patients. Assessing whether the Span of Control (SOC) is appropriate and providing the necessary support for FLNMs to fulfil their responsibilities poses a considerable challenge for healthcare organisations. No tool exists in Spain to guide decisions regarding FLNM’s SOC and resource needs. The aim of this study is to design a tool for assessing the span of control of first-line nurse managers in hospitals. Methods: This study employed a tool development and content validation design to create the EASOC-Nursing instrument (Eliges Aragón SOC tool). The study was conducted in three stages: an integrative literature review, followed by a national Delphi study with 43 experts in nursing management, and finally, focus group discussions. Results: A tool was created to assess first-line nurse managers’ (FLNM) span of control (SOC) using 13 key indicators, organised into four categories: unit (operations and resources, conflicts, and logging and monitoring of activities), professional (staff and competencies), FLNM (autonomy, education, and leadership), and organisation (support systems, education, and research). It includes a total of 31 items and determines SOC adequacy by establishing cut-off points that classify it as below acceptable, appropriate, or excessive. When the SOC is inadequate, the tool provides specific recommendations for support measures, such as the provision of administrative personnel or the appointment of a co-leader. Conclusions: The EASOC-Nursing tool offers a comprehensive evaluation of the core dimensions of the FLNM role and its responsibilities in Spain. Furthermore, it delivers practical guidance on the most suitable types of support to facilitate the attainment of optimal outcomes for both patients and healthcare organisations. In light of the global nursing shortage, the availability of a robust and context-sensitive instrument to assess the SOC enables hospital nursing management to allocate resources more strategically, thereby enhancing working conditions for professionals and contributing to improved patient care outcomes.

Background: Patient experience has become a key component of healthcare quality assessment and improvement. Although its importance is increasingly recognized, there is a lack of standardized instruments specifically designed to assess patient experience in relation to nursing care during hospitalization. The starting point for this study is the ELIGES-Patient Experience questionnaire developed in 2024. This study aims to refine its content by incorporating the patient perspective and to evaluate its psychometric properties through a multicenter study. The final questionnaire will be intended to assess patient experience in relation to nursing care in inpatient units, providing a reliable tool for identifying opportunities for improvement and supporting person-centered care. Methods: A three-phase multicenter mixed-methods study will be conducted. First, a focus groups with expert patients will identify the key dimensions of patient experience related to nursing care during hospitalization. The initial questionnaire will then be reviewed and revised, yielding a first provisional version. Second, a national Delphi study involving expert patients will establish consensus on the questionnaire content, thereby yielding a consensus-based provisional version of the original instrument. Third, this provisional version of the questionnaire will undergo multicenter psychometric validation in six Spanish public hospitals. A pilot study will assess temporal stability and agreement, followed by administration of the provisional version to 2271 hospitalized patients to evaluate its psychometric properties. Expected Results: Following content refinement and psychometric validation, the resulting instrument is expected to provide a standardized measure of hospitalized patients’ experience of nursing care that may help identify areas for future evaluation and quality-improvement initiatives. Conclusions: Patient experience measurement lacks standardization, which hinders comparability and limits its use as a quality improvement tool. This highlights the need for instruments that are conceptually sound, methodologically robust, and operationally applicable. A distinctive feature of this protocol is the active involvement of patients throughout the entire process, in keeping with the principles of person-centered care and helping to strengthen the relationship between healthcare professionals and patients.