ICU nurses need evidence-based guidance for vasoactive medication titration.ICU nurses need evidence-based guidance for vasoactive medication titration.
Emphasizing long-term health and wellness and helping patients achieve goals.Emphasizing long-term health and wellness and helping patients achieve goals.
It is not uncommon for researchers to try to use the same dataset to conduct more than one inferential statistical analysis. For example, sometimes researchers want to conduct hypothesis testing with outcomes that are di...It is not uncommon for researchers to try to use the same dataset to conduct more than one inferential statistical analysis. For example, sometimes researchers want to conduct hypothesis testing with outcomes that are different from the originally planned main effect, or with a similar outcome but across different subgroups, using the same significance level for all tests. A significant finding could just be a product of an increased rate of spurious statistical significance or false-positive rate. This article introduces the topic of multiplicity, including definitions, examples, and implications for research studies, and offers potential solutions. It is intended primarily for nursing researchers and other health care professionals, students, and people conducting research based on statistical hypothesis analysis. It can also be used as an introductory guide for nurses who would like a basic understanding of multiplicity issues in studies based on inferential statistical analysis.
BACKGROUND: Work-related stress significantly impacts nurses' well-being and professional performance. Coping strategies and social support play a role in managing stress. Extensive research on nurses' stress exists, but...BACKGROUND: Work-related stress significantly impacts nurses' well-being and professional performance. Coping strategies and social support play a role in managing stress. Extensive research on nurses' stress exists, but an understanding of the relationships among variables such as sleep quality and mental health, among others, is limited. PURPOSE: This study aimed to examine the relationships among stress, sleep quality, and mental health (anxiety and depressive symptoms) in nurses in a hospital in southern Taiwan and to analyze how coping strategies and social support mediate these relationships. METHODS: Convenience sampling was used to collect data on demographics, stress, sleep quality, mental health, coping strategies, and social support in 202 nurses who were at least 20 years of age and had at least three months of nursing experience. Using structural equation modeling, we explored the potential mediating impact of coping strategies and social support on the relationship between stress and mental health. RESULTS: Among the study participants, 85.6% reported sleep issues, 60.9% depression, and 31.2% anxiety. Our model confirmed that work stress significantly impacts sleep quality, anxiety, and depression. Coping strategies mediated stress-related anxiety and depressive symptoms; social support also mediated stress-related anxiety but not depressive symptoms. CONCLUSIONS: This study highlights strong associations between stress, sleep quality, anxiety, and depressive symptoms, with coping strategies and social support as potential mediators. Nursing managers should integrate coping strategies and psychosocial support in workplace interventions to enhance the mental health and job performance of nurses in challenging settings, ultimately benefiting retention and patient care.
BACKGROUND: Postvoid residual (PVR) urine is common in older patients. It is often managed with intermittent catheterization because of its assumed association with the risk of urinary tract infection (UTI). This associa...BACKGROUND: Postvoid residual (PVR) urine is common in older patients. It is often managed with intermittent catheterization because of its assumed association with the risk of urinary tract infection (UTI). This association is uncertain, however, whereas the association between intermittent catheterization and increased risk of UTI is clear. Evidence further suggests that the threshold for intermittent catheterization in patients awaiting spontaneous urination after surgery can be raised without increasing the risk of UTI or voiding difficulties. PURPOSE: The purpose of this quality improvement project was to reduce the number of bladder scans and intermittent catheterizations in patients on a geriatric unit who had PVR urine and/or were awaiting spontaneous urination without an increase in hospital-acquired UTIs (HAUTIs). METHODS: The project took place on two geriatric units at Aarhus University Hospital in Aarhus, Central Denmark Region, Denmark. The Model for Improvement was used as the project framework. A workflow analysis was performed by two nurses from the units, who mapped the processes in place regarding patients' PVR urine from admission to discharge. A driver diagram was then created to map out the initiatives that would guide our process. Three cycles of the Plan-Do-Study-Act model were performed to develop a guideline on intermittent catheterization in cases of PVR urine. The data collection period was October 16, 2023, through June 30, 2024. The guideline was introduced in the third week of January 2024. Data on the number of bladder scans, intermittent catheterizations, and HAUTIs were obtained from external databases and analyzed weekly using run charts to evaluate whether changes occurred. The incidence rates (IRs) of HAUTIs in the project period were then compared with rates during the same period in the previous three years (2021, 2022, and 2023) to double-check that the IRs of HAUTIs did not increase when reducing intermittent catheterizations. RESULTS: According to the run charts, the median number of bladder scans per week decreased from 146 to 99 (a reduction of 32.2%), and the median number of intermittent catheterizations per week dipped from 41 to 26.5 (a reduction of 35.4%), whereas the number of HAUTIs showed only random variation. The IRs of HAUTIs were similar to those in the previous three years. CONCLUSION: These results suggest that use of a guideline on intermittent catheterization in patients with PVR urine may reduce the number of bladder scans and intermittent catheterizations without an increase in the incidence of HAUTIs.
This is the eighth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Pract...This is the eighth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey. To access previous articles in this EBDM series, go to https://links.lww.com/AJN/A256.
The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the fifth in a series on applying IS, describes how a nurse-led team at a multisite...The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the fifth in a series on applying IS, describes how a nurse-led team at a multisite health system used IS concepts, methods, and tools to implement a standardized nursing bundle on three adult inpatient units that aimed to reduce the incidence of nonventilator hospital-acquired pneumonia.