In the nursing profession, it is concerning to witness frequent occurrences of incivility in the workplace. Therefore, it is imperative to foster a shift in interpersonal interactions. One effective strategy to cultivate...In the nursing profession, it is concerning to witness frequent occurrences of incivility in the workplace. Therefore, it is imperative to foster a shift in interpersonal interactions. One effective strategy to cultivate a culture of civility is through the practice of Kindness. This review explored the role of kindness in nursing beyond bedside care, incorporating insights from psychology and social sciences to define and apply kindness in practice. The goal was to identify ways for nurses to use kindness to reduce workplace incivility and promote a thriving environment. The authors conducted an integrative review to synthesize data from various sources, including experimental and non-experimental studies, to enhance understanding and offer diverse perspectives on the subject. The authors systematically searched CINAHL, PubMed, Embase, and APA Psych Info for peer-reviewed papers on "kindness" and "nursing" published between 2012 and 2024, excluding opinion articles, letters, reviews, commentaries, and papers focused on kindness in the context of therapeutic care. The authors followed Whittmore and Kafl's (2005) structured date extraction protocol steps and performed comparative analysis of extracted data tables to verify content uniformity. Seven articles met inclusion criteria, and several key themes were identified: (1) Definition of kindness, (2) Examples of kindness in Action, illustrating how these behaviors manifest in everyday interactions, (3) Interpretation of kindness from multiple perspectives. Acts of intentional kindness are potent tools that can mitigate workplace incivility and cultivate a culture of kindness among nurses and, by extension, positively impact the broader society. Further research is essential to establish a unified definition of kindness in nursing, identify its antecedents and attributes, and conduct empirical studies to substantiate these concepts.
: The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses expe...: The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses experience their work as more fulfilling, they are more inclined to remain within a role for an extended period. One of the ways to determine the lived experience of nurses is to measure their Professional Quality of Life. This is the first study to look at the Professional Quality of Life of Flight Nurses who work in public sector Aeromedical Retrieval Services in New Zealand.: The aim of this study was to determine the Professional Quality of Life of Flight Nurses working in the public sector in New Zealand.: A survey based cross-sectional design was employed, using the Professional Quality of Life (ProQOL) V Health survey tool.: Online survey data was collected from a convenience sample of 169 Flight Nurses working in public sector Aeromedical Retrieval services in New Zealand.: Of the 88 respondents, all reported either high or average levels of Compassion Satisfaction (High 48.86%, Average 51.13%) and Perceived support (High 44.31%, Average 55.68%). The majority reported Low to Average scores for Secondary Traumatic Stress (Low 30.68%, Average 67.04% and High 2.27%), Burnout (Low 4.54%, Average 89.77% and High 5.68%) and Moral Distress (Low 23.86% and Average 76.13%).: This study highlights that Flight Nurses in New Zealand's public sector generally experience a positive Professional Quality of Life, but that there are also instances of Burnout and Secondary Traumatic stress.
Cognitive impairment and cardiovascular disease often coexist, and nurses are ideally positioned to detect and manage cognitive impairment in cardiac patients. This study explored nurses' perspectives on understanding, d...Cognitive impairment and cardiovascular disease often coexist, and nurses are ideally positioned to detect and manage cognitive impairment in cardiac patients. This study explored nurses' perspectives on understanding, detecting, and acting on cognitive impairment in cardiac patients. Using an exploratory descriptive design, nurses from acute and outpatient cardiac units were interviewed. Data were thematically analyzed. Sixteen nurses were interviewed, working in acute cardiology (n=7), cardiothoracic and intensive care (n=4), and cardiac rehabilitation (n=5). Three themes emerged: (1) Cognitive screening was not routine, with no clear protocols on who, when, and how to screen; (2) Nurses had varying understanding of cognitive impairment, dementia, and delirium; (3) Nurses acted on suspected cognitive changes to ensure patient safety, including referrals and care modifications. Cognitive screening was inconsistent, with barriers, such as workload and lack of education. Guidelines for feasible screening across settings are needed.
BACKGROUND: Childhood is a time when health behaviours are established and the foundations for health literacy are cemented. In Aotearoa New Zealand nurses are responsible for communicating health messages to children at...BACKGROUND: Childhood is a time when health behaviours are established and the foundations for health literacy are cemented. In Aotearoa New Zealand nurses are responsible for communicating health messages to children at key stages in children's lives. OBJECTIVES/AIMS: This review explores the ways in which nurses communicate health messages to children and adolescents in Aotearoa New Zealand. It evaluates whether current approaches to health communication are in-line with a child's rights-based approach. DESIGN: An integrative review using a systematic literature search strategy. DATA SOURCES: In July 2022, 9 databases were searched including: Medline (Ovid), Embase (Ovid), Scopus (Elsevier), Cochrane Library, EBSCO (host), Web of Science Core Collection, CINHIAL plus, psychINFO and PsychEXTRA. METHODS: Following title and abstract screening 41 articles went through to full-text screening. These were uploaded into NVivo v.12 for analysis. Results were analysed using content analysis with a deductive coding framework informed by the UN Convention on the Rights of the Child. A total of 20 articles met all inclusion criteria and were assessed of high quality using the Mixed Methods Appraisal Tool. RESULTS: Nurses communicate health messages using a variety of strategies, some of which align with the rights of the child. No evidence was found of nurses communicating health messages through play or creative activities or by adopting principles and practice of continuity of care, including health communication beyond the paediatric context. CONCLUSION: Opportunities exist for improvements to the rights of children and adolescents within nursing practice. Further research about the rights of children in healthcare services including not only identifying the barriers but research that includes interventions and proposes solutions is necessary .
BACKGROUND: Nurses play a key role in the recognition and response to clinical deterioration. AIM: The aim of this scoping review was to explore, map and synthesise existing research related to the ward nurses' role in r...BACKGROUND: Nurses play a key role in the recognition and response to clinical deterioration. AIM: The aim of this scoping review was to explore, map and synthesise existing research related to the ward nurses' role in recognising and responding to clinical deterioration. METHODS: A scoping review was undertaken to identify English only studies focused on the ward nurse's role in recognition and response to clinical deterioration of the hospitalised adult. Search terms included 'clinical deterioration', 'nurses', 'wards', 'general', 'hospital, units' and 'hospitals'. The Cumulative Index to Nursing and Allied Health Literature, EMBASE, Ovid MEDLINE, PubMed, ProQuest and Science Direct databases were searched for eligible studies. RESULTS: Forty-six studies met the inclusion criteria and three major themes were synthesised: (i) recognition of deterioration; (ii) nursing assessment; and, (iii) challenges responding to patient deterioration. CONCLUSION: The review highlighted significant variability in the ward nurses' role, activities, and skills in assessing, monitoring, managing and escalating care for clinical deterioration.
BACKGROUND: A case-management model of care is frequently used in acute-care settings for patients with major traumatic injuries; however, its application to trauma follow-up care after hospital discharge remains unclear...BACKGROUND: A case-management model of care is frequently used in acute-care settings for patients with major traumatic injuries; however, its application to trauma follow-up care after hospital discharge remains unclear. AIM: To describe the services provided by the Trauma Connect Clinic (TCC): a NP- led case management model, in trauma follow-up care. METHODS: An exploratory descriptive study design was used. Data collected included patient and injury characteristics, clinic activities, attendance rates, referral patterns and complications. RESULTS: Three-hundred and twenty-four TCC appointments were scheduled for 194 patients ( = 302) with an attendance rate of 93% ( = 302). Ongoing health issues included pain ( = 22, 37%), thrombotic events ( = 8, 13%) and infection ( = 7, 12%). Clinic activity included 77 referrals to the wider MDT ( = 77), radiology reviews ( = 225) and 39 prescribing events, consisting mainly of analgesia. CONCLUSION: A case management model can successfully deliver trauma follow-up care and efficiently use limited resources. Key elements involve careful assessment and management of patients' physical and emotional needs. Evaluation of longer-term outcomes of this model of care in trauma settings is required.
Liptrott SJ, Saliquni A, Giau L
… +10 more, Pecora R, Cimino C, Lo Piccolo A, Palermo A, Vidovic B, Cheda E, Imhof S, Tolotti A, Guastamacchia I, Cavatorti S
: Bladder ultrasound (BUS) provides an accurate measurement of post-void residual (PVR) volume and bladder assessment. Access to BUS is dependent on practitioner availability with delays resulting in poor symptom managem...: Bladder ultrasound (BUS) provides an accurate measurement of post-void residual (PVR) volume and bladder assessment. Access to BUS is dependent on practitioner availability with delays resulting in poor symptom management, delayed discharge and dissatisfaction. Developing nursing practice to perform BUS can address these patient's needs.: Through a quality improvement initiative the aims were (1) to develop theoretical knowledge and practical competence of nurses to perform BUS, (2) to evaluate nursing activity in relation to BUS, (3) to evaluate stakeholders perceptions of the initiative.: Based on the Deming Plan-Do-Study-Act (PDSA) cycle, an interprofessional team was created and a theoretical/practical based education program was devised. Activity in relation to the nurse-performed BUS was collected and analysed descriptively. Stakeholder perceptions were evaluated via patient and physician questionnaires subject to descriptive analysis and a focus group with nurses analysed descriptively.: The team developed a training program to perform BUS, certifying 11 nurses. Investigation of nursing activity related to BUS ( = 202) showed its use for PVR evaluation, and symptom and catheter assessment. It aided decision-making and nurse-physician communication. Stakeholders were satisfied with the initiative. Patients ( = 30) felt nurses were competent, clearly explaining the procedure, results and inspiring confidence. Physicians ( = 2) saw BUS as enhancing efficiency and care quality, while nurses ( = 7) felt this new skill enhanced nursing care providing a more holistic approach. Team reflection on the results of the evaluation confirmed BUS utility and activity, while nurses requested continuing education and a post-certification refresher course.: Through reflection on clinical practice areas for improvement to enhance patient care were identified by the nursing team. Application of the PDSA cycle provided a structured approach to guide the quality improvement initiative. Improvements in nursing care and patient care processes have been observed and this has been a positive experience for stakeholders.
Transition from education to the workforce has been recognised as difficult and linked to 'reality shock.' Due to the unprecedented circumstances of the COVID-19 pandemic, many student nurses opted in for NHS emergency p...Transition from education to the workforce has been recognised as difficult and linked to 'reality shock.' Due to the unprecedented circumstances of the COVID-19 pandemic, many student nurses opted in for NHS emergency placements and prematurely transitioned to the workplace, which calls for an in-depth investigation of the work readiness and transition experiences of this cohort. The aim of this study was to investigate self-perceived work readiness, the effectiveness of support provided by the universities and the NHS as well as explore the experiences of student nurses who responded to the COVID-19 crisis to understand the impact of this early transition to the clinical workforce. A mixed methods study was conducted. It included two stages: (1) an online survey consisting of a work readiness questionnaire and close- and open-ended questions about received support; and (2) online semi-structured interviews that were thematically analysed.: Participants were nursing students from Scottish universities who took on emergency NHS placements. Thirty-three (30 females and 3 males) participants completed the survey and 8 of them (all female) participated in semi-structured interviews. The Work Readiness Scale for graduate nurses along with questions about the support received were completed in the first stage of the study. Organisational acumen was perceived by participants as higher than social intelligence, work competence and personal work characteristics. Three superordinate themes emerged: (1) participants expressed appreciation of and need for coordination of support from the university and the NHS as a key factor in easing into their role; (2) they indicated the sense of obligation as the key driver for taking up this placement; (3) placement was seen as an opportunity to understand their role and develop their professional identity. The findings found the importance of support from the clinical placement and academic teams to help with the integration and application of theory into practice.
UNLABELLED: Person-centred care is an international healthcare priority. Strategies are needed to support nurses and midwives to understand the meaning of person-centredness and support them to embed this philosophy into...UNLABELLED: Person-centred care is an international healthcare priority. Strategies are needed to support nurses and midwives to understand the meaning of person-centredness and support them to embed this philosophy into practice. Clinical supervision has been proposed as a strategy to support this but requires more evidence.The aim of this research was to evaluate a newly developed model of clinical supervision, underpinned by person-centred practice theory, to enhance the person-centred practices of new graduate nurses and midwives. DESIGN: Qualitative study (embedded within a mixed methods study) using focus groupsMethods: Group, online clinical supervision (named C.A.R.E.) underpinned by the Person-centred Practice Framework was provided to 103 new graduate nurses and midwives once per month for one hour, over six months. The researchers used [Braun, V., & Clarke, V. (2022). . SAGE]. Thematic Analysis to analyse data. RESULTS: Twenty one participated in the qualitative evaluation. Four themes were identified (1) Person-centredness in Action (person-centredness experienced and delivered by the new graduates) (2) Enhancing the Transitioning Toolkit (professional and personal growth as an outcome of reflection and learning together) (3) The Transitioning Environment (care environment and C.A.R.E. environment) and (4) Challenges to C.A.R.E. (team and organisation, and personal). CONCLUSION: This supportive safe space allowed new graduates to explore their and other's practices, in relation to person-centred practice theory. Through sharing their experiences, they increased their knowledge and confidence to incorporate new learning into their own practice. This clinical supervision model underpinned by the Person-centred Practice Framework provides person-centred benefits to the new graduates, patients and families. However, without organisational support the benefits will not be realised.
: The omission of time-critical medication doses may result in poor patient outcomes. There are few publications about the influence of electronic medication management (EMM) systems, including automated dispensing cabin...: The omission of time-critical medication doses may result in poor patient outcomes. There are few publications about the influence of electronic medication management (EMM) systems, including automated dispensing cabinets (ADC), on timely medication administration. The study aimed to evaluate the influence of EMM systems, including ADCs, on timely medication administration 6 and 30 months after EMM implementation, focussing on preventable time-critical medication dose omissions and documented reasons for not administering a dose.: Data on doses of regular inpatient medications not administered were obtained from electronic medication records (EMR) over 1 week in March 2019 and 4 weeks in March 2021. An omission was a dose not administered before the next due dose. Time-critical medications were defined using the health service's guidelines. Reasons for doses not being administered were obtained from nursing documentation in the EMR collated from digital health reports. Reasons for time-critical medication doses not given were defined as 'valid' or 'preventable'.: In 2019 and 2021, 620 and 2524 patients with 44,756 and 146,940 scheduled medication doses were reviewed. Of these, 4385 (9.8%) and 19,610 (13.4%) doses were not administered. In 2019 and 2021, there were 593 (1.3%) and 1811 (1.2%), < 0.0001, time-critical doses not administered. Preventable time-critical dose omissions decreased from 0.20% in 2019 to 0.15% ( = 0.015) in 2021. Wards with ADCs had a significantly lower rate of time-critical dose omissions compared to those without ADCs (1.1% vs 1.3%, = 0.014).: With the introduction of an EMM system, there was a decrease in the rate of time-critical medications not administered, including a reduced rate of preventable omissions over the 24-month period. Regular assessment of time-critical medication administration will help target patient safety improvements.
: Vaccination is efficacious at preventing influenza disease transmission, morbidity and mortality. Benefits of influenza vaccination for healthcare workers (HCW) are emphasized, yet vaccine uptake among HCW remains subo...: Vaccination is efficacious at preventing influenza disease transmission, morbidity and mortality. Benefits of influenza vaccination for healthcare workers (HCW) are emphasized, yet vaccine uptake among HCW remains suboptimal. Mandatory vaccination programs may increase influenza vaccine uptake, however, attitudes and beliefs of HCW towards these mandates are not well known.: This scoping review examined the attitudes and beliefs of HCW to ascertain the barriers and enablers to the implementation and acceptance of mandatory vaccination programs in healthcare settings.: Scoping review, guided by the PRISMA Extension for Scoping Reviews.: Literature published between 2019 and 2023 was reviewed from five electronic databases, between June and October 2023.: Quantitative, qualitative and mixed-methods studies were obtained. Studies were limited to full-text English articles, published within peer-reviewed journals over the last five years. Data were extracted by both authors and documented using a modified version of the JBI's scoping review data extraction instrument, and analyzed thematically.: The original search yielded 319 articles. Forty-two articles were screened, with 10 studies included. Most HCW had negative views towards mandatory influenza vaccination, influenced by geographical location, age and discipline. The protection of patients and affordability/accessibility of vaccination were described as enablers to the acceptance of mandatory measures. The belief that mandatory vaccination was a violation of autonomy and misconceptions concerning influenza transmission, vaccine mechanism of action, side effects and effectiveness, were described as common barriers.: Health services must carefully consider the context in which mandatory vaccination programs are implemented and employ strategies that incorporate education and promote vaccine accessibility, affordability and HCW autonomy. The quality of evidence retrieved was moderate to poor, with high heterogeneity between studies. Minimal Australian research was evident, limiting the generalisability of findings. These results should be interpreted with caution and further high-quality research is recommended.
BACKGROUND: Sepsis is a frequent cause of global deaths with time critical diagnosis and treatment impacting outcomes. Prehospital emergency nurses are pivotal in assessment that influences timely diagnosis. AIM: To gain...BACKGROUND: Sepsis is a frequent cause of global deaths with time critical diagnosis and treatment impacting outcomes. Prehospital emergency nurses are pivotal in assessment that influences timely diagnosis. AIM: To gain a deep understanding of nurse's experiences when caring for those with suspected sepsis. DESIGN AND METHODS: A qualitative study using semi-structured interviews and inductive content analysis according to the Elo Kyngäs method. FINDINGS: Early identification of sepsis by prehospital emergency nurses ( = 13) was augmented through a combination of clinical experience and the implementation of practice guidelines. There were three key components to practice improvement a) clinical experience, b) continuous education and c) explicit guidelines. CONCLUSIONS: Identification of sepsis in the prehospital environment can shorten the time to treatment for patients with sepsis. Early identification can be achieved by continuous education in the Emergency Medical Service (EMS), ensuring experienced personnel and including the EMS in medical guidelines.
: Australia provides education services to international students which includes international students completing a health professional education (HPE) degree. Studying for a HPE degree can be challenging for most stude...: Australia provides education services to international students which includes international students completing a health professional education (HPE) degree. Studying for a HPE degree can be challenging for most students. There are specific challenges for international students when completing a degree with clinical placements. The challenges international students can face include receiving adequate and timely information, understanding health service access, and receiving the correct information from education providers and agents.: To gain an in-depth understanding of the challenges for international health professional education students in accessing healthcare, understanding the requirements of compliance to attend clinical placements and the difficulties with attending clinical placements.: A semi-structured interview schedule based on findings from a survey ( = 318 participants) was used to explore international student perspectives in one-on-one interviews.: Data were collected from international HPE students from a single Australian metropolitan multi-campus university using a questionnaire, which included qualitative open-ended questions, in addition to semi-structured follow-on interviews. Data collection took place between March and October 2021 and qualitative data were inductively thematically analysed.: Challenges reported in interviews by six international students were focused on understanding the navigation of new administrative systems and compliance processes. Students noted gaps in the communication of understanding legislative compliance requirements to attend clinical placements, difficulties accessing healthcare and making use of overseas student health cover, organisational issues, and transport issues when attending clinical placements.: Higher education providers and international education agents must address communication deficits in course requirements linked to clinical placement prerequisites. This study highlights gaps in commencing international students' understanding, and higher education providers' communication of clear, timely detailed information.
: Many of the overseas qualified nurses educated work as health care assistants and support workers for a decreased wage without scope for professional advancement. There is an imperative to ease their entry to the nursi...: Many of the overseas qualified nurses educated work as health care assistants and support workers for a decreased wage without scope for professional advancement. There is an imperative to ease their entry to the nursing register.: To gather and provide evidence to the regulatory bodies regarding the demographics of this cohort of nurses and the challenges they face in attempting to register as a nurse.: This study used a mixed-method explanatory sequential design. The survey was completed by 857 unregistered nurses followed by five in-depth interviews. Results from both phases were triangulated.: The results signpost to the characteristics and challenges of these nurses working as unqualified grades of staff for a decreased wage without scope for professional advance.: The downward occupational spiral of internationally educated nurses underscores the paradoxical nature of the pedagogical application of transition theory, as these nurses are compelled to revert to a novice status.
Giesen J, Bakker-Jacobs A, van Vught A
… +3 more, Berings M, Vermeulen H, Waal GH
Contemp Nurse
· 2024 Jul · PMID 38949881
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BACKGROUND: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according...BACKGROUND: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promote EBP in nursing practice and improve related education, more insight into nurses' needs is necessary to overcome existing EBP barriers. OBJECTIVE: To identify the current needs to work with EBP principles among hospital and community care nurses and student nurses. DESIGN: A qualitative, exploratory approach with focus group discussions. METHODS: Data was collected between February and December 2020 through 5 focus group discussions with 25 nurses and student nurses from a hospital, a community care organisation, and nursing education schools (bachelor and vocational). Data were analysed using reflexive thematic analysis, and the main themes were synchronised to the seven domains from the Tailored Implementation for Chronic Diseases (TICD) checklist. RESULTS: Nurses and student nurses experience EBP as complex and require more EBP knowledge and reliable, ready-to-use evidence. They wanted to be facilitated in access to evidence, the opportunity to share insights with colleagues and more time to work on EBP. The fulfilment of these needs serves to enhance motivation to engage with evidence-based practice (EBP), facilitate personal development, and empower nurses and student nurses to take more leadership in working according to EBP principles and improve healthcare delivery. CONCLUSION: Nurses experience difficulties applying EBP principles and need support with their implementation. Nurses' and student nurses' needs include obtaining more EBP knowledge and access to tailored and ready-to-use information. They also indicated the need for role models, autonomy, incentives, dedicated time, and incorporation of EBP in daily work practice.
BACKGROUND: The COVID-19 pandemic has placed a significant pressure on the nursing workforce, leading to an increased risk of infection and work-related issues impacting nurses' mental health. This review aims to explore...BACKGROUND: The COVID-19 pandemic has placed a significant pressure on the nursing workforce, leading to an increased risk of infection and work-related issues impacting nurses' mental health. This review aims to explore the workplace challenges faced by older nurses and their impact on mental health. METHOD: This qualitative systematic review followed the Joanna Briggs Institute methodology. RESULTS: The review included 32 studies and identified three interconnected themes: heavy workload and nature of nursing, lack of recognition and feeling undervalued, and challenges in balancing personal life and work. These themes illustrated the complexity of the workplace challenges faced by older nurses. DISCUSSION AND CONCLUSION: Workplace demands and shift work were common negative contributors to mental health and wellbeing. The physical and cognitive capacity of older nurses may diminish due to age-related changes, making the workload more challenging. Recognition and support from the organisation, especially from management and leadership, played a crucial role in nurses' resilience.