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Promoting patient involvement through person-centred handovers in nursing

Por: Kidd · L.

Commentary on: Kullberg A, Sharp L, Dahl O, et al. Nurse perceptions of person-centered handovers in the oncological inpatient setting - A qualitative study. Int J Nurs Stud 2018;86:44–51.

Implications for practice and research

  • Person-centred handovers can enhance patient participation in healthcare decision-making, supporting the provision of high quality, safe person-centred care.

  • Consideration is needed to how person-centred handovers are understood and implemented in clinical practice to ensure that they foster genuine participation and partnership working between nursing teams and patients.

  • Context

    Nurse handovers are a routine form of communication and information exchange that occurs when one nurse hands over the responsibility of care for a patient to another nurse, for example at the end of a nursing shift.1 In daily practice, different models of handover are used.1 Evidence on nurses’ perspectives of person-centred handover (PCH) models, which incorporate and...

    Patients and nurses have differing views of what is meant by 'compassion

    Por: Green · L.

    Commentary on: Durkin J, Usher K, Jackson D. Embodying compassion: A systematic review of the views of nurses and patients. J Clin Nurs. 2018 Nov 28. doi: 10.1111/jocn.14722.

    Implications for practice and research

  • There is ambiguity regarding how compassion is defined and experienced within nursing.

  • Patients and nurses hold different views on what constitutes compassionate care.

  • Understanding the concept of compassion can help nurses in their clinical practice.

  • Focusing on the nature of compassion—particularly from the point of view of patients—is an important direction in nursing education and research.

  • Context

    Compassion has always been a key concept in nursing.1 2 In the UK, several instances of poor care propelled compassion to the foreground and prompted a series of policy responses that impact directly on the nursing profession. Consequently, compassionate care is increasingly recognised as being just as vital...

    Multidisciplinary disease management programme with or without exercise training may reduce heart failure-related rehospitalisation

    Por: Collier · L.

    Commentary on: Liu M, Wang C, Tung T, et al. Effects of a multidisciplinary disease management programme with or without exercise training for heart failure patients: secondary analysis of a randomized controlled trial. Int J Nursing 2018;8:94–102.

    Implications for practice and research

  • The inclusion of exercise training within a multidisciplinary disease management programme (MDP) may reduce rates of heart failure (HF)-related rehospitalisation.

  • When exercise is contraindicated, an MDP may reduce HF-related rehospitalisation rates for 12 months after discharge for an HF-related hospital stay.

  • Context

    Advances in the management of HF mean survival rates for patients with HF are increasing.1 While management of HF is focused around medicine regimens, lifestyle changes such as weight maintenance, smoking cessation and exercise are encouraged so patients may manage their symptoms more effectively.1 MDPs with structured patient education are effective in reducing HF-related rehospitalisation rates and mortality...

    Body sensor providing feedback to bedside staff reduced the prevalence of pressure ulcers in patients with critical illness

    Por: Swift · A.

    Commentary on: Pickham D, Berte N, Pihulic M, et al. Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study). Int J Nurs Stud 2018;80:12–19.

    Implications for practice and research

  • Hospital-acquired pressure injuries (HAPI) vary in prevalence but affect more than 4% of inpatients.

  • HAPIs lead to increased length of stay and are an indicator of poor care quality.

  • Sustained improvement in nursing practice is required to prevent HAPI.

  • Longer term follow-up in studies comparing different ways to reduce risk is required to find a way to sustain improvements in practice.

  • Context

    Hospital-acquired pressure injuries (HAPI) lead to increased length of stay and increased risk of mortality.1 Prevention of pressure ulcers requires careful assessment of the skin and risk factors such as limited mobility, loss of sensation, previous...

    Home management of heart failure based solely on symptom and fluid management, adherence and knowledge may not fully meet the complex needs of patients

    Por: Collier · L.

    Commentary on: Sevilla-Cazes, J, Ahmad F, Bowles K, et al. Heart failure home management challenges and reasons for readmission: a qualitative study to understand the patient’s perspective. J Gen Intern Med 2018;33(10):1700–7. DOI: 10.1007/s11606-018-4542-3.

    Implications for practice and research

  • Patients reported uncertainty about instructions for self-care after discharge for a heart failure (HF)-related admission.

  • Readmission for HF-related symptoms is viewed as a rationale choice by patients and families seeking a safe place.

  • Further research and evidence is needed into how palliative care should be integrated in to the care of patients with heart failure.

  • Context

    Hospitalisation for HF is common and associated with significant levels of morbidity and mortality.1 There are significant amounts of quantitative and qualitative research focused on home management of HF and reasons for readmission. This study4 aimed to address a perceived limitation in knowledge around potential differences...

    Tai Chi: a promising adjunct nursing intervention to reduce risks of cardiovascular disease and improve psychosocial well-being in adults with hypertension

    Por: Smith · G. D.
    Implications for practice and research

  • Nurses play a vital role in reducing the risk of individuals with hypertension developing cardiovascular disease (CVD). Tai Chi, a traditional Chinese exercise intervention, appears to provide a potentially effective form of physical activity for these individuals.

  • Future research of the effect of Tai Chi, a complex form of nursing intervention, should place more emphasis on objective exercise activity measures (accelerometers and pedometers).

  • Context

    The burden of CVD accounts for significant global morbidity and mortality.1 Substantial evidence suggests that physical inactivity is a major modifiable lifestyle factor related to the development of CVD. This experimental study, conducted by Chan et al,2 compared Tai Chi exercise with brisk walking in Hong Kong-based adults with hypertension, a known risk factor for the development of CVD. Tai Chi provides a traditional Chinese form of mind– body exercise, which...

    Higher rates of depression among women living with Coronary Heart Disease are associated with poorer treatment outcomes and prognosis

    Por: McGuigan · K.

    Commentary on: Buckland SA, Pozehl B, Yates B. Depressive symptoms in women with Coronary Heart Disease: A systematic review of the longitudinal literature. J Cardiovasc Nurs 2018;34:52–9. doi: 10.1097/JCN.0000000000000533.

    Implications for practice and research

  • As women experience significantly higher levels of depression than men particularly in the early stages of CHD, early intervention and support from healthcare professionals would be required to address symptoms and ensure better psychosocial adjustment, treatment adherence and prognosis across time.

  • Longitudinal research is required to map sex-specific psychosocial outcomes among those with CHD and to assess their impact on CHD.

  • Context

    The link between depressive symptomatology, coronary heart disease (CHD) and associated mortality and morbidity is well established.1 However, it is difficult to draw conclusions about the prognosis of women with CHD and depression as women have traditionally been under-represented in related research or trials. In studies...

    Professionals need to discuss more effectively the holistic needs of their patients regarding palliative care

    Por: Rodriguez · A.

    Commentary on: Collins A, McLachlan, SA, Philip, J. Communication about palliative care: A phenomenological study exploring patient views and responses to its discussion. Palliative Medicine 32:133–42.

    Implications for practice and research

  • Professionals could be more assertive in leading discussion around palliative care and be clearer about what this means in terms of disease trajectory and well-being for their patients.

  • Professionals need to discuss more effectively the holistic needs of their patients. Where it is appropriate to have open conversations about death and dying, this can be worthwhile for patients to encourage uptake of palliative care services and end-of-life care planning.

  • There is scope to explore further the communication practices and needs of professionals and patients with a range of life-limiting or life-threatening conditions in different care settings.

  • Due to the sensitive and complex nature of palliative care communication, therapeutic interventions are needed to be...

  • Cervical spine can be assessed effectively by emergency department triage nurses

    Por: Parker · M.

    Commentary on: Stiell IG, Clement CM, Lowe M, et al. A multicenter program to implement the Canadian C-Spine Rule by emergency department triage nurses. Ann Emerg Med. 2018. pii: S0196-0644(18)30300-7.

    Implications for practice and research

  • Allowing emergency department (ED) triage nurses to assess and implement the Canadian C-Spine Rule on ambulatory patients who present to the ED complaining of neck pain, and patients who attend the ED via the ambulance service with triple immobilisation in situ (sandbag, collared and tape) will reduce waiting times and improve patient experience.

  • Other guidelines are available for clinicians to consider when ‘clearing’ the c-spine, namely the National Emergency X-Radiography Utilization Study,1 the National Institute for Health and Care Excellence (2016) guidance paper on spinal injuries: initial assessment and management,2 and the Prehospital Trauma Life Support (2014) criteria.3 There is scope for future research to...

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