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☐ ☆ ✇ Journal of Advanced Nursing

Home‐based management on hospital re‐admission rates in COPD patients: A systematic review

Por: Rita Corcoran · Zena Moore · Pinar Avsar · Bridget Murray — Abril 1st 2024 at 09:20

Abstract

Aim

To determine the impact of home-based management on hospital re-admission rates in patients with chronic obstructive pulmonary disease (COPD).

Design

Systematic review methodology was utilized, combining meta-analysis, where appropriate, or a narrative analysis of the data from included studies.

Data Sources

Electronic databases CINAHL, MEDLINE, PubMed, Embase and SAGE journals for primary papers, 2015 to 2021, were searched between December 2020 and March 2021, followed by hand-searching key journals, and reference lists of retrieved papers.

Methods

The review followed the guidance of PRISMA. Data were extracted using a predesigned data extraction tool. Quality appraisal was undertaken using RevMan ‘risk of bias’ tool. Meta-analysis was undertaken using RevMan software.

Results

This review integrates evidence from eight studies, five Random Control Trials, two observational studies and one retrospective study. The studies span three continents, Asia, Europe and North America, and include 3604 participants with COPD. Home-based management in patients with COPD resulted in a statistically significant reduction in rates of hospital readmission. For the outcomes, length of stay and mortality, while slightly in favour of home-based management, the results were not statistically significant.

Conclusion

Given the burden of COPD on healthcare systems, and crucially on individuals, this review identified a reduction in hospital re-admission rate, a clinically important outcome.

Impact

This study focused on the impact on hospital re-admission rates among the COPD patient cohort when home-based management was involved. A statistically significant reduction in rates of re-admission to the hospital was identified. This is positive for the patient, in terms of hospital avoidance, and reduces the burden on hospital systems. Further research is needed to determine the impact on cost-effectiveness and to quantify the most ideal type of care package that would be recommended for home-based management.

☐ ☆ ✇ Journal of Advanced Nursing

Relationship between care dependency, adverse events, trust in nurses and satisfaction with care: The mediating role of patient‐reported missed care

Por: Öznur İspir Demir · Ayşegül Yilmaz · Betül Sönmez — Marzo 29th 2024 at 08:00

Abstract

Aim

The aim of the study was to investigate the mediating effect of patient-reported missed care in the relationship between care dependency, adverse events, trust in nurses and satisfaction with nursing care.

Design

A cross-sectional and correlational study.

Methods

A total of 374 patients were recruited from the medical and surgical inpatient units of two public university hospitals in Türkiye using a convenience sampling method from May to August 2022. The data were collected using the Care Dependency Scale, MISSCARE Survey-Patient, Trust in Nurses Scale and Newcastle Satisfaction with Nursing Care Scale. The relationships between the variables were analysed using a sequential mediation model (Model 6) in Hayes' PROCESS macro.

Results

Care dependency was found to have a significant negative effect on misscare-communication; however, it had no significant effect on misscare-basic care. Misscare-communication had a significant positive effect on the experience of adverse events, while misscare-basic care had no significant effect. Misscare-communication and basic care had a significant negative effect on trust in nurses and satisfaction with nursing care. Misscare-communication was found to have a partial mediating effect on the relationship between care dependency and experiencing adverse events, trust in nurses and satisfaction with nursing care.

Conclusion

The results emphasize the importance of misscare-basic care, communication and patients' care dependency in improving patient outcomes such as experiencing adverse events, trust in nurses and satisfaction with nursing care, and they extend existing nursing studies by addressing missed care and care dependency together from the perspective of patients.

Impact

We urge nurse managers to consider the role of misscare in the impact of patients' level of care dependency on patient outcomes. Accordingly, nurse managers should focus first on interventions to eliminate misscare-communication. Effective interventions to address factors that impact communication and fulfilment of basic care are necessary to achieve better patient outcomes.

Reporting Method

EQUATOR guidelines were followed using the STROBE reporting method.

Patient or Public Contribution

No patient or public contribution. Patients only contributed to data collection. Data were obtained from patients hospitalized in the medical and surgical inpatient units of two public university hospitals.

☐ ☆ ✇ Journal of Advanced Nursing

Beliefs and practices of the nursing team related to pressure injury preventive measures: A analysis of social representations

Abstract

Aims and Objectives

To analyse the process of elaborating social representations about pressure injury preventive measures by the nursing team (nurses and nurse technicians) and how this process relates to preventive practices for hospitalized patients.

Design

Qualitative study, with the application of the theory of social representations in its procedural methodological approach.

Methods

The study was carried out in an inpatient clinic of a public hospital in the state of Rondônia, Brazil. Totally, 28 nursing professionals in the medical clinic sectors who had worked directly with patient care for more than 6 months participated. The data were collected between July and September 2021 via in-depth interviews with the application of a semi-structured instrument. Analysis was carried out with the help of ALCESTE software, which performed a lexicographic analysis, and also via thematic analysis. The COREQ guided the presentation of the research report.

Results

The social representations were developed based on the professionals' symbolic beliefs about the visibility/invisibility of the results of applying preventive care. These symbolic constructions mobilized positive and negative feelings among the nursing team, which guided the classification of prevention practices as being of greater or lesser priority among other care activities. There were favourable attitudes among professionals, which included applying prevention measures in their daily routines, and unfavourable attitudes of non-adherence to the institution's protocol for preventing pressure injuries.

Conclusions

The nursing team's perception of pressure injury prevention is influenced by symbolic, affective, values, and social dimensions. Non-adherence behaviours are attributed to the belief in the invisibility of prevention outcomes, resulting in a reluctance to implement preventive measures.

Relevance to Clinical Practice

Understanding the subjective logic that explains the thinking and actions of the nursing team suggests the need to incorporate discussions on beliefs, values, sentiments, and attitudes of nursing professionals into educational programs on pressure injury prevention.

Patient or Public Contribution

No public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

A study to untangle the puzzle of urinary incontinence and frailty co‐occurrence among older adults: The roles of depression and activity engagement

Por: Chun‐Yan Wang · Si‐Jing Peng · Meng Zhao · Chen Wu · Ke‐Fang Wang — Marzo 25th 2024 at 08:50

Abstract

Aims

To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways.

Design

A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China.

Methods

Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism.

Results

A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant.

Conclusion

The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement.

Implications for the Profession and/or Patient Care

The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence.

Impact

What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers‘ understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence.

Reporting Method

The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Mapping health promotion practices across key sectors and its intersectoral approach at the local level: Study protocol

Abstract

Aims

This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions.

Design

A complementary multi-method study combining survey methods and qualitative interviews will be adopted.

Methods

Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed.

Discussion

This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building.

Impact

Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts.

Stakeholder Engagement

Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.

☐ ☆ ✇ Journal of Advanced Nursing

Associations between hospital organizational features, person‐centred care and nurse‐sensitive outcomes for persons with dementia in acute care: A systematic literature review

Por: Amber Casarez · Jessica G. Smith — Marzo 22nd 2024 at 06:39

Abstract

Aim(s)

The aim of this systematic literature review was to determine the extent and quality of quantitative evidence regarding associations between hospital organizational features, person-centred care (PCC) and nursing-sensitive outcomes among persons with dementia in the acute care setting.

Design

Systematic review.

Methods

Key terms were utilized to guide searches in four databases. The two reviewers deduplicated articles and came to a consensus for the final sample using inclusion and exclusion criteria.

Data Sources

MEDLINE/OVID, CINHAL, COCHRANE and WEB OF SCIENCE.

Results

There were 10 studies included. PCC was associated with better outcomes for persons with dementia (i.e. decreased restraint use, decreased length of stay, increased involvement with families and the patient, and increased nurse confidence and competence in caring for this population). Of the studies, none explicitly identified an association between nursing-sensitive outcomes, PCC and hospital organizational features in the acute care setting among persons with dementia.

Conclusion

This review highlights a clinically significant gap in knowledge regarding associations between hospital organizational features, PCC and nursing sensitive outcomes. The impact of face-to-face dementia competency training as a standard practice among acute care facilities, the importance of leadership engagement, support and involvement to improve nurse confidence and competence in caring for persons with dementia needs to be explored.

Impact Statement

These findings support future research to understand the relationship between organization features and patient-centred care and how these collectively impact nursing-sensitive outcomes, specifically in persons with dementia in acute care settings.

☐ ☆ ✇ Journal of Advanced Nursing

The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta‐analysis

Por: Benjamin Freedman · Wendy Wen Li · Zhanming Liang · Peter Hartin · Narelle Biedermann — Marzo 22nd 2024 at 06:19

Abstract

Aim

Workplace incivility is a barrier to safe and high-quality patient care in nursing workplaces and more broadly in tertiary hospitals. The present study aims to systematically review the existing evidence to provide a comprehensive understanding of the prevalence of co-worker incivility experienced and witnessed by nurses and other healthcare professionals, the effects of incivility on patient safety culture (PSC) and patient outcomes, and the factors which mediate the relationship between incivility and patient safety.

Methods

A systematic review with narrative synthesis and meta-analysis was undertaken to synthesize the data from 41 studies.

Data Sources

Databases searched included MEDLINE, PubMed, SCOPUS, CINAHL, PsycInfo, ProQuest, Emcare and Embase. Searches were conducted on 17 August 2021 and repeated on 15 March 2023.

Results

The pooled prevalence of experienced incivility was 25.0%. The pooled prevalence of witnessed incivility was 30.1%. Workplace incivility was negatively associated with the PSC domains of teamwork, reporting patient safety events, organization learning/improvement, management support for safety, leadership, communication openness and communication about error. The composite pooled effect size of incivility on these domains of PSC was OR = 0.590, 95% CI [0.515, 0.676]. Workplace incivility was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality. State depletion, profession, psychological responses to incivility, information sharing, help seeking, workload and satisfaction with organizational communication were found to mediate the relationship between incivility and patient safety.

Conclusion

Experienced and witnessed incivility is prevalent in tertiary hospitals and has a deleterious effect on PSC and PSOs. A better understanding of the mechanisms of this relationship will support the development of interventions aimed at reducing both incivility and patient harm.

Implications for the Profession and/or Patient Care Impact

This study quantifies the effect of incivility on PSC and outcomes. It provides support that interventions focusing on incivility are a valuable mechanism for improving patient care. It guides intervention design by highlighting which domains of PSC are most associated with incivility. It explores the profession-specific experiences of workplace incivility.

Reporting Method

This report adheres to PRISMA reporting guidelines.

Patient or Public Contribution

No patient or public contribution. The focus of this study is the nursing and healthcare workforce, therefore, patient or public involvement not required.

☐ ☆ ✇ Journal of Advanced Nursing

Integrating genomics into Canadian oncology nursing policy: Insights from a comparative policy analysis

Abstract

Aim

To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure—the United States (US) and the United Kingdom (UK)—to inform policy development for genomics-informed oncology nursing practice and education in Canada.

Design

Comparative document and policy analysis drawing on the 3i + E framework.

Methods

We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis.

Results

We found several types of policy documents guiding genomics-informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes.

Conclusion

Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education.

Implications for the profession

Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics-informed oncology nursing practice and education within an interprofessional context.

Impact

This study informs Canadian policy development for genomics-informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics.

☐ ☆ ✇ Journal of Advanced Nursing

Spiritual coping within medical professions: A psychometric analysis of the Numinous Motivations Inventory short form

Por: Elizabeth Williamson · Ralph L. Piedmont · Jesse Fox · Megan Rowe · Diane Robinson — Marzo 16th 2024 at 08:54

Abstract

Aim

To examine the psychometric properties of a short form version of the Numinous Motivation Inventory (NMI) for use with healthcare providers in measuring their existential engagement with life and to assess its relationship with spiritual coping and emotional dysphoria.

Design

Correlational and psychometric study.

Method

Data were collected from June to December 2022. Participants included 102 physicians, recruited from across the United States. Qualtrics was utilized to collect data, and they were evaluated with the NMI short form, Spiritual Coping Questionnaire and Depression, Anxiety, and Stress scale (DASS-21).

Results

Obtained fit statistics from structural equation modelling analysis indicated close fit of the NMI short form with the original model. Multiple regression analyses demonstrated the value of the NMI as a predictor of negative affect independent of spiritual coping. The NMI did not interact with Spiritual Coping, which was independent of negative affect.

Conclusions

The Numinous represents an important aspect of physicians' coping. The constructs can be utilized in training and clinical settings as a valuable and easy-to-use metric for promoting and assessing wellness. The implications of these findings and the value of the NMI were discussed.

Impact

An understanding of existential drivers can equip one to cope with the stressors of healthcare. The NMI short form has the capability to explore an individual's existential drivers through the understanding of three domains.

Reporting Method

Adhered to proper EQUATOR guidelines (GRRAS).

Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

The impact of the COVID‐19 pandemic on longitudinal trends of surgical mortality and inpatient quality of care in Ontario, Canada

Por: Steven Habbous · Maggie Ford · Stacey Bar‐Ziv · Terri Donovan · Erik Hellsten — Marzo 16th 2024 at 06:11

Abstract

Aims

Previous studies have shown the COVID-19 pandemic was associated with reductions in volume across a spectrum of non-SARS-CoV-2 hospitalizations. In the present study, we examine the impact of the pandemic on patient safety and quality of care.

Design

This is a retrospective population-based study of discharge abstracts.

Methods

We applied a set of nationally validated indicators for measuring the quality of inpatient care to hospitalizations in Ontario, Canada between January 2010 and December 2022. We measured 90-day mortality after selected types of higher risk admissions (such as cancer surgery and cardiovascular emergency) and the rate of patient harm events (such as delirium, pressure injuries and hospital-acquired infections) occurring during the hospital stay.

Results

A total 13,876,377 hospitalization episodes were captured. Compared with the pre-pandemic period, and independent of SARS-CoV-2 infection, the pandemic period was associated with higher rates of mortality after bladder cancer resection (adjusted risk ratio [aRR] 1.20 (1.07–1.34)) and open repair for abdominal aortic aneurysm (aRR 1.45 (1.06–1.99)). The pandemic was also associated with higher rates of delirium (adjusted odds ratio [aOR] 1.04 (1.02–1.06)), venous thromboembolism (aOR 1.10 (1.06–1.13)), pressure injuries (aOR 1.28 (1.24–1.33)), aspiration pneumonitis (aOR 1.15 (1.12–1.18)), urinary tract infections (aOR 1.02 (1.01–1.04)), Clostridiodes difficile infection (aOR 1.05 (1.02–1.09)), pneumothorax (aOR 1.08 (1.03–1.13)), and use of restraints (aOR 1.12 (1.10–1.14)), but was associated with lower rates of viral gastroenteritis (aOR 0.22 (0.18–0.28)). During the pandemic, SARS-CoV-2-positive admissions were associated with a higher likelihood of various harm events.

Conclusion

The COVID-19 pandemic was associated with higher rates of patient harm for a wide range of non-SARS-CoV-2 inpatient populations.

Impact

Understanding which quality measures are improving or deteriorating can help health systems prioritize quality improvement initiatives.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

The association of leader–member exchange and team–member exchange with nurses' innovative behaviours: A cross‐sectional study

Por: Liangying Cheng · Wanhong Wei · Jinyan Zhang · Ying Yao · Yanhui Zhang · Weiyan Zhu — Marzo 14th 2024 at 12:51

Abstract

Aim

To measure the association of leader–member exchange and team–member exchange with nurses' innovative behaviours through social exchange theory.

Background

The field of nursing is actively advocating innovation. Other fields have proven that leader–member exchange and team–member exchange can promote innovative behaviour, but such an association is not clear in nursing.

Design

A cross-sectional study.

Methods

A total of 560 nurses were selected from five tertiary hospitals in Henan Province (China) by multistage sampling. Data were collected from a self-report questionnaire. Thirty nurses in the pre-survey were used to verify the validity of the questionnaire. SPSS PROCESS macro was used to verify the association of leader–member exchange and team–member exchange with nurses' innovative behaviours.

Results

Leader–member exchange and team–member exchange were significantly associated with nurses' innovative behaviours, and team–member exchange had a mediating effect on the relationship between leader–member exchange and innovative behaviour.

Conclusions

Leader–member exchange and team–member exchange positively affect nurses' innovative behaviours. Leader–member exchange can promote nurses' innovative behaviours through the mediating role of team–member exchange.

Impact

This study indicated that leader–member exchange and team–member exchange should be given more attention in promoting nurses' innovative behaviours. This finding has implications for the promotion of innovative behaviours in nurses. Leaders need to focus on the innovative needs of nurses and offer support. Meanwhile, leadership training programs are necessary for managers to create positive team relationships.

Patient or Public Contribution

No patient or public involvement.

☐ ☆ ✇ Journal of Advanced Nursing

The effects of clinical learning environment and career adaptability on resilience: A mediating analysis based on a survey of nursing interns

Por: Yutong Xu · Wanting Zhang · Jia Wang · Zihan Guo · Weiguang Ma — Marzo 12th 2024 at 06:24

Abstract

Background

The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience.

Aims

To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience.

Methods

The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals.

Results

The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01).

Conclusion

Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.

☐ ☆ ✇ Journal of Advanced Nursing

Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study

Por: Lang Peng · Xianxian Zang · Ruili Liu · Ping Bai · Lu Wang · Guoyong Yang — Marzo 6th 2024 at 07:38

Abstract

Aim

To construct a nursing assessment framework for patients in anaesthesia recovery period.

Design

A three-round modified Delphi method was employed to capture the consensus of 22 panellists.

Methods

The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini-clinical evaluation exercise (mini-CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post-anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework.

Results

This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History-taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern.

Conclusion

The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts’ opinions.

Implications for the profession and patient care

The assessment framework constructed in this study could be used for the process evaluation of post-anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills.

Reporting method

The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.

Patient or public contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Impact of the COVID‐19‐pandemic and perception of self‐efficacy on the mental health of out‐of‐hospital emergency healthcare professionals by modality of care

Abstract

Objective

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services.

Design

Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February–30 April, 2021).

Methods

The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health.

Results

The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care.

Conclusions

Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality.

Implications

The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk.

Reporting Method

We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain).

Patient or Public Contribution

‘No patient or public involvement’.

☐ ☆ ✇ Journal of Advanced Nursing

Dementia friendly in the context of hospitalization: A concept analysis using the Walker & Avant Method

Por: Ellen Munsterman · Adriana Perez · Nancy Hodgson · Pamela Cacchione — Marzo 4th 2024 at 06:00

Abstract

Aim(s)

To evaluate the literature to inform and propose a conceptual definition for dementia friendly in the context of hospitalization.

Methods

The Walker & Avant method for concept analysis was utilized for this review.

Data Sources (Include Search Dates)

Initial search conducted June 2022. Repeated search conducted in February 2023. Databases for the literature search include Scopus, PubMed, CINAHL, PsycINFO, and AGELINE.

Results

Five attributes of the concept of dementia friendly in the context of hospitalization were identified including: staff knowledge/education, environmental modification, person-centred care, nursing care delivery and inclusion of family caregivers. Based on these attributes a conceptual definition is proposed.

Conclusion

A clarified definition for dementia friendly in the context of hospitalization will aid in understanding the concept, provide guidance for hospitals seeking to implement dementia-friendly interventions and benefit researchers aiming to study the impact of such programs.

Reporting Method

n/a.

Patient or Public Contribution

No Patient or Public Contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Clinical supervision experience of nurses in or transitioning to advanced practice: A systematic review

Por: Debbie Zonneveld · Tiffany Conroy · Lauren Lines — Marzo 4th 2024 at 05:39

Abstract

Aims

To systematically explore the clinical supervision (CS) experience for nurses transitioning to advanced practice.

Design

A qualitative systematic review using Joanna Briggs Institute meta-aggregation following an a priori protocol published on PROSPERO (CRD42023426658).

Data Sources

Qualitative studies obtained from Medline, CINAHL, PsycINFO, Scopus, Emcare and ERIC databases and ProQuest dissertations and theses for peer-reviewed, published and unpublished studies from inception to July 2023.

Review Methods

Two authors conducted data screening and abstraction. Quality was appraised using the Critical Appraisal Skills Programme tool and reporting followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist for systematic reviews.

Results

Sixteen studies contributed to five synthesized findings: CS that is beneficial requires structure and commitment, trusting relationships are foundational for learning, lifting burdens and preventing burnout, learning through reflection, critical thinking and feedback and barriers to CS.

Conclusions

This review provides a meaningful exploration of CS to support nurses transitioning to advanced practice. Well-structured supervision offers a safe space to share work-related concerns and develop an advanced practitioner identity. Sharing experiences helps alleviate work-related burdens and reduce professional isolation and burnout.

Implications for the Profession

Peer-support networks are vital for successful transition to advanced practice.

Impact

This review highlighted the impact of effective supervisory relationships in forming professional identity and possible links with nursing retention.

Public Contribution

No direct patient contributions are included as it forms part of a research degree.

☐ ☆ ✇ Journal of Advanced Nursing

Going the extra mile for patients: Service‐oriented high‐performance work systems drive nurses' job crafting and extra‐role service behaviour

Por: Yao Song · Zhen Wang · Lynda Jiwen Song — Febrero 28th 2024 at 13:53

Abstract

Aim

This study intends to investigate whether, how and when service-oriented high-performance work systems (SHPWSs) drive nurses' extra-role service behaviour.

Design

This was a quantitative cross-sectional study conducted with matched nurse–patient participants.

Method

We tested hypotheses using data from 284 nurses and their matched 566 patients. The data were collected in 2019. We conducted a set of hierarchical regression analyses to test our hypotheses.

Results

The results showed that SHPWSs have a positive impact on job crafting, which, in turn, mediates the link between SHPWSs and extra-role service behaviours. Additionally, the influence of professional identification moderates these relationships. Specifically, SHPWSs are significantly and positively associated with job crafting among highly professionally identified nurses. The indirect effect is significantly positive when nurses strongly identify with their profession but not significant when their professional identification is low.

Conclusion

The results indicated that SHPWSs can elicit job crafting among higher professional identifiers, which further increases extra-role service behaviours towards patients.

Impact

Our research emphasizes the significance of HRM themes in the healthcare service industry and their direct impact on healthcare personnel. Shifting from a management-centric to an individual-centric perspective, we focus on the proactive role of nurses. Furthermore, this study enhances the understanding of the boundary conditions for the effectiveness of SHPWSs.

Patient or Public Contribution

Nurses and their mated patients from a Chinese hospital contributed to this study by completing the survey.

☐ ☆ ✇ Journal of Advanced Nursing

The perspectives of nurses, as prominent advocates in sustainability, on the global climate crises and its impact on mental health

Por: Çiçek Ediz · Sevda Uzun — Febrero 28th 2024 at 13:43

Abstract

Objective

To evaluate the perspective of nurses in Turkey towards the global climate crisis and its impact on mental health using a qualitative approach.

Materials and Method

This study was conducted from August to September 2023 with 35 nurses living in seven regions of Turkey using an inductive qualitative approach. The researchers employed the snowball sampling method to select participants. Interviews with the participants were conducted until data saturation was reached. Thematic analysis was used to emerge themes.

Results

The findings revealed five main themes (perception of the global climate crisis, effects of the global climate crisis, effects of the global climate crisis on mental health, reflections of the global climate crisis on nursing and nurses' views on prevention and intervention studies for the global climate crisis). Also, the findings revealed 12 sub-themes (physical outcomes, mental outcomes, direct and indirect impacts, psychosocial effects and personal, national and international-based reflections).

Conclusion

Our study indicates that nurses exhibit genuine concern for the global climate crisis and experience psychological effects related to this pressing environmental issue. Nurses are keenly aware of their responsibility to safeguard the planet and demonstrate a strong sense of concern for the state of the world.

Impact

It is evident that nurses, being prominent advocates for sustainability, are cognizant of their responsibility to protect the planet and demonstrate genuine apprehension for the state of the world.

Implications

Nurses play a crucial role, as they make up 60% of the global healthcare workforce and are often the frontline healthcare professionals during natural disasters. It is vital to elucidate and clarify the terminology concerning the relationship between the climate crisis and the mental health of nurses, to determine the scope of this relationship and to make recommendations for future research areas.

Patient or Public Contribution

No patient or Public Contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Psychosocial impacts of being nil‐by‐mouth as an adult: A scoping review

Por: Elizabeth C. Hepper · John Wilson · Michael Drinnan · Joanne M. Patterson — Febrero 28th 2024 at 06:06

Abstract

Aim

To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult.

Design

A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR).

Methods

A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions.

Results

A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood.

Conclusion

Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group.

What is known about this topic?

Eating and drinking provides more than nutrition and hydration. A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth). Being nil by mouth (NBM) for short periods such as pre-operative fasting causes distress; however, little is understood about impact on longer-term abstinence from eating and drinking.

What this paper adds?

Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies. Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation. Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM.

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