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AnteayerEvidence-Based Nursing

Preventing post-traumatic stress disorder and supporting the mental health of hospital nurses: interventions and innovations

Por: Hughes · L. · McPeake · J. M.

Commentary on:

Liyanage, S. Addison, S. Ham, E. and Hilton, N.Z. (2021) Workplace interventions to prevent or reduce post-traumatic stress disorder and symptoms among hospital nurses: A scoping review. Journal of Clinical Nursing 00:1-11

Implications for practice

  • A shared approach between policymakers, organisations and healthcare staff is required to prevent and support those at risk of developing post-traumatic stress disorder (PTSD) in the workplace.

  • More research focusing on the prevention and management of PTSD in nurses is urgently needed.

  • Context

    Post-traumatic stress disorder (PTSD) occurs following exposure to traumatic events. It is recognised that nurses are at risk of developing PTSD or its symptoms. This can be attributed to several work-related reasons, including witnessing or directly experiencing trauma in the workplace, such as workplace violence, or the repeated exposure to the trauma suffered by those in their care.1 2 Developing...

    Palliative care nurses experiences caring for patients with eating deficiencies

    Por: Kean · T.

    Commentary on: Wallin V, Mattsson E, Omerov P, et al. Caring for patients with eating deficiencies in palliative care—registered nurses’ experiences: A qualitative study. Journal of Clinical Nursing [Internet]. 2021; 00:1–13 doi: 10.1111/jocn.16149

    Implications for practice and research

  • Registered nurses (RNs) play a critical role in nutrition support therapy in palliative/end-of-life care settings.

  • Research to examine the beliefs, values and attitudes of RNs in addressing psychological distress of patients/families experiencing nutritional challenges may inform curricular changes, standards of care and caregiver interactions.

  • Context

    RNs provide essential care to individuals with life-limiting illnesses, yet many RNs feel ill-prepared to address ethical issues associated with this care including nutrition support therapy.1,2 In this study,3 Wallin et al examine the internal conflict RNs may experience with eating deficiencies in palliative and end-of-life care. RNs may struggle to understand their own values...

    Encouraging women to do cervical cancer screening: a secondary preventive intervention with a multitude of behavioural dimensions

    Por: Moradi · S. · Taherinezhad Ledari · A.

    Commentary on: Forbes CA, Jepson RG, Martin-Hirsch PPL. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Syst Rev 2002:CD002834.

    Implications for practice and research

  • The participation of community health workers in encouraging and inviting women to undergo cervical cancer screening is very effective way for disease prevention.

  • Research on cervical cancer prevention interventions should be based on theories of behaviour change.

  • Context

    International Agency for Research on Cancer estimated that 6.5% of the new cases of cancer among women of all age groups originates from cervix uteri.1 According to the last report, cervical cancer with an age-standardised incidence rate of 13.3 per 100 000 is the fourth most common cancer of females.1 Cervical cancer screening for early detection and timely treatment of precancerous lesions along with human papillomavirus vaccination will prevent most cervical cancer cases.

    Overtime on a rotating-shift pattern impacts nurses alertness increasing risks for patients

    Por: Sorice · V. · Spackman · J.

    Commentary on: Min A, Hong HC, Son S, et al. Overtime and alertness of rotating-shift nurses: an observational study using ecological momentary assessment. J Clin Nurs 2022;11; doi:10.1111/JOCN.16218

    Implications for practice and research

  • Differences between age, gender and clinical experience should be further explored in relation to alertness and overtime.

  • Organisations should be aware of the risks to patient care when relying on overtime to cover staff shortages.

  • Context

    Nurses are typically scheduled to work long rotating shifts and routinely incorporate overtime to allow hospitals to provide round-the-clock care to patients. This can exacerbate fatigue diminishing productivity and making nurses more prone to errors.1 Recent studies highlighted the association between nurses’ overtime and poor patient outcomes with a call for further research required.2 When studying the impact of overtime on alertness in rotating shifts, Min et al employed an ecological...

    Parents experiences of care offered after stillbirth: available, accessible, acceptable, equitable and effective care

    Por: Hamzehgardeshi · Z. · Ansari · F. · Khoori · E.

    Commentary on: Horey D, Boyle FM, Cassidy J, et al. Parents’ experiences of care offered after stillbirth: an international online survey of high and middle-income countries. Birth 2021; 48:366–74. doi:10.1111/birt.12546.

    Implications for practice and research

  • Offering and availability of bereavement care options to women and her families are an important component of all maternity services. These options must be offered based on their needs.

  • Future research should examine why differences in bereavement care occur in different countries, how they affect parents, and in particular, how to support effective connections, decision, and follow-up care.

  • Context

    Stillbirth is undoubtedly one of the most distressing traumatic experiences with long-term impacts on bereaved parents.1 Unfortunately, despite care protocols, parents often report staff behaviour that can do more harm to parents.2 The purpose of this study was to describe the offering of bereavement care practices...

    KT: why it should be 'hotter than it is

    Por: Barwick · M.

    Knowledge translation (KT) is a science and a practice, and despite no longer being nascent, it has never achieved ‘hot’ status among STEM fields. Despite 20 years of growing international policy and research attention on reducing the evidence-practice and policy gap, KT and implementation science are not getting the attention they deserve. The ‘hot’ emerging fields are rooted in discovery, but discovery must translate into things we can understand, apply and use. Evidence-based innovations will not reach their potential unless they are accessible, and we can demonstrate how they can be implemented in real-world contexts. Academia has a longstanding laudatory focus on publication at the expense of application and impact, and shifting to a more balanced view is an uphill battle. Our academic institutions and funders, our governments and service provider organisations must put implementation at the forefront of their efforts if we are to realise optimal benefits from our innovations.

    Evidence for change: measurements of quality and effectiveness among community-based palliative care programmes

    Por: Kean · T.

    Commentary on: Vernon E, Hughes M, Kowalczyk M. Measuring effectiveness in community-based palliative care programs: A systematic review. Soc Sci Med. 2022; 296. doi.org/10.1016/j.socscimed.2022.114731

    Implications for practice and research

  • Community-based palliative care (CBPC) programmes can improve quality of life (QoL), decrease symptom burden and decrease hospital utilisation.1

  • Research to determine best practices in CBPC may inform standards of care worldwide.1

  • Context

    Medical, social and economic advances have been life-saving for many yet have also led to increased disease patterns and disease prevalence often resulting in life-limiting illnesses.2 Globally, nearly 40 million people need palliative care yet only about 14% receive it.3 Of those in need, 78% reside in low-income to middle-income countries.3 Increased need for palliative care and increased patient preference to die at home have extended palliative care services to CBPC programmes. Yet little...

    Professional discrimination toward nurses increases nurse silence threatening patient safety outcomes

    Por: Zhang · N. · Casas · B.

    Commentary on: Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses

    Implications for practice and research

  • More research should be conducted to understand the underlying mechanisms shaping the associations between professional discrimination and nursing silence.

  • Rates of professional discrimination tend to be high and similar to other types of discrimination within the nursing profession.

  • The environment created by nursing leadership and interdisciplinary superiors can inhibit bedside nurses’ interventions in patient safety.

  • Bedside nurses risk patient safety when they feel that they cannot adequately voice their concerns to their superiors.

  • Research can be expanded to include:

  • Exploration of the safety impacts the nursing workplace has on discrimination of minority patient populations.

  • If there is a correlation between the safety of minority nurses (including international and foreign-educated nurses) and the safety of their assigned...

  • Meta-analysis examining interventions aimed at reducing sedentary lifestyle in poststroke patients

    Por: Lawal · M.

    Commentary on: Saunders DH, Mead GE, Fitzsimons C, et al. Interventions for reducing sedentary behaviour in people with stroke (Review). Cochrane Database Syst Rev 2021, 6: 1–19.

    Implications for practice and research

  • The impact of stroke may lead to sedentary lifestyle among affected patients.

  • The level of physical activity may act as a buffer to a better quality of life, however, sedentary behaviour is not associated with reduced or increased mortality in people affected with stroke.

  • Further studies are required to bridge clinical and research gaps in this area.

  • Context

    Sedentary behaviour is associated with health risks1 such as heart attack, stroke, type 2 diabetes and adiposity. Due to the perceived benefits of physical activity, the WHO and the Department of Health in England guidelines both recommend replacing sedentary life with physical activity.1 2 Stroke is one...

    Addressing health beliefs in vaccination policies to increase uptake among older adults from ethnic minority backgrounds

    Por: Afriyie · D.

    Commentary on: Bhanu C, Gopal DP, Walters K, et al. Vaccination uptake amongst older adults from minority ethnic backgrounds: a systematic review. PLoS Med 2011; 18(11):e1003826. doi: 10.1371/journal.pmed.1003826

    Implications for practice and research

  • Healthcare professionals should tailor vaccination education to address people’s health belief models to minimise hesitancy.

  • An empirical study exploring the health beliefs and other factors influencing vaccination uptake among older adults from minority ethnic backgrounds.

  • Context

    Vaccine hesitancy is high among individuals from ethnic minority backgrounds (EMB). Globally, an age-based vaccination approach was implemented during the initiation of the COVID-19 vaccination.1 In this approach, older people were prioritised to receive COVID-19 vaccination since older adults were prone to contracting the disease as well as experiencing severe morbidity and mortality from the virus. This was more so in older EMB adults than similar-aged Caucasians. Despite availability of COVID-19 vaccines, vaccination...

    Healthcare professionals who provide palliative care require support to reduce symptoms of burnout

    Por: Nyatanga · B.

    Commentary on: Dijxhoorn, A-F. Q., Brom, L., van der Lindern, Y., et al. Prevalence of burnout in healthcare professionals providing palliative care and the effect of interventions to reduce symptoms: A systematic literature review. Palliative Medicine 2020, 1–21

    Implications for practice and research

  • A range of interventions may help reduce symptoms of burnout in healthcare professionals who provide palliative care.

  • Future research is required to further explore the nature and impact of burnout among generalists and specialist palliative care professionals.

  • Context

    Burnout is experienced more among healthcare professionals (HCPs) than the general population.1 Burnout is a complex process that develops over time and not only affects personal well-being of HCPs, but is often associated with human errors and poor patient care. This study2 explored the relationship between providing palliative care and potential for developing burnout, and interventions that may help...

    Asking parents/carers of young children with Down syndrome about specific eating behaviours and feeding practices could lead to more effective tailored support for feeding problems

    Por: Wood · S. · Clegg · J.

    Commentary on: Rogers SL, Smith B, Mengoni SE. Relationships between feeding problems, eating behaviours and parental feeding practices in children with Down syndrome: A cross-sectional study. J Appl Res Intellect Disabil. 2022;35(2):596–606.

    Implications for practice and research

  • Healthcare professionals should establish the specific nature of eating and feeding behaviours to offer tailored support.

  • Understanding the mechanisms impacting on feeding problems and identifying those at greatest risk would facilitate earlier interventions.

  • Context

    Children with Down syndrome (DS) are known to experience a higher prevalence of feeding problems. Anatomical and physiological differences result in varying degrees of neuromotor dysfunction that impact on eating, drinking and swallowing. Prior research has addressed the nature of feeding and swallowing difficulties in children with DS1 2 and begun to explore correlates of feeding problems, identifying parental feeding practices as a bi-directional influencing factor.3 This...

    Providing contextual and high-quality ECG training to nurses is essential for their expanding scope of practice

    Por: Singh · S. · Kapoor · S.

    Commentary on: Chen Y, Kunst E, Nasrawi D, Massey D, Johnston AN, Keller K, Fengzhi Lin F. Nurses’ competency in electrocardiogram interpretation in acute care settings: A systematic review. J Adv Nurs 2022.

    Implications for practice and research

  • Providing high-quality ECG training to nurses with renewal certifications is essential for their expanding scope of practice.

  • Exploring nurses’ ECG attitude, knowledge and skills can aid in defining ECG competencies, standardising assessment approaches and tools, and developing high-quality ECG training modules.

  • Context

    Health assessment is vital for nursing clinical judgements. Nurses rely on a multitude of sources, methods and skills to identify, assess, interpret, predict, monitor and evaluate patient health status.1 The ECG is a non-invasive robust tool to offer relatively prompt access to heart activity to nurses and other healthcare providers. Yet, a high level of proficiency is warranted to accurately and timely...

    Reduced alertness as a consequence of rotating shift patterns puts safe care delivery at risk

    Por: Sorice · V. · Russell · E.

    Commentary on: Min A, Hong HC, Son S, et al, Alertness during working hours among eight-hour rotating-shift nurses: an observational study. J Nurs Scholar 2021;75. doi:10.1111/JNU.12743

    Implications for practice and research

  • Organisational measures to implement alertness are necessary to safeguard patient care and staff well-being.

  • Further research is needed in order to optimise shift design and develop suitable countermeasures for all shift-working healthcare professional.

  • Context

    Increasing evidence suggests that shift-pattern generated fatigue in nurses can impair their ability to offer high-quality care to patients. Nevertheless, to guarantee 24-hour care, most healthcare professionals (HP) must comply with shift-working. Specifically, rotating-shifts are more likely to cause a decreased alertness and increased tiredness effect on HP due to continuous changes in their sleep patterns. As the consequences of sleep deprivation are comparable to those of blood alcohol concentrations of 0.05%–0.1%, Min et al used objective metrics to...

    Resources page

    Por: Heale · R.
    Evidence-based practice (EBP) resourcesEvidence-based nursing (EBN): research made simple series (free)

    https://ebn.bmj.com

    Free, concise articles published two to three times per year in EBN (available online) each of which describes an element of research (design, analysis, etc).

    Library: EBN resources

    https://s4be.cochrane.org/blog/2017/03/09/library-evidence-based-nursing-resources/

    This page features links to various resources related to EBN. Includes introductions and overviews of EBN, research made simple tutorials, blogs, images and videos, study skills and revision aids, point-of-care tools, databases and tools to assist with searching for research, additional EBN journals.

    EBP toolkit for nursing

    https://libguides.ohsu.edu/ebptoolkit/Resources

    Top nursing databases and point-of-care tools.

    Nursing reference centre plus (requires subscription, but does have some free material online)

    https://www.ebsco.com/health-care/products/nursing-reference-center-plus

    This evidence-based point-of-care resource includes continuously updated information, based on the best available evidence in nursing, allied health and biomedical literature, written specifically for...

    Approaches for educators to effectively teach research and research methods

    Por: Younas · A. · Fabregues · S. · Durante · A.
    Introduction

    Research and research methods courses are an integral part of undergraduate and graduate curricula across science, technology, engineering and mathematics (STEM) and non-STEM disciplines. However, research methods courses can be daunting and challenging for students because of the complex content and the students’ perceived fears of mastering practical skills and apply the learnt content in practice.1 2 Many students also find research methods content dreary, uninteresting, anxiety-provoking and irrelevant.3 4 Educators also encounter challenges in effectively teaching research methods due to diversity in methodological content, fragmented expertise, lack of consistent curricula, unavailability of resources to support research teaching and linguistic difficulties in understanding jargon-laden research language.5 6 In this paper, we outline some strategies that can be valuable for educators to effectively teach research and research methods at both undergraduate and graduate levels.

    Nurse-led dialogue-driven digital platform-based personalised education programmes may improve diabetes management of patients on basal insulin therapy

    Por: Singh · S. · Zettel · S.

    Commentary on: Huang W, Wei W, Wang J, et al. Effectiveness of a nurse-led online educational programme based on basic insulin therapy in patients with diabetes mellitus: A quasi-experimental trial. J Clin Nurs 2021. doi:10.1111/jocn.16041 [published Online First: 23 September 2021].

    Implications for practice and research

  • Nurses can adapt the online educational programme to their practice context and deliver it to local and remote patients with basal therapy.

  • Further research is required to develop a dialogue-driven digital platform-based transdisciplinary education programme to improve self-management of diabetes.

  • Context

    Globally, 537 million (1 in 10) adults live with diabetes, which caused 6.7 million deaths in 2021 and costed nearly one trilliant US dollars over the last 15 years.1 The basal therapy supplies consistent insulin to the body for an adequate control of blood glucose. Attitude, knowledge and insulin intake-related behaviour patterns of individuals with diabetes can influence...

    Non-pharmacological interventions may reduce levels of fear of childbirth, but the reduction may not be clinically significant

    Por: Hamzehgardeshi · Z. · Ansari · F.

    Commentary on: O'Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O'Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev. 2021(7). doi:10.1002/14651858.CD013321.pub2.

    Implications for practice and research

  • Healthcare providers such as gynaecologists, obstetricians and midwives as well as mental healthcare providers can reduce high-level or intense fears of childbirth in women and strengthen their sense of self-efficacy in the face of delivery, something that could result in a reduction of elective caesarean section.

  • However, in high-quality randomised clinical studies, the effectiveness of non-pharmacological interventions on other important outcomes such as maternal satisfaction and women’s anxiety should also be examined.

  • Context

    Pregnancy is a special situation in which there is a natural fear of the process of childbirth. However, the amount of fear is significantly related to the personality and knowledge of the parents in this regard. Numerous clinical studies have investigated...

    High effectiveness of papillomavirus vaccination in preventing cervical cancer: is not it time for low-income and middle-income countries to reap the benefits?

    Por: Moradi · S.

    Commentary on: Falcaro M, Castañon A, Ndlela B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade three cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet 2021; Dec 4;398 (10316):2084–2092.

    Implications for practice and research

  • The high burden of cervical cancer in low-income and middle-income countries highlights the need for early prevention.

  • Research on the beneficial effects of papillomavirus vaccination in low-income and middle-income countries is a priority.

  • Context

    International agency for research on cancer estimated that nearly 604 000 women were diagnosed with cervical cancer and about 342 000 women died from the disease worldwide in 2020.1 The main cause of cervical cancer is persistent infection with high-risk oncogenic strains of human papillomavirus (HPV) including 16 and 18. Vaccination against high-risk HPV types, and screening programmes made cervical cancer as one of the...

    Effect of depression on caregivers caring for family members living with dementia and other chronic illnesses

    Por: Alcindor · M. L.

    Commentary on: Lippe, M., Crowder, A., Carter, P. & Threadgill, H. (2021). Variables impacting the quality of life of dementia caregivers: A data visualization analysis. Journal of Nursing Scholarship 53:6, 772-780. https://mc.manuscriptcentral.com/evidencebased.

    Implications for practice and research

  • Healthcare professionals and caregivers must be educated about the impact and long-term effect of social isolation on patient with dementia and its implication on the declining health of caregivers caring for these patients.

  • The mixed methodology research can be used to explore the testimonial reports of the caregivers, as well as the statistical significance of the phenomenon (poorer health outcomes in caregivers of patients with dementia placed in quarantine).

  • Context

    Research findings indicate that caregivers of persons living with Alzheimer’s disease reported increased deterioration in their physical and mental health compared with caregivers of patients without dementia.1 This study was intended to help...

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