Un relato donde una paciente manifiesta su sentir ante la experiencia vivida durante la estancia en un centro sanitario, expresando su agradecimiento a la enfermera que le atendió. Resalta la importancia del cuidado emocional recibido, que influyó positivamente en su recuperación. El gesto humano de la enfermera a través de la escucha y su cercanía, hicieron que la paciente recuperara la esperanza en la mejora de su salud, recobrando el optimismo en su vida.
The prevalence of wounds and comorbidities such as dementia increase with age. With an ageing population, the likelihood of overlap of these conditions is strong. This study aimed to determine the prevalence of wound types and current management strategies of wound care for people with dementia in long‐term care (LTC). A scoping literature review, a cross‐sectional observational and chart audit study of residents in dementia specific facilities in LTC were conducted. The scoping review indicated that people with dementia/cognitive impairment are often excluded from wound related studies and of the nine studies included in this review, none looked at the prevalence of types of wounds other then pressure injuries. In the skin audit, skin tears were noted as the most common wound type with some evidence‐based practice strategies in place for residents. However, documentation of current wound occurred in less than a third of residents with wounds. This is the first study to note the prevalence of different wound types in people with dementia and current management strategies being used across two dementia‐specific facilities and a lack of research in this area limits evidence in guiding practice.
The purpose of this review was to identify the role and contribution of community‐based nurse‐led wound care as a service delivery model. Centres increasingly respond proactively to assess and manage wounds at all stages – not only chronic wound care. We conducted an integrative review of literature, searching five databases, 2007–2018. Based on inclusion and exclusion criteria, we systematically approached article selection and all three authors collaborated to chart the study variables, evaluate data, and synthesise results. Eighteen studies were included, representing a range of care models internationally. The findings showed a need for nurse‐led clinics to provide evidence‐based care using best practice guidelines for all wound types. Wound care practices should be standardised across the particular service and be integrated with higher levels of resources such as investigative services and surgical units. A multi‐disciplinary approach was likely to achieve better patient outcomes, while patient‐centred care with strong patient engagement was likely to assist patients' compliance with treatment. High‐quality community‐based wound services should include nursing leadership based on a hub‐and‐spoke model. This is ideally patient‐centred, evidence‐based, and underpinned by a commitment to developing innovations in terms of treatment modalities, accessibility, and patient engagement.
Hospital‐acquired pressure injuries (HAPIs) represent a serious clinical and economic problem. The cost of treating HAPIs in Australian public hospitals was recently reported at AUS$983 million per annum. There are three main sources of data for documenting pressure injury (PI) occurrence in Australian hospitals: incident reporting, medical record coded data, and real‐time surveys of pressure injury. PI data reported at hospital level and to external agencies using these three different sources are variable. This reporting issue leads to inaccurate data interpretation and hinders improvement in accuracy of PI identification and PI prevention. This study involved a comparison of the three different data sources in selected Australian hospitals, to improve the accuracy and comparability of data. Findings from this study provide benchmark areas for improvement in PI documenting and reporting. Better understanding the agreement between the three data sets could lead to a more efficient and effective sharing of data sources.
Corticosteroid‐induced skin atrophy (CISA) consists of a thinning of the skin and subcutaneous tissues, representing the natural consequence of a prolonged glucocorticosteroids use, both systemic as well as topical. It is characterised by the loss of elasticity and skin thickness, associated with an increased skin fragility leading to ecchymoses, haematomas, and steroid purpura. The management of CISA is a challenge for physicians, as the pathology is reversible in a minimal percentage of cases and only after a short topical steroid or low‐dose course therapy. Often wounds with large loss of substance represent the more common complication, after a surgical drainage which is often necessary. Skin necrosis with compartment syndrome of a leg is another potential risk for these patients. Here, we report a case of an elderly patient affected by multiple subcutaneous haematomas of the legs causing skin necrosis, arisen after the use of anticoagulants for a deep venous thrombosis. The patient was successfully treated with surgical drainage, negative pressure wound therapy (NPWT), and porcine xenograft with no complications. Finally, we discuss the evidence of the current literature on topic.
Introducción: La prematuridad y el bajo peso al nacer son factores predictivos asociados a la morbilidad y la mortalidad neonatal y, por lo tanto, dan lugar a complicaciones como el Síndrome de Dificultad Respiratoria (SDR), que es la principal complicación de los recién naci-dos que ingresan en la Unidad de Cuidados Intensivos Neonatales (UCIN). Objetivo: implementar cuidados integrales de enfermería especializados e individualizados al recién nacido extremadamente prematuro basados en recomendaciones de evidencia científica e intervenciones NIC. Presentamos la valoración integral de una persona recién nacida de 23 SDG con un peso de 500 g. más SDR remitidos desde un hospital comunitario básico a un hospital de tercer nivel de atención, donde se aplica el proceso de enfermería. Métodos: Se seleccionó un paciente a conveniencia de la UCIN, aplicando la metodología del proceso de enfermería, la evaluación integral a tra-vés de los 13 dominios de la NANDA, los datos se obtuvieron del expediente clínico, la entrevista con la madre y el examen físico del recién nacido Se identifican las principales respuestas humanas para analizar datos objetivos y subjetivos, se hacen juicios clínicos para implementar planes de atención bajo recomendaciones de guías de práctica clínica e intervenciones de NIC. Resultados: Se implementa-ron cinco planes de atención con diagnóstico priorizado de enfermería, cuatro reales y uno en riesgo, se identificaron los dominios más alterados: nutrición, eliminación/intercambio, crecimiento/desarrollo y seguridad/protección. Conclusiones: se realizaron intervenciones independientes e interdependientes observando mejoría en los dominios alterados, sin embargo, el recién nacido se mantuvo en una incubadora y permaneció en la UCIN para seguir los planes terapéuticos especializados, Esto implica que la UCIN debe contar con personal multidisciplinario altamente capacitado con conocimientos actualizados en atención neonatal.
by Lihong Gu, Feng Wang, Zhemin Lin, Tieshan Xu, Dajie Lin, Manping Xing, Shaoxiong Yang, Zhe Chao, Baoguo Ye, Peng Lin, Chunhui Hui, Lizhi Lu, Shuisheng HouJiaji Duck (JJ) is a Muscovy duck species that possesses many superior characteristics, and it has become an important genetic resource in China. However, to date, its genetic characteristics and genetic relationship with other duck breeds have not been explored yet, which greatly limits the utilization of JJ. In the present study, we investigated the genome sequences of 15 individual ducks representing five different duck populations, including JJ, French Muscovy duck (FF), mallard (YD), hong duck (HD) and Beijing duck (BD). Moreover, we investigated the characteristics of JJ-specific single nucleotide polymorphisms (SNPs) and compared the genome sequences of JJ vs. YD and JJ vs. BD using integrated strategies, including mutation detection, selective screening, and Gene Ontology (GO) analysis. More than 40 Gb of clean data were obtained for each population (mean coverage of 13.46 Gb per individual). A total number of 22,481,367 SNPs and 4,156,829 small insertion-deletions (Indels) were identified for the five duck populations, which could be used as molecular markers in breeding and utilization of JJ. Moreover, we identified 1,447,932 JJ-specific SNPs, and found that genes covering at least one JJ-specific SNP mainly involved in protein phosphorylation and dephosphorylation, as well as DNA modification. Phylogenetic tree and principal components analysis (PCA) revealed that the genetic relationship of JJ was closest to FF, while it was farthest to BD. A total of 120 and 111 genes were identified as positive selection genes for JJ vs. BD and JJ vs. YD, respectively. GO and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that the positive selection genes for JJ vs. BD ducks mainly involved in pigmentation, muscle contraction and stretch, gland secretion, and immunology, while the positive selection genes obtained from JJ vs. YD ducks mainly involved in embryo development, muscle contraction and stretch, and gland secretion. Taken together, our findings enabled us to better understand the characteristics of JJ and provided a molecular basis for the breeding and hybrid utilization of JJ in the future.
by Tim Rahmel, Stefanie Schmitz, Hartmuth Nowak, Kaspar Schepanek, Lars Bergmann, Peter Halberstadt, Stefan Hörter, Jürgen Peters, Michael AdamzikPatients with severe infections and especially sepsis have a high in-hospital mortality, but even hospital survivors face long-term sequelae, decreased health-related quality of life, and high risk of death, suggesting a great need for specialized aftercare. However, data regarding a potential benefit of post-discharge rehabilitation in these patients are scarce. In this retrospective matched cohort study the claim data of a large German statutory health care insurer was analyzed. 83,974 hospital survivors having suffered from septic shock, sepsis, and severe infections within the years 2009–2016 were identified using an ICD abstraction strategy closely matched to the current Sepsis-3 definition. Cases were analyzed and compared with their matched pairs to determine their 5-year mortality and the impact of post-discharge rehabilitation. Five years after hospital discharge, mortality of initial hospital survivors were still increased after septic shock (HRadj 2.03, 95%-CI 1.87 to 2.19; Padj 1.73, 95%-CI 1.71 to 1.76; Padj 1.70, 95%-CI 1.65 to 1.74; Padj 0.81, 95%-CI 0.77 to 0.85; Padj 0.81, 95%-CI 0.73 to 0.90; P
by Yohann Moanahere Chiu, Alain Vanasse, Josiane Courteau, Maud-Christine Chouinard, Marie-France Dubois, Nicole Dubuc, Nicolas Elazhary, Isabelle Dufour, Catherine HudonBackground
Frequent emergency department users are patients cumulating at least four visits per year. Few studies have focused on persistent frequent users, who maintain their frequent user status for multiple consecutive years. This study targets an adult population with chronic conditions, and its aims are: 1) to estimate the prevalence of persistent frequent ED use; 2) to identify factors associated with persistent frequent ED use (frequent use for three consecutive years) and compare their importance with those associated with occasional frequent ED use (frequent use during the year following the index date); and 3) to compare characteristics of “persistent frequent users” to “occasional frequent users” and to “users other than persistent frequent users”.Methods
This is a retrospective cohort study using Quebec administrative databases. All adult patients who visited the emergency department in 2012, diagnosed with chronic conditions, and living in non-remote areas were included. Patients who died in the three years following their index date were excluded. The main outcome was persistent frequent use (≥4 visits per year during three consecutive years). Potential predictors included sociodemographic characteristics, physical and mental comorbidities, and prior healthcare utilization. Odds ratios were computed using multivariable logistic regression.Results
Out of 297,182 patients who visited ED at least once in 2012, 3,357 (1.10%) were persistent frequent users. Their main characteristics included poor socioeconomic status, mental and physical comorbidity, and substance abuse. Those characteristics were also present for occasional frequent users, although with higher percentages for the persistent user group. The number of previous visits to the emergency department was the most important factor in the regression model. The occasional frequent users’ attrition rate was higher between the first and second year of follow-up than between the second and third year.Conclusions
Persistent frequent users are a subpopulation of frequent users with whom they share characteristics, such as physical and mental comorbidities, though the former are poorer and younger. More research is needed in order to better understand what factors can contribute to persistent frequent use.
by Abdellatif El-Ahmadi, Mujahed Sebastian Abassi, Hedvig Bille Andersson, Thomas Engstrøm, Peter Clemmensen, Steffen Helqvist, Erik Jørgensen, Henning Kelbæk, Frants Pedersen, Kari Saunamäki, Jacob Lønborg, Lene Holmvang
Nurse leaders who are mothers are at significant risk for experiencing stress, burnout, and occupational fatigue. Authentic Connections (AC) Groups is an intervention shown to be effective for fostering resilience among at‐risk moms, including physicians; however, it has not previously been tested with nurse leaders.
Our aims were to test the feasibility and acceptability of the AC Groups intervention with nurse leader mothers and examine its effects on participant resilience, as measured by increased self‐compassion and decreased distress, depression, perceived stress, and burnout.
A randomized controlled trial design was employed for this pilot study, with 36 nurse leaders at Mayo Clinic. AC participants attended group sessions for an hour per week for 12 weeks. Control group members were provided 1 hr per week of free time over 12 weeks. Multiple self‐report psychological measures were completed at baseline, post‐intervention, and 3‐month follow‐up.
The AC Groups intervention was feasible and well‐received by nurse leaders. Session attendance rates averaged 92%. Despite the small n’s, repeated measures of Analysis of Variance showed significantly greater improvements (p < .05) for participants in the AC Groups than control condition for depression, self‐compassion, and perceived stress, with large effect sizes ( 0.18–0.22). In addition, effect sizes for anxiety and feeling loved approximated the moderate range ( 0.05 and .07).
The AC intervention shows promise as a feasible intervention for mitigating nurse leader mothers’ stress by positively impacting indices of well‐being, including depression, self‐compassion, and perceived stress. Given, the prevalence of stress and burnout among nurse leaders, the effectiveness of the AC intervention in fostering resilience in this population has significant implications for research and practice. Further research is warranted with larger numbers from multiple sites, longer follow‐up periods, and biomarker measures of stress.
We now know that nurses are at greater risk for suicide than others in the general population. It is known that job stressors are prevalent in nurses who die by suicide. Yet, little is known about targeted suicide prevention for nurses. The first nurse‐centric Healer Education Assessment and Referral (HEAR) suicide prevention program was piloted for 6 months in 2016. The HEAR program was effective in identifying at‐risk nurses.
The purpose of this paper is to report the 3‐year sustainability and outcomes of this nurse suicide prevention program.
Descriptive statistics are provided of program outcomes over the course of 3 years.
Over the 3 years, 527 nurses have taken advantage of the screening portion of the program. Of these, 254 (48%) were Tier 1 high risk, and 270 (51.2%) were Tier 2 moderate risk. A startling 48 (9%) had expressed thoughts of taking their own life, 51 (9.7%) had a previous suicide attempt, whereas only 79 (15%) were receiving counseling or therapy. One hundred seventy‐six nurses received support from therapists electronically, over the phone, or in person; 98 nurses accepted referral for treatment. The number of group emotional debriefs rose from eight in 2016 to 15 in 2017 to 38 in fiscal year 2019. Many of the debriefs are now requested (vs. offered), demonstrating the development of a culture open to reaching out for mental health treatment.
The initial success of this pilot program has been sustained. A nurse suicide prevention program of education, assessment, and referral is feasible, well‐received, proactively identifies nurses with reported suicidality and facilitates referral for care. The HEAR program has provided service to physicians and residents for 10 years and now supports effectiveness in nurses. The HEAR program is portable and ready for replication at other institutions.
Evidence‐based practice (EBP) is a systematic problem‐solving approach to the delivery of health care that improves quality and population health outcomes as well as reduces costs and empowers clinicians to fully engage in their role, otherwise known as the quadruple aim in health care. The Helene Fuld Health Trust National Institute for Evidence‐based Practice in Nursing and Healthcare at The Ohio State University College of Nursing has been offering 5‐day EBP immersion programs since 2012. The goal of the program is for the participants to acquire EBP competence (e.g., knowledge, skills, and attitude) and sustain it over time.
The purpose of this study was to evaluate the effects of the 5‐day EBP immersion (i.e., an education and skills building program) on EBP attributes and competence over time.
A longitudinal pre‐experimental study was conducted that gathered data with an anonymous online survey from 400 program attendees who attended 16 5‐day immersions between September 2014 and May 2016. Participants completed five valid and reliable instruments at four points over 12 months, including EBP beliefs, implementation, competency, knowledge, and perception of organizational readiness and culture.
Findings indicated statistically significant improvements in EBP attributes and competency over time. The results of this study support the hypotheses that EBP competency and attributes can be significantly improved and sustained by attending an intensive 5‐day EBP educational and skills building program such as the one described in this study. This study can help leaders and organizations to mitigate many of the traditional barriers to EBP.
The results of this study indicate that EBP attributes and competencies can be improved and sustained by attending an intensive 5‐day EBP immersion, regardless of clinicians’ prior educational preparation.
To describe how intensive critical care nurses, whose experience is limited, experience caring for an organ donor during the donation process.
Intensive critical care nurses are involved in the care of organ donors and their relatives. This may be challenging and evoke a sense of providing an inhumane care. Few studies have explored how intensive critical care nurses whose experience is limited experience caring for an organ donor during the donation process.
An interview study with an inductive qualitative approach was conducted. The study was reported according to COREQ guidelines.
This study was performed during 2019. Participants were intensive critical care nurses (n = 7) from different hospitals (n = 4) with <3 years of experience and involvement in the donation process at least once but no more than three times. Data were analysed using qualitative content analysis.
Five categories emerged: the donation process is emotionally challenging; supporting relatives is an essential but demanding task; a complex and multifaceted process involving a high level of responsibility; needing appropriate prerequisites in the form of education and collegial support; and providing a dignified care based on respect for the organ donor.
Having limited experience as an intensive critical care nurse may not automatically mean that caring for an organ donor is experienced as more challenging than it is for a more‐experienced colleague. However, certain intensive critical care nurses whose experience caring for an organ donor is limited found it to be highly demanding due to its complexity, specifically in regard to informing relatives of the loss of their loved one and providing them with support.
Our study revealed a need for further education. This need could be met by simulation tasks during the specialist education in intensive critical care nursing, where primarily ethical aspects and strategies for meeting with and supporting relatives should be examined and practiced.
To explore the extent to which a checklist designed to support patient safety in hospital Emergency Departments was recognised and used by staff.
Patient crowding in UK Emergency Departments makes it difficult for staff to monitor all patients for signs of clinical deterioration. An Emergency Department Safety Checklist was developed at a UK hospital to ensure patients are regularly monitored. It was subsequently implemented in six hospitals and recommended for use across the National Health Service in England.
This was a qualitative study in two UK hospital Emergency Departments. Data collection consisted of sixty‐six hours of nonparticipant observation and interviews with twenty‐six staff. Observations were sampled across different days and times. Interviews sampled a range of staff. Data were analysed thematically. The study was undertaken in accordance with COREQ guidelines.
Staff described the Emergency Department Safety Checklist as a useful prompt and reminder for monitoring patients' vital signs and other aspects of care. It was also reported as effective in communicating patient care status to other staff. However, completing the checklist was also described as a task which could be overlooked during busy periods. During implementation, the checklist was promoted to staff in ways that obscured its core function of maintaining patient safety.
The Emergency Department Safety Checklist can support staff in maintaining patient safety. However, it was not fully recognised by staff as a core component of everyday clinical practice.
The Emergency Department Safety Checklist is a response to an overcrowded environment. To realise the potential of the checklist, emergency departments should take the following steps during implementation: (a) focus on the core function of clinical safety, (b) fully integrate the checklist into the existing workflow and (c) employ a departmental team‐based approach to implementation and training.
To explore the effects of hospital‐family holistic care model based on “Timing It Right” on the health outcome of Patients with permanent colostomy.
Colorectal cancer is a common malignant tumor of digestive system, which seriously threatens human life and health. Colostomy is one of the main treatments for colorectal cancer, which effectively improves the 5‐year survival rate of patients. However, the postoperative psychological and physiological rehabilitation nursing is still faced with great challenges due to the change of body image and defecation pathway caused by colostomy.
A randomized controlled trial was conducted and 119 patients with permanent enterostomy were randomly divided into two groups, with 60 cases in the intervention group and 59 cases in the control group. The intervention group received routine care、follow‐up and hospital‐family holistic care intervention based on “Timing It Right”, while the control group received routine care and follow‐up. The resilience, self‐care ability, complications and life quality of Patients with permanent enterostomy were compared between two groups before intervention，at discharge , 3 months and 6 months after discharge. CONSORT checklist was applied as the reporting guideline for this study (See supplementary File 1).
108 patients with permanent enterostomy completed the study (90.76%). At 3 months and 6 months after discharge, the resilience and quality of life in the intervention group were significantly better than those in the control group (t = 4.158 vs 7.406, t = 4.933 vs 8.611, P < 0.05); while the complications in the intervention group were significantly lower than that in the control group (25.5% vs 41.51%, 14.45% vs 30.19% ; P < 0.05). The self‐care ability of the intervention group was significantly better than that in the control group (t = 1.543 vs 3.656 vs 6.273, P < 0.05) at discharge, 3 months and 6 months after discharge. The interaction between time and grouping showed that the effect of time factor varied with the grouping. After intervention, there were significant differences in psychological resilience、 self‐care ability、complications and quality of life between the two groups at different observation points (P < 0.01). The three evaluation indices of intervention group increased with the migration of observation time points and were significantly better than those of control group, especially the quality of life (84.35±4.25 vs 60.45±8.42, P < 0.01).
The hospital‐family holistic care model based on “Timing It Right” can effectively improve the psychological resilience, self‐care ability, quality of life, reduce complications and improve the health outcomes of patients with permanent enterostomy.
Patients with permanent enterostomy have different needs for nursing care at different stages of the disease, and they are dynamically changing. The hospital‐family holistic care model based on “Timing It Right” can effectively improve the health outcomes of patients with permanent enterostomy, which is worthy of clinical application.
To evaluate the effectiveness of self‐care programmes in type 2 diabetes mellitus (T2DM) population in primary health care.
The impact of educational interventions on T2DM has been evaluated in various contexts, but there is uncertainty about their impact in that of primary care.
Systematic review and meta‐analysis.
A search was conducted in PubMed, CINAHL, WOS and Cochrane databases for randomised controlled trials carried out in the period January 2005‐December 2017, including studies with at least one face‐to‐face educational interventions. The quality of the evidence for the primary outcome was evaluated using the GRADE System. A meta‐analysis was used to determine the effect achieved although only the results classified as critical or important were taken into consideration. Checklist of Preferred Reporting Items for Systematic Reviews and Meta‐analyses has been followed. PROSPERO registration Number: CRD42016038833.
In total, 21 papers (20 studies) were analysed, representing a population of 12,018 persons with T2DM. For the primary outcome, HbA1c, the overall reduction obtained was −0.29%, decreasing the effect in long‐term follow‐up. The quality of the evidence was low/very low due to very serious risk of bias, inconsistency and indirectness of results. Better results were obtained for individual randomised trials versus cluster designs and in those programmes in which nurses leaded the interventions. The findings for other cardiovascular risk factors were inconsistent.
Educational interventions in primary care addressing T2DM could be effective for metabolic control, but the low quality of the evidence and the lack of measurement of critical results generates uncertainty and highlights the need for high‐quality trials.
Most of self‐care programmes for T2DM in primary care are focused on metabolic control, while other cardiovascular profile variables with greater impact on mortality or patient‐reported outcomes are less intensely addressed.
To explore the relationship between critical thinking disposition and research competence among clinical nurses.
The development of the nursing discipline and evidence‐based practice calls for research competence and critical thinking disposition among clinical nurses. The verification of the relationship between critical thinking disposition and research competence could make contributions to promoting related knowledge building and providing practical implications for nurses, nurse educators and nurse managers. However, there is a lack of evidence exploring the relationship between critical thinking disposition and research competence in clinical nurses.
A cross‐sectional study.
A total of 156 clinical nurses from two tertiary hospitals participated in this study. The Chinese Version of Critical Thinking Disposition Inventory and Research Competence Scale for Clinical Nurses were used to measure critical thinking disposition and nursing research competence, respectively. Data were collected in September 2017. Descriptive statistics, bivariate correlation and linear regression were used to analyse data. The STROBE checklist was used in reporting this study.
The clinical nurses surveyed showed a positive inclination to general critical thinking but reported an overall low level of nursing research competence. A moderate degree of positive correlation was found between critical thinking disposition and research competence among clinical nurses. Educational degree was also found as an influencing factor of nursing research competence of clinical nurses.
The critical thinking disposition of clinical nurses is positively related to their research competence.
Nurses with a passion for nursing research should pay attention to improving their critical thinking dispositions. Nurse educators and managers should provide better learning, working and research environments and more supports to cultivate critical thinking disposition and improve nursing research competence in nursing research education and practice.
We undertook a systematic scoping review of literature on nursing or midwifery abortion care to define the role and scope of the nurse and midwife within the global context of abortion.
An estimated 56 million women seek abortions each year; nurses and midwives are commonly involved in their care (Singh, Remez, Sedgh, Kwok, & Onda, 2018). As new models of abortion care emerge, there is a pressing need to develop a baseline understanding of the role and scope of nurses and midwives who care for women seeking abortions.
The review design was Arksey and O’Malley’s five‐stage methodological framework. The review follows the PRISMA‐ScR checklist.
MEDLINE, CINAHL, Scopus and Science Direct were used to identify original research, commentaries and reports, published between 2008‐2019, from which we selected 74 publications reporting on the nursing or midwifery role in abortion care.
Nurses and midwives provide abortion care in a variety of practice. Three themes emerged from the literature: the regulated role; providing psychosocial care and; the expanding scope of practice.
The literature on nursing and midwifery practice in abortion care is broad. Abortion‐related practices are potentially over‐regulated. Appropriately trained nurses and midwives can provide abortions as safely as physicians. The preparation of nurses and midwives to provide abortion care requires further research. Also, healthcare organisations should explore person‐centred models of abortion care.
Abortion care is a common procedure performed across many healthcare settings. Nurses and midwives provide technical and psychosocial care to women who seek abortions. Governments and regulatory bodies could safely extend their scope of practice to increase women’s access to safe abortions. Introduction of education programs, as well as embedding practice in person‐centred models of care, may improve outcomes for women seeking abortions.
This study aimed to examine the impact of caregivers' street clothes on people living in special care units (SCUs). We hypothesized that caregivers wearing street clothes would improve residents’ relationships with other residents and caregivers, and as a consequence would improve their quality of life.
Environmental factors have been recognized as important elements in the care of people with dementia. Among these factors, the importance of the caregivers’ appearance and more particularly their street clothes has been raised.
The Street Clothes study (STRECLO) was designed as a multicenter crossover observational study.
This study was conducted in two volunteer nursing homes. It involved videotaping residents (N=24) over a 6‐month period: caregivers wore uniform and then street clothes for two consecutive three‐month periods. Three outcome measures were observed: 1) behaviors of residents, 2) contents of conversations and 3) proximal interactions between residents and caregivers. The STROBE checklist was used to ensure quality reporting during this observational study.
When caregivers wore street clothes, we observed: 1) greater solicitation and less anxiety in residents, 2) content of conversations between residents and caregivers included more personal and less health information, and 3) more proximal interaction between caregivers and residents.
To our knowledge, this is the first study which investigated the long‐term effects on residents of SCU caregivers wearing street clothes. Our study demonstrated the potential benefit of not wearing uniform on the quality of life of institutionalized people with dementia.
Given the budgetary constraints faced by nursing homes, wearing street clothes for caregivers could be readily applied to clinical practice and represents a promising way to increase the quality of life of dementia residents and their families.