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AnteayerEvidence-Based Nursing

International clinical experiences may increase cultural competency and support nurses personal and professional development

Por: Racine · L.

Commentary on: Ulvund I, Dadi GB, Sundal H. Nurses benefit from international clinical placement as nurse students: a qualitative study. Nurse Educ Today 2023; 121:105663. doi: 10.1016/j.nedt.2022.105663. Epub 2022 Nov 25.

Implications for practice and research

  • International clinical placements benefit nurses’ personal and professional development and these skills may be applied in their future careers.

  • More research is needed to assess the long-term outcomes of international clinical placements among nurses in the workforce.

  • Context

    Globalisation and diversity require that nurses develop the skills and knowledge to become culturally safe and competent both locally and globally and in all clinical contexts.1 Cultural competency and cultural safety represent fundamental nursing skills in the 21st century. Nurse educators still heavily rely on international clinical experiences in low-income non-Western countries to develop undergraduate students’ cultural competency.2 Previous studies indicate that international clinical placements may...

    Mental state, well-being and coping are affected by a high-risk pregnancy

    Por: Holness · N. · Barfield · L.

    Commentary on: Williamson SP, Moffitt RL, Broadbent J, Neumann DL, Hamblin PS. Coping, wellbeing, and psychopathology during high-risk pregnancy: A systematic review. Midwifery. 2023 Jan;116:103556. doi: 10.1016/j.midw.2022.103556. Epub 2022 Nov 14.

    Implications for practice

  • Awareness of negative impacts of high-risk pregnancies on mental health will help to identify women in need of support.

  • Strategies can be created to improve coping and well-being for high-risk pregnant women.

  • Context

    Pregnancy is a period of major physiological changes. Psychological adjustments occur, more so with a high-risk diagnosis in pregnancy. In their systematic review, the authors outlined the state of the science of pregnant women’s psychopathology, coping and well-being when high-risk conditions including hypertension, diabetes and kidney disease develop during pregnancy. Pregnant women with these conditions can experience ineffective coping, poor well-being, anxiety and depression among other negative symptoms. Provider’s awareness, culturally appropriate education and support can reduce...

    Becoming unable to afford adequate home heating is associated with increased risk of severe mental distress

    Por: O'Sullivan · K. C.

    Commentary on: Clair A, Baker E. Cold homes and mental health harm: Evidence from the UK Household Longitudinal Study. Soc Sci Med. 2022 Dec;314:115461. doi: 10.1016/j.socscimed.2022.115461. Epub 2022 Oct 22 .

    Implications for practice and research

  • Supporting people to live in warm housing during a period of increasing living and energy costs in many countries will avoid social, economic and mental health harm.

  • Further research to understand the pathways between cold housing and increased mental health distress is needed.

  • Context

    Cold housing, driven by poor housing quality and energy poverty, is a significant public health issue in many countries.1 2 Cold housing is known to contribute to many negative physiological health outcomes including: increased risk of cardiovascular events, stroke and myocardial infarction; increased negative effects from chronic and acute respiratory disease; increased colds and influenza; exacerbation of chronic conditions for...

    Improved grief and symptoms of depression in bereaved siblings: promising findings from an online intervention

    Por: Andriessen · K.

    Commentary on: Wagner B, Hofmann L, Maaß U. A therapist-supported internet-based intervention for bereaved siblings: a randomized controlled trial. Palliat Med. 2022 Dec;36(10):1532–1543. doi: 10.1177/02692163221122344. Epub 2022 Oct 20.

    Implications for practice and research

  • An online 6-weeks 12-session CBT-based writing intervention can improve grief and depression in bereaved siblings up to 1 year postintervention.

  • Further research may examine the potentially effective components and the effectiveness of the intervention in populations such as males and people bereaved by suicide.

  • Context

    Bereaved siblings have an increased risk of developing long-term health-related problems after loss. A population-wide study revealed higher risks of depression, substance use and a twofold risk of attempted suicide compared to non-bereaved siblings.1 Other research reported a 71% increase of all-cause mortality during a 37-year follow-up period.2 The risk was two-fold when the siblings died by the same cause.

    Digital mental health interventions with individual support may complement mental health services for adults with intellectual disabilities

    Por: Desroches · M. L.

    Commentary on: MacHale R, Ffrench C, McGuire B. The experiences and views of adults with intellectual disabilities accessing digital mental health interventions: A qualitative systematic review and thematic synthesis. J Appl Res Intellect Disabil. 2023 May;36(3):448-457. doi: 10.1111/jar.13082. Epub 2023 Feb 13.

    Implications for practice and research

  • Digital mental health interventions may be useful to complement in-person mental health services, with sufficient supports for meaningful use.

  • User-centred design research with adults with intellectual disabilities and supporters is needed at all phases of digital mental health intervention development and evaluation.

  • Context

    Providers report that digital interventions are effectively being delivered to adults with intellectual disabilities; there is less research about how digital health interventions are received and experienced by people with intellectual disabilities.1 This study by MacHale et al synthesises the experiences of adults with intellectual disabilities using digital mental health interventions, mental...

    NHS England long-term workforce plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?

    Por: Twycross · A. · Wray · J.

    The long-awaited NHS England workforce plan1 (the plan) was launched in June 2023 by the Prime Minister (Rishi Sunak) and NHS England CEO (Amanda Pritchard) and heralded as:

    The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history.1

    This is a laudable aim, but can this ambitious plan really deliver the actions needed to transform the long-term future of this critical workforce?

    Workforce planning is crucial to the success of the National Health Service (NHS) and has been notable by its absence in recent decades. The publication of this plan could be seen as a step in the right direction. Workforce planning requires2:

  • Data analysis of the current workforce and...

  • To die or not to die: manikin death in resuscitation simulation does not impact nursing students self-efficacy

    Por: Lapierre · A. · Lavoie · P.

    Commentary on: Tucker G, Urwin C, Unsworth J. The impact of unsuccessful resuscitation and manikin death during simulation on nursing student’s resuscitation self-efficacy: A quasi-experimental study. Nurse Educ Today. 2022 Dec;119:105587. doi: 10.1016/j.nedt.2022.105587. Epub 2022 Oct 4.

    Implications for practice and research

  • A well-structured resuscitation simulation can improve nursing students’ self-efficacy, whether or not it ends with the death of the manikin.

  • Future research should examine the impact of manikin death on other essential factors that contribute to nursing students’ learning.

  • Context

    Simulation is widely used to train nursing students in assessing and managing cardiac arrest. However, considerable debate has been about whether the manikin should die due to unsuccessful cardiopulmonary resuscitation in simulation. Some believe that it could cause undue stress and interfere with learning.1 Others argue that death after resuscitation is expected and that successful resuscitation in every simulation distorts...

    Need to reduce anxiety and obtain individualised information are considered the main supportive components of parents/caregivers of children with cancer through the COVID-19 pandemic in the UK

    Por: Ebrahimpour · F.

    Commentary on: Collaco N, Gamble A, Morgan JE, Phillips B, Culliford D, Darlington AS. Experiences and support needs of parents/caregivers of children with cancer through the COVID-19 pandemic in the UK: a longitudinal study. Arch Dis Child. 2023 Mar;108(3):198–203. doi: 10.1136/archdischild-2022-324905. Epub 2022 Nov 30.

    Implications for practice and research

  • To teach paediatric oncology nurses how to provide child-family-centred care based on specific needs.

  • To spark research ideas on nursing interventions for anxiety in children with cancer and their families.

  • Context

    The study based on literature mentions that parents/caregivers of children with cancer have additional worries about the potential impact of COVID-19 on their children’s health. It was conducted to identify the experiences, information and support needs of parents/caregivers of children with cancer throughout the different stages of the COVID-19 pandemic in the UK.

    Methods

    The study used an online survey including...

    What we can learn from paediatric ED visit changes during pandemics and epidemics

    Por: Rahman · N. · Pines · J. M.

    Commentary on: Roland D, Gardiner A, Razzaq D, Rose K, Bressan S, Honeyford K, Buonsenso D, Da Dalt L, De T, Farrugia R, Parri N, Oostenbrink R, Maconochie IK, Bognar Z, Moll HA, Titomanlio L, Nijman RGG; in association with the REPEM network (Research in European Paediatric Emergency Medicine) as part of the EPISODES Study. Influence of epidemics and pandemics on paediatric ED use: a systematic review. Arch Dis Child. 2023 Feb;108(2):115–122. doi: 10.1136/archdischild-2022-324108. Epub 2022 Sep 26.

    Implications for practice and research

  • Healthsystems must be prepared for paediatric emergency department (ED) volume shifts during epidemics and pandemics.

  • Two interventions to increase efficient paediatric ED use include: (1) parental education about home care and (2) real-time remote advice.

  • Context

    Epidemics and pandemics have major impacts on ED care. Studies examining the COVID-19 pandemic noted large early US ED visit declines.1 In some...

    Improving consensus-based evidence from Delphi studies with coproduced qualitative research

    Por: Ding · D. · Nguyen · B.

    Commentary on: Monforte J, Davis C, Saleem S, Smith B. Moving on From the Delphi Study: The Development of a Physical Activity Training Programme Prototype Through Co-produced Qualitative Research. Qual Health Res. 2022 Nov;32(13):1952–1964. doi: 10.1177/10497323221126535. Epub 2022 Sep 14.

    Implications for practice and research

  • Dialogical inquiry, which aims to facilitate people hearing themselves and others in collaborative and non-hierarchical settings, is compatible with the practice of coproduction.

  • A Delphi study alone may be insufficient for informing the design of educational programmes, curriculum or policy agenda. Additional follow-up qualitative interviews should be conducted to rectify, improve and expand on consensus-based knowledge.

  • Context

    Regular physical activity is critical to the health and well-being of people living with disabilities (PLWD).1 PLWD are often unable to be as active as they want due to various obstacles, such as a lack of safe and suitable environments,...

    Commentary on a Turkish kangaroo care study

    Por: Clarkson · G.

    Commentary on: Toprak FÜ, Erenel AS. The effect of kangaroo care practice after caesarean section on paternal-newborn interaction: A mixed-methods study in Turkey. Midwifery. 2022 Dec; 115:103489. doi: 10.1016/j.midw.2022.103489. Epub 2022 Sep 15.

    Implications for practice and research

  • Turkish fathers should be encouraged to hold their infants by kangaroo care (KC) after maternal caesarean section.

  • Future research in Turkey could focus on the facilitators and barriers to paternal skin-to-skin holding.

  • Context

    Newborns, when consoled with skin-to-skin holding, or KC, are better able to adapt physiologically after caesarean delivery. KC in Turkey is a desired practice, but when the mother has caesarean section, this delays the practice. In Turkey, fathers are not routinely offered KC. Since there is a high rate of caesarean sections in Turkey, the nursing staff do not offer KC to many infants. There are two hypotheses in this study: (1) newborns...

    Womens perceptions of risk, safety and autonomy drive what we (providers and society) consider non-normative choices in pregnancy and childbirth

    Por: Benyamini · Y.

    Commentary on: Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery. 2023 Jan;116:103532. doi: 10.1016/j.midw.2022.103532. Epub 2022 Oct 30

    Implications for research and practice

  • Nurses should strive to understand women’s needs, past experiences and sociocultural background as a basis for discussing their choices in a non-judgemental way.

  • Research on non-normative choices in childbearing should include ethnic and sexual minorities, and evaluate protocols for sensitive, women-centred discussion of birthing choices.

  • Context

    Preferences about childbirth range along a wide continuum from physiological, sometimes even unassisted births, to caesarean sections by maternal request. Despite this wide range, most births in the western world take place in medical settings, making it in practice a medical event, reflecting society’s and health professionals’ views of risk and safety that define birth choices which are considered normative....

    One-third of nurses intend to leave their job because of the COVID-19 pandemic

    Por: de Cordova · P. B. · Reilly · L.

    Commentary on: Ulupınar F, Erden Y. Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis. J Clin Nurs. 2022 Nov 27. doi: 10.1111/jocn.16588. Epub ahead of print.

    Implications for practice and research

  • During COVID-19, nurses experienced stress, anxiety and fear. Psychological support will help retain staff.

  • Further longitudinal studies on the long-term psychological impacts of the pandemic are needed.

  • Context

    The impact of the COVID-19 pandemic on nurses was unprecedented with high volumes of critically ill patients. This strain on direct care nurses included an increased workload, long hours, separation from family, potential exposure and patient death.1 These factors impacted nurses’ psychological well-being and led to increased reports of nurses intending to leave their jobs. This rapid systematic review and meta-analysis aimed to synthesise the literature of rate of nurses’ intent to leave their job from...

    Overview of the role of different conservative interventions as first-line treatment in the management of urinary incontinence in women

    Por: Rajan · K. · Nambiar · A. K.

    Commentary on: Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022 Sep 2;9(9):CD012337. doi: 10.1002/14651858.CD012337.pub2.

    Implications for practice and research

  • Pelvic floor muscle training is an effective conservative treatment option for managing all types of urinary incontinence (UI) in women in isolation or combined with other measures and should be considered first-line treatment in women with UI.

  • Further research is needed on long-term outcomes of conservative interventions and their impact on quality of life.

  • Context

    Urinary incontinence (UI) is a highly prevalent condition affecting nearly 25% of women, especially in older age groups.1 It is characterised by involuntary leakage of urine and can have a significant impact on quality of life, leading to psychological distress and placing a financial burden...

    Sources of vaccine information may have role in decreasing hesitancy among healthcare workers in UK toward receiving COVID-19 regularly

    Por: Pal · S.

    Commentary on: Veli N, Martin CA, Woolf K, Nazareth J, Pan D, Al-Oraibi A, Baggaley RF, Bryant L, Nellums LB, Gray LJ, Khunti K, Pareek M; UK-REACH Study Collaborative Group. Hesitancy for receiving regular SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis from the UK-REACH study. BMC Med. 2022 Oct 10;20(1):386. doi: 10.1186/s12916-022-02588-7.

    Implications for practice and research

  • Understanding the sources of information as drivers of acceptance toward a regular COVID-19 vaccine could allow for targeted messaging to improve uptake.

  • Further research is needed to assess if the trends in intended hesitancy toward potential regular vaccines translates to vaccination behaviour.

  • Context

    Mass vaccination against COVID-19 has been one of the key measures to combat the spread of COVID-19. Initial vaccines have been highly efficacious in reducing infection prevalence and mortality. However, the emergence of variant strains and waning of immunity from initial vaccination...

    Experiences of newly registered nurses transitioning from nursing student to registered nurse: a qualitative systematic review

    Por: Brady · J. · Tatterton · M. J.
    Background and purpose

  • This is a summary of See et al.1

  • Newly registered nurses experience high levels of emotional exhaustion, stress and burnout, with high attrition rates in the first-year post-qualification.

  • The purpose of this review was to consolidate the available evidence on the experiences of newly registered nurses transitioning from the role of student nurse to that of registered nurse.

  • Methods

    Results and areas for future research

  • Thirty-one studies were included in the review, comprising thirty qualitative and one mixed-method study.

  • A total of 452 newly registered nurses were enrolled across the studies from Australia, Canada, Singapore, England, Nepal, Netherlands, Pakistan and Taiwan.

  • Four themes were identified: knowledge deficit, overwhelming clinical practice, importance of workplace support and the meaning of ‘being a nurse’.

  • Twenty-four studies discussed how newly graduated registered nurses experienced anxiety,...

  • Clinical nursing supervisors and healthcare staff play a significant role in decreasing undergraduate baccalaureate nursing student clinical stress

    Por: Stubin · C.

    Commentary on: Mazalová L, Gurková E, Štureková L. Nursing students' perceived stress and clinical learning experience. Nurse Educ Pract. 2022 Oct;64:103 457. doi: 10.1016/j.nepr.2022.103457. Epub 2022 Sep 24.

    Implications for practice and research

  • Clinical nursing supervisors may be unfamiliar with the demands and challenges students encounter in the clinical environment, and the amount of encouragement and assistance they require to be successful in the nursing profession.

  • Further research should focus on intervention studies examining how clinical nursing supervisors control nursing student clinical stressors to improve student outcomes.

  • Context

    The clinical environment is the prevailing source of stress during nursing students’ educational experience. Although clinical supervisors are predominantly supportive to students in the clinical environment, current literature recognises certain clinical nursing supervisor actions and behaviours as causes of nursing student clinical stress.1 Clinical supervisors have a responsibility to identify and understand nursing student clinical...

    Role of nursing education to facilitate nursing students competency to recognise and respond to intimate partner violence

    Por: van der Wath · A.

    Commentary on: Shaqiqi W, Innab A. Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence. J Adv Nurs. 2022 Sep 5. doi: 10.1111/jan.15424. Epub ahead of print.

    Implications for practice and research

  • Nurses’ competency to recognise and respond to women exposed to intimate partner violence (IPV) should be facilitated during undergraduate nursing training.

  • Research needs to generate evidence for the best educational strategies to facilitate and integrate these competencies into nursing education curricula.

  • Context

    International guidelines1 require healthcare professionals to identify women exposed to IPV, and manage them based on their healthcare needs. To capacitate nurses to effectively respond to these women, undergraduate curricula should include learning outcomes based on evidence-based practice. Shaqiqi and Innab assessed the attitudes of nursing students and their preparedness to manage IPV.2 The study assessed the following variables:...

    Perceived organisation support would buffer the impact of work frustration on burn-out among intensive care unit nurses

    Por: Saravanabavan · L. · Poongavanam · V.

    Commentary on: Yanbei R, Dongdong M, Yun L, Ning W, Fengping Q. Does perceived organization support moderate the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey. BMC Nurs. 2023 Jan 23;22(1):22. doi: 10.1186/s12912-023-01180-5.

    Commentary

    Implications for practice and research

  • Providing intensive care unit (ICU) nurses with organisational supports by showcasing that the organisation cares about their well-being, gives importance to their opinions, is proud of their achievements will decrease their work frustration.

  • Future research and auditing of programmes and events to monitor organisational support to ICU nurses in reduction of work frustration and burn-out. Such monitoring systems could translate into better patient outcome.

  • Context

    The psychological strain of caring for very ill patients causes significant mental stress for all ICU healthcare professionals. When stress is prolonged, it might eventually cause burn-out and deterioration of patient...

    Build teamwork on a solid foundation: team familiarity promotes effective interprofessional collaboration

    Por: Rosen · M. A.

    Commentary on: Iyasere CA, Wing J, Martel JN, et al. Effect of increased interprofessional familiarity on team performance, communication, and psychological safety on inpatient medical teams: a randomized clinical trial. JAMA Intern Med. 2022 Nov 1;182(11):1190–1198. doi: 10.1001/jamainternmed.2022.4373.

    Implications for practice and research

    Team member familiarity has a positive impact on teamwork and interprofessional communication. Organisational design should consider team member familiarity.

    Context

    Interprofessional teamwork matters for patient and workforce outcomes. Familiarity of team members is associated with improved teamwork and communication, safety and quality of care, utilisation and patient outcomes. However, much of the existing research is observational in nature. This study evaluated the impact of a team member familiarity intervention on the quality of nurse and resident interactions, perceptions of organisational climate and care outcomes.

    Methods

    This single site randomised clinical trial evaluated the effect of a resident scheduling intervention designed to...

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