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AnteayerInternacionales

Pressure Injury Assessment Tools for Oncology Patients: A Systematic Review

ABSTRACT

Aim

The objective of this systematic review was to evaluate the measurement properties of pressure injury risk assessment tools for cancer patients using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology, and to serve as a reference for clinical nurses in their hospital duties when choosing high-quality assessment tools.

Design

A systematic review based on COSMIN methodology.

Data Sources

The English literature in PubMed, Embase, Web of Science, Cochrane Library, CINAHL and the search period ranged from the inception of the database to September 30, 2024.

Methods

Two reviewers independently screened the studies, extracted the data, and evaluated the methodological quality and measurement properties of the included studies.

Results

Seven studies met the inclusion criteria. Two tools—the PUSO (Pressure Ulcer Scale in Oncology) and the Cuire scale—demonstrated sufficient evidence of content validity and structural validity, meeting the COSMIN quality standards. None of the studies reported the cross-cultural validity, stability, and measurement error of the assessment tool.

Conclusion

Following the COSMIN assessment, the PUSO and the Cuire were developed using rigorous procedures, ensuring sufficient overall quality for content validity, structural validity, and other measurement properties. We recommend their use across various environments, based on the quantity and content of specific items. The PUSO was recommended for clinical screening, whereas the Cuire scale was deemed more suitable for use in outpatient, community, and scientific research settings. However, these measurement properties are not without flaws, and their clinical application requires further validation.

Establishment of a risk prediction model for peripherally inserted central catheter‐related bloodstream infections based on a systematic review and meta‐analysis of 20 cohorts

Abstract

Background

Peripherally inserted central catheters (PICCs) are commonly used for extended intravenous therapy but are associated with a significant risk of bloodstream infections (BSIs), which increase morbidity and healthcare costs.

Aim

The aim of this study was to identify patients at high risk of developing PICC-related bloodstream infections (PICC-RBSIs) to establish new and more specific targets for precise prevention and intervention.

Methods

A search was conducted from the earliest available record to May 2024 among the following databases: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus, and Chinese National Knowledge Infrastructure (CNKI). Hand searching for gray literature and reference lists of included papers was also performed. We assessed the quality of the studies using the Newcastle–Ottawa Scale (NOS) checklist. Two reviewers screened all the retrieved articles, extracted the data, and critically appraised the studies. Data analysis was performed using RevMan statistical software.

Results

A total of 20 cohort studies involving 51,907 individuals were included in the analysis. The statistically significant risk factors identified were hospital length of stay, line type (tunneled), history of PICC placement, multiple lumens, previous infections, chemotherapy, total parenteral nutrition, hematological cancers, delays in catheter care, local signs of infection (e.g., localized rashes), previous BSIs, and diabetes mellitus. Due to high heterogeneity among studies regarding previous BSIs, this factor was excluded from the final predictive model, while all other risk factors were included.

Conclusions

The present meta-analysis identified risk factors for PICC-RBSIs and developed a predictive model based on these findings, incorporating 10 risk factors that integrate both patient-specific and procedural factors.

Linking Evidence to Action

Integrating the risk prediction model for PICC-RBSI into clinical guidelines and training is essential. Healthcare providers should be trained to use this model to identify high-risk patients and implement preventive measures proactively. This integration could enhance personalized care, reduce infection incidence, and improve patient outcomes. Future research should update the model with new risk factors and validate its effectiveness in diverse clinical settings.

Best Evidence Summary for the Prevention of Pressure Injuries in Orthopaedic Patients

ABSTRACT

Aim

To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards.

Design

The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University.

Method

According to the “6S” model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023.

Data Sources

The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc.

Results

Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation.

Conclusion

This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation.

Implications for the Profession and Patient Care

The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients.

Impact

Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide.

State

The PRIMA manifest is utilised during the text preparation process.

Trail Registration: ES20245365

Framework for Nursing Quality Assessment in Tracheotomy Dysphagia Following Craniocerebral Trauma Using the Structure‐Process‐Outcome Model

ABSTRACT

Aim

This study aimed to establish a comprehensive set of nursing-sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the ‘structure-process-outcome’ model.

Design

A Delphi survey.

Methods

The research utilised a mixed-methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts.

Results

The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90–5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first-level indicators, 23 second-level indicators and 52 third-level indicators.

Conclusion

The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes.

Implication for the Profession and Patient Care

This study develops targeted NSQIs to improve dysphagia management in ABI patients’ posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training.

Patient or Public Contribution

Expert-driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient-centred care.

Assessing Skin Tear Knowledge Among Nurses: A Multicentre Cross‐Sectional Survey

ABSTRACT

Aims

To assess the knowledge of nurses in Chinese hospitals regarding skin tears, focusing on evaluating their understanding and proficiency in managing and preventing skin tears, exploring the impact of demographic and professional factors on their knowledge levels and identifying specific areas where additional training or education is needed.

Design

This study is a multicentre cross-sectional survey conducted in the Henan province of China using a stratified cluster sampling method.

Methods

The study utilised the Chinese version of the Skin Tear Knowledge Assessment Instrument (OASES) for evaluating nurses' knowledge levels based on a questionnaire comprising 22 questions on the online platform Wenjuanxing (www.wjx.cn). All questions had to be answered, with only one option selectable per question. Response validity was ensured by excluding questionnaires that showed a clear response pattern, were completed in under 60 s, or scored 0 points. Descriptive analysis, item-level analysis and multiple linear regression analysis were performed.

Results

A total of 1675 clinical nurses participated in this study. Age was a significant factor influencing skin tear knowledge, with older nurses (age, 41–60 vs. 18–40 years) demonstrating higher knowledge scores. Additionally, female nurses exhibited higher average knowledge scores compared to male nurses. Further, different departments, education levels, job titles and having completed relevant courses significantly influenced skin tear knowledge among nurses. However, on multivariate analyses, we found that working in the intensive care unit, having a higher education background and job title and having studied courses on wound, ostomy or incontinence were independent factors influencing knowledge on skin tear, indicating the need for targeted educational interventions.

Conclusion

In conclusion, targeted educational interventions and continuous professional development are essential to bridge the identified knowledge gaps among nurses in Chinese hospitals regarding skin tear management.

Reporting Method

The Strengthening the Report of Observational Studies in Epidemiology checklist guidelines were followed.

Implications for the Profession and/or Patient Care

Enhancing nurses' knowledge and skills in skin tear management through targeted educational programmes could improve patient care quality, reduce the incidence of skin tears and promote better wound care outcomes in clinical settings.

Impact

This study addresses the problem of knowledge gaps in skin tear management among nurses. The main findings indicate varied understanding and significant factors influencing this knowledge. The research impacts nurses and patients in Chinese hospitals, emphasising the need for specialised training and professional development to improve skin tear management and patient care. No patient or public contribution.

Relationship between emotional intelligence and job stressors of psychiatric nurses: A multi‐centre cross‐sectional study

Abstract

Aim

To investigate the impact of socio-demographic factors and job stressors on the emotional intelligence of psychiatric nurses.

Background

Emotional intelligence plays a crucial role in enabling nurses to effectively manage their own emotions, comprehend the emotions of others and assist individuals in dealing with diverse stressors. Nevertheless, a comprehensive conceptualization of the relationship between job stressors and emotional intelligence remains lacking.

Design

This study employs a multi-centre cross-sectional design.

Methods

A multi-centre cross-sectional survey involving 1083 registered nurses from 11 psychiatric hospitals across four provinces in China was conducted. Non-probability sampling was utilised. The survey encompassed assessments of nurse job stressors, emotional intelligence using a scale and socio-demographic characteristics using a questionnaire. A multiple linear regression model was applied to identify significant variables associated with emotional intelligence based on demographic attributes and various nurse job stressors. The study adhered to the STROBE checklist.

Results

The findings revealed a noteworthy negative correlation between nurse job stressors and emotional intelligence. Socio-demographic factors and job stressors of certain nurses were able to predict emotional intelligence and its dimensions among psychiatric nurses, with percentages of 44.50%, 40.10%, 36.40%, 36.60% and 34.60%.

Conclusion

Providing emotional intelligence training for psychiatric nurses could enhance their capacity to cope effectively with workplace stress, particularly among younger nurses who engage in limited physical activities.

Relevance to Clinical Practice

The analysis of the relationship between emotional intelligence and nurse job stressors could facilitate early detection and intervention by managers based on pertinent factors. This, in turn, could elevate the emotional intelligence level of psychiatric nurses.

No Patient or Public Contribution

This study did not recruit participants, so details of participants were not be involved.

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