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Codes of ethics are, for many, important documents that define the key values and behaviours expected of healthcare professionals. They are also documents that have been widely criticised. These criticisms range from being vague to failing to provide guidance on many important issues. Codes, however, vary substantially in their scope, content and the guidance they provide.
This scoping review sought, in the context of comparative studies of codes, to examine the form (i.e., the structure of the code, its contents, principles or rules for example) and function (what the code says it does, either explicitly or implicitly) of codes, along with their points of con/divergence.
A systematic search was carried out using Scopus, PsycInfo, CINAHL and Medline.
Thirty-one papers met inclusion criteria and were included in this review. Results suggest that while there were a number of similarities seen across codes, there were also substantial points of divergence related to the content of codes and structure. These differences were seen across professions, countries and time, suggesting that culture, history, politics and perhaps even geography influence the content of codes.
These findings are discussed in light of the broader literature that examines and critiques codes.
To identify the prevalence and types of missed nursing care in a Danish hospital context from patients' perspectives and to examine associations between missed nursing care, patient demographics, and patient-reported adverse events.
Cross-sectional study.
A total of 284 medical and surgical patients from 21 wards at a Danish university hospital completed the Danish version of the MISSCARE Survey–Patient. Descriptive statistics and analyses of associations between missed nursing care and patient demographics and adverse events were conducted.
Patients reported an overall prevalence of missed nursing care of 15%, with most omissions occurring in the physical care domain (22%), followed by psychosocial care (13%) and timeliness (6%). The most frequently missed activities included oral care, clarity about which nurse was responsible for their care, repositioning in bed, and help with eating. Medication errors were significantly associated with higher missed nursing care scores across all domains, while associations with other adverse events and demographics were inconsistent.
Patients generally perceived a low prevalence of missed nursing care, although notable variations were observed across care domains and specific activities. Incorporating patient perspectives alongside nurse perspectives offers a more complete understanding of missed nursing care.
Continuous assessment of missed nursing care from patients' perspectives could serve as a valuable complement to nurse-reported assessments, helping to identify specific areas for improvement. Targeted interventions addressing activities with higher patient-reported missed nursing care may enhance both care quality and patient outcomes.
STROBE guidelines were followed.
Patients were not involved in the study's design, conduct, or reporting.
This study highlights missed nursing care from patients' perspectives, revealing key care gaps. The findings can inform hospital administrators, nursing leaders, nursing educators, and policymakers in developing strategies to improve care quality and patient satisfaction.
This study aimed to explore the perceived preparedness and psychosocial well-being of general ward nurses prior to their deployment into the outbreak intensive care units (ICUs) during the COVID-19 pandemic.
With the surge in COVID-19 cases requiring ICU care, non-ICU nurses maybe deployed into the ICUs. Having experienced through SARS, hospitals in Singapore instituted upskilling programs to secure general ward nurses’ competency in providing critical care nursing. However, no studies have explored the perceptions of general ward nurses on deployment into the ICUs during the COVID-19 pandemic.
Qualitative descriptive study.
The study was conducted at Singapore’s epicentre of COVID-19 management. Five focus groups were conducted following purposive sampling of 30 general ward nurses identified for outbreak ICU deployment. Focus groups were audio-recorded, transcribed verbatim and data thematically analysed. This study was conducted and reported in accordance with the COREQ checklist.
Three salient themes arose, exemplifying the transition from clinical experts in the general wards to practising novices in the outbreak ICUs. Firstly, ‘Into the deep end of the pool’ described general ward nurses’ feelings of anxiety and stress associated with higher exposure risk and expanded responsibilities to nurse critically ill patients. Secondly, ‘Preparing for “war”’ illustrated deployed nurses’ need for clear communication and essential critical care nursing training. Lastly, ‘Call of duty’ affirmed the nurses’ personal and professional commitment to embrace this transition into the ICUs, and their desire for greater psychosocial support.
The study findings highlight that though general ward nurses perceived their impending ICU deployment positively, they require ongoing support to facilitate a smoother transition.
Findings provided an evidence base to improve the preparedness of general ward nurses deployed into the ICUs during the COVID-19 pandemic within key areas of training, information dissemination and psychosocial resilience.
To translate, cross-culturally adapt, validate and psychometrically test the MISSCARE Survey–Patient for assessing patients' perspectives on missed nursing care (MNC) in a Danish hospital setting.
A two-phase cross-cultural adaptation and psychometric validation study.
The study was conducted in two phases. First, the MISSCARE Survey–Patient was cross-culturally adapted to ensure its relevance in a Danish hospital context. This phase involved translation and back-translation, expert committee reviews and cognitive interviews with 18 inpatients to establish content validity. Second, a convenience sample of 284 patients from surgical and medical departments completed the adapted survey. Psychometric properties were evaluated using structural equation modelling to test a second-order formative model.
The cross-cultural adaptation phase led to minor and substantial revisions, including the addition of six new items to enhance content validity. These items addressed aspects of nursing care relevant to patients in the contemporary hospital setting that were not captured by the original survey. Structural equation modelling confirmed the second-order formative model and demonstrated robust psychometric properties.
The MISSCARE Survey–Patient was successfully adapted and validated for use in Danish hospitals, ensuring strong content validity and psychometric robustness.
The Danish version of the survey provides a valuable tool for assessing MNC from patients' perspectives in hospital settings. Its use can help identify specific areas where nursing care falls short, guiding targeted initiatives to enhance care quality and patient safety. By integrating patients' experiences into quality improvement initiatives, the survey supports the development of more person-centred care practices.
The study adhered to the COnsensus-based Standards for the selection of health Measurement INstruments reporting guideline for studies on measurement properties of patient-reported outcome measures.
Patients were not involved in the study's design, conduct, or reporting.
The Danish version of the survey facilitates data collection on patients' perspectives of MNC in contemporary hospital settings, providing valuable insights into care quality. By offering a validated tool to assess MNC from patients' perspectives, the survey helps hospitals identify care gaps, prioritise improvement efforts and enhance person-centred care.
To synthesise the effects of psychosocial interventions compared with standard care in improving psychosocial outcomes of parents of children with cancer receiving active treatment.
This was a systematic review and meta-analysis that was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
All randomised controlled trials examining the effects of psychosocial interventions for parents of children with cancer were considered eligible. All identified articles were imported into Endnote X9. Two independent authors conducted study selection and data extraction. Risk-of-Bias version 2 and the Grading of Recommendations Assessment, Development and Evaluation approach were used to evaluate the methodological quality and overall quality of the evidence, respectively. Review Manager 5.4.1 software was used for data analysis, and sensitivity and subgroup analyses were conducted to examine heterogeneity, if applicable.
Seven databases, including PubMed, Embase, Scopus, PsycINFO, CENTRAL, CINAHL and ProQuest, were searched up to 6 December 2023.
Sixteen studies involving 1379 participants were included in the systematic review, with 12 studies pooled for meta-analysis. Psychosocial intervention was effective in anxiety symptoms and depressive symptoms among parents of children with cancer. No significant differences were observed in parental stress and quality of life between psychosocial intervention and control groups.
This study showed that psychosocial intervention was beneficial for decreasing anxiety symptoms and depressive symptoms of parents of children with cancer. Future trials with a more robust methodology are needed to augment current findings.
As our systematic review showed that psychosocial interventions were effective in decreasing anxiety symptoms and depressive symptoms among parents of children with cancer, healthcare professionals could consider integrating psychosocial support for these parents.
This systematic review had no patient or public contribution.
This review was registered at PROSPERO (CRD42022384452) on 29 December 2022. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=384452).
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