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AnteayerInternacionales

The role of nurse–patient mutuality on self‐care behaviours in patients with chronic illness

Abstract

Aim

To examine the role of nurse–patient mutuality on three self-care behaviours in chronic illness patients.

Design

A cross-sectional multi-centre study was conducted.

Methods

Mutuality was measured with the Nurse–Patient Mutuality in Chronic Illness scale which has the dimensions of developing and going beyond, being a point of reference and deciding and sharing care, and self-care was measured with the Self-care of Chronic Illness Inventory (SC-CII). Multivariable linear regression analyses were used to assess the contribution of three dimensions of mutuality on self-care maintenance, monitoring and management behaviours controlling for patient gender, age, education, number of medications, and presence of a family caregiver.

Results

The sample included 465 inpatients and outpatients with at least one chronic illness. The three dimensions of mutuality had different roles in their influence on the three dimensions of self-care. Developing and going beyond was significantly associated with self-care maintenance and self-care monitoring behaviours. Point of reference was significantly associated with self-care maintenance behaviour. Deciding and sharing care was significantly associated with self-care monitoring and self-care management behaviours.

Conclusion

The mutuality between nurse and patient may be a novel area of research to support and improve patient self-care behaviours with implications for clinical practice and education.

Implication for Profession and Patient Care

Mutuality between nurse and patient increases patient engagement, symptom recognition, decision-making process and patient-centred approach favouring the development of self-care behaviours.

Impact

Mutuality between nurse and patient is a new concept and its association with the patient outcomes could bring relevance to the nursing profession. Self-care behaviours are important in the management of chronic diseases, but are difficult to perform. Mutuality between nurse and patient influences the three different behaviours of self-care in chronic illness, for this reason it is important to increase the level of mutuality in this dyad.

Reporting Method

STROBE checklist for cross-sectional studies was followed in this study.

Patient or Public Contribution

Patients were involved in the sample of the study.

Evidence‐based healthcare competence of social‐ and healthcare educators: A cross‐sectional study

Abstract

Aim

The purpose of the study was to describe social and healthcare educators' evidence-based healthcare competence and explore the associated factors.

Design

A descriptive, cross-sectional study was carried out.

Methods

The research spanned 5 universities, 19 universities of applied sciences, and 10 vocational colleges in Finland from September to December 2022. Social and healthcare educators (n = 256), of which 21 worked at universities, 176 worked at universities of applied sciences, and 49 worked at vocational colleges. Data collection employed a self-assessed instrument that was designed to measure evidence-based healthcare competence based on the JBI Model of Evidence-based Healthcare. Competence profiles were formed using K-cluster grouping analysis.

Results

The educators' self-evaluations of their level of evidence-based healthcare competence were generally at a satisfactory level, with subsequent analyses identifying four distinct profiles of evidence-based healthcare competence. The profiles demonstrated statistically significant differences in terms of evidence synthesis and evidence transfer competencies. The factors associated with evidence-based healthcare competence included level of education, the year in which a professional had obtained their highest degree, current organization of employment, and participation in continuing education.

Conclusions

Educators require various types of support for developing high levels of evidence-based healthcare competence. The identification of distinct competence profiles can be pivotal to providing educators with training that is tailored to their exact needs to provide an individualized learning path.

What Problem Did the Study Address?

Educators value the role of evidence in teaching, which reinforces the need to integrate aspects of the JBI Model of evidence-based healthcare into educators' competencies. Aspects of the JBI Model of evidence-based healthcare have not been holistically measured, with only certain components of the model considered separately. Educators need to better understand the global healthcare environment so they can identify research gaps and subsequently develop healthcare systems through their educational role. Higher academic education, work experience, organizational support, and continuous education play essential roles in the development of educators' evidence-based healthcare competence.

What Were the Main Findings?

Educators generally have high levels of competence in evidence-based healthcare. Educators have mastered the different components of the JBI model of evidence-based healthcare but need to improve in areas such as the transfer and implementation of evidence.

Where and on Whom Will the Research Have an Impact?

Determining evidence-based healthcare competence profiles for educators can be used to provide individualized learning paths for the development of evidence-based healthcare competence. Educators need to further develop their competence in evidence-based healthcare to ensure successful implementation and high-quality education in the future.

Patient or Public Contribution

No patient or public contribution.

Workplace violence, work‐related exhaustion, and workplace cognitive failure among nurses: A cross‐sectional study

Abstract

Aim

To examine the relationships between nurses' exposure to workplace violence and self-reports of workplace cognitive failure.

Design

A cross-sectional study.

Methods

An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non-physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure.

Results

Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non-physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work-related exhaustion. Work-related exhaustion predicted significantly higher scores for workplace cognitive failure.

Conclusion

Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work-related exhaustion.

Implications for the Profession and/or Patient Care

Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work-related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure.

Impact

This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work-related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work-related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses.

Reporting Method

We have followed the STROBE checklist in reporting this study.

Patient or Public Contribution

No Patient or public contribution.

A protocol for a systematic review of social dimensions of resilience in older adults

Abstract

Background

Populations are ageing, making the quality of old age a crucial issue. Some adversity in old age, such as loss of loved one or loss of physical function, is often experienced, as is the need for recovery from such adversity. Resilience in later life has become an important topic and has accumulated much empirical research. However, the research has mainly centred on individual factors, such as personality, rather than social factors, such as family relationships or community engagement. There is no systematic review of the social dimensions of resilience in old age, a focus that should be especially important for policy and practice seeking to create supporting environments.

Methods

Our review comprises quantitative and qualitative empirical original English language studies, published 2013–2023, using predefined search phrases including ‘resilience’ and various terms for old age and social dimensions. Titles and abstracts are screened by the first two authors using registered exclusion criteria. Final inclusion, based on full-text reading, is decided using registered inclusion criteria, and verified by co-authors. Qualitative articles are read by authors specialized in qualitative research and quantitative articles by authors specialized in quantitative research. Due to large expected heterogeneity, meta-analysis is not conducted, but weighted effect sizes or funnel plots may be prepared if parallel quantitative studies are encountered. Qualitative studies are synthesized using meta-aggregation. The risk of bias is evaluated with applicable Joanna Briggs Institute checklists for each study design. A narrative synthesis brings together the qualitative and quantitative studies.

Conclusion

Methodological strengths and weaknesses of the included studies are reported to assess the quality of the research. Summary of the most significant social dimensions of resilience in old age is prepared, emphasizing interactions between contexts, stressors, mechanisms and outcomes; and research gaps are identified.

Systematic Review Registration

Protocol is registered in PROSPERO (CRD42023412532).

A systematic review of reasons and risks for acute service use by older adult residents of long‐term care

Abstract

Aims and Objectives

To identify the reasons and/or risk factors for hospital admission and/or emergency department attendance for older (≥60 years) residents of long-term care facilities.

Background

Older adults' use of acute services is associated with significant financial and social costs. A global understanding of the reasons for the use of acute services may allow for early identification and intervention, avoid clinical deterioration, reduce the demand for health services and improve quality of life.

Design

Systematic review registered in PROSPERO (CRD42022326964) and reported following PRISMA guidelines.

Methods

The search strategy was developed in consultation with an academic librarian. The strategy used MeSH terms and relevant keywords. Articles published since 2017 in English were eligible for inclusion. CINAHL, MEDLINE, Scopus and Web of Science Core Collection were searched (11/08/22). Title, abstract, and full texts were screened against the inclusion/exclusion criteria; data extraction was performed two blinded reviewers. Quality of evidence was assessed using the NewCastle Ottawa Scale (NOS).

Results

Thirty-nine articles were eligible and included in this review; included research was assessed as high-quality with a low risk of bias. Hospital admission was reported as most likely to occur during the first year of residence in long-term care. Respiratory and cardiovascular diagnoses were frequently associated with acute services use. Frailty, hypotensive medications, falls and inadequate nutrition were associated with unplanned service use.

Conclusions

Modifiable risks have been identified that may act as a trigger for assessment and be amenable to early intervention. Coordinated intervention may have significant individual, social and economic benefits.

Relevance to clinical practice

This review has identified several modifiable reasons for acute service use by older adults. Early and coordinated intervention may reduce the risk of hospital admission and/or emergency department.

Reporting method

This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

Patient or public contribution

No patient or public contribution.

Predictors of fall protection motivation among older adults in rural communities in a middle‐income country: A cross‐sectional study using the Protection Motivation Theory

Abstract

Aims

To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale.

Design

A cross-sectional study.

Methods

The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into ‘faller’ and ‘non-faller’, employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions.

Results

A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities.

Conclusion

Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation.

Implications for the profession and/or patient care

These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults.

Patient or Public Contribution

Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.

The role of psychological ownership in linking decent work to nurses' vigor at work: A two‐wave study

Abstract

Introduction

Nurses' vigor at work profoundly impacts the quality of patient care. However, the determinants of nurses' vigor remain underexplored in the current nursing literature, and the mechanism through which these determinants exert their effects remains unclear.

Aim

This study aimed to elucidate the mediating role of psychological ownership in linking decent work to nurses' vigor at work.

Methods

A two-wave, time-lagged study was conducted to collect data from 289 nurses working across three hospitals in Port Said, Egypt, between March and June 2023. Data were collected using the Decent Work Scale, the Psychological Ownership Scale, the Shirom–Melamed Vigor Measure, on an Introductory Information Form. Mediation testing was performed using structural equation modeling.

Results

Decent work was significantly associated with psychological ownership and vigor at work. Psychological ownership partially mediated the relationship between decent work and nurses' vigor at work.

Conclusion

Decent work practices are critical in fostering nurses' vigor while working, and psychological ownership plays a mediating role in this relationship.

Clinical relevance

Hospital administrators should value decent work practices, which could enhance psychological ownership, resulting in a potential improvement in nurses' vigor at work.

Comparing didactic approaches for practical skills learning in Scandinavian nursing simulation centres: A qualitative comparative study

Abstract

Aim

To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges.

Background

Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking.

Design

A qualitative comparative design was used.

Methods

During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in-depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted.

Results

The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty-two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches.

Conclusion

Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning.

Implications for Profession and/or Patient Care

Cross-country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high-quality care.

Patient or Public Contribution

No Patient or Public Contribution.

Reporting Method

This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines.

Adherence to PRISMA 2020 reporting guidelines and scope of systematic reviews published in nursing: A cross‐sectional analysis

Abstract

Introduction

Systematic reviews are considered the highest level of evidence that can help guide evidence-informed decisions in nursing practice, education, and even health policy. Systematic review publications have increased from a sporadic few in 1980s to more than 10,000 systematic reviews published every year and around 30,000 registered in prospective registries.

Methods

A cross-sectional design and a variety of data sources were triangulated to identify the journals from which systematic reviews would be evaluated for adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines and scope. Specifically, this study used the PRISMA 2020 reporting guidelines to assess the reporting of the introduction, methods, information sources and search strategy, study selection process, quality/bias assessments, and results and discussion aspects of the included systematic reviews.

Results

Upon review of the 215 systematic reviews published in 10 top-tier journals in the field of nursing in 2019 and 2020, this study identified several opportunities to improve the reporting of systematic reviews in the context of the 2020 PRISMA statement. Areas of priority for reporting include the following key areas: (1) information sources, (2) search strategies, (3) study selection process, (4) bias reporting, (5) explicit discussion of the implications to policy, and lastly, the need for (6) prospective protocol registration.

Discussion

The use of the PRISMA 2020 guidelines by authors, peer reviewers, and editors can help to ensure the transparent and detailed reporting of systematic reviews published in the nursing literature.

Clinical Relevance

Systematic reviews are considered strong research evidence that can guide evidence-based practice and even clinical decision-making. This paper addresses some common methodological and process issues among systematic reviews that can guide clinicians and practitioners to be more critical in appraising research evidence that can shape nursing practice.

Importance of specific vital signs in nurses' recognition and response to deteriorating patients: A scoping review

Abstract

Aim(s)

To explore the published research related to nurses' documentation and use of vital signs in recognising and responding to deteriorating patients.

Design

Scoping review of international, peer-reviewed research studies.

Data Sources

Cumulative Index to Nursing and Allied Health Literature Complete, Medline Complete, American Psychological Association PsycInfo and Excerpta Medica were searched on 25 July 2023.

Reporting Method

Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.

Results

Of 3880 potentially eligible publications, 32 were included. There were 26 studies of nurses' vital sign documentation: 21 adults and five paediatric. The most and least frequently documented vital signs were blood pressure and respiratory rate respectively. Seven studies focused on vital signs and rapid response activation or afferent limb failure. Five studies of vital signs used to trigger the rapid response system showed heart rate was the most frequent and respiratory rate and conscious state were the least frequent. Heart rate was least likely and oxygen saturation was most likely to be associated with afferent limb failure (n = 4 studies).

Conclusion

Despite high reliance on using vital signs to recognise clinical deterioration and activate a response to deteriorating patients in hospital settings, nurses' documentation of vital signs and use of vital signs to activate rapid response systems is poorly understood. There were 21studies of nurses' vital sign documentation in adult patients and five studies related to children.

Implications for the profession and/or patient care

A deeper understanding of nurses' decisions to assess (or not assess) specific vital signs, analysis of the value or importance nurses place (or not) on specific vital sign parameters is warranted. The influence of patient characteristics (such as age) or the clinical practice setting, and the impact of nurses' workflows of vital sign assessment warrants further investigation.

Patient or Public Contribution

No Patient or Public Contribution.

Enhancing blood pressure management protocol implementation in patients with acute intracerebral haemorrhage through a nursing‐led approach: A retrospective cohort study

Abstract

Aim

To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients.

Design

Retrospective cohort study of prospectively collected data over 6 years.

Methods

Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID-19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first-hour target achievement (primary outcome), tomography-to-treatment and treatment-to-target times, first-hour maximum dose of antihypertensive treatment and 6-h and 24-h systolic blood pressure variability.

Results

Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment-to-target time and increased the rate of first-hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first-hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6-h and 24-h systolic blood pressure variability. However, 6-h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID-19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography-to-treatment time and increased the first-hour maximum dose of antihypertensive treatment.

Conclusion

Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients.

Reporting Method

STROBE guidelines.

Patient and Public Contribution

No Patient or Public Contribution.

Ageism directed at older nurses in their workplace: A systematic review

Abstract

Aims

To identify and synthesise evidence related to ageism in older regulated nurses' practice settings.

Design

A systematic review following Joanna Briggs Institute methodology.

Methods

The review included empirical studies that involved older nurses as the primary study population and studies that focused on ageism in older nurses' work environments, including strategies or interventions to address ageism within the workplace. Following the initial screening, all relevant studies were critically appraised by two reviewers to ensure they were appropriate to include in the review. A synthesis without meta-analysis reporting (SWiM) guideline was employed in the review.

Data Sources

Medical Literature Analysis and Retrieval Systems Online, Scopus, Psychological Information Database and Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched to identify empirical studies and a range of academic institutional websites were accessed for master's and doctoral dissertations and theses. The search covered the period from January 2022 to May 2022, and only publications in English from 2000 onwards were considered.

Results

Nineteen studies were included, ten qualitative studies, seven quantitative studies and two mixed methods secondary analyses. Our results revealed that negative perceptions and beliefs about older nurses' competencies and skills prevail in their practice settings, which influences older nurses' health and well-being as well as their continuation of practice. Further, older nurses' continuation of practice can be facilitated by having a positive personal outlook on ageing, meaningful relationships in their practice settings and working in an environment that is age-inclusive.

Conclusion

To combat ageism in older nurses' practice settings and support their continuation of practice, effective interventions should be organisational-led. The interventions should focus on fostering meaningful relationships between older nurses and their colleagues and managers. Further, healthcare institutions should implement initiatives to promote an age-inclusive work environment that supports an age-diverse nursing workforce.

Implications for the profession and/or patient care

The review findings offer insights for healthcare managers, policymakers and researchers, emphasising the need for anti-ageism policies in healthcare organisations. According to WHO (2021), educational activities such as role-playing and simulation during in-service training may also be effective interventions. Additionally, incorporating anti-ageism initiatives into staff meetings and mandating anti-ageism training could support the continuation of practice for older nurses while fostering a more age-diverse nursing workforce.

Impact

We found evidence on the presence of ageism in older nurses' workplace and the detrimental effects of ageism on older nurses' well-being and continuation of practice. Importantly, we identified a lack of organisational initiatives to address ageism and support older nurses. These findings should encourage healthcare organisations to address ageism in older nurses' practice settings and prompt policymakers to develop age-inclusive policies that support older nurses' continuation of practice.

Reporting method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis Without Meta-analysis checklists were used to report the screening process.

Trial and Protocol Registration

The PROSPERO registration number for the review was CRD42022320214 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320214).

No Patient or Public Contribution.

Advanced practice nurses' evidence‐based healthcare competence and associated factors: A systematic review

Abstract

Background

Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC.

Aim

To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors.

Design

A systematic review.

Data Sources

CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar.

Methods

Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis.

Results

The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies.

Conclusion

The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs.

Implications for the Profession

We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice.

Registration, and Reporting Checklist

The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist.

Patient/Public Contribution

None.

Oral intake of solid medications in patients with post‐stroke dysphagia. A challenge for nurses?

Abstract

Aim

To provide a comprehensive overview of how stroke nurses manage solid medication (SM) delivery to patients with post-stroke dysphagia.

Design

Cross-sectional study.

Methods

A self-administered online survey was carried out among nurses in German-speaking countries between September and December 2021.

Results

Out of a total of 754 responses, analysis was conducted on 195 nurses who reported working on a stroke unit. To identify swallowing difficulties in acute stroke care, 99 nurses indicated routinely administering standardised screenings, while 10 use unvalidated screenings, and 82 are waiting for a specialist evaluation. Regardless of whether screening methods are used or not, most preferred a non-oral route of medication administration for patients with suspected dysphagia. None of the respondents reported administering whole SMs orally to patients. If screening methods indicate dysphagia, approximately half of the respondents would modify SMs. Participants who stated to use the Gugging Swallowing Screen managed the SM intake guided by its severity levels. One-third of the group who awaited assessment by the dysphagia specialist provided modified medication before the consultation.

Conclusion

Most of the nurses on stroke units use swallowing screens and avoid the administration of whole SMs in post-stroke dysphagia. In addition to the non-oral administration, SMs are modified if dysphagia is suspected. Precise guidance on the administration of SM is needed, based on screening tests and prior to expert consultation.

Trial and Protocol Registration

ClinicalTrials.gov: Registration ID: NCT05173051/ Protocol ID: 11TS003721.

Implications for the profession and/or patient care

The present paper serves to alert nurses to the issue of patient safety when administering medication for acute stroke-induced dysphagia.

Impact

SM delivery after acute stroke-induced dysphagia is often neglected. While nurses are aware of the risk associated with dysphagia and would not give whole SMs to patients, the modification of tablets and their administration with semisolids are common.

Reporting Method

This study was reported according to the Checklist for Reporting of Survey Studies (CROSS).

Spiritual coping within medical professions: A psychometric analysis of the Numinous Motivations Inventory short form

Abstract

Aim

To examine the psychometric properties of a short form version of the Numinous Motivation Inventory (NMI) for use with healthcare providers in measuring their existential engagement with life and to assess its relationship with spiritual coping and emotional dysphoria.

Design

Correlational and psychometric study.

Method

Data were collected from June to December 2022. Participants included 102 physicians, recruited from across the United States. Qualtrics was utilized to collect data, and they were evaluated with the NMI short form, Spiritual Coping Questionnaire and Depression, Anxiety, and Stress scale (DASS-21).

Results

Obtained fit statistics from structural equation modelling analysis indicated close fit of the NMI short form with the original model. Multiple regression analyses demonstrated the value of the NMI as a predictor of negative affect independent of spiritual coping. The NMI did not interact with Spiritual Coping, which was independent of negative affect.

Conclusions

The Numinous represents an important aspect of physicians' coping. The constructs can be utilized in training and clinical settings as a valuable and easy-to-use metric for promoting and assessing wellness. The implications of these findings and the value of the NMI were discussed.

Impact

An understanding of existential drivers can equip one to cope with the stressors of healthcare. The NMI short form has the capability to explore an individual's existential drivers through the understanding of three domains.

Reporting Method

Adhered to proper EQUATOR guidelines (GRRAS).

Public Contribution

No patient or public contribution.

Design and content validation of a checklist about infection‐prevention performance of intensive care nurses in simulation‐based scenarios

Abstract

Objective

To design, develop and validate a new tool, called NEUMOBACT, to evaluate critical care nurses' knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention through simulation scenarios involving central venous catheter (CVC), endotracheal suctioning (ETS) and mechanically ventilated patient care (PC) stations.

Background

Simulation-based training is an excellent way for nurses to learn prevention measures in VAP and CRB.

Design

Descriptive metric study to develop NEUMOBACT and analyse its content and face validity that followed the COSMIN Study Design checklist for patient-reported outcome measurement instruments.

Methods

The first version was developed with the content of training modules in use at the time (NEUMOBACT-1). Delphi rounds were used to assess item relevance with experts in VAP and CRB prevention measures, resulting in NEUMOBACT-2. Experts in simulation methods then assessed feasibility, resulting in NEUMOBACT-3. Finally, a pilot test was conducted among 30 intensive care unit (ICU) nurses to assess the applicability of the evaluation tool in clinical practice.

Results

Seven national experts in VAP and CRB prevention and seven national simulation experts participated in the analysis to assess the relevance and feasibility of each item, respectively. After two Delphi rounds with infection experts, four Delphi rounds with simulation experts, and pilot testing with 30 ICU nurses, the NEUMOBACT-FINAL tool consisted of 17, 26 and 21 items, respectively, for CVC, ETS and PC.

Conclusion

NEUMOBACT-FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation.

Relevance for Clinical Practice

Our validated and clinically tested tool could facilitate the transfer of ICU nurses' knowledge and skills learning in VAP and CRB prevention to critically ill patients, decreasing infection rates and, therefore, improving patient safety.

Patient or Public Contribution

Experts participated in the Delphi rounds and nurses in the pilot test.

Does a program‐based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

Abstract

Background

Menopausal women often complain of a range of physical and psychological symptoms known as menopausal syndrome. These symptoms are associated with fluctuating hormone levels, sleep disturbances, and mood swings.

Aim

This study aimed to examine the efficacy of a program-based cognitive behavioral group therapy (CBT) for insomnia and depression among women experiencing menopause.

Methods

A randomized controlled trial of 88 women experiencing menopause was conducted in Egypt from June to September 2022 in outpatient clinics at Mansoura University Hospitals in Egypt. Participants were randomly assigned to a control group (45 women) and an intervention group (43 women). The intervention group received 7 weeks of CBT sessions. Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory 2nd Edition (BDI-II) were administered before and after the intervention.

Results

In the intervention group, there was a significant difference in scores of the subdomains of PSQI, including sleep efficiency, daytime dysfunction, subjective sleep quality, and sleep disturbance (t = 8.911, 11.77, 7.638, and 11.054, respectively), while no significant difference in domains of using sleep medication, sleep duration, and sleep latency. Significant improvements were observed between pre-and-post-intervention in the intervention group for the total scores of PSQI, ISI, and BDII-II (t = 12.711, 16.272, and 12.384, respectively), indicating a large effect size for the three studied variables (r = .81, .87, .8, respectively).

Linking Evidence to Action

This study demonstrated the efficacy of group CBT for lowering insomnia and depression in women experiencing menopause. Thus, results indicated the need of considering prompt and appropriate interventions such as CBT as a safe treatment option to prevent the aggravation of sleep and emotional problems for menopausal women.

Trial Registration

ClinicalTrials.gov Identifier: NCT05920460.

Being a nurse between research and clinic: What challenges and opportunities for a PhD‐prepared nurse? Overview from an Italian paediatric hospital

Abstract

Aim

To report a reflection on the role, challenges and opportunities for nurses with advanced education in research outside the academic field.

Design

A discursive paper.

Data Sources

We reported the case of an Italian paediatric research hospital where PhD-prepared nurses started to apply their knowledge and competencies in different fields, both in clinical and organizational settings. From this experience, an overview of the possible barriers and challenges that PhD-prepared nurses may face up within the hospital setting.

Discussion

The application of PhD-prepared nurses in hospital settings could be an opportunity to advance high standards of quality of care in managerial and clinical areas and to create networks between highly specialized professional figures and different clinical-care realities.

Conclusion

More research is needed to explore how to apply the advanced competencies of PhD-prepared nurses within healthcare organizations to provide high-quality and safe care and services.

This paper can provide insights for a reflection on applying and developing PhD-prepared nurses' skills and competencies within the hospital setting in clinical, research and managerial areas. This can enhance the effective application of highly competent nursing professional figures.

Patient or Public Contribution

No Patient or Public Contribution, due to study design.

Patient safety in surgical settings: A study on the challenges and improvement strategies in adverse event reporting from a nursing perspective

Abstract

Aims

To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives.

Design

An exploratory, descriptive qualitative study was conducted with a theoretical-methodological orientation of phenomenology.

Methods

In-depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis.

Results

Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non-punitive culture and superior feedback.

Conclusion

The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety.

Implications

It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture.

Impact

This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety.

Reporting Method

The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines.

Patients or Public Contribution

No patients or public contribution.

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