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AnteayerInternacionales

Research Capacity and Culture on Nurses' Evidence‐Based Practice Implementation

ABSTRACT

Background

The research-to-practice gap often occurs when evidence-based practice (EBP) is inadequately implemented into clinical practice. Nurses are critical to bridging the gap in EBP implementation (EBPI) and identifying effective strategies to promote its use in practice; however, they need a supportive work environment to develop the necessary research capacity/culture (RCC).

Aims

The purpose of this study was to examine relationships between nurses' perceptions of individual RCC and EBPI, team RCC and EBPI, and health care organization RCC and EBPI, adjusting for educational background, health care organization setting, and health care organization type.

Methods

Survey data were collected from 175 nurses across the United States using a prospective cross-sectional study design. The Research Capacity in Context (RCC) tool and EBPI scale were used to measure nurses' perception of RCC and nurses' EBPI, respectively. Simple linear regression was used to assess the relationship between organizational, team, and individual RCC and EBPI. Multiple linear regression was used to adjust for pertinent participant demographics.

Results

The results of this study indicated that organization (R 2 = 0.033, p = 0.016), team (R 2 = 0.064, p < 0.001), and individual (R 2 = 0.155, p < 0.001) RCC were significantly associated with nurse EBPI. Moreover, findings remained significant after adjusting for educational background, health care organization setting, and type. The regression model suggested that education significantly predicted EBPI (R 2 = 0.142, p < 0.001).

Linking Evidence to Action

These results emphasize the importance of building RCC in health care organizations, as it can be an effective strategy to increase nurses' EBPI, which has been shown to impact patient outcomes directly. Future research should identify strategies to assist organizations and leadership in building RCC among nurses.

Authentic Nursing Leadership and Safety Climate Across Hospital Settings During the COVID‐19 Pandemic: A Cross‐Sectional Study

ABSTRACT

Aim

To analyse the relationship between authentic nursing leadership and safety climates across hospital settings during the COVID-19 pandemic.

Background

Authentic nursing leadership shapes the safety climate by fostering positive perceptions of workplace policies, processes, procedures and practices that influence how safety is prioritised and addressed within an organisation.

Design

A cross-sectional study.

Methods

Our study was conducted from December 2021 to December 2022 in six Brazilian hospitals. Participants were nursing staff working in General Medicine Units, Intensive Care Units (ICU) and Emergency Departments (ED) who provided care to patients with COVID-19. The Authentic Leadership Questionnaire and the Safety Attitudes Questionnaire were used to measure nursing staff perceptions of authentic leadership and safety climates. Data were analysed using descriptive and inferential statistics.

Results

391 nursing staff across six hospitals participated. Self-awareness significantly enhanced perceptions of the safety climates. Additionally, being a Registered Nurse and working in the ICU were positively associated with achieving safe climates in the working environment. In contrast, working in EDs was significantly negatively related to safety climates.

Conclusions

The COVID-19 pandemic underscored a lack of authentic nursing leadership and unsafe climates. Therefore, it is critical to implement educational strategies that foster authentic leadership, particularly focusing on self-awareness, to promote more positive safety climates. Ensuring that leadership and safety climates are relationship-focused is critical to enhancing patient outcomes.

Implications for the Profession and/or Patient Care

Nursing staff's perceptions of authentic leadership and safety climates are important in making more informed decisions about patient management.

Impact

Since self-awareness increases positive perceptions of safety climates, nursing staff should exercise it to guide their actions in facing future health crises.

Reporting Method

STROBE guidelines.

Patient or Public Contribution

Higher self-awareness in relationships with others is a predictor of safety climates and can lead to enhanced patient outcomes.

Examining the Association Between Perceived Quality of Care and Experienced Coercion Among Patients in Acute Mental Health Units in Spain: A National Cross‐Sectional Study

ABSTRACT

Aim

To examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units.

Design

National cross-sectional study.

Methods

Data were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences.

Results

Perceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the “secluded” dimension showing the strongest association. The association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety.

Conclusion

Higher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings.

Implications for the Profession and/or Patient Care

For mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes.

Impact

The study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care.

Reporting Method

STROBE reporting guideline.

Patient or Public Contribution

No patient or public contribution.

Patient Satisfaction With the Level of Competence of the Triage Nurse in Hospital Emergency Departments

ABSTRACT

Aims

To analyse the level of patient satisfaction regarding the care received in triage and its relationship with the competency level of clinical nurses in a hospital setting.

Design

A cross-sectional, prospective and multicentre study of nurses in hospital emergency triage and the patients they attended.

Method

Data were collected between October and November 2019 using two questionnaires; one collected sociodemographic factors, professional experience of the nurse and the competency assessment questionnaire for clinical nurses in the hospital setting (COM_VA). The other questionnaire recorded the age of patients, reason for consultation, pain and the Patient Satisfaction with Emergency Nursing Care Scale (CECSS). The abstract includes an indication of the chosen checklist, specifically the STROBE checklist for descriptive observational studies.

Results

The study included a sample of 624 patients and 77 nurses. The findings indicated that the nurses' level of competence, with an average score of 8.61, is significantly correlated with patient satisfaction. A total of 90.2% of patients reported being satisfied with the care they received during triage, highlighting the technical competence and empathy of the nurses as highly valued attributes. However, areas for improvement were identified, particularly in pain management and addressing the emotional needs of patients. Other factors related to nursing competence that influenced patient satisfaction included perceived safety in clinical practice and the sense of respect from the multidisciplinary team. Additionally, the intensity of pain experienced by patients during triage was a significant determinant of their overall satisfaction.

Conclusions

The results of this study indicate that the higher the level of nursing competence, the more satisfied the patients. In addition to knowledge and skills in triage, aspects such as empathy, concern and assertive listening influence patient satisfaction, and, therefore, perceived quality of care.

Reporting Method

In preparing the manuscript, the authors adhered to the relevant EQUATOR guidelines and the STROBE checklist for descriptive observational studies.

Public or Patient Contribution

No public or patient or professional contribution outside of participation for data collection purposes.

Trial Registration: N/A. This was not a clinical trial

Barriers and facilitators in self‐care and management of chronic kidney disease in dialysis patients: A systematic review of qualitative studies

Abstract

Aim

To identify and synthesise qualitative studies on barriers and facilitators perceived by dialysis patients in relation to self-care and disease management.

Design

Systematic review of qualitative studies.

Data Sources

Qualitative study articles were extracted from PUBMED, MEDLINE, COCHRANE, WEB OF SCIENCE (WOS), CINAHL PsycINFO and EMBASE and electronic journals of the Spanish Society of Nephrology and Spanish Society of Nephrological Nursing until May 2022. Studies on barriers and/or facilitators affecting self-care and disease management expressed by people undergoing haemodialysis or peritoneal dialysis were included.

Review Methods

The SPICE (Setting, Perspective, Intervention, Comparison and Evaluation) strategy was used to develop issues and subissues through the thematic synthesis of the qualitative findings. GRADE-CERQual was used to evaluate the articles.

Results

From 172 articles, 15 qualitative articles about barriers and facilitators perceived by patients concerning self-care and disease management were finally included. Identified eight facilitators and four barriers.

Conclusion

Patients perceived a significant number of barriers and facilitators. It is possible to identify which aspects facilitate self-management of their disease and to understand that the processes are individualised. This is why therapeutic strategies should be designed to foster the participation and empowerment of the person in the management of the disease.

Implications for the profession and/or patient care

Identifying the barriers and facilitators concerning the management of chronic kidney disease furnishes us with knowledge for individualised clinical practice and improved care processes.

Impact

This review is the first to synthesise barriers and facilitators in haemodialysis patients about the management of their disease and treatment. The results enable the proposal of improvements in the training of healthcare personnel, clinical practice guidelines and action protocols to improve the daily life and management of the disease by patients.

No patient or public contribution due to this is a systematic review.

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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