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Evaluate the effect of IV line labels on nurses' identification of high-alert medications in a simulated scenario of multiple infusions for critically ill patients.
Randomised crossover simulation experimental study.
A study was conducted on 29 nurses working in intensive care for over 6 months. They were given two critical scenarios in a simulated environment, one with labels and the other without labels, involving multiple intravenous infusions. The nurses had to identify the medications infused into the critical patients' intravenous lines and disconnect a specific line. The data were collected and analysed to evaluate the errors made by the nurses in identifying and disconnecting the medications and the time they spent carrying out the tasks. The Wilcoxon test was used to analyse the variation in outcome before and after the intervention.
Approximately one-third of the study participants incorrectly identified the intravenous lines in both scenarios. There was no significant difference in the average number of errors between the scenarios with and without labels. However, the time taken to perform the tasks in the scenario with labels was 1 min less than in the scenario without labels, suggesting a potential efficiency gain.
The labels on the intravenous lines allowed for quick drug identification and disconnection. The professionals performed similarly in correctly recognising the high-alert medication intravenous lines, in the scenarios with or without labels.
The label can be used as a technology to prevent misidentification of high-alert medications administered to critically ill patients through intravenous lines, thereby enhancing medication safety in healthcare institutions.
No Public Contribution.
This study aimed to investigate factors influencing the acceptance of smartphone applications among high-risk pregnant women in the Lao People's Democratic Republic to support continuous care.
An explanatory sequential mixed-methods design.
The quantitative phase included 167 high-risk pregnant women recruited from four tertiary hospitals in Vientiane, Lao PDR. Validated questionnaires were used to measure demographics, digital technology usage, eHealth literacy and anxiety. Data were analysed using descriptive statistics and multiple regression analysis. In the qualitative phase, in-depth interviews with 20 women were conducted to further explore experiences, perceptions and barriers related to smartphone application usage. Interviews were analysed via direct content analysis.
Quantitative findings indicated that smartphone application acceptance was significantly predicted by eHealth literacy (B = 1.53, 95% CI 1.22–1.84, p < 0.001) and pre-existing non-communicable diseases (B = 4.39, 95% CI 1.05–7.73, p = 0.010). Anxiety negatively impacted acceptance (B = −0.28, 95% CI −0.51 to −0.05, p = 0.019). The model explained 53.9% of the variance in smartphone application acceptance (R 2 = 0.539). Qualitative findings highlighted four key themes: awareness of pregnancy risks, unclear health information, perceived benefits of smartphone applications including accessibility and emotional reassurance and practical barriers such as internet costs and limited digital literacy.
Positive perceptions of smartphone applications regarding accessibility and reassurance were observed, alongside significant barriers, such as limited digital literacy and internet costs. Addressing these factors may enhance the adoption and effective utilisation of digital health technologies among high-risk pregnant populations.
No patient or public contribution.
To map interventions in the sexuality of men with stomas.
Scoping review, following JBI and PRISMA-ScR guidelines to report results.
Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions.
The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation.
Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education.
This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered.
This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients.
This study complies with the PRISMA-ScR.
There was no patient or public contribution.
The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9.
This study aims to describe the exercise of clinical leadership by nurses within hospital care units, identify the factors influencing it and explore how nurses perceive its impact.
Qualitative multiple case study.
The study involved 36 interviews, 120 h of observation and documentary analyses with nurses across various roles within three nursing teams to capture collective leadership. Thematic and cross-case analyses were also conducted.
Nurses' clinical leadership was manifested in five distinct forms, irrespective of their role: (1) initiating actions involving reflective thinking and intervention, (2) influencing others through coaching, (3) actively participating in and mobilising efforts to enhance the quality of care, (4) fostering optimal synergy and team cohesion, and (5) leveraging personal and collaborative capacities. Factors influencing this leadership included clinical, human and material resources, time, a work environment that promotes autonomy and a positive work climate. Nurses perceived their leadership as having a positive impact on patients, themselves, the interdisciplinary team and the organisation. These findings were integrated into a modellisation of the exercise of nurses' clinical leadership based on Le Moigne's (La Théorie du Système Général. Théorie de la Modélisation. Paris: Presses Universitaires de France, 2006) philosophical approach.
This study provides a perspective on nurses' collective clinical leadership in hospital care units, emphasising its leverage effect and the achievement of positive impacts. The proposed model serves as a valuable tool for nurse managers to better understand and support the exercise of clinical leadership.
The model can guide nurse managers in supporting clinical leadership within teams, assist individual nurses in associating clinical leadership with their practice and assist with mobilising their leadership skills.
This study explores how nurses across various roles within a hospital care unit exercise clinical leadership. The findings reveal five active forms of nurses' clinical leadership, perceived by nurses to positively impact patients, the interdisciplinary team and the organisation. Nurses and managers can use these five forms to foster a collective approach to clinical leadership.
None.
This study introduces an innovative model for understanding and promoting nurses' clinical leadership. It provides insights into the positive impact of this leadership approach and the significance of promoting it.
Standards for Reporting Qualitative Research [SRQR] (O'Brien et al. Academic Medicine, 89, 2014 and 1245).
Not registered
Fatigue, depression, anxiety and cognitive difficulties are reported by 1/3 of patients following transient ischemic attack (TIA).
To explore the timeline and how the diagnosis impacts individuals experiencing lasting challenges after TIA. Furthermore, to identify what they believed facilitated return to everyday life.
Qualitative exploratory study with a phenomenological-hermeneutic approach.
Individual semi-structured interviews and thematic analysis.
Fifteen patients were included. Four themes were identified; (1) ‘They say it is transient – no, not for me’ where all participants described lasting challenges emphasizing invalidating fatigue and impaired social participation, (2) ‘I am a changed person; how does this impact my future?’ which reflects altered identity and elevated alertness to symptoms, (3) ‘Time has been my ally and new perspectives have evolved’ where most participants described improvement over time and a few considered the diagnosis a wake-up call to change lifestyle. Lastly (4) ‘What would have helped me recover?’ which unfolds that close, trustful relations influence positively. In addition, the system often failed to support. Participants described pressure to return to work and lack of trust and negative experiences when involving their general practitioner.
During the 4 months since diagnosis, participants experienced limitations impacting physical, psychological and social domains. They felt uninformed that lasting challenges could affect them. Different coping strategies were activated, and participants with close, supportive relations managed better. A pressure to return to work and a lack of trust in the general practitioner affected their recovery negatively. Overall, return to everyday life after TIA was considered stressful and appropriate support lacking.
To be able to support patients with challenges following TIA, we as healthcare professionals need to understand the identified impact and life changing circumstances. Currently the system seemingly is not able to provide timely, sufficient and competent support.
We know from the literature that up to 1/3 of patients following transient ischemic attack experience lasting challenges measured on a variety of questionnaires. This is paradoxical to a diagnosis defined by focal neurological symptoms that resolve within 24 h. It is unknown how patients with lasting challenges experience the timeline from diagnosis and until 4 months after, how the diagnosis impacts the lives of these individuals, and what they believe as beneficial in returning to their everyday life.
These participants with self-reported lasting challenges experienced substantial impacts on physical, psychological and social domains. Further, they felt alone with their struggles and when in need of support from the healthcare system, it failed to provide this. A pressure to return to work and a lack of trust in the general practitioner affected return to everyday life negatively, whereas close and supportive relations facilitated positively.
This study will have an impact on the healthcare professionals that provide support and the (limited) follow-up services to patients after TIA. These healthcare professionals are often specialized nurses who need to know what these patients experience and need in order to act upon their struggles and provide timely support.
The Standards of Reporting Qualitative Research (SRQR).
Patients with TIA was involved in planning this study. They participated in a panel to plan a prospective observational cohort study and emphasized the importance of exploring the subjective perspectives of impact and prognosis for those patients struggling in a longer term (through qualitative interviews).
To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long-term care facilities (LTCF) for older adults.
This was a cross-sectional study. The competence test, ‘the Ms. Olsen test’, was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non-experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables.
The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff.
This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish-speaking RNs working in institutional care homes caring for patients according to national practice standards.
These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings.
Caring according to national practice standards and caring for severely ill patients are associated with clinical competence.
The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross-sectional studies.
Registered and PNs completed a questionnaire for the data collection.
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.
Simulation-based training is an excellent way for nurses to learn prevention measures in VAP and CRB.
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.
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.
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.
NEUMOBACT-FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation.
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.
Experts participated in the Delphi rounds and nurses in the pilot test.
To explore challenges in everyday life for people with long-term cognitive effects of COVID-19 and whether a rehabilitation programme contributed to the remedy thereof.
Healthcare systems around the world need knowledge about acute COVID-19 treatment, long-term effects exerting an impact on peoples' everyday lives, and how to remedy these.
This is a qualitative study with a phenomenological approach.
Twelve people with long-term cognitive effects of COVID-19 participated in a multidisciplinary rehabilitation programme. Individual semi-structured interviews were made. Data were analysed thematically.
Three themes and eight sub-themes emerged with respect to everyday life challenges and experiences of the rehabilitation programme. The themes were (1) Personal insight and knowledge, (2) Changed daily routines at home and (3) Coping with working life.
Participants experienced long-term effects of COVID-19 as cognitive challenges, fatigue and headaches, which affected their everyday lives, that is inability to overcome daily tasks at home and at work, maintaining family roles and relations with relatives. The rehabilitation programme contributed to a vocabulary and insights related to the long-term effects of COVID-19 and the experience of being a different person. The programme contributed to changes in daily routines, organising breaks in everyday life and explaining challenges to family/relatives and the way in which they affected daily routines and their role in the family. In addition, the programme supported several of the participants in finding the right workload and working hours.
We recommend multidisciplinary rehabilitation programmes inspired by cognitive remediation of long-term COVID-19 cognitive effects. Municipalities and organisations could collaborate in the development and completion of such programmes, possibly comprising both virtual and physical elements. This could facilitate access and reduce costs.
Patients contributed to the conduct of the study by participating in the data collection via interviews.
Data collection and processing of data are approved by the Region of Southern Denmark (journal number: 20/46585).
This study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P 
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