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To explore the factors affecting the sustainable improvement of nurses' evidence-based practice (EBP) competency after receiving an EBP training program.
A sequential mixed-methods study.
Thirty-seven ICU nurses participated from an adult ICU in Egypt. The qualitative phase used a category-generating approach with focus group interviews and content analysis. The quantitative phase followed a cross-sectional descriptive design using self-report questionnaires. The study adhered to the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines and was registered with ClinicalTrials.gov (NCT05941364).
Qualitative analysis generated six subcategories, organised into three overarching themes: working environment challenges, job dissatisfaction and organisational obstacles. Quantitative findings revealed low levels of motivation (M = 19.1, SD = 2.2, out of 60), self-efficacy (M = 18.4, SD = 8.66) and self-regulation (M = 124.9, SD = 52.6). The highest mean score was observed for the Sustained Implementation Support Scale (M = 94.7, SD = 5.0, out of 140). These variables showed negative correlations with the sustainability gap. Integration of findings through a joint display demonstrated a convergence of results regarding training program burden and low motivation.
Sustaining nurses' EBP literacy requires addressing long-term obstacles such as inadequate job satisfaction, limited workplace support and lack of team cohesion. Sustained organisational support and leadership development are essential for EBP clinical integration.
The study highlights key strategies for nurses' development to enhance care quality, including improving self-efficacy through mentorship and fostering a supportive work environment. Health policies should establish EBP as a core competency, offer flexible schedules, ongoing training, adequate resources, and empower nurse leaders for successful implementation.
This study addresses the critical challenge of sustaining nurses' competency improvements after EBP training. The findings are crucial for healthcare administrators, policymakers and educators aiming to design effective EBP training programs. By addressing these factors, the study has the potential to improve patient outcomes.
No patient or public contribution.
This study aimed to examine the challenges faced by pediatric nurses in implementing and sustaining clinical handover in intensive care units (ICUs), focusing on identifying key barriers affecting the handover process in these specialised environments.
Pediatric nurses encounter several challenges that hinder the effective implementation of clinical handover in intensive care settings. These challenges can compromise patient safety and care continuity. Understanding these obstacles is essential for identifying areas for improvement and enhancing handover practices in pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs).
A descriptive, cross-sectional study was conducted in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) of the specialised university hospital for children in Alexandria, Egypt. The sample included 127 nurses who provided direct care to critically ill children. Participants were selected using convenience sampling. Data were collected using a self-administered questionnaire designed to assess various challenges encountered during the clinical handover process. The questionnaire covered five key areas: nurse-related challenges, handover quality-related challenges, organisational challenges, environmental challenges and communication challenges. Data were analysed using descriptive and inferential statistical methods, including multivariate regression analysis. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The study found that the most significant challenges during clinical handover were nurse-related (mean = 74.7, SD = 5.6), followed by organisational challenges (mean = 69.2, SD = 16.7). Statistically significant differences were observed in nurses' characteristics, such as gender, age, marital status, years of experience and the place and duration of handover. Nurses who conducted longer handovers or performed them at the bedside reported fewer challenges compared to those who performed handovers at the nursing station or those with shorter durations.
Pediatric nurses in critical care settings face significant challenges in clinical handover, with barriers such as resistance to change, non-standardised language, time constraints and outdated reports being prominent. Female nurses, older nurses and those working in settings with less standardised handover practices reported more difficulties. Addressing these challenges is critical for improving handover processes, ensuring better patient safety and enhancing care outcomes.
Standardised handover protocols tailored to intensive care workflows, along with targeted training for nurses, are essential to address the identified challenges. These measures will enhance communication, improve handover efficiency and promote patient safety in pediatric ICUs. No patient or public contribution.
More than one-third of all diseases in the world are non-communicable diseases (NCDs), and poorer health outcomes are linked to low health literacy (HL), in which nurses have a significant role to play. Various studies have confirmed that there is an association between HL and NCDs. However, less is known about how nurses can intervene in the development of HL in patients with NCDs. This systematic review was carried out to explore, in a comprehensive way, nursing interventions that could promote HL in patients with NCDs.
A systematic review (PROSPERO registration number: CRD370625) was carried out on five databases (PubMed MEDLINE, Web of Science, Scopus, ScienceDirect and JSTOR). Sequences that provided information for our study topic were retrieved and analysed following PRISMA guidelines for systematic reviews.
In total, 1915 titles and abstracts were screened, 71 articles were assessed in full-text screening and 25 studies were included in the review. Around 23 different nurse-led intervention strategies were identified, but only 11 major ones were explored in detail. The majority of them prioritised communication (teach-back), self-management programs, counselling and education. In the majority of the trials, a significant positive outcome was discovered. Both nurses and patients needed to devote time and attention to the complex nurse-led HL interventions.
Nurses' HL interventions have shown promise in promoting HL and other health outcomes in people with NCDs, but they need to be tailored to fit specific patients. Nursing programs should include more than just patient teaching strategies.
Nurses' HL efforts hold potential for enhancing HL in NCD patients, provided they are customised to individual needs.
To evaluate the impact of spatial separation on patient flow in the emergency department.
This was a retrospective, time-and-motion analysis conducted from 15 to 22 August, 2022 at the emergency department of a tertiary hospital in Kuala Lumpur, Malaysia. During this duration, spatial separation was implemented in critical and semi-critical zones to separate patients with symptoms of respiratory infections into respiratory area, and patients without into non-respiratory area. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Patients triaged to critical and semi-critical zones were included in this study. Timestamps of patient processes in emergency department until patient departure were documented.
The emergency department length-of-stay was longer in respiratory area compared to non-respiratory area; 527 min (381–698) versus 390 min (285–595) in critical zone and 477 min (312–739) versus 393 min (264–595) in semi-critical zone. In critical zone, time intervals of critical flow processes and compliance to hospital benchmarks were similar in both areas. More patients in respiratory area were managed within the arrival-to-contact ≤30 min benchmark and more patients in non-respiratory area had emergency department length-of-stay ≤8 h.
The implementation of spatial separation in infection control should address decision-to-departure delays to minimise emergency department length of stay.
The study evaluated the impact of spatial separation on patient flow in the emergency department. Emergency department length-of-stay was significantly prolonged in the respiratory area. Hospital administrators and policymakers can optimise infection control protocols measures in emergency departments, balancing infection control measures with efficient patient care delivery.
STROBE guidelines.
None.
The study obtained ethics approval from the institution's Medical Ethics Committee (MREC ID NO: 20221113–11727).
The author has checked and make sure our submission has conformed to the Journal's statistical guideline. There is a statistician on the author team (Noor Azhar).
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