Conectar
To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.
Qualitative descriptive study.
Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.
We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.
Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.
This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.
Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes.
This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research.
This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes.
A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability.
AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field.
Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical considerations, and data privacy to guarantee its effective implementation and positive impact on the quality and safety of healthcare.
With ambient listening systems increasingly adopted in healthcare, analyzing clinician-patient conversations has become essential. The Omaha System is a standardized terminology for documenting patient care, classifying health problems into four domains across 42 problems and 377 signs/symptoms. Manually identifying and mapping these problems is time-consuming and labor-intensive. This study aims to automate health problem identification from clinician-patient conversations using large language models (LLMs) with retrieval-augmented generation (RAG).
Using the Omaha System framework, we analyzed 5118 utterances from 22 clinician-patient encounters in home healthcare. RAG-enhanced LLMs detected health problems and mapped them to Omaha System terminology. We evaluated different model configurations, including embedding models, context window sizes, parameter settings (top k, top p), and prompting strategies (zero-shot, few-shot, and chain-of-thought). Three LLMs—Llama 3.1-8B-Instruct, GPT-4o-mini, and GPT-o3-mini—were compared using precision, recall, and F1-score against expert annotations.
The optimal configuration used a 1-utterance context window, top k = 15, top p = 0.6, and few-shot learning with chain-of-thought prompting. GPT-4o-mini achieved the highest F1-score (0.90) for both problem and sign/symptom identification, followed by GPT-o3-mini (0.83/0.82), while Llama 3.1-8B-Instruct performed worst (0.73/0.72).
Using the Omaha System, LLMs with RAG effectively automate health problem identification in clinical conversations. This approach can enhance documentation completeness, reduce documentation burden, and potentially improve patient outcomes through more comprehensive problem identification, translating into tangible improvements in clinical efficiency and care delivery.
Automating health problem identification from clinical conversations can improve documentation accuracy, reduce burden, and ensure alignment with standardized frameworks like the Omaha System, enhancing care quality and continuity in home healthcare.
Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve these outcomes, but their effectiveness remains unclear, especially in the advanced stages.
This meta-analysis aimed to examine the efficacy of death education interventions on death anxiety, depression, and quality of life in advanced cancer sufferers, and to explore the influence of the intervention site, duration, the age of participants, and dyadic relationships with caregivers on the effectiveness of these interventions.
A meta-analysis of randomized controlled trials was performed.
A systematic search of 10 electronic databases identified 19 eligible RCTs with 1531 participants. Data were extracted and analyzed via Review Manager 5.4. Subgroup analyses were performed on the basis of the intervention site, duration, age of participants, and presence of caregivers.
In comparison to the control intervention, the death education intervention notably alleviated death anxiety (SMD = −2.11, 95% CI: −5.91 to −0.89, p = 0.008) and depression (SMD = −0.45, 95% CI: −0.72 to −0.18, p = 0.001). Quality of life (SMD = 0.86, 95% CI: 0.39–1.33, p = 0.0003) was also significantly improved. Subgroup analyses revealed that interventions with longer durations, conducted in professional settings, and targeting younger patients were more likely to be effective in reducing depression and enhancing the quality of life. Interventions without family companionship were more effective in improving depression, while interventions with family companionship were more effective in improving quality of life.
Death education interventions are effective at improving death anxiety, depression, and quality of life in patients with advanced cancer. Tailoring interventions to individual features and cultural backgrounds is crucial to achieving the best effect.
Death education is an effective and important intervention measure that can help patients with advanced cancer better cope with death anxiety and depressive emotions and improve their quality of life. Clinical medical workers should select appropriate death education programs based on the specific conditions of patients and provide necessary support and guidance.
CRD42024565376
Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission between couples. We aim to examine the mediation of dyadic coping between antepartum anxiety and stress in expectant mothers and fathers.
We implemented a cross-sectional study in Guangzhou, China, from October 2023 to January 2024.
Three-hundred and twenty-nine Chinese pregnant couples completed the Perceived Stress Scale, the Dyadic Coping Inventory, and the State–Trait Anxiety Inventory. The actor-partner interdependence mediation model was used for data analysis.
Expectant mothers experienced antepartum anxiety symptoms at a rate of 42.6%, while the rate for expectant fathers was 32.5%. Regarding the actor effects, stress was positively associated with antepartum anxiety in expectant mothers (β = 0.66, 95% confidence interval CI [0.56, 0.74]) and fathers (β = 0.58, 95% CI [0.42, 0.70]), with dyadic coping acting as a mediator (expectant mothers: β = 0.08, 95% CI [0.03, 0.14]; fathers: β = 0.11, 95% CI [0.04, 0.19]). Regarding the partner effects, maternal dyadic coping was positively associated with paternal stress (β = 0.10, 95% CI [0.01, 0.19]).
The study highlights the interplay of stress, dyadic coping, and antepartum anxiety in expectant mothers and fathers, emphasizing the need to assess their antepartum anxiety and implement couple-centered interventions to enhance their psychological well-being during the first trimester of pregnancy.
This study highlights the importance of assessing antepartum anxiety in both expectant mothers and fathers, emphasizing the mediation of dyadic coping in reducing stress and anxiety. The findings support the integration of couple-centered mental health interventions into routine antepartum care to enhance psychological well-being during pregnancy.
The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.
Scoping review.
This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.
The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.
Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.
This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
Patients with advanced cancer often face numerous physical, psychological, and practical challenges from their disease and treatments, yet interventions addressing their specific unmet needs remain limited.
This study aimed to evaluate the effectiveness of a tailored psychoeducational intervention (PEI) on stress, anxiety, depression, coping, and fatigue among advanced cancer patients in Indonesia.
A randomized controlled trial was conducted from August 2022 to March 2023 in Indonesia.
A total of 151 advanced cancer patients from a referral hospital in Indonesia were randomized into intervention and control (conventional management) groups. Participants were assessed using validated questionnaires including the Depression, Anxiety, and Stress Scale (DASS-21), Fatigue Severity Scale (FSS), and Brief COPE at three time points: baseline (T0, before intervention), after first intervention (T1), and after second intervention (T2). The PEI was delivered face-to-face with telephone follow-up calls. Generalized Estimating Equations (GEE) analysis was used to evaluate the intervention's effectiveness.
The intervention was significantly associated with improved coping and reduced fatigue scores. Significant time effects were observed for depression, stress, coping, and fatigue scores. For anxiety, a significant impact was found at the second time point but not at the third, compared to the baseline. The difference-in-difference (DID) analysis revealed significant effects on coping and fatigue scores, while anxiety only showed significance at the second time point.
This study provides evidence for the potential effectiveness of PEI in improving coping strategies, relieving stress, anxiety, and depression, and reducing fatigue among advanced cancer patients in Indonesia.
The tailored PEI, including follow-up phone calls, can be independently implemented by nurses. Focusing on patients' unmet needs and spirituality, this intervention can help manage mental health issues and strengthen coping mechanisms, potentially leading to positive effects on physical conditions such as fatigue.
The study aims to assess the extent of compulsory citizenship behaviors (CCBs) and their impact on the nurses' subjective vitality based on self-determination theory.
CCBs are harmful to both nurses and organizations. These behaviors mean employees are expected to perform additional tasks outside their job descriptions. Although CCBs are highlighted within the recent nursing literature, empirical evidence of their effects is lacking.
This is descriptive cross-sectional research. The study included 244 staff nurses using a convenience sampling method who worked in two hospitals in Istanbul. Data were collected via a survey consisting of a personal information form, the compulsory citizenship scale, and the subjective vitality scale. STROBE guidelines were followed when reporting the study. Descriptive statistical analyses, independent samples t-test, one-way ANOVA test, Pearson's correlation, and hierarchical simple linear regression analyses were used.
The participants' mean scores for compulsory citizenship and subjective vitality were 3.34 out of 5 (SD = 1.05) and 4.15 out of 7 (SD = 1.36), respectively. Nurses' compulsory citizenship scores significantly differed according to their education level, income, and sector. Their subjective vitality scores statistically differed according to their income levels. Regression analysis revealed that CCBs were significant negative predictors of subjective vitality (β = −0.22, p < 0.01).
By examining the CCBs and subjective vitality relationship, the current study extended the existing knowledge by drawing attention to the destructive and harmful effects of CCBs on positive psychological sources of nurses' subjective vitality. CCBs negatively predicted subjective vitality.
Organizational factors such as CCBs, which leads to a lack of autonomy, affect nurses' well-being, thus affecting care quality and patient safety. As the International Council of Nurses mentioned, “Nurses cope with many physical, mental, emotional, and ethical challenges. It is essential that we address these challenges in a way that supports their overall health”. In this regard, managers and policymakers in hospitals should develop preventive cautions for CCBs. However, in-service training activities should be carried out to increase awareness about the harmful effects of CCBs on nurses' psychological well-being.
Today in academia and health care, creating a vision and crafting a career path that progresses toward that vision is essential. Career cartography is the comprehensive and iterative process of applying the science of cartography within the context of policy toward achieving a career with impact.
The purpose of this article is to advance the knowledge and application of the original publication as described by Feetham and Doering in 2015. Career cartography supports scientific thinking, communicates science, and addresses the uncertainty of a career.
We conducted a critical analysis of differences between the original publication and our current practical experience of career cartography. Workshops conducted the past 10 years have advanced our understanding of the career cartography components and their utility to one's career. This analysis is informed by a review of the 25 publications citing the 2015 publication to evaluate how scholars report applying the process across health professions and organizations.
All components of career cartography are expanded beyond the 2015 publication to include application of the process with exemplars.
Career cartography is an effective guide across disciplines and at all stages of a career for determining, directing, evaluating, and communicating one's career and its impact.
The intentional and ongoing use of career cartography maximizes the impact one's chosen career can have on improvements to health and health policy.
Despite evidence supporting nurse-led digitalized diabetes interventions, gaps persist in understanding their specific impact on community-dwelling patients with type 2 diabetes mellitus (T2DM). Prior reviews lacked a quantitative synthesis of these interventions' effects on outcomes like self-care, HbA1c, and quality of life (QoL), limiting their applicability to clinical practice. This study aimed to systematically evaluate and quantify the effectiveness of nurse-led digitalized diabetes management programmes for community-dwelling adults with T2DM.
We searched six databases to identify relevant articles from their inception to June 2024. Randomized controlled trials that evaluate the effects of nurse-led digitalized diabetes management programs for community-dwelling patients with T2DM were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise the included studies. The pairwise meta-analysis was performed through the software Comprehensive Meta-Analysis Version 3.0.
Eleven RCTs were included, encompassing 2943 participants from various regions. Nurse-led digitalized programs significantly improved self-care behaviors (SMD = 1.15; 95% CI: 0.49 to 1.81), and QoL (SMD = 0.65; 95% CI: 0.37 to 0.94). The interventions also demonstrated a clinically meaningful reduction in HbA1c levels (MD = -0.25%; 95% CI: −0.43 to −0.06), highlighting their potential in improving glycaemic control. Heterogeneity across studies was substantial for self-care but moderate for HbA1c and QoL.
Nurse-led digitalised diabetes management programmes effectively enhance self-care behavior, reduce HbA1c levels, and improve QoL among community-dwelling patients with T2DM. These findings underscore the potential of digitalised interventions as scalable and accessible alternatives to traditional diabetes management, particularly in non-institutionalized settings.
Nurse-led digitalised diabetes management programmes can empower community-dwelling patients with T2DM to achieve better health outcomes by enhancing self-care and glycaemic control while improving QoL. Their integration into routine clinical practice could address barriers to care, optimize diabetes management, and reduce the long-term burden of the disease.
The International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024594874
To identify the prevalence of musculoskeletal disorders among hospital nurses and explore their effects on productivity loss.
An analytical cross-sectional study with secondary data analysis was conducted.
Data were collected via an online survey of 607 registered nurses working in general and tertiary hospitals in South Korea. Multivariate logistic regression analysis was performed to examine the association between musculoskeletal disorders and four productivity loss indicators: absenteeism, presenteeism, perceived productivity loss, and work limitations.
Musculoskeletal disorders were highly prevalent among hospital nurses, with 83.9% of participants reporting musculoskeletal disorder symptoms in the past week. Lower back complaints had the highest prevalence. Nurses with musculoskeletal disorders were 3.74 times more likely to experience presenteeism than those without musculoskeletal disorders. They were also 3.00 times more likely to report perceived productivity loss and 2.24 times more likely to experience work limitations. However, no significant relationship was observed between musculoskeletal disorders and absenteeism.
Musculoskeletal disorders contribute to presenteeism, productivity loss, and work limitations among hospital nurses. Targeted interventions for preventing and managing musculoskeletal disorders are essential to mitigate productivity losses and improve nurses' health and job performance. Strategies such as ergonomic workplace modifications, early detection, and effective management of musculoskeletal disorders can help maintain nurses' productivity and well-being.
Addressing musculoskeletal disorders is critical for enhancing nurse productivity and for ensuring the delivery of high-quality patient care. Healthcare organizations can safeguard nurses' health and patient outcomes by reducing presenteeism and work limitations.
Amid a global nurse staffing crisis, in 2019 Scotland legislated the Health and Care (Staffing) (Scotland) Act to address health care workforce challenges. Instead of requiring patient-to-nurse ratios as legislated elsewhere, this act requires staffing decisions according to guiding principles, duties, and a common staffing method. Measuring variation in hospitals' adherence to the act's provisions at baseline is important for policymakers to evaluate fulfillment of the act's requirements and goals. Results will inform policymakers about which provisions are achieved at baseline and which require support for employers to achieve. The purpose of the study was to establish the baseline of nurse staffing standards in Scotland at April 2024 implementation of the Act. Nurse reports of quality, safety, and their intent to leave were measured to complement assessment of the implementation status.
A cross-sectional study design was used. A convenience sample of registered nurses and nursing support workers was recruited through professional organizations and trade unions. Nurses were invited to complete an online survey between May 1 and July 31, 2024. The survey content included demographic and professional characteristics, international nursing metrics, the Act's provisions, and job intentions. Descriptive statistics were calculated to describe the sample, act's provisions, and nurses' job intentions.
The sample comprised 1870 nurses, of whom 93% were registered nurses, from all regions with characteristics reflecting the Scottish nursing workforce. Regarding the act's provisions, 9% reported that nursing staffing is appropriate to provide safe, high-quality care every shift. Similarly, few nurses reported that the quality of care was excellent (17%) or graded safety an A (10%). Most nurses disagreed that current staffing levels met the eight guiding principles. Most nurses reported that the common staffing method and duties regarding real-time staffing decisions were followed at best occasionally. Nearly half of nurses (45%) intend to stay in their current job over the next year. Among those intending to leave their current job, about half plan to leave the profession through retirement or another unspecified job change. The other half plan to seek another similar nursing job or promotion.
Few nurses report that the act's overarching goal is being met at the point of implementation. Although most nurses see nursing as a long-term career, workforce disruption is anticipated through routine turnover, promotion, or retirement, requiring workforce retention policies. Whether the act's complex provisions can be achieved and its goals fulfilled may not reverse the trend of exiting nurses. The complexity of the approach will be a challenge to achieving the objective of safe staffing. Therefore, this approach to achieving safe staffing may be too complex to be recommended widely. These remain urgent questions for Scottish policymakers, nurse leaders, and researchers.
This study aimed to examine the effect of an integrative cognitive training program by family caregivers on cognitive function among persons with traumatic brain injury.
A randomized controlled trial, repeated measures design was utilized.
The participants were adult persons diagnosed with mild-to-moderate TBI and their family caregivers. They were recruited from the neurology ward at a tertiary hospital in Thailand. One hundred participants were randomly assigned to the experimental group (n = 50) and the control group (n = 50). The experimental group received an integrative cognitive training program from family caregivers based on the theory of neural plasticity in combination with a systematic review, while the control group received usual care. Cognitive function was assessed at baseline and week 2, week 4, and week 6 follow-up using the Montreal Cognitive Assessment. Data were analyzed using descriptive statistics, Chi-square, Fisher's exact test, and repeated measures ANOVA.
The results showed a significant improvement in cognitive function scores in the experimental group over time (p < 0.001). Additionally, participants in the experimental group who received an integrative cognitive training program by family caregivers demonstrated significantly higher cognitive function scores compared to the control group at week 4 and week 6 follow-up assessments (p < 0.001). The effect sizes were large (η 2 = 0.14) with a test power of 90%.
An integrative cognitive training program can enhance neuroplasticity and improve cognitive function among persons with mild-to-moderate traumatic brain injury. Moreover, involving family caregivers in the rehabilitation process can improve community engagement and cognitive abilities in persons with traumatic brain injury.
Healthcare professionals in neurological settings should incorporate an integrative cognitive training program into their usual care and educate family caregivers to continue the intervention at home for improving cognitive function among persons with mild-to-moderate traumatic brain injury.
TCTR20230828002
Drinking is the most problematic health behavior among adolescents. Adolescent drinking behavior is likely to continue into adulthood and can lead to various social problems, development of multiple diseases, and even death. Grit is defined as the ability to persist in the face of a struggle. While grit can be a protective factor against risky health behaviors, there is a lack of information on how grit is related to adolescent drinking behavior. Based on the integrative model of adolescent health risk behavior, this study aimed to examine how intrapersonal, interpersonal, and cultural/environmental factors were related to adolescent drinking behaviors. Especially, this study aimed to examine the relationship between grit and adolescent drinking behavior by adding grit as a psychosocial maturity factor.
A cross-sectional study using a nationally representative sample of Korean adolescents.
A secondary data analysis of the 5th wave of the Korean children and youth panel survey (N = 2252) was conducted. The study sample comprised 11th-grade high school students. Descriptive statistics and logistic regression analyses were performed
Model 1 included intrapersonal, interpersonal, and cultural/environmental factors associated with adolescent drinking behavior. Model 2 added grit to the factors in model 1 to examine how grit is related to adolescent drinking behavior. After controlling for intrapersonal, interpersonal, and cultural/environmental factors, a higher level of grit was associated with lower odds of drinking behavior among adolescents (OR = 0.413, 95% CI = 0.257–0.662, p < 0.001)
A higher level of grit was associated with lower odds of drinking behavior among adolescents after adjusting for intrapersonal, interpersonal, and cultural/environmental factors
As grit can help deter risky health behaviors, guardians, teachers, and school nurses should focus on fostering grit among adolescents through education, mentorship, and intervention programs
Nurses and healthcare support staff have a higher suicide risk than the public. This elevated risk calls for increased efforts to support mental health. Additionally, nursing leaders' education on employee-specific suicide prevention is lacking.
An evidence-based project was implemented using the PICO question: Among nurse leaders at an academic healthcare system in California, does the provision of an educational program using role-playing practice and the creation of a suicide prevention toolkit versus no standard education or training improve self-efficacy and knowledge on how to take action with a team member who is suspected of being suicidal or voicing suicidal ideation?
Education sessions were planned based on the literature, with surveys collected preintervention, immediately posteducation, and 1-month postintervention to assess suicide prevention self-efficacy and knowledge. Knowledge was measured using a researcher-constructed questionnaire validated by six suicide prevention experts. The General Self-Efficacy Scale (range: 10–40) was used.
Sixty participants attended one of 11 scheduled remote-learning sessions. Mean self-efficacy significantly improved (pre: 31.3 [n = 46, min: 18, max: 40]; immediate post: 33.49 [n = 37, min: 24, max: 40]; 1-month post: 33.77 [n = 31, min: 28, max: 40]) (X 2 = 8.0184, df = 2, p = 0.01815). The proportion of incorrect knowledge questions was significantly lower postintervention (mean pre: 24.5%, immediate post: 11.5%, 1-month post: 10.7%, X 2 = 23.195, df = 2, p = 0.000001). All participants (100%, n = 55) recommended the program. Leaders reported feeling better prepared to support suicidal employees.
Project results demonstrate the need to provide suicide prevention training for leaders. The authors recommend requiring training/return demonstration competency as a component of new leaders' onboarding. This program can easily be modified for nurses from prelicensure through senior leadership.
Suicide rates in healthcare members are higher than those of the general population. Suicide prevention programs can help nursing leaders feel better prepared to support and connect at-risk healthcare workers with resources.
Delay in detecting acute deterioration in older adults in care homes is associated with avoidable hospitalizations and adverse outcomes, including premature death.
Underpinned by the Knowledge to Action Framework, this study aimed to understand the barriers and enablers to direct care staff detecting and responding to the early signs of acute deterioration in care home residents.
Online focus groups or interviews with regulated (registered and enrolled nurses) and unregulated (assistants in nursing and personal care workers) direct care staff from participating care homes were conducted. Homes were recruited using disproportionate stratified random sampling to include metropolitan, inner regional, and outer regional care homes. Interview and focus group recordings were transcribed verbatim and analyzed using inductive thematic analysis.
Eighty direct care staff (n = 48 regulated; n = 32 unregulated) from eight care homes participated. Fifteen focus groups (n = 7 unregulated staff, n = 8 regulated staff) and two interviews (n = 1 regulated staff, n = 1 unregulated staff) were conducted between July 2021 and October 2022. Four themes related to the barriers and enablers of detecting and responding to acute deterioration were generated: decision-making within the scope of practice; resource availability; streamlined communication; and teamwork.
Findings highlight the challenges direct care staff encounter in being able to detect early signs of acute deterioration and implement appropriate care pathways. Perceived barriers and enablers highlighted in this study need to be considered when developing and implementing programs to optimize the timely detection of, and response to, acute deterioration in care homes.
Workforce knowledge, experience, and confidence deficits are significant barriers to detecting acute deterioration, while the unique workforce mix in care homes poses additional challenges for the accurate detection of early signs of acute deterioration. Knowing the resident, working as a team, and valuing the contribution of aged care staff and families in managing acute deterioration are enablers to achieving better outcomes for residents experiencing acute deterioration.
The aim of the study was to explore the impact of patient safety culture on nurses' negative work outcomes resulting from patient safety incidents, as well as the mediating roles of second victim support and distress.
A cross-sectional survey was conducted. The participants included 208 nurses, each with over a year of clinical experience, working in hospitals across South Korea.
Data were collected through self-reported questionnaires on general characteristics, patient safety culture, second victim support and distress, and negative work outcomes. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Scheffé test, and Pearson correlation coefficients. Additionally, model 6 of Hayes' PROCESS macro and the Sobel test were employed to determine the mediating effect.
Mediation analysis revealed significant indirect effects of patient safety culture on the work outcomes experienced by nurses following patient safety incidents, mediated by second victim distress, after controlling for participants' marital status, position, and the severity of patient safety incidents.
This study demonstrates that in healthcare settings, patient safety culture that supports the second victim and alleviates second victim distress mitigates the negative work outcomes resulting from patient safety incidents. The findings highlight the significance of culturally sensitive support systems, particularly considering the diverse impacts on Korean nurses. Based on this study, healthcare leaders are recommended to develop strategies to support nurses and reduce their second victim distress, which can ultimately improve patient safety and the quality of nursing care.
The findings of this study can be used to develop strategies to support second victims in addressing their distress. Taking steps to alleviate the distress of second victims will help prevent negative work outcomes in nurses.
FreshRSS 