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Dissemination of results following clinical trials and community-based research provides value to participants and communities beyond the intent of the primary study. Organizations participating in multi-site research may see similar benefits if local results are shared; however, it is not standard practice. Evaluation of the impact of results sharing in multi-site research is needed.
To assess the benefits of organizational participation in a multi-site pediatric pain study when results were shared, identify how sites applied local results, and the outcomes of participation, including subsequent improvement efforts and scholarship.
Following data collection for a 12-hospital multi-site study, site research teams shared their experiences collecting the data and lessons learned. All sites received a packet with overall results, their local results, and an interpretation guide. 4 years later, the sites were surveyed about initiatives that were undertaken because of the primary study.
Following data collection, 10 of 12 sites described unanticipated benefits of participation, including identifying gaps and strengths of documentation, generation of new practice questions, and identification of new opportunities for improvement. Seven sites answered the follow-up survey 4 years later. Most sites (n = 6, 85.7%) used their data to inform multiple practice changes (M = 2.8, SD 0.75), including changes in pain documentation (n = 5, 83.3%), assessment (n = 4, 66.7%), policy (n = 4, 66.7%), and treatments (n = 4, 66.7%). Five sites reported an average of 2.4 (SD 1.14) additional activities stimulated by participation, but not directly due to data. Three sites used results for American Nurses Credentialing Center Magnet Recognition applications.
When multi-site investigators provide local data, organizations see long-term benefits, including new collaborations, quality improvement efforts, and research. Additional exploration of collaborative strategies between investigators and practice settings in multi-site research is needed for pediatric pain management and beyond.
Post-stroke depression is the most common neuropsychiatric consequence and reduces rehabilitation effectiveness. However, the efficacy of virtual reality (VR) on mental health treatment for patients after a stroke is uncertain.
The aim of this study was to evaluate the efficacy of VR as a co-adjuvant form of treatment to reduce depression in stroke patients admitted to neurorehabilitation units.
We systematically searched medical databases including PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception to November 16, 2023. Clinical trials comparing the use of VR as an adjuvant form of treatment in stroke patients' rehabilitation with the usual treatment were included. Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses were performed according to type of stroke, VR characteristics, and the scale used to measure depression. Meta-regression analysis was performed for intervention duration and to determine the mean age of the participants.
Eight studies and 388 stroke patients were included. The VR interventions were associated with a lower risk of depression in patients (ES = −0.69; 95% CI [−1.05, −0.33]; I 2 = 57.6%; p ≤ .02). The estimates were not affected by the type of stroke, the type of VR used, the blinding process, the type of scale used to detect depression, the duration of the intervention (weeks and minutes), and the total number of sessions. Meta-regression shows that younger samples (p = .00; 95% CI [0.01, 0.08) and longer interventions (p = < .05; 95% CI [−0.00, −0.00) lead to a greater reduction in depression.
This review provides an important basis for treating depression in patients after a stroke. Professionals working in stroke neurorehabilitation units should consider VR as a form of co-adjuvant treatment for depression in patients.
CRD42022303968.
Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care.
This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic.
This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer.
We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes.
Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.
Nurses' lack of clinical judgment often leads to adverse patient outcomes due to failure to recognize clinical deterioration, intervene, and manage complications. Teaching clinical judgment through a nursing process can help nursing students provide safe and competent patient care with improved health outcomes and to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
The aim of this study was to examine the effect of tutoring on clinical judgment of undergraduate nursing students utilizing Lasater's Clinical Judgment Rubric (LCJR). This study also compared the clinical judgment of male and female nursing students and students from different semester levels.
This quasi-experimental study utilized a single group pretest, posttest design. A convenience sample of n = 40 undergraduate nursing students from the Los Angeles County College of Nursing and Allied Health participated in the study. The participants underwent a pretest simulation, four sessions of the Clinical Judgment Model (CJM)-based tutoring, and a posttest simulation.
The posttest clinical judgment scores (35.70 ± 3.6) were significantly different from the pretest scores (25.78 ± 5.20). The tutoring had a significant effect on the clinical judgment of nursing students t(39) = −11.64, n = 40, p < .001, at 95% CI of the mean difference.
Enhancing nursing students' clinical judgment is crucial to provide high-quality, safe patient care with improved health outcomes. The CJM-based tutoring is an effective strategy for developing clinical judgment in nursing students. This new teaching approach can train students to critically think, develop clinical judgment, and prepare for the complex healthcare environment. Therefore, nurse educators should focus on integrating clinical judgment into the prelicensure nursing program curriculum as a priority.
FreshRSS 