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☐ ☆ ✇ Evidence-Based Nursing

Home-based model is an important cost-effective alternative to centre-based cardiac rehabilitation

Por: Batalik · L. · Su · J. J. — Septiembre 26th 2023 at 16:14

Commentary on: Shields GE, Rowlandson A, Dalal G, Nickerson S, Cranmer H, Capobianco L, Doherty P. Cost-effectiveness of home-based cardiac rehabilitation: a systematic review. Heart. 2023 Feb 27:heartjnl-2021-320459. doi: 10.1136/heartjnl-2021-320459. Epub ahead of print.

Implications for practice and research

  • Home-based cardiac rehabilitation (CR) is a cost-effective alternative/supplementary model to increase CR accessibility, improve health benefits and reduce health service use.

  • More robust clinical trials are needed as the heterogeneity in design, particularly the intervention dosage, staffing models, telehealth features, hybrid approach and individual costs, challenges the evidence base.

  • The psychological care component is missing in the current cost-effectiveness analysis of home-based CR.

  • Context

    Despite evidence that exercise-based cardiovascular rehabilitation (CR) is an effective intervention, patient uptake and adherence are uncertain. Recent research suggests that home-based CR interventions are as effective and safe as those supervised in a centre.1 Therefore, home-based telemedicine...

    ☐ ☆ ✇ Evidence-Based Nursing

    How misinformation exposure influences vaccine status

    Por: Fox · S. — Septiembre 26th 2023 at 16:14

    Commentary on: Neely SR, Eldredge C, Ersing R, Remington C. Vaccine Hesitancy and Exposure to Misinformation: a Survey Analysis. J Gen Intern Med. 2022 Jan;371,:179-187. doi: 10.1007/s11606-021-07171-z. Epub 2021 Oct 20.

    Implications for practice and research

  • Implementing strategic trustworthy communication that targets misinformation themes counters negative information about vaccines and helps achieve community support for vaccination programmes.

  • Amplifying the presence of health professionals on social media and collaborating with political thought leaders may help to anticipate, identify and offset health-related misinformation.

  • Context

    Since the emergence of the SARS-CoV-2 in late 2019, there has been an unprecedented global change. Each country took actions to respond to the outbreak including guidance development, surveillance and epidemiology, testing, providing emergency supplies and rapid vaccine development. During this time, governments struggled to keep up with misinformation, conspiracy theories, social media rumours and uncertainty.1 This resulted in misinformation...

    ☐ ☆ ✇ Evidence-Based Nursing

    Refusal of care behaviours among people with major neurocognitive disorder highlight the need for multiple research approaches to account for the complexity of the phenomenon

    Por: Daneau · S. · Auclair · I. — Septiembre 26th 2023 at 16:14

    Commentary on: Backhouse T, Killett A, Mioshi E, Khondoker M. What are the factors associated with people with advanced dementia refusing assistance with personal care? Int J Geriatr Psychiatry. 2023 Jan;38(1): e5857. doi: 10.1002/gps.5857.

    Implications for practice and research

  • To promote caregivers’ capacity for action, the occurrence of refusal of care in people living with a major neurocognitive disorder (NCD) can be conceptualised as a need for the caregiver to adapt the care offered, its characteristics and/or the approach used.

  • Further research should address the relationship between agitation and refusal of care in people with an NCD, while considering its complexity, to reduce both behaviours.

  • Context

    Refusal of care or resistance to care is the terms frequently used to describe people living with a major NCD refusing care verbally or physically. As people with an NCD have significant cognitive impairment, these behaviours are common...

    ☐ ☆ ✇ Evidence-Based Nursing

    Early mobilisation in the intensive care unit randomised controlled trial: a need to look beyond the surface

    Por: Anekwe · D. · Spahija · J. — Septiembre 26th 2023 at 16:14

    Commentary on: TEAM Study Investigators and the ANZICS Clinical Trials Group; Hodgson CL, Bailey M, Bellomo R, Brickell K, Broadley T, Buhr H, Gabbe BJ, Gould DW, Harrold M, Higgins AM, Hurford S, Iwashyna TJ, Serpa Neto A, Nichol AD, Presneill JJ, Schaller SJ, Sivasuthan J, Tipping CJ, Webb S, Young PJ. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med 2022;387(19):1747–58. doi:10.1056/NEJMoa2209083. Epub 26 Oct 2022.

    Implications for practice and research

  • Early mobilisation may improve patient outcomes; however, starting with a higher dosage at the early stage of critical illness may not provide any added benefit.

  • Future research should explore the intensity, timing, duration and level of activity required to optimise physical rehabilitation of critically ill patients.

  • Context

    Early mobilisation (EM) refers to the practice of initiating physical activity that is of sufficient intensity to elicit acute physiological effects...

    ☐ ☆ ✇ Evidence-Based Nursing

    Stigmatisation and workplace violence against healthcare workers: the need for evidence-based preventive strategies

    Por: Chowdhury · S. R. — Septiembre 26th 2023 at 16:14

    Commentary on: Saragih ID, Tarihoran DETAU, Rasool A, Saragih IS, Tzeng HM, Lin CJ. Global prevalence of stigmatization and violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. J Nurs Scholarsh. 2022;54(6):762–71. doi: 10.1111/jnu.12794. Epub 12 Jul 2022.

    Implications for practice and research

  • Health administrators and policymakers should appropriately address issues of stigmatisation and violence against healthcare workers through strategic planning that considers the unique nature of the workplace as well as local culture to ensure better healthcare for the patients.

  • Future research should focus on synthesising evidence-based preventive strategies and management protocols to avert the escalation of stigmatisation and violence towards healthcare workers during catastrophic public health crises.

  • Context

    Violence in the workplace is a common issue in healthcare settings. However, since the beginning of the COVID-19 pandemic, there has been an increase in the number of reports in...

    ☐ ☆ ✇ Evidence-Based Nursing

    Fathers with intellectual disabilities require support to successfully navigate fatherhood

    Por: Marsh · L. · Brown · M. — Septiembre 26th 2023 at 16:14

    Commentary on: Ćwirynkało K, Parchomiuk M. Support as described by fathers with intellectual disabilities. J Appl Res Intellect Disabil. 2023 Mar;36(2):320-332. doi: 10.1111/jar.13061. Epub 2022 Dec 9

    Implications for practice and research

  • Fathers with intellectual disabilities require informal and formal supports to successfully navigate parenthood.

  • The voices of fathers with intellectual disabilities should be prominent in future disability research.

  • Context

    Men with intellectual disabilities become good fathers with appropriate supports in place. Some fathers with intellectual disabilities were underestimated by partners, relatives and professionals, with their abilities to parent continually questioned. While formal and informal supports were viewed as helpful and necessary, there were differences between the support required and those provided. To develop their parenting skills and competence, fathers with intellectual disabilities require additional support.

    Methods

    This study explored the lived experiences of social support of 20 Polish fathers with intellectual...

    ☐ ☆ ✇ Evidence-Based Nursing

    Statutory mental health services in the UK do not meet the needs of people from ethnic minority groups

    Por: Barreto · M. — Septiembre 26th 2023 at 16:14

    Commentary on: Bansal N, Karlsen S, Sashidharan SP, Cohen R, Chew-Graham CA, Malpass A. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Med. 2022 Dec 13;1912:e1004139. doi: 10.1371/journal.pmed.1004139.

    Implications for practice and research

  • Mental health service providers need to listen to the voices of ethnic minorities to offer services that align with their needs and experiences and reduce mental health disparities.

  • Research should evaluate the effectiveness of alternative approaches to, and co-production of, biomedical mental healthcare for specific ethnic minority groups.

  • Context

    Mental health disparities are well documented in the UK, despite free access to healthcare. Individuals from minoritised ethnic groups are more likely than white British individuals to: suffer from undiagnosed and untreated mental illness; access healthcare via crisis pathways (and less likely to access via primary care); and receive a diagnosis of severe mental illness. This is costly...

    ☐ ☆ ✇ Evidence-Based Nursing

    Oxygen supplementation above a low-flow nasal cannula in patients with COVID-19 may improve arterial oxygen levels but not breathlessness

    Por: Prakash · J. · Sahay · N. — Septiembre 26th 2023 at 16:14

    Commentary on: Poncin W, Baudet L, Braem F, Reychler G, Duprez F, Liistro G, Belkhir L, Yombi JC, De Greef J. Systems on top of nasal cannula improve oxygen delivery in patients with COVID-19: a randomized controlled trial. J Gen Intern Med 2022;37(5):1226–32. doi: 10.1007/s11606-022-07419-2. Epub 8 Feb 2022.

    Implications for practice and research

  • The adverse consequences of continuous exposure to high concentrations of oxygen must be considered before instituting prolonged oxygen therapy in patients with COVID-19.

  • Hypoxaemia is significant in patients with COVID-19, and isolated arterial oxygen pressure (PaO2) improvement may not necessarily translate into any significant survival benefit nor relieve the distress of breathlessness.

  • Context

    Oxygen therapy is important in COVID-19 management. The low-flow nasal cannula (NC) has some drawbacks. The patient’s peak inspiratory flow rate requirements are not met due to significant leakage around the source. A need to improve oxygen...

    ☐ ☆ ✇ Evidence-Based Nursing

    Efficacy of light intervention in improving mood and behaviour, but not sleep in intellectually disabled older adults

    Por: Annarumma · L. · De Gennaro · L. — Septiembre 26th 2023 at 16:14

    Commentary on: Böhmer MN, Oppewal A, Valstar MJ, Bindels PJE, van Someren EJW, Maes-Festen DAM. Light up: an intervention study of the effect of environmental dynamic lighting on sleep-wake rhythm, mood and behaviour in older adults with intellectual disabilities. J Intellect Disabil Res. 2022 Oct;66(10):756–781. doi: 10.1111/jir.12969. Epub 2022 Aug 25.

    CommentaryImplications for practice and research

  • Increasing light exposure in care facilities improves mood and behaviour in older adults with intellectual disability (ID).

  • Light exposure protocols should be implemented and investigated to determine the optimal intervention parameters.

  • Context

    Sleep problems are frequently experienced by older adults with ID living in residential care facilities1 due to instability and disruption of their sleep-wake rhythm.2 Light exposures protocols have been shown to improve sleep-wake rhythm, mood and behaviour in several clinical conditions, but literature in older adults with ID is still quite...

    ☐ ☆ ✇ Evidence-Based Nursing

    Phenomenography: an alternative to the usual qualitative method

    Por: Rolls · K. — Septiembre 26th 2023 at 16:14
    Introduction

    Phenomenography is a method of exploring the phenomenon of interest by examining how a group of individuals experience said phenomenon, uncovering the similarities and differences of this shared experience. The purpose of this paper is to outline the case for phenomenography as a research method ideally suited to explore the complex problems encountered by nurses and midwives within their everyday practice.

    Research paradigm

    Phenomenography emerged in the mid-1970s from the landmark study by Marton and Saljo1 2 where they endeavoured to explain why students at the same university and course arrived at different solutions for the same problems. Phenomenography is a second-order perspective because it focuses on participants and is concerned with understanding the collective view rather than understanding an experience through multiple individual experiences. A key assumption is that individual experiences are ‘logically related’ when phenomena they experience are the...

    ☐ ☆ ✇ Evidence-Based Nursing

    Resources page

    Por: Wray · J. — Septiembre 26th 2023 at 16:14

    This edition of the Evidence Based Nursing (EBN) resources page is focused on further information to support the editorial by Alison Twycross and Jane Wray ‘NHS (National Health Service (NHS) England Long-term Workforce Plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?’

    EBN has published a number of commentaries that provide useful additional information relating to the UK NHS workforce.

  • Collaboration between universities and nursing placement providers is essential to ensure the well-being of the future nursing workforce %7C Evidence-Based Nursing (bmj.com) Dr Anne Mills highlights the importance of joint initiatives between educational settings and placement providers to promote student nurse well-being.

  • Supporting positive workplace cultures focused on staff well-being is discussed in; Negative workplace behaviour: nurses’ power games, blame culture and incivility-why nurses do not care for each other %7C Evidence-Based Nursing (bmj.com)...

  • ☐ ☆ ✇ Evidence-Based Nursing

    Nurse-driven patient empowerment intervention reduces patients anxiety and depression during the discharge from critical care units

    Por: Al Qadire · M. — Septiembre 26th 2023 at 16:14

    Commentary on: Cuzco C, Castro P, Marín Pérez R, Ruiz García S, Núñez Delgado AI, Romero García M, Martínez Momblan MA, Benito Aracil L, Carmona Delgado I, Canalias Reverter M, Nicolás JM, Martínez Estalella G, Delgado-Hito P. Impact of a Nurse-Driven Patient Empowerment Intervention on the Reduction in Patients' Anxiety and Depression During ICU Discharge: A Randomized Clinical Trial. Crit Care Med. 2022 Dec 1;50(12):1757-1767. doi: 10.1097/CCM.0000000000005676. Epub 2022 Sep 30.

    Implications for practice and research

  • Critical care nurses are advised to implement a nurse-driven patient empowerment intervention (NEI) in their daily practice to aid discharged patients.

  • The long-term effects of NEI on patients with varying diseases need further evaluation.

  • Context

    Several studies have indicated that a significant proportion of patients who have been admitted or discharged from an intensive care unit (ICU) experienced high levels of anxiety and depression.1 2

    ☐ ☆ ✇ Evidence-Based Nursing

    People affected by dementia had mixed experiences of using technology during COVID-19

    Por: Pessoa Lima · D. · Rosa · I. D. — Septiembre 26th 2023 at 16:14

    Commentary on: Chirico I, Giebel C, Lion K, Mackowiak M, Chattat R, Cations M, Gabbay M, Moyle W, Pappadà A, Rymaszewska J, Senczyszyn A, Szczesniak D, Tetlow H, Trypka E, Valente M, Ottoboni G. Use of technology by people with dementia and informal carers during COVID-19: A cross-country comparison. Int J Geriatr Psychiatry. 2022 Sep;37(9). doi: 10.1002/gps.5801.

    Implications for practice and research

  • Consider patient and caregiver preferences for using technology.

  • Offer training on the use of technology.

  • Provide the most suitable schedule for caregivers.

  • More multicentre randomised controlled trials are needed to assess the feasibility of telehealth in different stages of dementia.

  • Context

    The COVID-19 pandemic brought to light the need to adopt technology in healthcare systems worldwide due to the need for physical distancing and isolation measures, especially in the older adult group.1 2 Several studies have...

    ☐ ☆ ✇ Evidence-Based Nursing

    Virtual wards versus hospital at home: care models for older people

    Por: Wheeldon · M. — Septiembre 26th 2023 at 16:14

    Commentary on: Norman G, Bennett P, Vardy ERLC. Virtual wards: a rapid evidence synthesis and implications for the care of older people. Age Ageing. 2023 Jan 8;52(1):afac319. doi: 10.1093/ageing/afac319.

    Implications for practice and research

  • While virtual wards are now an accepted model of care delivery for older people further research and evaluation of this model specifically focused on patient selection, the use of technology, impact on carers, and patient and carer satisfaction is needed.

  • The use of virtual modalities of care for older people can be a viable alternative to face to face assessment and care.

  • Context

    Since the COVID-19 pandemic, there has been increased interest in Virtual Wards as a viable and cost-effective alternative to hospital-based care. Applying this model of care for frail elderly people has become more common but there remains confusion about the difference and/or overlap in the models of...

    ☐ ☆ ✇ Evidence-Based Nursing

    Women with intellectual disability require accessible and inclusive reproductive healthcare

    Por: Brown · H. K. — Septiembre 26th 2023 at 16:14

    Commentary on: Schuengel C, Cuypers M, Bakkum L, Leusink GL. Reproductive health of women with intellectual disability: antenatal care, pregnancies and outcomes in the Dutch population. J Intellect Disabil Res. 2022 Sep 27. doi: 10.1111/jir.12982. Epub ahead of print.

    Implications for practice and research

  • There is a need for accessible and inclusive reproductive healthcare for women with intellectual disability (ID).

  • Further research is required to identify factors explaining reproductive health disparities in women with ID.

  • Context

    Reproductive health is an important aspect of the human rights of women with ID. Described as ‘the forgotten generation’, many women with ID were institutionalised or sterilised following eugenic practices that prevailed for much of the 20th century.1 Important social and human rights advances over the last 50 years have resulted in more opportunities for childbearing for women with ID.2 However, evidence from the...

    ☐ ☆ ✇ Evidence-Based Nursing

    Research skills should be embedded in undergraduate nursing programmes

    Por: Powers · J. — Septiembre 26th 2023 at 16:14

    Commentary on: Gros-Navés S, Contreras-Higuera W, Canet-Vélez O, Torralbas-Ortega J, Taló M, Roca J. The effect of writing a bachelor thesis on attitudes towards nursing research and development: A cross-sectional comparative study between students and professionals. Nurse Educ Today. 2022 Nov;118:105 532. doi: 10.1016/j.nedt.2022.105532. Epub 2022 Aug 31.

    Implications for practice and research

  • Promoting research development early in nursing education improves perceptions and use of research findings among practising nurses.

  • Future research is essential to identify strategies that contribute to developing clinical inquiry skills leading to optimal patient outcomes.

  • Context

    Research is essential for nursing practice and must be duly enhanced during university training. There is considerable evidence linking research and evidence-based practice to improved nursing practice.1 In this study, Gros-Navés et al sought to assess the impact of writing a bachelor’s thesis on attitudes towards nursing research and development among students/nursing graduates.

    ...
    ☐ ☆ ✇ Evidence-Based Nursing

    Build teamwork on a solid foundation: team familiarity promotes effective interprofessional collaboration

    Por: Rosen · M. A. — Septiembre 26th 2023 at 16:14

    Commentary on: Iyasere CA, Wing J, Martel JN, et al. Effect of increased interprofessional familiarity on team performance, communication, and psychological safety on inpatient medical teams: a randomized clinical trial. JAMA Intern Med. 2022 Nov 1;182(11):1190–1198. doi: 10.1001/jamainternmed.2022.4373.

    Implications for practice and research

    Team member familiarity has a positive impact on teamwork and interprofessional communication. Organisational design should consider team member familiarity.

    Context

    Interprofessional teamwork matters for patient and workforce outcomes. Familiarity of team members is associated with improved teamwork and communication, safety and quality of care, utilisation and patient outcomes. However, much of the existing research is observational in nature. This study evaluated the impact of a team member familiarity intervention on the quality of nurse and resident interactions, perceptions of organisational climate and care outcomes.

    Methods

    This single site randomised clinical trial evaluated the effect of a resident scheduling intervention designed to...

    ☐ ☆ ✇ Evidence-Based Nursing

    Perceived organisation support would buffer the impact of work frustration on burn-out among intensive care unit nurses

    Por: Saravanabavan · L. · Poongavanam · V. — Septiembre 26th 2023 at 16:14

    Commentary on: Yanbei R, Dongdong M, Yun L, Ning W, Fengping Q. Does perceived organization support moderate the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey. BMC Nurs. 2023 Jan 23;22(1):22. doi: 10.1186/s12912-023-01180-5.

    Commentary

    Implications for practice and research

  • Providing intensive care unit (ICU) nurses with organisational supports by showcasing that the organisation cares about their well-being, gives importance to their opinions, is proud of their achievements will decrease their work frustration.

  • Future research and auditing of programmes and events to monitor organisational support to ICU nurses in reduction of work frustration and burn-out. Such monitoring systems could translate into better patient outcome.

  • Context

    The psychological strain of caring for very ill patients causes significant mental stress for all ICU healthcare professionals. When stress is prolonged, it might eventually cause burn-out and deterioration of patient...

    ☐ ☆ ✇ Evidence-Based Nursing

    Role of nursing education to facilitate nursing students competency to recognise and respond to intimate partner violence

    Por: van der Wath · A. — Septiembre 26th 2023 at 16:14

    Commentary on: Shaqiqi W, Innab A. Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence. J Adv Nurs. 2022 Sep 5. doi: 10.1111/jan.15424. Epub ahead of print.

    Implications for practice and research

  • Nurses’ competency to recognise and respond to women exposed to intimate partner violence (IPV) should be facilitated during undergraduate nursing training.

  • Research needs to generate evidence for the best educational strategies to facilitate and integrate these competencies into nursing education curricula.

  • Context

    International guidelines1 require healthcare professionals to identify women exposed to IPV, and manage them based on their healthcare needs. To capacitate nurses to effectively respond to these women, undergraduate curricula should include learning outcomes based on evidence-based practice. Shaqiqi and Innab assessed the attitudes of nursing students and their preparedness to manage IPV.2 The study assessed the following variables:...

    ☐ ☆ ✇ Evidence-Based Nursing

    Clinical nursing supervisors and healthcare staff play a significant role in decreasing undergraduate baccalaureate nursing student clinical stress

    Por: Stubin · C. — Septiembre 26th 2023 at 16:14

    Commentary on: Mazalová L, Gurková E, Štureková L. Nursing students' perceived stress and clinical learning experience. Nurse Educ Pract. 2022 Oct;64:103 457. doi: 10.1016/j.nepr.2022.103457. Epub 2022 Sep 24.

    Implications for practice and research

  • Clinical nursing supervisors may be unfamiliar with the demands and challenges students encounter in the clinical environment, and the amount of encouragement and assistance they require to be successful in the nursing profession.

  • Further research should focus on intervention studies examining how clinical nursing supervisors control nursing student clinical stressors to improve student outcomes.

  • Context

    The clinical environment is the prevailing source of stress during nursing students’ educational experience. Although clinical supervisors are predominantly supportive to students in the clinical environment, current literature recognises certain clinical nursing supervisor actions and behaviours as causes of nursing student clinical stress.1 Clinical supervisors have a responsibility to identify and understand nursing student clinical...

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