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Nursing well-being is foundational to the specialties workforce and broader healthcare industry worldwide. Despite frequent reports and descriptions of activities that support nurses' well-being, most reports describe singular activities and programs that lack science-based structures contextualized within academic healthcare systems (AHS) with validated impact.
To evaluate and synthesize the existing national and international literature on nurse well-being initiatives offered in AHS.
Over 18 months, an 8-member interprofessional team conducted a scoping review adhering to PRISMA-ScR reporting guidelines. Five databases were searched, and results were screened in a multistep process by researcher pairs. Discrepancies were resolved by a third team member's review. Citations were reviewed uniquely three times to ensure methodological rigor. A final set of 54 articles was extracted for key data elements pertinent to the research question describing setting, population, study design, intervention, and other subsidiary fields. Reviewers additionally analyzed publication quality indicators and trends for additional implications for research and practice.
Among the 54 eligible articles, 72% were research and 28% were evidence-based practice, quality improvement, or doctoral dissertations. The concepts studied were psychosocial (e.g., resiliency) and physical (e.g., sleep). The number of instruments used per study ranged from 1 to 11. Thirty percent of studies utilized a framework from various disciplines that included nursing, social and behavioral sciences, and safety science principles. Nurses were included as authors 67% of the time, and 35% received funding from either the public or private sector.
Work-related stressors have been associated with physician suicide. Physician burnout and depression were exacerbated by the COVID-19 pandemic, remain unresolved and of national concern. Future pandemics are predicted. This study is the first to characterize professional and pandemic-related stressors in physician suicides during the COVID-19 pandemic.
This study aimed to evaluate whether there was a change in reported job-related stressors after the beginning of the COVID-19 pandemic.
Physician suicides were identified within the National Violent Death Reporting System dataset (March 1, 2020 to December 31, 2021). Free-text law enforcement and medical examiner notes for physician suicides were analyzed using reflexive thematic analysis.
Of 307 physician suicides, 70 included professional or pandemic-related stressors associated with death. Themes included pandemic-related dysregulation, financial distress, relationship issues, mental/physical/substance use problems, grief, and discipline.
While loss of employment, physical, mental health, legal, and substance use issues continue to be associated with suicide, grief and pandemic-specific stress were novel findings. Fear of disease, quarantine, and prolonged illness due to contracting COVID warrant psychological support. Psychological support is also indicated for recent discharge, grief management, transition into retirement, and during disciplinary processes. The stress of a pandemic may exacerbate previous risks. Proactive physician suicide prevention measures remain indicated.
Work addiction is characterized by a compulsive drive to work excessively, often leading to diminished job satisfaction and negatively impacting professional quality of life and creativity. Critical care nurses require a creative mindset to deal with the variety of obstacles encountered during their work. Creativity is essential for succeeding as a critical care nurse in today's competitive world. Furthermore, creativity is crucial to healthcare organizations aiming to achieve excellence and development, particularly in the context of global growth, high demands, and a limited supply of human resources.
To investigate work addiction among critical care nurses' and its relationship with their creativity and professional quality of life.
A cross-sectional study was conducted in 4 ICUs at El-Menshawy General Hospital in Elgarbia, Egypt. All nurses were invited to complete a survey in Google Forms that included the Dutch Work Addiction Scale, Nurses Creativity Questionnaire, and Professional Quality of Life Scale.
A total of 242 intensive care nurses participated in the study: Pediatric (82), Medical (92), Neurological (30), and Cardiac (38). This study revealed that higher levels of work addiction in nurses were associated with increased creativity (r = 0.311, p < 0.001) and improved professional quality of life (r = 0.574, p < 0.001). Also, more than half (53.7%) of critical nurses had moderate levels of work addiction and just under half (49.3%) also had a moderate level of creativity and professional quality of life. Statistically significant differences were found between critical care nurses' levels of work addiction, creativity, and professional quality of life (p = 0.001). Multiple regression analyses indicated that work addiction and other parameters significantly predicted nurses' creativity (R 2 = 0.453, p < 0.001). Specifically, work addiction (B = 0.606, p < 0.001), compassion satisfaction (B = 0.692, p < 0.001), burnout (B = 0.438, p < 0.001), and secondary traumatic stress (B = 0.199, p = 0.025) were significant predictors of creativity. Additionally, attributes related to work addiction and other parameters significantly predicted professional quality of life (R 2 = 0.467, p < 0.001). Sensitivity toward problems (B = 0.874, p < 0.001) and risk-taking (B = 2.098, p < 0.001) were attributes that improved professional quality of life.
Findings highlight the need for strategies to manage work addiction among critical care nurses, fostering a balance that enhances creativity and professional quality of life. Implementing time management training, minimizing multitasking, and leveraging technology can improve efficiency and well-being in high-demand healthcare settings.
Although medication errors pose life-threatening risks to patients, and reporting them can help prevent future incidents, our understanding of the factors influencing nurses' intentions to report such errors remains incomplete. Furthermore, the underlying mechanisms driving this association have yet to be fully identified.
The study aimed to explore the association between nurse managers' anger expression and nurses' intentions to report medication errors and to examine the mediating role of perceived uncertainty in this association.
Two separate studies were conducted. In Study 1, a methodological study was carried out between January and February 2024 to develop and validate a scale assessing nurses' intentions to report medication errors. This study involved 209 clinical nurses from two tertiary governmental hospitals in Mansoura, Egypt. In Study 2, a cross-sectional survey was conducted between April and June 2024 to test the study hypotheses. A total of 286 clinical nurses from three different tertiary governmental hospitals in Mansoura, Egypt, completed a questionnaire measuring leader anger expression, perceived uncertainty, and intentions to report medication errors. Data were analyzed using structural equation modeling.
In Study 1, the findings provided evidence for the reliability and validity of the Medication Errors Reporting Intention Scale. In Study 2, nurse managers' anger expression was negatively associated with nurses' intentions to report medication errors (β = −0.77, p < 0.001). Perceived uncertainty mediated this association (β = −0.62, 95% CI [−2.80, −0.96]).
Nurse managers should implement strategies to regulate their expressions of anger, thereby alleviating uncertainty among nurses and potentially enhancing their intention to report medication errors.
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.
Coronary artery disease (CAD) is a major health problem of atherosclerotic cardiovascular (CV) disease and early intervention is regarded important. Given the proven effect of a lifestyle intervention with nursing telephone counselling and mHealth use in health care, yet the comparisons of both support are lacking, this study is proposed.
This study aimed to compare the effects of a coronary artery disease (CAD) support program using a mobile application versus nurse phone advice on exercise amount and physical and psychological outcomes for clients at risk of CAD.
A prospective randomized controlled trial was conducted. Ethical approval was obtained. Two-hundred and twenty-six clients were screened, and a total of 168 clients who were at risk of CAD and routinely used smartphones were randomized into the app support group (App group) or the nurse phone advice (NPA) group. Although all participants received the same health talk delivered by a cardiac nurse at the community center, the App group received additional CAD app support, whereas the NPA group received nurse phone advice for 20 min monthly. The app content comprised (1) CAD knowledge in 10 modules, (2) individual exercise records with their own goals and health measures, and (3) a chest pain action list. The intervention lasted for 3 months. Health outcome data were collected at baseline (T0) and after 1 (T1) and 3 (T2) months. The outcomes were the total amount of exercise (primary outcome), self-efficacy in illness management, perceived stress, and CAD risk profile (body weight, body mass index, and lipid concentration). Generalized estimating equation models were used to assess differential changes in all outcomes within 3 months.
The attrition rates at 3 months were 3.49% and 9.30% for the App and NPA groups, respectively. The App support group was superior to the NPA group in significantly increasing total exercise amount and reducing body weight, waist circumference, triglycerides, and increased self-efficacy in illness management.
The result provides further insights of app development to support health promotion programs for community-dwelling adults at risk of CAD.
Person-centered care emphasizes the importance of valuing and supporting the humanness of a person living with dementia as compared to focusing heavily on disease symptom management and treatment. The state of the evidence and outcomes from person-centered care is unclear and is an important knowledge gap to address informed evidence-based care for persons living with dementia.
To synthesize the evidence on the efficacy of person-centered care in improving health outcomes in people living with dementia.
Our search using the following databases: Academic Search Complete, CINAHL, COCHRANE library, EMBASE, MEDLINE, PubMed, and Google Scholar. The methodology quality of the included studies was assessed using a revised Cochrane risk-of-bias tool for randomized trials. Meta-analyses were performed using the DerSimonian and Laird random effects model to investigate the effectiveness of person-centered care on improving health outcomes in persons living with dementia.
Seventeen trials were included in this systematic review and meta-analysis. Person-centered care implementation was found to improve cognitive function (pooled SMD: 0.22; 9CRD420223808975% CI [0.04, 0.41], p = .02) in persons living with dementia, although outcomes including the impact of the care model on activities of daily living, agitation, depression, and quality of life remain inconclusive.
Person-centered care improves the cognitive function of persons living with dementia, which is clinically meaningful and should not be ignored or overlooked in delivering evidence-based care to this population. The findings of this study emphasize the importance of person-centered care implementation among people living with dementia as an approach in improving health outcomes particularly on cognitive function improvement. Person-centered care emphasizes the personhood of individuals living with dementia while respecting their needs, values, and beliefs and is identified as a preferred model of delivering dementia care in all settings as a non-pharmacological approach.
Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP.
The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs.
The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis.
Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal.
Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.
Outcomes associated with rapid response teams (RRTs) are inconsistent. This may be due to underlying facilitators and barriers to RRT activation that are affected by team leaders and health systems.
The aim of this study was to synthesize the published research about facilitators and barriers to nurse-led RRT activation in the United States (U.S.).
A systematic review was conducted. Four databases were searched from January 2000 to June 2023 for peer-reviewed quantitative, qualitative, and mixed methods studies reporting facilitators and barriers to RRT activation. Studies conducted outside the U.S. or with physician-led teams were excluded.
Twenty-five studies met criteria representing 240,140 participants that included clinicians and hospitalized adults. Three domains of facilitators and barriers to RRT activation were identified: (1) hospital infrastructure, (2) clinician culture, and (3) nurses' beliefs, attributes, and knowledge. Categories were identified within each domain. The categories of perceived benefits and positive beliefs about RRTs, knowing when to activate the RRT, and hospital-wide policies and practices most facilitated activation, whereas the categories of negative perceptions and concerns about RRTs and uncertainties surrounding RRT activation were the dominant barriers.
Facilitators and barriers to RRT activation were interrelated. Some facilitators like hospital leader and physician support of RRTs became barriers when absent. Intradisciplinary communication and collaboration between nurses can positively and negatively impact RRT activation. The expertise of RRT nurses should be further studied.
Elopement jeopardizes patient safety, affects the hospital's reputation, and results in financial ramifications. In an academic community hospital, executive leadership approached a team of nurse leaders for expertise following the elopement of a vulnerable patient.
The team's goal was to identify evidence-based strategies to mitigate future elopement events. Following an extensive literature review and gap analysis, the organization recognized opportunities pertaining to elopement management, including patient assessment, prevention strategies, and facility-wide response when events occur. The nurse leader team thoroughly searched current literature to answer the Population, Intervention, Comparison, and Outcome (i.e., PICO) questions of interest. Following a critical appraisal of 55 articles, 26 were utilized to make practice change recommendations. The body of evidence included a variety of age groups and diagnoses.
After the synthesis of the literature, the team provided recommendations to the organization. These recommendations included the assessment of patient-specific risks and the implementation of elopement prevention measures as fundamental elements for incidence reduction. The team partnered with multidisciplinary stakeholders for the revision of policies, processes, and electronic medical record documentation.
The organization monitored elopement events and the duration of each event throughout the phases of implementation. Pre-implementation data, collected from January to June 2021, demonstrated 34 individual elopement cases lasting an average of 118 min each. In comparison, post-implementation data collected during the same time frame in 2022 found only 12 events lasting an average of 24 min each.
The organization implemented evidence-based recommendations to standardize the facility's approach to elopement. With structured assessment, precautions, and response, the organization demonstrated a notable decline in the number and duration of elopement events. Hardwiring processes, analyzing data, and adjusting expectations within an evidence-based framework should assist the organization's drive to further enhance patient safety surrounding elopement events.
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