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AnteayerInternacionales

Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery

Abstract

Purpose

The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery.

Design

A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018.

Methods

At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan‐Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time‐dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status.

Results

A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery.

Conclusions

Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery.

Clinical Relevance

Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient.

Factors That Influence Nurse Staffing Levels in Acute Care Hospital Settings

Abstract

Purpose

To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings.

Design

A cross‐sectional design was used for this study.

Methods

The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients’ sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05.

Results

Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model.

Conclusions

Nurse staffing levels were associated with hospital characteristics rather than patient characteristics.

Clinical Relevance

This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.

Exploring the Impact of Shame on Health‐Related Quality of Life in Older Individuals

Abstract

Purpose

To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people.

Design and Methods

A cross‐sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form‐36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software.

Results

Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = ‐0.173, p W = .004, effect on men bM = ‐0.138, p ​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = ‐0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = ‐0.392, p W = .002 and bM = ‐0.384, p M = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = ‐4.267, p = .033).

Conclusion

Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health‐related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health‐related quality of life on mental health components, leading to greater external shame.

Clinical Relevance

These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

They Are Partners in Care: A Qualitative Exploration of Physicians’ Perceptions of Primary Care Advanced Practice Nurses

Abstract

Purpose

This study explores physicians’ perceptions of the advanced practice nurse (APN) role in the primary care setting in Singapore.

Methods and Design

A descriptive qualitative design utilizing face‐to‐face semistructured interviews was conducted on a purposive sample of 16 primary care physicians from six primary care clinics. Thematic analysis and constant comparative analysis were used.

Findings

Three themes were identified: a collaborative partner in primary care, a conduit for specialist care and information, and a leader in community care. Physicians generally reported positivity about the clinical role of APNs and their potential in leading community care. However, they verbalized role ambiguity beyond clinical practice.

Conclusions

Physicians viewed primary care APNs as competent healthcare professionals. They viewed APNs as specialists in their fields, with the potential for expanding their services into the community. However, there remains gaps in physicians’ understanding of the primary care APNs’ nonclinical roles. The findings from this study indicate a need for nursing schools and nurse leaders to increase awareness of the complete APN role among physicians. APNs’ roles in educating healthcare professionals and delivering care to the community can be further developed.

Clinical Relevance

APNs are at the forefront in leading nursing care. There is a need to develop greater collaborative partnerships while delineating their respective roles in patient care.

Evaluation of the Accuracy of Nursing Diagnoses Determined by Users of a Clinical Decision Support System

Abstract

Purpose

To analyze the accuracy of nursing diagnoses determined by users of a clinical decision support system (CDSS) and to identify the predictive factors of high/moderate diagnostic accuracy.

Methods

This is an exploratory‐descriptive study carried out from September 2017 to January 2018. Participants were nurses, resident nurses, and senior year undergraduates. Two written case studies provided the participants with the clinical data to fill out the assessment forms in the CDSS. The accuracy of the selected diagnostic labels was determined by a panel of experts using the Diagnostic Accuracy Scale, Version 2. Descriptive statistics were used to describe the level of accuracy according to each group of participants. Analysis of variance was used to compare the mean percentages of accuracy categories across groups. A linear regression model was used to identify the predictors of diagnostic accuracy. The significance level was 5%. The study was approved by the Ethics Committee.

Results

Fifteen undergraduates, 10 residents, and 22 nurses were enrolled in the study. Although resident nurses and students had selected predominantly highly accurate diagnoses (51.8 ± 19.1 and 48.9 ± 27.4, respectively), and nurses had selected mostly diagnoses of moderate accuracy (54.7 ± 14.7), there were no differences in the accuracy level of selected diagnoses across groups. According to the linear regression model, each diagnosis added by the participants decreased the diagnostic accuracy by 2.09% (p = .030), and no experience or a low level of experience using the system decreased such diagnostic accuracy by 5.41% (p = .022).

Conclusions

The CDSS contributes to decision making about diagnoses of less experienced people. Adding diagnoses not indicated by the CDSS and experience with the system are predictors of diagnostic accuracy.

Clinical Relevance

In‐service education regarding the use of CDSSs seems to be crucial to improve users’ clinical judgment and decision making.

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Abstract

Purpose

Secondary prevention of coronary artery disease, self‐management behavior, and blood pressure control are important to cardiovascular event prevention and promotion of quality of life (QOL), but they are underutilized. The purpose of this study was to investigate the effects of a self‐efficacy theory–based health information technology intervention implemented through blood control and patient self‐management.

Design

A clinical randomized waitlist‐controlled trial.

Methods

The study was conducted at a medical center in Taipei, Taiwan. A total of 60 subjects were randomly assigned to either the immediate intervention (experimental) group or the waitlist control group. The primary endpoint was systolic blood pressure at 3 months; secondary end points included self‐management behavior and QOL. Treatment for the immediate intervention group lasted 3 months, while the waitlist control group received routine care for the first 3 months, at which point they crossed over to the intervention arm and received the same intervention as the experimental group for another 3 months. Both groups were evaluated by questionnaires and physiological measurements at both 3 and 6 months postadmission. The results were analyzed using generalized estimating equations.

Results

Systolic blood pressure significantly improved for the intervention group participants at 3 months, when there was also significant improvement in self‐management behavior and QOL. There was no significant or appreciable effect of time spent in the waitlist condition, with treatments in the two conditions being similarly effective.

Conclusion

The use of a theory‐based health information technology treatment compared with usual care resulted in a significant improvement in systolic blood pressure, self‐management behavior, and QOL in patients with coronary artery disease.

Clinical Relevance

This treatment would be a useful strategy for clinical care of cardiovascular disease patients, improving their disease self‐management. It also may help guide further digital health care strategies during the COVID‐19 pandemic.

Nurse‐to‐nurse collaboration between nurses caring for older people in hospital and primary health care: A cross‐sectional study

Abstract

Aims and objectives

To assess the level of nurse‐to‐nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse‐to‐Nurse Collaboration Between Sectors Instrument.

Background

Nurse‐to‐nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration.

Design

A cross‐sectional survey design was used. This study adhered to the STROBE checklist.

Methods

A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse‐to‐Nurse Collaboration Between Sectors Instrument (86 items, 7–point Likert‐type scale), the Nurse‐Nurse Collaboration Scale and the Patient‐Centred Competency Scale.

Results

Nurses rated the overall level of nurse‐to‐nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable.

Conclusions

Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse‐to‐Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested.

Relevance to clinical practice

Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration.

Team‐based learning in nursing education: A scoping review

Abstract

Aims and objectives

To explore the use and student outcomes of Team‐Based Learning in nursing education.

Background

Team‐Based Learning is a highly structured, evidence‐based, student‐centred learning strategy that enhances student engagement and facilitates deep learning in a variety of disciplines including nursing. However, the breadth of Team‐Based Learning application in nursing education and relevant outcomes are not currently well understood.

Design

A scoping review of international, peer‐reviewed research studies was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews.

Methods

The following databases were searched on 7 May 2020: Cumulative Index of Nursing and Allied Health Literature, MEDLINE Complete, PsycINFO and Education Resources Information Center. Search terms related to nursing, education and Team‐Based Learning. Original research studies, published in English, and reporting on student outcomes from Team‐Based Learning in nursing education programmes were included.

Results

Of the 1081 potentially relevant citations, 41 studies from undergraduate (n = 29), postgraduate (n = 4) and hospital (n = 8) settings were included. The most commonly reported student outcomes were knowledge or academic performance (n = 21); student experience, satisfaction or perceptions of Team‐Based Learning (n = 20); student engagement with behaviours or attitudes towards Team‐Based Learning (n = 12); and effect of Team‐Based Learning on teamwork, team performance or collective efficacy (n = 6). Only three studies reported clinical outcomes.

Conclusions

Over the last decade, there has been a growing body of knowledge related to the use of Team‐Based Learning in nursing education. The major gaps identified in this scoping review were the lack of randomised controlled trials and the dearth of studies of Team‐Based Learning in postgraduate and hospital contexts.

Relevance to clinical practice

This scoping review provides a comprehensive understanding of the use and student outcomes of Team‐Based Learning in nursing education and highlights the breadth of application of Team‐Based Learning and variability in the outcomes reported.

The effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients: A randomised controlled trial

Abstract

Aims and objectives

To investigate the effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients.

Background

Reverse Trendelenburg position is recommended for obese patients; however, the effect among critically ill patients, especially those on mechanical ventilation, has limited study.

Design

Randomised, controlled pretest, repeated post‐test trial with two parallel groups.

Methods

The study started from 13 January 2020–12 March 2020. Adult critically ill patients with a body mass index ≥30 were randomly assigned by computer‐generated randomisation to either reverse Trendelenburg position group (intervention) or semi‐recumbent position group (active comparator control). Outcome measures were ventilation parameters (dynamic compliance, partial pressure of arterial carbon dioxide and minute volume) and oxygenation parameters (hypoxaemic index and partial pressure of arterial oxygen). Measures were assessed immediately before positioning and after positioning in 10 minutes, 20 minutes and 30 minutes. CONSORT checklist was used to report the current study.

Settings

Four general intensive care units.

Results

One hundred and ten patients (55 patients in each group) completed the study. The reverse Trendelenburg position group had a higher improvement than the semi‐recumbent position group as estimated by mean differences in their dynamic compliance, minute volume, partial pressure of carbon dioxide, partial pressure of oxygen and hypoxaemic index.

Conclusion

Reverse Trendelenburg position improves obese patients’ respiratory parameters more than semi‐recumbent position.

Relevance to clinical practice

This study directs nurses to use the reverse Trendelenburg position, which is an important position for enhancing the parameters of ventilation and oxygenation of obese mechanically ventilated patients.

Stressors for emergency department nurses: Insights from a cross‐sectional survey

Abstract

Aims and Objectives

This study aimed to profile stress, exploring whether demographics and/or other factors uniquely contribute to stress for emergency departments nurses.

Background

Nursing has been identified as a stressful profession with the potential to have negative impacts on nurses’ physical and mental health. Nurses working in emergency departments face unique daily stressors.

Design

Cross‐sectional survey using a correlational design.

Methods

The survey was distributed in May 2019 to ED nurses working in New South Wales (NSW), Australia. A total of 242 nurses completed the survey, of which 190 cases were analysed. A standardised scale was used in the survey, the Expanded Nursing Stress Scale (ENSS). The sampling method for this research was non‐probability purposive sampling. STROBE checklist was used for this manuscript.

Results

The results of this study indicated that emergency department nurses experience stress in their work settings. Stress is experienced predominantly because of problems in dealing with patients and their families, high workloads, and uncertainty concerning treatment.

Conclusions

The results of this study provide valuable insights into the work‐related stress experienced by emergency department nurses. This information can be used to inform the development of strategies to minimise stress for emergency nurses.

Relevance to clinical practice

This study builds on existing, and contributes to new, knowledge about the current stressors for emergency department nurses. The results provide insights into how policies and procedures may need to be adjusted and interventions developed, that can help in reducing stress.

Factors associated with teaching efficacy among nurse educators in hospital settings

Abstract

Aims and objectives

The objective of this study was to examine differences in personal characteristics, core practice competency and role stress according to levels of teaching efficacy among clinical nurse educators working in general hospitals.

Background

In the clinical setting, successful adaptation to instruction among practicing clinical nurse educators is challenging.

Design

Secondary analysis of data through a cross‐sectional study design was adopted.

Methods

Originally, 565 nurses were recruited from general hospitals; 364 were included in this study. Participants were nurses with more than 1 year of experience in various settings from 16 general hospitals wherein nursing students trained for clinical practicum in five cities in South Korea. Self‐reported data were collected via the Teaching Efficacy, Core Practice Competency and Perceived Stress Scales assessing clinical education‐related teaching efficacy, core practice competency and role stress. In the analyses, comparison between nurses with high and low teaching efficacy was conducted. We have followed through the EQUATOR (e.g. STROBE) research checklist for the preparation of this manuscript.

Results

According to univariate analysis, levels of teaching efficacy were shown to be higher with age, longer clinical careers, in those undergoing a doctoral course or with a doctorate, previous experience in providing clinical education and enrolment in continuing education for clinical education. In the multivariate analysis, enrolment in continuing education for clinical education, assessment and intervention skills, critical thinking skills, teaching skills and role ambiguity were associated with level of teaching efficacy among nurse educators.

Conclusion

Based on the results of this study, we recommend that nursing administrators should foster the recognition of personal characteristics in potential clinical nurse educators or preceptors with high teaching efficacy.

Relevance to clinical practice

Nurses should be supported by providing them with opportunities for professional development to enhance teaching efficacy.

Hospice palliative care nurses’ perceptions of spiritual care and their spiritual care competence: A mixed‐methods study

Abstract

Aims and Objectives

To understand hospice palliative care nurses’ (HPCNs) perceptions towards spiritual care and their competence to provide spiritual care.

Background

Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients’ spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited.

Design

A mixed‐methods research design was used.

Methods

Quantitative data were collected from 282 nurses in forty hospice palliative care (HPC) institutions in South Korea and analysed using descriptive statistics, independent t‐test, one‐way ANOVA with Bonferroni test and multiple regression. Qualitative data collection involved two stages: first, an open‐ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative data sets were analysed separately using content analysis. This study followed the GRAMMS guidelines.

Results

Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in ‘attitude towards the patient's spirituality’ and ‘communication’, whereas the ‘assessment and implementation of spiritual care’ and ‘professionalisation and improving the quality of spiritual care’ had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardised terminology, and the opportunity to reflect on nurses’ own spirituality.

Conclusions

Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance.

Relevance to clinical practice

The results of this study provide a useful resource to develop educational programmes for strengthening the SCC of nurses and the entire HPC team.

Learning to be a doctoral supervisor: Experiences and views of nurse supervisors of higher degree research students

Abstract

Aims and objectives

Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like.

Background

Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence.

Design

Qualitative storytelling, semi‐structured interviews were conducted via a videoconferencing programme, audio‐recorded and thematically analysed with twenty‐one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines.

Results

Thematic analysis revealed four themes: ‘I had a great mentor’: the importance of mentorship and role modelling; ‘Sometimes it's just trial and error’: learning through experience; ‘It's like tick a box’: strengths and limitations of formal supervisor training; and ‘The training should be more holistic’: what should be in supervisor training.

Conclusions

We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline‐based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training.

Relevance to clinical practice

Further development of clinical nursing is inextricably linked to quality nurse‐led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence‐informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing.

General self‐efficacy and social support as mediators of the association between perceived stress and quality of life among rural women with previous gestational diabetes mellitus

Abstract

To explore the association between perceived stress and quality of life (QoL) and the mediating role of general self‐efficacy and social support in this association.

Gestational diabetes mellitus (GDM) is one of the most common metabolic diseases suffered by pregnant women. Women with previous GDM may experience more medical‐related stress and have a lower QoL than those without it.

A multisite correlational study.

Four hundred sixty‐five women with previous GDM living in rural areas in China participated in this study from November 2017 to June 2019. The participants completed a set of self‐reported socio‐demographic questionnaires, the Perceived Stress Scale, the General Self‐Efficacy Scale, the Social Support Rating Scale and the World Health Organization QoL assessment (Brief version). STROBE checklist was used as the guideline for this study.

The mean QoL score was 13.97 (SD 2.07) for physical health, 13.75 (SD 1.98) for psychological health, 14.96 (SD 1.99) for social relations and 12.49 (SD 1.74) for environmental conditions. About 43.9% of women with previous GDM reported increased stress, which was negatively correlated with each of these QoL domains. Yet, the negative effect of perceived stress on QoL could be completely or partly mediated by better social support or general self‐efficacy among this population.

Nearly half of the women in the study living in rural China reported increased stress after delivery, and there is room to improve QoL in the environmental domain among women with previous GDM. Increasing general self‐efficacy or social support can help these women avoid the negative effects of perceived stress on their QoL.

These findings suggest that healthcare providers need to be cognizant of the importance of self‐efficacy and social support for women with previous GDM in both enhancing QoL and reducing the negative impact of perceived stress on QoL.

Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study

Abstract

Aims and objectives

To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock.

Background

Although work environment is related to transition shock in newly licensed nurses, little is known about the factors of nursing work environment associated with transition shock. Furthermore, resilience is known to help nurses positively face workplace challenges; however, there is little evidence on the associations between resilience and transition shock in new nurses.

Design

A cross‐sectional, descriptive study.

Methods

Data from 163 new nurses with <12 months of work experience in the current hospital since graduation were analysed. Participants' characteristics, work environment, nurse resilience and transition shock were self‐reported. Multivariable linear regressions were performed in three steps (following the STROBE checklist).

Results

The highest mean score of transition shock was obtained for the item ‘I perceive the limitations of my professional knowledge in nursing care'. In the regression analysis adjusted for all variables, two factors of work environment—‘nurse staffing and resource adequacy’ and ‘collegial nurse‐physician relationships’—were associated with transition shock. Meanwhile, resilience was not related to transition shock.

Conclusions

The gap between newly licensed nurses' theoretical and practical knowledge continues to exist. Adequate nurse staffing and a positive relationship with physicians, rather than nurse resilience, were more likely to associate with new nurses' transition shock.

Relevance to clinical practice

Hospitals need to provide ward‐based simulations and case‐based learning methods to enhance nurses' transition to professional practice. For nurses' transition, hospitals should make efforts to provide adequate nurse staffing and resources. Furthermore, hospitals should provide communication opportunities to build a positive collaborative culture between nurses and physicians. Unit nurse managers need to assess newly licensed nurses' perception of nurse–physician professional relationship and create an atmosphere of respect and understanding for each other.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

Abstract

Aims and objectives

To analyse nursing students’ perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

Background

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students’ clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

Design

Cross‐sectional, correlational study.

Methods

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students’ satisfaction with the clinical learning environment and learning process was measured using a 4‐point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

Results

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

Conclusions

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

Relevance to clinical practice

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

The association between self‐reported workload and perceptions of patient safety culture: A study of intensive care unit nurses

Abstract

Aim and Objective

This study aimed to examine the association between workload and patient safety culture (PSC) among intensive care unit (ICU) nurses.

Background

ICU nurses play a vital role in promoting patient safety and are essential indicators in any healthcare system including ICUs. Research studies focusing on the relationship between nursing workload and PSC among ICU nurses are limited.

Design

Descriptive correlational design.

Methods

The study participants involved 380 ICU nurses at two hospitals in Riyadh, Saudi Arabia. Data were collected between February 2019–April 2019 and were analysed using SPSS v.22 statistical software. This study was guided by the STROBE checklist.

Results

The results showed that ICU nurses have high positive perceptions in the following PSC subscales: teamwork within units, organisational learning–continuous improvement, frequency of events reported, feedback and communication about error, management support for patient safety, teamwork across units, supervisor/manager expectations and actions promoting patient safety, handoffs and transitions, nonpunitive response to errors, staffing and overall perceptions of patient safety. However, the participants collectively considered the overall grade on patient safety as poor. The participants had high mean scores in physical demand, effort, mental demand and overall workload. A statistically significant variability existed in the mean scores of the PSC subscales and workload of ICU nurses. The overall workload was significantly and negatively associated with the PSC perceptions of ICU nurses.

Conclusion

The ICU nurses experienced high overall workload, physical demand, effort and mental demand which influenced the poor grade of their overall perceived PSC.

Relevance to Clinical Practice

Identifying differences and associations with the perceptions of ICU nurses regarding workload and PSC is important because such perceptions may affect their delivery of nursing care. Hospital and nursing administrators must use the study results to find strategies that address workload issues and enhance patient safety.

Assessment of nurses’ respect for patient privacy by patients and nurses: A comparative study

Abstract

Aims

To determine whether nurses respect or violate patient privacy by comparing nurses’ and patients’ opinions.

Background

Although nurses want to respect patient privacy, they can sometimes violate patient privacy or not pay enough attention.

Method

This comparative and cross‐sectional study was conducted with 357 patients and 305 nurses in 12 public hospitals in Trabzon, Turkey. Data were collected with an information form and the Patient Privacy Scale. Reporting is consistent with the STROBE checklist for cross‐sectional studies.

Results

The total mean score of the patient privacy scale was 4.6 ± 0.39 for nurses and 4.5 ± 0.41 for patients, and no significant difference was found between their scores (U = 52999.0; p = .554). Further, the nurses (U = 14358.0; p = .000) and the patients (U = 13272.5; p = .006) in the public hospitals had statistically significantly higher overall privacy scores than those in the training and research hospitals. The overall privacy scale scores were higher and more statistically significant in the patients hospitalised in surgical clinics than those hospitalised in clinics for internal diseases (U = 8514.0; p = .005) and in single compared to married patients (U = 12364.5; p = .034).

Conclusion

Nurses respected patient privacy highly according to both nurses and patients, and there was no significant difference between their views. However, nurses working in training and research hospitals and internal diseases clinics need to improve their approaches to patient privacy.

Relevance to clinical practice

The results of this study could be used to reduce patient privacy vulnerabilities in complex hospitals and clinics such as training and research hospitals and to improve institutional policies and activities regarding patient privacy. By comparing the results of patients and nurses, the study provided more consistent and accurate data about patient privacy.

‘Getting the most out from keywords’

Journal of Clinical Nursing, Volume 30, Issue 7-8, Page e23-e24, April 2021.
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