RESUMO
Background: Specific knowledge is required in pediatric oncology, and specialization of nurses has been identified as a priority. In Sweden, a national program in pediatric oncology nursing has been offered since 2003. The aim of this study was to gain knowledge of nurses' perceptions of the impact of this educational program. Methods: Eighty nurses who had completed the educational program in three cohorts (2012-2019) were invited to participate in this cross-sectional survey. An electronic study-specific questionnaire containing multiple-choice questions was used. Data were analyzed using descriptive statistics and correlation tests. Results: Fifty-nine (74%) nurses completed the survey, of whom 98% responded that they would recommend the program to a large/fairly large extent. At the time of the survey, 15 (25%) participants had left pediatric oncology care. Among the remaining 44, 31 (71%) of the nurses were working bedside, and 13 (42%) of these combined this with a special position (e.g., consultant nurse). The education resulted in career advancement, as the number of nurses with special positions increased following completion of the program, from 20% to 59%. The vast majority stated that the knowledge gained from the education contributed to increased confidence in interactions with the children/families. Discussion: Continuing education of nurses in pediatric oncology has an impact on career opportunities in clinical practice and contributes to nurses' confidence and professional work. However, education is not enough to retain competent nurses. Employers need to be aware of the role of the work environment, aspects of work-life balance and career paths.
Assuntos
Neoplasias, Enfermeiras e Enfermeiros, Enfermagem Oncológica, Enfermagem Pediátrica, Criança, Humanos, Estudos Transversais, Oncologia, Enfermeiras e Enfermeiros/psicologia, Enfermagem Pediátrica/educação, Educação Continuada em Enfermagem, Enfermagem Oncológica/educação, Pesquisa em Avaliação de EnfermagemRESUMO
BACKGROUND AND LOCAL PROBLEM: The COVID-19 pandemic created a gap in global health learning, requiring creative solutions to bridge the divide. Collaborative online international learning (COIL) is a program between universities located in different geographic areas that aims to build cross-cultural learning and collaboration. INTERVENTION: Faculty members from Uganda and the United States worked collaboratively to plan a 2-session COIL activity for nursing and midwifery students. Twenty-eight students from the United States and Uganda participated in the pilot quality improvement project. MEASURES: Students completed a 13-question REDCap survey measuring satisfaction, time commitment for the activity, and increase in knowledge about differently resourced healthcare systems. Students also were asked to provide qualitative feedback in that survey. RESULTS: Survey results indicate a high level of satisfaction and an increased understanding of a new healthcare system. The majority of students wanted more scheduled activity times, the opportunity to meet face to face, and/or more robust sessions in the future. CONCLUSION: This COIL activity between students in the United States and Uganda was a no-cost activity that provided global health learning opportunities for students during the global pandemic. The COIL model is replicable, adaptable, and customizable for a variety of courses and time spans.
Assuntos
Educação a Distância, Cooperação Internacional, Tocologia, Estudantes de Enfermagem, Humanos, COVID-19/epidemiologia, Educação a Distância/organização & administração, Tocologia/educação, Pesquisa em Educação em Enfermagem, Pesquisa em Avaliação de Enfermagem, Pandemias, Inquéritos e Questionários, Uganda/epidemiologia, Estados Unidos/epidemiologia, Estudantes de Enfermagem/psicologia, Docentes de Enfermagem/psicologia, Projetos PilotoRESUMO
OBJECTIVE: To improve rates of exclusive breastfeeding during the postpartum hospital stay by implementing a new role of dedicated neonatal assessment nurse (NAN), whose primary function was neonatal care beginning immediately after birth. DESIGN: Quality improvement project with plan-do-study-act using evidence-based guidelines for implementing the NAN role. SETTING/LOCAL PROBLEM: Labor and delivery department of a tertiary care teaching hospital in the southeastern United States; breastfeeding exclusivity rates at this hospital were in the range of 50%. PARTICIPANTS: Registered nurses employed in the labor-delivery-recovery unit, mother-baby unit, and NICU. INTERVENTION/MEASUREMENTS: The NAN role was implemented to promote immediate skin-to-skin care (SSC) for stable newborns after vaginal and cesarean birth. Each NAN's competency was evaluated at the beginning and end of the education session through a pretest/posttest, and a skills validation was used to affirm their readiness for the new role. The outcome measure was breastfeeding exclusivity at the time of discharge from the hospital. SSC initiation and duration immediately after birth were the process measures. RESULTS: Twenty-five bedside registered nurses participated in this quality improvement project. There was a statistically significant difference between the pretest and posttest scores (p < .001), indicating a knowledge increase. All nurses met the skills validation criteria. The rate of SSC immediately after vaginal birth increased from 49% to 82% and after cesarean birth from 33% to 63%. Breastfeeding exclusivity rate at the time of discharge from the hospital increased from 50% to 86%. CONCLUSION: The NAN role provided transitional care at the bedside without the separation of mothers and newborns. This was an innovative role, without the need to hire new staff, that provided evidence-based care, resulting in improved SSC and exclusivity of breastfeeding before discharge.
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Aleitamento Materno, Relações Mãe-Filho, Enfermagem Neonatal, Papel do Profissional de Enfermagem, Feminino, Humanos, Recém-Nascido, Aleitamento Materno/estatística & dados numéricos, Enfermagem Neonatal/organização & administração, Melhoria de Qualidade, Pesquisa em Avaliação de EnfermagemRESUMO
ABSTRACT: Innovation is needed to solve nursing workforce issues during times of crisis. A collaborative effort between a hospital system and several universities resulted in the Bridge to Professional Practice Program that was implemented during a period of high patient volume and nursing student downtime. The program provided support for staffing needs and clinical hours to promote readiness for practice for students. The program evaluation outcomes and recommendations for improvement are addressed.
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Bacharelado em Enfermagem, Hospitais, Relações Interinstitucionais, Recursos Humanos de Enfermagem Hospitalar, Humanos, Bacharelado em Enfermagem/organização & administração, Estudantes de Enfermagem, Mão de Obra em Saúde, Inovação Organizacional, Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição, Pesquisa em Avaliação de EnfermagemRESUMO
BACKGROUND: Robert Wood Johnson Foundation Future of Nursing Scholars program used multi-pronged approach to support nurses completing accelerated PhD programs. PURPOSE: The purpose of this manuscript was to describe scholars' experiences completing PhDs, their dissertation characteristics, program leadership development sessions, scholar perceptions of program components. METHODS: Of 201 scholars, 157 (78%) completed quantitative exit surveys, providing: satisfaction with doctoral programs and FNS curricula, types of dissertation data used, dissertation formats. Interviews held with five scholars to capture representative themes. FINDINGS: Scholars utilized primary and secondary data for dissertations; 53% primarily used secondary data. The majority (68%) used manuscript dissertation formats. Approximately 64% completely agreed program curricula helped prepare them for professional transitions, to work collaboratively, lead confidently. Proportion of FNS graduates (42%) pursuing postdoctoral positions exceeded national trends. DISCUSSION: Despite stresses posed by accelerated PhD programs, scholars are well-situated to advance nursing science. Findings suggest secondary data analyses work well for accelerated programs. Scholar program experiences were positive.
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Educação de Pós-Graduação em Enfermagem, Pesquisa em Enfermagem, Estudantes de Enfermagem, Feminino, Humanos, Currículo, Educação de Pós-Graduação em Enfermagem/organização & administração, Previsões, Fundações, Liderança, Pesquisa em Avaliação de Enfermagem, Pesquisa em Enfermagem/educação, Estudantes de Enfermagem/psicologia, Estudantes de Enfermagem/estatística & dados numéricos, Inquéritos e QuestionáriosRESUMO
PURPOSE: This research identifies nursing outcomes for patients with multiple traumas who present changes in physical mobility. METHODS: This was a thorough literature review, following Whittemore and Knafl's method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses´ guidelines (2005) and adopting the Oxford Center for Evidence-Based Classification Medicine-Levels of Evidence (2011). The literature search included databases from Virtual Health Library, Cochrane Library, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PubMed, SciVerse Scopus, The Cumulative Index to Nursing and Allied Health Literature, and Web of Science. It was conducted between October and December 2019 and updated in April 2022. FINDINGS: Upon our first analysis of the 254 articles that could correlate to the present study, we concluded that 15 of them are of foremost relevance. The nursing outcomes found are correlated with skin care, position in hospital bed, pressure injury prevention, self-care assistance to bath, intimate, and oral hygiene, pain control, circulatory precaution, and impaired physical mobility assistance. All of these outcomes are directly or indirectly involved with the consequences of mobility impairment. CONCLUSIONS: The main nursing outcomes of our research identified for patients with multiple traumas were related to mobility, the consequences of immobility, self-care, and skin maintenance. In conclusion, this review highlights the importance of measuring outcomes related to the provision of nursing care. IMPLICATIONS FOR NURSING PRACTICE: The nursing outcomes classification provides results that can be used across the continuum of care to assess the patient's status after nursing interventions. It also allows for improved care for multiple trauma patients who have altered mobility, identifying the real needs of these patients.
OBJETIVO: Esta pesquisa propõe a identificação dos resultados de enfermagem para pacientes politraumatizados que apresentam alterações na mobilidade física. MÉTODOS: Trata-se de uma revisão minuciosa da literatura, seguindo o método de Whittemore e Knafl e as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2005) e adotando o Oxford Centre for Evidence-Based Classification Medicine - Levels of Evidence (2011). A busca na literatura incluiu bases de dados da Biblioteca Virtual em Saúde; Biblioteca Cochrane; Base de dados Excerpta Medica; Sistema de Análise e Recuperação de Literatura Médica Online; PubMed®; SciVerse Scopus; O Índice Cumulativo para Enfermagem e Literatura de Saúde Aliada; e Web of Science. As buscas foram realizadas entre outubro e dezembro de 2019 e atualizadas em abril de 2022. RESULTADOS: Em nossa primeira análise dos 254 artigos que poderiam se correlacionar com o presente estudo, concluímos que 15 deles são de maior relevância. Os resultados de enfermagem encontrados estão correlacionados aos cuidados com a pele, posição no leito hospitalar, prevenção de lesão por pressão, assistência ao autocuidado ao banho, higiene íntima e oral, controle da dor, precaução circulatória e assistência à mobilidade física prejudicada. Todos os resultados acima mencionados estão direta ou indiretamente envolvidos com as consequências do comprometimento da mobilidade. CONCLUSÕES: Os principais resultados de enfermagem de nossa pesquisa identificados para pacientes politraumatizados foram relacionados à mobilidade, consequências da imobilidade, autocuidado e manutenção da pele. Em conclusão, esta revisão destaca a importância de medir os resultados relacionados à prestação de cuidados de enfermagem. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A Classificação de Resultados de Enfermagem fornece resultados que podem ser usados ââem todo o continuum de cuidados para avaliar o estado do paciente após intervenções de enfermagem. Também permite melhorar o atendimento aos politraumatizados que apresentam mobilidade alterada, identificando as reais necessidades desses pacientes.
Assuntos
Limitação da Mobilidade, Traumatismo Múltiplo, Humanos, Traumatismo Múltiplo/enfermagem, Avaliação de Resultados em Cuidados de Saúde, Pesquisa em Avaliação de EnfermagemRESUMO
AIMS: To explore the perceptions of women with lived experience of domestic and family violence on accessing healthcare and to identify how nurses can facilitate and support women experiencing domestic and family violence to receive the care they need. DESIGN: A qualitative single site study. METHODS: As part of an evaluation of a nurse-led domestic and family violence service, a 2-h focus group was conducted with four women with lived experience of domestic and family violence on 14 December 2021. The Levesque Framework provided a novel approach to identify barriers and facilitators to healthcare access. The focus group guide included eight open-ended questions. The audio recording was transcribed and analysed using Braun and Clark's thematic analysis process. RESULTS: The Levesque Framework helped highlight individual and structural challenges in accessing healthcare faced by women experiencing domestic and family violence. Dominant themes were first contact, comprehensiveness of services and domestic violence awareness. CONCLUSION: The growing incidences of domestic and family violence are confounding communities worldwide. Despite the high profile of domestic and family violence in Australia, access to healthcare remains problematic. These preliminary findings suggest that nurses have opportunities to facilitate access in relation to the approachability, acceptability and appropriateness of services. Realizing these opportunities requires education that enables nurses' capacity to provide an effective first contact and facilitate comprehensive care by embodying a no wrong door culture. We intend to explore these concepts in future focus groups. IMPACT: This study explored the factors impacting access to healthcare for women experiencing domestic and family violence. Accessing healthcare when experiencing domestic and family violence in Australia is problematic. Findings suggest that nursing has opportunities to facilitate the approachability, acceptability and appropriateness of services. These findings will be valuable to nurses across all healthcare settings, nursing education providers and health workforce planners.
Assuntos
Violência Doméstica, Acessibilidade aos Serviços de Saúde, Feminino, Humanos, Austrália, Violência Doméstica/psicologia, Grupos Focais, Acessibilidade aos Serviços de Saúde/organização & administração, Acessibilidade aos Serviços de Saúde/estatística & dados numéricos, Pesquisa Qualitativa, Relações Enfermeiro-Paciente, Pesquisa em Avaliação de Enfermagem, Adolescente, AdultoRESUMO
BACKGROUND: Children with life-limiting conditions are a unique population with multiple health and social care needs. Key literature indicates the need for education to support registered nurses providing care, including palliative care, to these children. In response to the COVID-19 pandemic, a palliative care programme was converted to an online programme, adopting a blended approach between national and regional facilitators. OBJECTIVES: To assess nurses' satisfaction with a re-designed palliative care programme centred around the care of children with life-limiting conditions, including their perceptions of the online format. DESIGN AND METHODS: A descriptive correlational design and online survey was used to explore the participants' perception of the content and online delivery of the Care of the Child with a Life-Limiting Condition programme. Nine sessions, comprised of five national and four regional webinars, were delivered. RESULTS: Attendees registered (n = 169) from throughout the Republic of Ireland, with 130 attending all webinars. Attendees stated online delivery of education increased their accessibility to highly qualified experts. The short, concise nature of sessions was well received. Online delivery and recorded sessions contributed to convenience with the ability to access and process information in attendees' own time being welcomed. However, the negative impact of losing face-to-face interactions was noted, including the opportunity to build relationships with colleagues caring for children with life-limiting conditions. CONCLUSIONS: Results suggest that the redesigned online programme contributed to participants' knowledge, encouraged participation and increased accessibility. An e-Learning model enables specialised education to be more equitable and accessible, ensuring regional areas are not disadvantaged due to geographical remoteness from tertiary educational centres. However, the lack of face-to-face contact was acknowledged as a hindrance to socialisation and networking. When developing future programmes, focus should be put on creating opportunities for networking and social development to compensate for the lack of face-to-face contact.
Assuntos
COVID-19, Educação em Enfermagem, Enfermagem de Cuidados Paliativos na Terminalidade da Vida, Criança, Humanos, Atitude do Pessoal de Saúde, COVID-19/epidemiologia, COVID-19/prevenção & controle, Educação a Distância, Educação em Enfermagem/organização & administração, Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação, Pesquisa em Educação em Enfermagem, Pesquisa em Avaliação de Enfermagem, Pandemias, Satisfação Pessoal, Enfermeiras e Enfermeiros/psicologia, Irlanda/epidemiologiaRESUMO
PURPOSE: This quality improvement project created a guide for critical care providers transitioning patients to comfort measures only encouraging communication, collaboration, and shared decision making; ensuring management of patients' end-of-life symptoms and needs; and enhancing provider satisfaction by improving structure and consistency when transitioning patients. DESCRIPTION OF THE PROJECT: Interviews conducted with staff in intensive care units revealed opportunities to improve structure and processes of transitioning patients at the end of life. A subcommittee of experts designed a checklist to facilitate interdisciplinary conversations. Impact on provider satisfaction and symptom management was assessed. Presurveys circulated used a Research Electronic Data Capture tool. A checklist was implemented for 3 months, and then postsurveys were sent. Charts were audited to identify improvement in symptom management and compared with retrospective samples. OUTCOMES: Clinical improvements were seen in communication (12%), collaboration (25%), shared decision making (22%), and order entry time (17%). In addition, 72% agreed the checklist improved structure and consistency; 69% reported improved communication, collaboration, and shared decision making; 61% felt it improved knowledge/understanding of patient needs; and 69% agreed it improved management of patient symptoms. CONCLUSION: After checklist implementation, staff felt more involved and more comfortable, and reported more clarity in transitioning patients; no improvement in patient outcomes was realized.
Assuntos
Lista de Checagem, Enfermagem de Cuidados Críticos/organização & administração, Recursos Humanos de Enfermagem Hospitalar/psicologia, Conforto do Paciente/organização & administração, Satisfação Pessoal, Comunicação, Tomada de Decisão Compartilhada, Humanos, Unidades de Terapia Intensiva, Relações Interprofissionais, Pesquisa em Avaliação de Enfermagem, Melhoria de QualidadeRESUMO
PURPOSE/OBJECTIVES: Blood culture collection is a common procedure performed in emergency departments. Rate of blood culture contamination is a metric that is tracked by organizations to ensure appropriate treatment for patients suspected of having bacteremia and ensure appropriate use of hospital resources. A team of nurses and technicians undertook a quality improvement project to decrease blood culture contamination rates in a suburban emergency department. DESCRIPTION OF THE PROJECT: The project included use of standardized blood culture collection kits, creation of a dedicated collection team, and implementation of a new blood culture collection device. OUTCOME: Through this work, blood culture contamination rates decreased from greater than 3.0% to less than 1.5% consistently for nearly 24 months. CONCLUSIONS: Providing feedback and continued monitoring has made this quality improvement initiative a success for the department and the organization and has resulted in cost savings of nearly 2 million dollars.
Assuntos
Hemocultura/métodos, Serviço Hospitalar de Emergência/organização & administração, Contaminação de Equipamentos/prevenção & controle, Enfermeiros Clínicos, Melhoria de Qualidade/organização & administração, Bacteriemia/enfermagem, Contaminação de Equipamentos/estatística & dados numéricos, Humanos, Pesquisa em Avaliação de EnfermagemRESUMO
OBJECTIVE: The Best Practice Spotlight Organizations Program is being developed in Spain to reduce the variability of clinical practice by implementing clinical practice guidelines from the Registered Nurses' Association of Ontario. This study described the results of the implementation of the guide "Risk assessment and prevention of pressure ulcers". METHODS: We carried out a retrospective observational study (2015-2018) at the Hospital Universitario Virgen de las Nieves on 4,464 patients from 22 hospitalization units, analyzing type of unit, risk assessment, preventive measures, origin and category of ulcers. Descriptive analysis and contingency tables were performed with the Chi-square statistic p<0.05. RESULTS: The patients at risk were 62.2% in medical units, 53.4% in surgical units and 90% in intensive care. The application of preventive measures was 67.9%, 60.2% and 92.1% (respectively) for each unit. In medical units, 13.1% of pressure ulcers were identified, of which 68.1% were present at the time of admission. While in surgical units and intensive care they developed during hospitalization (60.8% and 88.9% respectively) (p<0.001). The presence of ulcers seemed to show a decreasing trend in the years analyzed (19.6% to 11.2%). CONCLUSIONS: There are favorable environments for implantation (medical units and intensive care) that reflect a higher level of risk assessment, use of pressure management surfaces and a decrease in prevalence. The recommendations have not been implemented homogeneously, with differences depending on the type of unit.
OBJETIVO: El Programa Centros Compro-metidos con la Excelencia en Cuidados®, se desarrolla en España, para reducir la variabilidad de la práctica clínica, implantando guías de práctica clínica de la Registered Nurses' Association of Ontario. Este estudio describió los resultados de la implantación de la guía "Valoración del riesgo y prevención de las úlceras por presión". METODOS: Se realizó un estudio observacional retrospectivo (2015-2018) en el Hospital Universitario Virgen de las Nieves sobre 4.464 pacientes de 22 unidades de hospitalización, analizando el tipo de unidad, la valoración del riesgo, las medidas preventivas, la procedencia y la categoría de las úlceras. Se realizó análisis descriptivo y tablas de contingencia con el estadístico Chi-cuadrado p<0,05. RESULTADOS: Los pacientes de riesgo fueron el 62,2% en unidades médicas, 53,4% en las quirúrgicas y el 90% en cuidados intensivos. La aplicación de medidas preventivas fue del 67,9%, 60,2% y 92,1% (respectivamente) para cada unidad. En unidades médicas se identificaron un 13,1% de úlceras por presión, de las cuales el 68,1% estaban presentes en el momento del ingreso. Mientras que en unidades quirúrgicas y en cuidados intensivos se desarrollaron durante la hospitalización (60,8% y 88,9% respectivamente) (p<0,001). La presencia de úlceras pareció mostrar una tendencia a la disminución en los años analizados (19,6% a 11,2%). CONCLUSIONES: Existen entornos favorecedores para la implantación (unidades médicas y cuidados intensivos) que reflejan mayor nivel de valoración del riesgo, de utilización de superficies de gestión de la presión y disminución de la prevalencia. No se ha conseguido implantar las recomendaciones de forma homogénea existiendo diferencias en función del tipo de unidad.
Assuntos
Guias de Prática Clínica como Assunto, Úlcera por Pressão, Humanos, Pesquisa em Avaliação de Enfermagem, Ontário, Úlcera por Pressão/enfermagem, Estudos Retrospectivos, Medição de Risco, Sociedades de Enfermagem, EspanhaRESUMO
ABSTRACT: Recommendations for social distancing and avoidance of mass gatherings during the COVID-19 pandemic have correlated with increased depressive symptoms in some individuals, such as loss of interest in daily activities, sleeplessness, or sadness. Perinatal depression screening using established, validated tools can aid with early diagnosis, guide management strategies, and optimize outcomes for pregnant women and their families. Identifying at-risk patients early in pregnancy and implementing a plan of care with appropriate mental health resources such as counseling or therapy have been shown to decrease clinical depression by more than 40%.
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COVID-19/psicologia, Depressão/diagnóstico, Programas de Rastreamento/enfermagem, Assistência Perinatal, Gestantes/psicologia, Adolescente, Adulto, COVID-19/epidemiologia, Feminino, Humanos, Diagnóstico de Enfermagem, Pesquisa em Avaliação de Enfermagem, Gravidez, Adulto JovemAssuntos
COVID-19/enfermagem, Enfermagem de Cuidados Críticos/organização & administração, Capacitação em Serviço, Recursos Humanos de Enfermagem Hospitalar/educação, Recursos Humanos de Enfermagem Hospitalar/organização & administração, COVID-19/epidemiologia, Competência Clínica, Humanos, Pesquisa em Avaliação de Enfermagem, Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Nurses, midwives and other health professionals who return to practice come from a range of backgrounds and return for a variety of reasons. Much of the research on return to practice concerns programme provision rather than returnee experience. AIM: This qualitative study focused on the experiences of nursing, midwifery and allied health students undertaking a return to practice programme at a higher education institute. It interpreted the perceptions of the student experience of returning to clinical practice following a lapse in professional registration. METHODS: Data collection methods were qualitative and involved focus groups. Findings were analysed using thematic analysis. FINDINGS: Several themes and subthemes emerged from the data, including 'the importance of returnee identity' and 'challenges and barriers'. Findings demonstrated different approaches to and influences on returnees' learning journeys. CONCLUSION: Previous knowledge, skills and experience were often hidden from view and hard to explain although crucial to returnee success.
Assuntos
Educação Continuada em Enfermagem, Tocologia, Estudantes de Enfermagem, Reeducação Profissional, Grupos Focais, Humanos, Aprendizagem, Tocologia/educação, Pesquisa em Educação em Enfermagem, Pesquisa em Avaliação de Enfermagem, Pesquisa Qualitativa, Estudantes de Enfermagem/psicologiaRESUMO
BACKGROUND: Nurses are in a prime position to identify sepsis early by screening patients for sepsis, a skill that should be embedded into their daily practice. However, compliance with the sepsis bundle remains low. AIMS: To explore the effects of sepsis training on knowledge, skills and attitude among ward-based nurses. METHODS: Registered nurses from 16 acute surgical and medical wards were invited to anonymously complete a questionnaire. FINDINGS: Response rate was 39% (98/250). Nurses with sepsis training had better knowledge of the National Early Warning Score 2 for sepsis screening, and the systemic inflammatory response syndrome (SIRS) criteria, demonstrated a more positive attitude towards sepsis screening and management, were more confident in screening patients for sepsis and more likely to have screened a patient for sepsis. CONCLUSIONS: Sepsis training improves nurses' attitudes, knowledge and confidence with regards to sepsis screening and management, resulting in adherence to evidence-based care, and should become mandatory for all clinical staff.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde, Recursos Humanos de Enfermagem Hospitalar, Sepse, Humanos, Capacitação em Serviço, Pesquisa em Educação em Enfermagem, Pesquisa em Avaliação de Enfermagem, Recursos Humanos de Enfermagem Hospitalar/educação, Recursos Humanos de Enfermagem Hospitalar/psicologia, Sepse/enfermagem, Inquéritos e QuestionáriosRESUMO
PURPOSE: The aims of this study were to examine interrater agreement of delirium between clinical nurses and a clinical nurse specialist, determine delirium subtype prevalence, and examine associated patient, procedure, and hospital factors. DESIGN: A descriptive cross-sectional design and a convenience sample of nurses and patients on progressive care units were used in this study. METHODS: Clinical nurse specialist data were collected on a case report form, and clinician and patient data were obtained from electronic databases. Interrater agreement of delirium prevalence was assessed by κ statistic, and logistic regression models were used to determine patient factors associated with delirium. RESULTS: Of 216 patients, 23 had delirium; clinical nurses identified fewer cases than the clinical nurse specialist: 1.8% versus 10.7%; κ agreement, 0.27 (0.06, 0.49). By delirium subtype, hypoactive delirium was more frequent (n = 10). Factors associated with delirium were history of cerebrovascular disease (odds ratio [95% confidence interval], 2.8 [1.01-7.7]; P = .044), history of mitral valve disease (odds ratio [95% confidence interval], 0.31 [0.09-0.90]; P = .041), and longer perfusion time (odds ratio [95% confidence interval], 1.7 [1.1-2.7]; P = .016). One factor was associated with hypoactive delirium, longer perfusion time (odds ratio [95% confidence interval], 2.2 [1.3-4.2]; P = .008). CONCLUSIONS: Because clinician-clinical nurse specialist delirium agreement was low and hypoactive delirium was common, clinical interventions are needed.
Assuntos
Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos, Delírio/enfermagem, Enfermeiros Clínicos, Enfermeiras e Enfermeiros, Diagnóstico de Enfermagem/estatística & dados numéricos, Variações Dependentes do Observador, Complicações Pós-Operatórias/enfermagem, Idoso, Estudos Transversais, Delírio/epidemiologia, Feminino, Humanos, Masculino, Pessoa de Meia-Idade, Pesquisa em Avaliação de Enfermagem, Complicações Pós-Operatórias/epidemiologia, Prevalência, Fatores de RiscoRESUMO
ABSTRACT: Nurses are at the forefront of providing care to individuals with mental illness in various healthcare settings, yet the World Health Organization and others have found that many nurses are inadequately prepared to provide mental health care. This article discusses the nurse's role in providing care to individuals with mental illness and the importance of integrating more mental health education into undergraduate nursing curricula.
Assuntos
Bacharelado em Enfermagem/organização & administração, Transtornos Mentais/enfermagem, Enfermagem Psiquiátrica/educação, Escolas de Enfermagem/organização & administração, Competência Clínica, Currículo, Humanos, Transtornos Mentais/epidemiologia, Papel do Profissional de Enfermagem, Pesquisa em Educação em Enfermagem, Pesquisa em Avaliação de Enfermagem, Estudantes de Enfermagem/psicologiaRESUMO
BACKGROUND: The nursing shortage has been deemed a public health crisis as the turnover rate of newly licensed graduate nurses (NLGNs) continues to grow. One of five NLGNs are leaving the profession due to work dissatisfaction and feelings of inadequacy, risking patient safety. METHOD: A prospective, randomized controlled trial evaluated the impact of a 6-week digital intervention (text messaging) on NLGNs' self-reported stress, resiliency, sense of support, and intention to leave their jobs, organization, and profession. Messages to the experimental group (n = 10) conveyed emotional, esteem, and networking support, and messages to the control group (n = 11) were medical facts. RESULTS: The digital intervention in the form of medical facts increased the control group's sense of social support. Stress, resilience, and intention to leave their jobs, organizations, or profession did not change for either the control or experimental group. CONCLUSION: A digital intervention, such as text messaging, potentially can increase NLGNs' sense of support during their first year of hire. [J Contin Educ Nurs. 2021;52(8):367-374.].
