Journal of nursing care quality最新文献

Background: Community of Practices promotes members' collective learning, shared identity, and efforts to increase uptake of evidence-based practices.

Purpose: To describe how a virtual Community of Practice facilitated and supported nurse champions to increase clinician health literacy practices in pediatric ambulatory clinics.

Methods: Transcripts from meetings June 2023 to May 2024 and interviews with champions and leaders conducted in March 2024 were analyzed using directed content analysis and the integrated Promoting Action on Research Implementation in Health Services implementation framework. Clinician practices were assessed at baseline, 6, and 12 months.

Results: The virtual Community of Practice increased champions' knowledge, provided resources, and supported ways to address clinic barriers. Observable impacts, such as teach-back identifying misunderstandings, boosted buy-in. Leadership support varied. Formalizing the community of practice into a formal council fostered sustainability. Clinics reported significant improvements in health literacy practices.

Conclusion: A virtual Community of Practice can facilitate and support champions' facilitation of health literacy implementation in pediatric ambulatory clinics.

Background: Hospitalizations are challenging for older adults and people living with dementia due to geriatric syndromes and behavioral disturbances. Person-centered care (PCC) is a proven strategy to improve outcomes.

Problem: We experienced an increase in behavioral disturbances and long stays of Veterans with dementia in an acute care setting.

Approach: We used the Consolidated Framework for Implementation Research and Expert Recommendations for Implementing Changes to implement a Geriatric-Cognitive Impairment Protocol to promote PCC and geriatric best practices.

Results: Through identification of barriers and facilitators, PCC interventions were enacted, behavioral disturbances declined, and nurses reported a more person-centered environment and improved access to tools to provide evidence-based care.

Conclusion: Implementation science strategies can facilitate PCC and geriatric best practices through a modifiable nursing protocol.

Background: Nurses' knowledge, attitudes, and practices (KAP) regarding external ventricular drainage (EVD) significantly impact patient care quality.

Purpose: The study aimed to develop and validate a suitable questionnaire for assessing neurosurgical nurses' KAP regarding EVD care.

Methods: This study developed a questionnaire from a literature review, semi-structured interviews, team discussions, and 2 Delphi rounds, then administered it to 841 neurosurgical nurses to assess its psychometric properties, including content validity, structural validity, and reliability.

Results: The final 40-item questionnaire had a Cronbach's α of 0.871, split-half reliability of 0.820, test-retest reliability of 0.853, with the content validity index ranging from 0.861 to 1.000. Exploratory factor analysis revealed 11 factors, collectively accounting for 64.17% of the total variance.

Conclusions: The developed questionnaire can serve as a useful tool for assessing neurosurgical nurses' knowledge, attitudes, and practices regarding EVD care.

Background: To reduce the burden of care and prevent health care-associated infections, the comprehensive nursing care services (CNCSs) model was implemented in South Korea.

Purpose: The purpose of this study was to review and synthesize the association between CNCS units and patient outcomes.

Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement guidelines. Articles published between 2013 and March 2025 were searched.

Results: Online searches yielded 9417 articles; 23 articles were included in the review. Multivariate analyses evaluating the impact of CNCS units on 7 patient outcomes were conducted in 8 studies. Approximately half the relationships between CNCS units and patient outcomes were positive and significant.

Conclusion: Inconclusive relationships between CNCSs and patient outcomes were found. Future studies should investigate the consequences of CNCSs using a longitudinal study design and other covariates to draw a causal relationship.

Background: The quality of care interactions is crucial for the quality of life of assisted living residents. However, limited research has explored how interaction quality varies across different care tasks.

Purpose: This study aimed to assess whether the quality of care interactions differs by care task type in assisted living communities.

Methods: This was a descriptive study done in 4 assisted living communities in Maryland. A total of 152 staff-resident care interactions were observed across various care tasks (eg, clinical care and dietary care) using an observation tool that categorizes the quality of the interaction as positive social, positive care, neutral, negative protective, or negative restrictive.

Results: Most interactions were positive care (36%) and occurred during supportive/ambulatory care (34%). Care interactions during supportive/ambulatory care were significantly more negative than interactions during intimate personal care ( P  = .022).

Conclusion: Future research should focus on interventions aimed at improving the quality of care interactions during supportive/ambulatory care tasks.

Background: Early breast milk expression helps establish lactation and increase milk production.

Local problem: In mothers of infants admitted to this neonatal intensive care unit (NICU), 63% met target milk volumes on day 7 and 43% on day 14 postpartum.

Methods: A pre/post quasi-experimental design was used.

Interventions: Breast milk expression was initiated within 6 hours of delivery.

Results: A total of 69 mothers were included (34 baseline; 35 post-implementation). Time to first milk expression decreased from 9.21 to 7.97 hours, P  = .381. Milk volumes increased by 16.9% on day 7 (402.29 mL to 470.11 mL, P  = .358) and 5.18% at 14 days postpartum (618.15 mL to 650.17 mL, P  = .778).

Conclusions: Initiation of milk expression within 6 hours of delivery may positively impact milk production among mothers of premature infants.

Background: Oncology care is complex, increasing the risk of patient harm. Nurses play a key role in identifying and addressing safety issues. Gaps in nurses' understanding of quality, safety, and harm may impede improvement efforts, particularly in safety reporting.

Purpose: We examined oncology nurses' experiences with and perceptions of quality and safety in patient care, including their understanding of harm and how they use safety reporting systems in clinical practice.

Methods: We used interpretive description methodology and conducted semi-structured interviews with 28 nurses at an urban oncology center.

Results: Oncology nurses' accounts of quality, safety, and harm were nuanced and closely connected. Safety reporting systems present challenges and limitations in capturing nurses' concerns.

Conclusion: Expanding harm definitions, streamlining reporting, and ensuring meaningful organizational responses are essential for fostering a culture of safety and quality improvement in oncology.

Background: Workplace violence poses a serious threat to safety and well-being of health care workers.

Purpose: The purpose of this systematic review was to assess the accuracy and applicability of predictive models for workplace violence risk among health care workers.

Methods: Ten databases were searched through May 2025. The Prediction Model Risk of Bias Assessment Tool was used to evaluate model quality. Predictors were classified using the Job Demands-Resources framework.

Results: Ten studies reporting 18 models were included. The pooled area under the curve was 0.87 (95% confidence interval [CI], 0.81-0.93). Predictors were categorized into 3 main categories and 7 subcategories.

Conclusions: Current workplace violence risk models lack clinical utility; future research must strengthen rigor and validation for practical application.

Background: Older adults frequently require complex care decisions causing potential patient-nurse conflicts due to perceived or real disconnects between care team recommendations and patient preferences.

Purpose: This study evaluated a novel Negotiation and Dispute Resolution (NDR) training program designed to equip nurses with practical skills to navigate these challenges.

Methods: Nurses underwent 90-minute NDR training and then completed a mixed-method survey. Qualitative and quantitative responses were aggregated and analyzed.

Results: All respondents reported frequent conflicts in their daily work with older adult patients. Only 34% (n = 29) rated their baseline negotiation knowledge above "limited" on a 5-point Likert scale (Very Substantial, Substantial, Moderate, Limited, or Very Limited). Post-training, all rated their knowledge as "moderate" or higher (P < .005) with high satisfaction and intent to apply learned strategies into practice.

Conclusions: This study demonstrates NDR training is feasible and effectively enhances nurses' negotiation knowledge and satisfaction.