Pub Date : 2023-08-01DOI: 10.1016/j.ijnsa.2023.100147
Eman Kamel Hossny , Hammad S. Alotaibi , Aml Moubark Mahmoud , Nermine Mohamed Elcokany , Mohamed Mahmoud Seweid , Nouf Afit Aldhafeeri , Abeer Mohamed Abdelkader , Seham Mohamed Abd Elhamed
Background
Nursing managers and leaders must fight to retain nurses in hospitals by constructing an inviting organizational climate that is attractive to work in, not toxic. The organizational climate is primarily affected by employees’ internal work environment and behavior. Hence, nursing managers and leaders must implement effective strategies to increase nurses intention to stay by address the organizational climate.
Aim
This study was designed to assess nurses’ perception of the effects of organizational climate and toxic leadership behaviors on their intention to stay and the differences in these domains between the two hospitals studied.
Methods
A descriptive comparative design was used. Data were collected in 2022 from 250 nurses working in the two largest hospitals in Assiut, an Egyptian city south of Cairo, using three self-administered questionnaires: the organizational climate questionnaire (42 items categorized into nine domains), the toxic leadership scale (30 items categorized into five domains), and the Chinese version of the intent-to-stay scale.
Results
Most nurses reported their intention to stay as “normal.” The nurse participants perceived that a positive organizational climate was not present, but toxic leadership was at a low level (13.6% and 25.6%, respectively). The model of regression analysis was significant, showing that the organizational climate represented by supportive systems impacted nurses’ intention to stay in the hospitals under study. Meanwhile, toxic leadership behaviors, represented by authoritarian leadership, unpredictability in the university hospital, and self-promotion in the insurance hospital, affected nurses’ intention to stay.
Conclusion
Positive organizational climate played a significant role in retaining nurses through investing in incentives and providing supportive systems. Authoritarian leadership, unpredictability, and the self-promotion of leaders' behaviors impacted the nurses and the climate negatively. Hence, we recommend investing in potential strategies to improve the nurses’ intention to stay through performance standards, increased pay and benefits, clear reward mechanisms, participation in decision making, and assessments of leaders’ behaviors. Furthermore, decision and policy makers need to establish effective, supportive systems in hospitals to retain nurses. Hence, nursing managers and leaders must rethink how they can use their leadership skills and behavior in a positive manner to promote nurse retention.
{"title":"Influence of nurses’ perception of organizational climate and toxic leadership behaviors on intent to stay: A descriptive comparative study","authors":"Eman Kamel Hossny , Hammad S. Alotaibi , Aml Moubark Mahmoud , Nermine Mohamed Elcokany , Mohamed Mahmoud Seweid , Nouf Afit Aldhafeeri , Abeer Mohamed Abdelkader , Seham Mohamed Abd Elhamed","doi":"10.1016/j.ijnsa.2023.100147","DOIUrl":"10.1016/j.ijnsa.2023.100147","url":null,"abstract":"<div><h3>Background</h3><p>Nursing managers and leaders must fight to retain nurses in hospitals by constructing an inviting organizational climate that is attractive to work in, not toxic. The organizational climate is primarily affected by employees’ internal work environment and behavior. Hence, nursing managers and leaders must implement effective strategies to increase nurses intention to stay by address the organizational climate.</p></div><div><h3>Aim</h3><p>This study was designed to assess nurses’ perception of the effects of organizational climate and toxic leadership behaviors on their intention to stay and the differences in these domains between the two hospitals studied.</p></div><div><h3>Methods</h3><p>A descriptive comparative design was used. Data were collected in 2022 from 250 nurses working in the two largest hospitals in Assiut, an Egyptian city south of Cairo, using three self-administered questionnaires: the organizational climate questionnaire (42 items categorized into nine domains), the toxic leadership scale (30 items categorized into five domains), and the Chinese version of the intent-to-stay scale.</p></div><div><h3>Results</h3><p>Most nurses reported their intention to stay as “normal.” The nurse participants perceived that a positive organizational climate was not present, but toxic leadership was at a low level (13.6% and 25.6%, respectively). The model of regression analysis was significant, showing that the organizational climate represented by supportive systems impacted nurses’ intention to stay in the hospitals under study. Meanwhile, toxic leadership behaviors, represented by authoritarian leadership, unpredictability in the university hospital, and self-promotion in the insurance hospital, affected nurses’ intention to stay.</p></div><div><h3>Conclusion</h3><p>Positive organizational climate played a significant role in retaining nurses through investing in incentives and providing supportive systems. Authoritarian leadership, unpredictability, and the self-promotion of leaders' behaviors impacted the nurses and the climate negatively. Hence, we recommend investing in potential strategies to improve the nurses’ intention to stay through performance standards, increased pay and benefits, clear reward mechanisms, participation in decision making, and assessments of leaders’ behaviors. Furthermore, decision and policy makers need to establish effective, supportive systems in hospitals to retain nurses. Hence, nursing managers and leaders must rethink how they can use their leadership skills and behavior in a positive manner to promote nurse retention.</p></div><div><h3>Study registration</h3><p>Not registered</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47687508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-28DOI: 10.1016/j.ijnsa.2023.100146
Catherine Henshall , Zoe Davey , Clair Merriman , Laura Strumidlo , Laura Serrant , Jo Brett , Eila Watson , Jane V. Appleton , Mary Malone
Introduction
High-quality pre-registration student nurse training and development is integral to developing a sustainable and competent global nursing workforce. Internationally, student nurse recruitment rates have increased since the onset of the COVID-19 pandemic; however, attrition rates for student nurses are high. During the pandemic, many student nurses considered leaving the programme due to academic concerns, feeling overwhelmed, and doubting their clinical skills. Little was known about the extent to which nursing education prior to COVID-19 had prepared students for their role in managing the healthcare crisis or the impact on their resilience. Thus, this study aimed to explore how the COVID-19 pandemic impacted on the resilience levels of student nurses across the United Kingdom.
Methods
Data were collected as part of a multi-site qualitative study named ‘COV-ED Nurse’ and involved pre-placement surveys, placement diaries, and post-placement interviews with nursing students. Student nurse participants were recruited from across the United Kingdom, from all years of study, and from all four nursing branches: children, adult, mental health, and learning disabilities. Participants were asked to complete a pre-placement survey that collected demographic details and information about their placement expectations. They were also asked to record a weekly audio-visual or written diary to describe their placement experiences, and, on completion of their placements, students were interviewed to explore their experiences of this time. Data were thematically analysed using the Framework Approach. Ethical approvals were obtained.
Results
Two hundred and sixteen students took part in the wider study. The current study involved a subset of 59 students’ data. Four main themes were identified: ‘coping with increased levels of acuity’, ‘perceived risks of the pandemic’, ‘resilience when facing uncertainty and isolation’, and ‘the importance of coping mechanisms and support structures.’
Discussion
From this study, we have generated insights that can be applied to nursing research, education, policy, and practice and identified the wide-ranging impact that the COVID-19 pandemic had on student nurses and their abilities to remain resilient in an unstable environment. The value of communication and support networks from a wide range of sources was highlighted as key to navigating many uncertainties. In addition, the extent to which students were able to navigate their personal and professional roles and identities influenced their ability to cope with and continue along their training pathways.
{"title":"The impact of the COVID-19 pandemic on nursing students’ navigation of their nursing programmes and experiences of resilience. A qualitative study","authors":"Catherine Henshall , Zoe Davey , Clair Merriman , Laura Strumidlo , Laura Serrant , Jo Brett , Eila Watson , Jane V. Appleton , Mary Malone","doi":"10.1016/j.ijnsa.2023.100146","DOIUrl":"10.1016/j.ijnsa.2023.100146","url":null,"abstract":"<div><h3>Introduction</h3><p>High-quality pre-registration student nurse training and development is integral to developing a sustainable and competent global nursing workforce. Internationally, student nurse recruitment rates have increased since the onset of the COVID-19 pandemic; however, attrition rates for student nurses are high. During the pandemic, many student nurses considered leaving the programme due to academic concerns, feeling overwhelmed, and doubting their clinical skills. Little was known about the extent to which nursing education prior to COVID-19 had prepared students for their role in managing the healthcare crisis or the impact on their resilience. Thus, this study aimed to explore how the COVID-19 pandemic impacted on the resilience levels of student nurses across the United Kingdom.</p></div><div><h3>Methods</h3><p>Data were collected as part of a multi-site qualitative study named ‘COV-ED Nurse’ and involved pre-placement surveys, placement diaries, and post-placement interviews with nursing students. Student nurse participants were recruited from across the United Kingdom, from all years of study, and from all four nursing branches: children, adult, mental health, and learning disabilities. Participants were asked to complete a pre-placement survey that collected demographic details and information about their placement expectations. They were also asked to record a weekly audio-visual or written diary to describe their placement experiences, and, on completion of their placements, students were interviewed to explore their experiences of this time. Data were thematically analysed using the Framework Approach. Ethical approvals were obtained.</p></div><div><h3>Results</h3><p>Two hundred and sixteen students took part in the wider study. The current study involved a subset of 59 students’ data. Four main themes were identified: ‘coping with increased levels of acuity’, ‘perceived risks of the pandemic’, ‘resilience when facing uncertainty and isolation’, and ‘the importance of coping mechanisms and support structures.’</p></div><div><h3>Discussion</h3><p>From this study, we have generated insights that can be applied to nursing research, education, policy, and practice and identified the wide-ranging impact that the COVID-19 pandemic had on student nurses and their abilities to remain resilient in an unstable environment. The value of communication and support networks from a wide range of sources was highlighted as key to navigating many uncertainties. In addition, the extent to which students were able to navigate their personal and professional roles and identities influenced their ability to cope with and continue along their training pathways.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.1016/j.ijnsa.2023.100144
Naomi Simpson , Dianne Wepa , Rachael Vernon , Annette Briley , Mary Steen
Background
Workplace bullying, and violence within the midwifery profession, has been a well-documented concern in health literature since the early 1990′s. However, contemporary research highlights that workplace bullying, and violence is often inflicted upon midwifery students. Workplace bullying, and violence has both short- and long-term effects on the student, including psychological trauma and poor mental health, loss of passion for the midwifery profession and absenteeism. To consider a solution to this phenomenon, current literature regarding midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence has been reviewed.
Objective
To explore and critique current literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence.
Design
An integrative review.
Review methods
Toronto & Remington's six-stage systematic framework was used to conduct the review, with rigour and validity for the research process.
Results
Following critical appraisal, 12 articles met the inclusion criteria. Four themes emerged: (1) Prevalence and types of workplace bullying, and violence towards midwifery students. (2) Impact of workplace bullying, and violence on midwifery students’ experiences during the degree. (3) Impact of negative workplace culture on the midwifery profession. (4) The requirement to develop strategies for midwifery students to address workplace bullying, and violence.
Conclusions
Workplace bullying, and violence is a global health concern within the midwifery profession with evidenced impact on midwifery students’ professional and personal lives. Organisational systems and approaches were identified as causes of a toxic clinical environment and workplace bullying, and violence, which impacted midwifery students’ experiences. Suggestions supported universities incorporating conflict resolution strategies into midwifery degree programs, to prepare midwifery students to manage workplace bullying, and violence.
Tweetable abstract
Workplace bullying, and violence is a global health concern entrenched within the midwifery profession, impacting midwifery students’ professional and personal lives. Incorporating conflict resolution strategies into Bachelor of midwifery degree programs, may help prepare midwifery students to manage workplace bullying, and violence.
{"title":"Midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence: An integrative review","authors":"Naomi Simpson , Dianne Wepa , Rachael Vernon , Annette Briley , Mary Steen","doi":"10.1016/j.ijnsa.2023.100144","DOIUrl":"10.1016/j.ijnsa.2023.100144","url":null,"abstract":"<div><h3>Background</h3><p>Workplace bullying, and violence within the midwifery profession, has been a well-documented concern in health literature since the early 1990′s. However, contemporary research highlights that workplace bullying, and violence is often inflicted upon midwifery students. Workplace bullying, and violence has both short- and long-term effects on the student, including psychological trauma and poor mental health, loss of passion for the midwifery profession and absenteeism. To consider a solution to this phenomenon, current literature regarding midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence has been reviewed.</p></div><div><h3>Objective</h3><p>To explore and critique current literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence.</p></div><div><h3>Design</h3><p>An integrative review.</p></div><div><h3>Review methods</h3><p>Toronto & Remington's six-stage systematic framework was used to conduct the review, with rigour and validity for the research process.</p></div><div><h3>Results</h3><p>Following critical appraisal, 12 articles met the inclusion criteria. Four themes emerged: (1) Prevalence and types of workplace bullying, and violence towards midwifery students. (2) Impact of workplace bullying, and violence on midwifery students’ experiences during the degree. (3) Impact of negative workplace culture on the midwifery profession. (4) The requirement to develop strategies for midwifery students to address workplace bullying, and violence.</p></div><div><h3>Conclusions</h3><p>Workplace bullying, and violence is a global health concern within the midwifery profession with evidenced impact on midwifery students’ professional and personal lives. Organisational systems and approaches were identified as causes of a toxic clinical environment and workplace bullying, and violence, which impacted midwifery students’ experiences. Suggestions supported universities incorporating conflict resolution strategies into midwifery degree programs, to prepare midwifery students to manage workplace bullying, and violence.</p></div><div><h3>Tweetable abstract</h3><p>Workplace bullying, and violence is a global health concern entrenched within the midwifery profession, impacting midwifery students’ professional and personal lives. Incorporating conflict resolution strategies into Bachelor of midwifery degree programs, may help prepare midwifery students to manage workplace bullying, and violence.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46825373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many newly qualified nurses experience transition challenges because they feel unprepared for the reality of the nursing profession owing to the theory-practice gap. Transition challenges amongst newly qualified nurses have profound consequences for the nursing profession and patient care. A detailed and nuanced understanding of the complexity in transition-related challenges during extraordinary conditions like the coronavirus disease 2019 pandemic is needed for newly qualified nurses to remain in the nursing profession.
Objective
This study explored the experience of newly qualified nurses entering the nursing profession who had their clinical placement education missed, shortened, or substituted since they had to serve as health care assistants during the coronavirus disease 2019 pandemic.
Design
An exploratory and descriptive study design was used.
Settings
Workplaces for newly qualified nurses.
Participants
A purposive sample of 10 newly qualified Norwegian nurses working in various clinical placement nursing settings were included.
Methods
Data were collected in April and May 2022 via individual interviews conducted via Zoom. Thematic analysis was applied to identify themes. Triangulation was employed to ensure trustworthiness.
Findings
Three major themes emerged: relational aspects of nursing, practical aspects of nursing, and inadequacies in the pedagogical plan of teaching and learning. The themes indicate that the limited or suspended clinical placement education during the pandemic affected the competence of newly qualified nurses.
Conclusions
During the coronavirus disease 2019 pandemic, clinical placement education for student nurses was limited or suspended owing to safety concerns. The short clinical placement durations affected the competence of newly qualified nurses, as they lacked exposure to real-world patient care scenarios as in non-pandemic times. Furthermore, our findings indicate that newly qualified nurses’ clinical placement experiences provide important knowledge and insight for educators in terms of education and support for future student nurses going into situations with short clinical placement hours. The conclusion highlights the implications of the findings and recommendations and the need for further support and education for newly qualified nurses after the pandemic.
Study registration details
The study was approved by the Norwegian Social Data Service (project number 396247). The registration date was 2021–11–04.
Tweetable abstract
Transition-related challenges became more prominent during the coronavirus disease 2019 pandemic than during non-pandemic times.
{"title":"Clinical placement education during the coronavirus disease 2019 pandemic shapes new nurses: A qualitative study","authors":"Monika Ravik, Etty Ragnhild Nilsen, Marianne Wighus, Randi Garang Mofossbakke, Gro Gade Haanes","doi":"10.1016/j.ijnsa.2023.100145","DOIUrl":"10.1016/j.ijnsa.2023.100145","url":null,"abstract":"<div><h3>Background</h3><p>Many newly qualified nurses experience transition challenges because they feel unprepared for the reality of the nursing profession owing to the theory-practice gap. Transition challenges amongst newly qualified nurses have profound consequences for the nursing profession and patient care. A detailed and nuanced understanding of the complexity in transition-related challenges during extraordinary conditions like the coronavirus disease 2019 pandemic is needed for newly qualified nurses to remain in the nursing profession.</p></div><div><h3>Objective</h3><p>This study explored the experience of newly qualified nurses entering the nursing profession who had their clinical placement education missed, shortened, or substituted since they had to serve as health care assistants during the coronavirus disease 2019 pandemic.</p></div><div><h3>Design</h3><p>An exploratory and descriptive study design was used.</p></div><div><h3>Settings</h3><p>Workplaces for newly qualified nurses.</p></div><div><h3>Participants</h3><p>A purposive sample of 10 newly qualified Norwegian nurses working in various clinical placement nursing settings were included.</p></div><div><h3>Methods</h3><p>Data were collected in April and May 2022 via individual interviews conducted via Zoom. Thematic analysis was applied to identify themes. Triangulation was employed to ensure trustworthiness.</p></div><div><h3>Findings</h3><p>Three major themes emerged: relational aspects of nursing, practical aspects of nursing, and inadequacies in the pedagogical plan of teaching and learning. The themes indicate that the limited or suspended clinical placement education during the pandemic affected the competence of newly qualified nurses.</p></div><div><h3>Conclusions</h3><p>During the coronavirus disease 2019 pandemic, clinical placement education for student nurses was limited or suspended owing to safety concerns. The short clinical placement durations affected the competence of newly qualified nurses, as they lacked exposure to real-world patient care scenarios as in non-pandemic times. Furthermore, our findings indicate that newly qualified nurses’ clinical placement experiences provide important knowledge and insight for educators in terms of education and support for future student nurses going into situations with short clinical placement hours. The conclusion highlights the implications of the findings and recommendations and the need for further support and education for newly qualified nurses after the pandemic.</p></div><div><h3>Study registration details</h3><p>The study was approved by the Norwegian Social Data Service (project number 396247). The registration date was 2021–11–04.</p></div><div><h3>Tweetable abstract</h3><p>Transition-related challenges became more prominent during the coronavirus disease 2019 pandemic than during non-pandemic times.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41952264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.1016/j.ijnsa.2023.100143
Melissa Heufel , Sarah Kourouche , Kate Curtis
Introduction
Emergency departments frequently care for patients at the end of life and should have robust processes for reviewing delivery of care. The aim of this scoping review is to examine and collate the chart audit tools available to assess the quality of end of life care of patients who die in the emergency department, or, in the subsequent hospital admission.
Methods
A scoping review of the literature using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, and the methodological framework outlined by Arksey and O'Malley was conducted. Primary and secondary research, along with grey literature were searched. Both adult and paediatric populations were included. Databases Ovid Emcare, CINAHL and Medline were searched from 1961 to December 2022; followed by screening and appraisal. Articles were compared and data synthesised into categories.
Results
Fifty-eight articles were included generating three categories; contexts for end of life audit use, development and evaluation of audit tools, and audit characteristics / components. Four tools focused on the emergency department, however, did not comprehensively review both end of life and emergency department specific data. A draft audit tool for the emergency department was developed that consisted of the common elements to evaluate end of life care as identified in this review, emergency department-specific quality of care measures and the integration of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool.
Conclusion
No audit tool to comprehensively review end of life care provided for patients at the end of life in the emergency department was found. We developed an audit tool based on best available evidence that now needs testing for validity, feasibility, and usability to evaluate end of life in the emergency department setting is required.
{"title":"Development of an emergency department end of life care audit tool: A scoping review","authors":"Melissa Heufel , Sarah Kourouche , Kate Curtis","doi":"10.1016/j.ijnsa.2023.100143","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2023.100143","url":null,"abstract":"<div><h3>Introduction</h3><p>Emergency departments frequently care for patients at the end of life and should have robust processes for reviewing delivery of care. The aim of this scoping review is to examine and collate the chart audit tools available to assess the quality of end of life care of patients who die in the emergency department, or, in the subsequent hospital admission.</p></div><div><h3>Methods</h3><p>A scoping review of the literature using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, and the methodological framework outlined by Arksey and O'Malley was conducted. Primary and secondary research, along with grey literature were searched. Both adult and paediatric populations were included. Databases Ovid Emcare, CINAHL and Medline were searched from 1961 to December 2022; followed by screening and appraisal. Articles were compared and data synthesised into categories.</p></div><div><h3>Results</h3><p>Fifty-eight articles were included generating three categories; contexts for end of life audit use, development and evaluation of audit tools, and audit characteristics / components. Four tools focused on the emergency department, however, did not comprehensively review both end of life and emergency department specific data. A draft audit tool for the emergency department was developed that consisted of the common elements to evaluate end of life care as identified in this review, emergency department-specific quality of care measures and the integration of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool.</p></div><div><h3>Conclusion</h3><p>No audit tool to comprehensively review end of life care provided for patients at the end of life in the emergency department was found. We developed an audit tool based on best available evidence that now needs testing for validity, feasibility, and usability to evaluate end of life in the emergency department setting is required.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49857231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14eCollection Date: 2023-12-01DOI: 10.1016/j.ijnsa.2023.100143
Melissa Heufel, Sarah Kourouche, Kate Curtis
Introduction: Emergency departments frequently care for patients at the end of life and should have robust processes for reviewing delivery of care. The aim of this scoping review is to examine and collate the chart audit tools available to assess the quality of end of life care of patients who die in the emergency department, or, in the subsequent hospital admission.
Methods: A scoping review of the literature using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, and the methodological framework outlined by Arksey and O'Malley was conducted. Primary and secondary research, along with grey literature were searched. Both adult and paediatric populations were included. Databases Ovid Emcare, CINAHL and Medline were searched from 1961 to December 2022; followed by screening and appraisal. Articles were compared and data synthesised into categories.
Results: Fifty-eight articles were included generating three categories; contexts for end of life audit use, development and evaluation of audit tools, and audit characteristics / components. Four tools focused on the emergency department, however, did not comprehensively review both end of life and emergency department specific data. A draft audit tool for the emergency department was developed that consisted of the common elements to evaluate end of life care as identified in this review, emergency department-specific quality of care measures and the integration of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool.
Conclusion: No audit tool to comprehensively review end of life care provided for patients at the end of life in the emergency department was found. We developed an audit tool based on best available evidence that now needs testing for validity, feasibility, and usability to evaluate end of life in the emergency department setting is required.
{"title":"Development of an emergency department end of life care audit tool: A scoping review.","authors":"Melissa Heufel, Sarah Kourouche, Kate Curtis","doi":"10.1016/j.ijnsa.2023.100143","DOIUrl":"10.1016/j.ijnsa.2023.100143","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency departments frequently care for patients at the end of life and should have robust processes for reviewing delivery of care. The aim of this scoping review is to examine and collate the chart audit tools available to assess the quality of end of life care of patients who die in the emergency department, or, in the subsequent hospital admission.</p><p><strong>Methods: </strong>A scoping review of the literature using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, and the methodological framework outlined by Arksey and O'Malley was conducted. Primary and secondary research, along with grey literature were searched. Both adult and paediatric populations were included. Databases Ovid Emcare, CINAHL and Medline were searched from 1961 to December 2022; followed by screening and appraisal. Articles were compared and data synthesised into categories.</p><p><strong>Results: </strong>Fifty-eight articles were included generating three categories; contexts for end of life audit use, development and evaluation of audit tools, and audit characteristics / components. Four tools focused on the emergency department, however, did not comprehensively review both end of life and emergency department specific data. A draft audit tool for the emergency department was developed that consisted of the common elements to evaluate end of life care as identified in this review, emergency department-specific quality of care measures and the integration of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool.</p><p><strong>Conclusion: </strong>No audit tool to comprehensively review end of life care provided for patients at the end of life in the emergency department was found. We developed an audit tool based on best available evidence that now needs testing for validity, feasibility, and usability to evaluate end of life in the emergency department setting is required.</p>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46096364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.1016/j.ijnsa.2023.100142
Lisa S. van Tol , Hanneke J.A. Smaling , Sarah I.M. Janus , Monique A.A. Caljouw , Wilco P. Achterberg
Background
COVID-19 infection prevention measures can negatively impact nursing home residents’ well-being. Society has been concerned about the imbalance between infection prevention and residents’ well-being, and about nursing home residents’ autonomy in COVID-19 policymaking.
Objective
This study explores consensus among nursing home staff about which measures they found to be most important in contributing to preventing infections and to maintaining well-being of residents during COVID-19 outbreaks. In addition, this study explores the decision-making processes regarding COVID-19 measures and the involvement of residents or their representatives.
Design
Mixed methods based on an online nominal group technique.
Setting(s)
Dutch nursing homes, June–November 2020.
Participants
Managers, policy advisors, elderly care physicians, psychologists, a spiritual counselor, nurses, care assistants, and resident representatives (N = 35).
Methods
Four panels from the viewpoint of infection prevention, and four panels from the viewpoint of well-being were performed with 3 to 7 participants per panel. Participants individually selected the measure they found most important, discussed these measures together in an online conversation, and rated the importance and urgency of these measures during COVID-19 outbreaks on a 5-point Likert scale. The measures that were rated as (very) important and (very) urgent by all members of that panel were defined as ‘prioritized in consensus’. Panels also discussed the decision-making process regarding COVID-19 measures and the involvement of residents or their representatives. These conversations were transcribed verbatim and thematically coded using an inductive approach.
Results
The infection prevention panels prioritized isolation measures; testing measures; testing and isolation combinations; use of personal protective equipment around (suspected) infected residents; and preparation for outbreaks by COVID-19 outbreak teams. The well-being panels prioritized cohort isolation, testing combined with cohort isolation and with isolation in residents’ rooms, exceptions to visitor bans, maximum numbers of visitors, and registration and accompanying visitors to the residents’ rooms. Resident representatives and staff were dissatisfied with their reduced involvement in policy making during the first months of the COVID-19 pandemic, although they understood that decisions had to be made quickly.
Conclusions
Staff and resident representatives should be involved in COVID-19 policy making. According to them, priority COVID-19 measures should include: cohort isolation, testing and isolation combinations, use of personal protective equipment, crisis management by COVID-19 outbreak teams, and nursing home visit regulations and instruction
{"title":"Priority measures to prevent infections and maintain residents’ well-being during COVID-19 outbreaks in nursing homes: Consensus among staff and resident representatives determined in an online nominal group technique study","authors":"Lisa S. van Tol , Hanneke J.A. Smaling , Sarah I.M. Janus , Monique A.A. Caljouw , Wilco P. Achterberg","doi":"10.1016/j.ijnsa.2023.100142","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2023.100142","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 infection prevention measures can negatively impact nursing home residents’ well-being. Society has been concerned about the imbalance between infection prevention and residents’ well-being, and about nursing home residents’ autonomy in COVID-19 policymaking.</p></div><div><h3>Objective</h3><p>This study explores consensus among nursing home staff about which measures they found to be most important in contributing to preventing infections and to maintaining well-being of residents during COVID-19 outbreaks. In addition, this study explores the decision-making processes regarding COVID-19 measures and the involvement of residents or their representatives.</p></div><div><h3>Design</h3><p>Mixed methods based on an online nominal group technique.</p></div><div><h3>Setting(s)</h3><p>Dutch nursing homes, June–November 2020.</p></div><div><h3>Participants</h3><p>Managers, policy advisors, elderly care physicians, psychologists, a spiritual counselor, nurses, care assistants, and resident representatives (<em>N</em> = 35).</p></div><div><h3>Methods</h3><p>Four panels from the viewpoint of infection prevention, and four panels from the viewpoint of well-being were performed with 3 to 7 participants per panel. Participants individually selected the measure they found most important, discussed these measures together in an online conversation, and rated the importance and urgency of these measures during COVID-19 outbreaks on a 5-point Likert scale. The measures that were rated as (very) important and (very) urgent by all members of that panel were defined as ‘prioritized in consensus’. Panels also discussed the decision-making process regarding COVID-19 measures and the involvement of residents or their representatives. These conversations were transcribed verbatim and thematically coded using an inductive approach.</p></div><div><h3>Results</h3><p>The infection prevention panels prioritized isolation measures; testing measures; testing and isolation combinations; use of personal protective equipment around (suspected) infected residents; and preparation for outbreaks by COVID-19 outbreak teams. The well-being panels prioritized cohort isolation, testing combined with cohort isolation and with isolation in residents’ rooms, exceptions to visitor bans, maximum numbers of visitors, and registration and accompanying visitors to the residents’ rooms. Resident representatives and staff were dissatisfied with their reduced involvement in policy making during the first months of the COVID-19 pandemic, although they understood that decisions had to be made quickly.</p></div><div><h3>Conclusions</h3><p>Staff and resident representatives should be involved in COVID-19 policy making. According to them, priority COVID-19 measures should include: cohort isolation, testing and isolation combinations, use of personal protective equipment, crisis management by COVID-19 outbreak teams, and nursing home visit regulations and instruction ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49857232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.1016/j.ijnsa.2023.100141
Eunjung Ko, Thanchanok Wongvibul, Karen M. Rose, Jin Jun
Background
The number of people living with dementia continues to grow, increasing the demands on unpaid caregivers of people living with dementia. Caregiving can be emotionally and mentally distressing. In response, numerous interventions have been developed and tested to improve mental health in caregivers of people living with dementia. However, the effects of self-guided interventions on mental health in this population have remained understudied.
Objective
We systematically examined the effects of self-guided interventions on stress, burden, and mental health of unpaid caregivers of people living with dementia.
Design and Data Sources
A systematic review method following PRISMA guideline was used. PubMed, CINAHL, PsycINFO, Scopus, and Embase databases were searched using relevant search terms for the study aims from September to November 2022. The search was limited to peer-reviewed articles written in English. This review included articles that examined 1) unpaid caregivers of people living with dementia; 2) a self-guided, self-directed, or self-facilitated intervention; and 3) intervention to improve psychological or mental health as an outcome of interest. The exclusion criteria were: 1) secondary data analysis research based on an intervention study, 2) systematic reviews or meta-analyses, or 3) articles that evaluated only the acceptability or feasibility of a program. The collected data were synthesized using descriptive analysis with tabular summaries. The quality of each paper included was assessed by using JBI Quality Assessment tools.
Results
A total of 16 articles and 1,182 unpaid caregivers of people living with dementia were included in this review. Stress, burden, depressive symptoms, anxiety, quality of life, self-efficacy, positive aspects of caregiving, social support, and personal relationship were measured in at least three articles. Depressive symptoms and burden were the most frequently measured outcomes. Stress was generally reduced after the interventions. However, the results of burden and mental health from each intervention were mixed and inconsistent. Interestingly, interventions that lasted less than 3 months were more likely to have better efficacy.
Conclusions
Although the results of self-guided interventions are mixed, this is a potentially useful tool in improving emotional well-being for unpaid caregivers of people living with dementia due to low time burden, ease-to-access, and affordability. Future direction in intervention development should include identifying the optimal length and components of self-guided interventions and collaboration with clinicians for wider distribution to unpaid caregivers of people living with dementia.
Registration
This review was not registered at the PROSPERO, and a review protocol was not prepared.
{"title":"The effects of self-guided interventions on stress, burden, and mental health in caregivers of people living with dementia: A systematic review","authors":"Eunjung Ko, Thanchanok Wongvibul, Karen M. Rose, Jin Jun","doi":"10.1016/j.ijnsa.2023.100141","DOIUrl":"10.1016/j.ijnsa.2023.100141","url":null,"abstract":"<div><h3>Background</h3><p>The number of people living with dementia continues to grow, increasing the demands on unpaid caregivers of people living with dementia. Caregiving can be emotionally and mentally distressing. In response, numerous interventions have been developed and tested to improve mental health in caregivers of people living with dementia. However, the effects of self-guided interventions on mental health in this population have remained understudied.</p></div><div><h3>Objective</h3><p>We systematically examined the effects of self-guided interventions on stress, burden, and mental health of unpaid caregivers of people living with dementia.</p></div><div><h3>Design and Data Sources</h3><p>A systematic review method following PRISMA guideline was used. PubMed, CINAHL, PsycINFO, Scopus, and Embase databases were searched using relevant search terms for the study aims from September to November 2022. The search was limited to peer-reviewed articles written in English. This review included articles that examined 1) unpaid caregivers of people living with dementia; 2) a self-guided, self-directed, or self-facilitated intervention; and 3) intervention to improve psychological or mental health as an outcome of interest. The exclusion criteria were: 1) secondary data analysis research based on an intervention study, 2) systematic reviews or meta-analyses, or 3) articles that evaluated only the acceptability or feasibility of a program. The collected data were synthesized using descriptive analysis with tabular summaries. The quality of each paper included was assessed by using JBI Quality Assessment tools.</p></div><div><h3>Results</h3><p>A total of 16 articles and 1,182 unpaid caregivers of people living with dementia were included in this review. Stress, burden, depressive symptoms, anxiety, quality of life, self-efficacy, positive aspects of caregiving, social support, and personal relationship were measured in at least three articles. Depressive symptoms and burden were the most frequently measured outcomes. Stress was generally reduced after the interventions. However, the results of burden and mental health from each intervention were mixed and inconsistent. Interestingly, interventions that lasted less than 3 months were more likely to have better efficacy.</p></div><div><h3>Conclusions</h3><p>Although the results of self-guided interventions are mixed, this is a potentially useful tool in improving emotional well-being for unpaid caregivers of people living with dementia due to low time burden, ease-to-access, and affordability. Future direction in intervention development should include identifying the optimal length and components of self-guided interventions and collaboration with clinicians for wider distribution to unpaid caregivers of people living with dementia.</p></div><div><h3>Registration</h3><p>This review was not registered at the PROSPERO, and a review protocol was not prepared.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47668276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.ijnsa.2023.100142
Lisa S. van Tol, H. Smaling, Sarah Janus, M. A. Caljouw, W. Achterberg
{"title":"Priority COVID-19 measures in nursing homes","authors":"Lisa S. van Tol, H. Smaling, Sarah Janus, M. A. Caljouw, W. Achterberg","doi":"10.1016/j.ijnsa.2023.100142","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2023.100142","url":null,"abstract":"","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41499067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-29DOI: 10.1016/j.ijnsa.2023.100139
Sara Borrelli , Renuka Ramasamy , Ruth Wong , Helen Spiby
Background
Modern slavery is a largely hidden crime disproportionately affecting women and girls, with 71% of the world's enslaved people being female and approximately one third estimated to be pregnant. Healthcare professionals experience difficulties in caring for mothers affected by modern slavery, including asking appropriate questions and initiating discussions, making safe referrals, being uncertain about entitlements, and facing obstacles in accessing language support and specialist mental health services. Despite the expectation of cohesive and consistent services, which avoid the recounting of experiences that may re-traumatise, interdisciplinary collaborations between maternity services and non-statutory agencies remain unclear.
Objective
To map the available evidence and resources on maternity care provision and non-statutory support to pregnant women and mothers affected by modern slavery.
Design
A scoping review was conducted following the JBI methodology for scoping reviews.
Methods
Five databases (Applied Social Sciences Index & Abstracts, Cumulated Index to Nursing and Allied Health Literature, Dissertations & Thesis A&I, Embase, Scopus) were searched. Inclusion criteria: English language; published between 2012 and May 2022; related to both maternity care provision and modern slavery; cross-sectional perspectives, including survivor mothers, healthcare professionals, midwives, and non-statutory service staff; any methodology. Exclusion criteria: general healthcare or not maternity related; opinion pieces, letters, book reviews, commentaries. Grey literature was searched using relevant websites reporting theses, blogs, policies, guidelines, and resources.
Results
Twelve articles reporting 11 studies and 29 grey literature reports were retained for the scoping review. Three key themes were identified from research studies: a) women's perspectives on barriers to access and engagement with maternity services; b) challenges and needs identified by healthcare professionals; and c) the impact of human trafficking on maternal and neonatal outcomes. The grey literature resources comprised mainly blogs, information sheets, leaflets or webpages, and research or consultation reports. Maternity was being experienced by survivor mothers with the following: unfamiliarity with and lack of access to systems and information across all sectors, barriers to care and entitlements, contemporary threats of violence from partners/traffickers, restricted ability to move freely, issues related to traumatisation, dispersal policies, and dealing with multiple new systems.
Conclusions
Although several sources indicate principles that should be adopted, the detail of how optimal care and support during maternity should be provided by healthcare prof
{"title":"Care and support during maternity for mothers affected by modern slavery: A scoping review","authors":"Sara Borrelli , Renuka Ramasamy , Ruth Wong , Helen Spiby","doi":"10.1016/j.ijnsa.2023.100139","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2023.100139","url":null,"abstract":"<div><h3>Background</h3><p>Modern slavery is a largely hidden crime disproportionately affecting women and girls, with 71% of the world's enslaved people being female and approximately one third estimated to be pregnant. Healthcare professionals experience difficulties in caring for mothers affected by modern slavery, including asking appropriate questions and initiating discussions, making safe referrals, being uncertain about entitlements, and facing obstacles in accessing language support and specialist mental health services. Despite the expectation of cohesive and consistent services, which avoid the recounting of experiences that may re-traumatise, interdisciplinary collaborations between maternity services and non-statutory agencies remain unclear.</p></div><div><h3>Objective</h3><p>To map the available evidence and resources on maternity care provision and non-statutory support to pregnant women and mothers affected by modern slavery.</p></div><div><h3>Design</h3><p>A scoping review was conducted following the JBI methodology for scoping reviews.</p></div><div><h3>Methods</h3><p>Five databases (Applied Social Sciences Index & Abstracts, Cumulated Index to Nursing and Allied Health Literature, Dissertations & Thesis A&I, Embase, Scopus) were searched. Inclusion criteria: English language; published between 2012 and May 2022; related to both maternity care provision and modern slavery; cross-sectional perspectives, including survivor mothers, healthcare professionals, midwives, and non-statutory service staff; any methodology. Exclusion criteria: general healthcare or not maternity related; opinion pieces, letters, book reviews, commentaries. Grey literature was searched using relevant websites reporting theses, blogs, policies, guidelines, and resources.</p></div><div><h3>Results</h3><p>Twelve articles reporting 11 studies and 29 grey literature reports were retained for the scoping review. Three key themes were identified from research studies: <strong>a)</strong> women's perspectives on barriers to access and engagement with maternity services; <strong>b)</strong> challenges and needs identified by healthcare professionals; and <strong>c)</strong> the impact of human trafficking on maternal and neonatal outcomes. The grey literature resources comprised mainly blogs, information sheets, leaflets or webpages, and research or consultation reports. Maternity was being experienced by survivor mothers with the following: unfamiliarity with and lack of access to systems and information across all sectors, barriers to care and entitlements, contemporary threats of violence from partners/traffickers, restricted ability to move freely, issues related to traumatisation, dispersal policies, and dealing with multiple new systems.</p></div><div><h3>Conclusions</h3><p>Although several sources indicate principles that should be adopted, the detail of <em>how</em> optimal care and support during maternity should be provided by healthcare prof","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49857229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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