International Journal of Nursing Studies Advances最新文献

Background

Through their expertise and diverse skills, Parkinson Nurses are key care providers for people with Parkinson's disease. They are seen as an important profession for person-centered and multidisciplinary care, considered priorities in Parkinson's care delivery. Currently, however, little is known about the priorities that this profession itself defines for the care of Parkinson's patients and how they perceive their own role in the care process.

Objective

To explore the perspective of Parkinson Nurses on care priorities in people with Parkinson's disease.

Design

Qualitative study.

Setting(s)

The iCare-PD study served as the object of study by establishing an interdisciplinary, person-centered and nurse-led care model in several European countries and Canada. The nurses who participated in this model were part of the study.

Participants

Six Parkinson Nurses participated in the study.

Methods

We conducted a thematic focus group, adopting the paradigm of pragmatism to draft an interview guide. The focus group was based on the inspiration card method and followed recommendations for co-creation processes.

Results

Parkinson Nurses define care priorities for Parkinson's in areas of education, multi-professionalism, and need-orientation. They see themselves as mediators and coordinators of care delivery processes.

Conclusions

In line with international recommendations, Parkinson Nurses prioritize key aspects of multidisciplinary and person-centered care. At the same time, however, the nurses also name care priorities that go beyond the international recommendations. It is therefore crucial to integrate the perspective of this important profession into recommendations for the delivery of healthcare for people with Parkinson's.

Tweetable abstract How do specialized nurses define priorities for person-centered Parkinson's care? Answers are sought in this qualitative study by @MarlenaMunster.

Background

Chronic illness diagnosis while living in low resourced communities creates ongoing adversity in the process of adaptation. Resilience is an important phenomenon of study to improve health outcomes. The subject in this particular population has been poorly studied.

Objective

To conceptualize resilience of individuals with chronic illness who reside in low resource communities.

Design

Concept analysis

Data sources

Seminal works and current studies were searched in PubMed (including Medline), Science Direct, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Google Scholar, OVID, Ebsco, and the Cochrane Database. Qualitative and quantitative studies that investigated individual resilience of adults in the setting of chronic illness who reside in low resource communities were included. Exclusions included children with chronic illness and resilience of communities and populations.

Methods

Walker and Avant's method of concept analysis was utilized. The key elements for conceptualizing resilience in the setting of chronic illness who reside in low resource communities included defining attributes, antecedents and consequences of resilience identified from the literature search.

Results

Analysis revealed three defining attributes: (1) reflection, contemplation, and the will to live despite adversity through hope; (2) personal transcendence through action; and (3) continuous personal transcendence and maintenance. Antecedents and consequences of resilience in the setting of chronic illness who reside in low resource communities were described and outlined.

Conclusions

The conceptualization of resilience in the setting of chronic illness who reside in low resource communities is based on the defining attributes, antecedents, and consequences that resulted in a preliminary conceptual model. The model can be further tested in diverse populations to add to the existing knowledge on the subject, and develop interventions to foster resilience aimed to improve health outcomes and quality of life.

Background

The introduction of nursing associates in England in 2017 as a professional ‘bridging’ role aimed to mitigate chronic staffing shortages, enable career progression of healthcare assistants and release registered nurses to provide more complex care. Limited evidence exists about the alignment between the identity and purpose of nursing associate roles described by the UK independent regulator, the Nursing & Midwifery Council, and the expectations, obligations, and team dynamics encountered in practice.

Purpose

Investigate the perceptions of nursing associate roles through the views and experiences of role holders, registered nurses, and healthcare assistants.

Setting

Two British National Health Service (NHS) Hospital Trusts in London, England (UK).

Methods

For this registered service evaluation, data were collected via in-person, semi-structured interviews. Verbatim transcripts were coded inductively. An adapted framework analysis method, suitable for use with Excel, was applied to support the identification of cross cutting themes. We used the Standards for Reporting Qualitative Research checklist for reporting this study.

Results

Eleven registered nurses, five nursing associates, and five healthcare assistants participated. Their experiences seldom reflected the policy vision of the nursing associate role in practice. Several participants likened the nursing associate role to the fable of the ‘Emperor's New Clothes’ in which expectations and reality diverge. With this over-arching theme, four sub-themes were identified: (1) preparedness of organisational infrastructure to support this role; (2) credibility of the role in practice; (3) perceived organisational “blindness” to the ambiguities of the role and (4) increasing task orientation and segmentation in care delivery.

Conclusion

There is a discrepancy between the identity of the nursing associate role as imagined in the policy agenda and its reality in practice. There is a need for more protected and well-defined training, clear role boundaries, and accessible career progression pathways for nursing associates. Moreover, honest dialogue at an organisational and policy level must continue, so that the challenges and opportunities of the nursing associate role are properly realised.

Tweetable abstract

Emperor's new clothes! Experiences and views of new nursing associate roles in NHS (UK) acute hospitals @CarolynSpring3.

Background

An external vendor providing off-the-shelf spinal orthoses to inpatients created significant costs and barriers to quality care for spinal surgery patients. A nursing leadership team initiated a quality improvement project to reduce the cost of providing off-the-shelf spinal orthoses and improve the care provided to spinal patients.

Objective

To develop and evaluate a nursing-led process for providing off-the-shelf orthoses to spinal surgery patients and eliminate high costs.

Design

Quality improvement project evaluated as a retrospective interrupted time-series

Setting

Post Surgery Inpatient Unit Level II Trauma Center in a United States hospital located in Florida

Participants

Vendor Program: 134 patients; Centralized Program: 155 patients

Methods

The nursing leadership team developed a centralized spinal orthoses program where the bedside nurse fitted the patient with a spinal orthosis, eliminating the need for an external orthotist. The study quantifies changes in study metrics by comparing patients identified through chart review who received care in the vendor program to those who received care in the centralized program utilizing nonparametric statistical techniques.

Results

The centralized nursing-led spinal orthosis program allowed the unit to mobilize patients more quickly than patients managed under the vendor program (3.85 hr. [95 % CI: 1.27 to 7.26 hrs] reduction; p = 0.004). The overall length of stay was reduced by 0.78 days ([1.34 – 0.02 days]; p = 0.063) or 18.72 h. While the statistical test did not indicate significance, the 18.72-hour reduction in length of stay represents a potential clinically relevant finding. Evaluating patients that suffered a primary spinal injury and no complications (vendor program: 54 patients; centralized program: 86 patients) showed a similar reduction in time to mobilization (4.5 hr reduction [0.53 to 12.93 hrs]; p = 0.025), but the length of stay reduction increased to 1.02 days [0.12 to 1.97 days], a difference determined to be statistically significant (p = 0.014). Centralizing the process for providing off-the-shelf spinal orthoses reduced the cost of a thoracic-lumbar sacral orthosis by $1,483 and the price of a lumbar-sacral orthosis by $1,327. Throughout the study, the new program reduced the cost of providing spinal orthoses by $175,319.

Conclusions

The results demonstrate that the nursing-led centralized spinal orthosis program positively impacted the quality of care provided to our patients while also reducing the cost of delivering the orthoses.

Tweetable abstract

A nursing-led centralized spinal orthosis program reduces the cost of care while reducing time to mobilization and length of stay.

Background

Orientation programs for new nurses play an essential role in preparing them for challenges in clinical practice. Different countries have applied varying program components and durations in organizing these programs.

Objectives

To explore the program components, impact, and duration of the orientation programs for new graduate nurses in hospital care settings.

Method

We gathered information from studies conducted in various countries. Searches were conducted on databases including PubMed, Sage Journal, ScienceDirect, EBSCO, and Wiley, with secondary searches from 2018 to 2023 using Arkey and O'Malley's Review Scoping Framework. The inclusion criteria comprised studies with primary data, both qualitative and quantitative, focusing on new nurses undergoing orientation programs in hospitals.

Results

Of the 989 articles screened, 14 were included. Methods identified included providing hands-on experience, sharing information, reflecting on work experiences, and developing technical skills. Significant findings encompassed increased competence, knowledge, confidence, and satisfaction, as well as professional development and positive organizational impacts. The duration of orientation programs ranged from 2 weeks to 2 years, depending on the program type and new graduate nurse needs.

Conclusion

This scoping review elucidates program components, impact, and duration of new nurse orientation programs in hospitals, providing valuable insights for hospital management in designing and developing improved programs.

Tweetable abstract

Exploring program components, impact, and duration of hopitals new graduate nurse orientation programs, revealing insights to enhance patient care and nursing practice@Ns_Ernawaty

Background

Some cancer patients not only endure physical and mental distress due to the disease and treatment but also shoulder the responsibility of raising their children. This situation significantly impacts the patients' quality of life. While there is a growing body of qualitative research focusing on parenting concerns among cancer patients, there remains a lack of comprehensive qualitative evidence.

Objective

This study aims to conduct a systematic review and synthesis of qualitative research evidence, investigating the experiences of cancer patients in raising minor children.

Design

Systematic review and synthesis of qualitative studies.

Setting(s)

Through a screening process employing inclusion/exclusion criteria, qualitative studies specifically addressing cancer patients raising minor children were identified.

Participants

Participants: A total of 669 participants from 40 studies were included in the review.

Methods

Four English (Pubmed, Web of Science, Embase and Cochrane Library) and three Chinese (CNKI, Wanfang and Sinomed) databases were searched for qualitative studies of the real-life experiences of raising children in cancer patients from the establishment of the library to January 2024. The methodological quality of the included literature was assessed using the Critical Appraisal Skill Program (CSAP). Qualitative data were extracted, summarized, and meta-synthesized.

Results

A total of 26 studies were included in this meta-synthesis, encompassing 11 different countries. 160 themes were extracted from these included literatures, which were combined into ten categories, ultimately forming four themes: the impact of parents' disease on their children, the challenges of parenting, coping strategies, and multifaceted parenting needs. Based on the Confidence in the Output of Qualitative research synthesis (ConQual) approach, the confidence level of the synthesized findings ranged from moderate to low.

Conclusions

Cancer patients experience significant psychological stress while raising children, which can lead to a reduction in their quality of life and influence treatment decisions. These findings elucidate the parenting concerns experienced by cancer patients, allowing medical staff to understand their emotions and treatment preferences. Additionally, healthcare professionals should pay attention to the special needs of this group and develop targeted interventions to support and reduce patients' psychological stress and burden.

Background

Incidents affecting patient safety can cause unnecessary injury to a patient. It is generally accepted that incident reporting can improve patient safety. In Ethiopian public hospitals, especially in the Hadiya zone, patient safety-related incidents are commonly witnessed, but there is no evidence of reporting behavior among healthcare professionals.

Purpose

This study aimed to assess patient safety incident reporting behavior and its associated factors among healthcare professionals working in public hospitals in the Hadiya zone, South Nation's, Nationalities, and Peoples’ Region, Ethiopia, in 2021.

Method

A cross-sectional study design was employed, among 345 healthcare professionals working in public hospitals in the Hadiya zone from August 1–30, 2021. A simple random sampling technique was used to select study participants, and a structured self-administered questionnaire which is adapted from a Hospital survey on patient safety survey and literature was used to collect the data. The data were entered into a data attraction template prepared using the Epi data software and then exported to the SPSS version 25 software for analysis. Descriptive analyses were conducted to determine the general characteristics and distributions of the data collected. An inferential statistical analysis was conducted using the logistic regression model to identify associations between outcome and predictor variables. The odds ratio with the 95 % confidence interval was used to test the associations between the outcome variable and predictor variables. Finally, statistical significance was set at p-value < 0.05.

Results

From the total of 354 healthcare professionals expected, 334 participants, which gave a response rate of 94.4 %, had completed and returned the questionnaire. The result shows that overall patient safety incident reporting behavior among healthcare professionals was 28.7 % (95 % Confidence Interval (CI): (24.6, 33.2). Being a nurse professional [Adjusted Odd Ratio (AOR): 5.48, 95 % CI: (1.67, 17.80)], having job training [AOR: 2.87, 95 % CI: (1.46, 6.28)], having a team within the units [AOR=2.79, 95 %CI: (1.23, 6.28)], communication openness [AOR=2.78, 95 %CI: (1.44, 5.37)], and management support [AOR=2.8, 95 %CI; (1.40, 5.60)] were found to factor significantly associated with patient safety incident reporting behaviour.

Conclusion

This study revealed that the incident-reporting behavior among healthcare professionals was low compared to previous studies. Being a nurse professional, having an on -job training, having a team within the unit, communication openness, perception of the time reporting takes, fear of administration sanction and management support were factors associated with their patient safety incident reporting behavior. Managers should focus on patient safety incidents, prepare continuous training progr