Open Nursing Journal最新文献

Background: Pressure ulcers increase hospital stays and treatment costs due to their complications. Therefore, recognizing factors that contribute to pressure ulcer risk are important to patient safety.

Objective: To evaluate the association between the scores of the Waterlow, Braden, and Norton scales and clinical and social characteristics in critically ill patients.

Method: A cross-sectional study of 78 patients in an adult intensive care unit of a university hospital in Northeastern Brazil was conducted from July to December 2015. Data included social and clinical information and the risk factors of the Braden, Norton and Waterlow scales. Data were analysed by the descriptive and inferential statistics.

Results: Most of the participants were female, adults and elderly people with brown skin colour, low education levels and insufficient income. Most of them showed a high risk for developing pressure ulcers using the three evaluated scales. Age, smoking status, diabetes and hypertension were associated with scores on the Waterlow, Braden and Norton scales.

Conclusion: Age, use of the tobacco, diabetes and hypertension were associated with the risk of pressure ulcers in ICU patients.

Background: Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses.

Objective: We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department. We investigated relations between capillary refill time and vital signs recorded in triage and blood tests, by analyzing the clinical records. Mortality at 24 hours, 7 days and over 14 days was investigated by calling the patients after discharge.

Method: Observational, single-center study on a sample of consecutive patients aged ≥ 18 years in the Emergency Department of a major Milan hospital, from June to October 2014. Multivariate logistic regression was used to investigate the impact of clinical variables on capillary refill time.

Results: 1001 patients were enrolled, aged 59 ± 21 (473 aged 65 or more). Longer refill times were found in patients admitted to hospital units after medical consultations in the emergency department compared to those discharged or sent to outpatients. In elderly patients, statistically significant association was found between increased capillary refill time and sepsis (sensitivity 100%, specificity 83.33%, area under the receiver operating characteristics curve 65.95% CI 47-83), oxygen saturation, mean blood pressure, and lactates. In persons aged 45 to 64, altered refill times were associated with abnormal values of glicemia, platelets, and urea.

Conclusion: Capillary refill time can be used by nurses at triage as a complementary parameter to normal vital signs. This is one of the few studies investigating refill time in adult patients.

Background: There is a lack of theoretical framework supporting stem cell transplant nurses in their assessment, judgment and caring interventions of sibling stem cell donors.

Objective: The purpose of this study was to explore sibling stem cell donors' main concerns and how they deal with them before and after donation.

Method: Ten healthy sibling donors, 5 men and 5 women, with a median age of 54 years were included in this study when they were due to donate stem cells to a brother or sister. Data were collected prospectively on three occasions (before the donation and three and twelve months after it) through in-depth interviews, which were recorded and transcribed verbatim for analysis by the Grounded Theory method according to Charmaz.

Results: This study describes the efforts of the ten donors to fulfil their duty as a sibling by doing what they considered necessary in order to help. Their efforts were summarised in a process wherein the grounded theory generated three main categories; Prepare, Promote and Preserve. A clear path of transition leading to fulfilment is evident, starting before the donation and continuing for one year afterwards.

Conclusions: Being a sibling stem cell donor means doing what you have to do to fulfil your duty and if possible, saving the life of a seriously ill brother or sister. The relationship between the siblings is strengthened by the donation process. Sibling stem cell donation appears to be about fulfilment and the theoretical framework may support clinicians in their evaluation and support of donors.

Background: The novel influenza A (H1N1) pdm09 (A/H1N1pdm) pandemic of 2009-2010 had a great impact on society.

Objective: We analyzed data from the absentee survey, conducted in elementary schools of Oita City, to evaluate the A/H1N1pdm pandemic and to estimate the basic reproductive number (R₀ ) of this novel strain.

Method: We summarized the overall absentee data and calculated the cumulative infection rate. Then, we classified the data into 3 groups according to school size: small (<300 students), medium (300-600 students), and large (>600 students). Last, we estimated the R₀ value by using the Susceptible-Infected-Recovered (SIR) mathematical model.

Results: Data from 60 schools and 27,403 students were analyzed. The overall cumulative infection rate was 44.4%. There were no significant differences among the grades, but the cumulative infection rate increased as the school size increased, being 37.7%, 44.4%, and 46.6% in the small, medium, and large school groups, respectively. The optimal R₀ value was 1.33, comparable with that previously reported. The data from the absentee survey were reliable, with no missing values. Hence, the R₀ derived from the SIR model closely reflected the observed R₀ . The findings support previous reports that school children are most susceptible to A/H1N1pdm virus infection and suggest that the scale of an outbreak is associated with the size of the school.

Conclusion: Our results provide further information about the A/H1N1pdm pandemic. We propose that an absentee survey should be implemented in the early stages of an epidemic, to prevent a pandemic.

Background: The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs' daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults.

Aim: To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare.

Method: Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients' homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions.

Results: The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice.

Conclusion: To improve the IWSS technology's low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care.

Background: Health care workers (HCWs) represent high risk population for viral hepatitis infection.

Objectives: This study sought to assess the knowledge of HCWs regarding hepatitis B (HBV) and hepatitis C (HCV) infection.

Methods: In a multi-center cross sectional study, all HCWs from eight teaching hospitals were invited to participate in the study and to fill in a self-administered questionnaire.

Results: A total of 1008 eligible HCWs have responded to the study. A high proportion of the study participants (55.4% and 52.9%) had unsatisfactory knowledge about HBV and HCV. Mean knowledge score toward HBV was significantly higher among more educated staff, p <0.001 and vaccinated personnel, P=0.02. Majority of responders answered correctly to transmission questions toward HBV and HCV (90% and 80%, respectively). There was statistically significant difference in only transmission domain score between various hospitals (p<0.05). The highest scores were related to surgical hospital.

Conclusion: Although more than ninety percent of our participants were educated about HBV and HCV, knowledge about nature of disease, prevention, treatment and vaccine availability was unsatisfactory. Continuous training program toward viral infection is a matter of necessity.

Background: Having a family member living in a residential home affects the entire family and can be hard to handle. Family members require encouraging and open communication support from nurses during and after relocation to a residential home. A Family Systems Nursing intervention, "Family Health Conversations" (FamHC) was conducted in order to strengthen the health of families having relatives at residential home for older people.

Objectives: The aims of this study were to evaluate the responses to the Family Health Conversations in families with a member living at a residential home for older people and to integrate the empirical results with a theoretical assumption upon which the intervention was based.

Methods: A mixed methods research design was used. The Swedish Health-Related Quality of Life Survey and the Family Hardiness Index were administered before and 6 months after the intervention. Qualitative data was collected by semi-structured interviews with each family 6 months post-intervention. The sample included 10 families comprising 22 family members.

Result: Main finding was that FamHCs helped family members process their feelings about having a member living at a residential home and made it easier for them to deal with their own situations. FamHCs helped to ease their consciences, improve their emotional well-being, and change their beliefs about their own insufficiency and guilt. Seeing problems from a different perspective facilitated the families' thinking in a new way.

Conclusion: These findings showed that FamHC could be an important type of intervention to improve family functioning and enhance the emotional well-being.

Background: Information and Communication Technology (ICT) opens up new possibilities for introducing innovative teaching and learning methods to deliver education in different educational areas. Use of internet and social media has grown rapidly and is a key way in how nurses and nurse educator students find information. However, the evidence is still lacking how nurse educator students use social media.

Objective: The aim of this study is to describe nurse educator students' use of social media and the ways in which their educational needs are related to social media.

Method: The data were collected using a structured questionnaire that included one open question. Altogether, 49 nurse educator students completed and returned the questionnaire (response rate 96%). The quantitative data were analysed using statistical programme SPPS and content analysis.

Results: While many nurse educator students reported using the tools of social media, others claimed that they do not use social media at all. Facebook was most common (53% use it every day) and YouTube (17%) the second most common form of social media used to support daily living. The participants reported using YouTube (6% use it every day) and Facebook (4%) most often as support in their studies. They reported using Second life as virtual reality form of social media, the least. The most common educational needs of nurse educator students include receiving more in-depth information about how to use social media, as well as more practice in using it.

Conclusion: In the future, the education of the nurse educator students should include even more in-depth information about the forms of social media and about the advantages of using it in teaching. The education should encourage nurse educator students and provide them with more possibilities to train and make use of the benefits of social media as support in their daily lives and studies. There is need for more robust evidence of social media use in nurse educator students education.

Background: Considering that many nursing actions affect other people's health and life, sensitivity to ethics in nursing practice is highly important to ethical leaders as a role model.

Objective: The study aims to explore ethical sensitivity in ethical nursing leaders in Iran.

Method: This was a qualitative study based on the conventional content analysis in 2015. Data were collected using deep and semi-structured interviews with 20 Iranian nurses. The participants were chosen using purposive sampling. Data were analyzed using conventional content analysis. In order to increase the accuracy and integrity of the data, Lincoln and Guba's criteria were considered.

Results: Fourteen sub-categories and five main categories emerged. Main categories consisted of sensitivity to care, sensitivity to errors, sensitivity to communication, sensitivity in decision making and sensitivity to ethical practice.

Conclusion: Ethical sensitivity appears to be a valuable attribute for ethical nurse leaders, having an important effect on various aspects of professional practice and help the development of ethics in nursing practice.