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Positive Nursing Practice Environment: A Concept Analysis. 积极的护理实践环境:概念分析。
IF 2.4 Q1 NURSING Pub Date : 2024-10-17 DOI: 10.3390/nursrep14040222
Soraia Pereira, Marlene Ribeiro, Mariana Mendes, Rosilene Ferreira, Eduardo Santos, Cintia Fassarella, Olga Ribeiro

Background/Objectives: In recent years, research has increasingly highlighted the significance of nursing practice environments, linking positive settings with enhanced job satisfaction, professional autonomy, and care quality. Such environments can decrease turnover, stress, and costs while improving patient safety. Despite this extensive literature, there is limited consensus on defining a 'positive nursing practice environment', highlighting the need for a systematic analysis to advance understanding and application. This study aims to explore and clarify the concept of a 'Positive Nursing Practice Environment'. Methods: This study applied Walker and Avant's approach for concept analysis, conducting a comprehensive database search to gather relevant evidence. To review the available evidence on the concept of nursing practice environments, we followed the methodology proposed by JBI for scoping reviews. Results: The inclusion of 166 studies meeting the criteria provided a broad understanding of the topic, revealing 10 key attributes of a 'positive nursing practice environment' and identifying various antecedents and consequences affecting clients, nurses, and institutions. Conclusions: The concept analysis of a 'Positive Nursing Practice Environment' offers valuable insights into nurses' working conditions, systematically identifying characteristics that impact professionals, patients, and institutions. This analysis lays the groundwork for future research and practical improvements in nursing practice environments. This study was not registered.

背景/目标:近年来,越来越多的研究强调了护理实践环境的重要性,将积极的环境与提高工作满意度、专业自主性和护理质量联系起来。这种环境可以减少人员流动、压力和成本,同时提高患者安全。尽管有大量相关文献,但关于 "积极的护理实践环境 "的定义却鲜有共识,这凸显了进行系统分析以促进理解和应用的必要性。本研究旨在探索和澄清 "积极护理实践环境 "的概念。研究方法本研究采用 Walker 和 Avant 的概念分析方法,进行了全面的数据库搜索,以收集相关证据。为了审查有关护理实践环境概念的现有证据,我们遵循了 JBI 提出的范围审查方法。结果:符合标准的 166 项研究为我们提供了对该主题的广泛理解,揭示了 "积极的护理实践环境 "的 10 个关键属性,并确定了影响客户、护士和机构的各种前因后果。结论积极的护理实践环境 "概念分析为护士的工作条件提供了宝贵的见解,系统地识别了影响专业人员、患者和机构的特征。该分析为今后的研究和切实改善护理实践环境奠定了基础。本研究未经注册。
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引用次数: 0
The Management and Prevention of Delirium in Elderly Patients Hospitalised in Intensive Care Units: A Systematic Review. 重症监护病房住院老年患者谵妄的管理与预防:系统回顾
IF 2.4 Q1 NURSING Pub Date : 2024-10-15 DOI: 10.3390/nursrep14040219
Sarai Zaher-Sánchez, Pedro José Satústegui-Dordá, Enrique Ramón-Arbués, Jose Angel Santos-Sánchez, Juan José Aguilón-Leiva, Sofía Pérez-Calahorra, Raúl Juárez-Vela, Teresa Sufrate-Sorzano, Beatriz Angulo-Nalda, María Elena Garrote-Cámara, Iván Santolalla-Arnedo, Emmanuel Echániz-Serrano

Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment.

Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications.

Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews.

Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia.

Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.

背景:谵妄或急性意识模糊状态(ACS)是老年患者在医院经常出现的一种复杂并发症,会影响患者的独立生活能力,增加患者的发病率和死亡率。重症监护室(ICU)中的危重病人经常会出现重症监护室谵妄,导致住院时间和重症监护室停留时间延长、死亡率上升和长期功能损害:本综述旨在评估现有干预措施的证据,这些干预措施可有效管理和预防重症监护室谵妄,降低短期发病率和死亡率、重症监护室和住院时间以及其他长期并发症的发生:为进行本系统性综述,我们检索了 2018 年 1 月至 2024 年 8 月期间的 Medline、PubMed、Cochrane Library、CINHAL、LILACS、SciELO 和 Dialnet(英语、西班牙语和法语)。对 MeSH 描述进行了调整,以搜索不同的数据库。我们还检查了 Prospero 正在进行的系统性综述:电子检索共获得 2656 项研究,其中 14 项试验符合资格标准,共有 14711 名参与者。我们纳入了 8 项随机临床试验 (RCT)、4 项队列分析、1 项系统综述和 1 项观察性试验,其中包括入住重症监护病房的 65 岁以上的参与者。其中 10 项研究以药物干预为基础,3 项研究以非药物干预为基础,其余研究以混合(药物和非药物)干预为基础。其中包括六项安慰剂研究,另外四项报告了不同药物之间的比较。在非药物干预方面,护理计划的重点是优化可改变的风险因素或使用强光等疗法。在混合干预方面,我们发现了有创技术与镇静镇痛的结合:由于右美托咪定的镇静效果令人满意,因此它是一种可行的选择,因为尽管奥氮平的效果更安全,但术后使用血管紧张素抑制剂系统可显著降低谵妄的发生率。至于异丙酚,则没有发现明显的差异。在非药物疗法和混合疗法中,强光疗法能够降低谵妄的发生率,硬膜外/全身麻醉联合疗法对所有亚型谵妄均有效。至于其他干预措施,科学证据仍不足以提供明确的建议。
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引用次数: 0
Perception of University Nursing Students and Faculty Members Regarding Simulated Practices: A Mixed Methods Study. 大学护理专业师生对模拟实习的看法:混合方法研究。
IF 2.4 Q1 NURSING Pub Date : 2024-10-14 DOI: 10.3390/nursrep14040217
Rosalbina Castillo Núñez, Rosa Nury Zambrano Bermeo, Nancy Francisca Bonilla Casierra, Massimo Tusconi, Felice Curcio, Cesar Ivan Aviles Gonzalez

Introduction: Clinical simulation has been used as a teaching strategy for students in health programmes, fostering greater preparedness and confidence in performing procedures.

Objective: This study aimed to analyse the perception of fourth-semester nursing students and teachers regarding the simulated practice methodology implemented in a private university in Cali, Colombia.

Method: A robust mixed-methods approach was used, incorporating quantitative surveys and qualitative interviews with 41 students and 5 teaching nursing faculty members. Data triangulation was applied to ensure the robustness of the results.

Results: Both students and teachers reported a positive perception of simulated practice, which contributes to knowledge acquisition and contextual learning. Students emphasised that simulation improved their prior knowledge and motivated them to explore new topics. Lecturers emphasised the importance of well-trained instructors in simulation environments. However, participants identified challenges affecting performance, including simulation duration, group size, realism, and resource constraints.

Conclusions: Students and teachers recommend strategic changes to the curriculum to optimise simulation practices.

简介临床模拟已被用作健康课程学生的一种教学策略,可增强学生在执行程序时的准备程度和信心:本研究旨在分析哥伦比亚卡利一所私立大学护理专业第四学期学生和教师对模拟实践方法的看法:采用了一种稳健的混合方法,包括定量调查和定性访谈,访谈对象包括 41 名学生和 5 名护理专业教师。结果:学生和教师都表示对该项目有积极的看法:结果:学生和教师都对模拟实践有积极的看法,认为模拟实践有助于知识获取和情境学习。学生们强调,模拟实践提高了他们的原有知识水平,激发了他们探索新课题的兴趣。讲师强调了模拟环境中训练有素的讲师的重要性。不过,学员们也指出了影响模拟成绩的挑战,包括模拟时间、小组规模、逼真度和资源限制:学生和教师建议对课程进行战略性调整,以优化模拟实践。
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引用次数: 0
Experiences of Newly Qualified Nurses' Engagement with Quality Improvement in Practice: A Qualitative Follow-Up Study. 新晋护士在实践中参与质量改进的经验:定性跟踪研究》。
IF 2.4 Q1 NURSING Pub Date : 2024-10-14 DOI: 10.3390/nursrep14040218
Lorraine Armstrong, Ashley Shepherd, Fiona Harris

Background: Nurse education plays an essential role in preparing future nurses to engage with quality improvement (QI) initiatives in their organisations and improve patient care. However, frontline nurses continue to report that a lack of QI knowledge hinders their abilities to engage in improvement work. In the UK, student nurses are now trained in QI within their degree to enable them to contribute to improvements once qualified.

Objectives: This qualitative follow-up study investigated the sustainability of QI engagement in nurses who undertook QI training and a QI project during their degree and explored the factors influencing their engagement in QI once qualified.

Methods: This paper followed the COREQ criteria to report upon 10 semi-structured interviews undertaken with registered nurses and focuses on their experiences of QI engagement post-registration. The data were investigated using an inductive thematic analysis and Nvivo 14.

Findings: Five themes emerged: transition to a newly qualified nurse, QI knowledge decline, influencing factors (hierarchy, leadership, COVID-19 pandemic, data access and location), and skill transferability.

Conclusions: This study showed that qualified nurses can sustain their QI knowledge and remain engaged with QI where they experience positive QI leadership and were exposed to ongoing QI activity in their preceptorship year. However, a lack of QI opportunities and a culture which does not consider QI a responsibility of new nurses is seen to hinder engagement. Educational institutions and practice partners require careful collaboration to assess and develop ongoing QI learning activities that support new nurses to engage in QI.

背景:护士教育在培养未来护士参与所在机构的质量改进(QI)计划和改善患者护理方面发挥着至关重要的作用。然而,一线护士仍然表示,缺乏质量改进知识阻碍了他们参与改进工作的能力。在英国,护士学生现在都要在学位期间接受 QI 培训,以便在获得资格后能够为改进工作做出贡献:这项定性跟踪研究调查了在攻读学位期间接受过质量改进培训和质量改进项目的护士参与质量改进的可持续性,并探讨了影响他们在获得资格后参与质量改进的因素:本文遵循 COREQ 标准,报告了对注册护士进行的 10 次半结构式访谈,重点关注她们注册后参与质量改进的经验。采用归纳式主题分析和 Nvivo 14 对数据进行了研究:出现了五个主题:向新合格护士过渡、QI 知识下降、影响因素(等级制度、领导力、COVID-19 大流行、数据访问和位置)以及技能可转移性:本研究表明,如果合格护士在实习前一年经历了积极的QI领导并接触到持续的QI活动,他们就能保持QI知识并继续参与QI活动。然而,缺乏QI机会以及不将QI视为新护士责任的文化被认为会阻碍参与。教育机构和实践伙伴需要认真合作,评估和开发持续的QI学习活动,以支持新护士参与QI。
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引用次数: 0
"This Is Me" an Awareness-Raising and Anti-Stigma Program for Undergraduate Nursing Students: A Pre-Post Intervention Study. 针对护理专业本科生的 "这就是我 "提高认识和反羞辱计划:前后期干预研究。
IF 2.4 Q1 NURSING Pub Date : 2024-10-12 DOI: 10.3390/nursrep14040216
Olga Valentim, Tânia Correia, Lídia Moutinho, Paulo Seabra, Ana Querido, Carlos Laranjeira

Background: Stigma education for nursing students has focused solely on stigma reduction, with studies showing temporary improvements in attitudes. However, nursing education research should also emphasize the importance of critical reflection and self-reflection to enhance attitudes, beliefs, topic comprehension, and learning satisfaction. This study aimed to evaluate the effectiveness of the "This is me" intervention regarding knowledge, attitudes, and communication skills of senior undergraduate nursing students in responding to mental illness-related stigma.

Methods: This study employed a psychoeducational intervention for reducing mental illness stigma, using a questionnaire survey to assess pre- and post-intervention effects, with 37 eligible nursing students undergoing clinical training in psychiatric services between 16 May and 15 July 2022. Instruments included sociodemographic and health questions, the MICA-4 scale to evaluate students' attitudes toward mental illness, the MAKS to measure mental health knowledge, the Empathy Scale (JSPE-S), the Intergroup Anxiety Scale (SS-12), and the Attribution Questionnaire (AQ-27).

Results: Most students were female (73.0%) and single (70.3%), with a mean age of around 29 years. After implementing the psychoeducational program, there was a statistically significant increase in overall stigma-related knowledge (MAKS: Z = -1.99, p < 0.05), a decrease in intergroup anxiety (IAS: Z = -3.42, p < 0.05), and reductions in the perceptions of patients as dangerous (AQ27-Dangerousness: Z = -2.399, p < 0.05) and fear (AQ27-Fear: Z = -2.415, p < 0.05). Additionally, there was an improvement in empathy, specifically in Perspective Taking (JSPE: Z = -2.555, p < 0.05).

Conclusions: This program may contribute to mental health literacy related to stigma, positively impacting therapeutic relationships and communication with people with mental illness and resulting in more effective care practices.

背景:针对护理专业学生的污名化教育只侧重于减少污名化,研究表明,这种教育能暂时改善学生的态度。然而,护理教育研究还应强调批判性反思和自我反思的重要性,以增强态度、信念、主题理解力和学习满意度。本研究旨在评估 "这就是我 "干预对高年级本科护生应对精神疾病相关污名化的知识、态度和沟通技巧的有效性:本研究采用了一种心理教育干预方法来减少对精神疾病的成见,通过问卷调查来评估干预前后的效果。调查工具包括社会人口学和健康问题、评估学生对精神疾病态度的MICA-4量表、测量精神健康知识的MAKS量表、移情量表(JSPE-S)、群体间焦虑量表(SS-12)和归因问卷(AQ-27):大多数学生为女性(73.0%)和单身(70.3%),平均年龄约为 29 岁。在实施心理教育计划后,与成见相关的总体知识(MAKS:Z =-1.99,P < 0.05)有了统计学意义上的显著增加,群体间焦虑(IAS:Z =-3.42,P < 0.05)有所减少,对病人危险性的认知(AQ27-危险性:Z =-2.399,P < 0.05)和恐惧感(AQ27-恐惧感:Z =-2.415,P < 0.05)有所降低。此外,移情能力也有所提高,特别是在透视能力(JSPE:Z = -2.555,p < 0.05)方面:结论:该项目有助于提高与污名化相关的心理健康素养,对治疗关系和与精神病患者的沟通产生积极影响,并能带来更有效的护理实践。
{"title":"\"This Is Me\" an Awareness-Raising and Anti-Stigma Program for Undergraduate Nursing Students: A Pre-Post Intervention Study.","authors":"Olga Valentim, Tânia Correia, Lídia Moutinho, Paulo Seabra, Ana Querido, Carlos Laranjeira","doi":"10.3390/nursrep14040216","DOIUrl":"https://doi.org/10.3390/nursrep14040216","url":null,"abstract":"<p><strong>Background: </strong>Stigma education for nursing students has focused solely on stigma reduction, with studies showing temporary improvements in attitudes. However, nursing education research should also emphasize the importance of critical reflection and self-reflection to enhance attitudes, beliefs, topic comprehension, and learning satisfaction. This study aimed to evaluate the effectiveness of the \"This is me\" intervention regarding knowledge, attitudes, and communication skills of senior undergraduate nursing students in responding to mental illness-related stigma.</p><p><strong>Methods: </strong>This study employed a psychoeducational intervention for reducing mental illness stigma, using a questionnaire survey to assess pre- and post-intervention effects, with 37 eligible nursing students undergoing clinical training in psychiatric services between 16 May and 15 July 2022. Instruments included sociodemographic and health questions, the MICA-4 scale to evaluate students' attitudes toward mental illness, the MAKS to measure mental health knowledge, the Empathy Scale (JSPE-S), the Intergroup Anxiety Scale (SS-12), and the Attribution Questionnaire (AQ-27).</p><p><strong>Results: </strong>Most students were female (73.0%) and single (70.3%), with a mean age of around 29 years. After implementing the psychoeducational program, there was a statistically significant increase in overall stigma-related knowledge (MAKS: Z = -1.99, <i>p</i> < 0.05), a decrease in intergroup anxiety (IAS: Z = -3.42, <i>p</i> < 0.05), and reductions in the perceptions of patients as dangerous (AQ27-Dangerousness: Z = -2.399, <i>p</i> < 0.05) and fear (AQ27-Fear: Z = -2.415, <i>p</i> < 0.05). Additionally, there was an improvement in empathy, specifically in Perspective Taking (JSPE: Z = -2.555, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>This program may contribute to mental health literacy related to stigma, positively impacting therapeutic relationships and communication with people with mental illness and resulting in more effective care practices.</p>","PeriodicalId":40753,"journal":{"name":"Nursing Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509943","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}
引用次数: 0
Psychometric Testing of an Arabic Version of the Attitude Toward Skin-to-Skin Contact Instrument among Women in Saudi Arabia: A Cross-Cultural Validation Study. 沙特阿拉伯妇女对皮肤接触态度问卷阿拉伯语版本的心理测试:跨文化验证研究
IF 2.4 Q1 NURSING Pub Date : 2024-10-11 DOI: 10.3390/nursrep14040215
Abeer Hawsawi, Ritin Fernandez, Maria Mackay, Ibrahim Alananzeh, Abbas Al Mutair

Background/objectives: The World Health Organization recommends skin-to-skin contact immediately after birth, yet the practice rate remains low in Saudi Arabia, impacting the health and well-being of mother-baby dyads. No previous studies have explored Saudi women's attitudes toward skin-to-skin contact, a critical factor in developing strategies to increase its adoption. This study aimed to develop and evaluate an instrument to assess attitudes toward skin-to-skin contact among women in Saudi Arabia.

Methods: An instrument was developed by modifying the validated "Mother-Newborn Skin-to-Skin Contact Questionnaire". Psychometric testing was conducted to validate the instrument through a cross-cultural survey involving 383 participants recruited from two hospitals in Saudi Arabia using a convenience sampling method. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.885, indicating that the sample size was suitable for performing exploratory factor analysis.

Results: The overall Cronbach's alpha value was 0.85, reflecting adequate internal consistency of the questionnaire. The criteria of the two-factor confirmatory factor analysis were also met. The majority of women (85.6%) demonstrated a positive attitude towards skin-to-skin contact. A positive correlation was observed between higher educational levels and the total attitude score (r = 0.161, p = 0.002).

Conclusions: The developed questionnaire is a reliable tool for measuring attitudes towards skin-to-skin contact among women in Saudi Arabia. The findings highlight the importance of educational interventions to improve the uptake of this practice.

背景/目标:世界卫生组织建议婴儿出生后立即进行皮肤接触,但在沙特阿拉伯,这种做法的比例仍然很低,影响了母婴二人的健康和福祉。以前没有研究探讨过沙特妇女对皮肤接触的态度,而这是制定策略提高皮肤接触采用率的关键因素。本研究旨在开发和评估一种工具,以评估沙特阿拉伯妇女对皮肤接触的态度:方法:通过修改经过验证的 "母亲-新生儿皮肤接触问卷 "开发了一种工具。采用方便抽样法从沙特阿拉伯的两家医院招募了 383 名参与者,通过跨文化调查对该工具进行了心理测试验证。Kaiser-Meyer-Olkin 抽样充分性测量值为 0.885,表明样本量适合进行探索性因素分析:总体 Cronbach's alpha 值为 0.85,反映出问卷具有足够的内部一致性。双因素确认性因素分析的标准也得到了满足。大多数妇女(85.6%)对皮肤接触持积极态度。教育程度较高与态度总分之间呈正相关(r = 0.161,p = 0.002):所编制的问卷是衡量沙特阿拉伯妇女对皮肤接触态度的可靠工具。调查结果表明,教育干预对于提高这种做法的普及率非常重要。
{"title":"Psychometric Testing of an Arabic Version of the Attitude Toward Skin-to-Skin Contact Instrument among Women in Saudi Arabia: A Cross-Cultural Validation Study.","authors":"Abeer Hawsawi, Ritin Fernandez, Maria Mackay, Ibrahim Alananzeh, Abbas Al Mutair","doi":"10.3390/nursrep14040215","DOIUrl":"https://doi.org/10.3390/nursrep14040215","url":null,"abstract":"<p><strong>Background/objectives: </strong>The World Health Organization recommends skin-to-skin contact immediately after birth, yet the practice rate remains low in Saudi Arabia, impacting the health and well-being of mother-baby dyads. No previous studies have explored Saudi women's attitudes toward skin-to-skin contact, a critical factor in developing strategies to increase its adoption. This study aimed to develop and evaluate an instrument to assess attitudes toward skin-to-skin contact among women in Saudi Arabia.</p><p><strong>Methods: </strong>An instrument was developed by modifying the validated \"Mother-Newborn Skin-to-Skin Contact Questionnaire\". Psychometric testing was conducted to validate the instrument through a cross-cultural survey involving 383 participants recruited from two hospitals in Saudi Arabia using a convenience sampling method. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.885, indicating that the sample size was suitable for performing exploratory factor analysis.</p><p><strong>Results: </strong>The overall Cronbach's alpha value was 0.85, reflecting adequate internal consistency of the questionnaire. The criteria of the two-factor confirmatory factor analysis were also met. The majority of women (85.6%) demonstrated a positive attitude towards skin-to-skin contact. A positive correlation was observed between higher educational levels and the total attitude score (r = 0.161, <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>The developed questionnaire is a reliable tool for measuring attitudes towards skin-to-skin contact among women in Saudi Arabia. The findings highlight the importance of educational interventions to improve the uptake of this practice.</p>","PeriodicalId":40753,"journal":{"name":"Nursing Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509965","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}
引用次数: 0
Exploring the Association between Complexity of Care, Medical Complexity, and Length of Stay in the Paediatric Setting Using a Nursing Minimum Data Set: A Study Protocol. 使用护理最低数据集探索儿科护理复杂性、医疗复杂性和住院时间之间的关联:研究协议。
IF 2.4 Q1 NURSING Pub Date : 2024-10-10 DOI: 10.3390/nursrep14040213
Manuele Cesare, Fabio D'Agostino, Antonello Cocchieri

Background/objectives: The complexity of care requires systematic documentation to fully understand its relationship with medical complexity and its impact on patient outcomes. The Nursing Minimum Data Set (NMDS) plays a crucial role by capturing essential nursing data, enabling a detailed analysis of care and its impact on outcomes, such as length of stay (LOS). However, despite its potential, the use of NMDS in paediatric care remains limited. This study aims to explore the association between nursing and medical complexities and LOS in paediatric patients.

Methods: A descriptive, retrospective, monocentric study will be conducted. The data will be collected through a nursing information system (Professional Assessment Instrument (PAIped)) and the hospital discharge register of patients admitted to the paediatric department in 2022 in an Italian university hospital. Conclusions and Expected Results: The use of PAIped will allow for the description of the complexity of care and enable an analysis of its relationship with medical complexity and LOS.

背景/目的:护理的复杂性需要系统的记录,以充分了解其与医疗复杂性的关系及其对患者预后的影响。护理最低数据集(NMDS)通过采集基本护理数据发挥着至关重要的作用,可对护理及其对住院时间(LOS)等结果的影响进行详细分析。然而,尽管 NMDS 具有潜力,但在儿科护理中的应用仍然有限。本研究旨在探讨儿科患者的护理和医疗复杂性与住院时间之间的关系:方法:将进行一项描述性、回顾性、单中心研究。数据将通过护理信息系统(专业评估工具(PAIped))和意大利一所大学医院儿科 2022 年收治病人的出院登记册收集。结论和预期结果:使用 PAIped 可以描述护理的复杂性,并分析其与医疗复杂性和 LOS 的关系。
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引用次数: 0
Balance and Walking Speed Outcomes in Individuals Receiving Inpatient Rehabilitation for Acute Cerebellar Stroke. 接受急性小脑卒中住院康复治疗的患者的平衡能力和行走速度效果。
IF 2.4 Q1 NURSING Pub Date : 2024-10-10 DOI: 10.3390/nursrep14040214
Uzair Hammad, Abigail W Anderson, Emma Scammon, Reid Whiting, Juan Pablo Rodriguez, Rolando T Lazaro, Morris Casano Beato

Background/objectives: Cerebellar strokes account for only 2-3% of all strokes occurring annually in the United States but represent a disproportionally higher share of morbidity and mortality. Evidence examining the effect of inpatient rehabilitation on functional outcomes following a cerebellar stroke is limited. This study aimed to examine the effects of inpatient rehabilitation on balance and walking speed in individuals with cerebellar stroke. A secondary purpose of this study was to examine the length of inpatient rehabilitation stay of the included patients.

Methods: A retrospective analysis was conducted using review of patient records during their inpatient rehabilitation stay from January 2021 to February 2022 at a large hospital system in the southeast United States. Balance and gait outcomes were examined on admission and discharge from inpatient rehabilitation that included physical therapy interventions. A paired t-test examined for changes in outcomes from admission to discharge. Pearson correlation examined for the association between length of stay and outcomes.

Results: A total of 15 records were reviewed. There were significant improvements in the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), and the 10-Meter Walk Test (10MWT) (p's < 0.01) from admission to discharge with large effect sizes (range d = 0.70-1.67) following inpatient rehabilitation. The average length of stay was 12.67 days (SD = 6.5) and the mean total hours of combined occupational, physical, and speech therapy was 27.33 (SD = 6.52) h. There was a moderate association between length of stay and PASS (r = 0.525, p = 0.04) and BBS (r = 0.546, p = 0.04) outcomes.

Conclusions: Patients who underwent inpatient rehabilitation following acute cerebellar strokes demonstrated improvements in balance and gait speed. Study results could assist clinicians designing interventions for patients with cerebellar strokes in the inpatient rehabilitation setting.

背景/目的:在美国每年发生的所有脑卒中中,小脑卒中仅占 2-3%,但其发病率和死亡率却高得不成比例。研究住院康复对小脑卒中后功能预后影响的证据非常有限。本研究旨在探讨住院康复治疗对小脑卒中患者平衡能力和行走速度的影响。本研究的另一个目的是研究纳入患者的住院康复时间:方法:研究人员对美国东南部一家大型医院系统 2021 年 1 月至 2022 年 2 月期间住院康复患者的病历进行了回顾性分析。对住院康复患者入院和出院时的平衡和步态结果进行了研究,其中包括物理治疗干预。配对 t 检验检测了从入院到出院期间的结果变化。皮尔逊相关性检验了住院时间与结果之间的关联:共审查了 15 份记录。住院康复治疗后,从入院到出院,Berg 平衡量表(BBS)、卒中姿势评估量表(PASS)和 10 米步行测试(10MWT)均有明显改善(p's < 0.01),且影响大小较大(范围 d = 0.70-1.67)。住院时间与PASS(r = 0.525,p = 0.04)和BBS(r = 0.546,p = 0.04)结果之间存在中度关联:结论:急性小脑卒中后接受住院康复治疗的患者在平衡能力和步速方面都有所改善。研究结果有助于临床医生在住院康复环境中为小脑卒中患者设计干预措施。
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引用次数: 0
Areas for Improvement and Barriers Identified in Measuring the Quality of Nursing Care: Perceptions of Patients and Professionals. 在衡量护理质量方面发现的有待改进的领域和障碍:病人和专业人员的看法。
IF 2.4 Q1 NURSING Pub Date : 2024-10-09 DOI: 10.3390/nursrep14040211
Maria Consuelo Company-Sancho, Manuel Rich-Ruiz, Marta Guillen Toledano, Luis-Miguel Cairós-Ventura, Josefa D Gil Perez, Ana María de Pascual Y Medina, María Pilar Peláez Alba, Ana Isabel Barreno Estévez, María Emma Alonso Poncelas, Carolina Rodríguez Orihuela, Pedro Ruyman Brito-Brito

Background: Quality indicators in healthcare are essential to raising awareness about the appropriateness of nursing care. However, identifying the key indicators continues to pose a challenge, above all if one wants to include users and professionals.

Aim: Identify which aspects of nursing care should be measured to assess the results of nursing care and how to do so.

Methodology: Interpretive qualitative exploratory study. The participants were users and professionals of an autonomous regional health service in Spain. The information was collected by means of two focus groups and eight semi-structured interviews conducted between November 2022 and March 2024. The data were analysed thematically using the Braun and Clarke process.

Results: The users and professionals agreed on the need to measure emotional skills and attitudes such as empathy, respect, and warmth when dealing with patients. The professionals highlighted workload and inefficiency of the current record system as barriers to adequately reflecting their work. They proposed improvements in the recording tool and the need for more human resources, as well as leadership that is more focused on quality.

Conclusions: It is crucial to develop indicators that reflect both the emotional and technical aspects of nursing care. The participation by patients and professionals alike in this design and selection will make it possible to improve the quality of care and advances in the nursing profession. This study was not registered.

背景:医疗质量指标对于提高人们对护理工作适当性的认识至关重要。然而,确定关键指标仍是一项挑战,尤其是如果要将用户和专业人员包括在内的话。目的:确定应衡量护理的哪些方面,以评估护理结果,以及如何做到这一点:解释性定性探索研究。参与者为西班牙一个自治区医疗服务机构的使用者和专业人员。在 2022 年 11 月至 2024 年 3 月期间,通过两个焦点小组和八次半结构化访谈收集信息。采用布劳恩和克拉克方法对数据进行了专题分析:结果:用户和专业人员一致认为,在与病人打交道时,需要衡量情感技能和态度,如同理心、尊重和热情。专业人员强调,当前记录系统的工作量和低效率阻碍了他们充分反映自己的工作。他们建议改进记录工具,需要更多的人力资源以及更加注重质量的领导层:制定能反映护理工作中情感和技术两方面的指标至关重要。病人和专业人员共同参与设计和选择,将有可能提高护理质量和护理专业的进步。本研究未经注册。
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引用次数: 0
Implementation of Green Lean Six Sigma in Dutch Healthcare: A Qualitative Study of Healthcare Professionals' Experiences. 在荷兰医疗机构实施绿色精益六西格玛:对医疗保健专业人员经验的定性研究。
IF 2.4 Q1 NURSING Pub Date : 2024-10-09 DOI: 10.3390/nursrep14040210
Marieke Sijm-Eeken, Annick Greif, Linda Peute, Monique Jaspers

Introduction: The healthcare sector significantly contributes to environmental degradation, highlighting the need for sustainable practices. Green Lean Six Sigma (GLSS) offers a relevant and impactful approach to reduce healthcare's environmental footprint while improving efficiency. By incorporating environmental considerations into Lean Six Sigma, GLSS has the potential to mitigate healthcare's environmental impact and promote environmental sustainability. This study aims to gain insight into healthcare professionals' experiences with GLSS at their workplace. Materials and Methods: This qualitative exploratory study employed semi-structured surveys based on theory of training evaluation from Kirkpatrick with Dutch healthcare professionals in the first six to eight months after completing GLSS training. Results: Even though 76% (N = 16) of trained healthcare professionals applied GLSS at their workplace and 43% of them (N = 9) completed a project within the first six to eight months after training, they all experienced one or more barriers. The most frequently reported barriers were lack of time, difficulties with project selection and a lack of management support. GLSS project results included reduction of products, energy, costs and travel, green choices in procurement and sustainable food choices. GLSS also helped to create awareness on the environmental impact of healthcare and to optimize processes by reducing costs, waiting time, workload and defects. Discussion: This is the first study to report experiences from applying GLSS in healthcare. Furthermore, it is the first study presenting GLSS training evaluation results in terms of participant behaviour and organizational outcomes. Conclusions: Results of this study can be used to enhance GLSS deployment programs and to optimize organizational settings for successful GLSS implementation in healthcare.

导言:医疗保健行业是造成环境恶化的重要因素,因此需要采取可持续的做法。绿色精益六西格玛(GLSS)提供了一种相关且有影响力的方法,可在提高效率的同时减少医疗保健行业对环境的影响。通过将环境因素纳入精益六西格玛,GLSS 有可能减轻医疗保健对环境的影响,促进环境的可持续发展。本研究旨在深入了解医疗保健专业人员在工作场所使用 GLSS 的经验。材料与方法:这项定性探索性研究根据柯克帕特里克(Kirkpatrick)的培训评估理论,对荷兰医疗保健专业人员在完成 GLSS 培训后的前六到八个月进行了半结构式调查。研究结果尽管 76% (16 人)接受过培训的医疗保健专业人员在其工作场所应用了 GLSS,其中 43% (9 人)在培训后的头六到八个月内完成了一个项目,但他们都遇到了一个或多个障碍。报告最多的障碍是缺乏时间、项目选择困难和缺乏管理支持。GLSS 项目的成果包括减少了产品、能源、成本和差旅,在采购和可持续食品选择方面实现了绿色选择。GLSS 还帮助人们认识到医疗保健对环境的影响,并通过减少成本、等待时间、工作量和缺陷来优化流程。讨论:这是第一份报告在医疗保健领域应用绿色医疗系统经验的研究报告。此外,这也是第一份从参与者行为和组织成果方面介绍 GLSS 培训评估结果的研究报告。结论:本研究的结果可用于加强 GLSS 部署计划,并优化组织设置,以便在医疗保健领域成功实施 GLSS。
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引用次数: 0
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Nursing Reports
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