Nursing Reports最新文献

Background/Objectives: To address long-standing staffing challenges and elevating care standards in the United States, new legislation will require a minimum of 0.55 h per resident day (HPRD) of registered nurse (RN) care, 2.45 HPRD of certified nursing aide (CNA) care, and a combined total of 3.48 HPRD across any combination of nursing staff. We examine differences in family members' views of care quality between facilities meeting the minimum staffing requirements and those that do not and whether there is any difference in those associations by facility ownership. Methods: This cross-sectional study utilized public data from 218 Medicare and Medicaid-certified nursing facilities in Maryland, collected in 2023. We used regression analyses to examine the association between staffing requirements and quality of care ratings, considering facility ownership status as a potential moderator. Results: Compared to facilities with CNA staffing levels below the cut off, facilities that met the CNA staffing requirement were rated more favorably by family members in overall quality and across the subdomains of staffing, care, activities, and security. In contrast, meeting the RN 0.55 cut off was not associated with family ratings across any quality domain. A facility for-profit status did not moderate the relationship between staffing and family ratings. Conclusions: These results suggest that CNA staff time is a significant driver of care quality and that non-profit facilities may already be closer to meeting new federal requirements. These findings highlight the need for regulations that support the minimum nursing staffing requirements to enhance care quality. Future research should identify the specific factors contributing to higher quality care in non-profit facilities and explore ways to implement these practices in for-profit settings.

Background: Training on the use of ultrasounds (US) is offered to nurses after their degree in specialization courses or in a work setting. When considering the positive impact of US on patient quality of care, this training should be offered to undergraduate nursing students. The aim of this quality improvement project was to assess the quality of nursing curricula by evaluating the effects of an ultrasound technology educational program (USTep) on nursing students' knowledge, self-confidence, satisfaction and perceived usefulness of the training for the acquisition of US skills. Methods: 118 nursing students completed a 3-h USTep, that combined a theoretical introduction with simulation training. Data were collected before and after the USTep, using a survey with closed and open-ended questions. Results: After the educational program, a net increase was seen in knowledge about US (pre-test 48.1% vs. post-test 93.4%, p < 0.00001) and in student self-confidence (pre-test m = 1.7 ± 0.9 vs. post-test m = 3.9 ± 0.8, p < 0.001). According to the participants, this training benefited the students (during their training and for future employment opportunities), the patients, and the profession. Lastly, 97% of the sample expressed satisfaction with the training experience. Conclusions: This quality improvement project shows that a 3-h USTep improved undergraduate nursing students' knowledge, self-confidence, and satisfaction.

Background: Most of the communication training programs developed over the past two decades were monodisciplinary, relied on traditional teaching methods, and targeted the hospital context. Objectives: The aim of this study is to assess the impact of a short, interdisciplinary, experiential-based communication program (Teach-to-Communicate program) targeted at nursing home (NH) personnel with regard to short-term, staff-related outcomes. Methods: This study is part of a larger quality improvement project based on a pre-post single-arm intervention design. We focused on a 6 h residential program involving 30 participants with different scopes of practice working in an NH. Traditional and experiential learning methods were used, including lectures, small group discussions, brainstorming sessions, videos on successful and failed communication, role play, and storytelling based on real cases. The primary outcome was the acquired knowledge of communication strategies and protocols (pre- and post-test quiz). Secondary outcomes were self-reported knowledge, preparedness, confidence, and satisfaction with training (5-point Likert questions). Results: A statistically significant improvement in acquired knowledge with a large size effect (0.7, p < 0.001) was observed. Self-reported preparedness and confidence ameliorated for all measured communication skills and topics, with the highest effect size registered for self-reported preparedness and confidence in engaging in difficult communication (both 0.7, p < 0.001). Participants were highly satisfied with the training, and particularly with the use of video cases (mean 4.6, SD 0.6) and the relevance to clinical practice (mean 4.7, SD 0.5). Conclusions: The Teach-to-Communicate program holds promise for improving knowledge and self-confidence regarding difficult communication among NH staff, and highlights the utility of video cases in communication skills training.

Background/Objectives: The use of simulated learning as a teaching approach has been used and embedded in nursing theoretical curriculum for many years. There is a wealth of evidence to support the positive impact simulated learning or simulated-based education can have on the student experience, developing skill competency and enhancing patient outcomes. However, the evidence on the use of simulation as a replacement for clinical practice learning in undergraduate nursing education is limited. In response to the challenges posed by the COVID-19 pandemic, the authors introduced virtual simulated practice learning experiences (SPLE) for a cohort of year one pre-registration adult and mental health nursing students. The SPLE project aimed to assess the effectiveness of simulated practice learning as a viable alternative to traditional clinical practice learning and to explore student satisfaction with the new practice learning experience approach. Methods: All year one student nurses attending the four simulated practice learning experience (SPLE) weeks were invited to participate and complete a generated questionnaire within the virtual practice environment on their final day of each SPLE week. The questionnaire employed a mix of both quantitative and qualitative questions across key areas to evaluate the effectiveness of the SPLE and explore student satisfaction with their overall practice learning experience. Results: A total of 216 students participated in the simulated practice learning weeks across the spring semester in 2023 with a response rate of 98-100% across all four SPLE weeks. Students reported an overall satisfaction score of 88%, highlighting their preparedness and positive feedback on the organisation, delivery, and content of the SPLE. Qualitative analysis revealed key themes, including the development of transferable skills and personal growth, the value of peer learning, the benefits of a virtual environment, and appreciation of service user and healthcare professional input. Students reported significant personal growth, improved communication skills, and a deeper understanding of holistic care through interactive and collaborative learning experiences. Conclusions: This evaluation underscores the innovative potential of simulated practice learning to enhance nursing practice education, emphasising the importance of integrating emerging technologies and diverse pedagogical approaches. The findings suggest that SPLEs can effectively prepare nursing students for the complexities of clinical practice while addressing the evolving demands of healthcare. Future research should focus on longitudinal studies to assess the sustained impact of simulated learning on clinical experiences and professional development.

Retrospective studies have suggested that performing perioperative abdominal wall exercises may decrease the incidence of parastomal hernias. Objectives: This study seeks to assess the usefulness of supervised preoperative and postoperative abdominal wall exercises in the prevention of parastomal hernia. Methods: An observational study of patients who underwent a stoma, temporary or permanent, between January 2019 and December 2020, was performed. Minimum follow-up was 12 months. During the first 12 months of recruitment, patients were enrolled on a consecutive basis and assigned to the control group, and the remaining patients were assigned to the intervention group. A propensity score matching was performed to obtain totally comparable groups. A set of exercises was designed by the Rehabilitation Department, and their performance was supervised by physiotherapists and stoma therapists. The diagnosis of parastomal hernia was made by physical examination and computed axial tomography. Descriptive statistics of the study group were performed. Subsequently, prediction models for the occurrence of parastomal hernia were created based on binary logistic regression and classification trees. Results: After propensity matching and inclusion criteria, 64 patients were included (colostomy: n = 39, ileostomy: n = 25). Independent prognostic variables for parastomal hernias in colostomy were age (p = 0.044) and perioperative exercises (p = 0.003). The binary logistic regression model based on these variables gave an AUC of 97.6. The classification tree model included only perioperative exercises with an AUC of 92.5%. In the case of ileostomy, perioperative exercises were the only independent prognostic variable identified. The classification-tree-based model reported an AUC of 84%. Conclusions: The performance of supervised abdominal wall training and strengthening exercises may be useful in the prevention of parastomal hernias.

Background: Effective communication in healthcare is essential for ensuring teamwork that is continuous, effective, and efficient. It plays a crucial role in supporting comprehensive and holistic care for patients while also guaranteeing the safety and satisfaction of the services provided.

Objective: To determine the relationship between effective communication (as well as its dimensions: transmission of institutional culture, source of employee motivation, and facilitation of teamwork and conflict resolution) and teamwork among nurses in a national hospital in Peru.

Methods: The research employed a quantitative, correlational, cross-sectional approach with a non-experimental design. The study population consisted of 328 nurses working in various hospital departments between January and October 2024. Data were collected using two questionnaires: The first assessed effective communication through three dimensions: transmission of institutional culture, source of employee motivation, and facilitation of teamwork and conflict resolution. The second instrument evaluated teamwork across three dimensions: institutional context, composition, and process.

Results: A very strong positive correlation was observed between effective communication and teamwork among nurses, with a coefficient of 0.925 and a p value < 0.01.

Conclusions: The study found a strong link between effective communication and teamwork among nurses. It underscores the role of communication, organizational culture, and motivation in strengthening teamwork, which enhances patient care and healthcare delivery. The findings highlight the impact of institutional culture, motivation, and conflict resolution, emphasizing soft skills and ethical behavior in improving team dynamics and organizational strategies.

Background: The prevalence of chronic health problems in childhood, such as food and respiratory allergies, as well as endocrine and skin disorders, has increased globally. Parents and children experience difficulties in managing their illness that reduce their quality of life and increase the presence of negative feelings such as fear or anxiety during school hours. Objectives: The aim of this study was to describe and understand the parents' experiences of the management of children with chronic health problems during school hours. Methods: A qualitative descriptive study design was used. Semi-structured interviews were conducted with 17 parents (1 male and 16 female) who have children with a chronic health problem between September 2022 and June 2023. The data were analyzed with the help of a qualitative data analysis software. The COREQ checklist was used to develop the study. Results: Two categories and four subcategories emerged from the data analysis: (1) Parents' Perceptions, with the subcategories 1.1., The School Nurse, and 1.2., Educational Environment; and (2) Chronic Pediatric Health Problems, with the subcategories 2.1., Emotional Impact, and 2.2., Lack of Resources. Conclusions: Children with chronic health problems are unprotected during school hours due to the absence of a school nurse. Parents and teachers have to cope with their care without the necessary knowledge, which makes it difficult to manage children with chronic health problems in the school environment.

Background/Objectives: The global nursing shortage encompasses issues such as the uneven nurse distribution in low- and middle-income countries, nurse outflow to other countries, and nurse retirement in developed countries, necessitating effective retention strategies. Our objective was to clarify the changes in facility selection reasons among Japanese nurses after changing jobs and the personal attributes influencing facility selection. Methods: In January 2023, an online survey was conducted among licensed practical nurses, registered nurses, midwives, and public health nurses in Japan. The survey items included personal attributes (age and sex), information on ≤five employment facilities, and facility selection reasons. The variations in facility selection reasons by facility number were analyzed using a generalized linear model with a binomial distribution. A logistic regression analysis was conducted with personal attributes and reasons for workplace selection as the independent and dependent variables, respectively. Results: In total, 721 participants were included; 90.8% selected hospitals as their first place of employment. As nurses changed jobs, they increasingly selected non-hospital facilities, including nursing homes, nursery schools, and government agencies. With multiple job changes, the facility selection reasons included "good location for commuting", "good salary", and "convenient working style". Among personal attributes, "age", "sex", "age at employment at the facility", "educational background", "number of children", and "living alone" influenced workplace choice reasons. Conclusions: Considering the study results, country-specific demographic trends, medical policy changes, and nursing-shortage-related causes, medical facility managers and policymakers should devise appropriate employment conditions and develop recruitment strategies, especially for situations with severe nursing shortages. Nurses can learn from the career choices of others to manage their own careers.

Background/Objectives: The nursing profession is expected to undergo substantial transformations in the coming years due to rapidly evolving sociocultural, environmental, and technological changes. Defining and assessing nursing competencies are essential to ensuring high-quality care and fostering professional development. This systematic review aims to explore the future nursing competencies required and the sociocultural factors influencing their evolution. Methods: A comprehensive systematic search was conducted in several indexed databases PubMed, CINAHL, Scopus, and Web of Science databases using keywords such as "nursing competencies", "future", "healthcare systems", and "demographic change". Studies published within the last five years were included, and a rigorous quality assessment was performed. Results: The findings suggest that key sociocultural and technological factors-including environmental sustainability, technological advancements, innovation, globalization, urbanization, policy uncertainty, and demographic shifts-will significantly shape the development of nursing competencies. It is projected that nearly 70% of the nursing workforce will operate in highly unpredictable environments. The review highlights the need to develop interpersonal, higher-order cognitive, and system-level competencies, alongside complementary skills in personal and customer services, decision making, technology utilization, creativity, and scientific methodologies. Conclusions: Addressing the future challenges in nursing requires a holistic and strategic approach, including a cultural shift within the profession supported by targeted policies and sustained investment in education and continuous professional development. Training systems should prioritize the development of core competencies and promote lifelong learning to ensure adaptability in an evolving healthcare landscape.

Background: Sleep quality is crucial for patient recovery and well-being, yet hospitalized patients often suffer from poor sleep due to environmental disruptions, clinical routines, and psychosocial stressors. While these challenges are well-documented, qualitative insights into nurses' perspectives-essential frontline providers shaping the sleep environment-are scarce, especially within rapidly evolving healthcare systems like Saudi Arabia's. This study explores nurses' perceptions of factors influencing patient sleep quality in a private hospital in Al Ahsa, Saudi Arabia, and identifies strategies for improvement.

Methods: We conducted a qualitative, cross-sectional study using semi-structured interviews with 14 registered nurses from diverse nationalities, specialties (Obstetrics/Gynecology, Medical-Surgical, Pediatrics, Intensive Care, Orthopedics, Bariatrics), and experience levels. Interviews were conducted in Arabic or English, audio-recorded, transcribed, and thematically analyzed using ATLAS.ti software. Roy's Adaptation Model guided the examination of environmental, patient-specific, and systemic factors affecting sleep.

Findings: Four primary themes emerged: (1). Environmental Factors: noise from alarms, equipment, family presence, and late-night activities, along with abrupt lighting changes, consistently disrupted sleep. (2). Patient-Specific Factors: pain, emotional distress, cultural expectations, and family involvement influenced sleep experiences. (3). Systemic and Contextual Factors: language barriers, infrastructural disparities between private and governmental hospitals, and limited resources can impeded effective sleep-promoting strategies. (4). Role of Health Technology: nurses recognized the potential of innovations like smart lighting and wearable monitors to enhance sleep quality but faced challenges in implementation due to knowledge gaps and limited familiarity. Roy's Adaptation Model highlighted how effective adaptation through physiological and cognitive-emotional pathways, as observed by nurses, was facilitated or hindered by these factors.

Conclusions: Enhancing in-hospital sleep quality requires a holistic, culturally sensitive approach that integrates environmental modifications, patient-centered care, and systemic improvements. Strategic investments in staff communication training, infrastructural upgrades, language support services, and the adoption of health technologies can promote adaptive responses and optimize patient rest. By leveraging theory-driven insights and context-specific strategies, healthcare systems-particularly those undergoing rapid development-can better support nurses in fostering restorative sleep environments as a fundamental component of patient-centered care, thereby enhancing patient recovery, satisfaction, and overall well-being.