SAGE Open Nursing最新文献

Introduction: Catheter-associated urinary tract infections (CAUTIs) remain a major healthcare-associated concern despite being largely preventable. They contribute to prolonged hospital stays, increased antimicrobial resistance, and higher healthcare costs.

Objective: This study evaluated the effectiveness of a structured CAUTI prevention bundle combined with a nursing empowerment program in a tertiary care hospital in Makkah, Saudi Arabia. The objective was to update evidence-based practices, improve compliance with urinary catheter insertion and maintenance protocols, and enable nurses to independently discontinue catheters without a documented clinical indication.

Methods: Conducted between October 2023 and May 2024, the prospective single-arm intervention included 247 adult patients requiring indwelling urinary catheters across medical, surgical, and neurosurgical wards. CAUTI rates were measured according to CDC/NHSN (Centers for Disease Control and Prevention/National Healthcare Safety Network) criteria, and bundle compliance was monitored using standardized audits.

Results: The intervention led to a 73% reduction in CAUTI incidence, from 5.4 to 1.41 per 1,000 catheter-days. Nursing compliance improved markedly, rising from 56% to 93%, while catheter utilization remained stable. Additionally, the average catheter days per patient decreased by 41%.

Conclusion: These findings highlight the critical impact of structured protocols and nursing empowerment on reducing infection rates and enhancing clinical efficiency. The results support broader implementation of similar strategies in alignment with Saudi Vision 2030's healthcare improvement goals.

Introduction: Peer learning is an educational strategy used in clinical training for nursing students that has proven to be beneficial for both students and supervisors.

Objective: This study aimed to describe the perceptions and experiences of first-line managers, clinical supervisors, and educators in nursing with peer learning (PL) as a supervision model. It also aimed to describe the implementation process, focusing on key factors and obstacles to successful implementation in healthcare systems facing pressure from registered nurse (RN) shortages.

Method: This qualitative descriptive interview study involved individual and focus group interviews with 20 participants from three groups: first-line managers, clinical supervisors, and educators in nursing. Interviews were analyzed using deductive content analysis, guided by the i-PARIHS framework.

Results: While PL improved supervision quality, adaptability, and recruitment opportunities, it required active engagement from staff and students, and ongoing collaboration with the university. Experienced challenges were students with varying competence levels and inadequate continuity due to the shortage of RNs. Participants found the introductory activities and scheduled meetings valuable but faced challenges related to time allocation and a lack of RNs to act as clinical supervisors.

Conclusion: Despite PL's benefits, the RN shortage hinders its implementation, necessitating the development of flexible models that can be implemented despite the shortage.

Introduction: Permanent ostomy surgery has been shown to improve patient survival rates; however, it also results in changes to body image, bowel habits, and lifestyle. These changes can significantly affect both the physical and mental well-being of patients, ultimately impacting their overall quality of life (QOL).

Objective: This study examines the effectiveness of the Information-Knowledge-Attitude-Practice (IKAP) nursing model in patients with permanent stomas, with a particular focus on its impact on self-efficacy and QOL. The goal is to enhance the self-care abilities of patients and their families, thereby promoting a swift return to normal social activities.

Methods: A retrospective study design was used to select patients who underwent permanent ostomies in the Department of General Surgery at the hospital, between January 2015 and December 2022. Both the IKAP group (IKAP nursing model) and the control group included 94 patients. IKAP group included: (1) establishing an intervention group; (2) developing a public relations strategy and a tailored education program; (3) applying health education; and (4) implementing behavioral intervention. The two groups with various nursing modalities were assessed using the Basic Demographic Data Questionnaire, the Self-Efficacy Scale for Stoma Patients, the Quality-of-Life Scale for Stoma Patients, and data on stoma complications. SPSS software (version 20.0) was used for general description and single-factor analysis of data for comparison between groups.

Results: Three months postoperatively, the IKAP group performed better than the control group in terms of self-efficacy (92.09 $\pm$ 10.12 vs 66.17 $\pm$ 12.83, t = 8.219, P = 0.000). There was significant difference in the ostomy complication rate between the two groups (6 [6.38%] vs 17 [18.09%], c ² = 3.946, P = 0.041). In terms of QOL, the IKAP group scored better in the functional dimension and symptom dimension.

Conclusion: The IKAP model can effectively improve self-efficacy and QOL, reduce complications, and enhance participation in social activities and family life for patients with permanent enterostomy.

[This corrects the article DOI: 10.1177/17483026241256093.].

As artificial intelligence (AI) becomes increasingly integrated into healthcare systems, ethical challenges surrounding patient data confidentiality and informed data sharing have intensified-particularly for nurses, who serve as key custodians of health information. This commentary examines the current state of nurses' knowledge and practices related to data confidentiality in the AI era, highlighting significant gaps in training, awareness, and institutional support. The commentary calls for urgent reforms in nursing education, policy, and global governance frameworks to ensure that technological innovation does not compromise patient trust or ethical standards.

Background: The novel coronavirus disease 2019 (COVID-19) pandemic restricted nursing practicums, which limited students' clinical experience. In many programs, hands-on training was replaced with simulations, potentially affecting new nurses' practical skills and decision-making. Consequently, preceptors guiding inexperienced nurses faced increased instructional burdens and challenges in ensuring safe and competent practice.

Objectives: This study aimed to examine how disruptions to clinical practicums due to the COVID-19 pandemic impacted the role performance of preceptors supporting newly graduated nurses in 2022 over time.

Methods: A longitudinal survey involving 426 preceptors from 39 hospitals in Hyogo Prefecture, Japan, was conducted three times in 2022 (June, September, and December). The main outcome assessed was preceptor role performance, which was measured using the 35-item Preceptor Role Self-Evaluation Scale. Secondary outcomes included participant demographics and perceived difficulties in guiding new nurses under COVID-19-related practicum restrictions, and they were assessed on a 5-point scale. Ethical and institutional approval was obtained, and the surveys were distributed online via QR codes and email. Participation was voluntary and anonymous, with responses linked over time using the participants' email addresses.

Results and conclusion: Seventy-six preceptors (six males and 70 females; 17.8% response rate) completed all three surveys. In June, those reporting higher instructional difficulty demonstrated significantly higher role performance, particularly in planning, evaluation, accident prevention, and cooperation between ward staff and patients. By September and December, their ability to cooperate was significantly better. These findings indicate that preceptors who perceived greater difficulty initially improved their performance, which highlights the heightened instructional demands caused by COVID-19 disruptions to clinical training.

Background: Chronic kidney disease (CKD) is the presence of an abnormality in kidney structure or function that persists for more than three months. The prevalence of CKD among diabetic patients in developing countries has not been well studied. Therefore, this study aimed to determine the prevalence of CKD and related factors among diabetes patients who visited particular Addis Ababa government hospitals.

Methods: An institution-based cross-sectional study was conducted from July 2023 to May 2024 among 304 people with diabetes. Data were collected using a questionnaire through face-to-face interviews. Binary logistic regression analyses were carried out to identify factors associated with CKD.

Results: The study findings showed that 35 (11.5%) had CKD. People living in urban area including cities and towns (AOR = 6.68; 95% CI (1.95-22.91), not engaged physical activity: It encompasses all movement, including exercise, sports, and even everyday activities like walking, cleaning, or working (AOR = 1.95; 95% CI (1.33-11.50)), body mass index (BMI) between 18 and 24.99 kg/m² (AOR = 2.05; 95% CI (1.38-3.05), duration of diabetes after diagnosis (10 to 14 years) and >14 years (AOR = 6.16; 95% CI (1.03-36.89)), as well as not correctly taking prescribed medication (AOR = 7.75; 95% CI(1.31-18.50), patients with co-morbidities (AOR = 3.0 (95%CI (1.0-8.6), and daily consumption of sugar and fat (AOR = 3.0 (95% CI(1.01-6.39)) were found to be significantly associated with these variables.

Conclusion: This study demonstrated that the proportion of CKD in the study participants was relatively high compared to previous studies. Multivariable logistic regression analysis showed that residence, physical activity, body mass index, duration of diabetes after diagnosis, status of taking prescribed medication, patients with co-morbidities, daily consumption of sugar and fat were significantly associated with CKD (p < .05).

Introduction: The commitment of nurses to their profession involves belief in professional values, commitment to its goals, willingness to exert effort, commitment to stay in the profession and handle its challenges. Lack of commitment hinders goal achievement and fosters indifference, leading to poor performance, turnover, and dissatisfaction. However, evidence on professional commitment and its associated factors among nurses in Ethiopia, especially in the study area, is limited.

Objective: The first objective was to determine the level of professional commitment, and the second was to identify its determinants among nurses in East Gojjam Zone, Northwest Ethiopia.

Method: A facility-based cross-sectional study was conducted in 391 nurses using a simple random sample technique from November 1 to November 30, 2024. Data were collected using a self-administered structured questionnaire. After verifying its completeness, the data were entered and cleaned using EpiData version 4.2, and then exported to Statistical Package for Social Science version 27 for statistical analysis. Simple and multivariable linear regression analyses were conducted using a 95% confidence interval (CI) to identify predictors. A p-value < .05 was considered statistically significant.

Results: In this study, a total of 381 individuals returned and completed the questionnaire, yielding a response rate of 97.4%. The mean score of professional commitment of nurses was 33.47 ± 6.10 (95% CI [32.86, 34.08]). Perceived promotional opportunity (β = 0.655; [0.213-1.097]), affective organizational commitment (β = 0.299; [0.208-0.389]), work-life balance (β = 0.125; [0.049-0.201]), and normative organizational commitment (β = 0.359; [0.186-0.532]) were significant predictors of professional commitment.

Conclusion: This study revealed that the level of professional commitment of nurses was medium. Perceived promotional opportunity, affective organizational commitment, work-life balance, and normative organizational commitment were significant predictors of professional commitment. Therefore, providing better promotion opportunities, enhancing normative commitment, and enhancing work-life balance could increase nurses' commitment.

Introduction: Spine musculoskeletal disorders (SMSDs) may interfere with breastfeeding and negatively impact maternal and infant health. Physical activity (PA) is known to reduce the risk of musculoskeletal issues.

Objective: This study aimed to assess the impact of PA levels on the occurrence of SMSDs in Lactating Women in Cameroon.

Methods: This cross-sectional study conducted from September to December 2024 included 399 nursing women in the Foumbot Health District, Cameroon using a consecutive non-probability convenience sampling. PA was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and SMSDs were evaluated using an adapted version of the Nordic Musculoskeletal Questionnaire (NMQ). Data were analyzed using SPSS version 23.0, and multivariate logistic regression was used to identify associations. The level of significance was set at p < 0.05.

Results: The mean (SD) age of participants was 24.3 (5.1) years, and that of their infants was 11.1 (8.5) weeks. The Madonna position was the most common breastfeeding position, used by 388 (97.2%) nursing women. Among participants, 236 (59.1%) reported SMSDs, with the most affected region being the upper back 98 (41.5%). PA levels were high in 149 (37.3%) participants, moderate in 208 (52.1%), and low in 42 (10.5%). No significant association was found between PA and SMSDs. However, working in the informal sector significantly increased the risk of SMSDs (aOR = 2.21, CI: 1.33-3.67, p = 0.002).

Conclusion: SMSDs are highly prevalent in nursing women. Interventions should address occupational risk factors to reduce their impact in similar settings.

Introduction: Post-anesthetic pediatric emergence delirium results in acute confusion and hallucinations during recovery from anesthesia. Early recognition and intervention by peri-operative nurses is crucial, particularly in rural areas where nurses are required to manage a diverse array of medical scenarios. The aim of this review is to enhance awareness among peri-operative nurses of the importance of recognizing and managing post-anesthetic pediatric emergence delirium.

Methods: A narrative review finalized in May 2025 identified literature reporting peri-operative nurses' experiences recognizing and managing post-anesthetic pediatric emergence delirium. This review utilized the databases PubMed, CINAHL, and Scopus, hand searching and reference list checking to identify relevant articles.

Results: Five core themes specific to post-anesthetic pediatric emergence delirium were distilled: identification, risk factors; diagnostic challenges; post-anesthetic screening tools; and nursing interventions. Commonly used anesthetic agents increase the risk of post-anesthetic pediatric delirium for children undergoing surgery. Implementation of validated screening tools to detect symptoms and initiate interventions is recommended. Nurses have a crucial role in the post-operative monitoring of children, identifying early signs of post-anesthetic pediatric emergence delirium and taking timely action to mitigate its impact to ensure optimal health outcomes. Developing, implementing, and evaluating robust educational strategies to develop nurses' competency to recognize and respond effectively to post-anesthetic pediatric emergence delirium are recommended.

Conclusion: While post-anesthetic pediatric emergence delirium is not well understood, it is essential that peri-operative nurses are familiar with this phenomenon and are able to recognize and initiate appropriate interventions. This is particularly important in rural health care environments given the generalist nursing staff profile.