Journal of Research in Nursing最新文献

Background: The Nursing Interventions Classification (NIC) is a comprehensive, researched-based classification of 614 interventions whose responses can be influenced by a complex range of physiological, psychological, social and cultural conditions which present a challenge to establishing a specific level of evidence when findings are from studies using varied research contexts and methods.

Aims: To develop criteria for establishing evidence levels for interventions included in the NIC according to research designs commonly used in nursing.

Methods: A Design Science Research (DSR) approach was developed in four stages: (a) problem awareness, (b) solution suggestion, (c) artefact development, and (d) conclusion with presentation of the solution.

Results: Six criteria were established to determine the quality information produced by each paper: level of analysis, study design, temporality, unit of analysis, information capture strategy, and comparison strategy. An evidence level classification for the NIC based on the accumulation of qualified information identified for an intervention was established in relation to the four levels, each with four sublevels.

Conclusions: This study develops criteria and a classification system to assess evidence levels for the NIC, enhancing knowledge on the reliability and effectiveness of interventions in clinical practice and patient care.

Background: Patients receiving parenteral nutrition (PN) are often thought to be at higher risk of catheter-related blood stream infections (CRBSIs) than patients receiving other infusions. Nursing practice in the administration of PN has focused on traditional aseptic/sterile techniques using sterile gloves because of this perceived risk.

Aims: To identify the evidence base for current aseptic practice in the administration of PN and association with incidence of CRBSI.

Methods: A systematic review was conducted. MEDLINE, EMBASE, CINAHL Plus, and Cochrane Library databases were searched for studies reporting aseptic technique used/taught in administration of PN.

Results: Thirty-nine papers were identified. After title, abstract, and full text screening six studies were included. All studies were low-quality evidence, observational or quasi-experimental designs; no relevant controlled trials were identified. Evidence did not support the use of any one aseptic technique when administering PN. A structured approach to education and standardisation appeared to improve technique and reduce CRBSI. Use of sterile gloves versus non-sterile gloves did not appear to impact on CRBSI.

Conclusions: There is no evidence to support the use of aseptic/sterile technique over other techniques in nurse administration of PN. However, there is a need for higher quality research in this area.

Background: Moral distress occurs when individuals are unable to act according to their ethical values and beliefs due to constraints. It is a prevalent issue in healthcare settings, particularly among nurses. Critical care nurses (CCNs) confront challenges such as high rates of patient mortality, intense stressors, and end-of-life discussions and decisions, which make them more prone to experience moral distress.

Aim: To synthesise the existing literature pertaining to the consequences of moral distress among CCNs.

Methods: An integrative review of empirical literature was performed across three online databases: PubMed, CINAHL and PsycINFO using search terms related to nurses, critical care, moral distress, and ethical dilemmas. A total of 366 papers were retrieved. After applying the eligibility criteria and assessing the quality of the included studies using the Johns Hopkins Nursing Evidence-Based Practice tool, nine papers were included in this review and synthesised using content analysis.

Results: Reviewing the included papers revealed three main themes of moral distress consequences: impacts on nurses' well-being and job satisfaction, impact on patient care, and impact on turnover intention and burnout rate.

Conclusions: All studies reported negative consequences of moral distress among CCNs, highlighting the need for further research and organisational efforts to support nurse well-being.

Background: Promoting health self-management is an essential component of nursing care for maintaining quality of life in individuals with cardiovascular conditions.

Aims: This systematic review aimed to identify aetiological factors associated with ineffective health self-management (IHSM) in adults with cardiovascular conditions.

Method: Systematic review of aetiological factors. Databases: Medline, Web of Science, CINAHL, Scopus, and LILACS in July 2024. Combined key terms: adult, health risk behaviours, self-management, and cardiovascular diseases (CVDs). Inclusion criteria: adults with cardiovascular conditions and aetiological factors for IHSM. Exclusion criteria: acute disease exacerbations, intensive, palliative, or immediate post-surgical settings. All included studies were critically appraised for bias using the relevant assessment tools. Data were synthesised according to the theory of causation and validation of nursing diagnoses, and a meta-analysis was performed.

Results: Forty-five studies were included, predominantly cross-sectional studies, clinical trials, and cohort studies. The most common cardiovascular conditions addressed were systemic arterial hypertension and congestive heart failure. Thirty-five potential factors associated with IHSM were identified and categorised in factors: predisposing, disabling, precipitating, and reinforcing.

Conclusions: The identified factors provide insights for nursing practice when caring for patients with cardiovascular conditions and contribute to scientific knowledge by highlighting patient self-management needs.

Implications for nursing practice: This review identifies novel aetiological factors that should be integrated into nursing care plans for patients with CVD. It also validates and expands upon related factors within the NANDA-I taxonomy. Critically, our findings underscore the value of using theory to clarify the origins of a nursing diagnosis, enabling nurses to identify more precisely the root causes of ineffective health self-management.

Background: The transition from student nurse to newly registered professional can be challenging, sometimes leading newly qualified nurses to reconsider their career choice. Workforce shortages and the experience and aftermath of the COVID-19 pandemic may have exacerbated the pressures on recent cohorts.

Aim: To gain understanding of experiences of transition into professional practice in an English NHS Trust during the COVID-19 pandemic.

Methods: The objectives of this study were met using a qualitative, exploratory, intrinsic case study design. A convenience sample of 16 newly qualified nurses were recruited. Transcripts were analysed as individual interviews then subjected to across group analysis. Data analysis was conducted independently by the research team members. Data were subjected to qualitative content analysis.

Results: The findings describe the nurses' experiences of transition to professional practice during the pandemic, there were two main themes: the transition experience and growing into the role.

Conclusions: The study offers insights into experiences of transition in the context of the COVID-19 pandemic. The study demonstrates that workplace culture has a significant impact on transition experiences. Emotionally safe, supportive environments are a prerequisite for an effective transition, allowing development of the confidence and skills necessary for independent practice and a successful career.

Background: Peripheral arterial disease (PAD) affects between 3% and 10% of the global population. Transitional care programmes (TCPs) aim to ensure continuity between hospital-based acute care and primary healthcare. Nurses play a pivotal role in supporting this transition. TCPs may reduce hospital readmissions, emergency department (ED) attendances and improve patients' quality of life (QoL). This scoping review examines whether nurse-led TCP improves the management of patients undergoing lower limb vascular surgery, including the effectiveness of remote (telehealth) delivery.

Methods: This review followed the Joanna Briggs Institute (JBI) methodology. Eligible studies included adults hospitalised with peripheral vascular disease who had undergone major surgery. A comprehensive search of PubMed, CINAHL, Web of Science, Scopus, JBI Evidence Synthesis and grey literature via Google Scholar was conducted for studies published between 1 January 2000 and 30 June 2024.

Results: Of 888 papers screened, 6 met the inclusion criteria. Nurse-led TCPs were associated with reduced hospital readmissions and improved patient reported QoL. No significant differences were observed in unplanned surgery, major amputation, or mortality.

Conclusion: TCPs are associated with improved patient QoL outcomes and reduces hospital readmissions when incorporating education, telenursing, and a multiprofessional approach - led by a transition nurse.

Background: Patient satisfaction is vital in healthcare, influencing treatment adherence, health outcomes, occurrence of complications, and the likelihood of returning for care.

Aims: This study aimed to assess the impact of the nursing workforce's nationality diversity, years of service, and staffing levels on patient satisfaction in a tertiary hospital, in Saudi Arabia.

Methods: A retrospective analysis was conducted, correlating patient satisfaction scores from Press Ganey^® reports with nursing data from hospital manpower reports collected from 1 July 2019 to 30 June 2023. Descriptive statistics were used, with significance set at p ⩽ 0.05.

Results: Pearson's correlation coefficient yielded no relationship between: the nurses' years of service versus mean patient satisfaction scores (r = -0.02, p = 0.695), nursing staff levels versus mean patient satisfaction scores (r = 0.04, p = 0.49; Figure 2) and number of nationalities in the care units versus mean patient satisfaction scores (r = -0.057, p = 0.27).

Conclusions: These findings suggest that factors beyond nurse numbers, tenure, or nationality diversity might significantly influence patient satisfaction. Improving other aspects of care and addressing diverse patient needs can allow nursing to further enhance patient satisfaction, health outcomes, and the quality of nursing services provided.

Background: Pre-pandemic studies highlight burnout among early career nurses, with environmental and interpersonal factors contributing to high turnover rates. The Dr Lorna Breen Health Care Provider Protection Act, enacted in the United States (U.S.) in 2022, catalysed the formation of this investigatory team, which used a socio-ecological approach to address nurse burnout and mental health in Nebraska, United States.

Aims: This study evaluated the effectiveness of a webinar series designed to address key drivers of nurse burnout through evidence-based content. The series focused on equipping participants with knowledge and practical strategies to promote systems-level change and improve workforce well-being.

Methods: A mixed methods survey design was employed to analyse changes in knowledge, subjective competence, intention to implement skills, perceived barriers, and impact on team performance.

Results: Attendees who completed the webinar evaluations (N = 277 unique respondents) reported enhancements in knowledge and subjective competence post-webinar(s). Thematic content analysis of qualitative responses identified themes related to problem-solving, awareness, advocacy, and education. Barriers included organisational structure, financial constraints, and resistance to change.

Conclusions: The webinar series showed promise as a scalable, systems-level intervention for nurse well-being, highlighting the need to address organisational and cultural factors beyond individual behaviour change.

Background: Missed nursing care is a significant factor influencing patient safety and the overall quality of care, with direct implications for health outcomes.

Objective: The aim of this study is to conduct an exploratory analysis to examine complex perceptions of missed nursing care through metaphorical expressions of nursing professionals.

Methods: Utilising a phenomenological methodology, and one to one interviews, this investigation applies metaphor analysis to capture the nuanced understanding of missed care among clinicians. The study was conducted with a sample of 79 nurses employed at a public hospital. The research adheres to the COREQ checklist for qualitative studies.

Results: The analysis yielded 39 distinct metaphors, which were categorised into 6 thematic areas: neglected nature, dysfunction, deviation from health, emotional deprivation, dangers, and risks and disappointment. These thematic categories reveal the multifaceted nature of missed nursing care as perceived by nurses and underscore the detrimental effects it has on patient outcomes.

Conclusion: The findings of this study provide valuable insights into the underlying dynamics of missed nursing care, and offer potential pathways for improving nursing practices and enhancing the quality of patient care.