Nursing Open最新文献

Aim: The aim of this study is to develop a clinical decision-making tool to guide utilisation of vein visualisation technologies and enhance chances of successful peripheral intravenous catheter (PIVC) insertion, using data collected from a vascular access team in a large paediatric medical centre in the United States.

Design: Quantitative two-phase, cluster analysis design.

Methods: The study consisted of the following two phases: (1) a quantitative retrospective chart review to evaluate clinician utilisation and preference for vein visualisation technologies and (2) a quantitative prospective design, including a post-discharge retrospective chart review, to confirm utilisation of vein visualisation technologies and factors influencing clinician decision-making.

Results: A total of 16 groups were created based on the cluster analysis and expert clinician input. The results of first-attempt success analyses identified optimal device recommendations for each of the 16 patient groups. For patients older than 2 years old, the NIR device was more likely to result in first-attempt success regardless of BMI or access site and the NIR device was most optimal for almost all categories of paediatric patients regardless of BMI or access site. The transilluminator was found to be the most optimal device to use with younger patients (< 2 years old) who are underweight.

Conclusion: Vein visualisation technology is recommended by professional nursing organisations to improve PIV access. Yet, adoption of this useful technology to aid selection of an optimal vein for insertion and visualisation during insertion is limited. This is the first study to develop a clinical decision-making tool for vein visualisation technology in PIVC insertion.

Implications for the profession and patient care: Vein visualisation technology allows for a rapid, thorough assessment of patients' vasculature to determine an optimal site for PIVC placement beyond what is visible to the naked eye or achievable using traditional methods. The tool was designed to guide healthcare professionals towards successful first attempt PIVC insertions, thereby improving patient outcomes and efficiency of care.

Patient or public contribution: None.

Aim: The research aim was to understand the inpatient experience of women who received postoperative care for mastectomy surgery in an acute surgical ward.

Design: A Qualitative Descriptive Research design was used.

Methods: The lead researcher conducted individual semi-structured interviews with 10 women who received postoperative care following mastectomy surgery in an acute hospital surgical ward. The transcribed interview data was analysed using a thematic analysis.

Results: A mastectomy is a momentous event in any woman's life. In the initial post-operative phase, the physical intrusion of surgery, aesthetics of the ward, and mixed-gender rooms were all found to influence the women's journey towards holistic recovery. Therapeutic care from all in the healthcare team and a ward setting conducive to recovery were identified as favourable influences towards physical and emotional healing.

Conclusion: Recognising that a mastectomy 'is not just physical' may help the breast care team optimise the first 24 h of postoperative care in preparation for the challenges the women may face on discharge.

Implications for the profession and/or patient care: In an acute inpatient setting, a women's physical needs may be prioritised over the psychological and emotional ramifications of a mastectomy. Post-operative inpatient care for breast cancer surgery requires not only professional competency with clinical and technical tasks, but therapeutic nursing and communication skills to support women's psychological needs.

Patient or public contribution: The findings were drawn from 10 women, narrating their inpatient experience for breast cancer surgery. All women had undergone a unilateral or bilateral mastectomy following breast cancer.

Aim: This study examines the moderating role of specific job resources in the association between job demands, vigour, sustainable performance and fatigue in nursing home staff.

Design: A multi-location cross-sectional survey study in line with the STROBE guidelines.

Methods: Online self-completion questionnaires were distributed in the Summer of 2022. A total of 667 healthcare employees from 24 nursing home locations in the Netherlands participated in this study. Data were analysed using hierarchical multiple regression analysis.

Results: Job resources were able to moderate the relation between job demands on the one hand, and vigour, sustainable performance and fatigue on the other. Regression analyses revealed that high cognitive job resources moderated (i.e., strengthened) the positive association between cognitive job demands and successively cognitive liveliness, physical strength and sustainable performance. Furthermore, high emotional job resources moderated (i.e., buffered) the positive relation between emotional job demands and emotional and cognitive fatigue, respectively.

Conclusions: It can be concluded that job resources are crucial for nursing home staff to deal with their high job demands. Maintaining a healthy balance between job demands and sufficient, matching, job resources to promote vigour and sustainable performance, as well as to prevent fatigue of staff, seems to be important.

Implications for the profession: There is an urgent need to train nursing home staff to cope better with increasing job demands. Because job demands cannot be reduced in many situations, this study revealed that the idea of boosting job resources instead is appealing to both staff and managers.

Patient or public contribution: Dutch healthcare staff from 24 nursing home locations were involved in this study by responding to the online survey.

Aim: To evaluate nurses' workload during the coronavirus disease 2019 (COVID-19) pandemic and to identify their perception of medical serviced robots (MSRs) that may help with or replace the tasks of nurses in negative-pressure isolated wards and general wards.

Design: Cross-sectional survey.

Methods: A researcher-made questionnaire was applied that assessed nurses' current workload and their attitudes towards and perceptions of MSRs. A visual analogue scale (VAS) from 1 to 10 was used to assess workload. Perceptions evaluated on a 5-point Likert scale ranging from one point for 'strongly disagree' to five points for 'strongly agree'. A higher VAS score indicated a higher workload. On the other hands, a higher Likert score indicated a more positive perception and three points was neutral. The questionnaire was conducted on 150 nurses in negative-pressure isolated wards for the management of COVID-19 and 150 nurses in general wards. Quota sampling technique was used as sampling technique. Data analysis was performed through independent t-tests, chi-square tests and two-tailed tests. The p-value <0.05 was interpreted to statistically significant.

Results: Two hundred eighty-two participants responded and 142 belonged to the negative-pressure isolated ward. The overall response rate was 94%, and 94.7% in the negative isolated ward. The mean score ± standard deviation for nursing-related psychological stress at the current work site was 7.18 ± 1.58 points, and the mean score for physical workload was 7.65 ± 1.48. The need for MSRs was rated as 3.66 ± 0.86 out of 5. Overall, a positive attitude towards MSRs was confirmed, with no difference between ward groups. The overall ratings were 3.14 ± 1.15 for perceived availability and 3.26 ± 1.13 for perceived efficiency. Both nurse groups perceived that MSRs were most available and efficient for monitoring and measurements. Nurses in negative-pressure isolated wards perceived MSRs more positively than did nurses in general wards regarding setting of alarms (p = 0.003) and delivery of medical devices/materials (p = 0.013). Based on these results, functional development of MSRs associated with monitoring, measurements, setting of alarms and delivery should be prioritized. No patient or public contribution.

Background: Sustainability represents an increasingly vital yet inconsistently implemented topic in nursing education. Formal concept analysis can promote unified conceptualisation to inform sustainability integration in nursing curriculums.

Objective: Analyse the concept of 'nursing education for sustainable development' using the Walker and Avant framework to clarify meaning and application in nursing programmes.

Method: The literature was systematically searched for attributes, antecedents and consequences used to formulate a concept definition, and compared to existing conceptualisations.

Results: Core concept attributes are interconnectedness of human/ecological health, sustainability-focused curriculums, competency cultivation and social justice orientations. Antecedents include recognising ecological determinants of health and committed nursing faculty. Consequences encompass the preparation of sustainability-competent nurses and elevated nursing contributions to sustainable health systems.

Conclusion: The concept analysis provides an original synthesised perspective advancing coherence and applicability to guide sustainability education in nursing programmes through a translational framework for competency, curriculum design and content delivery approaches.

Reporting method: We followed the guidelines outlined in the Walker and Avant framework in the conduct and reporting of this paper.

Patient or public contribution: No patient and public contribution.

Aim: The aim is to delineate the concept of sleep disturbances in health professional students during the COVID-19 pandemic.

Design: A concept analysis was conducted.

Methods: A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used.

Results: A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID-19-related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high-quality care even during crises like the COVID-19 pandemic.

Patient or public contribution: No patient or public contribution.

Aim: To develop and test different machine learning algorithms for predicting nocturnal hypoglycaemia in patients with type 2 diabetes mellitus.

Design: A retrospective study.

Methods: We collected data from dynamic blood glucose monitoring of patients with T2DM admitted to the Department of Endocrinology and Metabolism at a hospital in Shanghai, China, from November 2020 to January 2022. Patients undergone the continuous glucose monitoring (CGM) for ≥ 24 h were included in this study. Logistic regression, random forest and light gradient boosting machine algorithms were employed, and the models were validated and compared using AUC, accuracy, specificity, recall rate, precision, F1 score and the Kolmogorov-Smirnov test.

Results: A total of 4015 continuous glucose-monitoring data points from 440 patients were included, and 28 variables were selected to build the risk prediction model. The 440 patients had an average age of 62.7 years. Approximately 48.2% of the patients were female and 51.8% were male. Nocturnal hypoglycaemia appeared in 573 (14.30%) of 4015 continuous glucose monitoring data. The light gradient boosting machine model demonstrated the highest predictive performances: AUC (0.869), specificity (0.802), accuracy (0.801), precision (0.409), recall rate (0.797), F1 score (0.255) and Kolmogorov (0.603). The selected predictive factors included time below the target glucose range, duration of diabetes, insulin use before bed and dynamic blood glucose monitoring parameters from the previous day.

Patient or public contribution: No Patient or Public Contribution.

Aim: The aim of this study is to explore Iranian nurses' experiences regarding the consequences of bullying.

Design: A qualitative descriptive study is carried out using conventional content analysis and Granheim and Lundman's method.

Methods: Data for this study were collected through 12 in-depth, semi-structured individual interviews with nurses employed at a teaching hospital in REDACTED, western Iran. Purposeful sampling was employed until data saturation was achieved. Data management was conducted using MAXQDA software.

Results: The participants consisted of 12 nurses, with a mean age of 36.1 ± 8.6 years. Their experiences of workplace bullying were analysed and categorised into a main theme called 'Consequences of Workplace Bullying', with two categories identified as 'Organisational Consequences' and 'Individual Consequences'. The organisational consequences were further elaborated through two subcategories: 'work performance consequences' and 'patient care consequences'. The individual consequences category included subcategories including 'psychosomatic consequences', 'psychological consequences' and 'family consequences'.

Conclusion: Workplace bullying among nurses can have negative impacts on patients, nurses and organisations. In order to mitigate these effects, nurse managers can take proactive measures by implementing management strategies and fostering a positive work culture. By addressing the underlying factors and promoting a supportive environment, the adverse consequences of workplace bullying can be reduced or prevented.

Patient or public contribution: Yes.

Aim: The human adenovirus (HAdV) is beginning to spread rapidly in children through human, surface and animal vectors. Around 12,000 cases were recognised in 2022 in West Bengal and a shocking number of cases arose throughout India and in other under-developed areas. This is going to be a big threat to public health since no vaccine, awareness or protocol policies were introduced. Early detection, immediate isolation and proper policy developments are the key factors in overcoming the situation. Therefore, we performed this rapid review and discussed probable mitigation strategies, updated research on vaccine development, and treatment strategies to control the outbreaks of mutated HAdV.

Design: This is a narrative review of publicly available information.

Methods: Here, we extracted updated information and data using the terms HAdV outbreaks, mutations, species, risks and prevention from Google Scholar and PubMed. We considered relevant articles that have discussed prevention strategies, ongoing research, and antiviral drugs for managing HAdV outbreaks.

Results: Early detection from throat swabs, isolation and symptomatic treatments are required to minimise viral infections. A massive test needs to be performed to find the affected people. The cases should be immediately isolated. It is recommended to treat high-touch surfaces with heat- or bleach-containing cleaners to prevent the spread of infection. Oxygen support and many broad-spectrum antivirals have been used to treat HAdV. Several studies showed antibody neutralisation and interactions between the natural killer cell receptor KIR3DS1 and HLA-F in infected cells, indicating possible therapeutic options in the future. HAdV-4 and HAdV-7 vaccines have been limitedly approved for administration to military personnel.

Conclusion: Isolation, certain safety measures, broad-spectrum antiviral drugs and further research on new vaccines could be useful to prevent this virus from producing a worldwide pandemic. Also, the authorities should ensure the proper therapeutic interventions and nursing care facilities for the infected children.

Patient or public contribution: Patient or public contribution was not relevant to our work.