BMC Nursing最新文献

Background: Nursing is a caring profession for which compassion is a core value. Increasing stress and declining job satisfaction are among the major challenges in nursing. Demographic and work-related factors may influence nurses' compassion satisfaction and compassion fatigue (i.e., burnout and secondary traumatic stress) levels. In this study, the level of compassion fatigue and compassion satisfaction and their associated factors were examined among nurses in a tertiary hospital.

Methods: A cross-sectional study was conducted at a tertiary hospital in Malaysia. The data were collected over a period of 6 months via online distribution of the Personal Information Form, Copenhagen Psychosocial Questionnaire (COPSOQ) version III and Professional Quality of Life (ProQOL) version V questionnaires. The Cronbach's alpha internal consistency of the questionnaire scales was mostly acceptable and above 0.75. Descriptive statistics were used to summarize the sociodemographic and rank domains of work environment-related factors for nurses and their levels of compassion satisfaction and compassion fatigue. Relationships between sociodemographic factors and the levels of compassion fatigue, compassion satisfaction, and burnout were assessed by bivariate analyses. A p value < 0.05 was considered to indicate statistical significance.

Results: A total of 323 registered nurses participated in this study. A majority of the participants were female (91%, n = 294), and the mean age of the participants was 33.01 ± 8.50 years. The majority of the participants had moderate levels of compassion satisfaction (71%, n = 229); 46% (n = 148) had moderate levels of burnout, and 45% (n = 147) had moderate levels of secondary traumatic stress. Hierarchical multiple regression analysis revealed that the health and well-being and demands at work domain were significantly associated with compassion satisfaction, burnout and secondary traumatic stress levels among nurses.

Conclusions: In this study, the majority of the nurses reported decreased compassion satisfaction and increased burnout. These findings provide valuable insights, as there may be detrimental effects on the healthcare industry and retention of nurses if no action is taken to combat compassion fatigue. Recommendations to motivate nurses and reduce demands at work should be explored by healthcare organizations to increase nurses' performance and job satisfaction.

Background: Development of effective guideline for delirium management is still seeking nowadays. As nurses are in the first confrontation line for delirium, their prospective in identifying barriers are essential in developing integrated strategies and clinical guidelines.

Objective: To explore the barriers focusing on intensive care unit (ICU) nurses' point of views to provide an evidence-based support for effective nurse-led delirium management in ICU settings.

Methods: Whittemore and Knafl framework was recruited to build up this integrative review. PRISMA guidelines were followed to search about barriers of nurse-led delirium management. Articles published up to June 2024 in five databases; Web of Science, Scopus, PubMed, CINAHL and EMBASE using related keywords were involved. Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of articles included in this review and then reported nurse-led delirium barriers were mapped according to COM-B model.

Results: Twenty-three articles out of 1,020 research articles were included in this review after carefully checked according to the exclusion and inclusion criteria. based on MMAT, 7 articles achieved 100%, 11 articles were achieved 80%, and 5 articles achieved 60%. Nurses' knowledge deficit is the most common psychological capability barriers of nurse-led delirium management, while complexity of delirium screening tools was found to be a physical capability barriers. High workload, lack of staff, lack of time, lack of documentation and lack/ shortage of guidelines were barriers mapped to physical opportunity, while communication barriers in particular patient's intubation and sedation were mapped to social opportunity barriers. Motivation was represented by addressing delirium as a major problem, self-confidence, psychological support and considering nurse's views.

Conclusions: Nurse's knowledge deficit, complexity of delirium screening tools, high workload, lack of time, lack of documentation, lack/ shortage of guideline, and impaired communication were barriers of nurse led delirium management. This study is promising in ease of application in clinical practice since delirium barriers in ICU settings were well-presented in a COM-B framework that may facilitate therapeutic strategies and related decision making.

Background: Teamwork is a core competence for all health care professionals and quality of care is a vital outcome. The pandemic backdrop of 2020-2022 led to initial chaos and adaptation of the nurses' roles and responsibilities in the intensive care unit. Therefore, the purpose was to describe the intensive care nurses' experiences of working in teams during the Covid-19 pandemic and discussing the results through the lens of transitiontheory.

Methods: Individual and semi-structured interviews were conducted with 16 intensive care nurses. The interview transcripts were analysed using Braun & Clarke's six-step inductive thematic analysis.

Results: The intensive and critical care nurses' experiences during the first 18 months of the Covid-19 pandemic captured chronological and conceptual commonalities, which were represented in three themes, "Losing the security of the ICU team", "Having time to adapt and finding structure for collaborative work", and "Gaining professional growth through adapting collaborative work to contextual challenges".

Conclusion: Losing the security of the intensive care unit team, having to adapt to constant changes, and the need to provide care to an increased number of critically ill patients led to a sense of being left to manage on their own. The intensive care unit nurses missed the interprofessional collaboration that had previously been a core part of their professional role. The adaptability and willingness to find solutions helped nurses regain control, manage the challenges they faced and find new ways to collaborate.

Clinical trial number: Not applicable.

Background: Errors not only affect patients as the primary victim but also have a negative impact on nurses as the secondary victim; therefore, understanding the reasons for the second victim's error, as well as the elements that contribute to this phenomenon, is critical for managing the mistake. The main purpose of this research was to determine the status of second victims of error and related factors in nurses.

Methods: This is an analytical-descriptive study conducted in Iran. The study's statistical population comprised all nurses working in the five teaching hospitals of Ardabil city. A random sampling method was used. The data collection tool included a demographic characteristics questionnaire, a questionnaire on previous nursing error experience characteristics, and the Second Victim Experience and Support Tool. The collected data was analyzed in SPSS-16 software.

Results: The results obtained from this research showed that the average score of second victims of error among nurses participating in the study was 85.89 (10/17). Based on the results obtained, there was a significant relationship between the number of second victims of error phenomena with age (p < 0.01 and r = -0.179) and work experience (p < 0.01 and r = -0.156), the number of cases of errors in 12 previous months, having an error that resulted in injury in the last 12 months, the history of going to court, the way nursing errors were reported, and the way managers dealt with nurses' errors (p < 0.05).

Conclusions: The nurses under study had an average level of the phenomenon of second victims of error, and a set of individual and organizational factors were influential in the development of this phenomenon. The second victim of error phenomenon was more prevalent among novice nurses, who tended to make more mistakes in a reprimanding work environment. Therefore, it is recommended that hospitals use a justice-oriented policy instead of a reprimand policy against nursing errors.

Background: A higher level of nursing professionalism improves autonomy among nurses, the quality of nursing care, and patient outcomes. However, inconsistent findings on the prevalence of nursing professionalism and associated factors have been reported among studies conducted in Ethiopia, and a meta-analysis of pooled results have not been performed. Therefore, the aim of this systematic review and meta-analysis was to determine the pooled prevalence of higher levels of nursing professionalism and factors associated with it.

Methods: PubMed, Science Direct, HINARI, African Journals Online, Google Scholar, and university online institutional repositories in Ethiopia were accessed from 15/10/2024-30/10/2024. The items were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed via the Newcastle-Ottawa Scale. Cross-sectional studies were included without time period limits. Data extraction was conducted via Microsoft Excel and analyzed with STATA 17. The Galbraith plot, I² statistic and meta-regression were used to determine heterogeneity. We used a random effects model in the presence of heterogeneity. Publication bias was assessed via funnel plots and Egger's based regression. We also computed a sensitivity analysis and subgroup analysis by sample size and study period.

Results: Twelve primary studies involving 3710 nurses were included in this systematic review and meta-analysis. The pooled prevalence of higher levels of nursing professionalism was 43%. Bachelor's degree and above educational status (POR: 1.80, CI: 1.38, 2.33), learning from government colleges (POR: 2.14, CI: 1.34, 3.42), better payment (POR: 1.85, CI: 1.16, 2.98), long years of work experience (POR: 2.15, CI: 1.73, 2.68), positive self-image (POR: 3.85, CI: 2.17, 6.84), job satisfaction (POR: 2.42, CI: 1.49, 3.95) and training opportunities (POR: 2.88, CI: 1.14, 7.32) were factors that determined higher levels of nursing professionalism in Ethiopia.

Conclusion: The pooled prevalence of higher levels of nursing professionalism in Ethiopia was low. Educational status, and attending college, payment, work experience, self-image, job satisfaction, and training were factors that determined the level of professionalism. These factors can be modified to increase the level of nursing professionalism in Ethiopia.

Objective: To explore differences in patient reported outcomes, health care resources and expenditures in persons with multiple sclerosis (pwMS) with or without access to an MS-nurse.

Methodology: An observational, multicenter and cross-sectional study was conducted. Seven centers with, and twelve centers without an MS-nurse participated. The multiple sclerosis impact scale-29 (MSIS-29) was the primary outcome measure. Secondary outcome measures included: hospital anxiety and depression scale, coping measures, health-economic and disease-knowledge parameters.

Results: Three hundred thirty-four pwMS were included, of which 196 had access to an MS-nurse. Mean age was 44.5 ± 11.4 and 69% were women. The median expanded disability status scale and patient determined disease steps were respectively 2.0 (IQR 2.5) and 2.5 (IQR 3). No statistical significant differences between centers with or without an MS-nurse were observed for the MSIS-29 (total) (mean ranks: 169.9 vs. 157.8; Z = -1.114; p = .253), depression (X²= 1,772, p = .412), anxiety (X²= 0.446, p = .800) or health expenditures. MS-disease knowledge was higher in patients followed in centers with an MS-nurse than in centers without (17.08(3.37) vs. 15.30(3.39), t(331) = 4.734, p < .001).

Conclusion: We did not observe clinical differences regarding HRQoL in pwMS between centers with and without an MS-nurse. Yet, we did observe a higher level of MS-specific knowledge in pwMS who had access to an MS-nurse, which may emphasize the important role of MS-nurses in educating and improving self-efficacy and adherence. Belgian registration number B300201421282.

Background: Patient safety incidents are recognized as significant contributors to patient mortality, thus demanding immediate attention and strategic interventions in healthcare systems. The room-of-error education program serves as a solution, as it provides a case-based learning platform allowing nursing students to identify and resolve medical errors within a controlled environment systematically. This study aimed to identify the context, mechanisms, and outcomes of room-of-error training programs.

Methods: This study adopted a systematic review methodology aligning with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Comprehensive searches were conducted across key databases, including OvidMEDLINE, Embase, Cochrane, and CINAHL, by utilizing specific terms related to healthcare providers, nursing students, room-of-error education, medical errors, simulation training, and virtual intervention. Included studies focused on healthcare providers or students, error recognition, RFE-related training, and randomized or quasi-experimental trials, while exclusion criteria were non-English/Korean studies, non-original articles, abstracts, and qualitative studies. Risk of bias in the selected studies was assessed using the Risk Of Bias In Non-randomized Studies version 2.0 tool.

Results: The search strategy yielded 2,447 articles, with eight studies meeting the inclusion criteria. Predominantly quasi-experimental in design, these eight studies primarily focused on nurses as the target population. Simulations were found to be widely integrated into room-of-error programs, emphasizing skill performance and critical thinking. Half of the studies provided preparation time, 37.5% included feedback, and 62.5% covered medication errors, with 87.5% using offline delivery, 62.5% offering individual education, and program durations ranging from 4 to 35 min, with 25% having no time limit for error inspection. Diverse content, including topics such as medication errors and infection control, was found to be delivered through offline or virtual formats and group-based or individual education.

Conclusions: The findings provide valuable insights into the characteristics and outcomes of room-of-error training programs for healthcare professionals and students. This study emphasizes the significance of practical, case-based approaches in nursing education to augment knowledge, confidence, and competencies, thereby enhancing patient safety in clinical practice.

Background: Students must be prepared for the transference of medication administration (pharmacology knowledge and clinical skills) to clinical practice. The Preparedness for Medication Oral Administration questionnaire has been used in several studies and demonstrated strong internal reliability and consistency. The questionnaire has been revised to align with updated medication competencies. The factor structure or dimensionality of the questionnaires has not been examined.

Aim: To examine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire.

Method: Data from a previous study were used to determine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire. Three new items were added to the revised questionnaire, and the focus shifted from the oral route of medication administration. An exploratory factor analysis was conducted to assess the reliability and dimensionality of the revised questionnaire, using principal axis factoring and Oblique rotation on the 20 items.

Results: Two hundred fourteen final-year undergraduate nursing students completed the questionnaire; the Kaiser-Meyer-Olkin measure confirmed sampling adequacy (.96) and Bartlett's test of sphericity χ²(214) 3003.534 p < .001 adequate sample size-to-variable ratio and inspection of the correlation matrix for loadings > 0.30. The 20 items produced a 2-factor solution, which was also confirmed by parallel analysis, with the deletion of 4 items not meeting item loadings of > 0.4. The final revised version of the questionnaire titled the Preparedness for Medication Administration Revision2 (PMAR2) contained 16 items loading onto one of the 2 factors titled Clinical Reasoning and Confidence to Practice Safely. Cronbach alpha coefficients for the factors were .89 to .95, respectively.

Conclusion: This research provides information for a psychometrically sound tool to assess students' preparedness for medication administration once they graduate and become independent practitioners.

Background: Given the increasing trend of disasters, terrorist attacks, pandemics and other crises, crisis leadership is crucial for nurses who lead others and for those working in such situations. There is a need to define and explore the concept of trust as a component of crisis leadership in nursing. This concept analysis aimed to explore the concept of trust in crisis leadership from a nursing perspective.

Methods: A hybrid concept analysis was conducted. The method consisted of three phases: (I) a theoretical phase relying on a structured literature search, including 11 scientific publications; (II) a field-work phase, in which qualitative thematic analysis of interviews with 30 nurses who had been deployed and/or had led others during crises, was conducted and (III) a final analytic phase, where the results from these data collections were merged.

Results: The analysis suggested that the fundamentals of trust included a perceived intention to do good, the capabilities of both the leader and the team and the perceived predictability of the leader's behaviour. Trust was found to be built on a perceived forward-looking direction, self-trust and the personal attributes of the leader, such as ethical conduct, the ability to predict the development of crises and an intention to take responsibility and be honest. The social attributes of the relationship between the leader and the team included the intention not to leave anyone behind, loyalty and fostering a sense of belonging among team members. The organisational attributes included a clear organisational structure and clarity of mandate.

Conclusions: Trust is an essential component of crisis leadership that depends on a leader's perceived intention to do good, predictability of the leader's behaviour and the capabilities of both the leader and the team. The development of trust relies on the personal attributes of the leader, the social relationship between the leader and the team and organisational attributes. Nurses appointed to lead others during a crisis need to understand the fundamentals of trust as part of leadership in highly demanding situations. Thus, it can be argued that being a leader in a crisis situation requires distinct personal and professional attributes and skills compared to those used to meet routine demands.