Applied Nursing Research最新文献

Aims

To determine the effect of virtual reality glasses intervention on pain, vital signs, and patient satisfaction of hemodialysis patients undergoing AVF catheter puncture.

Design

Randomized controlled study.

Methods

The study was conducted in 60 patients receiving dialysis treatment in the HD unit of a public hospital in Turkey. The data were collected via the “Patient Identification Form”, “Visual Analog Scale/VAS” and “Hemodynamics Variables Inspection Form”. The patients in the experiment group watched videos through the virtual reality glasses for totally 5 minutes in average, 2 minutes before the AVF cannulation process and 3 minutes during the process. No intervention was applied to the patients in the control group other than the normal nursing interventions in the HD unit.

Results

In the intra-group comparisons, the 2nd and 3rd measurement average pain level scores of the patients with in the experimental group were determined to be statistically significantly lower compared to their 1st measurement (p < 0.05); the 3rd measurement average pain level scores of the control group were determined to be statistically significantly lower compared to their 1st and 2nd measurements (p < 0.05).

Conclusions

It was determined that the virtual reality glasses decreased the pain that emerges during the AVF cannulation process and increased the patient satisfaction level. It is suggested that the virtual reality glasses should be used by the nurses in the HD unit since it is easily applicable in coping with pain in the patients and since it is an invasive method.

Background

Pressure injuries continue to be a significant problem in perioperative patients. Surgical patients are particularly at risk due to lack of mobility and sensation during surgery and the early recovery period. The AORN (2024) recommends that healthcare organizations develop a comprehensive prevention program that includes risk assessment, prevention, and education.

Objectives

To measure the effect of an educational intervention on perioperative nurses' knowledge, attitudes, and behaviors towards pressure injury prevention after one week and again after six months.

Methods

Nurse's knowledge, attitudes, and behaviors were measured at three different time periods using quantitative nonexperimental pretest posttest longitudinal design. Three hundred fifty-four perioperative registered nurses from 11 acute care hospitals participated.

Results

Nurses' knowledge scores were in the moderate range. Statistically significant differences were found between pre-test and posttest 1 scores, indicating that knowledge improved after nurses completed the education intervention and information was retained six months after. Nurses' attitudes were neither positive nor negative towards pressure injury prevention. Regarding behavior, the majority of nurses reported carrying out pressure injury prevention strategies, however only half reported carrying out daily risk assessment strategies.

Conclusions

To prevent pressure injury in perioperative patients, it is imperative that guidelines for the prevention of perioperative pressure injury (AORN, 2024) are integrated into nursing practice.

Background

The global population of older aged 65 and over is increasing, which means an increase in people living with long-term health conditions and multimorbidity. Implementing new digital health technologies enables increased patient empowerment and responsibility, and the ability to respond to changes in their condition themselves, with less involvement of healthcare professionals. Important parameters need to be addressed for this digitally enabled empowerment to be successful, these include increased individual and organizational health literacy, the establishment of joint decision-making activities among patients and healthcare professionals, and efforts that target the individual's ability to manage their condition, which include education to increase skills and providing technology for self-monitoring.

Objective

To identify needed competencies of digital healthcare professionals to be able to provide the needed services to service users with chronic obstructive pulmonary disease in a 24/7 digital healthcare service.

Method

Five registered nurses' work was observed weekly for five months. In total 13 participatory observations were conducted. Data from the observations was transcribed and analysed through inductive content analysis.

Results

Five main categories were identified in the analysis; 1) tasks, 2) communication, 3) the relationships between the registered nurses, 4) service users, and 5) technology. These categories contain different competencies needed for registered nurses working in a digitalized healthcare system.

Conclusions

Future digital healthcare professionals will require several competencies, to be able to deliver proper care in a digital health community that goes beyond traditional healthcare competencies, including social, technological, and communication skills.

Background

While timely activation and collaborative teamwork of Rapid Response Teams (RRTs) are crucial to promote a culture of safety and reduce preventable adverse events, these do not always occur. Understanding nurses' perceptions of and experiences with RRTs is important to inform education and policy that improve nurse performance, RRT effectiveness, and patient outcomes.

Aim

The aim of this study was to explore nurse perceptions of detecting patient deterioration, deciding to initiate RRTs, and experience during and at conclusion of RRTs.

Methods

A qualitative descriptive study using semi-structured focus group interviews was conducted with 24 nurses in a Chicago area hospital. Interviews were audio-recorded, transcribed verbatim, and coded independently by investigators. Thematic analysis identified and organized patterns of meaning across participants. Several strategies supported trustworthiness.

Results

Data revealed five main themes: identification of deterioration, deciding to escalate care, responsiveness of peers/team, communication during rapid responses, and perception of effectiveness.

Conclusions

Findings provide insight into developing a work environment supportive of nurse performance and interprofessional collaboration to improve RRT effectiveness. Nurses described challenges in identification of subtle changes in patient deterioration. Delayed RRT activation was primarily related to negative attitudes of responders and stigma. RRT interventions were often considered a temporary fix leading to subsequent RRTs, especially when patients needing a higher level of care were not transferred. Implications include the need for ongoing RRT monitoring and education on several areas such as patient hand-off, RRT activation, nurse empowerment, interprofessional communication, role delineation, and code status discussions.

Background

While breastfeeding is globally recommended, its duration still represents a public health issue.

Aim

To examine the association between the period of exclusive breastfeeding (EBF) and the duration of overall human milk nutrition, and to identify determinants associated with the duration of EBF and overall human milk nutrition length.

Study design

The presented study is a cross-sectional study. A total of 209 healthy Polish women of Caucasian origin, aged 19–42 years, who were the mother of a child aged 3–12 months, were enrolled in the study. Data were collected from 2018 to 2020 using an anonymous questionnaire. Statistical analyses included one way ANOVA and liner regression.

Results

After birth almost all newborns were exclusively breastfed (96.7 %), but the supply of mother's milk declined as the children's ages increased. The duration of breastfeeding is strongly associated with EBF, especially until the child is six months old (p < 0.001). Mother's breastfeeding self-efficiency and her will for breastfeeding, comfortable latch, younger infant age, avoiding of a pacifier and excluding additional food may explain 36 % of variation of EBF duration (p < 0.001) and could be useful information for exclusive breastfeeding support.

Conclusions

The practice of exclusive breastfeeding strongly affects overall breastfeeding duration. The promotion of exclusive breastfeeding, rather than of overall breast milk supply, is crucial.

Aim

To identify the nurses' perceptions on the occurrence of Medication Administration Errors (MAEs) and barriers to reporting using the MAE Reporting Survey.

Background

MAEs is a serious public health threat that causes patient injury, death, and results to expensive health care.

Methods

Descriptive statistical analysis.

Results

The most frequent reasons for MAEs according to the nurses were physicians' medication orders are not legible (4.67 ± 1.21) and unit staffing levels are inadequate (4.63 ± 1.45). The most frequent reason for unreported MAEs were when med errors occur, nursing administration focuses on the individual rather than looking at the systems as a potential cause of the error (4.95 ± 4.33) and nurses could be blamed if something happens to the patient as a result of the medication error (4.29 ± 1.48). The highest prevalent non-IV related MAEs included wrong time of administration (M = 3.02 ± 2.37) and medication administered after the order to discontinue has been written (M = 2.60 ± 2.11), both with 0–20 % of reported non-IV MAEs. The highest prevalent IV related MAEs included wrong time of administration (M = 2.76 ± 2.29) and medication administered after the order to discontinue has been written (M = 2.45 ± 2.01). More than half (n = 95, % = 54.29) of the respondents stated that 0–20 % of all types of medication errors, including IV and non-IV medication errors are reported.

Conclusions

The findings supported the notion that nurses perceive low percentages of MAEs reporting.

Objectives

The primary goal of this study was to identify and understand the burden experienced by informal caregivers of patients with HF at the time of hospital discharge. The researchers aimed to guide future education interventions and promote informal caregiver burden screening.

Design

The researchers administered the Zarit Burden Interview (ZBI) as a quantitative tool to assess informal caregiver burden. The ZBI is a standardized questionnaire used to measure the extent of burden experienced by informal caregivers. After administering the ZBI, the researchers conducted semi-structured interviews with five informal caregivers of patients with HF. These interviews were guided by probing questions related to ZBI items that were rated with high levels of burden (3 “quite frequently” or 4 “nearly always”).

Results

The quantitative data showed that the informal caregivers' burden scores on the ZBI ranged from 4 to 41. Male informal caregivers tended to report lower burden scores. The non-spouse informal caregiver had the highest burden score at 41. The qualitative analysis of the interviews revealed several themes related to informal caregiver burden, including fear, patient expectations, patient dependence on caregivers, social isolation, and stressors associated with medication changes after discharge. Despite the qualitative insights into specific burden-related issues, the quantitative analysis of the ZBI scores showed that, on average, informal caregivers reported little to no burden at the time of acute exacerbation of HF in the patient.

Conclusion

The study's findings suggest that while informal caregivers may not report prominent levels of overall burden, they do face specific challenges and stressors, such as social isolation and managing medication changes post-discharge. These findings can inform the development of targeted support and interventions for informal caregivers of patients with HF.

Idiopathic pulmonary fibrosis (IPF) is a restrictive chronic lung disease that results in scarring of the tissue due to an unknown cause. Dyspnea is experienced by 90 % of patients and is correlated with reduced quality of life and survival times. Breathing techniques can improve perceived dyspnea, however, are not readily taught outside of inpatient hospital settings and pulmonary rehabilitation programs, the latter being accessed by only 3 % of patients with chronic lung disease. Telehealth may be an option to increase access to this imperative symptom management education to improve symptom management and patient outcomes.

Aims

1) To determine the feasibility of a telehealth breathing intervention for patients living with IPF; 2) To determine the usability of the telehealth system; 3) To describe within-group changes in dyspnea, quality of life, anxiety, and depression.

Design

A single-group, pre-post intervention.

Methods

Study participants were recruited from community-dwelling patients living with IPF. Pre-intervention data was collected on symptoms using standardized questionnaires. Participants enrolled in one telehealth Zoom session per week over the course of four weeks and practiced breathing exercises 10-minutes per day. Following the intervention, participants completed post-intervention, feasibility, and usability questionnaires. Data were analyzed using descriptive statistics.

Results

All feasibility benchmarks were met. Following the intervention, mean symptom scores improved, however were not statistically significant.

Conclusion

These data indicate that a telehealth breathing intervention is a feasible option to increase access to the symptom management strategy of breathing techniques to manage perceived dyspnea to positively influence symptoms experienced by patients living with idiopathic pulmonary fibrosis.

Purpose

The purpose of this study was to describe beliefs and attitudes that underpin vaccine confidence and hesitancy in nurses who chose not to vaccinate for COVID-19. The research question that guided this work was: What are the beliefs and attitudes of nurses who chose to not vaccinate for COVID-19?

Methods

This study followed a focus group methodology to collect qualitative data from focused discussions to gather insights into the beliefs and attitudes of participants. Two focus groups consisting of 3 to 5 participants were conducted virtually.

Results

Using open coding, six themes were generated. Based on descriptors provided by participants, two themes were focused on beliefs, and four were related to attitudes about the vaccine. Findings suggest that participants' beliefs and attitudes were strengthened during this time in the pandemic. This event further divided nurses included in this study from their peers who chose to vaccinate and their employers who mandated inoculation.

Conclusions

Understanding the perceptions of this sample has given insight into the thoughts and feelings of nurses who chose not to vaccinate against COVID-19. This is a perspective that is often absent from scientific literature. Knowledge gained from this study may assist in supporting strategies such as open communication, conflict resolution, and collaboration in an effort to mitigate the divide within the nursing workforce, which may ultimately contribute to nursing retention in clinical settings.

A number of countries now recommend population-wide depression screening for perinatal women, using validated tools. A stepped-approach to screening – involving universal screening with a brief measure, followed by targeted screening using a longer measure for those women identified as at greater risk – is used in some settings. This brief report describes the test performance characteristics of a 3-item mood screening instrument, developed for use within a digital parenting program. Participants (n = 404) in this cross-sectional study were mothers of children aged up to 3 years. The majority (65.5 %) were first-time mothers, and their mean age was 32.8 years. Data were collected using an online survey. The test performance of the brief 3-item mood screening instrument (possible score range = 0–300) was examined using Receiver Operating Characteristic (ROC) analysis, with a score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) used as the reference standard. The mood screening instrument demonstrated excellent range when compared to the reference standard. Optimal balance between sensitivity (0.77) and specificity (0.78), was achieved at a cut-point of 160 or less. Analysis was limited by using only the EPDS as the reference standard. This preliminary data supports the use of this 3-item mood screening instrument to screen for postnatal depression symptoms and may be integrated into a mobile Health or online tool. Future research should examine the test performance of the 3-item mood screening instrument against a diagnostic tool.