British journal of nursing (Mark Allen Publishing)最新文献

Specialist nurses working in Therapeutic Apheresis Services (TAS) at NHS Blood and Transplant participate in an on-call rota. This means working above and beyond their rostered hours and can lead to them working 24 hours in one period. There is a noted risk of fatigue for people who work more than 13 hours in one stretch, and therefore it is important to understand how to recognise and manage the signs of fatigue. A literature review was performed to understand fatigue in various industries and how this was managed. This was then coupled with TAS internal data collection, exit interview data and sickness data to inform the design of a Fatigue Identification Questionnaire filled out by nurses during on-call working. Due to the strong link between fatigue and the hours worked, it is recommended that further work is undertaken to implement fatigue-management processes.

Introduction: Peripheral intravenous cannulation (PIVC) is a common and complex procedure with low first-attempt success rates, causing patient suffering and increased healthcare costs. Quiet Eye (QE) training, a gaze-focused approach, has shown promise in improving procedural PIVC skills. We will examine the effectiveness of traditional technical training (TT) and QE training (QET) on student nurse PIVC performance.

Methods: Forty-four participants will be randomly assigned to either the TT or QET groups using a blocked randomization method to ensure balanced group sizes. Blinded outcome assessments will minimize bias. Data will be collected using a structured questionnaire and a mobile eye tracker to simultaneously record gaze and hand movements. Participants will complete pre-intervention, post-intervention, and one-week retention tests using a light-skinned manikin arm. A transfer task, utilizing a dark-skinned manikin arm, will assess participants' skills post-trials. The TT group will receive traditional instruction on hand movement improvement; the QET group will receive feedback on their gaze behaviours. The primary outcome measure will be PIVC first attempt success defined as being able to flush the inserted catheter with 10 mL (maximum) normal saline into the vessel. A trial will be considered unsuccessful if more than gentle pressure on the syringe plunger is needed to flush the catheter or if the participant abandoned the attempt before attempting the flush. Other dependent variables will be QE duration (%), number of fixations, total movement time(s), and movement phase time(s). We will analyze data with descriptive and inferential statistics, including mixed model ANOVA and Chi-Square tests.

Discussion: This study examines the significance of improving PIVC first attempt success rates and highlights QET potential as an intervention. Emphasis is placed on critical implications for health care, particularly the importance of integrating QET into nursing education programs. Future research utilizing large-scale trials and longitudinal designs is recommended.

Background: Incidence of peripheral venous cannula (PVC) bacteraemia have been rising in a trust in the south-west of England, with a 267% increase noted over the 2022/23 financial year compared with the previous year.

Aim: To use a multimodal approach to reduce the incidence of PVC bacteraemia and improve patient safety.

Methods: The initiative consisted of an educational poster highlighting the severity of infection associated with PVCs alongside key prevention messages rooted in Trust policy. Teaching sessions, complementing the poster, were delivered by the infection prevention and control team to each clinical area.

Findings: The data showed that the provision of further educational resources and wider support resulted in a 54.5% decrease in the incidence of PVC bacteraemia in 2023/24 compared with the previous year. An audit undertaken in the fourth quarter of 2023/24 (January-March) found zero cases of PVC bacteraemia for the first time in 2 years.

Conclusion: Dedication and collaborative working are vital for securing the success of quality improvement projects. PVC-related bacteraemias and the severity of infection remain an under-acknowledged and under-recognised topic within health care, with further research required.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses some recently published reports considering the national patient safety picture and issues around the duty of candour.

Background: Irrespective of where nurses work, they may provide care to individuals with substance use disorders. Unfortunately, some nurses may not understand how to work with these individuals and stigmatisation may occur.

Aim: To explore how to provide effective care for these individuals.

Method: A qualitative descriptive study examining helpful interventions for individuals with substance use disorders through interviewing four substance abuse specialist nurses.

Findings: Findings consider person-centred care, such as how to create a therapeutic relationship with individuals with substance use disorders, empowerment of these individuals and providing hope, and employing a holistic approach.

Conclusion: Nurses may encounter individuals with substance use disorders and may benefit from knowledge of how best to intervene.

The Nursing and Midwifery Council's Standards for Student Supervision and Assessment (SSSA), introduced in 2018, shifted from a mentorship model to a coaching model, creating new roles for practice supervisors, assessors, and academic assessors. This study explores the experiences of nursing students, practice assessors, and supervisors working with the SSSA. Using a qualitative approach, 14 semi-structured interviews were conducted with nursing students and staff. Thematic analysis identified three key themes: SSSA-related training, organisational support, and expectations from students and staff. Findings suggest time constraints, inconsistent training, and use of the electronic practice assessment documentation (e-PAD) platform require attention to improve the learning experience.

Introduction: In response to the SARS-CoV-2 pandemic in March 2020 and required adherence to infection control measures and patient and staff safety, an integrated respiratory team (IRT) developed guideline-based templates to support the team in teleconsultation reviews of their patients. Patients had been diagnosed with sleep disordered breathing, chronic obstructive pulmonary disease, asthma, interstitial lung disease or had oxygen assessment needs.

Methods: Nine IRT members collaboratively developed content for the templates to assist in clinical reviews. In February 2023 semi-structured interviews were conducted and recorded with eight of the IRT members using Microsoft Teams, then thematically analysed.

Results: Qualitative analysis revealed 13 themes. The templates were considered time-saving and advantageous in teleconsultation reviews. They supported evidence-based, structured, and consistent reviews. They were felt to uphold patient safety, supporting knowledge and skills. IRT members reported the templates had no adverse effects on autonomy, patient-professional relationships or person-centred care. They facilitated good multidisciplinary team working and communication. One interviewee reported that the templates supported the Nursing and Midwifery Council Code.

Conclusion: The templates continue to be used across the regional service by the IRT. Their benefit has been realised beyond the pandemic. Refinements will be made as guidelines are updated. The development of these innovative templates may be of interest and value to other respiratory teams.