Collegian最新文献

Background

People experiencing homelessness face significant health disparities and higher rates of morbidity and premature mortality, resulting in increased demands on the acute health system. Nurses have a key role in supporting vulnerable populations to access appropriate care.

Aim

To determine if increased service demand might be addressed through expanding nurse-led services and further developing the roles of nurses within the Homeless Health Service.

Methods

A 14-item cross-sectional survey was designed to obtain the views of staff employed by a Homeless Health Service (n = 50) in nursing and non-nursing roles. Quantitative data were analysed using descriptive statistics and nonparametric tests. Qualitative data were analysed thematically.

Findings

Seven of the 20 respondents were from nursing roles, and the remainder were from non-nursing staff including physicians, allied health personnel, and peer workers. Respondents identified service gaps in the Homeless Health Service that nurses could potentially address by optimising the scope of practice in physical and mental health assessments and referral pathways. Most (95%) pledged in-principle support for enhancing the nursing role within the Service. Qualitative themes were falling through the gaps, resourcing and workforce, and collaborating with other care providers. Solutions to improve access to care included outreach clinics, mental health and chronic disease management, advanced nursing roles, crisis teams, and specialised care for older clients.

Discussion

Awareness of service gaps and ways of improving access to care is critical and may facilitate the implementation of other strategies to better meet client needs. However, issues including funding and eligibility for health care are beyond the influence of nursing scope of practice.

Conclusion

Study findings indicate strong support for optimising the scope of nursing roles through improving client access to assessment, treatment, education, support, and referral. More specifically, outreach health support, mental health assessment, and enhanced provision of after-hours care were noted as key areas that could be enhanced through optimisation of nursing scope.

Background

Rural hospitals in low-income countries have limited resources and services. Nurses in these settings are more susceptible to workplace violence (WPV) and deserve significant attention.

Purpose

This study aimed to assess the prevalence of WPV (verbal and physical) against nurses who work in rural hospitals in Jordan.

Method

A descriptive cross-sectional survey on WPV among nurses who worked in rural governmental hospitals (n = 431). A modified version of the questionnaire developed by ILO/International Council of Nurses/World Health Organization/Public Services International Workplace Violence in the Health Sector Country Case Study – Questionnaire was utilised.

Result

Out of 431 nurses who worked in the selected hospitals, 81% faced verbal violence, and one quadrant faced physical violence (25.5%). In the last year, 49.1% and 55.5% of participants experienced physical and verbal violence, respectively. Exposed to physical violence, most frequently were males (14.4%) under 30 years old (14.8%) and married (12.5%). Verbal violence was predominantly experienced by females (45.2%), those under 30 years old (44.5%), and when dealing with both genders (76.8%). Most of the relatives of patients were the perpetrators of both forms of violence. Participants’ gender, age, education level, and the patient’s gender were associated factors with experiencing verbal and physical violence.

Conclusion/Implication for future practice

The greater incidence rate of WPV among nurses in rural hospitals reflects the need to implement effective preventive measures and security protocols and build progressive training and supervision systems for healthcare providers to address conflict management and de-escalation techniques tailored to the specific needs of nurses in rural hospitals. As a result, Jordan’s governments and non-governmental organisations have to devote more time, money, and effort to promoting awareness in rural population cities about the need to combat violence against nurses.

Background

Evidence-based practice (EBP) is widely recognised in healthcare as a means of improving patient outcomes by incorporating patient preferences, clinical experience, and rigorous research. Although it has demonstrated potential in promoting healthcare, increasing patient safety, and reducing costs, there are still challenges in implementing and applying EBP in practice. The aim of this study was to explore the barriers and facilitators identified by nurses concerning the implementation of EBP in the care provided to children and their families.

Methods

Two focus groups were held with a total of 32 nurses from a paediatric unit of a university hospital. The qualitative data were organised using NVivo, and thematic analysis was undertaken following Bardin’s three-phase process.

Findings

Three categories emerged: Facilitators for the Implementation of EBP, Barriers to the Implementation of EBP, and Family and Child-Centred Care in Clinical Practice. The main facilitators are the presence of mentors, institutional recognition, an environment that promotes EBPs, and the interest and motivation of the team. The main barriers highlighted were unassertive intradisciplinary and interdisciplinary communication, time management, tradition, and inexperience in research. Organisations must implement policies that promote environments conducive to EBP.

Conclusion

It is crucial to prioritise ongoing professional development, integrate this practice into nursing education, promote innovative organisational cultures, and embrace the principles of Family-Centred Care. Nurses recognise the importance of mentors as key to implementing this practice.

Aims

To review and assess the literature about the safety and appropriateness of weaning small babies from incubators to open cots weighing less than 1600 g.

Design

A systematic review.

Review methods

The Critical Appraisal Skills Programme tool was used to assess the relevance and quality of the available literature from May 1994 until November 2023.

Data sources

Google Scholar, PubMed, Ovid, Scopus, Cumulative Index of Nursing and Allied Health, and PsycInfo.

Results

A total of 164 articles were retrieved, of which 14 studies met the inclusion criteria and are included in this review. Randomised controlled trials have proven that babies could safely wean from incubators to cots at 1600 g. Retrospective chart review studies have shown that babies can successfully transition from a crib into an open cot at 1500 g or even 1400 g. One retrospective study also identified babies transitioning successfully at 1200 g. Eight studies showed no adverse outcomes for early weaning. Eight studies showed no difference or a shorter length of stay in smaller babies.

Conclusions

With the improving capacity of incubator technology to maintain a stable temperature in babies, it seems evident that using a specific and controlled approach to weaning small babies from an incubator to an open cot can lead to earlier discharge. Small babies can be weaned safely from an incubator to a cot, and those who are weaned more effectively and expediently may have better outcomes, such as better weight gain, reduced length of stay, and earlier discharge home.

Tweetable abstract

Small babies can be weaned successfully from an incubator into a cot at 34 weeks gestation or 1600 g or less without any adverse effects @Vskinner9.

Background

Nursing management encompasses actions such as planning, organising, commanding, coordinating, and controlling, all of which directly impact staff satisfaction and the quality of care provided in healthcare institutions. Therefore, the experience and qualifications of nurse managers are indispensable. Despite nursing management being taught in nursing schools through both theoretical and practical classes, gaps in the field are still evident, and even conceptualising the process can be challenging.

Aim

To describe nurses’ perceptions of nursing management through metaphors.

Methods

This is a descriptive study with a qualitative approach that involved a total of 84 participants (47 staff nurses and 37 nurse managers). Data were collected online in Brazil between February 10, 2024, and March 25, 2024, through Google Forms. The metaphor analysis technique was used.

Findings

Technical, interpersonal, and conceptual skills, as well as basic management functions, were identified through the metaphors of staff nurses and nurse managers. The categories of metaphors for ‘nurse manager’ are as follows: ‘Leadership and guidance’, ‘Coordination and balance’, ‘Adaptation and flexibility’, ‘Support and empathy’, and ‘Vision and vigilance’. The categories of metaphors for ‘nursing management’ are as follows: ‘Obstacles and strategic planning’, ‘Coordination and harmony’, and ‘Balance and control’.

Discussion

Nurse managers should act as role models for the other members of their teams. The lack of certain skills in nurse managers and failures in some functions of nursing management indicate that the selection and education of nurse managers deserve special attention.

Conclusion

Both staff nurses and nurse managers are aware of the important role played by nursing management in the well-being of the team and the quality of care, consequently, in the success of healthcare institutions. Healthcare institutions must be rigorous in choosing their nurse managers. Additionally, educational institutions must pay attention to the theoretical teaching and practical education of nurses to effectively perform nursing management.

Background

The knowledge nursing students acquire during their undergraduate degree influences the quality of patient care they provide for many years to come. However, previous studies indicate that students may have a limited understanding of core patient safety concepts.

Objectives

The objectives of this study were to (i) examine nursing students’ performance in an interactive patient safety e-learning module titled ‘One shift, four patients … a day in the life of a new graduate nurse’; and (ii) explore students’ level of satisfaction with the module using the Satisfaction with the Patient Safety E-Learning Module scale.

Design

A cross-sectional design was used with students’ knowledge and levels of satisfaction examined using descriptive statistics.

Setting and participants

In total, 1038 third-year undergraduate nursing students from 22 Australian universities attempted the module.

Results

The mean correct score was 74%, but there were significant differences in knowledge levels evident across the four activities that comprised the module. Participants achieved the highest mean score in Activity 2 (Predicting, monitoring, and responding to adverse events [79%]) and the lowest in Activity 3 (Clinical reasoning [66%]). The mean score for Activity 1 (Infection control and medication safety) was 74%, and for Activity 4 (Cultural competence), the score was 77%.

The level of student satisfaction with the module was high with responses to each survey item exceeding 4.0 out of 5.0. The Cronbach’s alpha for the satisfaction scale was 0.99, and the Content Validity Index was >0.9.

Conclusions

Universities are responsible for preparing nursing students to become safe clinicians. The results from this study indicate that participants’ overall level of knowledge of key patient safety concepts was adequate. However, as knowledge is the foundation for safe practice, these results suggest that further attention to imbedding patient safety in nursing curricula is required.

Problem

Patients and health systems rely on a skilled and available cancer nursing workforce to deliver quality nursing care to optimise cancer outcomes. Understanding the education, qualifications, and roles of cancer nurses across Australia is an essential aspect of effective service planning.

Aim

To explore the associations between the geographical location of cancer nurses and their education, qualifications, roles, activities, and scope of practice.

Methods

A cross-sectional electronic survey was distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The self-report survey captured demographics, education, qualifications, roles, scope of practice, and salary. Descriptive statistics and bivariate analysis were used to summarise and report the findings.

Findings

Responses were received from 930 nurses. Most identified as female (94%), lived in metropolitan areas (69%), worked in dedicated cancer centres (79%), and in the public sector (69%). While 80% had more than 10 years of nursing experience and 70% possessed postgraduate qualifications, 58% indicated their intention to remain in the profession for 10 years or less. Roles, pay, education, and activities varied across regions, states, and territories, with regional nurses more likely to be involved in multiple activities and roles compared with their metropolitan counterparts.

Conclusion

This study highlights the importance of understanding geographic variations within the cancer nursing workforce to formulate strategies aimed at enhancing workforce sustainability and, consequently, patient outcomes. Addressing disparities in education and opportunities for career advancement is crucial to ensuring equitable access to quality cancer care nationwide.

Background

During natural disasters, priorities are frequently revised, and new strategies are adopted to deal with the enormity and outcome of the disaster. Understanding how resilient healthcare systems adapt and respond under these unexpected conditions is important in learning how to respond more effectively in future events to provide high-quality care.

Aim

We aimed to understand concepts and definitions of resilient healthcare from a systems perspective in the context of natural disasters.

Methods

Using scoping review methodology, as described by Joanna Briggs Institute.

Findings

Of 1011 articles screened, 18 met eligibility criteria and were included in the review. Natural disasters in the included papers were bushfires, floods, earthquakes, hurricanes, and tsunamis, ranging across five geographical locations.

Discussion

We identified broad definitions of resilient healthcare that reflect the varied healthcare systems’ responses to disasters. Definitions of resilient healthcare came from the ecology field, resilient engineering, and resilience in healthcare systems. The adaptive capacity of health systems during a natural disaster response is key to ecological resilience. Moreover, resilient engineering and resilience in healthcare determined the proposed potential of a resilient system by monitoring, anticipating, responding, and learning from disasters. Consequently, healthcare systems are recognised as complex adaptive systems.

Conclusion

This review identified that adapting and adjusting at a systems level is crucial for effective resilience in healthcare and natural disasters. Further research is needed to explore what concepts of resilience healthcare are used from a whole system perspective and how the system’s adaptive capacity supports handling the event before, during, and after the disaster.

Background

Fatigue is commonly reported in shiftworking emergency department nurses. Fatigue can be both acute and chronic, with both types impacting organisational outcomes. However, chronic fatigue is reported to have a greater impact on nurses’ health and wellbeing.

Aim

To understand ways shiftworking emergency department nurses with varying levels of fatigue attempt to overcome and mitigate the effects of fatigue at work and home and essentially recover.

Methods

A mixed method approach utilised nurses’ free-text responses as part of an online survey. Shiftworking emergency department nurses’ responses were compared between those with low chronic fatigue and high chronic fatigue.

Findings

Regardless of fatigue level, shiftworking emergency department nurses reported sleep and rest, exercise and self-care activities at home, and caffeine consumption and work breaks at work to reduce the effects of fatigue. However, at work, only nurses with low chronic fatigue described using more and varied strategies, such as staying active, socialising with colleagues, and making healthy dietary choices, to mitigate fatigue effects.

Discussion

Shiftworking emergency department nurses with varying fatigue levels differ in strategies utilised to reduce the effects of fatigue. The use of diverse and numerous strategies to combat fatigue was associated more with low chronic fatigue than high chronic fatigue. These findings may be of benefit to shiftworking emergency department nurses and nursing managers to assist nurses in recovering from the effects of fatigue at home and through the allocation of rostering and resources to support nurses’ working lives.