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.
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.
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.
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.
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.
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.
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.
This study aimed to assess the prevalence of WPV (verbal and physical) against nurses who work in rural hospitals in Jordan.
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.
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.
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.
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.
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.
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.
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.
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.
A systematic review.
The Critical Appraisal Skills Programme tool was used to assess the relevance and quality of the available literature from May 1994 until November 2023.
Google Scholar, PubMed, Ovid, Scopus, Cumulative Index of Nursing and Allied Health, and PsycInfo.
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.
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.
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.
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.
To describe nurses’ perceptions of nursing management through metaphors.
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.
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’.
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.
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.
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.
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.
A cross-sectional design was used with students’ knowledge and levels of satisfaction examined using descriptive statistics.
In total, 1038 third-year undergraduate nursing students from 22 Australian universities attempted the module.
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.
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.