Contemporary Nurse最新文献

Background: The highly complex and technological environment of critical care manages the most critically unwell patients in the hospital system, as such there is a need for a highly trained nursing workforce. Intensive care is considered a high-risk area for errors and adverse events (AE) due to the severity of illness and number of procedures performed.

Objective: To investigate if the percentage of Critical Care Registered Nurses (CCRN) within an Intensive Care Unit (ICU) is associated with an increased risk of patients experiencing an AE.

Design & setting: We conducted a retrospective cohort study of patients admitted between January 2016 and December 2020 to a tertiary ICU in Australia. Descriptive statistics and multivariable logistic regression were used to investigate the relationship between the proportion of CCRNs each month and the occurrence of an AE defined as any one of a medication error, fall, pressure injury or unplanned removal of a central venous catheter or endotracheal tube per patient.

Results: A total of 13,560 patients were included in the study, with 854 (6.3%) experiencing one AE. Patients with an AE were associated with higher illness severity and frailty scores. They were more commonly admitted after medical emergency team response calls and were less commonly elective ICU admissions. Those with an AE had longer ICU and in-hospital length of stay, and higher ICU and in-hospital mortality, on average. After adjusting for ICU LOS and acute severity of illness, being admitted during a month of higher critical care nursing skill-mix was associated with a statistically significant lower odds of having a subsequent AE (OR 0.966 [95% CI: 0.944-0.988], p 0.003).

Conclusion: An increasing percentage of CCRNs is independently associated with a lower risk-adjusted likelihood of an AE. Increasing the skill-mix of the ICU nursing staff may reduce the occurrence of AEs and lead to improved patient outcomes.

Background: A review and meta- analysis of empathic communication and patients' expectations of interventions has shown that if positive messages are delivered there is a small but measurable reduction of pain and anxiety and some improvements in physical outcomes. Aim: To identify elements of health messages that may have a positive impact on patient health outcomes to guide effective nurse-patient- communication. Methods: Data were extracted from each study in a qualitative analysis of a systematic review investigating the health effects of positive messages, and analysed following the principles of thematic analysis. Findings: Central to effective positive messages were good communication skills. Five key features were identified. Discussion: The non-treatment care categories such as cognitive care and emotional care can significantly influence health outcomes across a range of interactions. Conclusion: Strategies to facilitate positivity can be incorporated into nursing education programs designed to improve patient outcomes.

Background: There is an active strategy to recruit international nurses and midwives to help manage vacancy gaps in the United Kingdom's healthcare system. However, there is little evidence detailing how recruiting organisations prepare new recruits for the Objective Structured Clinical Exam (OSCE) they are required to pass.Aims and objectives: To gather and analyse feedback from recruiting organisations on the preparation offered to international nurses and midwives on arrival in the United Kingdom, prior to undertaking an OSCE in order to gain Nursing and Midwifery Council professional registration.Design and methods: An online cross-sectional questionnaire. The data was analysed using thematic analysis.Results: Four main themes were generated from thematic analysis of the qualitative data: SAME IDEAS DIFFERENT PRACTICE; PASSING THE OSCE; INDIVIDUALISED SUPPORT; SUPPORT NETWORKS.Conclusion: Differences in how organisations prepare and support international nurses and midwives to undertake the OSCE suggest standardised approaches could benefit new recruits.Impact statement: Addressing an evidence gap, this research suggests recruits may benefit from standardised support around working and living in the UK.

Background: Development of the Nurse practitioner role and the specialisation of practice is an increasing focus in healthcare. To date, a bibliometric evaluation of scholarly work referring to Nurse Practitioners, has not been located in the published literature.

Objective: With the aim of identifying the top 100 cited articles in the Nurse Practitioner domain, the Scopus™ database was searched for Nurse Practitioner studies during 2007-2021. Using bibliometric analysis we identified prolific authors; annual trend; citation rates; countries of origin; and study design.

Results: There were 1768 papers identified across 360 peer reviewed journals in 33 countries.

Conclusions: Finding from this analysis provides evidence of an evolving research area of inquiry which contributes to knowledge of the Nurse Practitioner role and scope of practice.

Impact statement: This review provides a comprehensive analysis of undergraduate nursing students' exit examinations and indicates that more clinical evaluation methods should be developed to ensure adequate competence.

Background: Diagnostic accuracy studies are important to identify the best set of defining characteristics for a given nursing diagnosis. The reliability of nursing inferences can be increased by using clinical indicators with high prediction capacity helping nurses to be more accurate in their clinical practice.

Objective: To clinically validate the nursing diagnosis Decreased diversional activity engagement in adult patients with diabetes.

Method: A diagnostic accuracy study with a cross-sectional design was carried out patients with type 2 diabetes. A latent class model with random effects was used to measure the sensitivity and specificity.

Results: The diagnosis of Decreased diversional activity engagement was present in 62.2% of the patients. The defining characteristics with high sensitivity (good indicators for confirmation) were discontent with situation, physical deconditioning, and altertion in mood. Boredom, flat affect, discontent with situation, and frequent naps were the defining characteristics with the highest specificity values. These factors are considered good integrating components of the diagnosis under investigation in patients with diabetes.

Conclusion: The nursing diagnosis decreased diversional activity engagement is frequent in patients with diabetes, and discontent with situation can be considered a good predictor of its occurrence due to its high values of specificity and sensitivity.

Impact: The use of accurate clinical indicators in the diagnostic reasoning of nurses contributes to the achievement of outcomes centered on the patient's human responses.

Background: The use of social media platforms to convey public opinions and attitudes has exponentially increased over the last decade on topics related to health. In all these social media postings related to the pandemic, specific attention has been focused on healthcare professionals, specifically nurses.

Objective: This study aimed to explore how the keyword 'nurse' is located in COVID-19 pandemic-related tweets during a selected period of the pandemic in order to assess public perception.

Methods: Tweets related to COVID-19 were downloaded from Twitter for the period January 1st, 2020, to November 11th, 2021. Sentiment analysis was used to identify opinions, emotions, and approaches expressed in tweet which included 'nurse', 'COVID-19', and 'pandemic' as either keyword or hashtags.

Results: A total of 2,440,696 most used unique words in the downloaded 582,399 tweets were included and the sentiment analysis indicated that 24.4% (n = 595,530) of the tweets demonstrated positive sentiment while 14.1% (n = 343,433) of the tweets demonstrated negative sentiment during COVID-19. Within these results, 17% (n = 416,366) of the tweets included positive basic emotion words of trust and 4.9% (n = 120,654) of joy. In terms of negative basic emotion words, 9.9% (n = 241,758) of the tweets included the word fear, 8.3% (n = 202,179) anticipation, 7.9% (n = 193,145) sadness, 5.7% (n = 139,791) anger, 4.2% (n = 103,936) disgust, and 3.6% (n = 88,338) of the tweets included the word surprised.

Conclusions: It is encouraging to note that with the advent of major health crises, public perceptions on social media, appears to portray an image of nurses which reflects the professionalism and values of the profession.

Background: Nurses play a vital role in health promotion, and there may be a link between a nurse's own lifestyle practices and how they educate others. Supporting health and well-being in student nurses is critical given they will be educating others once registered and practicing.

Objectives: To explore the health and health behaviours of undergraduate nursing and midwifery students considering the demands of their profession, their public health role and their ability to be role models.

Design: Multi-methods study.

Methods: Undergraduate nursing students in the second and third years of their programme were invited to self-complete a health and health behaviour questionnaire in a Scottish and Australian Higher Education Institution. Qualitative data were collected from a convenience sample of 20 third-year nursing and midwifery students.

Results: Two hundred and thirty-five Scottish students and 113 Australian students, 175 (85%) and 84 (74%), respectively, completed the questionnaire. Some differences and similarities were noted across groups, in particular, perceived physical health, the prevalence of binge drinking, smoking and being overweight/obese and some dietary measures were found to be less favourable among Scottish students. There were worryingly high levels of poor mental well-being at both higher education institutions, with scores on a mental well-being scale suggesting that (82) 34.7% of Scottish students and 33 (29.6%) of Australian students were at risk of depression. Nine Scottish students and 11 Australian students were interviewed. Key contributors and barriers to healthy behaviours were noted across both groups of students in relation to lifestyle. Students perceived that certain elements of their curriculum had implications on their ability or motivation to make healthy lifestyle choices.

Conclusion: The poor health and health behaviours of future nurses need to be addressed in their higher education to shape resilient role models for future nursing practice.

Impact statement: Priority should be given to supportive learning environments for student nurses that foster emotional support and encourage healthy lifestyles.

Objectives: The purpose of this study was to translate the Work-Related Quality of Life Scale (WRQoLS-2) into Chinese and validate the capacity of the tool to effectively measure this concept in a cohort of nursing professionals from mainland China.

Methods: The Chinese version of the WRQoLS-2 (WRQoLS-2C) was developed using forward and backward language translation. In total, 639 nurses were invited to complete the WRQoLS-2C. Two weeks later, 79 (12.4%) nurses were retested. Construct validity was analysed using exploratory and confirmatory factor analysis (EFA, CFA). Cronbach's α and the intraclass correlation coefficient (ICC) were used to assess internal consistency, reliability and test-retest reliability. Correlation between the WRQoLS-2C and the Quality of Nursing Work Life scale (QNWL) total score was used to assess criterion-relation validity.

Results: A seven-factor structure was revealed and confirmed using EFA (explaining 70.3% of the variance) and CFA (χ²= 680.39, df = 413, χ²/df = 1.65, p < 0.001). The goodness-of-fit index was 0.88, and adjusted goodness-of-fit index 0.86 indicating a reliable model. The internal consistency (Cronbach's α = 0.94) and test-retest reliability (ICC = 0.84) of the WRQoLS-2C were high. The correlation coefficient between the WRQoLS-2C and QNWL total scores was 0.79 (p < 0.01).

Conclusion: The WRQoLS-2C was a reliable and valid instrument that can be used to assess WRQoL in the mainland China nursing profession.

Impact statement: There are few options available to assess work related quality of life in Chinese language. This study has confirmed that the WRQoLs-2C is an effective instrument to measure this concept in nurses from mainland China.

Plain language summary (pls): Work related quality of life is an important predictor of workplace turnover intension. Managers can take measures to improve work related quality of life and reduce employee attrition. There are very few tools to measure work related quality of life and fewer in Chinese language. We translated the WRQoLS-2 into Chinese according to Brislin's translation model, following cross-cultural adaption guidelines, and verified its reliability and validity in a cohort of mainland Chinese nurses. The translated instrument has good reliability and validity in nurses, but has not yet been verified in other occupational groups.