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Original Research: Alarm Fatigue: Exploring the Adaptive and Maladaptive Coping Strategies of Nurses. 原创研究:警报疲劳:探索护士的适应性和不适应性应对策略。
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2024-09-11 DOI: 10.1097/01.naj.0001063808.07614.8d
Olawunmi Obisesan,Ericka Barber,Patricia Martin,Nicole Brougham,Heidi Tymkew
BACKGROUNDTo improve patient safety, hospitals use alarm notification systems to increase nurses' real-time situational awareness of a patient's condition. Such alarms are critical to nurses' clinical decision-making and prioritization, thus helping to improve patient care and care efficiency. But the frequent and often simultaneous ringing of alarms, including many that are false, nonemergent, or nonactionable, has led to overwhelm, alarm distrust, and desensitization, resulting in alarm fatigue.PURPOSEThis study aimed to explore oncology nurses' lived experiences with alarms and the adaptive and maladaptive strategies they use to cope with alarm fatigue.METHODSThis qualitative, phenomenological study was guided by the theoretical framework of the Roy Adaptation Model. A purposive sample of nine nurses was recruited from two oncology units at a large midwestern Magnet hospital in the United States. Qualitative data were collected using a six-question, semistructured interview guide. Interviews were conducted either face-to-face in a private conference room on the unit or via the online videoconferencing platform Zoom.RESULTSData analysis yielded five themes, the most prominent being the high volume and frequency of alarms. Nurse participants reported adopting more maladaptive than adaptive coping strategies. Overall, they felt that the high frequency of false, nonemergent, and nonactionable alarms disrupted their workflow and contributed to a general desensitization to alarms.CONCLUSIONSThis study's findings offer valuable insight into the problem of alarm fatigue among nurses. Practical measures are urgently needed to reduce nurses' cognitive overload; shift nonnursing responsibilities to other staff; and implement efficiency-focused process changes, such as reengineering workflows to minimize interruptions. Every effort should be made to redesign protocols to reduce alarm fatigue, including by decreasing the number of false, nonemergent, and nonactionable calls and alarms.
背景为了提高病人的安全性,医院使用警报通知系统来提高护士对病人状况的实时了解。这些警报对护士的临床决策和优先次序的确定至关重要,从而有助于改善病人护理和提高护理效率。但是,频繁且经常同时响起的警报声,包括许多错误、非紧急或不可操作的警报声,导致了护士对警报的不知所措、不信任和脱敏,从而产生了警报疲劳。本研究旨在探讨肿瘤科护士对警报的生活体验,以及她们应对警报疲劳的适应性和不适应性策略。研究人员从美国中西部一家大型磁性医院的两个肿瘤科抽取了九名护士作为样本。定性数据的收集采用了一个包含六个问题的半结构化访谈指南。访谈在病房的私人会议室面对面进行,或通过在线视频会议平台 Zoom 进行。结果数据分析得出了五个主题,其中最突出的是警报的数量和频率较高。护士参与者表示,他们采取了更多的适应性应对策略,而非适应性应对策略。总体而言,他们认为错误、非紧急和不可操作的警报频率过高,扰乱了他们的工作流程,并导致了对警报的普遍不敏感。当务之急是采取切实可行的措施,减轻护士的认知负荷;将非护理职责转移给其他员工;实施注重效率的流程变革,如重新设计工作流程以尽量减少干扰。应尽一切努力重新设计规程以减少警报疲劳,包括减少错误、非紧急和无法采取行动的呼叫和警报数量。
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引用次数: 0
Original Research: Exploring Nurses' Use of Humor in the Workplace: A Thematic Analysis. 原创研究:探索护士在工作场所使用幽默的情况:专题分析。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001028312.41339.c1
Edessa Cadiz, Karyn Buxman, Magda Angel, Carin Resseguie, Carolyn Wilder, Lilian Chan, Jessica Bejar, Jaclyn Russe, Judy Davidson

Background: The nursing work environment is often stressful and can lead to burnout. The use of humor may help nurses adapt and cope. Although most would agree that, in general, humor can help build camaraderie and ease tense situations, little is known about how nurses use humor in their professional lives.

Purpose: The study's main purpose was to explore how humor is used and perceived by nurses in the workplace.

Methods: A sample of LPNs, RNs, and advanced practice RNs was recruited in the United States. Participants were interviewed via the videoconferencing platform Zoom. Data from the video recordings, audio transcripts, and investigators' field notes were analyzed using reflexive thematic analysis.

Results: Sixteen nurses were interviewed about their use of humor, whether intentional or spontaneous, in the workplace. Three main themes were identified: entertainment , influencing others , and well-being . Participants reported using humor with self and others, including patients, families, and colleagues. Reported benefits include emotional regulation, relationship building, and work enjoyment. Some participants noted feeling insecure over when and whether the use of humor was "appropriate."

Conclusions: The results indicate that nurses' use of humor in the workplace had many benefits. Participants reported that humor could relieve tension, create bonds and strengthen relationships, and enhance both learning and work environments. Many recognized that humor can also be maladaptive and harmful, and that sensitivity and caution are part of using humor skillfully. Still, the benefits of humor appear to outweigh the risks. We conclude that humor is a useful tool nurses can and should use to optimize their nursing experience.

背景介绍护理工作环境通常压力很大,可能导致职业倦怠。使用幽默可以帮助护士适应和应对压力。尽管大多数人都同意,一般来说,幽默有助于建立友情和缓解紧张局势,但人们对护士在职业生活中如何使用幽默却知之甚少。目的:本研究的主要目的是探讨护士在工作场所如何使用和感知幽默:方法:在美国招募了一批 LPN、RN 和高级实践 RN。参与者通过视频会议平台 Zoom 接受采访。采用反思性主题分析法对视频录像、音频记录和调查人员现场记录中的数据进行了分析:结果:16 名护士接受了关于他们在工作场所有意或自发使用幽默的访谈。访谈确定了三大主题:娱乐、影响他人和幸福。受访者称,他们对自己和他人使用幽默,包括病人、家人和同事。据报告,幽默的好处包括调节情绪、建立关系和享受工作。一些参与者指出,他们对何时以及是否 "适当 "使用幽默感到不安全:研究结果表明,护士在工作场所使用幽默有很多好处。参与者表示,幽默可以缓解紧张、建立联系和加强关系,并改善学习和工作环境。许多人认识到,幽默也可能是不适应和有害的,敏感和谨慎是巧妙使用幽默的一部分。不过,幽默的益处似乎大于风险。我们的结论是,幽默是护士可以而且应该用来优化护理经验的有用工具。
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引用次数: 0
Radiology Nursing. 放射护理。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050804.89533.d2
Ellen F Arslan

These nurses provide care throughout various imaging exams.

这些护士在各种成像检查过程中提供护理。
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引用次数: 0
Expanding Child Health Screenings Through School-Community Partnerships. 通过学校-社区合作扩大儿童健康检查。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050820.21339.31
Ellen M McCabe, Nakia C Best, Sheryl Bennett, Emma Johnson, Beth E Jameson

Abstract: Child health screenings are a critical, but often overlooked, aspect of children's medical care. School-community partnerships to conduct screenings and ensure that diagnostic follow-up and treatment occur can help achieve optimal child health outcomes. Such partnerships also serve to mitigate the impact of social determinants of health on children's well-being, address health disparities, and promote health equity. This article reviews four essential childhood health screenings-vision, hearing, dental, and mental health-and discusses how schools and community partners can collaborate to offer these screenings.

摘要:儿童健康检查是儿童医疗保健的一个重要方面,但往往被忽视。学校与社区合作开展筛查并确保诊断跟进和治疗,有助于实现最佳的儿童健康结果。这种合作关系还有助于减轻健康的社会决定因素对儿童福祉的影响、解决健康差异问题并促进健康公平。本文回顾了四种基本的儿童健康筛查--视力、听力、牙科和心理健康,并讨论了学校和社区合作伙伴如何合作提供这些筛查。
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引用次数: 0
Implementing a Peer Support Program for Second Victims. 为第二受害者实施同伴支持计划。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050816.14247.78
Bernadette Johnson, Luci New, Michele Ballister, Courtney Brown, Susan Scott

Abstract: The second victim phenomenon describes the distress frequently experienced by health care providers after an unintentional medical error or unexpected adverse event. However, few health care institutions have initiatives that proactively address this phenomenon. The pilot project discussed in this article aimed to create a peer support program for health care providers experiencing the second victim phenomenon. The project team validated the need for such a program among health care providers in the perioperative departments of two facilities within a large health care organization in the southeastern United States. To do this, they used a survey, the Second Victim Experience and Support Tool. Among survey respondents in the two departments, 80% and 87.6% indicated a strong desire to discuss their emotional challenges with a respected peer colleague after a traumatic event. The project team then developed and implemented a peer support program in three phases to 1) educate staff across the facility on second victimization, 2) recruit and train volunteer peer supporters, and 3) launch the pilot program by embedding these peer supporters in the two perioperative departments. A survey completed by participants in the pilot program showed that 80% of respondents found the peer support extremely beneficial, 20% found it very beneficial, and 100% would recommend peer support to a colleague. This successful pilot project could inform the establishment of peer support programs at other institutions to assist health care providers experiencing the second victim phenomenon.

摘要:"第二受害者 "现象是指医疗服务提供者在发生意外医疗差错或意外不良事件后经常经历的痛苦。然而,很少有医疗机构会主动应对这一现象。本文讨论的试点项目旨在为遭遇第二受害者现象的医疗服务提供者创建一个同伴支持计划。项目团队在美国东南部一家大型医疗机构的两个围手术期部门的医护人员中验证了对此类项目的需求。为此,他们使用了一项调查,即 "第二受害者体验和支持工具"。在这两个科室的调查对象中,分别有 80% 和 87.6% 的人表示强烈希望在创伤事件发生后与一位德高望重的同行同事讨论他们所面临的情感挑战。随后,项目团队分三个阶段制定并实施了同伴支持计划:1)对整个医疗机构的员工进行二次伤害教育;2)招募并培训志愿同伴支持者;3)将这些同伴支持者安排到两个围手术期科室,以启动试点计划。试点项目参与者完成的调查显示,80% 的受访者认为同伴互助非常有益,20% 的受访者认为非常有益,100% 的受访者会向同事推荐同伴互助。这一成功的试点项目可以为其他机构建立同伴支持计划提供参考,以帮助遭遇第二受害者现象的医疗服务提供者。
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引用次数: 0
A Conversation with the 'Comic Nurse,' MK Czerwiec. 对话 "漫画护士 "MK Czerwiec。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050808.10287.04

A graphic medicine pioneer advocates for the use of comics in nursing.

一位图形医学先驱倡导在护理工作中使用漫画。
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引用次数: 0
Florida Becomes the First State to Allow Cesarean Deliveries Outside of Hospitals. 佛罗里达州成为第一个允许在医院外进行剖腹产的州。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050772.67849.d3
Karen Roush

The new law has raised alarm among maternal health experts.

新法律引起了产妇保健专家的警觉。
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引用次数: 0
Intersectionality in Nursing Practice. 护理实践中的交叉性。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050784.82087.8e
Carl A Kirton

Developing an intersectionality-informed stance.

形成跨学科的立场。
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引用次数: 0
New Antibiotic for Three Serious Infections. 治疗三种严重感染的新抗生素
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050792.07330.00
Diane S Aschenbrenner
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引用次数: 0
Lower Risk of Upper GI Bleeding with Pantoprazole in Adults Receiving Mechanical Ventilation. 泮托拉唑降低了接受机械通气的成人上消化道出血的风险。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1097/01.NAJ.0001050840.25519.46
Karen Rosenberg

According to this study.

根据这项研究。
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引用次数: 0
期刊
American Journal of Nursing
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