Contemporary nurse最新文献

Background: The turnover of new and mid-career nurses has been increasing, leading to challenges in recruiting and retaining nursing staff.

Objectives: Securing and retaining mid-career nurses is crucial for ensuring high-quality care. However, little is known about mid-career nurses' experiences regarding turnover. This study aimed to understand the experiences of mid-career nurses and identify strategies to enable mid-career nurses to maintain long-term employment in health services.

Design: Colaizzi's phenomenological methodology was adopted to illuminate the subjective meaning derived from the work-related challenges of mid-career nurses, leading to turnover. Focus group interviews were conducted to delve into the work challenges faced by mid-career nurses.

Method: The participants were 23 mid-career nurses working in one tertiary hospital and six secondary hospitals across three Korean cities, recruited using purposive and snowball sampling. The inclusion criteria entailed a minimum of three years of nursing experience and current employment within a designated department or clinical area within the hospital environment, commonly known as a nursing unit. Such units encompassed a range of clinical settings, including medical-surgical units, intensive care units, and emergency rooms. The interview data were transcribed verbatim, and significant statements were extracted from abstract sentences to derive themes through an analytical process.

Results: Analysis of the work experiences of 23 mid-career nurses in medical institutions yielded 15 themes and 4 theme clusters derived from 353 meaningful statements. These theme collections were identified as 'Difficulties endured as a mid-career nurse', 'Meaningless and regrettable new graduate nurses' education', 'An inexpressibly poor work environment', and 'Systems and policies needed to remain in the hospital'.

Conclusions: Difficulties faced by mid-career nurses including the establishment of an education and career development system, provisions for guaranteed leave, a diverse and flexible work system, opportunities for effective communication, and engagement with the opinions of mid-career nurses should promptly be addressed.

Background: Vaccination is efficacious at preventing influenza disease transmission, morbidity and mortality. Benefits of influenza vaccination for healthcare workers (HCW) are emphasized, yet vaccine uptake among HCW remains suboptimal. Mandatory vaccination programs may increase influenza vaccine uptake, however, attitudes and beliefs of HCW towards these mandates are not well known.Aims: This scoping review examined the attitudes and beliefs of HCW to ascertain the barriers and enablers to the implementation and acceptance of mandatory vaccination programs in healthcare settings.Design: Scoping review, guided by the PRISMA Extension for Scoping Reviews.Methods: Literature published between 2019 and 2023 was reviewed from five electronic databases, between June and October 2023.Data sources: Quantitative, qualitative and mixed-methods studies were obtained. Studies were limited to full-text English articles, published within peer-reviewed journals over the last five years. Data were extracted by both authors and documented using a modified version of the JBI's scoping review data extraction instrument, and analyzed thematically.Results: The original search yielded 319 articles. Forty-two articles were screened, with 10 studies included. Most HCW had negative views towards mandatory influenza vaccination, influenced by geographical location, age and discipline. The protection of patients and affordability/accessibility of vaccination were described as enablers to the acceptance of mandatory measures. The belief that mandatory vaccination was a violation of autonomy and misconceptions concerning influenza transmission, vaccine mechanism of action, side effects and effectiveness, were described as common barriers.Conclusions: Health services must carefully consider the context in which mandatory vaccination programs are implemented and employ strategies that incorporate education and promote vaccine accessibility, affordability and HCW autonomy. The quality of evidence retrieved was moderate to poor, with high heterogeneity between studies. Minimal Australian research was evident, limiting the generalisability of findings. These results should be interpreted with caution and further high-quality research is recommended.

Background: Sepsis is a frequent cause of global deaths with time critical diagnosis and treatment impacting outcomes. Prehospital emergency nurses are pivotal in assessment that influences timely diagnosis.

Aim: To gain a deep understanding of nurse's experiences when caring for those with suspected sepsis.

Design and methods: A qualitative study using semi-structured interviews and inductive content analysis according to the Elo Kyngäs method.

Findings: Early identification of sepsis by prehospital emergency nurses (n = 13) was augmented through a combination of clinical experience and the implementation of practice guidelines. There were three key components to practice improvement a) clinical experience, b) continuous education and c) explicit guidelines.

Conclusions: Identification of sepsis in the prehospital environment can shorten the time to treatment for patients with sepsis. Early identification can be achieved by continuous education in the Emergency Medical Service (EMS), ensuring experienced personnel and including the EMS in medical guidelines.

Background: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promote EBP in nursing practice and improve related education, more insight into nurses' needs is necessary to overcome existing EBP barriers.

Objective: To identify the current needs to work with EBP principles among hospital and community care nurses and student nurses.

Design: A qualitative, exploratory approach with focus group discussions.

Methods: Data was collected between February and December 2020 through 5 focus group discussions with 25 nurses and student nurses from a hospital, a community care organisation, and nursing education schools (bachelor and vocational). Data were analysed using reflexive thematic analysis, and the main themes were synchronised to the seven domains from the Tailored Implementation for Chronic Diseases (TICD) checklist.

Results: Nurses and student nurses experience EBP as complex and require more EBP knowledge and reliable, ready-to-use evidence. They wanted to be facilitated in access to evidence, the opportunity to share insights with colleagues and more time to work on EBP. The fulfilment of these needs serves to enhance motivation to engage with evidence-based practice (EBP), facilitate personal development, and empower nurses and student nurses to take more leadership in working according to EBP principles and improve healthcare delivery.

Conclusion: Nurses experience difficulties applying EBP principles and need support with their implementation. Nurses' and student nurses' needs include obtaining more EBP knowledge and access to tailored and ready-to-use information. They also indicated the need for role models, autonomy, incentives, dedicated time, and incorporation of EBP in daily work practice.

Background: Patient harm from unsafe care is an increasingly global phenomenon leading to death or disability. Drawing on their expertise, Advanced Practice Nurses provide the opportunity to improve care quality and safety.

Aim: To explore Nurse Practitioners and Clinical Nurse Consultants' experiences in patient safety.

Design: A qualitative design was used involving six audio-visually recorded focus group interviews. Participants working in an acute or community adult nursing speciality were involved.

Methods: Twenty-eight Advanced Practice Nurses (female 82.1%, mean age 47.5 ± 10 years) were recruited by convenience and snowball sampling. After transcription of interview data, qualitative content analysis was conducted.

Results: Six categories were identified: patient safety as the highest priority (1), special contribution to patient safety (2), patients/relatives role in safety (3), multidisciplinary team approach (4), government regulation in safety (5), and further needs to improve safety (6). Advanced Practice Nurses saw themselves as role models and leaders for other healthcare staff through their expertise and professional experience and thus able to see the bigger picture in health. They identified as change agents at the system-level due to their decision-making ability and multi-professional team connectivity.

Conclusions: This study emphasises the key position of extended nursing roles and the need for future development of patient safety strategies in hospitals and community care. As influential leaders, Advanced Practice Nurses are best placed to identify improvements. They play a central role in guiding the multi-professional team, the patient and their family, educating nursing staff, and identifying and addressing system-wide safety gaps to improve patient safety.

Background: While nurses are strategically placed to support the achievement of universal health, their practice may not always be informed by evidence, especially in a context where research evidence is not commonly used to inform practice.Objective/Aim/Hypothesis: Improve management of clients with CNCDs in Caribbean community through evidence-based practice (EBP) capacity building workshops.Design/Methods: A descriptive, quantitative design was used for this study. Participants included Community Based Nurses who attended an initial and recall workshop on EBP in a Caribbean island. All participants were included as the sample. Data were collected as a Pre-Test and Post Test before the initial workshop and at the recall workshop. Analysis was done quantitatively. Since the sample was small, only descriptive statistics were used.Results: Data showed 64% of participants had no experience with EBP, 55% needed more essential resources to participate in EBP and 55% recognized a need to include EBP to change their clinical practice effectively.Conclusions: The nurses and district supervisors observed a high level of interest and commitment to initiating and completing EBP projects. However, the reality of significant workplace demands, and limitations in consistent logistical and supervisory support impacted long-term sustainability.

Background: Globally, nurses and midwives have a higher rate of being overweight/obese than the general population, influenced by workplace environments that impact dietary habits.

Objective: This systematic review aimed to identify barriers/facilitators to healthy eating among nurses in clinical settings.

Design: This systematic review followed Joanna Briggs Institute's guidelines for qualitative systematic reviews.

Methods: Eight electronic databases: PROQUEST CENTRAL, SCIENCEDIRECT, MEDLINE, CINAHL, PsycINFO, WEB SCIENCE, PUB MED, and SCOPUS were searched. Articles were screened using JBI SUMARI®, and quality assessment was done using the JBI critical appraisal checklist. Data were extracted using the JBI data extraction tool.

Results: Nine qualitative studies were reviewed, involving 488 nurses, concluding 37 distinct findings. Two synthesised findings emerged: barriers, and facilitators to healthy eating, related to organisational (shift work/long working hours), personal, physical workplace environment, and social factors.

Conclusions: The review emphasises the necessity of promoting attainable healthy eating practices at organisational, personal, environmental, and social levels within the workplace.

Registration: PROSPERO International prospective register of systematic reviews, ID: CRD42022309259.