Showing papers in "Journal of Nursing Education and Practice in 2023"
TL;DR: In this paper , the authors used quantitative descriptive analysis to determine whether or not there is a relationship between parenting parents and the level of independence in fulfilling ADL in children with disabilities.
Abstract: Introduction: Mentally retarded children have limitations in taking care of themselves due to their motor and cognitive factors. The role of parents is very important to improve the ability of disabled children to be independent in fulfilling the needs of daily activities such as eating, toileting, and dressing. There are three types of parenting, authoritarian, permissive, and democratic.
Objectives: This study aims to determine whether or not there is a relationship between parenting parents and the level of independence in fulfilling ADL in children with disabilities.
Method: The method used in this research is quantitative descriptive analysis, the sample size is 35 parents who have mentally retarded children at SLB Mekar Sari 1 Cibinong using a total sampling technique, collecting data using a questionnaire.
Result: After the Chi-Square test was carried out, a p-value of 0.007 was obtained so that the p-value <0.05.
Conclusion: This study has limitations in self-care due to a motor and cognitive factors. So it can be concluded that there is a relationship between parenting style and the level of ADL independence of children with disabilities at SLB Mekar Sari 1 Cibinong.
TL;DR: In this article , a literature search was performed in the MEDLINE, CINAHL, and ERIC databases in November 2022, and fifteen studies were included and analyzed using deductive content analysis.
Abstract: Background and objectives: Virtual reality simulation (VRS) can be used to complement experiential learning, as it enables nursing students to further learn and refine nursing skills outside of the clinical setting. However, gathering evidence for its effectiveness as a teaching method in achieving learning outcomes is still ongoing, and thus there is a lack of systematic synthesis. The objective of this systematic literature review is to analyze VRS scenarios with a high level of immersion and their impact on learning outcomes in nursing education.Methods: A literature search was performed in the MEDLINE, CINAHL, and ERIC databases in November 2022. As a result, fifteen studies were included and analyzed using deductive content analysis.Results: The studies reported twelve different scenarios for virtual reality simulations with high levels of immersion, the focus of which was on acute critical care, broader nursing processes, neonatal and pediatric care, single nursing interventions, and observation of patients’ symptoms. The associated learning objectives were mainly achieved in the domains of cognition and psychomotor skills.Conclusions: There are several VRS scenarios that show potential for use in nursing education. The VRS scenarios are effective in improving learning outcomes, particularly those related to knowledge and skills. Overall, the supportive body of evidence gained through this review may help nurse educators in integrating virtual simulations in their curricula. In the future, nursing and adult learning theories should be given greater consideration, and the aspect of affective learning could be included in design and implementation. Moreover, future research could benefit from exploring the long-term effects of learning after using VRS with a high level of immersion to provide valuable evidence for developing VRS teaching methods in nursing.
TL;DR: Wang et al. as mentioned in this paper explored nurses' experiences, the supports they received from hospitals, and the support they expected when returning to work after the second/third childbirth, and highlighted the necessity to dedicate resources to support diverse needs of returning nurse mothers such that they can balance family life and work.
Abstract: Background: Since China encounters challenges of the aging population, especially a decrease in the working-age population, the Chinese government officially ended the one-child policy and has implemented the second/third child policies. This study aimed to explore nurses’ experiences, the supports they received from hospitals, and the supports they expected when returning to work after the second/third childbirth.Methods: Asynchronous focus groups and one-on-one in-person interviews were held with nurses from three hospitals in Wenzhou city who had returned to work within three months following their second/third childbirth. Data collection and analysis were conducted using Maslow’s Hierarchy of Needs as a guiding framework.Results: Twenty-three nurses were included in this study. Themes emerged around five needs, including physiological, safety, love and belonging, esteem, and self-actualization. Regarding these needs, nurses expressed receiving some support, including support from managers and colleagues and flexible scheduling assignments. However, there was also a lack of other supports, including dedicated time and space for breastfeeding, parental leave, nearby and affordable childcare, unit assignment and working schedules considering individual circumstances, mental health support, and opportunities for professional development.Conclusions: Our findings highlight the necessity to dedicate resources to support the diverse needs of returning nurse mothers such that they can balance family life and work. While longer-duration studies with larger sample sizes in other regions of China are needed, our findings also suggest future studies on exploring third childbirth experiences, evaluating supportive interventions, and creating a specific theoretical model on the comprehensive needs of nurses returning to work after childbirth.
TL;DR: This paper explored the faculty role within the Canadian higher education workplace related to the phenomenon of gossip and reflect on ways to stop this unhealthy social communication tradition, which contributes to irreversible damage to a person's career and character.
Abstract: This paper will explore the faculty role within the Canadian higher education workplace related to the phenomenon of gossip and reflect on ways to stop this unhealthy social communication tradition. Failure to address gossip, a form of bullying, in academia contributes to irreversible damage to a person’s career and character. Sadly, faculty in nursing and the nursing profession are champions of this unprofessional behaviour. Navigating through a workplace environment tainted with gossip is a skill faculty must work on to prevent unfortunate consequences. The impacts of gossip must be recognized and handled responsibly. It is never too late to reflect on our communication practices and the potential impact on our workplace environment, including role modelling the nursing culture on learners.
TL;DR: In this article , the authors describe nursing care in UTI patients who have impaired urinary elimination, and the results obtained after the nursing action is the patient's pain gradually decreases, the frequency of urination is smooth even though it still feels pain when urinating, the problem of urinary elimination disorders gradually improved characterized by an improved elimination pattern of decreased patient pain complaints.
Abstract: Introduction: Urinary tract infection (UTI) or Urinarius Tractus Infection is a condition where there is a bacterial infection of microorganisms that occurs in the urinary tract. The occurrence of UTI is due to the presence of pathogenic microorganisms in the urinary tract. These microorganisms enter through direct contact from the nearest source of infection, hematogenous or lymphomatous. Symptoms of UTI are the desire to urinate that continues to be felt, pain or sensation of heat when urinating (this set of conditions is called anyang-anyang), turbid and sharp-smelling urine, frequent urination, bloody or purulent urine, in women generally the patient will feel pelvic pain, especially in the pelvic center and the bone area around the genitals
Objectives: To describe nursing care in urinary tract infection patients who have impaired urinary elimination.
Method: This research uses qualitative descriptive methods in the form of case studies. Nursing care was given to Mrs. K for 3 days. Data collection techniques obtained from the results of interviews, observations, and physical examinations
Result: The problem of urinary elimination disorders that occur in patients with urinary tract infections can be overcome by conducting deep breath relaxation therapy to reduce the pain experienced by the patient, training the patient not to hold urination, and advising the patient to increase the frequency of drinking. The results obtained after the nursing action is the patient's pain gradually decreases, the frequency of urination is smooth even though it still feels pain when urinating
Conclusion: After nursing treatment for 3x24 hours, the problem of urinary elimination disorders gradually improved characterized by an improved elimination pattern of decreased patient pain complaints.
TL;DR: In this article , the authors conducted a follow-up and comparative study to identify the prevalence of exclusive breastfeeding, its survival curve and associated factors, in adolescent mother-premature infant dyads and compare two hospitals aligned or not with the Baby-Friendly Hospital Initiative up to 6 months.
Abstract: Background: Studies have shown that the duration of exclusive breastfeeding is shorter in adolescent mothers and preterm infants. The objective was to identify the prevalence of exclusive breastfeeding, its survival curve and associated factors, in adolescent mother-premature infant dyads and to compare two hospitals aligned or not with the Baby-Friendly Hospital Initiative up to 6 months.Methods: Follow-up and comparative study. Carried out in two reference hospitals (certified as Baby-Friendly Hospital Initiative and Non-certified). The participants were 67 adolescent mothers and 69 premature infants hospitalized in Neonatal Unit where the follow-up began in all the dyads with the informed consent. Data collection was carried out in clinical files and interview of adolescent mothers in the hospitals and by telephone in the follow-up. (February 2016 to March 2017). The variables were Exclusive breastfeeding, sociodemographic, perinatal and clinical status of the premature infants. The statistical analysis was descriptive and we applied Kaplan-Meier and Pearson's r Test (significance p ≤ .05).Results: The exclusive breastfeeding was 27.1%, 63.8%, 66.7%, 48.1% and 26.3% in internment, discharge, 15 days post-discharge, third and sixth month of life, respectively. The exclusive breastfeeding survival: at Baby-Friendly Hospital Initiative (40%, 30 days post discharge) and Non-Baby-Friendly Hospital Initiative (30%, 15 days post discharge) (p ≤ .05). Cessation of breastfeeding due to the perception of low milk production (15 days post-discharge, r = .556, p ≤ .05).Conclusions: The prevalence and the survival curve of exclusive breastfeeding are low, especially in Non-Baby-Friendly Hospital Initiative, and the perception of low milk production. The health system efforts are required to initiate and continue exclusive breastfeeding according with WHO recommendations.
TL;DR: In this article , the authors examined whether community, population, and public health (CPPH) baccalaureate nurse educators received education on the use of clinical debriefing with their students and described the type of deb-riefing approaches used to transfer nursing theory into clinical practice.
Abstract: Objective: The Next Generation NCLEX licensing examination is used to assess entry-level nurses’ ability to use clinical judgment in the care of individuals, families, and populations. An approach in developing clinical judgment is using a standardized debriefing process after a clinical experience. The purpose of this research was to examine whether community, population, and public health (CPPH) baccalaureate nurse educators received education on the use of clinical debriefing with their students and to describe the type of debriefing approaches used to transfer nursing theory into clinical practice.Methods: This study used a mixed method approach. Convenience sampling was used to conduct a descriptive survey of CPPH educators use of clinical debriefing using SurveyMonkey®. Three focus group sessions were held with participants representing a variety of BSN degree formats in nursing programs across the continental United States. These virtual meetings used the Zoom® conference platform. Each focus group was recorded with a transcription of the session. Transcriptions were evaluated using NVivo® and placed into five themes with additional subthemes.Results: The analysis indicated that CPPH BSN nurse educators lack formal training in the use of post-clinical debriefing. Educators’ debriefing approaches are not formalized or standardized across nursing programs and do not meet current best practices. Nurse educators identified barriers to debriefing with students, including geographic location, variety of clinical placements, and large numbers of students. Some nurse educators use debriefing techniques developed in non-nursing disciplines and for non-clinical debriefing situations. Focus group participants expressed interest in the development of a clinical debriefing tool for CPPH courses.Conclusions: The research demonstrates that CPPH nurse educators do not feel experientially prepared to lead debriefing. The lack of formalized education has resulted in nurse educators using debriefing methods that do not meet best practices. This could result in ineffective student development of clinical judgment.
TL;DR: In this article , the authors conducted a qualitative, descriptive and exploratory research in two Universities in Santa Catarina State, Brazil, with fourteen professors and fourteen students, collected in a semi-structured interview with professors and focus groups with students, through a digital platform.
Abstract: Introduction: Healthy work environments are positive for the construction and realization of professional identities. From the beginning of their vocational training, nursing students experience work environments in the area of health, accompanied by teaching nurses. Therefore, the object, the work environment, is important in the analysis of the work and teaching-learning process.Methods: Qualitative, descriptive and exploratory research. Developed in two Universities in Santa Catarina State, Brazil, with fourteen professors and fourteen students. Data were collected in a semi-structured interview with professors and focus groups with students, through a digital platform with previously scheduled times. The data were analyzed according to content analysis. The study was approved by a research ethics committee.Results: The findings were organized in the four dimensions that make up the World Health Organization's model of healthy work environments: the physical, psychosocial environment, resources for personal health and the institution's involvement in the community.Conclusions: Perceptions about healthy work environments are closely related to the conditions and requirements imposed to perform the work. Healthy work environments are the result of the infrastructure of institutions, work management and characteristics specially implicated in the teaching-learning process.
TL;DR: In this paper , the authors used correlation with a cross-sectional approach to determine the relationship between the history of complementary feeding and the eating behavior of parents with the nutritional status of picky eater children.
Abstract: Introduction: Picky eater is a picky eating behavior in children. Picky eaters are a common problem with children's eating patterns. The factors that cause picky eaters are a history of complementary foods and parental eating behavior. A good child's diet will affect the nutritional status of children to be good.
Objective: To determine the relationship between the history of complementary feeding and the eating behavior of parents with the nutritional status of picky eater children
Methods: This research design uses correlation with a cross-sectional approach. A sample of 52 respondents was taken using purposive sampling. Data were collected by questionnaire and analyzed using Chi-square.
Result: Statistical test using Chi-Square test with a significance level of a = 0.05 or 95%. The results of the research found that the value of p = 0.012 < a = 0.05 and p = 0.043 < a = 0.05.
Conclusion: There is a significant relationship between the history of complementary feeding and parents’ eating behavior with the nutritional status of picky eater children.
TL;DR: In this paper , the authors evaluated the impact of the Community Champions program on clinical practice amongst alumnae who have participated in the program and found that they were able to translate skills learned in Community Champions, such as community awareness, patient interaction, and teamwork, into practice.
Abstract: Student organizations focused on community engagement are a way to prepare nursing students to meet the needs of diverse populations in clinical practice. The purpose of this study was to evaluate the impact that the Community Champions program, an example of a community engagement organization, has on clinical practice amongst alumnae who have participated in the program. A survey was distributed via email to alumnae of Community Champions who have graduated in the past 4 years. Respondents indicated that they were able to translate skills learned in the Community Champions program, such as community awareness, patient interaction, and teamwork, and were able to identify examples of how skills were used in practice. Those who do not currently participate in community engagement cited lack of time and knowledge of community opportunities as limitations for volunteering. These data support that student community engagement provides skills relevant to professional nursing practice and has implications for strategies to promote community engagement among nurses.
TL;DR: Magnet Site Visits are part of the comprehensive review process for organizations seeking the American Nurses Credentialing Center's (ANCC) prestigious Magnet® recognition for nursing excellence as mentioned in this paper .
Abstract: Magnet Site Visits are part of the comprehensive review process for organizations seeking the American Nurses Credentialing Center’s (ANCC) prestigious Magnet® recognition for nursing excellence. In 2021, the ANCC’s Magnet Recognition Program® began offering the option for an onsite or Virtual Site Visit (VSV) for domestic and international organizations. These visits are the culmination of years of work that showcase the best in nursing practice and interprofessional collaboration. Chief Nursing Officers (CNOs) and Magnet Program Directors (MPDs) collaborate to strategically plan these visits. This article will describe a Magnet® recognized community hospital’s preparation for a VSV during the height of the COVID-19 pandemic. It will include development of partnerships with Information Technology Specialists, planning and logistics for meetings, development and implementation of a comprehensive education plan, and the overall orchestration of a VSV. Strategies will address the engagement of nurses and leaders amidst the challenges of the COVID-19 pandemic. With strategic planning, effective change management, and the adoption of technology, MPDs may gain confidence to facilitate a Magnet Site Visit virtually or in-person.
TL;DR: In this article , the authors describe nursing care for skin/tissue integrity disorders in Mr. S with type II diabetes mellitus in the Ar Rahman room RSI Purwokerto.
Abstract: Background: Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia that occurs due to insulin secretion, or both. The disorder causes abnormalities in the metabolism of carbohydrates, fats, and proteins.
Purpose: To describe nursing care for skin/tissue integrity disorders in Mr. S with type II diabetes mellitus in the Ar Rahman room RSI Purwokerto.
Method: Descriptive research design in the form of a case study with a nursing process approach consisting of assessment, nursing diagnosis, intervention, implementation, and evaluation. Nursing care was carried out to Mr. S for 3x24 hours. Data collection techniques using observation, interviews, physical examination, and documentation.
Results: The nursing evaluation which was carried out on June 16-18 2022 was carried out using the SOAP method, including subjectively the patient stating that his body was still weak, the wound had not healed and the pain had decreased. Objective, K/u: weak, GDS: 320mg/dl, a wound with a length of 3 cm and a width of 2 cm is visible, on the dressing there is seepage of liquid reddish yellow smelling and festering, the patient can tilt right and left, the total score of the BJWAT assessment increases from 28 to 29. Analysis, the problem not resolved, continue the intervention.
Conclusion: Evaluation on the third day of tissue damage, skin damage, pain and redness has not been resolved.
TL;DR: In this paper , a scoping review of existing evidence showing the implications of working multiple jobs for drowsy driving accidents is presented. But, the adverse effects are not restricted to the healthcare contexts in which nurses work; nurses must also commute back home, which can exacerbate nurses' fatigue.
Abstract: Background and objectives: Nurses driving while sleep-deprived is a global problem; however, few studies have examined sleep deprivation impacted by nurses working multiple jobs concurrently. Nurses work in high-pressure environments and endure long working hours, which can exacerbate nurses' fatigue. As a result, nurses are susceptible to sleep deficiency and disrupted circadian rhythms. Conceivably, sleep deficiency and disruption in circadian rhythms impact nurses' performance and well-being. The strain of long work hours and insufficient sleep worsens when nurses work multiple jobs. Nevertheless, the adverse effects are not restricted to the healthcare contexts in which nurses work; nurses must also commute back home—this scoping review canvasses existing evidence showing the implications of working multiple jobs for drowsy driving accidents.Methods: In-depth primary data analysis highlights the connection between the two measures (multiple job-holding and drowsy driving accidents). A total of ten studies were identified from CINAHL, PubMed, ScienceDirect, and MEDLINE. These databases contain recent research on nursing trends. The focus was on studies published from 1988 to 2022. This timeframe widens the pool of evidence that can be included in the research using Arksey and O'Malley's five-step process for conducting this scoping review.Results: The review finds ten studies spotlighting the relationship between intensified job demands associated with multiple job-holding and fatigue, which predisposes nurses to drowsy driving and accidents. In-depth primary data analysis highlights the connection between the two measures; multiple job-holding and drowsy driving accidents.Conclusions: Nurses must be optimal performers, yet they work under exceptionally stressful circumstances. The present study suggests that sleep deficiency and disruptions to circadian rhythms have profound negative implications for nurses' well-being beyond health facilities. Sleep interruption is challenging when nurses hold multiple jobs due to intensified job demands. In addition, exhausted nurses working several jobs are prone to drowsy driving, which can lead to accidents. Subsequent research needs to precisely document the implications of multiple job-holding among nurses concerning its impact on drowsy driving and accidents.
TL;DR: In this paper , a mixed-methods study explores Medical-Surgical nursing burnout, secondary traumatic stress (STS), and support from professional nursing organization leadership and membership perspectives.
Abstract: Day to day care of patients throughout the continuum of life puts nurses at risk for burnout and secondary traumatic stress (STS). This mixed-methods study explores Medical-Surgical (MS) nursing burnout, STS, and support from professional nursing organization leadership and membership perspectives. Seventy-two nurses were recruited from a nursing organization website and surveyed to provide demographic and Professional Quality of Life Scale Version 5 (ProQOLv5) data. After quantitative data collection, nurse respondents were asked if they would like to participate in a Zoom interview. Qualitative data was derived from in-depth interviews of six medical-surgical nurses and free-text responses from three other participants. The nurses interviewed provided detailed personal definitions of burnout, which led to the identification of themes of “awareness” and “triggers: fueling the fire of burnout,” and also exposed the fluctuating nature of burnout. Participants defined STS as “invasiveness into one’s life” and reflected on the impact that it can have both personally and professionally. Despite the fluctuating nature of burnout and the invasiveness of STS, the nurses interviewed revealed a passion for nursing that served as a driving force for the day-to-day struggle, affirming, “I am a med-surg nurse.” Overcoming burnout and STS lead nurses to “lessons learned: I did not know what I did not know,” which focused on personal and professional growth and development. An overarching theme of “dream vs. reality” captures these stabilizing and destabilizing forces at play in bedside MS nursing.
TL;DR: In this article , the Covid-19 emergency has been declared the sixth public health emergency by the World Health Organization (WHO) and a pre-experimental design method has been used to determine differences in the level of public anxiety before and after administration education about the vaccine.
Abstract: Introduction: The Covid- 19 emergency has been declared the sixth public health emergency by the World Health Organization (WHO). Until now there is still no drug that is considered capable of effectively treating this virus. One of the efforts that are considered to be able to help reduce transmission is the provision of the Covid-19 vaccine. However, the vaccination solution has, of course, recreated a polemic against some people. One of them is the doubts that arise because the development of vaccines is carried out in a very fast period. This raises concern or anxiety from some people about the side effects or impacts of the vaccine. For this reason, promotive and preventive efforts from the government are needed, one of which is through health workers by providing education so that the public gets correct information and does not cause fear and anxiety about the Covid- 19 vaccination program.
Objectives: The purpose of this study was to determine differences in the level of public anxiety before and after administration education about the Covid- 19 vaccine.
Method: This study used the pre-experimental design method with the research design used the One-Group Pretest-Posttest Design. The population in this study were the people of RT 03 Lulut Village, Klapanunggal District, who had not been vaccinated against Covid-19, namely 97 people. The sample in this study was 15 people with several inclusion and exclusion criteria. The data collection in this study was by giving questionnaires to the public using a standard anxiety level questionnaire consisting of 14 questions. Analysis using the paired t-test method.
Result: The results show the level of public anxiety before and after providing education about the Covid-19 vaccine at RT 03 Lulut Village, Klapanunggal District with ρ – value = 0.000
Conclusion: There are differences in the level of public anxiety before and after providing education about the Covid-19 vaccine at RT 03 Lulut Village, Klapanunggal District.
TL;DR: In this article , a cross-sectional approach was used to determine the relationship between environmental conditions, parents' smoking habits and hand-washing behavior with the incidence of acute respiratory infections in children at Matraman Hospital.
Abstract: Introduction: Acute respiratory infections in toddlers are caused by factors such as the condition of the home environment and toddler factors (nutritional status, exclusive breastfeeding, completeness of immunization, baby's age and low birth weight). Conditions in the home environment that can affect the air quality in the house can trigger the occurrence of Acute Respiratory Infections (ARI), including environmental tobacco smoke or affect cigarette smoke in the house.
Objective: To determine the relationship between environmental conditions, parents' smoking habits and hand-washing behavior with the incidence of ARI in children at Matraman Hospital
Methods: The research design is analytic with a cross-sectional approach. In this study, the population was 58 children who experienced acute respiratory infections at the Matraman Hospital. The sampling technique used Accidental sampling. the research instrument used a questionnaire/questionnaire and was analyzed using the Chi-Square Test.
Results: Based on the results of the Chi-Square test, it was found that there was a relationship between environmental conditions and the incidence of ARI in children with a P-value = 0.017 and an OR value of 4.615. The relationship between parents' smoking habits at home and the incidence of ARI in children has a P-value = 0.001 and an OR value of 8.640. The relationship between handwashing behavior at home and the incidence of ARI in children has a P-value = 0.003 and OR 6.750.
Conclusion: The description of the results of the study was that in most of the incidents of mild ARI, environmental conditions were good, parents' smoking habits at home were good and hand-washing behavior at home was good. There is a relationship between environmental conditions, parents' smoking habits at home and hand-washing behavior at home with the incidence of ARI in children at Matraman Hospital. The most influential factor in the incidence of ARI in children at Matraman Hospital is parents' smoking habits at home
TL;DR: In this paper , a qualitative study was conducted to explore the experiences of novice mid-level academic nurse leaders who transitioned from educators to academic administrators, which revealed that role preparation, professional development, and support were essential facilitators during the transition process.
Abstract: Objective: The shortage of academic nurse leaders (ANLs) is imminent and creates a crisis for the nursing profession. Academic administrators influence the nursing workforce’s preparation. When nursing programs and educators fail to address the urgent nursing shortage, this can result in short- and long-term impacts for the nursing profession. The purpose of this qualitative study was to explore the experiences of novice mid-level ANLs who transitioned from educators to academic administrators.Methods: A basic qualitative research design was conducted to gain insight into the transition experiences of 10 novice mid-level ANLs. A purposeful sampling technique was used to recruit and select qualified study participants. Individual interviews via Zoom were used to collect data from participants. The researcher used a semi-structured, open-ended interview protocol. A thematic analysis with a constant comparison method, was used to analyze the data.Results: The interview results yielded six themes, which included (1) transitioning into an academic nurse leader, (2) role preparation and professional development, (3) having support, (4) insufficient time, (5) public challenges, and (6) feeling confident but still learning.Conclusions: The study results revealed that role preparation, professional development, and support were essential facilitators during the transition process. The results also suggested that early role preparation of emerging ANLs could build a cadre of qualified, well-prepared academic administrators, thus ensuring academic leadership succession. Recommendations for practice included role socialization, individualized leadership development programs, and formal structured mentoring.
TL;DR: This article explored for changes in student engagement, and satisfaction, and achievement among students in a flipped classroom learning environment between mid and end of semester, and further explained quantitative results through qualitative student feedback.
Abstract: Engagement is critical for students to meet learning outcomes, yet modern classrooms face challenges with engagement when using a traditional didactic approach. Alternative options include using a flipped classroom where students review content prior to class, and teachers use in-class activities to increase application, analysis, and synthesis of information. This study aimed to (1) explore for changes in student engagement, and satisfaction, and achievement among students in a flipped classroom learning environment between mid and end of semester; and (2) to further explain quantitative results through qualitative student feedback. A convergent mixed methods design was used to recruit sixty-four nursing students in a Midwest U.S. College of Nursing, who completed a survey at mid and end of semester in the Fall of 2015. Students were also given the opportunity to participate in a focus group (n = 36) after the final survey. Most students were satisfied with the flipped classroom approach including before class materials, knowledge check quizzes using real-time response software, and the group test activity. However, participants were unsatisfied with reflective journal writing and group-based in class learning activities. Qualitative focus group data provided an explanation of quantitative results by identifying aspects of the flipped classroom viewed as helpful or not. Themes included small groups, enthusiastic teacher, repetition and application, doubling up on work, engaging, and dislike for course topic. More research is needed on pedogeological approaches to engage modern students, so they are prepared for nursing practice after graduation. The flipped classroom approach, which leverages multiple learning strategies, may be valuable to engage students and promote application of content.
TL;DR: In this paper , the authors conducted a systematic review to identify the perspectives of patients with Parkinson's disease on treatment, care and rehabilitation and found that patients' perspectives are a source of vital knowledge that informs health professionals' ability to provide individualised and patient-centered care.
Abstract: Background and objective: Parkinson’s disease has considerable impact on the quality of life of both patients and their caregivers. Patients’ perspectives are a source of vital knowledge that informs health professionals’ ability to provide individualised and patient-centered care. Objective: The aim of this systematic review was to identify the perspectives of patients with Parkinson’s disease on treatment, care and rehabilitation.Methods: The authors conducted a systematic review and searched the following bibliographic databases: MEDLINE, EMBASE, CINAHL, PsycInfo and Scopus for original studies, in June 2020 (renewed December 21, 2021). Grey literature was searched at www.parkinson.org, http://www.epda.eu.com, www.apdaparkinson.org and in the OpenSIGLE and HMIC databases. We included studies focusing on patients with Parkinson’s disease aged 18 or older that reported patients’ perspectives on treatment, care and rehabilitation. Results were analysed using thematic synthesis. Results: Thirteen studies were included, each of them applying qualitative methods and including between 1 and 95 patients. The authors identified 17 descriptive themes which resulted in three analytic themes: Significance of self, Significance of informal caregivers and peers, and Significance of professionals.Conclusions: Our findings could be important in helping healthcare professionals plan and deliver treatment, care and rehabilitation based on patients’ priorities in the context of suffering from a chronic disease.
TL;DR: In this paper , the axillary Impella enables heart failure patients to ambulate inside the CICU while waiting for destination therapy, which is one treatment option in advanced heart failure and pre-heart transplant patients.
Abstract: Background and objective: The prevalence of heart failure (HF) in the US has increased over several years. The American Heart Association (AHA) documents that HF has a prevalence of 6 million cases among Americans aged 20 years and older. HF is a complex syndrome that results from the structural or functional impairment of ventricular filling or ejection of blood, leading to symptoms including poor exercise tolerance, shortness of breath, and signs of HF such as edema and rales. The aim of the study was to add to the knowledge base from one medical center's experience using Impella device in ambulatory heart failure and pre-heart transplant patients.Results: The axillary Impella enables HF patients to ambulate inside the CICU while waiting for destination therapy. RNs in our medical center's CICU can take care of these patients effectively and competently because of extensive prior experiences with the AxIABP. Nursing staff have adapted existing nursing procedures, protocols, and lessons learned from experiences with the AxIABP to manage this new patient population.Discussion: Impella is one treatment option in advanced HF and pre-heart transplant patients. The development of an alternative insertion technique that allows patients to ambulate instead of being on bedrest continues to evolve. Our medical center’s experiences with taking care of ambulatory HF and pre-heart transplant Impella patients have shown that this is a safe and effective treatment.
TL;DR: In this article , an evidence-based project aimed to determine the feasibility of implementing a peer support program to minimize trauma in healthcare professionals (HCP)s following unanticipated adverse events.
Abstract: Introduction: This evidence-based project aimed to determine the feasibility of implementing a peer support program to minimize trauma in healthcare professionals (HCP)s following unanticipated adverse events. Based on the forYOU Program designed by Sue Scott at the University of Missouri Health System, this program trained peers to offer real-time caring and support to other clinicians coping with such events. Most healthcare professionals are involved in at least one adverse event in their careers. Albert Wu, MD (2000) coined the term second victim to capture the essence of the trauma experienced by healthcare professionals when an unanticipated event negatively impacts a patient. When left unchecked, this trauma can result in moral distress, stress disorders, and burnout as the clinician ruminates over the event. Providing emotional support has improved second victims' emotional well-being and recovery. Therefore, healthcare leaders are encouraged to develop comprehensive programs to provide easy access to peer and social support when they experience an adverse event.Methods: Designed for implementation in the Women's Service Department of a 350-bed southwestern hospital, this project employed a pre-/post-evaluation of subjective outcomes using an online survey for nurses. A core group of trainers attended a two-day peer support train-the-trainer event hosted by the forYOU Program at the University of Missouri Health Care System. This group trained 26 peer supporters representing the four departments in Women's Services and both shifts. Baseline data was collected (n = 44) to assess the frequency and impact of unanticipated adverse events, the perceived support, and the type of support received. Following the four-month implementation in the Summer/Fall of 2020, post-data was obtained, including a program awareness assessment (n = 17).Results: Pre- and post-implementation of the Peer Support Program, nurses in Women's Services reported adverse events impacting their emotional well-being. Post-program, more nurses reported receiving support (86% post-program versus 43% pre-program). Before employment, 79% of nurses who received support received peer support, versus 86% receiving peer support post-implementation. The implementation occurred during the COVID pandemic, which may have resulted in a decreased post-assessment sample size. However, the peer supporters reported hesitancy in completing encounter forms feeling that providing support was “too personal”. The participants said that they found the peer support program worthwhile.Conclusions: Nurses on the implementation units indicated receiving more support after the peer support program was implemented and felt the program was beneficial. Since unanticipated events are inevitable in health care, the steering committee recommended sustaining and spreading the program to all the nursing departments. More data is needed to determine the full impact of the program.
TL;DR: In this article , a Magnet-designated acute care community hospital in Southeast Texas experienced a COVID-19 surge during the summer of 2020 that increased the acuity of admitted patients.
Abstract: A Magnet®-designated acute care community hospital in Southeast Texas experienced a COVID-19 surge during the summer of 2020 that increased the acuity of admitted patients. The critical care, intermediate care, and COVID-19 units were consistently at capacity. These beds were no longer considered an available resource, but their need continued to grow. As hospital acuity increased, patients were placed in medical or surgical (medsurg) units when historically they may have been placed in a critical care unit. Hospital leadership determined that more space was needed to cohort COVID-19 patients, specifically those on high-flow oxygen. Given the decrease in observation status patients, an existing observation unit was converted into a high-flow oxygen unit using team nursing and personal protective equipment (PPE) zones. The successful transformation of the observation unit provided a guide on the cohorting of patients and team nursing approach for any future disease surges.
TL;DR: In this paper , the impact of 40 days of theoretical and practical training on 43 selected nurses from 16 hospitals located in the Hai’l Health cluster, situated in the city of Hai'l, Saudi Arabia.
Abstract: Objective: Competent and trained nurses are essential for critical care preparedness. This study assesses the impact of an educational training program (Jahezon) on the participants' critical care knowledge by comparing their pre- and post-knowledge outcomes.Methods: This study used a quasi-experimental one-group pre-test-post-test design to examine the impact of 40 days of theoretical and practical training on 43 selected nurses from 16 hospitals located in the Hai’l Health cluster, situated in the city of Hai’l, Saudi Arabia. The training program started on November 2021, the curriculum covered a comprehensive range of critical care nursing concepts and was divided into four phases. The instrument used to assess knowledge was a 50-item multiple-choice questionnaire, which was administered as a pre-test, post-test, and a 6-month follow-up test format. The data were analyzed using SPSS v29.0.Results: The mean total scores were the highest in the follow up test (M = 9.87, SD = 2.34), followed by the post-test (M = 7.57, SD = 0.98) and the pre-test (M = 5.91, SD = 1.06), showing a statistically significant difference (F(2, 117) = 64.834, p < .001). From the pre-test to the post-test, 93% of the total scores improved. The only demographic factor that affected the test scores was gender, with female nurses scoring higher.Conclusions: The nurses' knowledge improved significantly after their participation in the critical care training program, but more research is needed to determine their actual performance in caring for critically ill patients during a pandemic.
TL;DR: In this article , the authors used a quantitative descriptive design to examine the relationship between psychological variables and heart failure self-management and found that relatively mild alterations in depression and anxiety were associated with physical activity during the pandemic and having engaged in Cardiac Rehabilitation prior to the lockdowns.
Abstract: Covid-19 presented tremendous challenges to healthcare systems throughout the world. In particular, the presence of comorbid conditions became a significant factor due to the greatly increased risk of hospitalization and death in people living with diseases such as Congestive Heart Failure. While the literature has long indicated relationships between psychological challenges (depression and anxiety), the pandemic represented a particular challenge due to the way that it limited individual’s ability to engage in activities outside of the home. While all activities were limited, exercise presented a particular challenge as it is so essential to Congestive Heart Failure self-management. The current study used a quantitative descriptive design to examine the relationship between psychological variables and heart failure self-management. The study indicated relatively mild alterations in depression and anxiety. However, the results indicated a significant relationship between physical activity during the pandemic and having engaged in Cardiac Rehabilitation prior to the lockdowns (p < .05). Further, the results indicated that self-efficacy related to self-management was higher in patients who engaged in higher activity levels (p < .001). The study supported the importance of cardiac rehabilitation and subsequent exercise in establishing self-efficacy and beneficial outcomes in patients living with Congestive Heart Failure.
TL;DR: In this article , the authors implemented several rapid-cycle change interventions with a high-level action plan to reduce the left without being seen (LWBS) rate in emergency departments.
Abstract: Background and objective: The COVID-19 pandemic in 2020 increased the volume of patients seeking care in the Emergency Department (ED) for a respiratory crisis. Our community hospital experienced a filling of inpatient beds, leading to an overflow of admitted patients in the ED, where adequate staff (nurses, physicians, radiology, and laboratory staff), equipment, and rooms or places for patients were lacking. Times to obtain procedures that included cardiology, laboratory, and radiology performed and resulted significantly increased. Left without being seen (LWBS) is a challenge faced by EDs across the United States (US) and has become more prevalent since the COVID-19 pandemic. Best practice suggests an LWBS rate of less than 2%, but our hospital experienced an increasing rate of hitting over 5\% in January 2021. To reduce this rate, we implemented multiple rapid-cycle Plan-Do-Check-Act (PDCA) change interventions in triage and throughout the ED.Implementation/Methods: We implemented several rapid-cycle change interventions with a high-level action plan. These actions included hiring medical/surgical nurses to care for admitted patients awaiting beds, adding additional medical providers, implementing greeters, creating specialty chairs inside a major hospital thoroughfare, opening a 12-bed Admit Care Unit (ACU) adjacent to the ED, and more.Results: The rate of LWBS decreased from a high of 5.3% in January 2021 to 1.09% in January 2022.Conclusion/Implications to Practice: Patients in the ED recorded as LWBS are at higher risk for safety and quality transgressions. We continue to work toward excellent patient care by continuing to implement rapid-cycle changes in response to barriers as they arise. More research is needed to expand and rethink the process of ED throughput during pandemics and emergent national crises.
TL;DR: This study identifies nursing students’ vaccine understanding by exploring information learned from formal online vaccine education specifically the Nursing Initiative Promoting Immunization Training Modules (NIP-IT).
Abstract: Background and objective: Despite the importance of vaccination in disease prevention some people choose to remain unvaccinated. Nurses are influential in the choice to vaccinate. Considering the possibility of poor public understanding of vaccines and need for continued improvement in vaccination rates, it is essential for nurses to be knowledgeable and adept at addressing vaccine concerns, especially since the COVID-19 pandemic. Vaccination education formally begins in nursing school. The objective of this study was to identify nursing students’ vaccine understanding by exploring information learned from formal online vaccine education specifically the Nursing Initiative Promoting Immunization Training Modules (NIP-IT).Methods: Nursing students enrolled in a Community Health Nursing course were required to complete three online, self-study, modules entitled Vaccine Preventable Diseases, Vaccine Concerns, and Nursing Roles. The nursing students who completed these modules responded, in writing, to an open-ended prompt asking them to identify what new piece of information they learned. Responses gathered from 244 nursing students between September of 2016 and April of 2018 were categorized and grouped according to theme using a first and second cycle coding process. Responses containing more than one idea were considered separate responses and categorized accordingly totaling 273 responses.Results: Nursing student responses revealed five major themes regarding new information learned from the online modules: (1) barriers to vaccination; (2) components of vaccines; (3) the influence of nurses; (4) vaccine-preventable diseases; and (5) community immunity.Conclusions: Formal vaccine education is a critical component of a comprehensive nursing program. The nursing students in this study described information they learned when completing the NIP-IT modules, thus it was inferred the nursing students did not have a full understanding of vaccine concepts prior to viewing the modules. Formal nursing school vaccine education is essential in developing nurses capable of navigating vaccine issues and promoting health and preventing disease through vaccination advocacy.
TL;DR: In this article , a framework for integrating palliative care into the nursing curriculum to accelerate advanced practice care competencies was developed, which includes sequential lectures, case studies, practice scenarios, articles, and interprofessional palliativity care simulations across multiple courses.
Abstract: Introduction and objective: It is essential that nursing education prepares graduates to achieve the core skills required for the delivery of quality evidence-based palliative care. Hence, integrating advanced practice palliative care content into the nursing curriculum is an important priority. The objective of this study was to develop a framework and describe the process of integrating palliative care into the nursing curriculum to accelerate advanced practice palliative care competencies.Methods: Case-study methodology was used to describe an educational initiative. Through this initiative, palliative care education and skills-based resources have been integrated into the graduate nursing curriculum.Results: Varied palliative care learning resources have been incorporated and include sequential lectures, case studies, practice scenarios with identified palliative care needs, articles, and interprofessional palliative care simulations across multiple courses. To integrate palliative care content into the nursing curriculum a Framework for Integrating Palliative Care in Nursing Education was developed consisting of a cycle of five specific processes: 1) Assessment of curricular needs and goals, 2) Identification and development of resources, 3) Integration of teaching and learning activities, 4) Evaluation of content and learning, 5) Dissemination of resources and findings. A supportive organizational structure and an academic-practice partnership were identified as essential infrastructures for these processes.Conclusions: This educational initiative was vital in increasing the advanced practice nursing workforce with essential palliative care competencies to provide clinical leadership in a rapidly changing healthcare delivery system.
TL;DR: In this article , the authors adopted a mixed method study design to determine the suitable specialty nurses for ICU attachment during a pandemic, and they explored experiences, perceptions and factors influencing resilience of non-ICU nurses during the COVID-19 pandemic.
Abstract: Background and objective: The coronavirus outbreak in 2019 has created unprecedented pressure on health care staff and material resources such as PPEs, Ventilators, Oxygen supplies, hospital beds etc. Ensuring an adequate supply of nurses to maintain a high standard of care and safe infective care practices in the phase of the increased patient load is a huge challenge for all stakeholders. Utilizing non-ICU nurses for ICU care is an option. However, factors that influence the optimal selection and coping behaviour (resilience) of a non-ICU nurse are not well examined. In this paper, we “adopt a mixed method design” to determine the suitable specialty staff for ICU attachment during a pandemic. I will emphasise the significance of educational training and preparation of critical care on non-ICU nursing staff in relation to their adaption and coping level throughout this study. The objectives of this study were (1) to explore experiences, perceptions and factors influencing resilience of non-ICU nurses during the COVID-19 pandemic and (2) to review the lived experience of non-ICU nurses after the critical care competency training programme.Methods: After obtaining the comments from the Dissertation Review Board, the study adopted a mixed method study design. The authors selected 76 samples (eight males and sixty-eight females) by “non-probability convenient sampling”. The authors used a survey for data collection lasting 8 weeks. The authors used descriptive (frequency, percentage distribution, mean and standard deviation) and inferential statistics to analyse the data collected.Results: The study revealed that most of the staff (75%) met the prepared objectives of the orientation program. Approximately 90% of the staff agreed that they are able to take care of critically ill patients with minimal supervision. Further, 29% of the staff stated that psychological preparation & staff readiness are the first priorities to be considered before ICU attachment. We also evaluated the ability of the staff to bear the ICU workload, and 51% of the staff reported it being bearable. This number is similar to the number of staff who reported suitable health status to physical exertion needs of the ICU. Staff age, marital status, gender, qualification, area of experience, and years of experience did not influence staff coping mechanisms. However, the attachment staff with previous ICU exposure have effective coping mechanisms during their attachment in ICU.Conclusions: In shortage of ICU staff in case of a pandemic, staff with neurology and neurosurgery background showed a higher confidence and coping level to ICU stressful environment. Furthermore, staff with other clinical backgrounds can work effectively during this circumstance with organized training, preparedness plan, effective clinical follow up and psychological support. All these factors facilitate the coping mechanism.
TL;DR: In this article , a quality improvement project is proposed to integrate staff education, every 4 hours vital signs monitoring guided by sepsis screening score and structured response via a process map to reduce unplanned 30-day readmission rate by 25% from baseline at a hospital-based skilled nursing facility.
Abstract: Background: Sepsis is a common and costly medical emergency, often leading to unplanned readmissions. The purpose of this quality improvement project is to integrate staff education, every 4 hours vital signs monitoring guided by sepsis screening score, and structured response via a process map to reduce unplanned 30-day readmission rate by 25% from baseline at a hospital-based skilled nursing facility (HBSNF).Methods: This project was conducted at an 18-bed HBSNF. Prior to implementing this project, all registered nurses and patient care assistants received education on sepsis. Registered nurses were also trained in the proper use of Nursing Sepsis Management Order Set and How to Respond: A Patient with Suspected Sepsis Process Map. From September 1 to November 30, 2020, the project gradually increased vital signs monitoring frequency from every 12 hours to every 4 hours based on patients’ sepsis risk stratified by sepsis screening score in 3 phases. Systemic Inflammatory Response Syndrome criteria was used to identify sepsis-related unplanned readmissions.Results: Overall, the 3-month vital signs monitoring compliance rate was 96% (5019/5223). The sepsis-related unplanned 30-day readmission rate was reduced from baseline 47% (17/36) to 21% (4/19) at the end of this project, about a 55% decrease from baseline.Conclusions: The combination of an evidence-based electronic surveillance system and change in management strategies significantly reduced sepsis-related unplanned 30-day readmissions at this HBSNF. Dissemination of these innovations could improve sepsis management in other HBSNFs and positively impact patients’ health outcomes and healthcare costs.
TL;DR: In this article , the effect of chayote soup and celery leaves on blood pressure levels in respondents with hypertension in the East Kalabahi Village, Teluk Mutiara District, Alor Regency, NTT.
Abstract: Background: Hypertension is a problem that needs to be watched out for because there are no specific signs and symptoms, of hypertension and some people still feel healthy to do their activities as usual, this is what makes hypertension a silent killer.
Purpose: To determine the effect of chayote soup and celery leaves on blood pressure levels in respondents with hypertension in the East Kalabahi Village, Teluk Mutiara District, Alor Regency, NTT.
Methods: This research is a quantitative study by conducting experiments to find the effect of treatment. The type of research used was pre-experimental designs (non-designs), with a one-group pre-test and post-test design. The sample used in this study was total sampling i.e. 30 people.
Results: The results of the t-paired sample test for systolic blood pressure obtained t (29) = 9.798 p-value = 0.000 < α = 0.05 and the Wilcoxon Signed Ranks test for diastolic blood pressure yielded Z-count = -3.694 p-value = 0.000 < α = 0.05, which means H0 is rejected and Ha is accepted.
Conclusion: There is an effect of giving chayote soup and celery leaves on blood pressure levels in hypertension sufferers in the Kalabahi Timur Village, Teluk Mutiara District, Alor Regency, NTT.