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Almarhabi M, Cornish J, Raleigh M, Philippou J. Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia. NURSE EDUCATION TODAY 2024; 134:106092. [PMID: 38262185 DOI: 10.1016/j.nedt.2024.106092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care. OBJECTIVES To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions. DESIGN A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development. SETTINGS Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia. PARTICIPANTS Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated. METHODS Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis. FINDINGS Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement. CONCLUSION This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided. TWEETABLE ABSTRACT The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.
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Affiliation(s)
- Maha Almarhabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Jocelyn Cornish
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Mary Raleigh
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
| | - Julia Philippou
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
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Almarhabi M, Cornish J, Raleigh M, Philippou J. In-service education in trauma care for intensive care unit nurses: An exploratory multiple case study. Nurse Educ Pract 2023; 72:103752. [PMID: 37619286 DOI: 10.1016/j.nepr.2023.103752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
AIM This study explores the perceptions of intensive care units (ICUs) nurses with different educational backgrounds regarding their abilities in trauma care and the in-service education they receive to support it. BACKGROUND The advanced care of patients with traumatic injuries in ICU environments requires skilled and knowledgeable nurses, who need continuing and in-service education to provide the best care. Therefore, it is essential to understand the competencies and educational support these nurses may need in the ICUs to ensure safe and effective care delivery. DESIGN An exploratory multiple case study design was used, comprising three hospitals located in two different regions of Saudi Arabia. METHODS The study was conducted between October 2021 and March 2022. A total of forty ICU clinical staff, twelve managers, nine leaders and seven clinical educators participated in semi-structured interviews, which were complemented by a review of available documents on the trauma care in-service education syllabi, competencies and protocols. Interview data were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis. FINDINGS The data analysis revealed two interrelated categories relevant to trauma care: (i) care practice and (ii) education practice. The trauma care practice category highlighted the limited competencies and education in trauma care, as well as the perceived challenges and educational needs of nurses. The education practice category described the staff learning behaviours, supervision practices and in-service education systems in the participants' settings. CONCLUSIONS The study concludes that there is a lack of trauma care education at the examined sites. It suggests the need for further research to develop a theoretical foundation for trauma care education that can meet ICU nurses' educational needs while this being feasible to implement in the specific ICU context and practice.
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Affiliation(s)
- Maha Almarhabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Jocelyn Cornish
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Mary Raleigh
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Julia Philippou
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
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Marshall C, Forgeron P, Harrison D, Young NL. Exploration of nurses' pediatric pain management experiences in rural hospitals: A qualitative descriptive study. Appl Nurs Res 2018; 42:89-97. [PMID: 30029720 DOI: 10.1016/j.apnr.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hospitalized children continue to experience inadequate pain management. Children in the rural hospital setting may be at risk due to unique challenges experienced by Registered Nurses (RNs) in this context. OBJECTIVES To understand the experience of pain care from RNs who work in rural hospitals with inpatient pediatric patients. DESIGN Qualitative description that used semi-structured interviews to explore RNs' inpatient pediatric pain care experiences. PARTICIPANTS RNs who: 1) worked directly with pediatric in-patients; 2) spoke English; 3) and who worked in rural Northern Ontario. Hospital sites were selected based on population density, from one province in Canada. To reduce heterogeneity, only sites with dedicated pediatric beds were eligible (n = 9). METHODS This qualitative descriptive study used semi-structured interviews over Skype and telephone. Data were analyzed using inductive content analysis. RESULTS Ten participants were recruited from seven sites. Five main categories were identified, with one category that influenced all other categories. Rural RNs needed to practice as generalists as they care for many types of patients. Resource challenges included a lack of specialist expertise and educational opportunities. Pediatric pain was not perceived as a priority within their organizations. Most participants perceived there were no explicit standards for pain care. Moving forward the adoption of built in assessments in electronic documentation was suggested as a solution to standard pain care. CONCLUSIONS Opportunity exists to improve pediatric pain management, however, without a systematic approach that considers the rural context, pain care for children will continue to be based on individual's beliefs and knowledge.
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Affiliation(s)
- Carolyn Marshall
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Paula Forgeron
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Denise Harrison
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Nancy L Young
- Laurentian University, Faculty of Rural and Northern Health, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.
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Bibi S, Rasmussen P, McLiesh P. The lived experience: Nurses' experience of caring for patients with a traumatic spinal cord injury. Int J Orthop Trauma Nurs 2018; 30:31-38. [PMID: 29934253 DOI: 10.1016/j.ijotn.2018.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/26/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Nurses are involved in delivering care for patients following acute traumatic spinal cord injury throughout the entire care journey. An injury of this type is significant for the individual and their family and can be challenging for nurses delivering care for patients with life changing injuries, especially for nurses new to this setting. There is a lack of research that examines the experience of nurses caring for these patients in the acute setting. METHOD A hermeneutic phenomenological approach was used to understand the experience of nurses caring for patients in the acute setting who had sustained a traumatic spinal injury with associated neurological deficit. Using the phenomenological approach guided by the insight of Gadamer and Max Van Manen, participants with a broad range of experience were recruited and interviewed. The responses were transcribed into a text and subjected to hermeneutic analysis. Burnard's (1991) 14-step process and the hermeneutic approach were used to interpret and understand the phenomenon of interest. CONCLUSION The study highlights the experience and challenges of providing care to these individuals. Although patients had significant physical disabilities and were often dependent physically, the nurses' concerns were directed more towards fulfilling their psychological needs. Nurses identified grieving patients and felt their role was to provide realistic hope to motivate them. They felt an internal tension regarding desensitisation towards their patients, but this was often an internal protective mechanism to deal with the significance of the events surrounding these patients. Nurses new to this setting took time to learn the routines and manage the unique challenges effectively. Caring for these patients gave the nurses the opportunity to understand their patients and their families, and appreciate that both groups will fluctuate in their behavior throughout the acute process, as they adjust to grief and loss.
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Affiliation(s)
- Shareena Bibi
- Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
| | - P Rasmussen
- Adelaide Nursing School, University of Adelaide, Australia
| | - P McLiesh
- Adelaide Nursing School, University of Adelaide, Australia
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Abstract
Trauma leads to 5.7 million annual deaths globally, accounting for 25%-33% of global unintentional deaths and 90% of the global trauma burden in low- and middle-income countries. The Lancet Commission on Global Surgery and the World Health Organization assert that emergent and essential surgical capacity building and trauma system improvement are essential to address the global burden of trauma. In response, the Rutgers Global Surgery program, the School of Nursing and Medicine, and the Robert Wood Johnson University Hospital faculty collaborated in the first Interprofessional Models in Global Injury Care and Education Symposium in June 2016. This 2-week symposium combined lectures, high-fidelity simulation, small group workshops, site visits to Level I trauma centers, and a 1-day training course from the Panamerican Trauma Society. The aim was to introduce global trauma nurses to trauma leadership and trauma system development. After completing the symposium, 10 nurses from China, Colombia, Kenya, Puerto Rico, and Uruguay were surveyed. Overall, 88.8% of participants reported high levels of satisfaction with the program and 100% stated being very satisfied with trauma lectures. Symposia, such as that developed and offered by Rutgers University, prepare nurses to address trauma within system-based care and facilitate trauma nursing leadership in their respective countries.
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Morrison LE, Joy JP. Secondary traumatic stress in the emergency department. J Adv Nurs 2016; 72:2894-2906. [PMID: 27221701 DOI: 10.1111/jan.13030] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 11/27/2022]
Abstract
AIM To investigate the prevalence of secondary traumatic stress among Emergency nurses in the West of Scotland and explore their experiences of this. BACKGROUND Unexpected death, trauma and violence are regular occurrences that contribute to the stressful environment nurses working in the Emergency department experience. A potential consequence of repeated exposure to such stressors can be referred to as secondary traumatic stress. DESIGN Triangulation of methods of data collection, using two distinct phases: Phase 1 - quantitative Phase 2 - qualitative METHODS: Quantitative data were collated via postal questionnaire, from a convenience sample of Emergency nurses. Qualitative data were subsequently collated from a focus group constituting of a random sample of these Emergency nurses. Descriptive statistics were computed and thematic analysis conducted. All data were collated during February 2013. RESULTS/FINDINGS 75% of the sampled Emergency nurses reported at least one secondary traumatic stress symptom in the last week. Participants said that acute occupational stressors such as resuscitation and death were the influencing factors towards this. Strategies such as formal debriefing and social support were cited as beneficial tools for the management of secondary traumatic stress; however, barriers such as time and experience were found to inhibit their common use. CONCLUSION Secondary traumatic stress is a prevalent phenomenon among Emergency nurses in the West of Scotland and if not managed appropriately, could represent a significant barrier to the mental health of this group and their capacity to provide quality care.
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Sandström L, Nilsson C, Juuso P, Engström Å. Experiences of nursing patients suffering from trauma - preparing for the unexpected: A qualitative study. Intensive Crit Care Nurs 2016; 36:58-65. [PMID: 27173952 DOI: 10.1016/j.iccn.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/03/2016] [Accepted: 04/02/2016] [Indexed: 11/17/2022]
Abstract
SETTINGS AND OBJECTIVES A midsize hospital in the north of Sweden with a high-tech intensive care unit and space for up to 10 patients, with an attached postoperative ward for up to 15 patients. The wards are manned by critical care nurses who are also responsible for carrying a trauma pager. When the alarm goes off, the critical care nurse leaves her/his duties and joins a trauma team. The aim of the study was to describe critical care nurse's experiences of nursing patients suffering from trauma. METHOD A qualitative descriptive design was used. Data were collected through four focus group discussions with 15 critical care nurses analysed using qualitative content analysis. FINDINGS One theme: Preparing for the unexpected with four subthemes: (1) Feeling competent, but sometimes inadequate; (2) Feeling unsatisfied with the care environment; (3) Feeling satisfied with well-functioning communication; and (4) Feeling a need to reflect when affected. CONCLUSIONS Nursing trauma patients require critical care nurses to be prepared for the unexpected. Two aspects of trauma care must be improved in order to fully address the challenges it poses: First, formal preparation and adequate resources must be invested to ensure delivery of quality trauma care. Secondly, follow-ups are needed to evaluate care measures and to give members of the trauma team the opportunity to address feelings of distress or concern.
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Affiliation(s)
- Linda Sandström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden.
| | - Carina Nilsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Päivi Juuso
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Åsa Engström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Chou PL, Chien CS, Lee BO, Bai YL, Hung CC. Early Recovery Experience of Patients With Injury in Taiwan. J Nurs Scholarsh 2014; 46:245-52. [DOI: 10.1111/jnu.12084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Pi-Ling Chou
- Assistant Professor, Department of Nursing; Chung-Hwa University of Medical Technology; Taiwan
| | - Chi-Sheng Chien
- Department of Orthopaedic Surgery, Chi Mei Medical Center & Assistant Professor; Department of Electrical Engineering; Sothern Taiwan University of Science and Technology; Taiwan
| | - Bih-O Lee
- Associate Professor, Department of Nursing; Chang Gung University of Science and Technology; Chia-Yi Campus Taiwan
| | - Yu-Ling Bai
- Instructor, Department of Nursing; Chung-Hwa University of Medical Technology; Taiwan
| | - Chang-Chiao Hung
- Assistant Professor, Department of Nursing; Chang Gung University of Science and Technology; Chia-Yi Campus Taiwan
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Alzghoul MM. The experience of nurses working with trauma patients in critical care and emergency settings: A qualitative study from Scottish nurses’ perspective. Int J Orthop Trauma Nurs 2014. [DOI: 10.1016/j.ijotn.2013.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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