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Taylan S, Özkan İ, Yavuz van Giersbergen M. Nursing Students' Operating Room Experiences: A Qualitative Metasynthesis. J Perianesth Nurs 2024; 39:892-901. [PMID: 38661584 DOI: 10.1016/j.jopan.2023.12.029] [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: 05/03/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 04/26/2024]
Abstract
PURPOSE This study was conducted to analyze the findings of qualitative studies about nursing students' experiences with operating room (OR) practices. There is a need to conduct metasynthesis studies to highlight the overarching dimensions of nursing students' experiences in the OR learning environment, identify and summarize key elements, draw attention to the professional implications of the experience, and then help define the future research agenda. This original study is the first metasynthesis of qualitative studies focusing on nursing students' OR practice experiences. DESIGN A qualitative metasynthesis. METHODS This metasynthesis study was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and registered with PROSPERO (International prospective register of systematic reviews) (CRD42021252129). This metasynthesis consists of qualitative studies that included themes, were conducted with nursing students with OR experience, and were published in English between December 2000 and June 2022. Data were analyzed using the two-step metasynthesis procedures proposed by Sandelowski and Barroso. FINDINGS This metasynthesis study was carried out by analyzing 12 qualitative studies that met the inclusion criteria, reflected the results of a total of 244 nursing students, and were conducted in 7 different countries. As a result of the analysis of the studies, two main themes and seven subthemes were determined about the OR experiences of nursing students. The main themes of the study included (1) the OR environment and (2) professionalism and career choices. CONCLUSIONS The synthesis of studies in this research revealed nursing students' OR experiences and provided evidence about the association between these experiences and their professionalism and career goals. The research drew attention to the limitations and facilitators of the OR learning environment for nursing students and provided guidance for a positive interactive learning environment.
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Affiliation(s)
- Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey.
| | - İlknur Özkan
- Kumluca Faculty of Health Sciences, Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
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Taylan S, Özkan İ. Nursing Students' Perception of Missed Perioperative Nursing Care: Hermeneutic Phenomenology. J Perianesth Nurs 2024; 39:802-807. [PMID: 38583159 DOI: 10.1016/j.jopan.2023.12.013] [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: 05/23/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 04/09/2024]
Abstract
PURPOSE Missed nursing care is a condition that is likely to be encountered frequently in the surgical care process and is generally related to the educational and emotional needs of the patients. Perception of and witnessing missed care can affect nursing images, expectations, and experiences by causing nursing students to experience professional disappointment. The purpose of the study was to explore nursing students' perception of perioperative missed nursing care (PMNC) according to "role theory" and Benner's "novice to expert" theories. DESIGN The study used a qualitative design based on Heidegger's hermeneutical phenomenological approach. METHODS Study data were collected using a semistructured interview form prepared by the researchers through face-to-face interviews lasting approximately 50 minutes. The analysis of the data was conducted using van Manen's thematic analysis. The Standards for Reporting Qualitative Research checklist was used in reporting the study. FINDINGS This study, which was conducted to explore awareness of PMNC, consisted of 12 students, including five males and seven females. It was understood that nursing students noticed PMNC in clinical practice, experienced internal conflict about the issue, were concerned about the image of nursing, and experienced role and professional identity confusion. The themes of the study were formed in light of these experiences of nursing students. Three themes and 11 subthemes emerged in the study. The themes of the study were (1) perceived PMNC application-behavior patterns, (2) internal reflections of PMNC-its impact on professional identity development, and (3) perceptions of professionalism in perioperative nursing. CONCLUSIONS This study provided important data about the awareness of PMNC in the surgical clinical practice of nursing students in Turkey and the effects of this awareness on the professional roles and professional identity process. Students were aware of the behavioral patterns of PMNC and that they experienced internal conflict, anxiety about the nursing image, role confusion, and professional identity confusion due to this awareness. Some students justified the PMNC behaviors of the nurses and others saw themselves as the power to change the PMNC behaviors.
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Affiliation(s)
- Seçil Taylan
- Akdeniz University, Kumluca Faculty of Health Sciences, Nursing Department, Kumluca-Antalya, Turkey.
| | - İlknur Özkan
- Akdeniz University, Kumluca Faculty of Health Sciences, Nursing Department, Kumluca-Antalya, Turkey.
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Wieczorek-Wójcik B, Gaworska-Krzemińska A, Owczarek AJ, Kilańska D. Economic evaluation of the prevention of falls resulting from missed care in polish hospitals. Front Public Health 2024; 12:1228471. [PMID: 39351029 PMCID: PMC11440918 DOI: 10.3389/fpubh.2024.1228471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/27/2024] [Indexed: 10/04/2024] Open
Abstract
Objectives Falls are associated with increased morbidity, mortality, prolonged hospitalization and an increase in the cost of treatment in hospitals. They contribute to the deterioration of fitness and quality of life, especially among older patients, thus posing a serious social and economic problem. They increase the risk of premature death. Falls are adverse, costly, and potentially preventable. The aim of the study was to analyze the cost-effectiveness of avoiding one fall by nurse care provided by the nurses with higher education, from the perspective of the health service provider. Methods The economic analysis included and compared only the cost of nurse intervention measured by the hours of care provided with higher education in non-surgical departments (40.5%) with higher time spend by nurses with higher education level an increase in the number of hours by 10% (50.5%) to avoid one fall. The time horizon for the study is 1 year (2021). Cost-effectiveness and Cost-benefit analysis were performed. All registered falls of all hospitalized patients were included in the study. Results In the analyzed was based on the case control study where, 7,305 patients were hospitalized, which amounted to 41,762 patient care days. Care was provided by 100 nurses, including 40 nurses with bachelor's degrees and nurses with Master of Science in Nursing. Increasing the hours number of high-educated nurses care by 10% in non-surgical departments decreased the chance for falls by 9%; however, this dependence was statistically insignificant (OR = 1.09; 95% CI: 0.72-1.65; p = 0.65). After the intervention (a 10% increase in Bachelor's Degrees/Master of Science in Nursing hours), the number of additional Bachelor's Degrees/Master of Science hours was 6100.5, and the cost was USD 7630.4. The intervention eliminated four falls. The cost of preventing one fall is CER = USD 1697.1. Conclusion The results of these studies broaden the understanding of the relationship among nursing education, falls, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification.
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Affiliation(s)
| | | | - Aleksander Jerzy Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Dorota Kilańska
- Institute of Nursing and Midwifery, Medical University of Gdańsk, Gdańsk, Poland
- Department of Coordinated Care, Medical University of Lodz, Łódź, Poland
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Chiappinotto S, Bayram A, Lupi T, Basaran-Acil S, Gurkovà E, İspir Demir Ö, Kohanová D, Özsaban A, Grassetti L, Palese A. Unfinished nursing care occurrence, priority order and reasons as perceived by nursing students: An international study. Nurse Educ Pract 2024; 79:104100. [PMID: 39173395 DOI: 10.1016/j.nepr.2024.104100] [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: 05/23/2024] [Revised: 07/05/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024]
Abstract
AIM The study aimed to measure and compare differences (a) in the unfinished nursing care interventions overall and the order in which they are left unfinished; and (b) in the underline reasons, as perceived by Italian, Slovak and Turkish nursing students. BACKGROUND In recent years, in the nursing education context a novel line of research in the field of unfinished nursing care as those interventions required by patients, but omitted or delayed, has emerged. However, no studies have been conducted at the international level. DESIGN An international, comparative cross-sectional study was performed in 2022-2023 and reported here according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. METHODS A multinational research network was formed with a convenient sample of 13 universities and 60 campuses (4595 students). The Unfinished Nursing Care Survey for Students (UNCS4S) was administered. A total of 1850 students participated. RESULTS According to the UNCS4S total score, Italians reported an average 50.9 out of 110 unfinished nursing care interventions (CI95 % 47.6-54.1), Slovakians 54.9 (CI95 % 53.7-56.1) and Turkish students 50.4 (CI95 % 49.2-51.5) (p<0.001). Some interventions were reported more often as unfinished across countries as supervising the task assigned to the nursing aides, going to the patient without being called, spending the required time with the patient and their caregivers and emotionally supporting patients and their caregivers. In terms of reasons, total scores were statistically different across countries (Italy: 45.92 out of 90, CI95 % 43.91-47.9; Slovakia: 62, CI95 % 61.02-62.98; Türkiye: 72.29, CI95 % 71.13-73.45; p<0.001); however, at the factor level, communication issues, lack of material resources and issues in supervision of nursing aides were reported in all countries as the most important reasons of the unfinished nursing care. CONCLUSIONS Students learn to shape and set priorities early in their nursing careers with similar order in what to leave unfinished as first, despite the different educational structures, care cultures and healthcare systems. Among the unfinished nursing care reasons perceived, the most influential were similar across countries, suggesting common areas for improvement. How to better prepare students to be resilient and capable of managing the challenges posed by unfinished nursing care episodes due to the lack of resources and communications issues should be considered as a priority by nurse educators.
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Affiliation(s)
| | - Aysun Bayram
- Karadeniz Technical University, Faculty of Health Sciences, Department of Fundamentals Nursing, Trabzon, Türkiye.
| | - Tommaso Lupi
- University of Udine, Department of Medicine, Udine 33100, Italy.
| | - Seher Basaran-Acil
- Hacettepe University Faculty of Nursing, Nursing Services Administration Department, Ankara, Türkiye.
| | - Elena Gurkovà
- Elena Gurkova, University of Prešov, Faculty of Health Care, Department of Nursing, Prešov 08001, Slovakia.
| | - Öznur İspir Demir
- Osmaniye Korkut Ata University, Faculty of Health Sciences, Department of Gerontology, Osmaniye, Türkiye
| | - Dominika Kohanová
- Constantine the Philosopher University in Nitra, Faculty of Social Sciences and Health Care, Department of Nursing, Nitra 949 01, Slovakia.
| | - Aysel Özsaban
- Karadeniz Technical University, Faculty of Health Sciences, Department of Fundamentals Nursing, Trabzon, Türkiye.
| | - Luca Grassetti
- University of Udine, Department of Economy and Statistic, Udine 33100, Italy.
| | - Alvisa Palese
- University of Udine, Department of Medicine, Udine 33100, Italy.
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Dabney BW. RN-to-BSN Student Reports of Missed Nursing Care During the COVID-19 Pandemic. J Nurs Educ 2024; 63:478-481. [PMID: 38979734 DOI: 10.3928/01484834-20240505-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Missed nursing care (MNC) is an error of omission that affects patient safety and nurse job satisfaction. RN-to-baccalaureate nursing (BSN) students, who fulfill dual roles as learners and working nurses, possess valuable insights. Understanding their experiences during the coronavirus disease 2019 (COVID-19) pandemic is essential for nurse educators, as the stressors associated with MNC could have repercussions on student well-being and academic performance. METHOD This cross-sectional survey study used the MISSCARE Survey to explore the experiences of MNC among a sample of RN-to-BSN students during the COVID-19 pandemic. RESULTS The study findings indicate RN-to-BSN students encountered MNC and reported staffing issues and patient acuity as the primary reasons for such occurrences, aligning with existing literature. CONCLUSION Given the convergence between student reports and established research, it is imperative for nurse educators to address MNC with their students. This proactive approach will empower students to effectively manage this nursing practice concern. [J Nurs Educ. 2024;63(7):478-481.].
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Abawaji MA, Cardwell R, McKenna L. Missed nursing care among nursing students: A scoping review. NURSE EDUCATION TODAY 2024; 137:106169. [PMID: 38518403 DOI: 10.1016/j.nedt.2024.106169] [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: 10/27/2023] [Revised: 02/16/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Nursing students report facing inconsistencies between theoretical knowledge and actualities of clinical practice, and research indicates they witness missed nursing care during clinical practice. Understanding nursing students' experiences can inform improved clinical learning environments and enhance patient care quality. Recently, research has focused on students' views regarding missed care, yet comprehensive understandings of this phenomenon are lacking. OBJECTIVE This review explored what is known about missed nursing care from perspectives of nursing students. DESIGN A scoping review according to Arksey and O'Malley's framework and Joanna Briggs Institute methodology was undertaken. DATA SOURCES Key databases were searched, including Medline, Embase, CINAHL, Scopus, ProQuest, PsycINFO and Web of Science in August 2023. REVIEW METHODS The review included qualitative, quantitative, and structured literature reviews published in English between 2006 and 2023. Inclusion and exclusion criteria and keywords guided the search. Data screening and extraction were independently performed by two reviewers. Included studies were analysed using descriptive statistics and narrative synthesis. Findings are reported in accordance with the PRISMA-ScR. RESULTS Of the 5873 articles identified, nine were included in the review. Studies were conducted in seven countries. Themes in students' perceptions included negligence of patients' rights and dignity, living in limbo, and pragmatic acceptance. Reasons for missed care included ineffective teamwork, lack of interest in caring, and inefficient leadership. Missed nursing care adversely affected patient health, hindered student learning and professional growth. Strategies for improvement included enhancing teamwork, enforcing ethical issues, increasing supervision, and creating commitment to work. CONCLUSION Missed nursing care affects patient safety and education of nursing students. Incorporating practical training modules into curricula, establishing preceptorship programs, and incorporating ethics education into clinical practice are crucial to address missed nursing care. Further research in diverse settings is warranted.
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Affiliation(s)
- Muktar Abadiga Abawaji
- School of Nursing and Midwifery, La Trobe University, Australia; School of Nursing and Midwifery, Wollega University, Ethiopia.
| | - Rachel Cardwell
- School of Nursing and Midwifery, La Trobe University, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Australia.
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Moradi T, Rezaei M, Alavi NM. Delegating care as a double-edged sword for quality of nursing care: a qualitative study. BMC Health Serv Res 2024; 24:592. [PMID: 38715066 PMCID: PMC11075185 DOI: 10.1186/s12913-024-11054-4] [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: 12/03/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care. METHODS This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985). RESULTS In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword". CONCLUSIONS The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.
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Affiliation(s)
- Tayebeh Moradi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahboubeh Rezaei
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| | - Negin Masoudi Alavi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Kohanová D, Gurková E, Kirwan M, Žiaková K, Kurucová R. Nursing students' perceptions of unfinished nursing care: A cross-sectional study. Nurse Educ Pract 2024; 76:103942. [PMID: 38522345 DOI: 10.1016/j.nepr.2024.103942] [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: 11/28/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
AIM To investigate the prevalence, patterns and reasons for unfinished nursing care as perceived by nursing students. BACKGROUND Unfinished nursing care (UNC) is a frequently observed phenomenon in the acute care setting. To date, studies have focused primarily on the perspective of nurses or patients, but another important perspective is that of nursing students who provide nursing care in all healthcare settings. DESIGN A descriptive cross-sectional study. METHODS The study included 738 undergraduate nursing students from nine Slovak universities. Data were collected between September 2022 and February 2023 using the Slovak version of the Unfinished Nursing Care Survey tool (UNCS). Data were analyzed using descriptive and inferential statistics. RESULTS The mean composite score of UNCS was 2.48 (SD=0.68). In general, 100% of nursing students reported that nurses missed at least one or more nursing care activities during their last clinical placement. The average number of missed nursing care activities was 11.2 per nurse as perceived by nursing students during their last clinical placement. Nursing students reported that the most frequently omitted nursing care activity was spending time with patients and their caregivers (3.15 ± 1.11; 92.9%). The most frequently reported reason for UNC was an inadequate number of nurses on the ward (4.31 ± 1.01; 98.1%). In the study, reported UNC could be predicted by previous experience in healthcare, previous clinical rotation, number of patients per shift, perceived staff adequacy and outcome expectations (p <0.05). CONCLUSIONS The findings reveal that UNC is a widespread phenomenon and all nursing students report this phenomenon during their clinical placements. Spending time with patients and their caregivers emerged as the most frequently omitted nursing care activity, highlighting the importance of patient-centered care. The primary reason cited for UNC was an inadequate number of nurses, highlighting staffing issues as a significant contributing factor. These findings emphasize the need for targeted interventions to address staff shortages and improve nursing education to prepare students to address UNC in their future practice.
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Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, Slovakia.
| | - Elena Gurková
- Department of Nursing, Faculty of Health Care, University of Prešov, Slovakia
| | - Marcia Kirwan
- School of Nursing, Psychotherapy and Community Health, Dublin City University in Dublin, Ireland.
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Radka Kurucová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
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Al-Nawafleh AH, Altarawneh FZ. Nursing students perspectives of psychosocial care: cross-sectional study. BMC Nurs 2023; 22:392. [PMID: 37853417 PMCID: PMC10585772 DOI: 10.1186/s12912-023-01548-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Psychosocial care is an integral component of holistic nursing practices. This study aimed to examine how fourth-year nursing students at Mutah University perceive various care characteristics, specifically psychosocial care. METHODS A quantitative cross-sectional study was conducted using the Caring Dimension Inventory (CDI). Data were obtained from 105 nursing students before graduating from a Jordanian public educational institution. Data analyzed using the scoring of CDI and descriptive statistics. RESULTS The mean scores in the professional and technical domain of care were statistically higher for fourth-year nursing students (4.69 ± 0.25). This exceeded their scores in the psychosocial domain of care (3.37 ± 1.20). This suggests that fourth-year nursing students prioritize professional and technical care over psychosocial care. CONCLUSIONS Fourth-year nursing students tended to perceive the technical aspects of care as more significant than the psychosocial aspects. This highlights the need for nursing schools and healthcare providers to reconsider their focus and prioritize the importance of psychosocial care.
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Affiliation(s)
- Ahmad H Al-Nawafleh
- Department of Adult Health Nursing, Faculty of Nursing, Mutah University, Mutah, 61710, Jordan.
| | - Falah Zaal Altarawneh
- Falah Zaal Altarawneh (MSN, RN), Department of Community Health, Faculty of Nursing, Mutah University, Mutah, 61710, Jordan
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Alsalem N, Rashid FA, Aljarudi S, Al Bazroun MI, Almatrouk RM, Alharbi FM, Al Mansour L, Abuzaid NB. Exploring Missed Nursing Care in the NICU: Perspectives of NICU Nurses in Saudi Arabia's Eastern Health Cluster. Pediatr Rep 2023; 15:571-581. [PMID: 37873798 PMCID: PMC10594518 DOI: 10.3390/pediatric15040052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
(1) Background: Missed nursing care, an omission error characterized by delayed or omitted nursing interventions, poses significant risks to patients' safety and quality of car.; (2) Methods: This is a quantitative cross-sectional study on 151 nurses who work in NICUs in three main networks in the Eastern Health Province, Saudi Arabia: Dammam (n = 84), Qatif (n = 53), and Jubail (n = 14). The study uses a self-reported questionnaire (MISSCARE) and applies the 5-point Likert Scale. Statistical analysis data were analyzed using SPSS version 23.0. (3) Results: The primary reasons for missed care were shortage of nursing staff and unbalanced patient assignments. Missed nursing care negatively affects job satisfaction and was positively correlated with nurses' intentions to quit their jobs. Inadequate equipment, supplies, and breakdowns in communication between nurses and other healthcare professionals were also significant factors contributing to missed care. (4) Conclusions: Missed nursing care is associated with overwork, nursing shortages, and lower job satisfaction, impacting the quality of care provided in the NICU. Improving working conditions, nurse staffing, and patient assignment planning should be prioritized to address this issue effectively.
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Affiliation(s)
- Nasreen Alsalem
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
| | - Fatima Abu Rashid
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
| | - Saleh Aljarudi
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
| | | | - Roqayah Mirza Almatrouk
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
| | - Fatimah M. Alharbi
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
| | | | - Nahid Baker Abuzaid
- Maternity and Children Hospital, Dammam 32253, Saudi Arabia; (F.A.R.); (S.A.); (R.M.A.); (F.M.A.); (N.B.A.)
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Rahimi S, Ebadi A, Khankeh HR, Eghbali M, Sharifi A, Mohammadian B, Lotfi MS. Validation and psychometric properties of the Persian version of the MISSCARE survey. Nurs Open 2023; 10:6058-6066. [PMID: 37565382 PMCID: PMC10416002 DOI: 10.1002/nop2.1827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/20/2022] [Accepted: 05/07/2023] [Indexed: 08/12/2023] Open
Abstract
AIM To conduct, translate, and psychometric evaluation of the MISSCARE-Persian Survey. DESIGN A cross-sectional study was conducted in Iran in February-June 2021. METHODS The translation of the MISSCARE Survey was accomplished according to World Health Organization (WHO) guidelines. Construct validity was performed by (N = 300) exploratory factor analysis and confirmation. To assess the reliability, internal consistency was assessed using Cronbach's alpha coefficient, and relative stability was assessed using the interclass correlation coefficient (ICC). The study adhered to COSMIN guidelines. RESULTS The exploratory factor analysis, which resulted in the identification of three factors in the second part of the tool, explained 79.6% of the total variance. Confirmatory factor analysis indicated the model's good fit of information. The reliability of the first and second parts of the tool was 0.912 and 0.901, respectively. Additionally, the ICC was found to be 0.687 for the first and 0.706 for the second part of the tool.
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Affiliation(s)
- Shoeleh Rahimi
- University of Social Welfare and Rehabilitation Sciences (USWR)TehranIran
- Educational Supervisor of Faghihi Hospital in ShirazShiraz University of Medical SciencesFarsIran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Nursing FacultyBaqiyatallah University of Medical SciencesTehranIran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster research centerUniversity of Social Welfare and Rehabilitation SciencesTehranIran
- Department of Clinical Science and EducationKarolinska InstituteStockholmSweden
| | - Mohammad Eghbali
- Department of Nursing, school of Nursing and MidwiferyTorbat Heydariyeh University of Medical SciencesTorbat HeydariyehIran
| | - Azam Sharifi
- Nahavand School of Allied Medical SciencesHamadan University of Medical SciencesHamadanIran
| | - Batol Mohammadian
- Department of Operating Room, School of Allied Medical SciencesGonabad University of Medical SciencesGonabadIran
| | - Mohammad Sajjad Lotfi
- Trauma Nursing Research Centre, Faculty of Nursing and MidwiferyKashan University of Medical SciencesKashanIran
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12
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Palese A, Chiappinotto S, Bayram A, Sermeus W, Suhonen R, Papastavrou E. Exploring unfinished nursing care among nursing students: a discussion paper. BMC Nurs 2023; 22:272. [PMID: 37596561 PMCID: PMC10436392 DOI: 10.1186/s12912-023-01445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND In line with the impetus traceable among the nursing staff, studies regarding the perception of Unfinished Care among students have increased in recent years as also recommended by some policy documents in the consideration that, as future members of the staff, they are expected to raise concerns about failures in the standards of care. However, no discussion of their methodological requirements has been provided to date. The aim of this study is to debate Unfinished Care explorations among nursing students and developing recommendations. METHODS A Rapid Review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, followed by a scientific discussion based on empirical evidence that emerged from the review combined with expert knowledge. Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases were searched up to May 2022. RESULTS In the last five years, seven studies have been conducted by researchers affiliated at the university level, involving from 18 to 737 undergraduate students across Europe. By critically analysing their key aspects, there are derived some recommendations in conducting investigations in this field as, (a) the hidden meaning of Unfinished Care investigations among students by also deciding which concept is mostly appropriate to investigate; (b) the need of establishing alliances with the clinical settings in order to involve them in such explorations; (c) more complex research methods capable of exploring this issue among students by promoting learning outcomes and not only a simple data collection; and (e) the influences of these explorations on students' wellbeing, as well as on ethical implications and that regarding the relationship between the healthcare services and the universities. CONCLUSION Policymakers consider students to be key informants of the quality of nursing care issues witnessed during their clinical placements. The related emerging line of research is intriguing because of the underlying methodological, ethical and system complexities that need to be addressed according to some considerations.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Science, University of Udine, Udine, Italy.
| | | | - Aysun Bayram
- Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Walter Sermeus
- Leuven Institute for Healthcare Policy, University of Leuven, Leuven, Belgium
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
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Hunter KF, Dahlke SA. Fast thinking: How unconscious bias and binary language contribute to rationing of care to older persons. Int J Older People Nurs 2023; 18:e12538. [PMID: 37013362 DOI: 10.1111/opn.12538] [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: 08/15/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Binary or categorical thinking is a way of thinking in which the brain unconsciously sorts the masses of information it receives into categories. This helps us to quickly process information and keeps us safe through pattern recognition of possible threats. However, it can also be influenced by unconscious and conscious biases that inform our judgements of other people and situations. OBJECTIVES To examine nursing practice with older people through the lens of unconscious bias. METHODS In this critical analysis, using Kahneman's fast and slow thinking, we argue that nurses working with hospitalised older people often rely on thinking quickly in hectic work environments, which can contribute to unconscious and conscious bias, use of binary language to describe older persons and nursing tasks, and ultimately rationing of care. RESULTS Binary language describes older persons and their care simplistically as nursing tasks. A person is either heavy or light, continent or incontinent, confused or orientated. Although these descriptions are informed in part by nurses' experiences, they also reflect conscious and unconscious biases that nurses hold towards older patients or nursing tasks. We draw on explanations of fast (intuitive) and slow (analytical) to explain how nurses gravitate to thinking fast as a survival mechanism in environments where they are not supported or encouraged to think slow. CONCLUSIONS Nurses survival efforts in getting through the shift using fast thinking, which can be influenced by unconscious and conscious biases, can lead to use of shortcuts and the rationing of care. We believe that it is of paramount importance that nurses be encouraged and supported to think slowly and analytically in their clinical practice. IMPLICATIONS FOR PRACTICE Implications Nurses can engage in journaling and reflecting on their practice with older people to examine possible unconscious bias. Managers can support reflective thinking by supporting nurses through staffing models and encouraging conversations about person-centered care in unit practices.
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Affiliation(s)
- Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Ann Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Moon S, Chang SJ. Professional socialization of hospital nurses: A scale development and validation study. BMC Nurs 2023; 22:2. [PMID: 36597119 PMCID: PMC9811695 DOI: 10.1186/s12912-022-01169-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Tools currently available to measure professional socialization are outdated or could not reflect various properties of professional socialization of nurses. Thus, the objective of this study was to develop and validate a professional socialization measurement instrument for hospital nurses. METHODS Fifty-two items were initially extracted from literature reviews and in-depth interviews with 32 nurses. After content validity testing, 48 items remained. They were used to survey 881 hospital nurses in Korea in the testing phase for construct validity and reliability. RESULTS Four factors (21 items) were extracted: ethical practice and reflection, perception of respect and recognition, clinical competency based on leadership, and desires and motivation for professional development. These factors demonstrated good construct validity and reliability. Correlation coefficients of professional socialization with professional value, compassion satisfaction, secondary traumatic stress, and burden were 0.58 (p < 0.001), 0.70 (p < 0.001), - 0.08 (p = 0.014), and - 0.56 (p < 0.001), respectively. Reliability had a Cronbach's alpha of 0.95. Test-retest reliability intraclass correlation coefficient was 0.90. CONCLUSIONS The four professional socialization scale factors in this study reflected attributes of knowledge, skills, values, and professional roles. Professional socialization of nurses can be continuously developed by emphasizing elements of the professional socialization scale in nursing education programs. Nursing managers should help nurses go through the professional socialization process. The professional socialization scale will serve as a tool for developing careers of hospital nurses.
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Affiliation(s)
- Seongmi Moon
- grid.267370.70000 0004 0533 4667Department of Nursing, College of Medicine, University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan, 44610 South Korea
| | - Soo Jung Chang
- grid.411733.30000 0004 0532 811XDepartment of Nursing, Gangneung-Wonju National University, 150, Namwon-ro, Heungeop-myeon, Wonju, 26403 South Korea
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Pullan SJ, Rylance-Graham R, Crane J, Thornton E. Undergraduate nursing students' experiences of online education: A cross-sectional survey. TEACHING AND LEARNING IN NURSING : OFFICIAL JOURNAL OF THE NATIONAL ORGANIZATION FOR ASSCIATE DEGREE NURSING 2023; 18:56-62. [PMID: 36349288 PMCID: PMC9633324 DOI: 10.1016/j.teln.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
During the coronavirus pandemic, UK Academics were required to adjust their learning and teaching environment and pedagogical approaches, with little guidance or time. Feelings of frustration and uncertainty around student engagement were commonplace across Higher Education Institutions. This was heightened in professionally regulated courses, such as nursing. The shift to online learning created a situation where academics were frequently faced with a 'sea of black screens' and unable to ascertain student engagement. This study investigated undergraduate nursing students' experience of online education during the COVID-19 pandemic. An anonymous survey was distributed to each year of the undergraduate nursing programme and data subsequently analysed. Responses from 54 students revealed that engagement varied between different year groups. There were significant differences between those with pre-COVID (traditional face-to-face) teaching experience (years 2 and 3) and those without (year 1) in regard to self-reported engagement with online learning. The findings from this study revealed some powerful and emotional insights into the experience of online learning amongst UK students undertaking an undergraduate nursing programme during the COVID-19 pandemic.
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Affiliation(s)
- Samuel J Pullan
- School of Heath Sciences, Institute of Population Health, Thompson Yates Building, The Quadrangle, University of Liverpool, Liverpool, Merseyside L69 3GB, United Kingdom
| | - Rebecca Rylance-Graham
- School of Heath Sciences, Institute of Population Health, Thompson Yates Building, The Quadrangle, University of Liverpool, Liverpool, Merseyside L69 3GB, United Kingdom
| | - Julie Crane
- School of Heath Sciences, Institute of Population Health, Thompson Yates Building, The Quadrangle, University of Liverpool, Liverpool, Merseyside L69 3GB, United Kingdom
| | - Emma Thornton
- Institute of Population Health, Eleanor Rathbone Building, University of Liverpool, Liverpool, Merseyside L69 3GB, United Kingdom
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An Overview of Missed Nursing Care and Its Predictors in Saudi Arabia: A Cross-Sectional Study. Nurs Res Pract 2022; 2022:4971890. [PMID: 36278115 PMCID: PMC9581685 DOI: 10.1155/2022/4971890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nursing care is holistic, and missing any aspect of care can be critical to patients' health. However, due to the complex and intense nature of the nursing practice, nurses have to unintentionally prioritize some activities, forcing them to omit some aspects of nursing care. Aim To explore the dimensions of missed nursing care and its predictors within the Saudi Arabian healthcare system. Methods Quantitative, cross-sectional study used the MISSCARE survey by utilizing nonprobability convenience sampling to collect the data of 604 staff nurses working in inpatient wards in Jazan, Saudi Arabia. Results The overall mean of missed nursing care is (m = 1.37, SD = 0.45). Missed nursing care activities were mostly failure to attend interdisciplinary care conferences (m = 1.66, SD = 0.96) and patient ambulation thrice a day (m = 1.63, SD = 0.97). Missed nursing care was mainly caused by human resource shortage (m = 3.53, SD = 0.88). Missed nursing care is predicted by the turnover intention (B = 2.380, t = 3.829, p < 001) and job satisfaction (B = −0.864, t = −4.788, p < 001). Conclusion Although missed nursing care is evident in Saudi Arabia, it is significantly lower than the international rates, and it is mainly caused by labor resource shortage which directly influences nurses' job satisfaction and intention to leave. Optimizing the recruitment process, resource allocation and effective nurses' retention programs are proposed solutions that may be beneficial to mitigate missed nursing care.
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Blackman I, Shifaza F, Mc Neil L, Willis E, Verrall C, Henderson J. The presence of missed care: a staff development response. J Nurs Manag 2022; 30:3568-3577. [PMID: 35705193 DOI: 10.1111/jonm.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/16/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
AIMS This study quantifies the types and frequencies of missed care identified by nurses and measures its impact on their capacity to demonstrate mandatory practice standards as future hospital staff. BACKGROUND Considerable literature exists as to the nature of missed care but there is a paucity of findings about how missed care impacts on learning firstly as a student and then as a graduate nurse employed in a hospital setting. Additionally, there is little emphasis as to how staff development for nurses exposed to missed care may be implemented METHODS: A non-experimental research design using self-audit data was selected to collect information about the types and frequencies of missed care from nurses engaging in clinical experience. A convenience sample of 471 nursing students completing their undergraduate nursing degree program. A multi-variate statistical approach was used to apply and then model the consensus scores of undergraduate nurses' beliefs about the frequency of missed care. Implications for their developing competence in critical thinking, therapeutic communication and maintaining capacity for professional practice has been considered. RESULTS Eight variables directly affect student's total scores underpinning their understanding of missed care and their ability to meet professional standards of practice, given their exposure to care omission. These factors reflect differing nurse attributes, the nature of the clinical venues and shift times, preceptor type, student satisfaction with work teams and staffing adequacy. CONCLUSIONS Modeling outcomes suggest possible changes to hospital staff development learning program content, learning processes and how it may be better delivered through to minimise episodes of missed care.
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Affiliation(s)
- Ian Blackman
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Fathimath Shifaza
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Liz Mc Neil
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Claire Verrall
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Julie Henderson
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
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Janatolmakan M, Khatony A. Explaining the experiences of nurses regarding strategies to prevent missed nursing care: A Qualitative Study. J Nurs Manag 2022; 30:2054-2061. [PMID: 35510342 DOI: 10.1111/jonm.13662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe the experiences of nurses regarding strategies to prevent missed nursing care. BACKGROUND One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the healthcare policymakers. METHOD In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In-depth semi-structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management. RESULTS The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses", "manpower supply", "supervision", "specializing the activities", "providing resources and facilities", "encouraging teamwork", and "resolving dissatisfaction. " The main theme was " missed nursing care prevention strategies". CONCLUSION The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses 'empowerment, increasing nurses' job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies. Implications for nursing management Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care.
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Affiliation(s)
- Maryam Janatolmakan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Stress Levels and Coping Strategies Among Undergraduate Nursing Students in Greece During Economic Recession. Nurse Educ Pract 2022; 60:103299. [DOI: 10.1016/j.nepr.2022.103299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/18/2022]
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Strategies for Reducing Rationed Nursing Care: Qualitative Secondary Analysis. ACTA MEDICA MARTINIANA 2021. [DOI: 10.2478/acm-2021-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction: Nursing students spend a meaningful part of their professional training in clinical practice. However, to a significant extent, they actively or passively contribute to the occurrence of rationed nursing care in clinical practice. Therefore, it is crucial that they actively participate in implementing targeted strategies to reduce rationed nursing care.
Aim: To explore nursing students′ experience with strategies focusing on the reduction of rationed nursing care.
Methods: We chose a qualitative secondary analysis to address unpublished data related to nursing students′ experience with strategies focusing on reducing rationed nursing care. The data included a set comprising of 148 pages with transcribed verbatim of 18 semi-structured interviews. The data were analyzed by a deductive content analysis.
Results: Based on the outcome of the secondary analysis, we identified two meaningful categories: Preventive strategies in clinical practice and Importance and meaning of preventive strategies. These two categories reflected nursing students′ experience with targeted strategies to reduce rationed nursing care in clinical practice.
Conclusion: Proposal and subsequent implementation of preventive strategies are essential for reducing rationed nursing care phenomenon from the clinical practice environment. The perspective of nursing students is vital due to their intensive perception of rationed nursing care in clinical practice. Students may identify areas that work-place staff may not explicitly focus on and consider important but jeopardize the quality of care or patient safety.
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Habermann M, Stemmer R, Suhonen R. Missed nursing care as experienced by undergraduate nursing students. Pflege 2021; 35:15-21. [PMID: 34711066 DOI: 10.1024/1012-5302/a000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: In clinical settings where missed nursing care prevails, nursing students' instructions, supervision and the joint reflection on clinical practice with mentors are also affected and nursing students become involved in dealing with missed nursing care. AIM To explore the experience of missed nursing care in clinical placements, its meaning for nursing students, and actions they considered or took. METHODS Qualitative study based on a content analysis of nursing students' written reports. Nursing students in three universities in Germany with experience of at least one clinical practice placement were invited to participate. Online, they answered three open questions concerning missed nursing care focusing on: (1) experiences of the phenomenon, (2) its meaning and (3) actions that had been considered or taken when dealing with missed nursing care. A content analysis was performed. RESULTS The recruitment criteria were met by 69 nursing students. Four main themes and 20 sub-themes were identified. The reports covered all forms of missed nursing care. Becoming involved led to intrapersonal conflicts and, feelings of powerlessness but also to learning opportunities. It challenged professional and ethical standards. Students identified a broad spectrum of actions to answer the challenge. CONCLUSION Dealing with missed nursing care creates opportunities and challenges for nursing students. To build up a well-trained and sustainable nursing workforce, learning environments for nursing students must reflect the challenges and counteract deficits.
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Affiliation(s)
- Monika Habermann
- Centre of Nursing Research and Counselling, University of Applied Sciences, Bremen
| | | | - Riitta Suhonen
- Turku University Hospital and City of Turku, Welfare Services Division
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Grosso S, Longhini J, Tonet S, Bernard I, Corso J, De Marchi D, Dorigo L, Funes G, Lussu M, Oppio N, Grassetti L, Pais Dei Mori L, Palese A. Prevalence and reasons for non-nursing tasks as perceived by nurses: findings from a large cross-sectional study. J Nurs Manag 2021; 29:2658-2673. [PMID: 34369615 PMCID: PMC9291208 DOI: 10.1111/jonm.13451] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
AIM(S) To describe the prevalence and reasons for non-nursing tasks as perceived by nurses. BACKGROUND Four types of non-nursing tasks have been identified to date: (a) auxiliary; (b) administrative, (c) expected by allied health care professionals; and (d) medical. However, no studies on a large scale have been performed with the aim of identifying the prevalence of all of these non-nursing tasks, and factors promoting or hindering their occurrence, given that they represent a clear waste of nurses' time. METHOD(S) A cross-sectional study in 2017, following The Strengthening the Reporting of Observational studies. All active nurses registered in an Italian provincial Nursing Board (=1331) willing to participate were involved. A questionnaire survey exploring the nature of the nursing-tasks performed in daily practice and the underlying reasons was administered via paper/pencil and e-mail. RESULTS 733 nurses participated, of which 94.5% performed at least one type of non-nursing task, mainly administrative and auxiliary. Auxiliary tasks are less likely among nurses working in a community (Odds Ratio [OR] 0.43, 95% CI 0.29-0.63, p <0.01) or in a residential (OR 0.41, 95% CI 0.23-0.72, p <0.01) setting, in critical (OR 0.29, 95% CI 0.16-0.54, p <0.01) or surgical (OR 0.37, 95% CI 0.19-0.75, <p .01) hospital settings, and when they deal with unexpected clinical events (OR 0.58, 95% CI 0.44-0.77, p <0.01). Greater adequacy of nursing resources decreases the occurrence of auxiliary tasks (OR 0.98, 95% CI 0.97-0.99, p <0.01) while the need to compensate for a lack of resources (OR 1.44, 95% CI 1.07-1.93, p <0.01) increases it. CONCLUSION(S) Around one-third of shift time is devoted to non-nursing tasks; working in a hospital, in medical units, with lack of resources, and with patients with predictable clinical conditions might increase the occurrence of auxiliary tasks. IMPLICATIONS FOR NURSING MANAGEMENT Strategies to increase the time available for nursing care should consider the type of tasks performed by nurses, their antecedents, and the value-added to care in terms of patient' benefits.
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Affiliation(s)
| | - Jessica Longhini
- Department of Medical Sciences, University of Udine, Udine, Italy
| | | | - Ines Bernard
- Member of the Nursing Board IPASVI, Belluno, Italy
| | - Jacopo Corso
- Member of the Nursing Board IPASVI, Belluno, Italy
| | | | - Laura Dorigo
- Member of the Nursing Board IPASVI, Belluno, Italy
| | | | | | | | - Luca Grassetti
- Department of Medical Sciences, University of Udine, Udine, Italy
| | | | - Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy
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Palese A, Chiappinotto S, Canino E, Martinenghi G, Sist R, Milani L, Marcomini I, Grassetti L, Destrebecq A. Unfinished Nursing Care Survey for Students (UNCS4S): A multicentric validation study. NURSE EDUCATION TODAY 2021; 102:104908. [PMID: 33894594 DOI: 10.1016/j.nedt.2021.104908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/10/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Unfinished Nursing Care (UNC) indicates required interventions that are delayed or omitted. Nursing students are also exposed to UNC during their clinical rotations. However, no tools have been validated to date to collect UNC as perceived by them. OBJECTIVES To validate a tool measuring UNC as perceived by nursing students. DESIGN A validation study in 2018 by following the COnsensus-based Standards for the selection of health Measurement INstruments guideline. SETTING Three nursing programmes in Northern Italy. PARTICIPANTS All 1190 students who were attending their clinical rotation in hospital or community settings, were eligible. To assess the criterion validity, 30 clinical nurse supervisors in a random sample of units were involved. METHODS Content and face validity of the Unfinished Nursing Care Survey tool (UNCS) were assessed; then the tool, divided into part A (unfinished interventions) and B (reasons) was administered via Google and paper-pencil. Acceptability, construct validity (Mokken Scale Analysis, Exploratory and Confirmatory Factor Analyses), hypothesis testing, and criterion validity were assessed. RESULTS 737 students (61.9%) and 30 (100%) clinical nurse supervisors participated. On the Mokken Scale, with regard to part A, nursing interventions were ordered in higher and lower priority, reflecting different degrees of difficulty in terms of leaving the interventions unfinished. In the Confirmatory Factor Analyses, reasons for UNC were categorised into 'Communication', 'Priority setting', 'Nurses' aides' supervision', 'Material resources', 'Human resources', and 'Workload unpredictability'. Students in the second year perceived higher UNC occurrence; only some individual and nursing programme variables were significantly correlated with the UNC. No statistical differences emerged between the UNC perceptions of students and that of their clinical supervisors. CONCLUSION The Unfinished Nursing Care Survey for Students is composed of part A (22 items) and part B (18 items) seems to be valid in terms of acceptability, construct validity, hypothesis testing, and criterion validity.
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Lunardelli L, Danielis M, Bottega M, Palese A. Anticipated nursing care as perceived by nursing students: Findings from a qualitative study. Nurs Open 2021; 8:3373-3383. [PMID: 33939290 PMCID: PMC8510745 DOI: 10.1002/nop2.883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/25/2021] [Accepted: 03/15/2021] [Indexed: 11/11/2022] Open
Abstract
AIM To explore the perceptions of nursing students on the phenomenon of anticipated nursing care. DESIGN A descriptive-qualitative study was performed in 2019 according to the Consolidated Criteria for Reporting Qualitative Research principles. METHODS Data were collected using 16 face-to-face, audio-recorded interviews across four Italian Bachelor of Nursing degrees. Then, content analysis was performed, identifying, analysing and describing the anticipated nursing care phenomenon as perceived by nursing students. RESULTS Administering medications, providing fundamentals of care, managing some clinical procedures, freeing up the patient's bed and starting the shifts early emerged as the most anticipated nursing interventions. Stable, older patients who were more functionally dependent were reported to receive some fundamental nursing care before the expected time, while older, stable and more independent patients were used to receiving medications in advance. Anticipated nursing care is triggered by factors at the time management, resource, programming, professional and organizational levels.
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Affiliation(s)
- Lisa Lunardelli
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Matteo Danielis
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Michela Bottega
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Alvisa Palese
- Department of Medical Sciences, Udine University, Udine, Italy
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Nahasaram ST, Ramoo V, Lee WL. Missed nursing care in the Malaysian context: A cross-sectional study from nurses' perspective. J Nurs Manag 2021; 29:1848-1856. [PMID: 33544403 DOI: 10.1111/jonm.13281] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/08/2021] [Accepted: 01/31/2021] [Indexed: 12/15/2022]
Abstract
AIM To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses. BACKGROUND Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors. METHODS A cross-sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses. RESULTS The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00-5.00), which differed across 24 nursing care elements. Basic nursing care and communication-related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p < .001). No significant association was found between missed nursing care and nurses' intention to leave (p > .05). CONCLUSION The occurrence of missed nursing care was noted to be low. IMPLICATIONS FOR NURSING MANAGEMENT Practical strategies such as an acuity-based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care.
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Affiliation(s)
- Sri Theyshaini Nahasaram
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vimala Ramoo
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Ling Lee
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kalánková D, Bartoníčková D, Kirwan M, Gurková E, Žiaková K, Košútová D. Undergraduate nursing students' experiences of rationed nursing care - A qualitative study. NURSE EDUCATION TODAY 2021; 97:104724. [PMID: 33348299 DOI: 10.1016/j.nedt.2020.104724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nursing students are required to spend a significant portion of their educational preparation in clinical practice. Because of the prevalence of missed or rationed care, it seems irrefutable that students are exposed to rationed care during their practice placement, or that they contribute to its prevalence either actively or passively. OBJECTIVES The study aimed to discover how nursing students interpret the concept of rationed care, and their experiences of rationing in practice. DESIGN A descriptive qualitative study. PARTICIPANTS Eighteen final year nursing students from three universities within the Slovak Republic. METHODS Semistructured face-to-face interviews were conducted (n = 18). Data were analyzed using thematic analysis which resulted in the development of themes and subthemes. RESULTS We identified three meaningful themes focused on the phenomenon of rationed care from the perspective of nursing students, namely Incomplete care is normalized; Provision of impersonal patient care; and the Existence of a hidden curriculum for practice placements. CONCLUSIONS Student nurses were quite demanding about the learning experience during their clinical training. They are often frustrated by inconsistencies between their theoretical preparation and the realities of practice. They recognise difficulties for registered nurses in providing safe, high quality care in constrained circumstances, and although they are critical of this, they acknowledge their own acceptance of the situation. Based on this, students must establish an understanding of the theory behind, and reasons for rationed care before commencing clinical placement. A greater understanding would enable students to develop strategies for coping with inconsistencies and voicing concerns.
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Affiliation(s)
- Dominika Kalánková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic.
| | - Daniela Bartoníčková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic; Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic
| | - Marcia Kirwan
- School of Nursing and Human Sciences, Dublin City University in Dublin, Ireland.
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic.
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic.
| | - Dominika Košútová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
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Abstract
This article draws attention to the nature and importance of public policy. It argues that if nurses are to influence the quality of healthcare effectively, they must be engaged with policymakers to get nursing care issues on the policy agenda. There is an ethical imperative to do so, driven by the advocacy role of the nurse and rooted in the values base of nursing. In addition, it is argued that if one takes the role of patient advocacy seriously, as core to the nursing role, two things are required of nurses: We must (a) broaden the conceptualisation of patient advocacy beyond the individual patient to the system of healthcare resourcing and provision and (b) see systemic change as important as change at the bedside.
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Affiliation(s)
| | - P Anne Scott
- 8799National University of Ireland Galway, Ireland
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Markey K. Moral reasoning as a catalyst for cultural competence and culturally responsive care. Nurs Philos 2020; 22:e12337. [PMID: 33155425 DOI: 10.1111/nup.12337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/29/2020] [Accepted: 10/10/2020] [Indexed: 11/28/2022]
Abstract
The importance of developing cultural competence among healthcare professionals is well recognized. However, the widespread reports of insensitivity and deficiencies in care for culturally diverse patients illuminate the need to review how cultural competence development is taught, learnt and applied in practice. Unless we can alter the 'hearts and minds' of practising nurses to provide the care that they know they should, culturally insensitive care will continue operating in subtle ways. This paper explores the ideas behind nurses' actions and omissions when caring for culturally diverse patients and proposes the need to examine cultural competence development through a moral reasoning lens. Examining cultural competence development through a moral reasoning lens can help empower nurses, whilst nurturing commitment and courage to providing quality care that meets the needs of culturally diverse patients. The model of morality provides a framework that explores how moral motivation and behaviour occur and can provide a vehicle for critically examining the knowledge, skills and attitudes required to provide culturally responsive care.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Science Institute, University of Limerick, Limerick, Ireland
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Markey K, Ventura CAA, Donnell CO, Doody O. Cultivating ethical leadership in the recovery of COVID-19. J Nurs Manag 2020; 29:351-355. [PMID: 33098735 DOI: 10.1111/jonm.13191] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 12/21/2022]
Abstract
AIM To propose the necessity of fostering ethical leadership in the recovery of COVID-19. BACKGROUND Supporting physically and emotionally exhausted nurses, whilst ensuring quality standards of care delivery in the recovery phase of COVID-19, requires careful, considerate and proactive planning. EVALUATION Drawing on literature and utilizing Lawton and Paez Gabriunas' (2015) integrated ethical leadership framework (purpose, practices, virtues), possible practical suggestions for the operationalization of ethical leadership are proposed. DISCUSSION Nurse managers must maintain ethical vigilance in order to nurture value-driven behaviour, demonstrating empathy and compassion for nurses experiencing physical and emotional exhaustion because of COVID-19. It is important that open dialogue, active listening and self-care interventions exist. Nurse managers have an essential role in inspiring and empowering nurses, and building morale and a collective commitment to safe and quality care. CONCLUSION Nurse managers need to consider ways of empowering, supporting and enabling nurses to apply ethical standards in everyday practice. IMPLICATIONS FOR NURSING MANAGEMENT Fostering ethical nurse leadership requires careful and sensitive planning, as well as charismatic, compassionate and inspirational leaders. Supporting staff through respect, empathy, role modelling and genuine conscientiousness is essential for increasing job performance and sustaining an ethical work environment.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Carla Aparecida Arena Ventura
- Department of Psychiatric Nursing and Human Sciences, University of Sao Paulo at Ribeirao Preto College of Nursing, Ribeirao Preto, Brazil
| | - Claire O' Donnell
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
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Palese A, Cracina A, Marini E, Caruzzo D, Fabris S, Mansutti I, Mattiussi E, Morandini M, Moreale R, Venturini M, Achil I, Danielis M. Missed nursing education: Findings from a qualitative study. J Adv Nurs 2020; 76:3506-3518. [PMID: 32947646 DOI: 10.1111/jan.14533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/21/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
AIM To understand what nursing education activities are missed in the daily life of nursing programmes, by also identifying antecedents and consequences of missed educational activities. DESIGN A descriptive qualitative study according to the COnsolidated criteria for REporting Qualitative research guidelines. METHODS A purposeful sample of 32 participants with different roles (nurse educators, clinical nurses, students, and administrative personnel) and working in different settings (university, administrative, healthcare service levels) were involved in three focus groups and nine face-to-face interviews from 2019-2020. Both focus groups and face-to-face interviews were audio-recorded and transcribed verbatim. The data that emerged were thematically categorized by induction. FINDINGS Missed Nursing Education reflects those educational activities needed in the process of nursing education that are missed or delayed. Direct educational activities missed include clinical rotations, classroom teaching and students' overall learning experience. Indirect missed educational activities concern continuing professional development of nursing faculty members, nursing discipline development and the organizational processes of the nursing programme. As antecedents, missed nursing education is triggered by factors at the organizational, nursing faculty, and student levels. Consequences have been reported for students, nursing faculty, clinical nurses, and patients. CONCLUSIONS Missed Nursing Education can be considered a multifaceted, multicausal phenomenon, with multitargeted consequences. IMPACT To date, missed nursing care has only been investigated in clinical practice. However, care also permeates the relationship between nurse educators and students. Thus, at the point of 'educational care' delivery, aspects can also be omitted. Educational activities at risk of being missed or delayed affect the quality of nursing education and, in the short- and in the long- terms, also the quality of patient care. Some Missed Nursing Education antecedents can be modified by appropriate strategies that should be addressed by policy, health care and academic institutions.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Arianna Cracina
- General Surgical Department, University Hospital of Udine, Udine, Italy
| | - Eva Marini
- Anesthesia and Intensive Care Department, University Hospital of Udine, Udine, Italy
| | - Davide Caruzzo
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Stefano Fabris
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Irene Mansutti
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Elisa Mattiussi
- Department of Medical Sciences, Udine University, Udine, Italy
| | | | - Renzo Moreale
- Department of Medical Sciences, Udine University, Udine, Italy
| | | | - Illarj Achil
- Department of Medical Sciences, Udine University, Udine, Italy
| | - Matteo Danielis
- Department of Medical Sciences, Udine University, Udine, Italy
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Markey K, Murphy L, O'Donnell C, Turner J, Doody O. Clinical supervision: A panacea for missed care. J Nurs Manag 2020; 28:2113-2117. [DOI: 10.1111/jonm.13001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery Faculty of Education and Health Sciences University of Limerick Limerick Ireland
| | - Louise Murphy
- National University of Ireland Galway Galway Ireland
| | - Claire O'Donnell
- Department of Nursing and Midwifery Faculty of Education and Health Sciences University of Limerick Limerick Ireland
| | | | - Owen Doody
- Department of Nursing and Midwifery Faculty of Education and Health Sciences University of Limerick Limerick Ireland
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32
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Campbell CM, Prapanjaroensin A, Anusiewicz CV, Baernholdt M, Jones T, Patrician PA. Variables associated with missed nursing care in Alabama: A cross‐sectional analysis. J Nurs Manag 2020; 28:2174-2184. [DOI: 10.1111/jonm.12979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/08/2020] [Accepted: 02/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Marianne Baernholdt
- School of Nursing University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Terry Jones
- School of Nursing Virginia Commonwealth University Richmond Virginia
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Kalánková D, Kirwan M, Bartoníčková D, Cubelo F, Žiaková K, Kurucová R. Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. J Nurs Manag 2020; 28:1783-1797. [DOI: 10.1111/jonm.12978] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/09/2020] [Accepted: 02/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Dominika Kalánková
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
| | - Marcia Kirwan
- School of Nursing and Human Sciences Dublin City University in Dublin Glasnevin, Dublin Ireland
| | - Daniela Bartoníčková
- Department of Nursing 2nd Faculty of Medicine Charles University in Prague Prague Czech Republic
| | - Floro Cubelo
- School of Health and Social Studies Jyväskylä University of Applied Sciences Jyväskylä Finland
| | - Katarína Žiaková
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
| | - Radka Kurucová
- Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic
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34
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Albsoul R, FitzGerald G, Finucane J, Borkoles E. Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study. Int J Health Plann Manage 2019; 34:e1820-e1832. [PMID: 31448478 DOI: 10.1002/hpm.2898] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Missed nursing care (MNC) is a significant health care issue that impacts on the quality of health care and patient safety. It refers to delayed or omitted aspects of nursing care (totally or partially). MNC is an under-researched area in the Australian health care context. OBJECTIVE This research sought to further explore the MNC phenomenon in the context of an acute care hospital and to identify its common elements and the factors influencing its occurrence. DESIGN A convergent parallel mixed methods design was employed involving secondary analysis of routinely collected hospital data and a survey of 44 nursing staff using the MISSCARE survey instrument. The two sources of data were converged to address the objective. FINDINGS The study found that the most common elements of missed nursing care include failure of patient ambulation, emotional support for patients and/or family, and the provision of full documentation. These elements are consistent with previous international studies conducted in acute care hospital settings. This study identified that local context impacting on MNC was also important and included interruptions to workflow, "perceived" lack of management support, poor handover, and communication breakdown between the nursing team and medical staff. CONCLUSION Consideration of the local health care context is foundational in understanding the MNC phenomenon. The findings of this research may help nursing managers mitigate the possible effects of MNC and therefore improve patient safety in their acute care environment. Additional multisite studies are required to further explore factors associated with MNC in both general and local contexts.
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Affiliation(s)
- Rania Albsoul
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Finucane
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Erika Borkoles
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
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35
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Markey K, Tilki M, Taylor G. Resigned indifference: An explanation of gaps in care for culturally and linguistically diverse patients'. J Nurs Manag 2019; 27:1462-1470. [DOI: 10.1111/jonm.12830] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/13/2019] [Accepted: 07/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery University of Limerick Limerick Ireland
| | - Mary Tilki
- School of Health and Social Sciences Middlesex University London UK
| | - Georgina Taylor
- School of Health and Social Sciences Middlesex University London UK
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36
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Markey K, Okantey C. Nurturing cultural competence in nurse education through a values-based learning approach. Nurse Educ Pract 2019; 38:153-156. [PMID: 31284218 DOI: 10.1016/j.nepr.2019.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/19/2019] [Accepted: 06/14/2019] [Indexed: 11/24/2022]
Abstract
Global reports of cultural insensitivity continue despite the growing evidence highlighting the importance of nurturing cultural competence development in nurse education and practice. With the widening sociocultural diversification of the patient population, it is now imperative that nurse educators establish cultural competence as a graduate capability. The recent focus on revisiting and recommitting to core nursing values is welcomed, however further consideration is needed to ensure such values are lived in nurses behaviours, when engaging with culturally diverse patients. Undergraduate nurse education needs to embrace opportunities to engrain values based learning in curriculum design and utilise innovative learning and teaching approaches that ensure cultural competence is more explicitly developed. This paper discusses the importance of providing opportunities for students to critically review approaches to care, whilst ensuring cultural competency is a more visible responsibility of the future registered nurse in delivering quality care. The authors outline some practical approaches to examining core values underpinning nursing practice in the context of cultural competence development.
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Affiliation(s)
- Kathleen Markey
- Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick, Ireland.
| | - Christiana Okantey
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana.
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37
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Morley HP, Lotto RR. An exploration of student nurses' views of oral health care in the hospitalised child: A qualitative study. Nurse Educ Pract 2019; 38:79-83. [PMID: 31220704 DOI: 10.1016/j.nepr.2019.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 05/27/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
Hospitalization impacts negatively on oral health, where underlying medical conditions and interventions such as oxygen therapy and nil-by-mouth status increase susceptibility to complications. However, evidence suggests it is often overlooked, or viewed as low priority by nurses. The rationale for these beliefs is unclear. This study provides an exploration of these beliefs, focusing specifically on their development, as reflected in the experiences of adult and paediatric student nurses. Three focus groups were conducted, and thematic analysis applied. Whilst students theoretically understood the value of oral health care, in hospital it was overlooked, with other 'clinical' aspects of care valued more highly. 'Hierarchy of need' emerged as the over-arching theme. Interrelated sub-themes included: 'practice/theory mismatch,' highlighting lack of education and adequacy of exposure to oral health care encounters; 'resources,' where infrastructure was lacking; and 'disempowerment,' where students felt powerless to act. Exposure to oral health care encounters were less frequent in the paediatric setting, risking disempowerment of parents as well as students. These findings highlight the need to raise the profile of oral health care, both theoretically and practically, engendering a culture that embeds mouth care unobtrusively into day-to-day nursing practice, improving health care outcomes for those in our care.
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38
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Cleary‐Holdforth J. Missed Nursing Care: A Symptom of Missing Evidence. Worldviews Evid Based Nurs 2019; 16:88-91. [DOI: 10.1111/wvn.12351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joanne Cleary‐Holdforth
- Faculty of Science and HealthProgramme Chair‐MSc in Integrative Counselling and PsychotherapySchool of Nursing and Human SciencesDublin City University Dublin Ireland
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39
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Evans DJR, Pawlina W, Lachman N. Human skills for human[istic] anatomy: An emphasis on nontraditional discipline-independent skills. ANATOMICAL SCIENCES EDUCATION 2018; 11:221-224. [PMID: 29742329 DOI: 10.1002/ase.1799] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Darrell J R Evans
- Academic Division, The University of Newcastle, Callaghan, NSW, Australia
| | - Wojciech Pawlina
- Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
| | - Nirusha Lachman
- Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
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40
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Msiska G, Simwaka A, Munkhondya B, Kabuluzi E, Munkhondya TE. Factors Militating against the Delivery of Compassionate Care: A Malawian Perspective. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojn.2018.812067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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