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Kago R, Ota K, Niimi Y. Factors affecting early career registered nurses' views of building good relationships with patients: A qualitative empirical research study. Nurs Open 2024; 11:e2155. [PMID: 38581162 PMCID: PMC10997952 DOI: 10.1002/nop2.2155] [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: 04/25/2023] [Revised: 08/22/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
AIM To clarify the factors affecting early career registered nurses' (ECRNs') views on building good nurse-patient relationships. DESIGN An exploratory qualitative research design was implemented using detailed individual semi-structured interviews. METHODS Interview data were analysed using a thematic approach based on the systematic text condensation analysis proposed by Malterud. DATA SOURCES Eleven consenting nurses working in four hospitals. RESULTS Six characteristics were identified that influenced ECRNs' perceptions of building good nurse-patient relationships: finding clues through reflection, observing patients' reactions, clarifying their role as a nurse, doing their best for the patients, treating each patient as an irreplaceable individual and receiving support. CONCLUSIONS We discovered that the factors affecting ECRNs' views could be divided into two categories: factors that contribute to ECRNs' views on developing positive relationships with patients, and factors that influence ECRNs' relationships with patients but do not directly lead to positive relationships. It is critical for ECRNs to reflect on their experiences of poor relationship-building and observe patients' reactions. ECRNs seldom recognize that they have developed good relationships with their patients. It is critical to consider organizational environment and support as variables in developing a nurse-patient relationship so that the responsibility does not fall solely on ECRNs. IMPLICATIONS The results of this study provide clues to help ECRNs overcome difficulties in building relationships with patients. Furthermore, they can be used to develop educational programme for ECRNs. Future studies should use these findings to provide support to ECRNs and help them build relationships with patients.
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Affiliation(s)
- Reiko Kago
- School of Nursing and Health, Graduate School of Nursing and HealthAichi Prefecture UniversityNagoyaJapan
| | - Katsumasa Ota
- Faculty of Human Care at NumazuTohto UniversityNumazuJapan
| | - Yukari Niimi
- Department of Nursing, Faculty of Health and ScienceNagoya Women's UniversityNagoyaJapan
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Labrague LJ, T Kostovich C. A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review. West J Nurs Res 2024; 46:133-142. [PMID: 38014816 DOI: 10.1177/01939459231214598] [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] [Indexed: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Carol T Kostovich
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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Hojat LS, Wilson BM, Perez F, Mojica MF, Singer ME, Bonomo RA, Epstein LH. Association of COVID-19 coinfection with increased mortality among patients with Pseudomonas aeruginosa bloodstream infection in the Veterans Health Administration system. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e237. [PMID: 38156202 PMCID: PMC10753479 DOI: 10.1017/ash.2023.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 12/30/2023]
Abstract
Objective Pseudomonas aeruginosa bloodstream infection (PA-BSI) and COVID-19 are independently associated with high mortality. We sought to demonstrate the impact of COVID-19 coinfection on patients with PA-BSI. Design Retrospective cohort study. Setting Veterans Health Administration. Patients Hospitalized patients with PA-BSI in pre-COVID-19 (January 2009 to December 2019) and COVID-19 (January 2020 to June 2022) periods. Patients in the COVID-19 period were further stratified by the presence or absence of concomitant COVID-19 infection. Methods We characterized trends in resistance, treatment, and mortality over the study period. Multivariable logistic regression and modified Poisson analyses were used to determine the association between COVID-19 and mortality among patients with PA-BSI. Additional predictors included demographics, comorbidities, disease severity, antimicrobial susceptibility, and treatment. Results A total of 6,714 patients with PA-BSI were identified. Throughout the study period, PA resistance rates decreased. Mortality decreased during the pre-COVID-19 period and increased during the COVID-19 period. Mortality was not significantly different between pre-COVID-19 (24.5%, 95% confidence interval [CI] 23.3-28.6) and COVID-19 period/COVID-negative (26.0%, 95% CI 23.5-28.6) patients, but it was significantly higher in COVID-19 period/COVID-positive patients (47.2%, 35.3-59.3). In the modified Poisson analysis, COVID-19 coinfection was associated with higher mortality (relative risk 1.44, 95% CI 1.01-2.06). Higher Charlson Comorbidity Index, higher modified Acute Physiology and Chronic Health Evaluation score, and no targeted PA-BSI treatment within 48 h were also predictors of higher mortality. Conclusions Higher mortality was observed in patients with COVID-19 coinfection among patients with PA-BSI. Future studies should explore this relationship in other settings and investigate potential SARS-CoV-2 and PA synergy.
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Affiliation(s)
- Leila S. Hojat
- Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Brigid M. Wilson
- Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA
- Geriatric Research Education and Clinical Center (GRECC), the VA Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - Federico Perez
- Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA
- Geriatric Research Education and Clinical Center (GRECC), the VA Northeast Ohio Healthcare System, Cleveland, OH, USA
- Case Western Reserve University, Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, OH, USA
| | - Maria F. Mojica
- Case Western Reserve University, Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, OH, USA
- Research Service, VA Northeast Ohio Healthcare System, Cleveland, OH, USA
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
- Departments of Pathology, Pharmacology, Molecular Biology and Microbiology, Biochemistry, and Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Mendel E. Singer
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Robert A. Bonomo
- Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA
- Geriatric Research Education and Clinical Center (GRECC), the VA Northeast Ohio Healthcare System, Cleveland, OH, USA
- Case Western Reserve University, Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, OH, USA
- Research Service, VA Northeast Ohio Healthcare System, Cleveland, OH, USA
- Departments of Pathology, Pharmacology, Molecular Biology and Microbiology, Biochemistry, and Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Lauren H. Epstein
- Infectious Diseases, US Department of Veterans Affairs Medical Center, Decatur, GA, USA
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Abstract
OBJECTIVE In an increasingly competitive healthcare climate, ensuring an innovative nursing workforce is essential for organizational success and survival. BACKGROUND The authors aimed to evaluate the literature examining the association between leadership styles and innovative behaviors in the nursing workforce. METHODS A systematic review of articles from 5 databases was conducted from August 2022 to October 2022. RESULTS A total of 21 articles published in the English language were included in the review. This study provides evidence for the vital role of "relationship-oriented" leadership styles in fostering innovative behaviors among nurses. However, more research is needed to examine how "task-oriented" leadership styles contribute to innovativeness in nurses. Twelve mediators linking leadership styles to healthcare workers' innovative behaviors were identified and clustered into motivation-based, relation-based, and affective mediators. CONCLUSION Organizational strategies to foster relationship-based leadership styles among healthcare leaders are vital to support nurses' innovative behaviors.
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Affiliation(s)
- Leodoro J Labrague
- Author Affiliations: Clinical Assistant Professor (Dr Labrague) and Instructor (Toquero), Marcella Niehoff School of Nursing, Loyola University Chicago, Illinois
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Gualandi R, Ivziku D, Caruso R, Di Giacinto C, Lommi M, Tartaglini D, De Benedictis A. Nurse-Patient Communication and Relationship When Wearing Personal Protective Equipment: Nurses' Experience in a COVID-19 Ward. Healthcare (Basel) 2023; 11:1960. [PMID: 37444794 DOI: 10.3390/healthcare11131960] [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: 04/30/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
Little is known about which communication strategies nurses carried out and whether the nurse-patient relationship has been altered due to the mandated use of personal protective equipment during the COVID-19 pandemic. This study describes how nurse-patient communication and relationships took place from the point of view of nurses engaged in caring for patients with COVID-19. A qualitative descriptive study design following COREQ guidelines was conducted. Semi-structured telephone interviews with nurses working in the COVID ward of an Italian university hospital were performed between September 2020 and June 2021. Ten nurses were recruited using convenience sampling. One overarching theme, three main themes, and nine sub-themes were identified. The overarching theme 'The in-out relationship: 'in here and out there' and 'inside me and out of me' included the main themes 'A closed system different from normal', 'Uncovering meaningful human gestures', and 'A deep experience to live''. The relational nature of nursing-where 'me and you' and the context are the main elements-leads nurses to find new ways of interacting and communicating with patients, even in a new situation that has never been experienced. Enhancing human gestures, thinking about new contexts of care, and educating new generations to maintain human-to-human interaction, regardless of the context of care, are the directives to be explored for creating the future of nursing care.
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Affiliation(s)
- Raffaella Gualandi
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Dhurata Ivziku
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Rosario Caruso
- Clinical Research Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Chiara Di Giacinto
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Marzia Lommi
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy
| | - Daniela Tartaglini
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Anna De Benedictis
- Clinical Directory, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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