Knowledge and performance among nurses before and after a training programme on patient falls

Collaborative leadership to empower nurses to implement ABCDE emergency nursing in an emergency department in Nepal

PURPOSE

Emergency medicine can save lives and in 2018 the World Health Assembly passed resolution 72.16 ensuring the role of emergency care in all health systems. With a continued global shortage of emergency physicians, with many low-medium-income countries (LMIC) still to develop emergency medicine as a speciality, the role of emergency nurses is critical to deliver the WHO Emergency Care System Framework (WHO, 2018). Emergency medicine doctors play a critical role in collaborating with nurses, in emergency medicine where nurses are often the first clinicians are often the first clinicians to interact with patients in emergency care settings, making up the majority of health-care professionals in LMIC (Mamalelala, 2024). Yet emergency nursing has yet to become established in Nepal, where nurses are often recruited to emergency departments, without having received any training in emergency or critical care treatment and management. The purpose of this paper is to outline a collaborative leadership approach to co-design an airway, breathing, circulation, disability, exposure (ABCDE) structured approach to an emergency nursing training module designed for nurses to feel empowered in the emergency department and to report on its findings.

DESIGN/METHODOLOGY/APPROACH

This study draws upon mixed methodology research, enrolling 30 nurses (n = 30) from an emergency department in a tertiary hospital in Nepal through three stages of the project: Stage 1: training module co-design, collaborative leadership exploring the rationale for a training module and core features of design based on the ABCDE of emergency medicine; Stage 2: quantitative data were collected to assess baseline pre- and post-intervention knowledge and follow-up knowledge assessment at 30 and 45 days; Stage 3: qualitative data were collected with 24/30 (80%) nurses to evaluate the impact and application of the nurses ABCDE learning 7 months post-training. The qualitative survey was undertaken using online Google Forms.

FINDINGS

Nurses were fully engaged in the co-design and collaboration of the development of an ABCDE training module which was delivered over 3 h. Full engagement was secured from all nurses in the department, and there were statistically significant advances in ABCDE emergency knowledge from the baseline, however, this knowledge began to decrease at 30 and 45 days. A follow-up qualitative survey was distributed to nurses seven months after training with an 80% return rate, which reported a range of examples of how nurses were continuing to apply their learning in practice.

ORIGINALITY/VALUE

This training module for emergency nurses was designed collaboratively from the "bottom up" in a tertiary hospital in Nepal, recognising the need to develop emergency nursing in the emergency department. The data revealed promising findings, while knowledge decreased from the post-training questionnaire, qualitative evidence revealed significant changes in practice, with the greatest reported change in the management of the airway. While this training module has made a difference in the quality of care provided, there is a need for a country-wide strategy in this area otherwise it is likely that such an initiative will only be developed by hospitals at a local level (Lecky, 2014). Education and training initiatives for nurses that focus on an evidence-based approach to clinical practice can bridge the workforce gap in the short term, however, the Government of Nepal must decide on establishing a recognised post-graduate sub-specialty in emergency nursing, the duration of training, who should be trained and what curriculum should be followed (Lecky, 2014).

Nurses’ perceptions of fall risk factors and fall prevention strategies in acute care settings in Saudi Arabia

Aim

This study aimed to explore nurses’ perceptions of the factors associated with falls and of fall prevention strategies in acute care settings in Saudi Arabia.

Design

This is a cross‐sectional, correlational, descriptive study.

Methods

Data were collected from 102 nurses using a survey on the risk factors and prevention strategies of injurious falls.

Results

We found that impaired balance and muscle strength, limited mobility, and an inability to follow safety instructions were reported as the top factors in falls. Multidisciplinary fall prevention strategies are effective in reducing the prevalence of falls. Nurses with higher levels of education had higher perceptions towards the risk factors of falls. Formal patient safety training, including fall prevention education programmes, were shown to reduce falls by making nurses more aware of fall risk factors and prevention strategies. The findings of this study can be used to inform managers about factors that may contribute to falls in acute care settings.

Development and Effect of a Fall Prevention Program Based on King's Theory of Goal Attainment in Long-Term Care Hospitals: An Experimental Study

A fall prevention program based on King’s goal attainment theory was developed to verify its effect on those in long-term care hospitals. The experiment was conducted at K Long-Term Care Hospital in S city for eight weeks. The study employed 57 elderly patients and 58 nurses. The program comprised an individual training conducted in a ward and hospital room for 20–30 min and a group training held in a conference room for 60 min. Significance levels were analyzed at p < 0.05 via frequency analysis, descriptive statistics, independent sample t-test, χ²-test, Mann–Whitney’s U test, Wilcoxon code rank test, and Cronbach’s α, and the clinical trial number was KCT0005908. In the patient intervention group, fall prevention behavior and knowledge increased, and the fear of falling decreased. Fall prevention behavior and knowledge increased in the nurse intervention group. Patient and nurse interaction satisfaction also increased. In contrast, the number of falls and nurses’ burden did not decrease. The fall prevention program was verified via the interaction of personal, interpersonal, and social systems. Thus, the patient’s fear of falling was reduced. Moreover, the program was effective for the fall knowledge, interaction satisfaction, and fall prevention behavior of both the patient and nurse.

The nexus between health workers’ emotional intelligence and job performance

Purpose

This study aims to examine the effect of health workers’ emotional intelligence (EI) on job performance (JP), with potential confounding variables controlled for. The confounding variables introduced are gender, education, tenure and level of access to in-service training.

Design/methodology/approach

A cross-sectional quantitative research design was used in this study. A self-reported questionnaire was used to collect data from 1,163 health professionals, who were selected using the simple random sampling method. Confirmatory factor analysis (CFA) was used to test a framework of hypotheses.

Findings

The resulting CFA model is of a good fit at 5 per cent significance level [chi-square (χ2) = 1.492; p = 0.222]. Moreover, the study finds that EI significantly predicts JP among health workers after controlling for the lurking variables.

Originality/value

Though several studies have confirmed that EI makes a significant positive effect on health workers’ JP, none of them controlled for potential confounding variables. For this reason, the effect detected in previous studies could include the influence of lurking variables and is consequently spurious. Apart from contributing to extant literature, this study controls for these lurking variables in an attempt to enhance the value of empirical evidence that supports the relevance of EI to health-care performance.