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Stenkjaer RL, Egerod I, Moszkowicz M, Ista E, Greisen G, Weis J, Pagsberg AK, Herling SF. Prospective validation of Sophia observation withdrawal symptoms: A paediatric delirium scale in critically ill children in Denmark. Aust Crit Care 2024; 37:400-406. [PMID: 37164889 DOI: 10.1016/j.aucc.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Paediatric delirium (PD) is increasingly recognised as a common disorder in critically ill children with a reported prevalence ranging from 9% to 66%. We validated the PD component of the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale in a Danish setting to provide increased awareness and reliable identification of this critical condition, thereby paving the way for improved pathways to targeted delirium care. OBJECTIVE The objectives of this study were to criterion validate the PD component of the SOS-PD screening tool by comparing blinded psychiatric and nurse assessments and to estimate the prevalence of delirium in critically ill children in a Danish context. METHODS A prospective observational study was performed on critically ill children aged between 3 m and 18 y, admitted to an intensive care unit, with a hospital stay of 48 h or more. Assessments took place on a fixed weekday over an 18-month period. To test accuracy and criterion validity, bedside nurses' SOS-PD assessments were compared to the reference standard, a diagnostic assessment performed by a child psychiatrist according to the Diagnostic and Statistical Manual-V criteria by use of the Vanderbilt Assessment of Delirium in Infants and Children. RESULTS We included 141 children in the study, 30 (21%) of whom were diagnosed with delirium by the child psychiatrist. The accuracy of the delirium diagnosis was 93.6% (95% confidence interval [CI]: 88.3-97.1) among the nurses' SOS-PD assessments compared to the reference standard. The SOS-PD demonstrated a high sensitivity of 83.3% (95% CI: 65.3-94.4) and a high specificity of 96.4% (95% CI: 91.0-99.0) with five false-negative and four false-positive cases. CONCLUSION The PD component of the SOS-PD tool has good accuracy and validity for assessments performed by nurses compared to a child psychiatrist's diagnosis in critically ill children in a Danish setting. We recommend the use of the SOS-PD instrument in clinical practice.
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Affiliation(s)
- Rikke Louise Stenkjaer
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Ingrid Egerod
- Department of Intensive Care, Copenhagen University Hospital Rigshospitalet Blegdamsvej 9, 2100 Copenhagen, Denmark; University of Copenhagen, Department of Clinical Medicine Copenhagen, Denmark.
| | - Mala Moszkowicz
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, Copenhagen 2900 Hellerup, Denmark.
| | - Erwin Ista
- Department of paediatric Surgery, paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, 2100 Copenhagen, Denmark; University of Copenhagen, Department of Clinical Medicine Copenhagen, Denmark.
| | - Janne Weis
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Gentofte Hospitalsvej 3A, 1. sal, Copenhagen 2900 Hellerup, Denmark.
| | - Suzanne Forsyth Herling
- The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet Blegdamsvej 9, 2100 Copenhagen, Denmark; University of Copenhagen, Department of Clinical Medicine Copenhagen, Denmark.
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Liu Y, Li RL, Chen L, Zhao FY, Su YL, Jin S, Liu JE. Construction and validation of a risk-prediction model for chemotherapy-related cognitive impairment in patients with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01566-7. [PMID: 38512563 DOI: 10.1007/s11764-024-01566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Lu Chen
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Fu-Yun Zhao
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, 100050, Beijing, China
| | - Shuai Jin
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China.
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Teixeira L. Nursing assessment and care for a patient with a neurological disorder. Br J Nurs 2024; 33:252-255. [PMID: 38446514 DOI: 10.12968/bjon.2024.33.5.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The previous article discussed the pathophysiology involved in disorders of the nervous system. Having considered some of the most prevalent disorders, this second part uses a case study to explore effective patient assessment and emphasise the importance of facilitating patient self-management for improved outcomes. By addressing these key aspects, nursing professionals can enhance the quality of care and the support provided to individuals experiencing neurological disorders.
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Affiliation(s)
- Luis Teixeira
- Lecturer in Adult Nursing Complex Care, King's College London
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Douglas C, Alexeev S, Middleton S, Gardner G, Kelly P, McInnes E, Rihari-Thomas J, Windsor C, Morton RL. Transforming nursing assessment in acute hospitals: A cluster randomised controlled trial of an evidence-based nursing core assessment (the ENCORE trial). Int J Nurs Stud 2024; 151:104690. [PMID: 38237324 DOI: 10.1016/j.ijnurstu.2024.104690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Patient safety is threatened when early signs of clinical deterioration are missed or not acted upon. This research began as a clinical-academic partnership established around a shared concern of nursing physical assessment practices on general wards and delayed recognition of clinical deterioration. The outcome was the development of a complex intervention facilitated at the ward level for proactive nursing surveillance. METHODS The evidence-based nursing core assessment (ENCORE) trial was a pragmatic cluster-randomised controlled trial. We hypothesised that ward intervention would reduce the incidence of patient rescue events (medical emergency team activations) and serious adverse events. We randomised 29 general wards in a 1:2 allocation, across 5 Australian hospitals to intervention (n = 10) and usual care wards (n = 19). Skilled facilitation over 12 months enabled practitioner-led, ward-level practice change for proactive nursing surveillance. The primary outcome was the rate of medical emergency team activations and secondary outcomes were unplanned intensive care unit admissions, on-ward resuscitations, and unexpected deaths. Outcomes were prospectively collected for 6 months following the initial 6 months of implementation. Analysis was at the patient level using generalised linear mixed models to account for clustering by ward. RESULTS We analysed 29,385 patient admissions to intervention (n = 11,792) and control (n = 17,593) wards. Adjusted models for overall effects suggested the intervention increased the rate of medical emergency team activations (adjusted incidence rate ratio 1.314; 95 % confidence interval 0.975, 1.773), although the confidence interval was compatible with a marginal decrease to a substantial increase in rate. Confidence intervals for secondary outcomes included a range of plausible effects from benefit to harm. However, considerable heterogeneity was observed in intervention effects by patient comorbidity. Among patients with few comorbid conditions in the intervention arm there was a lower medical emergency team activation rate and decreased odds of unexpected death. Among patients with multimorbidity in the intervention arm there were higher rates of medical emergency team activation and intensive care unit admissions. CONCLUSION Trial outcomes have refined our assumptions about the impact of the ENCORE intervention. The intervention appears to have protective effects for patients with low complexity where frontline teams can respond locally. It also appears to have redistributed medical emergency team activations and unplanned intensive care unit admissions, mobilising higher rates of rescue for patients with multimorbidity. TRIAL REGISTRATION NUMBER ACTRN12618001903279 (Date of registration: 22/11/2018; First participant recruited: 01/02/2019).
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Affiliation(s)
- Clint Douglas
- School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia; Office of Nursing and Midwifery Services, Metro North Hospital and Health Service, Herston, QLD 4006, Australia.
| | - Sergey Alexeev
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2015, Australia
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, NSW, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - Glenn Gardner
- School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia
| | - Patrick Kelly
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Camperdown, NSW 2006, Australia
| | - Elizabeth McInnes
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, NSW, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | | | - Carol Windsor
- School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2015, Australia
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Cicero EC, Bosse JD, Ducar D, Rodriguez C, Dillard-Wright J. Facilitating Gender-Affirming Nursing Encounters. Nurs Clin North Am 2024; 59:75-96. [PMID: 38272585 DOI: 10.1016/j.cnur.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
The purpose of this article is to highlight the essentials for facilitating gender-affirming nursing encounters for transgender, nonbinary, and other gender expansive (TNGE) people. The authors illustrate what constitutes as gender-affirming nursing encounters by characterizing gender-affirming approaches to conducting and documenting a nursing assessment and describing techniques to overcome institutional-level challenges that may hinder a nurse's ability to establish gender-affirming therapeutic relationships with TNGE people. The authors also provide strategies that nurses can use to improve their health care organization and interprofessional collaborative practice to create psychologically and physically safe health care spaces for TNGE people.
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Affiliation(s)
- Ethan C Cicero
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Jordon D Bosse
- College of Nursing, University of Rhode Island, 350 Eddy Street, Providence, RI 02903, USA
| | - Dallas Ducar
- Transhealth, PO Box 9120, Chelsea, MA 02150, USA
| | - Christine Rodriguez
- Yale School of Nursing, Yale University; 400 West Campus Drive, Orange, CT 06477, USA
| | - Jess Dillard-Wright
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, 130 Skinner Hall, 651 North Pleasant Street, Amherst, MA 01103, USA
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Clemett V, Gunowa NO, Geraghty J, Woodward S. What influences the inclusion of skin tone diversity when teaching skin assessment? Findings from a survey. Br J Nurs 2024; 33:176-186. [PMID: 38386525 DOI: 10.12968/bjon.2024.33.4.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND Understanding the variances in visual skin changes across all skin tones is important in clinical care. However, the experiences of those teaching skin assessment to pre- and post-registrant nurses are unknown. AIMS To determine the barriers and facilitators experienced in teaching skin assessment across a range of skin tones to pre- and post-registrant nurses. METHODS A cross-sectional, mixed-methods online survey was undertaken throughout February and March 2023 based on the Theoretical Domains Framework of behaviour change. FINDINGS In this self-selecting sample, most participants were aware of why it was important to include all skin tones when teaching skin assessment and were professionally motivated to include this in their practice. However, resources and support are needed to overcome an unconscious bias in teaching skin tone diversity, resulting in a lack of availability of good quality photographs and educator confidence in their own skills. Educators not considering skin tone when selecting patient cases and relying on people with dark skin tones to highlight where practice is not inclusive may also lead to insufficient exposure for students. CONCLUSION There is some awareness of the importance of including diverse skin tones in teaching, but further education and resources are needed.
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Affiliation(s)
- Victoria Clemett
- Lecturer in Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Neesha Oozageer Gunowa
- Senior Lecturer and Community Pathway Lead, School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey
| | - Jemell Geraghty
- Lecturer in Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Sue Woodward
- Senior Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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Teixeira L. The nervous system and associated disorders. Br J Nurs 2024; 33:194-199. [PMID: 38386518 DOI: 10.12968/bjon.2024.33.4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Disorders of the nervous system, encompassing the brain, spinal cord and peripheral nerves, have emerged as a significant public health issue, with profound implications for individuals worldwide. These conditions result in significant morbidity and mortality. Many patients with neurological disorders often have comorbidities, further complicating their clinical presentation. Therefore, nurses must possess a comprehensive understanding of the nervous system and its associated disorders to formulate detailed care plans that address the unique needs of each patient. This article aims to explore the underlying pathophysiology of some of the most prevalent neurological disorders and how this informs effective patient assessment and diagnostic strategies. A further article will build on this to consider patient assessment and formulating a care plan in more detail.
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Affiliation(s)
- Luis Teixeira
- Lecturer in Adult Nursing Complex Care, Kings College London
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Kim J, Shin H. Exploring the effects of extended reality head-mounted display nervous system assessment training for nursing students: A pilot feasibility study. Nurse Educ Today 2024; 133:106089. [PMID: 38154214 DOI: 10.1016/j.nedt.2023.106089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Health assessment is crucial for planning nursing interventions. Specifically, cerebrovascular diseases involve rapid neurological changes that necessitate precise hands-on assessment skills training. OBJECTIVES This study developed and implemented an extended reality head-mounted display (HMD) nervous system assessment training program for nursing students to identify the usability and effectiveness of the system by analyzing their experiences. DESIGN This was a mixed-methods study that combined the quantitative element of a one-group pre-post-test design with the qualitative element of qualitative content analysis. SETTING University in Korea. PARTICIPANTS The study involved 36 nursing students in their 4th year who completed classes in health assessments and adult nursing (nervous system). METHODS An extended reality nervous system assessment training program was developed using the National Institutes of Health Stroke Scale and limb strength assessment. The learners wore HMD and received training at their own pace. System usability, confidence in nervous system assessment, learning satisfaction, and performance ability were measured and analyzed using SPSS Windows software version 28.0. Descriptive data were used for qualitative content analysis of the training experience. RESULTS The usability of the extended-reality HMD nervous system assessment training received positive feedback and most participants (94.4 %) agreed with the system's consistency. Confidence in nervous system assessment significantly improved after the training (p < .001). After the training, learning satisfaction and performance ability were high. Furthermore, advantages of XR-based learning devices and positive learning were observed. Nonetheless, issues such as difficulties in operating the device, inconvenience, physical side effects of wearing the device, and technical limitations existed. CONCLUSIONS This study developed and implemented an extended-reality HMD nervous system assessment training program to confirm its feasibility. However, challenges regarding device utilization need to be resolved for its effective development as a learning tool.
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Affiliation(s)
- Jiyoung Kim
- Department of Nursing, Inha University, Incheon, 100 Inha-ro, Michuhol-gu, Incheon 22212, Republic of Korea.
| | - Hyunjung Shin
- Department of Nursing, Inha University, Incheon, 100 Inha-ro, Michuhol-gu, Incheon 22212, Republic of Korea
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García-Pazo P, Pol-Castañeda S, Moreno-Mulet C, Pomar-Forteza A, Carrero-Planells A. Virtual reality and critical care education in nursing: A cross-sectional study. Nurse Educ Today 2023; 131:105971. [PMID: 37717425 DOI: 10.1016/j.nedt.2023.105971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/13/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND The nursing care of a critically ill patient in the intensive care unit requires specific training. Virtual reality can facilitate the nursing assessment of critically ill patients. OBJECTIVE To evaluate the utility of virtual reality as a tool for teaching nursing assessment of critically ill patients. DESIGN This is a cross-sectional study. SETTING University of the Balearic Islands (Spain) during the 2022 academic year. PARTICIPANTS Third-year nursing students. METHODS A specific environment was designed for virtual reality immersion using a BNEXT head-mounted display. Data were collected using three questionnaires: perception of self-efficacy regarding skill-acquisition in the nursing care process; immersivity; utility and tool satisfaction. RESULTS A total of 111 undergraduated nursing students responded, 86.8 % of whom had no previous intensive care units experience. They rated the virtual reality experience positively for learning the nursing care process, emphasising the need for skin and mucosal hygiene, patient mobilisation and family care, as well as an understanding of the therapeutic technology required. A total of 67.6 % felt as though they were physically present. They reported a high degree of acceptance and satisfaction. CONCLUSIONS Virtual reality has facilitated the exposure of students to an unfamiliar environment such as the intensive care units, proving to be useful, satisfying, and motivating in teaching the nursing care process.
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Affiliation(s)
- Patricia García-Pazo
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain; Development and Psychopathology Research Group (DEVPSY), Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain.
| | - Sandra Pol-Castañeda
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain; Hospital Universitari Son Llàtzer, Balearic Islands Health Service, 07198 Palma, Spain; Care, Chronicity, and Health Evidences Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain.
| | - Cristina Moreno-Mulet
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain; Care, Chronicity, and Health Evidences Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain.
| | - Antonio Pomar-Forteza
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain; Camp Redó Primary Health Care Center, Balearic Islands Health Service, 07010 Palma, Spain.
| | - Alba Carrero-Planells
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain; Care, Chronicity, and Health Evidences Research Group, Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain.
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González-Chordá VM, Aleixos DL, Reverter IL, Cervera-Gash À, Machancoses FH, Moreno-Casbas MT, Arasil PF, Chillerón MJV. Diagnostic accuracy study of the VALENF instrument in hospitalization units for adults: a study protocol. BMC Nurs 2023; 22:401. [PMID: 37891575 PMCID: PMC10604410 DOI: 10.1186/s12912-023-01567-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Recently, the VALENF instrument, Nursing Assessment by its acronym in Spanish, was developed as a meta-tool composed of only seven items with a more parsimonious approach for nursing assessment in adult hospitalization units. This meta-tool integrates the assessment of functional capacity, the risk of pressure injuries and the risk of falls. The general objective of this project is to validate the VALENF instrument by studying its diagnostic accuracy against the instruments commonly used in nursing to assess functional capacity, the risk of pressure injuries and the risk of falls. An observational, longitudinal, prospective study is presented, with recruitment and random selection based on admissions to six adult hospitalization units of the Hospital Universitario de La Plana. The study population will be made up of patients hospitalized in these units. The inclusion criteria will be patients over 18 years of age with a nursing assessment within the first 24 h of admission and an expected length of stay greater than 48 h and who sign the informed consent form. The exclusion criteria will be transfers from other units or centers. A sample of 521 participants is estimated as necessary. The evaluation test will be the VALENF instrument, and the reference tests will be the Barthel, Braden and Downton indices. Sociodemographic variables related to the care process and results such as functional loss, falls or pressure injuries will be collected. The evolution of functional capacity, the risk of falls and the risk of pressure injuries will be analyzed. The sensitivity, specificity and positive predictive values of the VALENF instrument will be calculated and compared to those of the usual instruments. A survival analysis will be performed for pressure injuries, falls and patients with functional loss. The VALENF instrument is expected to have at least the same diagnostic validity as the original instruments.Trial registration The study will be retrospectively registered (ISRCTN 17699562, 25/07/2023).
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Affiliation(s)
- Víctor M González-Chordá
- Nursing Research Group (GIENF-241), Ministerio de Ciencia E Innovación, Universitat Jaume I, Investén-ISCIII, Instituto de Salud Carlos III, Castellón de La Plana, Spain
| | - David Luna Aleixos
- Nursing Research Group (GIENF-241), Unidad de Hospitalización De Traumatología y Corta Estancia, Hospital Universitario de La Plana, Universitat Jaume I, EnfermeroCastellón de La Plana, Spain
| | - Irene Llagostera Reverter
- Nursing Research Group (GIENF-241, Universitat Jaume I, Avda Sos Baynat Sn. 12071, Castellón de La Plana, Spain.
| | - Àgueda Cervera-Gash
- Nursing Research Group (GIENF-241, Universitat Jaume I, Avda Sos Baynat Sn. 12071, Castellón de La Plana, Spain
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Monroy B, Sanchez K, Arguello P, Estupiñán J, Bacca J, Correa CV, Valencia L, Castillo JC, Mieles O, Arguello H, Castillo S, Rojas-Morales F. Automated chronic wounds medical assessment and tracking framework based on deep learning. Comput Biol Med 2023; 165:107335. [PMID: 37633087 DOI: 10.1016/j.compbiomed.2023.107335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 08/28/2023]
Abstract
Chronic wounds are a latent health problem worldwide, due to high incidence of diseases such as diabetes and Hansen. Typically, wound evolution is tracked by medical staff through visual inspection, which becomes problematic for patients in rural areas with poor transportation and medical infrastructure. Alternatively, the design of software platforms for medical imaging applications has been increasingly prioritized. This work presents a framework for chronic wound tracking based on deep learning, which works on RGB images captured with smartphones, avoiding bulky and complicated acquisition setups. The framework integrates mainstream algorithms for medical image processing, including wound detection, segmentation, as well as quantitative analysis of area and perimeter. Additionally, a new chronic wounds dataset from leprosy patients is provided to the scientific community. Conducted experiments demonstrate the validity and accuracy of the proposed framework, with up to 84.5% in precision.
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Affiliation(s)
- Brayan Monroy
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia.
| | - Karen Sanchez
- Department of Electrical Engineering, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Paula Arguello
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Juan Estupiñán
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Jorge Bacca
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Claudia V Correa
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Laura Valencia
- Department of Medicine, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Juan C Castillo
- Department of Medicine, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Olinto Mieles
- Sanatorio de Contratación ESE, Leprosy Control Program, Contratación, 683071, Colombia
| | - Henry Arguello
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Sergio Castillo
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Fernando Rojas-Morales
- Department of Systems Engineering and Informatics, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
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Valero-Chillerón MJ, Llagostera-Reverter I, Luna-Aleixós D, Moreno-Casbas M, Andreu-Pejó L, González-Chordá VM. Exploring the construct validity of the Barthel index in a sample of Spanish hospitalised patients. Enferm Clin (Engl Ed) 2023; 33:370-374. [PMID: 37714460 DOI: 10.1016/j.enfcle.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/29/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE Examine the construct validity of the Barthel Index in adult inpatient units. METHOD A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators. RESULTS CFA-1 results (χ2 = 161,616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item 'Bladder', offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09). CONCLUSION The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.
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Affiliation(s)
| | | | - David Luna-Aleixós
- Departamento de Enfermería, Universitat Jaume I, Castellón, Spain; Hospital Universitario de La Plana, Villarreal, Spain
| | - Mayte Moreno-Casbas
- Investén-ISCIII, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
| | | | - Víctor M González-Chordá
- Departamento de Enfermería, Universitat Jaume I, Castellón, Spain; Investén-ISCIII, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
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13
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Liu M, Whittam S, Thornton A, Goncharov L, Slade D, McElduff B, Kelly P, Law CK, Walsh S, Pollnow V, Cuffe J, McMahon J, Aggar C, Bilo J, Bowen K, Chow JSF, Duffy K, Everett B, Ferguson C, Frost SA, Gleeson N, Hackett K, Komusanac I, Marshall S, May S, McErlean G, Melbourne G, Murphy J, Newbury J, Newman D, Rihari-Thomas J, Sciuriaga H, Sturgess L, Taylor J, Tuqiri K, McInnes E, Middleton S. The ACCELERATE Plus (assessment and communication excellence for safe patient outcomes) Trial Protocol: a stepped-wedge cluster randomised trial, cost-benefit analysis, and process evaluation. BMC Nurs 2023; 22:275. [PMID: 37605224 PMCID: PMC10440862 DOI: 10.1186/s12912-023-01439-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Nurses play an essential role in patient safety. Inadequate nursing physical assessment and communication in handover practices are associated with increased patient deterioration, falls and pressure injuries. Despite internationally implemented rapid response systems, falls and pressure injury reduction strategies, and recommendations to conduct clinical handovers at patients' bedside, adverse events persist. This trial aims to evaluate the effectiveness, implementation, and cost-benefit of an externally facilitated, nurse-led intervention delivered at the ward level for core physical assessment, structured patient-centred bedside handover and improved multidisciplinary communication. We hypothesise the trial will reduce medical emergency team calls, unplanned intensive care unit admissions, falls and pressure injuries. METHODS A stepped-wedge cluster randomised trial will be conducted over 52 weeks. The intervention consists of a nursing core physical assessment, structured patient-centred bedside handover and improved multidisciplinary communication and will be implemented in 24 wards across eight hospitals. The intervention will use theoretically informed implementation strategies for changing clinician behaviour, consisting of: nursing executive site engagement; a train-the-trainer model for cascading facilitation; embedded site leads; nursing unit manager leadership training; nursing and medical ward-level clinical champions; ward nurses' education workshops; intervention tailoring; and reminders. The primary outcome will be a composite measure of medical emergency team calls (rapid response calls and 'Code Blue' calls), unplanned intensive care unit admissions, in-hospital falls and hospital-acquired pressure injuries; these measures individually will also form secondary outcomes. Other secondary outcomes are: i) patient-reported experience measures of receiving safe and patient-centred care, ii) nurses' perceptions of barriers to physical assessment, readiness to change, and staff engagement, and iii) nurses' and medical officers' perceptions of safety culture and interprofessional collaboration. Primary outcome data will be collected for the trial duration, and secondary outcome surveys will be collected prior to each step and at trial conclusion. A cost-benefit analysis and post-trial process evaluation will also be undertaken. DISCUSSION If effective, this intervention has the potential to improve nursing care, reduce patient harm and improve patient outcomes. The evidence-based implementation strategy has been designed to be embedded within existing hospital workforces; if cost-effective, it will be readily translatable to other hospitals nationally. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ID: ACTRN12622000155796. Date registered: 31/01/2022.
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Grants
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- Big Ideas Grant Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
- 1196352 National Health and Medical Research Council Investigator Leadership Grant
- New South Wales Nursing and Midwifery Strategy Reserve Fund
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Affiliation(s)
- Mark Liu
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 40 Edward Street, North Sydney, NSW, 2060, Australia
| | - Susan Whittam
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- St Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Anna Thornton
- St Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Liza Goncharov
- Institute for Communication in Healthcare, Australian National University, Baldessin Precinct Building, 110 Ellery Crescent, Acton, ACT, 2601, Australia
| | - Diana Slade
- Institute for Communication in Healthcare, Australian National University, Baldessin Precinct Building, 110 Ellery Crescent, Acton, ACT, 2601, Australia
| | - Benjamin McElduff
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 40 Edward Street, North Sydney, NSW, 2060, Australia
| | - Patrick Kelly
- School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Road, Camperdown, NSW, 2006, Australia
| | - Chi Kin Law
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW, 2050, Australia
| | - Sarah Walsh
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- St Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Vivien Pollnow
- St Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Jayde Cuffe
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Jake McMahon
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Christina Aggar
- Southern Cross University, Military Road, East Lismore, NSW, 2480, Australia
- Northern NSW Local Health District, Crawford House, Hunter Street, Lismore, NSW, 2480, Australia
| | - Jacqueline Bilo
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Karen Bowen
- Northern NSW Local Health District, Crawford House, Hunter Street, Lismore, NSW, 2480, Australia
| | - Josephine S F Chow
- South Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia
- Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW, 2170, Australia
| | - Katharine Duffy
- Northern NSW Local Health District, Crawford House, Hunter Street, Lismore, NSW, 2480, Australia
| | - Bronwyn Everett
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Caleb Ferguson
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Steven A Frost
- South Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Narelle Gleeson
- Lismore Base Hospital, 60 Uralba Street, Lismore, NSW, 2480, Australia
| | - Kate Hackett
- South Eastern Sydney Local Health District, The Sutherland Hospital and Community Health Service, Corner The Kingsway and Kareena Road, Caringbah, NSW, 2229, Australia
| | - Ivanka Komusanac
- Sydney Local Health District, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Sonia Marshall
- South Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia
| | - Sharon May
- Fairfield Hospital, Polding Street and Prairie Vale Road, Prairiewood, NSW, 2176, Australia
| | - Gemma McErlean
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Gregory Melbourne
- South Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia
| | - Jade Murphy
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Joanne Newbury
- The Sutherland Hospital, Corner The Kingsway and Kareena Road, Caringbah, NSW, 2229, Australia
| | - Deb Newman
- Lismore Base Hospital, 60 Uralba Street, Lismore, NSW, 2480, Australia
| | - John Rihari-Thomas
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Hayley Sciuriaga
- Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Lauren Sturgess
- St George Hospital, Gray Street, Kogarah, NSW, 2217, Australia
| | - Joanne Taylor
- St Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Karen Tuqiri
- Prince of Wales Hospital, 320-346 Barker Street, Randwick, NSW, 2031, Australia
| | - Elizabeth McInnes
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 40 Edward Street, North Sydney, NSW, 2060, Australia
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 40 Edward Street, North Sydney, NSW, 2060, Australia.
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Shimoni Z, Dusseldorp N, Cohen Y, Barnisan I, Froom P. The Norton scale is an important predictor of in-hospital mortality in internal medicine patients. Ir J Med Sci 2023; 192:1947-1952. [PMID: 36520351 DOI: 10.1007/s11845-022-03250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The Norton scale, a marker of patient frailty used to predict the risk of pressure ulcers, but the predictive value of the Norton scale for in-hospital mortality after adjustment for a wide range of demographic, and abnormal admission laboratory test results shown in themselves to have a high predictive value for in-hospital mortality is unclear. AIM The study aims to determine the value of the Norton scale and the presence of a urinary catheter in predicting in hospital mortality. METHODS The study population included all acutely admitted adult patients in 2020 through October 2021 to one of three internal medicine departments at the Laniado Hospital, a regional hospital with 400 beds in Israel. The main objective was to (a) identify the variables associated with the Norton Scale and (b) determine whether it predicts in-hospital mortality after adjustment for these variables. RESULTS The Norton scale was associated with an older age, female gender, presence of a urinary catheter, and abnormal laboratory tests. The odds of in-hospital mortality in those with intermediate, high, and very high Norton scale risk groups were 3.10 (2.23-3.56), 6.48 (4.02-10.46), and 12.27 (7.37-20.44), respectively, after adjustment for the remaining predictors. Adding the Norton scale and the presence of a urinary catheter to the prediction logistic regression model that included age, gender, and abnormal laboratory test results increased the c-statistic from 0.870 (0.864-0.876) to 0.908 (0.902-0.913). CONCLUSIONS The Norton scale and presence of a urinary catheter are important predictors of in-hospital mortality in acutely hospitalized adults in internal medicine departments.
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Affiliation(s)
- Zvi Shimoni
- The Adelson School Of Medicine, Ariel University, Ariel, Israel
- Sanz Medical Center, Laniado Hospital, Netanya, 4244916, Israel
| | | | - Yael Cohen
- Nursing Department, Laniado Hospital, Netanya, Israel
| | | | - Paul Froom
- Clinical Utility Department, Sanz Medical Center, Laniado Hospital, Netanya, 4244916, Israel.
- School of Public Health, University of Tel Aviv, Tel Aviv, Israel.
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15
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Tervo-Heikkinen T, Heikkilä A, Koivunen M, Kortteisto T, Peltokoski J, Salmela S, Sankelo M, Ylitörmänen T, Junttila K. Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study. BMC Nurs 2023; 22:198. [PMID: 37303039 DOI: 10.1186/s12912-023-01369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Several nursing interventions for pressure injury prevention have been identified, including risk and skin status assessment. The aim of this study was to explore prevention of pressure injuries in Finnish acute inpatient care. The data were collected on pressure injury risk and skin status assessments, repositioning, the use of support surfaces, preventive skin care, malnutrition risk assessment, and nutritional care. METHODS This multicentre, cross-sectional study was conducted in 16 acute care hospitals, excluding psychiatric care. Adult patients from inpatient care were recruited on the annual international Stop Pressure Ulcers Day in 2018 and 2019. Enrolment covered 6,160 participants in 503 units. Descriptive statistics were used to describe pressure injuries, risk assessments, and preventive nursing interventions. Cross tabulation, Pearson's chi-square and Fisher's exact tests were also used. Reporting follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS In all, 30% of the participants had their pressure injury risk assessed during the care, and for 19% within 8 h after admission. The same time limit in risk assessment was fulfilled for 16% of the participants with a pressure injury, and 22% of the participants using a wheelchair or being bedridden. A skin status assessment within 8 h after admission was conducted for 30% of all participants, and for 29% of the participants with a pre-existing pressure injury, and for 38% of the participants using a wheelchair or being bedridden. The risk of malnutrition was screened in 20% of the participants. Preventive interventions were targeted to participants with a pressure injury instead of patients with a high-pressure injury risk. CONCLUSION This study adds evidence about pressure injury risk assessments and the implementation of preventive nursing interventions in Finnish acute care. Skin status and pressure injury risk assessments were irregularly conducted, and the outcome was not used by nurses to guide the implementation of preventive interventions. The results reveal the gaps in evidence-based nursing practice, which require further efforts to prevent pressure injuries. Improving the national focus on pressure injury prevention practice is critical for improving healthcare for our patients.
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Affiliation(s)
- Tarja Tervo-Heikkinen
- Wellbeing Services County of North Savo, Kuopio University Hospital, PO Box 1711, Kuopio, FI70211, Finland.
| | - Anniina Heikkilä
- Helsinki University Hospital and University of Helsinki. Group Administration, FI00029 HUS. Helsinki, PO Box 705, Helsinki, Finland
| | - Marita Koivunen
- Wellbeing Services County of Satakunta, Department of Nursing Science, Pori, Finland, and University of Turku, Sairaalantie 3, Turku, FI28500, Finland
| | - Tiina Kortteisto
- Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Elämänaukio 2, PO Box 2000, Tampere, FI33521, Finland
| | - Jaana Peltokoski
- Wellbeing Services County of Central Finland, Hoitajantie 3, Jyväskylä, FI40620, Finland
| | - Susanne Salmela
- Wellbeing Services County of Ostrobothnia, Korsholmanpuistikko 44, Vaasa, FI65100, Finland
| | - Merja Sankelo
- Wellbeing Services County of South Ostrobothnia, Hanneksenrinne 7, Seinäjoki, FI60220, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Tuija Ylitörmänen
- Finnish Institute for Health and Welfare, PO Box 30, Helsinki, FI00271, Finland
| | - Kristiina Junttila
- Helsinki University Hospital and University of Helsinki, HUS Nursing Research Center, PO Box 442, Helsinki, FI00029 HUS, Finland
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Shen F, Hu LH, Huang HS, Li L. Development and validation of the scale for symptom clusters in patients with myasthenia gravis. BMC Neurol 2023; 23:196. [PMID: 37208623 DOI: 10.1186/s12883-023-03240-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Patients with myasthenia gravis(MG)often experience multiple symptoms concurrently, which can have an adverse effect on their quality of life(QOL). However, a specific, systemic and reliable scale for symptom clusters in MG is lacking. AIMS To develop reliable assessment scale for symptom clusters in patients with MG. DESIGN A cross-sectional descriptive study. METHODS Based on the unpleasant symptom theory(TOUS), the first draft of the scale was developed through review literature, qualitative interview, and Delphi expert correspondence, the items of the scale were presented and adjusted through cognitive interviews with 12 patients. To conveniently assess the validity and reliability of the scale, a cross-sectional survey was conducted in 283 patients with MG who were recruited from Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, from June to September 2021. RESULTS The final symptom cluster scale for patients with MG consisted of 19 items(MGSC-19), with a content validity index ranging from 0.828 to 1.000 for each item and the content validity index was 0.980. Four common variables (ocular muscle weakness, general muscular weakness, treatment-related side effects, and psychiatric problems) were identified by exploratory factor analysis, which explained 70.187% of the total variance. The correlation coefficients between the scale dimension and the overall score ranged from 0.395 to 0.769 (all P < 0.01), while the correlation coefficients between dimensions varied from 0.324 to 0.510 (all P < 0.01). The Cronbach's alpha, retest reliability, and half reliability were 0.932, 0.845, and 0.837, respectively. CONCLUSION The validity and reliability of MGSC-19 were generally good. This scale can be employed to identify the symptom clusters to help healthcare givers develop individualized symptom management measures for patients with MG.
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Affiliation(s)
- Fan Shen
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou district, Wuhan, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu-Hong Hu
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou district, Wuhan, China
| | - Hai-Shan Huang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou district, Wuhan, China.
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ling Li
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou district, Wuhan, China.
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Vikström-Dahl I, Bing-Jonsson PC, Rauhala A, Fagerström L. Revealing a gap in the clinical competence of nursing staff in nursing homes: a cross-sectional study with the Ms. Olsen test. BMC Nurs 2023; 22:130. [PMID: 37072846 PMCID: PMC10111312 DOI: 10.1186/s12912-023-01297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/08/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Nursing staff, caring for frail older people in long-term care, needs to have a certain level of clinical competence to identify diseases at an early stage and to assess and provide good nursing care. In Finland, nursing care is based on evidence-based and high-quality nursing care. However, earlier inspections by the National Supervisory Authority for Welfare and Health showed many discrepancies between the nursing staff's clinical competence and adequate and continuous education. AIM This study aimed to explore nursing staff, i.e. the clinical competence and decision-making skills of registered and practical nurses in nursing homes for older people in Finland and to analyse the association between nurses' clinical competence and fundamental background factors. METHODS We conducted a cross-sectional study of 337 participants in 50 nursing homes in the western part of Finland, between December 2020 and January 2021. The instrument used was the validated Ms. Olsen test, an extraction of NOP-CET. Statistical analyses were conducted with descriptive statistics and correlations and a cut-off for clinical competence. RESULTS This study with the Ms. Olsen test revealed that only one-fourth of the RNs and a third of the PNs passed the clinical competence test. In the self-evaluation, almost all participants evaluated themselves with good clinical competence. The Finnish Current Care Guidelines were used on a daily basis by 7.4% and weekly by 30%. Significant correlation was found between Swedish as a working language and mother tongue and the score for clinical competence. CONCLUSION The clinical competence test, the Ms. Olsen test, was used in Finland for the first time to evaluate the nursing staffs´ clinical competence in nursing homes. We found gaps in the clinical competence in Finnish nursing homes, both for PNs and RNs. The result differed remarkably from their self-assessments and the staff did not use the national nursing guidelines as required to develop their nursing skills and knowledge. Gaps in the clinical competence have been identified and can be used to develop targeted continuous education.
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Affiliation(s)
- Irén Vikström-Dahl
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland.
- Faculty of Health and Welfare, Novia University of Applied Sciences, Vaasa, Finland.
| | - Pia Cecile Bing-Jonsson
- Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
| | - Auvo Rauhala
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
- Finnish Centre for Client and Patient Safety, Wellbeing Services County of Ostrobothnia, Vaasa, Finland
| | - Lisbeth Fagerström
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
- Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
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Wolf LA, Il S, Ma A. A Problem Well-Named is a Problem Half-Solved: Usefulness of Nursing Diagnosis as a Way to Teach Emergency Nursing. J Emerg Nurs 2023; 49:57-59. [PMID: 36446669 DOI: 10.1016/j.jen.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/27/2022]
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19
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Li MM, Wu PP, Qiang WM, Li JQ, Zhu MY, Yang XL, Wang Y. Development and validation of a risk prediction model for breast cancer-related lymphedema in postoperative patients with breast cancer. Eur J Oncol Nurs 2022; 63:102258. [PMID: 36821887 DOI: 10.1016/j.ejon.2022.102258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Breast cancer-related lymphedema (BCRL) is a common post-operative complication in patients with breast cancer. Here, we sought to develop and validate a predictive model of BCRL in Chinese patients with breast cancer. METHODS Clinical and demographic data on patients with breast cancer were collected between 2016 and 2021 at a Cancer Hospital in China. A nomogram for predicting the risk of lymphedema in postoperative patients with breast cancer was constructed and verified using R 3.5.2 software. Model performance was evaluated using area under the ROC curve (AUC) and goodness-of-fit statistics, and the model was internally validated. RESULTS A total of 1732 postoperative patients with breast cancer, comprising 1212 and 520 patients in the development and validation groups, respectively, were included. Of these 438 (25.39%) developed lymphedema. Significant predictors identified in the predictive model were time since breast cancer surgery, level of lymph node dissection, number of lymph nodes dissected, radiotherapy, and postoperative body mass index. At the 31.9% optimal cut-off the model had AUC values of 0.728 and 0.710 in the development and validation groups, respectively. Calibration plots showed a good match between predicted and observed rates. In decision curve analysis, the net benefit of the model was better between threshold probabilities of 10%-80%. CONCLUSION The model has good discrimination and accuracy for lymphedema risk assessment, which can provide a reference for individualized clinical prediction of the risk of BCRL. Multicenter prospective trials are required to verify the predictive value of the model.
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Affiliation(s)
- Miao-Miao Li
- Breast Oncology Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Pei-Pei Wu
- Nursing Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Wan-Min Qiang
- Nursing Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Jia-Qian Li
- Breast Oncology Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Ming-Yu Zhu
- Breast Oncology Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Xiao-Lin Yang
- Breast Oncology Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
| | - Ying Wang
- Nursing Department, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
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20
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Byermoen KR, Eide T, Egilsdottir HÖ, Eide H, Heyn LG, Moen A, Brembo EA. Nursing students' development of using physical assessment in clinical rotation-a stimulated recall study. BMC Nurs 2022; 21:110. [PMID: 35538573 PMCID: PMC9087917 DOI: 10.1186/s12912-022-00879-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) phenomenological hermeneutical analysis of the stimulated recall interviews. Results Nursing students assessments shifted from a checklist approach to a symptom-based, more holistic and person-centred approach, emphasizing conversation as part of their assessments. The nursing students also reported that a safe and stimulating learning environment was a prominent feature for their continuing development. Learning from skilled role models with expectations to them using physical assessment skills facilitated their continuing skills appliance, interprofessional communication and reflective practice. Conclusions This study contribute with a novel, comprehensive and in-depth description of what influenced nursing students’ learning processes experiences of using physical assessment skills during clinical rotation. The results reveal the need for targeted course designs by implementing scaffolded learning activities in practical and theoretical courses aimed at strengthening students’ learning of physical assessment skills—building upon and emphasizing their prior knowledge and competence, which may lead to more confident registered nurses and promote patient safety in different health care contexts. We propose using stimulated recall systematically as a novel reflective learning activity in nursing education to foster clinical reasoning and metacognition skills and achieve deep learning.
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Affiliation(s)
- Kirsten Røland Byermoen
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Tom Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - H Ösp Egilsdottir
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Anne Moen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Forskningsveien 2B, 0371, Oslo, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
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21
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Izci-Balserak B, Zhu B, Wang H, Bronas UG, Gooneratne NS. Independent associations between sleep duration, gamma gap, and cognitive function among older adults: Results from the NHANES 2013-2014. Geriatr Nurs 2022; 44:1-7. [PMID: 34998076 DOI: 10.1016/j.gerinurse.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022]
Abstract
This study examined whether gamma gap mediated the association between sleep and cognitive function. Data from NHANES 2013-2014 were used. Three tests were used to measure cognitive function. Sleep was measured by three single questions. Gamma gap was calculated by subtracting albumin from total protein. Participants were 1392 older adults (53.2% females). Approximately 12% reported being told having sleep disorder, 1/3 reported having trouble sleeping, 25.9% had short sleep, and 12.5% had long sleep. Sleep disorders and sleep quality were not associated with cognitive function. Long sleep duration was an independent risk factor of reduced cognitive function on immediate recall, delayed recall, and executive function. Elevated gamma gap was also an independent risk factor of lower cognitive function. In a representative sample of older adults in the US, gamma gap and sleep duration were independent predictors of cognitive function. This study highlights the need for sleep assessment among older adults.
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Affiliation(s)
- Bilgay Izci-Balserak
- Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai 200025, China.
| | - Heng Wang
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Ulf G Bronas
- Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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22
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Quiñoz Gallardo MD, Barrientos Trigo S, Porcel Gálvez AM. [Effect of the guideline implementation "Risk assessment and prevention of pressure ulcers" of the Registered Nurses'Association of Ontario (RNAO).]. Rev Esp Salud Publica 2021; 95:e202109126. [PMID: 34565793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE The Best Practice Spotlight Organizations Program is being developed in Spain to reduce the variability of clinical practice by implementing clinical practice guidelines from the Registered Nurses' Association of Ontario. This study described the results of the implementation of the guide "Risk assessment and prevention of pressure ulcers". METHODS We carried out a retrospective observational study (2015-2018) at the Hospital Universitario Virgen de las Nieves on 4,464 patients from 22 hospitalization units, analyzing type of unit, risk assessment, preventive measures, origin and category of ulcers. Descriptive analysis and contingency tables were performed with the Chi-square statistic p<0.05. RESULTS The patients at risk were 62.2% in medical units, 53.4% in surgical units and 90% in intensive care. The application of preventive measures was 67.9%, 60.2% and 92.1% (respectively) for each unit. In medical units, 13.1% of pressure ulcers were identified, of which 68.1% were present at the time of admission. While in surgical units and intensive care they developed during hospitalization (60.8% and 88.9% respectively) (p<0.001). The presence of ulcers seemed to show a decreasing trend in the years analyzed (19.6% to 11.2%). CONCLUSIONS There are favorable environments for implantation (medical units and intensive care) that reflect a higher level of risk assessment, use of pressure management surfaces and a decrease in prevalence. The recommendations have not been implemented homogeneously, with differences depending on the type of unit.
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Affiliation(s)
- Mª Dolores Quiñoz Gallardo
- Hospital Universitario Virgen de las Nieves. Granada. España
- Grupo de investigación Ee-12 Hygia adscrito al Instituto de Investigación Biosanitaria (ibs.Granada). Granada. España
| | - Sergio Barrientos Trigo
- Departamento de Enfermería Universidad de Sevilla. Grupo de investigación CTS-1050 Cuidados Complejos, Cronicidad y Resultados en Salud adscrito al Instituto de Biomedicina de Sevilla (IBIS). Sevilla. España
| | - Ana María Porcel Gálvez
- Departamento de Enfermería Universidad de Sevilla. Grupo de investigación CTS-1050 Cuidados Complejos, Cronicidad y Resultados en Salud adscrito al Instituto de Biomedicina de Sevilla (IBIS). Sevilla. España
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Lee EK, Jeong HY, Kim KW. End-of-Life Assessments and Communication for Dying Patients and Their Families. J Hosp Palliat Care 2021; 24:194-197. [PMID: 37674563 PMCID: PMC10180061 DOI: 10.14475/jhpc.2021.24.3.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 09/08/2023]
Abstract
End-of-life assessments aim to help dying patients and their families plan clinical interventions in advance and prepare them for a peaceful end of life, in which the patient accepts life and death, and the family accepts the patient's departure. It is important to assess whether death is imminent within a few days, because critical hospice care is provided intensively during that period. The following five changes constitute objective evidence of the end of life: diminished daily living performance, decreased food intake, changes in consciousness and increased sleep quantity, worsening of respiratory distress, and end-stage delirium. As subjective evidence, it is suggested that sensitive perceptions of experienced nurses and the feelings of family members caring for patients should also be considered. When notifying a patient or family members that the end of life is approaching, the members of the multidisciplinary hospice team must communicate with each other, share accurate information, and provide consistent explanations. They must also listen to non-verbal communication in an empathic and supportive manner.
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Affiliation(s)
- Eun Kyung Lee
- Hospice Palliative Center, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hyae Yeong Jeong
- Hospice Palliative Center, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kyung Won Kim
- Department of Nursing, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
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Randhawa B, Lewis E, Owen C. Treating CLL with Bruton Tyrosine Kinase Inhibitors: The Role of the Outpatient Oncology Nurse. Semin Oncol Nurs 2021; 37:151177. [PMID: 34281733 DOI: 10.1016/j.soncn.2021.151177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To summarize the role of Bruton tyrosine kinase (BTK) inhibitors in the management of chronic lymphocytic leukemia with a focus on the nursing role in relation to patients with chronic lymphocytic leukemia being treated with BTK inhibitors. DATA SOURCES These include published articles (PubMed) and national and international guideline documents. CONCLUSION BTK inhibitors have revolutionized the therapy of chronic lymphocytic leukemia and have become the most frequently used therapy today. Despite the many advantages of BTK inhibitors, adverse events remain a leading cause of treatment discontinuation, particularly for the first-in-class BTK inhibitor. Second-generation BTK inhibitors appear to have a better tolerability profile but still require adverse event management given their prolonged duration of therapy. Awareness and management of side effects by the oncology care team is essential for ensuring both compliance and safety with ongoing treatment. IMPLICATIONS FOR NURSING PRACTICE Chronic lymphocytic leukemia is a chronic illness with a long-life expectancy. For the patients who require therapy, BTK inhibitor therapy is a frequently applied treatment with impressive efficacy. BTK inhibitors are continued indefinitely until disease progression or significant toxicity; therefore, the overall principles of careful assessment for side effects, diligent management for these, and individualized patient support provided by oncology nurses is vital in this patient population.
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Affiliation(s)
- Baljit Randhawa
- Alberta Blood and Marrow Transplant Clinic, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alb, Canada
| | - Ellen Lewis
- Alberta Blood and Marrow Transplant Clinic, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alb, Canada
| | - Carolyn Owen
- Associate Professor, Division of Hematology & Hematological Malignancies, University of Calgary, Calgary, Alb, Canada.
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Forsell L, Forsberg A, Kisch A, Rantala A. Inequalities and short-term outcome among patients assessed as non-urgent in a Swedish ambulance service setting. Int Emerg Nurs 2021; 57:101018. [PMID: 34147876 DOI: 10.1016/j.ienj.2021.101018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Within the ambulance service, assessment and referral of patients, especially those with non-urgent conditions, is a difficult and complicated task. Studies indicate that 12 to 20 percent of all patients are subjected to non-conveyance and discharged at the scene. There is lack of knowledge of what characterizes conveyed and non-conveyed patients. The aim of this study was to explore non-urgent patients who are conveyed or not conveyed to hospital and the short-term outcome of non-conveyance in a Swedish Ambulance Service setting. METHODS This study has a descriptive, cross-sectional design. All patients who were prioritized as non-urgent were eligible for the study and 1,048 patients were followed-up in an administrative data system that stores information about the patients' trajectory in both primary and hospital care. RESULTS More women than men were subjected to non-conveyance and most of the non-conveyed patients were left at home out-of-hours. 53% sought care again within 72 h. A large proportion of the non-conveyed patients were assessed as having unspecific symptoms. CONCLUSIONS There are prominent gender differences in the context of non-conveyance where unspecific symptoms seem to be the main reason for being left at home. As many of the non-conveyed patients who did not receive any advice about further investigation or intervention sought care again within 72 h, the assessments may be insufficient or inaccurate.
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Affiliation(s)
- Lena Forsell
- Department of Health Sciences, Lund University, Lund, Sweden; Emergency Department, Helsingborg General Hospital, Helsingborg, Sweden
| | - Anna Forsberg
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden
| | - Annika Kisch
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Haematology, Skåne University Hospital, Lund, Sweden
| | - Andreas Rantala
- Department of Health Sciences, Lund University, Lund, Sweden; Emergency Department, Helsingborg General Hospital, Helsingborg, Sweden.
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26
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Brühl A, Sappok-Laue H, Lau S, Christ-Kobiela P, Müller J, Sesterhenn-Ochtendung B, Stürmer-Korff R, Stelzig A, Lobb M, Bleidt W. Indicating Care Process Quality: A Multidimensional Scaling Analysis. J Nurs Meas 2021; 30:364-387. [PMID: 33431558 DOI: 10.1891/jnm-d-20-00096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Resident assessments are analyzed by multidimensional scaling. METHODS We analyzed observer-based real care and support time in four facilities with 209 residents during two working days; resident, organizational data and pairs of residents were assessed by registered and assistant nurses regarding the dissimilarity of resident pairs. Registered- and assistant nurses dissimilarity assessments are compared to criteriabased nursing management assessment. RESULTS The fits of management criteria matrices as external restrictions are higher in registered nurses' than in assistant nurses' assessments. These differences disappear with low staffing. CONCLUSION The influence of qualification levels on assessment is affected by staffing. Low complexity of Assistant Nurses assessments is connected to higher nursing care and support time in groups of demanding residents.
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Affiliation(s)
- Albert Brühl
- Vallendar University of Philosophy and Theology (PTHV), Vallendar, Germany
| | | | - Steffi Lau
- Vocational school Koblenz, Koblenz, Germany
| | | | - Joachim Müller
- Technical college Kobern-Gondorf, Kobern-Gondorf, Germany
| | | | | | | | - Michael Lobb
- Bethesda Foundation-St. Martin, Boppard, Germany
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Byermoen KR, Brembo EA, Egilsdottir HÖ, Heyn LG, Moen A, Eide H. Reflection on actions: Identifying facilitators of and barriers to using physical assessment in clinical practice. Nurse Educ Pract 2020; 50:102913. [PMID: 33321269 DOI: 10.1016/j.nepr.2020.102913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/11/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
Current research suggests that nursing students do not apply all sets of physical assessment skills (PAS) learned in their nursing education. The aim of this study was to evaluate third-year nursing students' process of clinical judgment using PAS in clinical rotation. Specific focus was on how the process of clinical judgment affected when the nursing students performed physical assessment, and which types of knowledge were implied in their practice. Ten nursing students performed PAS independently while in clinical rotation; these performances were audiotaped and observed. Shortly after, individual semi-structured stimulated recall interviews (SRI) took place. Regardless of the nursing students' stated level of PAS utilization, self-efficacy or scientific knowledge, clinical judgment was primarily based on contextual factors and personal prerequisites. This study contributes to in-depth knowledge about how nursing students perform physical assessment, how they describe their clinical judgment process and their strategies towards systematically and confidently using PAS. We conclude the paper with pedagogical strategies and learning activities that can facilitate reflection-in-action and reflection-on-action.
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Affiliation(s)
- Kirsten Røland Byermoen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Espen Andreas Brembo
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - H Ösp Egilsdottir
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Lena Günterberg Heyn
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Anne Moen
- University of Oslo, Institute for Health and Society, Faculty of Medicine, Nedre Ullevål 9, 0850, Oslo, Norway.
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
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Gutiérrez-Sánchez D, Gómez-García R, Cuesta-Vargas AI, Pérez-Cruzado D. The suffering measurement instruments in palliative care: A systematic review of psychometric properties. Int J Nurs Stud 2020; 110:103704. [PMID: 32717488 DOI: 10.1016/j.ijnurstu.2020.103704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/20/2020] [Accepted: 06/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The relief of suffering is considered one of the main goals to reach at the end of life, and nurses play an essential role in the prevention and relief of suffering. Validated instruments for assessing suffering can be useful, and selection of the most appropriate measure is crucial. To date, no systematic review has been performed that contrasts the measurement properties of instruments assessing suffering in the palliative care population, according to the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments methodology. OBJECTIVES The aim of this systematic review is twofold: (1) identify the measures assessing suffering in the palliative care population, and (2) assess the measurement properties of these measures. DESIGN A systematic review of the measurement properties of instruments assessing suffering in palliative care was carried out. DATA SOURCES The search strategy was conducted in Medline, CINAHL, PsycINFO, Web of Science, Cochrane Library, SciELO, Scopus, Cosmin database of systematic reviews and Open gray. REVIEW METHODS The following methodologies were applied: updated COnsensus-based Standards for the selection of health status Measurement INstruments, the Meta-Analysis of Observational Studies in Epidemiology, and the Assessing the Methodological Quality of Systematic Reviews tool. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42018106488). Eligible studies were those that satisfied the following criteria: a) validation studies of measures assessing suffering in the palliative care population, b) assessing at least one measurement property of a measure, c) published in English or Spanish and d) published between January 1980 and September 2019. The included studies were assessed for the methodological quality of the measurement properties and then compared in terms of both the measurement properties and the methodological quality of the processes used. The evidence for each measurement property was summarised and the quality of the evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS The search strategy yielded a total of nine studies and six instruments assessing suffering. The methodological quality of the studies was doubtful and the quality of the evidence was moderate for most of the measurement properties analysed. The Suffering Pictogram was the instrument with the best rating for methodological quality and quality of evidence, for most of the measurement properties evaluated. CONCLUSIONS Instruments assessing suffering in palliative care have been identified in this systematic review. The Suffering Pictogram seems to be the most useful instrument identified. Tweetable abstract: The relief of suffering is one of the main goals to reach at the end of life, and the selection of the most appropriate measure for assessing this construct is crucial.
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Affiliation(s)
- Daniel Gutiérrez-Sánchez
- Department of Nursing and Podiatry, University of Málaga, Spain; Biomedical Research Institute of Málaga (IBIMA), Spain
| | - Rafael Gómez-García
- Biomedical Research Institute of Málaga (IBIMA), Spain; Cudeca Foundation, Málaga, Spain
| | - Antonio I Cuesta-Vargas
- Biomedical Research Institute of Málaga (IBIMA), Spain; Department of Physiotherapy, University of Málaga, Spain; Queensland University of Technology, Queensland, Australia.
| | - David Pérez-Cruzado
- Biomedical Research Institute of Málaga (IBIMA), Spain; Occupational Therapy Department. San Antonio Catholic University of Murcia, Murcia, Spain
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Ewers R, Bloomer MJ, Hutchinson A. An exploration of the reliability and usability of two delirium screening tools in an Australian intensive care unit: A pilot study. Intensive Crit Care Nurs 2020; 62:102919. [PMID: 32873426 DOI: 10.1016/j.iccn.2020.102919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the inter-rater reliability and usability of two delirium screening tools designed for use in ICU; the Confusion Assessment Method for ICU and the Intensive Care Delirium Screening Checklist. RESEARCH METHODOLOGY/DESIGN A multiple methods design was used. The intra and inter rater reliability of the tools were evaluated using Kappa statistics and intra class correlation coefficients. Focus groups were conducted to explore ICU staff perceptions of the usability of the tools and feasibility of delirium screening. SETTING Private hospital ICU, Melbourne Australia. RESULTS 66 patients were assessed for delirium; median age of 71 (IQR 62-75) years. Seventeen patients (26%) scored positive for delirium using the screening tools and 11 (17%) had delirium confirmed on the medical ICU discharge summary. Ten nurse assessors performed 99 paired assessments using the two tools sequentially, demonstrating the intra and inter-rater agreement and reliability of the tools was moderate to high. Four focus groups were conducted with 16 participants. Content analysis identified three themes: (i) current recognition of delirium, (ii) benefits of delirium screening, and (iii) future directions for delirium management. Time and medical staff indifference were identified as barriers to screening, facilitators were education and having a follow-up plan. CONCLUSION This study found that the reliability and usability of the CAM-ICU and ICDSC were acceptable and that using structured delirium screening was feasible as part of a wider, multi-disciplinary delirium management plan.
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Affiliation(s)
| | - Melissa J Bloomer
- Deakin University, School of Nursing & Midwifery, Geelong, Vic 3220, Australia; Centre for Quality and Patient Safety Research, Deakin University, Geelong, Vic 3220, Australia; Epworth Deakin Centre for Clinical Nursing Research, Richmond, Vic 3121, Australia
| | - Anastasia Hutchinson
- Deakin University, School of Nursing & Midwifery, Geelong, Vic 3220, Australia; Centre for Quality and Patient Safety Research, Deakin University, Geelong, Vic 3220, Australia; Epworth Deakin Centre for Clinical Nursing Research, Richmond, Vic 3121, Australia
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Wang SJ, Ma CT, Lu HY, Song XH, Niu YZ, Chen GJ, Zhou T, Shen ZA. [Establishment and application of a clustered management plan for pulmonary care of massive burn casualties]. Zhonghua Shao Shang Za Zhi 2020; 36:665-670. [PMID: 32829605 DOI: 10.3760/cma.j.cn501120-20200220-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish a clustered management plan for pulmonary care of massive burn casualties (hereinafter referred to as the clustered management plan for pulmonary care), and to explore its application effects. Methods: (1) A clustered care intervention group was established, including the medical and nursing staff from the Department of Burns and Plastic Surgery, Department of Respiratory Medicine, and Department of Infection Control at the Fourth Medical Center of PLA General Hospital (hereinafter referred to as our hospital). Four major links, including pulmonary care assessment, chest and lung physical therapy, artificial airway management, and specialized infection control were sorted out according to the key points and difficulties in pulmonary care for massive burn casualties. Evidence-based nursing methods were employed to retrieve articles related to the above-mentioned four links from PubMed, Chinese Journal Full-Text Database, VIP Database and Wanfang Data using terms of " mass burn, respiratory management and airway management" and terms of ",," , and the clustered management plan for pulmonary care was established based on reading and discussion in combination with clinical practice and experience. (2) In this non-randomized controlled study, the clustered management plan for pulmonary care was applied to 73 massive burn patients (48 males and 25 females, aged 32 (25, 38) years) who were admitted to our hospital from January 2016 to December 2019 and met the inclusion criteria, and they were included into the clustered care group; 43 massive burn patients (25 males and 18 females, aged 35 (17, 45) years) who were admitted to our hospital from January 2013 to December 2015, received routine care and met the inclusion criteria were retrospectively included into routine care group. The pulmonary infection rate and mortality of patients in the two groups were recorded during the hospital stay. Data were statistically analyzed with chi-square test, Mann-Whitney U test, and independent sample t test. Results: (1) The clustered management plan for pulmonary care included a total of 12 specific measures covering four aspects of pulmonary care. The contents in pulmonary care assessment clearly stated to include the previous medical history, history of injury, respiratory status, hoarseness, pulmonary auscultation, etc. Chest and lung physical therapy included how to guide patients to effectively cough and do pursed lip breathing and abdominal breathing exercise, etc. Artificial airway management specified the preparation for the establishment of artificial airway at clinical reception, the observation index and frequency after tracheotomy, the method of humidification, the method and frequency of sputum suction, and the management of mechanical ventilation, etc. Specialized infection control required to strengthen hand hygiene and ventilator management. (2) The pulmonary infection rate and mortality of patients in the clustered care group were 2.74% (2/73) and 4.11% (3/73), respectively, significantly lower than 25.58% (11/43) and 18.60% (8/43) in routine care group (χ(2)=11.986, 5.043, P<0.05 or P<0.01). Conclusions: The clustered management plan for pulmonary care developed for massive burn casualties focuses on the major links and key points. The measures are systemic and comprehensive, simple but precise, and highly operable, covering the entire process of massive burn care, hereby reducing the pulmonary infection rate significantly and improving the success rate of treatment.
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Affiliation(s)
- S J Wang
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - C T Ma
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - H Y Lu
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - X H Song
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Y Z Niu
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - G J Chen
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - T Zhou
- Department of Nursing, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Z A Shen
- Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
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de Freitas Luzia M, Vidor ID, da Silva ACFE, de Fátima Lucena A. Fall prevention in hospitalized patients: Evaluation through the nursing outcomes classification/NOC. Appl Nurs Res 2020; 54:151273. [PMID: 32650884 DOI: 10.1016/j.apnr.2020.151273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/10/2020] [Accepted: 04/29/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the nursing outcomes of hospitalized patients at high risk for falls through NOC and correlate NOC outcomes called Knowledge: Fall Prevention and Fall Prevention Behavior with patients' sociodemographic and clinical variables. BACKGROUND Falls represent one of the major safety incidents in the hospital setting. The role of nursing is fundamental in preventing these events, from risk assessment to outcome evaluation. One of the strategies for evaluating nursing outcomes is the use of Nursing Outcomes Classification (NOC). METHODS A cross-sectional study conducted with a sample of 68 adult patients at high risk for falls admitted to clinical and surgical units. The patients received three evaluations. Data collect was prospective with an instrument containing five results and 28 NOC indicators. Descriptive and analytical analysis considered the NOC 5-point Likert scale. RESULTS Evaluation of the Knowledge: Fall Prevention and Fall Prevention Behavior outcomes showed that patients have a limited level of knowledge and rarely demonstrated preventive behavior. Vital Signs (0802), Medication Response (2301) and Safe Health Care Environment (1934) pointed to the existence of adequate patient monitoring and safe environment. CONCLUSION The evaluation of patient outcomes supported by a standardized classification system such as the NOC highlights the patient's clinical evolution and produces data that support the planning of care and management interventions, providing more effective and safer practices.
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Affiliation(s)
- Melissa de Freitas Luzia
- School of Nursing, Universidade Federal do Rio Grande do Sul, Rua São Manoel, 963 - Rio Branco, Porto Alegre, RS 90620-110, Brazil.
| | - Isabella Duarte Vidor
- School of Nursing, Universidade Federal do Rio Grande do Sul, Rua São Manoel, 963 - Rio Branco, Porto Alegre, RS 90620-110, Brazil
| | | | - Amália de Fátima Lucena
- School of Nursing, Universidade Federal do Rio Grande do Sul, Rua São Manoel, 963 - Rio Branco, Porto Alegre, RS 90620-110, Brazil
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Tuğrul E, Karaçam Z. Comparison of blood pressure and pulse readings measured on a bare arm, a clothed arm and on an arm with a rolled-up sleeve. Int J Nurs Stud 2020; 105:103506. [PMID: 32087407 DOI: 10.1016/j.ijnurstu.2019.103506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/17/2019] [Accepted: 12/14/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although there are standards for measuring blood pressure and pulse, nurses and other health professionals implement different practices. It has been observed that these measurements are sometimes taken over sleeves or with rolled-up sleeves due to various cultural factors or as a matter of convenience. There is a need to investigate whether measurements taken in this form can be counted on to be reliable. OBJECTIVE This study aimed to compare blood pressure and pulse readings measured on a bare arm, a clothed arm and on an arm with a rolled-up sleeve. METHODS This study, of analytical design, was conducted with 200 individuals at the Adnan Menderes University Research and Practice Hospital in January and December 2017. A questionnaire and a measurement recording form were used in collecting the data. The participants' blood pressure and pulse readings were taken and the circumference of the clothed and bare arm and arm skinfold thickness was measured. The data were analyzed using descriptive statistics, the independent samples t-test, and Pearson's correlation test. RESULTS The mean age of the individuals participating in the study was 33.38 ± 9.14 (range: 19-51). It was observed that in the measurements taken over a bare and clothed arm, mean systolic (114.48 ± 13.18 and 114.72 ± 12.21, respectively) and diastolic (70.42 ± 8.72 and 70.24 ± 8.63, respectively) blood pressure readings were statistically similar (t = -0.41, p = 0.682; t = 0.45, p = 0.653, respectively). On the other hand, in the measurements taken over an arm with a rolled-up, constricting sleeve, it was observed that mean systolic (116.76 ± 13.00) and diastolic (71.99 ± 9.15) blood pressure readings were statistically higher than measurements taken over a bare arm (t = -3.88, p = 0.000; t = -3.75, p = 0.000, respectively) and a clothed arm (t = -3.43, p = 0.001; t = -4.31, p = 0.000, respectively). Similarly, pulse readings taken from an arm with a rolled-up, constricting sleeve (82.40 ± 12.15) were found to be statistically higher than pulse readings taken from a bare arm (79.68 ± 12.30) and a clothed arm (80.44 ± 11.10) (t = -6.78, p = 0.000; t = -5.50, p = 0.000, respectively). The analysis indicated blood pressure and pulse readings were positively correlated with arm thickness but not correlated with the arm skinfold thickness or the thickness of the clothing. CONCLUSION The study revealed that constricting rolled-up sleeves and the thickness of the circumference of the arm were factors that produced higher systolic and diastolic blood pressure and pulse readings.
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Affiliation(s)
- Emel Tuğrul
- Nursing Faculty, Department Of Fundamentals Of Nursing, Aydın Adnan Menderes University, Kepez mevkii, Efeler, Aydın, Turkey.
| | - Zekiye Karaçam
- Health Science Faculty, Aydın Adnan Menderes University, Aydın, Turkey
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Kumar N, Choudhary RS, Malhotra K, Kathariya R. Maxillofacial Nursing: Assessing the Knowledge and Awareness of Nurses in Handling Maxillofacial Injuries Through a Comprehensive Survey. J Maxillofac Oral Surg 2020; 19:136-142. [PMID: 31988577 PMCID: PMC6954928 DOI: 10.1007/s12663-019-01240-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/13/2019] [Indexed: 11/26/2022] Open
Abstract
Aim To assess the knowledge and awareness of nurses in handling maxillofacial injuries. Method A cross-sectional questionnaire study was conducted among the staff nurses of the multi-specialty Gokul Newtech Hospital, Jamnagar, Gujarat. Forty nursing staff were included in the study. Kruskal–Wallis ANOVA, Spearman’s correlation and Mann–Whitney U tests were applied for statistical analysis. Result There was no statistically significant difference between the mean knowledge score concerning the study participant’s age, work experience, and education. According to the survey, a majority of the nurses either did not know the answer or answered incorrectly. Conclusion It can be concluded that there is a requirement of new guidelines and recommendations in the existing teaching and training modules being followed by the nursing schools across the country. Electronic supplementary material The online version of this article (10.1007/s12663-019-01240-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nishit Kumar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Jamnagar, Gujarat India
| | | | - Kamal Malhotra
- Dr. Malhotra’s Nuface Clinic, 1813 Maharaja Nagar, Ludhiana, Punjab India
| | - Rahul Kathariya
- Dental Galaxy, 201, 1st floor, 1443 Kaustubh Apts, Bajirao Road, Pune, Maharashtra 411002 India
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Martínez-Alberto CE, Brito-Brito PR, Fernández-Gutiérrez DA, Cabrera-García P, García-Hernández AM, Darias-Curvo S, Aguirre-Jaime A. Evaluation of the risk of diabetic peripheral neuropathy: Design and validation of the NeuDiaCan nursing screening procedure. Enferm Clin (Engl Ed) 2019; 30:89-98. [PMID: 31515153 DOI: 10.1016/j.enfcli.2019.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/20/2019] [Accepted: 07/07/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To design and validate a nursing screening procedure for diabetic peripheral neuropathy in primary care. METHODS The study was carried out in three phases. 1)Construction of an item bank to form the procedure with an exit score describing the patient's clinical situation. 2)Test and reduction of the initial tentative procedure on a sample of 50 patients using community nurse consultations, eliminating the components with low inter-intra nurse reliability. 3)Validation of the version of the procedure obtained in the previous step on a sample of 106 patients. Calculation of validity and reliability by eliminating components with low criterion validity with respect to the results of the diagnostic electromyography used as a reference standard. Cut-off points were estimated for the use of the procedure as a screening tool, predictive values, performance, internal consistency and inter-nurse reliability. RESULTS The initial tentative procedure consisted of 12 components that were reduced to 10. In the process of validation of this second version the procedure was simplified again, eventually comprising 6 components, with a cut-off point of 2.5 in its output scale, the point at which it reaches adequate values of sensitivity and negative predictors to be used as a screening instrument. For this cut-off point the inter-intra nurse reliability, criterion validity and predictive validity reached acceptable values. CONCLUSIONS NeuDiaCan as a nursing screening procedure for diabetic peripheral neuropathy in primary care is valid, reliable and easy to use.
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Affiliation(s)
- Carlos E Martínez-Alberto
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España.
| | - P Ruymán Brito-Brito
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España
| | | | - Patricia Cabrera-García
- Servicio de Endocrinología, Complejo Hospitalario Universitario de Canarias, Servicio Canario de la Salud, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Alfonso M García-Hernández
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de la Laguna, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Sara Darias-Curvo
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de la Laguna, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Armando Aguirre-Jaime
- Departamento de Salud Pública de la Universidad Europea de Canarias, miembro de Laureate International Universities, Instituto de Investigación en Cuidados del Ilustre Colegio de Enfermeros de Santa Cruz de Tenerife, Santa Cruz de Tenerife, España
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Neeman E, Gresham G, Ovasapians N, Hendifar A, Tuli R, Figlin R, Shinde A. Comparing Physician and Nurse Eastern Cooperative Oncology Group Performance Status (ECOG-PS) Ratings as Predictors of Clinical Outcomes in Patients with Cancer. Oncologist 2019; 24:e1460-e1466. [PMID: 31227648 DOI: 10.1634/theoncologist.2018-0882] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/23/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scale is commonly used by physicians and nurses in oncology, as it correlates with cancer morbidity, mortality, and complications from chemotherapy and can help direct clinical decisions and prognostication. This retrospective cohort study aimed to identify whether ECOG-PS scores rated by oncologist versus nurses differ in their ability to predict clinical outcomes. MATERIALS AND METHODS Over 19 months, 32 oncologists and 41 chemotherapy nurses from a single academic comprehensive cancer center independently scored ECOG-PS (range: 0-5) for a random sample of 311 patients with cancer receiving chemotherapy. Logistic regression models were fit to evaluate the ability of nurse and physician ECOG-PS scores, as well as the nurse-physician ECOG-PS score difference (nurse minus physician), to predict the occurrence of chemotherapy toxicity (CTCAE v4, grade ≥3) and hospitalizations within 1 month from ECOG-PS ratings, as well as 6-month mortality or hospice referrals. RESULTS Physician/nurse ECOG-PS agreement was 71% (Cohen's κ = 0.486, p < .0001). Nurse ECOG-PS scores had stronger odds ratio for 6-month mortality or hospice (odds ratio [OR], 3.29, p < .0001) than physician ECOG-PS scores (OR, 2.71, p = .001). Furthermore, ECOG-PS ratings by nurses, but not physicians, correlated with 1-month chemotherapy toxicity (OR, 1.44, p = .021) and 1-month hospitalizations (OR, 1.57, p = .041). Nurse-physician disagreement, but only when physicians gave "healthier" (lower) ratings, was also associated with worse outcomes (chemotherapy toxicity OR = 1.51, p = .045; 1-month hospitalization OR, 1.86, p = .037; 6-month mortality or hospice OR, 2.99, p < .0001). CONCLUSION Nurse ECOG-PS ratings seem more predictive of important outcomes than those of physicians, and physician-nurse disagreement in ECOG-PS ratings predicts worse outcomes; scoring by nurses may result in additional clinical benefit. IMPLICATIONS FOR PRACTICE Nurse-rated Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, compared with those rated by oncologists, better predicted hospitalizations and severe chemotherapy toxicity within 1 month from ECOG-PS assessment, as well as mortality or hospice referrals within 6 months. Physician-nurse disagreement in ECOG-PS scoring was associated with worse hospitalization, chemotherapy toxicity, and mortality and hospice referral rates. Rating performance statuses of patients with cancer by nurses instead or in addition to oncologists can result in additional clinical benefits, such as improved prognostication, as well as better informed clinical decision making regarding whether or not to administer chemotherapy, the need for additional supportive care, and goals of care discussions.
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Affiliation(s)
- Elad Neeman
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles California, USA
| | - Gillian Gresham
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA
| | - Navasard Ovasapians
- Department of Internal Medicine, Baylor College of Medicine, Huston, Texas, USA
| | - Andrew Hendifar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA
| | - Richard Tuli
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA
| | - Robert Figlin
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles California, USA
| | - Arvind Shinde
- Department of Hematology and Oncology, Transplant and Hepatopancreatobiliary Institute, St. Vincent Medical Center, Los Angeles, California, USA
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Khatiban M, Tohidi S, Shahdoust M. The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process. Int J Nurs Sci 2019; 6:329-333. [PMID: 31508455 PMCID: PMC6723353 DOI: 10.1016/j.ijnss.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 05/30/2019] [Accepted: 06/05/2019] [Indexed: 11/20/2022] Open
Abstract
Objectives Comprehensive nursing assessment, as the first step in the nursing process, involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process. The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process. Methods A randomized controlling design was conducted. Of 84 undergraduate nursing students, 42 students were allocated to the intervention or control group. In clinical education, a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process, while the control group received traditional methods. The data were gathered using a demographic information questionnaire, skills in nursing process development checklist, and attitudes towards nursing process questionnaire. Results The average scores for students’ attitude and skills in developing nursing process in the intervention group were greater than those of the control group. Conclusion Applying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.
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Affiliation(s)
- Mahnaz Khatiban
- Mother & Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahin Tohidi
- Department of Medical Surgical Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Corresponding author. Department of Medical Surgical Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Maryam Shahdoust
- Biostatistics Department, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Arias-Rivera S, López-López C, Frade-Mera MJ, Via-Clavero G, Rodríguez-Mondéjar JJ, Sánchez-Sánchez MM, Acevedo-Nuevo M, Gil-Castillejos D, Robleda G, Cachón-Pérez M, Latorre-Marco I. Assessment of analgesia, sedation, physical restraint and delirium in patients admitted to Spanish intensive care units. Proyecto ASCyD. Enferm Intensiva (Engl Ed) 2019; 31:3-18. [PMID: 31003871 DOI: 10.1016/j.enfi.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 01/25/2023]
Abstract
AIMS Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR. METHOD An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Block I: with questions on the unit's characteristics and routine practice; Block II: aspects of direct care and direct assessments of patients admitted to participating units. RESULTS One hundred and fifty-eight units and 1574 patients participated. The pain of communicative patients (CP) was assessed and recorded as standard in 109 units (69%), the pain of non-communicative patients (NCP) in 84 (53%), sedation/agitation in 111 (70%), and delirium in 39 units (25%). There was recorded use of PR in 39 units (25%). Validated scales were used to assess the pain of CP in 139 units (88%), of NCP in 102 (65%), sedation/agitation in 145 (92%), delirium in 53 units (34%). In 33 units (21%) pain, sedation/agitation and delirium of PC and NPC was assessed, and in 8 of these units there was a specific PR protocol and register. Among the patients who could be assessed, an absence of pain was reported in 57%, moderate pain in 27%; 48% were calm and collaborative, and 10% agitated; 21% had PR, and 12.6% of the patients had delirium. CONCLUSIONS The assessment of pain, sedation and delirium is demonstrated, and low percentages of agitation and delirium achieved. We observed a high percentage of patients with pain, and moderate use of PC. We should generalise the use of protocols to assess, prevent and treat pain and delirium by appropriately managing analgesia, sedation, and individual and well-considered use of PC. (ClinicalTrials.gov Identifier: NCT03773874).
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Affiliation(s)
- S Arias-Rivera
- Hospital Universitario de Getafe, Getafe, Madrid, España; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España; Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España.
| | - C López-López
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense, Madrid, España
| | - M J Frade-Mera
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario 12 de Octubre, Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense, Madrid, España
| | - G Via-Clavero
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitari de Bellvitge (GRIN-IDIBELL), Hospitalet de Llobregat, Barcelona, España
| | - J J Rodríguez-Mondéjar
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Gerencia de Urgencias y Emergencias 061, Servicio Murciano de Salud, Murcia, España; Universidad de Murcia, Instituto Murciano de Investigación Biomédica del HCU Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España
| | - M M Sánchez-Sánchez
- Hospital Universitario de Getafe, Getafe, Madrid, España; Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España
| | - M Acevedo-Nuevo
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España; Facultad de Ciencias de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - D Gil-Castillejos
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Juan XXIII, Tarragona, España
| | - G Robleda
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Escuela Superior de Enfermería Mar (ESIMar), Universidad Pompeu Fabra, Barcelona, España; Centro Cochrane Iberoamericano, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Cachón-Pérez
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - I Latorre-Marco
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España
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Poiroux L, Piquilloud L, Seegers V, Le Roy C, Colonval K, Agasse C, Zinzoni V, Hodebert V, Cambonie A, Saletes J, Bourgeon I, Beloncle F, Mercat A. Effect on comfort of administering bubble-humidified or dry oxygen: the Oxyrea non-inferiority randomized study. Ann Intensive Care 2018; 8:126. [PMID: 30560440 PMCID: PMC6297119 DOI: 10.1186/s13613-018-0472-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/11/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The clinical interest of using bubble humidification of oxygen remains controversial. This study was designed to further explore whether delivering dry oxygen instead of bubble-moistened oxygen had an impact on discomfort of ICU patients. METHODS This randomized multicenter non-inferiority open trial included patients admitted in intensive care unit and receiving oxygen. Any patient receiving non-humidified oxygen (between 0 and 15 L/min) for less than 2 h could participate in the study. Randomization was stratified based on the flow rate at inclusion (less or more than 4 L/min). Discomfort was assessed 6-8 and 24 h after inclusion using a dedicated 15-item scale (quoted from 0 to 150). RESULTS Three hundred and fifty-four ICU patients receiving non-humidified oxygen were randomized either in the humidified (HO) (n = 172), using bubble humidifiers, or in the non-humidified (NHO) (n = 182) arms. In modified intention-to-treat analysis at H6-H8, the 15-item score was 26.6 ± 19.4 and 29.8 ± 23.4 in the HO and NHO groups, respectively. The absolute difference between scores in both groups was 3.2 [90% CI 0.0; + 6.5] for a non-inferiority margin of 5.3, meaning that the non-inferiority analysis was not conclusive. This was also true for the subgroups of patients receiving either less or more than 4 L/min of oxygen. At H24, using NHO was not inferior compared to HO in the general population and in the subgroup of patients receiving 4 L/min or less of oxygen. However, for patients receiving more than 4 L/min, a post hoc superiority analysis suggested that patients receiving dry oxygen were less comfortable. CONCLUSIONS Oxygen therapy-related discomfort was low. Dry oxygen could not be demonstrated as non-inferior compared to bubble-moistened oxygen after 6-8 h of oxygen administration. At 24 h, dry oxygen was non-inferior compared to bubble-humidified oxygen for flows below 4 L/min.
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Affiliation(s)
- Laurent Poiroux
- Medical Intensive Care Department, Angers University Hospital, 4, rue Larrey, 49933 Angers Cedex, France
| | - Lise Piquilloud
- Adult Intensive Care and Burn Unit, Medical Intensive Care Department, Lausanne University Hospital, rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Valérie Seegers
- Département de Biométrie, Institut de Cancérologie de l’Ouest, 15 avenue Bocquel, 49055 Angers Cedex 02, France
| | - Cyril Le Roy
- Medical Intensive Care Department, Angers University Hospital, 4, rue Larrey, 49933 Angers Cedex, France
| | - Karine Colonval
- Medical Intensive Care Department, Orléans Regional Hospital, 4 avenue de l’hôpital, 45067 Orléans Cedex, France
| | - Carole Agasse
- Medical Intensive Care Department, Nantes University Hospital, 1 place Alexis-Ricordeau, 44093 Nantes Cedex 1, France
| | - Vanessa Zinzoni
- Intensive Care Department, La Roche-sur-Yon Hospital, Boulevard Stéphane Moreau, 85925 La Roche-Sur-Yon, France
| | - Vanessa Hodebert
- Intensive Care Unit, Saint-Malo Hospital, 1 Rue de la Marne, 35400 Saint-Malo, France
| | - Alexandre Cambonie
- Medical Intensive Care Department, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France
| | - Josselin Saletes
- Intensive Care Unit, Le Mans Hospital, 194 avenue Rubillard, 72037 Le Mans Cedex 9, France
| | - Irma Bourgeon
- Medical Intensive Care Department, Henri Mondor University Hospital, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - François Beloncle
- Medical Intensive Care Department, Angers University Hospital, 4, rue Larrey, 49933 Angers Cedex, France
| | - Alain Mercat
- Medical Intensive Care Department, Angers University Hospital, 4, rue Larrey, 49933 Angers Cedex, France
| | - for the REVA Network
- Medical Intensive Care Department, Angers University Hospital, 4, rue Larrey, 49933 Angers Cedex, France
- Adult Intensive Care and Burn Unit, Medical Intensive Care Department, Lausanne University Hospital, rue du Bugnon 46, 1011 Lausanne, Switzerland
- Département de Biométrie, Institut de Cancérologie de l’Ouest, 15 avenue Bocquel, 49055 Angers Cedex 02, France
- Medical Intensive Care Department, Orléans Regional Hospital, 4 avenue de l’hôpital, 45067 Orléans Cedex, France
- Medical Intensive Care Department, Nantes University Hospital, 1 place Alexis-Ricordeau, 44093 Nantes Cedex 1, France
- Intensive Care Department, La Roche-sur-Yon Hospital, Boulevard Stéphane Moreau, 85925 La Roche-Sur-Yon, France
- Intensive Care Unit, Saint-Malo Hospital, 1 Rue de la Marne, 35400 Saint-Malo, France
- Medical Intensive Care Department, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France
- Intensive Care Unit, Le Mans Hospital, 194 avenue Rubillard, 72037 Le Mans Cedex 9, France
- Medical Intensive Care Department, Henri Mondor University Hospital, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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Gray LC, Beattie E, Boscart VM, Henderson A, Hornby-Turner YC, Hubbard RE, Wood S, Peel NM. Development and Testing of the interRAI Acute Care: A Standardized Assessment Administered by Nurses for Patients Admitted to Acute Care. Health Serv Insights 2018; 11:1178632918818836. [PMID: 30618486 PMCID: PMC6299328 DOI: 10.1177/1178632918818836] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/16/2018] [Indexed: 11/21/2022] Open
Abstract
Background: Underpinning standards for developing comprehensive care in hospital is the need to identify, early in the admission process, functional and psychosocial issues which affect patient outcomes. Despite the value of comprehensive assessment of patients on admission, the process is often sub-optimal due to a lack of standardized assessment practices. This project aimed to develop a concise, integrated assessment for patients admitted to acute care and test its psychometric properties. Methods: Two international expert panels of clinicians and health scientists collaborated to establish design parameters. Using clinical observations and a variety of derivative applications sourced from the interRAI research collaborative repository, the panels constructed a draft instrument to examine feasibility, resource requirements, and inter-rater reliability. Field testing was conducted in Australia and Canada. Next, the system was revised to its final form, the interRAI Acute Care, after feedback and review from international interRAI members. Results: Constructed using 56 items, the interRAI Acute Care required a median of 15 minutes to complete. Inter-rater reliability tested on 130 paired assessments was substantial to almost perfect for 78% of the clinical items and moderate for the remaining 22% of items. A subset of 30 items from the admission assessment comprised the discharge assessment. Discussion: The interRAI Acute Care has been shown to be an efficient nursing assessment instrument with good psychometric properties. Implementation in a digital environment will enable documentation and care planning to comply with standards for quality of care in the general adult hospital population.
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Affiliation(s)
- Leonard C Gray
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Veronique M Boscart
- Schlegel Centre for Advancing Seniors Care, Conestoga College, Kitchener, ON, Canada
| | - Amanda Henderson
- Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Yvonne C Hornby-Turner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Susan Wood
- Quality and Patient Safety, Canterbury and West Coast District Health Boards, Christchurch, New Zealand
| | - Nancye M Peel
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Oliveira-Kumakura ARDS, Alonso JB, de Carvalho EC. Psychometric Assessment of the Nursing Outcome Swallowing Status: Rasch Model Approach. Int J Nurs Knowl 2018; 30:197-202. [PMID: 30362267 DOI: 10.1111/2047-3095.12229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To apply the Rasch model to test the psychometric assessment of the nursing outcome Swallowing status among poststroke patients. METHODS Cross-sectional study was conducted with 227 poststroke patients, which were evaluated by a nurse. The Rasch model was used to examine psychometric properties. FINDINGS Indicators fit the Rasch model and presented good reliability and good ability for separation index. The 5-point Likert scale did not present adequate discrimination and classification levels were compiled into three. CONCLUSIONS Data evidenced the use of a robust method to perform a clinical validity of the Swallowing status, complementing previous validation studies. RELEVANCE TO CLINICAL PRACTICE Using Rasch analysis serve as reference points to assess Swallowing status on a single scale. OBJETIVO Aplicar o modelo Rasch para testar as medidas psicométricas do resultado de enfermagem Estado da deglutição em pacientes acometidos por acidente vascular cerebral. MÉTODOS: Estudo transversal, realizado com 227 pacientes após AVC avaliados por um único enfermeiro. O modelo Rasch foi usado para examinar propriedades psicométricas. RESULTADOS Os indicadores se ajustaram ao modelo Rasch e apresentam boa confiabilidade e boa capacidade de separação. A escala Likert de 5 pontos não apresentou discriminação adequada e os níveis de classificação foram compilados em três pontos. CONCLUSÃO: Os dados evidenciaram o uso de um método robusto para a validade clínica do Estado da deglutição, complementando os estudos de validação anteriores. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: O uso do modelo Rasch serve como ponto de referência para avaliar o Estado da deglutição em uma única escala.
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Affiliation(s)
| | - Jonas Bodini Alonso
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Brazil
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Jiang XS, Xu L, Li L, Zhang LQ. [Investigation and analysis of the difference between the nursing needs of adult burn patients and nurses' cognition]. Zhonghua Shao Shang Za Zhi 2018; 34:731-735. [PMID: 30369144 DOI: 10.3760/cma.j.issn.1009-2587.2018.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the difference between the nursing needs of burn patients and nurses' cognition in order to adjust the nursing service behavior and improve the nursing quality. Methods: The convenience sampling method was adopted to select 400 burn inpatients admitted to the Department of Burns of the 180th Hospital of the People's Liberation Army from January to September 2017, and 38 nurses from the same department were selected by cluster sampling method. On the day of or the day before hospital discharge after instruction to discharging patients, the self-designed questionnaire was adopted to investigate the nursing needs of patients during hospitalization. The cognitive differences between patients and nurses in the overall level and specific dimensions of nursing needs were compared, and items of the nursing needs of patients which were higher than the cognition of nurses with statistically significant differences were recorded. The five most important nursing needs items considered by both patients and nurses were recorded and compared. Data were processed with independent sample t test. Results: The effective recovery rates of questionnaire for patients and nurses were 94.8% (379/400) and 100.0% (38/38), respectively. The total score of patients' nursing needs was (3.9±0.4) points, which was similar to (4.1±0.5) points of nurses' cognition of patients' nursing needs (t=1.611, P>0.05). The scores of patients' physiological needs and self-esteem needs dimensions were (4.0±0.6) and (3.9±0.6) points, respectively, significantly lower than (4.2±0.4) and (4.3±0.5) points of nurses (t=-2.476, -4.160, P<0.05 or P<0.01). The scores of patients' safety needs, love and belonging needs, and self-realization needs dimensions were similar to those of nurses (t=0.228, 1.356, -1.010, P>0.05). The scores of the patients in nursing needs items of the introduction of patients in the same room, medical staff accompanying them during the examination, leisure and recreational activities, the theoretical and technical proficiency of nurses, the guidance of anti-scar exercise, and the propaganda of drug knowledge were respectively (4.2±0.9), (3.3±1.2), (4.2±0.9), (4.5±0.7), (4.2±0.9), and (4.0±1.0) points, significantly higher than (3.5±0.9), (2.7±1.0), (3.5±1.3), (4.1±0.8), (3.8±1.0), and (3.6±0.9) points of the nurses (t=4.147, 3.515, 3.374, 3.282, 2.546, 2.265, P<0.05 or P<0.01). The five most important items for patients and nurses were pain nursing, the theoretical and technical proficiency of nurses, treating patients equally, instruction to discharging patients, timely visiting wards and privacy protection, pain nursing, introduction of medical staff, introduction of safety issues, getting the daily expenses listing, respectively. Only pain nursing was the same between patients and nurses. Conclusions: There are some differences between burn patients and nurses in the dimensions and items of nursing needs and the most important items of nursing needs. Nursing staff should focus on improving the nursing service items with insufficient cognition, adjusting the service supply, meeting the reasonable needs of patients, and improving the nursing satisfaction of patients.
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Affiliation(s)
- X S Jiang
- Department of Surgery, School of Nursing, Fujian Medical University, Fuzhou 350108, China
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Barlow EM, Dickens GL. Systematic review of therapeutic leave in inpatient mental health services. Arch Psychiatr Nurs 2018; 32:638-649. [PMID: 30029758 DOI: 10.1016/j.apnu.2018.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/11/2018] [Accepted: 02/11/2018] [Indexed: 10/18/2022]
Abstract
AIM To identify, critically evaluate, and synthesise the empirical evidence about therapeutic leave from mental health inpatient settings. BACKGROUND "Leave" occurs when a mental health inpatient exits the hospital ward with the appropriate authorisation alone, or accompanied by staff, family, or friends. Limited research has previously addressed therapeutic as opposed to unauthorised leave, and the evidence-base has not been systematically evaluated. DESIGN Systematic review methodology following relevant Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidance. DATA SOURCES Multiple electronic databases (CINAHL; Criminal Justice database; PsycARTICLES; Scopus; OpenGrey; Cochrane; GoogleScholar) for papers published from January 1967 to July 2017. REVIEW METHODS Information was extracted under the following headings: study, purpose/aims, sample, country, setting, design and data collection method(s), data collection instrument, and results. Papers were assessed, as per the hierarchy of scientific evidence, and where there was sufficient data, we calculated a range of standardised rates of leave incidence. RESULTS Standardised leave rates in forensic settings reflect security level. There was little meaningful information on which to base calculation of rates for civil settings. The strongest evidence supports leave used for supervised discharge; other forms of leave lack an evidence base and decisions appear to be made on the basis of heuristic rules and unsupported assumptions. Clinical decision making about therapeutic leave cannot claim to be evidence-based. CONCLUSION Research is urgently needed to provide information about how leave is managed, the best ways to support leave, and what happens on leave.
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Bavaresco T, Pires AUB, Moraes VM, Osmarin VM, Silveira DT, Lucena ADF. Low-level laser therapy for treatment of venous ulcers evaluated with the Nursing Outcome Classification: study protocol for a randomized controlled trial. Trials 2018; 19:372. [PMID: 30001202 PMCID: PMC6044085 DOI: 10.1186/s13063-018-2729-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/07/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Different methods are available for the treatment of venous ulcers. Most current approaches focus on a combination of topical and compressive therapy. Adjuvant low-level laser therapy may be helpful in lesions with a protracted healing course, but evidence for its use is still limited. This paper describes the protocol of a randomized controlled trial designed to compare the effect of adjuvant low-level laser therapy versus conventional venous ulcer tissue repair, evaluated by a nurse using clinical indicators from the Nursing Outcomes Classification (NOC). METHODS/DESIGN For this prospective randomized controlled trial, 40 adult patients of both sexes with active venous ulcers will be recruited. Subjects will be selected by the sealed-envelope method without any annotation or external identification that might refer to the type of study group. At the time of unblinding, a label with the description of the group to which the patient belongs (that is, control or intervention) will be found inside the envelope. Conventional treatment (topical medication and compressive therapy) will be offered to both groups. Additionally, the intervention group will receive adjuvant low-level laser therapy. All patients will be followed weekly until ulcer healing or for a maximum of 16 weeks. Evaluation of tissue repair will be based on 14 clinical indicators drawn from NOC for wound healing (secondary intention) and tissue integrity (skin and mucous membranes). The primary endpoint will be decreased wound size and scar formation. This laser therapy is expected to enhance the quality, speed, and effectiveness of the treatment of venous ulcers, a chronic condition. This should reduce associated costs to the health service and allow patients to resume their daily activities sooner. DISCUSSION This randomized clinical trial will use a validated method to investigate the effect of a novel intervention for the treatment of venous ulcers. TRIAL REGISTRATION ClinicalTrials.gov, NCT03229330 . Registered on July 2017.
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Affiliation(s)
- Taline Bavaresco
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil. .,, Caxias do Sul, Brazil.
| | - Ananda Ughini Bertoldo Pires
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Vítor Monteiro Moraes
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Viviane Maria Osmarin
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Denise Tolfo Silveira
- Nursing School at Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Amália de Fátima Lucena
- Nursing School at Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil.,Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecilia, Porto Alegre, RS, 90035-903, Brazil
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Morard MD, Gonzalez-Monge S, Rippert P, Roche S, Bernard JC, Lagauche D, Delvert C, Luauté J, Jacquin-Courtois S, Caillet F, Di Marco J, Ghelfi F, Otmani S, Calmels P, Royet M, Joseph PA, Ecochard R, Rode G, Vuillerot C. Construction and feasibility study of the SOFMER Activity Score (SAS), a new assessment of physical and cognitive activity. Ann Phys Rehabil Med 2018; 61:315-322. [PMID: 29777770 DOI: 10.1016/j.rehab.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES For hospitalizations in rehabilitation centers (RCs) in France, the quantification of healthcare givers' activity is based on the dependency of the patients, defined as a total or partial inability to perform activities required for daily living without help. The tools currently used to quantify dependency are not sufficiently precise. Here we describe the construction of a new tool, the SOFMER Activity Score (SAS scoring), which allows for a good description of the level of activity of patients hospitalized in RCs, and a feasibility study of the tool. METHODS After a study group proposed the first version of the SAS, the validity of its content was studied by the Delphi consensus method: 26 physicians or healthcare professionals known for their expertise in PMR responded to the first round. The feasibility study was prospective and involved multi-site professionals. Data related to the SAS determined by a multidisciplinary team were collected and compared to the Activité de la Vie Quotidienne (AVQ) scale, which is administered to all patients and included in medical and administrative data. RESULTS We included 81 patients in the feasibility study. The mean (SD) time to obtain the SAS was 4.5 (3.3) min. For 97.5% of scorings, the participating professionals judged that the SAS was compatible or fairly compatible with clinical practice. The internal structure of the SAS scale seemed better than that of the AVQ scale, for which the present study confirmed a floor effect for all items. CONCLUSIONS The SAS allows for measuring the level of physical and cognitive activity of a patient hospitalized in an RC. If validation studies for the SAS, exploring its reliability, construct validity or criterion validity, confirm the tool's good metrological qualities, the SAS will allow for a good quantification of the burden of care.
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Affiliation(s)
- M D Morard
- Service de médecine physique et de réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, L'Escale, 69500 Bron, France; Équipe dysfonction vasculaire et hémostase (DVH), Inserm, UMR1059 Sainbiose, université de Lyon, université Jean-Monnet, 42023 Saint-Étienne, France
| | - S Gonzalez-Monge
- Service de médecine physique et de réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, L'Escale, 69500 Bron, France
| | - P Rippert
- Pôle santé publique, service recherche et épidémiologie clinique, hospices civils de Lyon, 69003 Lyon, France
| | - S Roche
- Service de biostatistique, hospices civils de Lyon, 69003 Lyon, France
| | - J C Bernard
- CMCR des Massues - Croix Rouge française, 69005 Lyon, France
| | - D Lagauche
- Clinique IRIS, 69800 Saint Priest, France
| | - C Delvert
- Service de médecine physique et de réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, L'Escale, 69500 Bron, France; Union RESAMUT - Pouponnière la Fougeraie, 69370 Saint-Didier-au-Mont-d'Or, France
| | - J Luauté
- Service de médecine physique et de réadaptation neurologique, hospices civils de Lyon, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - S Jacquin-Courtois
- Service de médecine physique et réadaptation, hospices civils de Lyon, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - F Caillet
- Service de médecine physique et réadaptation, hospices civils de Lyon, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - J Di Marco
- Service de médecine physique et réadaptation, hospices civils de Lyon, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France
| | - F Ghelfi
- Hospices civils de Lyon, direction centrale des soins, 69002 Lyon, France
| | - S Otmani
- Pôle santé publique, service recherche et épidémiologie clinique, hospices civils de Lyon, 69003 Lyon, France
| | - P Calmels
- Service de médecine physique et de réadaptation, CHU de Saint-Etienne, hôpital Bellevue, 42000 Saint-Etienne, France
| | - M Royet
- Service de médecine physique et de réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, L'Escale, 69500 Bron, France
| | - P A Joseph
- Service de médecine physique et de réadaptation, CHU de Bordeaux, hôpital Saint-André et Pellegrin, pôle neurosciences cliniques, 33000 Bordeaux, France; Unité EA4136 handicap et système nerveux, université de Bordeaux 2, 33000 Bordeaux, France
| | - R Ecochard
- Service de biostatistique, hospices civils de Lyon, 69003 Lyon, France; Équipe biostatistique santé, CNRS UMR 5558, laboratoire de biométrie et biologie evolutive, 69310 Pierre-Bénite, France
| | - G Rode
- Hospices civils de Lyon, direction centrale des soins, 69002 Lyon, France; Inserm UMR-S 1028, CNRS UMR 5292, impact, centre de recherche en neurosciences de Lyon, université Lyon 1, 69000 Lyon, France
| | - C Vuillerot
- Service de médecine physique et de réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, L'Escale, 69500 Bron, France; Équipe biostatistique santé, CNRS UMR 5558, laboratoire de biométrie et biologie evolutive, 69310 Pierre-Bénite, France; Université Lyon I, 69100 Villeurbanne, France; Université de Lyon, 69000 Lyon, France.
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Dumitrescu I, Vliegher KD, Cordyn S, Maigre A, Peters E, Putzeys D. Perspectives on the delegation of hygienic care in the context of home nursing: a qualitative study. Br J Community Nurs 2018; 23:240-247. [PMID: 29708795 DOI: 10.12968/bjcn.2018.23.5.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In light of current trends and healthcare evolutions, delegation of patient care from home nurses to health care assistants (HCAs) is increasingly important. Hygienic care is an essential component of nursing education and practice, yet it has rarely been the subject of scientific literature. AIM To understand the opinions and experiences of home nurses and policy makers with regard to the meaning of hygienic care and the delegation of these acts in the context of home nursing. METHODS A descriptive qualitative study (six focus groups with home nurses and two with policy makers from the Belgian home nursing sector). Content analysis of the data and the use of NVivo 11.0 software. FINDINGS Hygienic care is a cyclical care process of continuously investing in a trusting relationship with a patient, assessing their care needs and ability for self-care and taking action and evaluating care as situations change. All of this must be mutally agreed with the patient and should consider their environment and lifestyle. The decision to delegate hygienic care is based on patient assessments and the patient's specific care needs using nursing diagnoses and indicators. Finally, barriers and facilitating factors for both delegating and providing hygienic care were addressed. CONCLUSION Hygienic care is a crucial component of nursing care, that can be delegated to HCAs with the necessary supervision.
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Affiliation(s)
- Irina Dumitrescu
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
| | - Kristel De Vliegher
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
| | - Sam Cordyn
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
| | - Audrey Maigre
- Nursing Department, Fédération de l'Aide et des Soins à Domicile, Bruxelles, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
| | - Edgard Peters
- Nursing Department, Fédération de l'Aide et des Soins à Domicile, Bruxelles, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
| | - Dominique Putzeys
- Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé, part of the Independent research group 'Collaboration Internationale des Praticiens et Intervenants en Qualité (dans le domaine de la) Santé
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Nanavaty J. Using visual thinking strategies with nursing students to enhance nursing assessment skills: A qualitative design. Nurse Educ Today 2018; 62:39-42. [PMID: 29287213 DOI: 10.1016/j.nedt.2017.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 11/14/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
This qualitative design study addressed the enhancement of nursing assessment skills through the use of Visual Thinking Strategies and reflection. This study advances understanding of the use of Visual Thinking Strategies and reflection as ways to explore new methods of thinking and observing patient situations relating to health care. Sixty nursing students in a licensed practical nursing program made up the sample of participants who attended an art gallery as part of a class assignment. Participants replied to a survey of interest for participation at the art gallery. Participants reviewed artwork at the gallery and shared observations with the larger group during a post-conference session in a gathering area of the museum at the end of the visit. A reflective exercise on the art gallery experience exhibited further thoughts about the art gallery experience and demonstrated the connections made to clinical practice by the student. The findings of this study support the use of Visual Thinking Strategies and reflection as effective teaching and learning tools for enhancing nursing skills.
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Saray Kilic H, Tastan S. Development of post hip replacement comfort scale. Appl Nurs Res 2017; 38:169-74. [PMID: 29241512 DOI: 10.1016/j.apnr.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/01/2017] [Accepted: 10/15/2017] [Indexed: 11/20/2022]
Abstract
AIM To develop and psychometrically test the Post Hip Replacement Comfort Scale (PHRCS). BACKGROUND Evaluation of the patient comfort after hip replacement surgery is highly important in order to increase the quality of patient care. The review of the relevant literature shows that a scale that specifically measures the patient comfort after hip replacement surgery is absent. DESIGN Methodological design was used. This study included the development of the scale and tested the psychometric properties of the scale. METHOD 180 patients who had been hip replacement surgery recruited from three education and research hospitals' orthopedic and trauma departments from January 2014 to December 2015. The study was conducted in three phases. In phase 1, scale items were developed based on the literature review and other comfort scales. In phase 2, the trial was applied with data collection forms. Phase 3 was conducted to evaluate the reliability and validity of the finalized inventory using item analysis. RESULTS The Cronbach's alpha coefficient value is 0.758. Test-retest results found positive and meaningful correlation between the scores of the scales, indicating the reliability of the scale. Scope, surface, criterion and construct validity analysis confirmed the validity of the scale. There were 26 items in the final scale. In our study, the average patient comfort score was 3.64±0.43 (from 1 to 5). CONCLUSION The PHRCS is recommended for evaluating patients' comfort after hip replacement surgery and examining the effects of nursing interventions on patients' comfort.
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Abstract
Background Falls screening tools are routinely used in hospital settings and the psychometric properties of tools should be examined in the setting in which they are used. The aim of this study was to explore the concurrent and predictive validity of the Austin Health Falls Risk Screening Tool (AHFRST), compared with The Northern Hospital Modified St Thomas’s Risk Assessment Tool (TNH-STRATIFY), and the inter-rater reliability of the AHFRST. Methods A research physiotherapist used the AHFRST and TNH-STRATIFY to classify 130 participants admitted to Austin Health (five acute wards, n = 115 two subacute wards n = 15; median length of stay 6 days IQR 3–12) as ‘High’ or ‘Low’ falls risk. The AHFRST was also completed by nursing staff on patient admission. Falls data was collected from the hospital incident reporting system. Results Six falls occurred during the study period (fall rate of 4.6 falls per 1000 bed days). There was substantial agreement between the AHFRST and the TNH-STRATIFY (Kappa = 0.68, 95% CI 0.52–0.78). Both tools had poor predictive validity, with low specificity (AHFRST 46.0%, 95% CI 37.0–55.1; TNH-STRATIFY 34.7%, 95% CI 26.4–43.7) and positive predictive values (AHFRST 5.6%, 95% CI 1.6–13.8; TNH-STRATIFY 6.9%, 95% CI 2.6–14.4). The AHFRST showed moderate inter-rater reliability (Kappa = 0.54, 95% CI = 0.36–0.67, p < 0.001) although 18 patients did not have the AHFRST completed by nursing staff. Conclusions There was an acceptable level of agreement between the 3 item AHFRST classification of falls risk and the longer, 9 item TNH-STRATIFY classification. However, both tools demonstrated limited predictive validity in the Austin Health population. The results highlight the importance of evaluating the validity of falls screening tools, and the clinical utility of these tools should be reconsidered.
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Affiliation(s)
- Catherine Maree Said
- Physiotherapy Melbourne School of Health Sciences, The University of Melbourne, Level 7, Alan Gilbert Building, 161 Barry St, Parkville, VIC, 3010, Australia. .,Department of Physiotherapy, Austin Health, Heidelberg, Australia.
| | - Leonid Churilov
- Statistics and Decision Analysis Academic Platform, The Florey Institute of Neuroscience & Mental Health, Heidelberg, VIC, 3084, Australia
| | - Kathryn Shaw
- Department of Physiotherapy, Austin Health, Heidelberg, Australia
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Jerez-Molina C, Lázaro-Alcay JJ, Ullán-de la Fuente AM. Transcultural adaptation into Spanish of the Induction Compliance Checklist for assessing children's behaviour during induction of anaesthesia. Enferm Clin (Engl Ed) 2017; 28:S1130-8621(17)30142-0. [PMID: 29054560 DOI: 10.1016/j.enfcli.2017.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 07/26/2017] [Accepted: 08/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Cross-cultural adaptation into Spanish of the Induction Compliance Checklist (ICC) for assessing children's behaviour during induction of anaesthesia. METHOD A descriptive cross-sectional observational study was conducted on a sample of 81 children aged 2 to 12 years operated in an ambulatory surgery unit of a paediatric hospital in Barcelona. Adaptation by translation-back translation of the tool and analysis of the scale's validity and reliability. RESULTS Face validity of the tool was guaranteed through a discussion group and inter-observer reliability was evaluated, obtaining an intraclass correlation index of r = 0.956. CONCLUSIONS The ICC scale validated for the Spanish population can be an effective tool for the presurgical evaluation of activities carried out to minimise children's anxiety. The ICC is an easy-to-use scale completed by operating room staff in one minute and would provide important information about children's behaviour, specifically during induction.
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Affiliation(s)
- Carmen Jerez-Molina
- Departamento de Enfermería, Unidad de Cirugía Ambulatoria, Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España.
| | - Juan J Lázaro-Alcay
- Departamento de Anestesiología y Reanimación, Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España
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Spedale V, Di Mauro S, Del Giorno G, Barilaro M, Villa CE, Gaudreau JD, Ausili D. Delirium assessment in hospitalized elderly patients: Italian translation and validation of the nursing delirium screening scale. Aging Clin Exp Res 2017; 29:675-683. [PMID: 27568017 DOI: 10.1007/s40520-016-0621-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/09/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. AIMS Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. METHODS This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. RESULTS The inter-rater reliability (Cohen Kappa) was 0.87-an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. DISCUSSION AND CONCLUSION Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.
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Affiliation(s)
- Valentina Spedale
- Azienda Socio Sanitaria Territoriale - ASST Monza, Università degli Studi di Milano-Bicocca, Monza, Italy.
| | - Stefania Di Mauro
- Dipartimento di Scienze della Salute, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Giulia Del Giorno
- Fondazione Monza e Brianza per il Bambino e la sua Mamma (MBBM), Monza, Italy
| | - Monica Barilaro
- Azienda Socio Sanitaria Territoriale - ASST Monza, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Candida E Villa
- Azienda Socio Sanitaria Territoriale - ASST Monza, Università degli Studi di Milano-Bicocca, Monza, Italy
| | | | - Davide Ausili
- Dipartimento di Scienze della Salute, Università degli Studi di Milano-Bicocca, Monza, Italy
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