Utilizing nursing standards in electronic health records: A descriptive qualitative study

BACKGROUND

The electronic health record (EHR), including standardized structures and languages, represents an important data source for nurses, to continually update their individual and shared perceptual understanding of clinical situations. Registered nurses' utilization of nursing standards, such as standardized nursing care plans and language in EHRs, has received little attention in the literature. Further research is needed to understand nurses' care planning and documentation practice.

AIMS

This study aimed to describe the experiences and perceptions of nurses' EHR documentation practices utilizing standardized nursing care plans including standardized nursing language, in the daily documentation of nursing care for patients living in special dementia-care units in nursing homes in Norway.

METHODS

A descriptive qualitative study was conducted between April and November 2021 among registered nurses working in special dementia care units in Norwegian nursing homes. In-depth interviews were conducted, and data was analyzed utilizing reflexive thematic analysis with a deductive orientation. Findings Four themes were generated from the analysis. First, the knowledge, skills, and attitude of system users were perceived to influence daily documentation practice. Second, management and organization of documentation work, internally and externally, influenced motivation and engagement in daily documentation processes. Third, usability issues of the EHR were perceived to limit the daily workflow and the nurses' information-needs. Last, nursing standards in the EHR were perceived to contribute to the development of documentation practices, supporting and stimulating ethical awareness, cognitive processes, and knowledge development.

CONCLUSION

Nurses and nursing leaders need to be continuously involved and engaged in EHR documentation to safeguard development and implementation of relevant nursing standards.

Nurses' wound care competency in a sample of hospitals in Northern Vietnam

BACKGROUND

This study aimed to investigate the current situation regarding wound care by nurses in eight hospitals in the north of Vietnam, in order to plan the training for nurses to enable them to achieve the National Basic Competency Standards for Nurses.

METHODS

A cross-sectional descriptive prospective study was conducted from June 2020 to October 2020, with nurses in eight hospitals in four provinces of Northern Vietnam - Hanoi, Quang Ninh, Thai Nguyen and Bac Ninh. Data were collected based on a checklist of direct observation of nurses who provide wound care. The two main indicators were the knowledge score and the practical capacity/competence of the nurses in wound care.

RESULTS

A total of 518 nurses participated in the study, the mean age was 32.25±7.31; with 438 (84.6%) being female. Clinical experience of less than 10 years was reported by 63.6%; college education level (diploma) was reported by 58.1%, university level by 28.2%; and post-university level by 4%. The highest mean scores for knowledge were found in the categories of health education for patients, followed by care of clean wounds, communication skills and team work, management and professional development and pressure ulcer wound care. Under the practice domain the highest mean scores were ability to plan wound care, followed by self-evaluation, identification of wound types and implementation of wound care plans.

CONCLUSIONS AND RECOMMENDATIONS

The results showed that when judged against the competency standards, nurses' level of wound care competency needs to be improved. Also that there is a distinct theory-practice gap, which must be addressed. It is recommended that hospitals should conduct training for all nurses using the basic competency standards for Vietnamese nurses to improve the quality of care.

Cultural intelligence and intercultural effectiveness among nurse educators: A mixed-method study

BACKGROUND

Due to globalisation, the education sector is becoming multi-cultural. It is important for nurse educators to be aware of various cultures and to be able to work efficiently with culturally diverse group of students and colleagues.

OBJECTIVES

To examine cultural intelligence and inter-cultural effectiveness among nurse educators and as well as to explore their experiences in culturally diverse education settings.

DESIGN

A mixed-method approach applying a sequential explanatory design.

RESULTS

Nurse educators' cultural intelligence (CQ) and intercultural effectiveness (IE) scores were above the median values, with an overall score of 76.33 (range 23-100) for CQ and 74.64 (range 58-87) for IE respectively. Individual CQ component scores were noted to be high. Although, the cognitive component was in the lower score range, which involves knowledge of norms, practices, values, rules of languages, and rules for expressing non-verbal behaviours. For IE, nurse educators had a lower score with Message Skills, which involved effective interactions conveying messages specific to a particular culture or group. The initial quantitative findings was explained by the narratives of nurse educators reinforcing that acquiring cultural intelligence is a continuous process of knowing and learning through active sharing and that cultural sensitivity overlaps with professional nursing standards.

CONCLUSION

In the presence of culture-related dilemmas, nurse educators resort and are guided by professional standards of cultural awareness, inclusivity and culturally safe practice in nursing. Future research might need to examine how objective measures of cultural intelligence and experience-based evidence from nurse educators contribute to shaping the professional nursing requirements and standards applied in the nursing curriculum.