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Glarcher M, Ferguson C, Patch M, Steven A, Vaismoradi M. Strategic de-implementation: strengthening patient safety by eliminating low value care practices. Contemp Nurse 2024:1-5. [PMID: 38767402 DOI: 10.1080/10376178.2024.2354319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Affiliation(s)
- Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Caleb Ferguson
- Centre for Chronic & Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Sydney, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Michelle Patch
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Alison Steven
- School of Health, Community and Education Studies, Northumbria University, Newcastle, UK
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Dowling M, Pape E, Geese F, Van Hecke A, Bryant-Lukosius D, Cerón MC, Fernández-Ortega P, Marquez-Doren F, Ward A, Semple C, King T, Glarcher M, Drury A. Advanced Practice Nursing Titles and Roles in Cancer Care: A Scoping Review. Semin Oncol Nurs 2024:151627. [PMID: 38556366 DOI: 10.1016/j.soncn.2024.151627] [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: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Advanced practice nursing roles in cancer care are diverse and exist across the cancer care continuum. However, the titles used and the scope of practice differ across countries. This diversity is likely to be misleading to patients and influence nurses' contribution to health care. An understanding of the current state of advanced practice nursing roles in cancer care internationally is needed to inform opportunities for future role development and enhance cancer nursing career pathways. METHODS This scoping review included a systematic search of four databases: MEDLINE, CINAHL, PsycINFO, and Academic Search Complete. Independent screening for papers meeting the review's inclusion criteria was undertaken using online screening software. Data extraction, coding, and mapping were undertaken in NVivo 12. RESULTS Of the 13,409 records identified, 108 met the review's inclusion criteria. A variety of roles in cancer care settings were described. The United States and the United Kingdom had the most titles for advanced practice nursing roles. Tumor-specific roles were described and integrated into different phases of the cancer care continuum. Trends in continuing professional development for advanced practice nurses in cancer care included the rise in Fellowship programs in the United States and practice-based education in the United Kingdom. CONCLUSIONS The differences in advanced practice nursing roles in cancer care allow regional and institutional variation to meet the needs of patient populations and health care system demands. However, a lack of clarity surrounding titles and roles results in confusion and underutilization of these nurses' highly specialized skill sets. IMPLICATIONS FOR NURSING PRACTICE Incongruence in titles and scope of practice internationally will ultimately result in a merging of roles. There is a need for international agreement on education requirements for advanced practice nursing roles to promote career pathways.
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Affiliation(s)
- Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
| | - Eva Pape
- Cancer Center, Ghent University Hospital, Belgium; Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium and Ghent University Hospital, Centre for Nursing Expertise, Belgium
| | - Franziska Geese
- Department of Nursing, Clinical Practice Development and Digitalisation, Bern University Hospital, Inselspital, Insel Gruppe, Switzerland
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium and Ghent University Hospital, Centre for Nursing Expertise, Belgium; Nursing Department, Ghent University Hospital, Belgium
| | - Denise Bryant-Lukosius
- School of Nursing and Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - M Consuelo Cerón
- Escuela de Enfermería, Facultad de Enfermería y Obstetricia, Universidad de los Andes-Chile
| | - Paz Fernández-Ortega
- Catalan Institute of Oncology and Faculty of Nursing, University of Barcelona, Spain
| | - Francisca Marquez-Doren
- School of Nursing, PAHO Collaborating Center, Pontificia Universidad Católica de Chile and School of Nursing Pontificia Universidad Católica de Chile, PAHO Collaborating Center and Sigma Chapter Alfa Beta Ómicron
| | - Ashleigh Ward
- School of Medicine, Dentistry and Nursing College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland; NHS Forth Valley, Stirling, UK
| | - Cherith Semple
- Institute of Nursing and Health Research, Ulster University / Cancer Services, South Eastern Health and Social Care Trust, Belfast, Northern Ireland
| | - Tracy King
- Cancer Care Research Unit (CCRU) Susan Wakil School of Nursing and Midwifery, The University of Sydney, Australia; Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Manela Glarcher
- Institute of Nursing Science, Paracelsus Medical University, Salzburg, Austria
| | - Amanda Drury
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Ireland
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Glarcher M, Vaismoradi M. A systematic integrative review of specialized nurses' role to establish a culture of patient safety: A modelling perspective. J Adv Nurs 2024. [PMID: 38366739 DOI: 10.1111/jan.16105] [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: 11/25/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
AIMS To understand specialized nurses' role in the culture of patient safety and their ability to promote and enforce it within healthcare. DESIGN A systematic integrative review using the approach of Whittemore and Knafl. METHODS Systematic literature search for qualitative, quantitative and mixed-methods studies, followed by data evaluation, quality assessment, analysis and research synthesis with a narrative perspective. Findings were contextualized within a 'framework for understanding the development of patient safety culture'. DATA SOURCES Searches were conducted in PubMed [including MEDLINE], Scopus, CINAHL, Web of Science and EMBASE from Jan 2013 until Sep 2023. RESULTS Sixteen studies published in English from six different countries were selected and used for research synthesis. Diverse enabling factors and enacting behaviours influencing specialized nurses' roles to promote patient safety culture were identified, mainly focusing on nurses' workload, professional experiences and organizational commitment. Patient safety outcomes focused on medication management, infection prevention, surveillance process in critical care, oversight on quality and safety of nurses' practice, patient care management, continuity of care, adherence to the treatment plan and implementation of a specialized therapeutic procedure. CONCLUSION Specialized nurses can make a significant contribution to promote patient safety culture and support organizational initiatives to prevent adverse events. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Stronger participation and leadership of specialized nurses in initiatives to improve patient safety culture requires appropriate investments and support by policy makers and managers in terms of resources and training. IMPACT There is a gap in existing literature on the contribution that specialized nurses can make in promoting patient safety culture. Review results highlight the importance of interprofessional collaboration and teamwork by involving specialized nurses. They inform healthcare policy makers about recognizing their roles and competencies in patient safety culture. Preferred reporting items for systematic reviews and meta-analysis. No patient or public contribution.
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Affiliation(s)
- Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, New South Wales, Australia
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Schuessler N, Glarcher M. Caregivers' Perspectives on Ethical Challenges and Patient Safety in Tele-Palliative Care: An Integrative Review. J Hosp Palliat Nurs 2024; 26:E1-E12. [PMID: 37747961 DOI: 10.1097/njh.0000000000000986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Tele-palliative care enables people with a life-limiting illness to consult with palliative care staff without having to leave their homes but requires commitment from all stakeholders, particularly on ethical challenges and patient safety issues. When using telecommunications and virtual technology, ethical challenges and patient safety aspects must be taken into account. The aim was to describe formal and informal caregivers' opportunities in tele-palliative care and the associated ethical and safety challenges using a Whittemore and Knafl integrative review method. Ethical and patient safety perspectives were extracted from studies reporting on tele-palliative care interventions. Content on ethically considerable information on the intervention was coded, categorized, and summarized into a matrix developed in advance from literature on socio-technical arrangements and eHealth applications. Nine studies from experimental and nonexperimental research were included. Four studies reported exclusively on the perspective of formal caregivers, 3 studies addressed the perspective of patients and informal caregivers, and 2 studies covered the perspectives of both. Studies of tele-palliative care interventions implicate effects on patient-caregiver relationships but also show that technology is not seen as a replacement of holistic palliative care. However, the authors do not address other relevant ethical issues (eg, sustainability) or consider aspects of patient safety. There is a need for further research to assess privacy, data security, and patient safety in tele-palliative care from the perspective of caregivers as telehealth becomes increasingly important.
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Mardani A, Azizi M, Alazmani Noodeh F, Alizadeh A, Maleki M, Vaismoradi M, Glarcher M. A concept analysis of transitional care for people with cancer. Nurs Open 2024; 11:e2083. [PMID: 38268301 PMCID: PMC10803885 DOI: 10.1002/nop2.2083] [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: 02/17/2023] [Revised: 11/17/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM Transitional care as the journey between different caregivers in multiple healthcare centres is crucial for the provision of care to people with cancer, but it is often complex and poorly coordinated. This study aimed to analyse the concept of transitional care for people with cancer. DESIGN Rodgers' evolutionary concept analysis. METHODS A systematic literature search was conducted on the databases of PubMed (including MEDLINE), EMBASE, Scopus and Web of Science to retrieve articles published between 2000 and 2022. RESULTS Twenty-nine eligible articles were selected and their findings were classified in terms of related concepts and alternative terms, antecedents, attributes and consequences. Attributes included three main categories, namely 'nurse-related attributes', 'organisation-related attributes' and 'patient-related attributes'. Antecedents of transitional care for people with cancer were categorized into two main categories: 'patient-related antecedents' and 'caregiver-related antecedents'. Consequences were categorized into 'psychological consequences' and 'objective consequences'.
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Affiliation(s)
- Abbas Mardani
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyZanjan University of Medical SciencesZanjanIran
| | - Maryam Azizi
- Department of Health in Disaster and Emergencies, Faculty of NursingAja University of Medical SciencesTehranIran
| | - Farshid Alazmani Noodeh
- Critical Care Nursing Department, Faculty of NursingAja University of Medical SciencesTehranIran
| | - Azizeh Alizadeh
- Department of Education and Research, Army Center of Excellence (NEZAJA)Center of Consultation of Khanevadeh HospitalTehranIran
| | - Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health SciencesNord UniversityBodøNorway
- Faculty of Science and HealthCharles Sturt UniversityOrangeNew South WalesAustralia
| | - Manela Glarcher
- Institute of Nursing Science and PracticeParacelsus Medical UniversitySalzburgAustria
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Maleki M, Mardani A, Iloonkashkooli R, Khachian A, Glarcher M, Vaismoradi M. The effect of hospital-to-home transitional care using a digital messaging application on the health outcomes of patients undergoing CABG and their family caregivers: a randomized controlled trial study protocol. Front Cardiovasc Med 2023; 10:1224302. [PMID: 38028499 PMCID: PMC10644205 DOI: 10.3389/fcvm.2023.1224302] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Given the increasing trend of care transition from healthcare settings to patients' own home, patients and their family caregivers should take more responsibilities for care at own home. This study is going to investigate the effect of a transitional care program from hospital to own home using a digital messaging application on patients' undergoing coronary artery bypass graft (CABG) surgery and their family caregivers' health outcomes. Methods A parallel randomized controlled trial study will be conducted in a hospital in a metropolis located in southwestern Iran. Sampling will be performed sequentially and the eligible dyad of patients and family caregivers will be randomly assigned to intervention and control groups. The intervention group will receive a transitional care program for 8 weeks using the WhatsApp on the mobile phone based on the person-centered care approach, but the control group will receive routine care for patient's transition. Data collection will be conducted at baseline, immediately after the intervention, and two months after the intervention using demographic questionnaire, Cardiac Self-Efficacy Scale (CSES), MacNew Heart Disease Health-Related Quality of Life questionnaire (MNHD-Q), Cardiac Symptom Scale (CSS), Morisky Medication Adherence Scale, and Caregiver Burden Scale (CBS). Descriptive and inferential statistics will be used for data analysis. Conclusions The results of this study will allow evaluating the effectiveness of an innovative transitional care program to patients' own home using a digital messaging application. If the transitional program is shown feasible and effective it can be incorporated into existing care programs and stimulate further studies on the use of digital solutions for improving the continuity of care in own home.
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Affiliation(s)
- Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Alice Khachian
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Behboudi-Gandevani S, Bidhendi-Yarandi R, Hossein Panahi M, Mardani A, Prinds C, Vaismoradi M, Glarcher M. Prevalence of preterm birth in Scandinavian countries: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231203843. [PMID: 37843530 PMCID: PMC10683576 DOI: 10.1177/03000605231203843] [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: 11/04/2022] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES As welfare societies, Scandinavian countries share characteristics of equality related to healthcare access, gender, and social services. However, cultural and lifestyle variations create country-specific health differences. This meta-analysis assessed the prevalence of preterm birth (PTB) and its categories in Scandinavian countries. METHODS A systematic search in key databases of literature published between 1990 and 2021 identified studies of the prevalence of PTB and its categories. Following the use of the Freeman-Tukey double arcsine transformation, a meta-analysis of weighted data was performed using the random-effects model and meta-prop method. RESULTS We identified 109 observational studies that involved 86,420,188 live births. The overall pooled prevalence (PP) of PTB was 5.3% (PP = 5.3%, 95% confidence interval [CI] 5.1%, 5.5%). The highest prevalence was in Norway (PP = 6.2%, 95% CI 5.3%, 7.0%), followed by Sweden (PP = 5.3%, 95% CI 5.1%, 5.4%), Denmark (PP = 5.2%, 95% CI 4.9%, 5.3%), and Iceland (PP = 5.0%, 95% CI 4.4%, 5.7%). Finland had the lowest PTB rate (PP = 4.9%, 95% CI 4.7%, 5.1%). CONCLUSIONS The overall PP of PTB was 5.3%, with small variations among countries (4.9%-6.2%). The highest and lowest PPs of PTB were in Norway and Finland, respectively.
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Affiliation(s)
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, School of Social Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Christina Prinds
- Department of Clinical Research, University South Denmark, Odense, Denmark; Department of Women’s Health, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Rihari-Thomas J, Glarcher M, Ferguson C, Davidson PM. Why We Need a Re-think of Patient Safety Practices. Contemp Nurse 2023:1-5. [PMID: 37015901 DOI: 10.1080/10376178.2023.2200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
| | - Manela Glarcher
- Assistant Professor, Institute of Nursing, Science and Practice
- Paracelsus medical University, Salzburg, Austria
| | - Caleb Ferguson
- A/Professor and Principal Research Fellow, School of Nursing, University of Wollongong, Australia
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Maleki M, Mardani A, Manouchehri M, Ashghali Farahani M, Vaismoradi M, Glarcher M. Effect of Chamomile on the Complications of Cancer: A Systematic Review. Integr Cancer Ther 2023; 22:15347354231164600. [PMID: 37052390 PMCID: PMC10108427 DOI: 10.1177/15347354231164600] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Despite significant advances in the diagnosis and treatment of cancer, many people across the world still suffer from this chronic disease and its complications. Chamomile as an herbal medicine has gained an increasing attention for relieving cancer complications. This study aimed to integrate and synthesize current international evidence regarding the effect of chamomile on cancer complications. METHODS A systematic review was undertaken. Five online databases including Web of Science, PubMed [including MEDLINE], Cochrane Library, Scopus, and Embase were searched and articles published from inception to January 2023 were retrieved. All clinical trials and similar interventional studies on human subjects examining the effects of chamomile on cancer complications were included in the review and research synthesis. Relevant data were extracted from eligible studies after quality appraisals using proper methodological tools. The review results were presented narratively given that meta-analysis was impossible. RESULTS A total of 2240 studies were retrieved during the search process, but 18 articles were selected. The total sample size was 1099 patients with cancer of which 622 participants were female. Fifteen studies used an RCT design. Various forms of chamomile were used such as mouthwash, topical material, tea, capsule, syrup and aromatherapy massage. Chamomile effectively reduced oral mucositis, skin complications, depression, and vomiting and also improved appetite and quality of life among cancer patients. CONCLUSION The use of chamomile as a non-pharmacologic and safe method can be helpful for mitigating cancer complications in patients with cancer. Therefore, it can be incorporated into routine care along with other therapeutic measures to reduce patients' suffering related to cancer. SYSTEMATIC REVIEW REGISTRATION NUMBER (PROSPERO) CRD42022307887.
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Affiliation(s)
- Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Manouchehri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ashghali Farahani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW 2800, Australia
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
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Glarcher M, Ferguson C. Why do we need a global network? Perspectives for the promotion of young scientists. J Adv Nurs 2022. [DOI: 10.1111/jan.15545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University Salzburg Austria
| | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine and Health University of Wollongong Wollongong New South Wales Australia
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Schuchter T, Mayer K, Glarcher M. Veränderungen in anhaltenden Extremsituationen. Procare 2022; 27:44-48. [PMID: 36712463 PMCID: PMC9875164 DOI: 10.1007/s00735-022-1644-2] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background The Covid-19 virus caused increased challenges for nursing professionals. Objectives This study aims to explore psychosocial stress in the work environment of nursing staff resulting from the pandemic within an Austrian hospital. In addition, differences in the experience between nurses and nursing assistants, in leadership and management positions, as well as between wards with (suspected) Covid-19 positive patients and wards without Covid-19 patients will be recorded. Design and Methods In a mixed-method study, a web-based survey was conducted using the Copenhagen Psychosocial Questionnaire (COPSOQ). The qualitative data was collected with four open questions. The results were analysed descriptively and inferentially with a one-way analysis of variance and the Mann-Whitney-U test. The qualitative data were analysed using content analysis. Results A total of 104 participants completed the survey. The results show that there is a burden on nursing professionals (p = 0.03) within the area of emotional and quantitative demands (p < 0.01), but no differences between the individual nursing groups emerged. Leadership and management positions report less stress than the rest of the nursing staff (p ≤ 0.05). When distinguishing between Covid-19 (suspected) wards and non-Covid-19 wards, two scales (demands for hiding emotions % possibilities for development) were statistically significant (p ≤ 0.04). Conclusion The results of this study illustrate the psychosocial burden of the Covid-19 pandemic on nurses with different characteristics and are in line with current research. Further studies should address the impact of the burden on nursing practice.
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Pirhofer J, Bükki J, Vaismoradi M, Glarcher M, Paal P. A qualitative exploration of cultural safety in nursing from the perspectives of Advanced Practice Nurses: meaning, barriers, and prospects. BMC Nurs 2022; 21:178. [PMID: 35787799 PMCID: PMC9251927 DOI: 10.1186/s12912-022-00960-9] [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: 12/01/2021] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Cultural safety requires healthcare professionals and organisations to improve healthcare, facilitate patient access to healthcare, and achieve equity within the workforce. Methods This ethnomethodological study, which consisted of two phases, explored the concept of cultural safety from the perspective of Advanced Practice Nurses. Semi-structured interviews and the nominal group technique were used to prioritise challenges related to cultural safety, identify barriers to clinical practise and assess educational needs. The data collected was subjected to thematic analysis. Results Nurses working in Austria, Germany and Switzerland were recruited (N = 29). Accordingly, the phenomenon of cultural safety in health care is not generally known and there is little prior knowledge about it. The most frequently discussed themes were communication difficulties, lack of knowledge, the treatment of people with insufficient language skills and expectations of treatment goals and outcomes, which can lead to conflicts and accusations of unequal treatment due to diverse cultural backgrounds. Conclusion Diverse cultures are encountered in German-speaking healthcare settings. Cultural safety is also about healthcare staff, as nurses with different socialisations encounter prejudice, discrimination and racism. Although the issue of power was not discussed, academic nurses were willing to make an effort to change. Only a minority were aware that lasting change requires challenging one’s own cultural structures and adapted behaviours, rather than pushing for the mere acquisition of cultural competence. Organisations were encouraged to introduce self-reflection sessions and provide better access to translation services to improve equity and support nurses.
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Affiliation(s)
- Jacqueline Pirhofer
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Johannes Bükki
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.,Diakonie-Klinikum Stuttgart, Rosenbergstrasse 38, 70176, Stuttgart, Germany
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049, Bodø, Norway
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Piret Paal
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
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Glarcher M, Kaiser K, Nestler N, Kutschar P. Psychometric Properties of the Safety Climate Survey in Austrian Acute Care: Factor Structure, Reliability, and Usability. J Patient Saf 2022; 18:193-200. [PMID: 34347738 PMCID: PMC9359777 DOI: 10.1097/pts.0000000000000888] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hospitals are complex organizations with a potential for medical errors that can be influenced by safety culture. Safety climate, as measurable element of safety culture, illustrates the perception of safety-relevant aspects of health care staff at a certain time. The Safety Climate Survey is applied internationally to measure safety climate. However, psychometrics for the German version of the survey have yet not been evaluated. The aim of this study is to explore the factor structure, reliability, and potential usefulness of the Safety Climate Survey in Austrian acute care. METHODS Cross-sectional surveys of physicians, therapists, and nurses/midwives were implemented. An exploratory factor analysis was carried out, both in total sample and split by 2 selected professions. After deriving a factor structure for both professions, internal consistency and scale means were calculated for the subscales. Finally, mean subscale differences between physicians and nurses/midwives were tested. RESULTS Of 5160 eligible staff, 933 respondents participated. A 6-factor solution explaining 59.1% of total variance was identified. Comparison by profession illustrated that the factor structures and item loading patterns differ between physicians and nurses/midwives. To achieve an overarching solution, 5 items were excluded from consecutive subscale measures because of cross-loadings and contradictory factor loadings. Subscales demonstrated good to low internal consistency (α = 0.794-0.535). Significant mean differences between subscales of professions were found relating to 3 factors. CONCLUSIONS The German Safety Climate Survey measures safety climate multidimensionally rather than unidimensionally and demonstrated some limitations in factor structures and item loadings but overall had satisfactory reliability of the 6 subscales.
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Affiliation(s)
- Manela Glarcher
- From the Paracelsus Medical University, Institute of Nursing Science and Practice, Salzburg, Austria
| | - Karin Kaiser
- From the Paracelsus Medical University, Institute of Nursing Science and Practice, Salzburg, Austria
| | - Nadja Nestler
- From the Paracelsus Medical University, Institute of Nursing Science and Practice, Salzburg, Austria
| | - Patrick Kutschar
- From the Paracelsus Medical University, Institute of Nursing Science and Practice, Salzburg, Austria
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Glarcher M, Kaiser K, Kutschar P, Nestler N. Safety climate in hospitals: A cross-sectional study on the perspectives of nurses and midwives. J Nurs Manag 2022; 30:742-749. [PMID: 35088479 PMCID: PMC9314869 DOI: 10.1111/jonm.13551] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/07/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022]
Abstract
Aims To explore nurses' and midwives' perspectives of safety climate in Austrian hospitals as measurable elements of safety culture and to identify areas of quality improvement. Background Due to close contact with patients, nurses and midwives play a vital role in ensuring patient safety. Method An online survey among 713 nurses and midwives was conducted, using the 19‐item Safety Climate Survey (SCS). To answer the survey, a 5‐point Likert scale was provided with higher ratings indicating a more positive safety climate. Results Results demonstrate a positive safety culture (MD 4.09, SD 0.53). Significant group differences in overall safety climate score could be found regarding nurses and midwives in managerial positions, between gender and participants age with low effect size. High item missing rates focus aspects on management/leadership, institutional concerns, leadership by physicians, and handling of adverse events. In addition, these items present the lowest ratings in safety climate. Conclusion Results indicate potentials for optimization in the areas of leadership communication and feedback, the handling of safety concerns, and visibility or improvement of patient safety strategies. Implications for Nursing Management A regular, standardized safety climate measurement can be a valuable tool for nurse managers and (political) decision‐makers to manage patient safety initiatives.
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Affiliation(s)
- Manela Glarcher
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
| | - Karin Kaiser
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
| | - Patrick Kutschar
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
| | - Nadja Nestler
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
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Glarcher M, Kundt FS, Meissner W, Osterbrink J. Quality Indicators (QI) of Acute Pain after Surgery in European Countries. Pain Manag Nurs 2021; 22:730-739. [PMID: 33642197 DOI: 10.1016/j.pmn.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 01/04/2021] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES It is common practice to use pain quality indicators (QI) to accurately assess the medical care situation of patients. This literature review identifies the status quo of acute pain QI among adult inpatients. DATA SOURCES Studies published in English or German were identified using a systematic search on CINAHL, Cochrane Library, PubMed, Web of Science, and Google Scholar from 01/2007 to 02/2018. Additional pain management journals, conference proceedings, and websites of health organizations and pain societies were manually screened. Studies about postoperative pain in adults (≥18 years) during inpatient stay after all types of surgery in Europe were included in this review. REVIEW/ANALYSIS METHODS The identified study results were categorized into structural, process, and outcome indicators based on Donabedian's framework of evaluating care quality. RESULTS The search identified 319 citations, of which 20 studies used structure, process, and outcome data including 180,988 patients and 1,970 health care professionals to gain insight into the quality of acute pain management. Overall, 80% used patient surveys to collect data. National data on pain management are reported in five European studies (France [2], the Netherlands, Spain, and Austria). CONCLUSIONS European studies comprehensively comparing acute pain management results are currently missing. Thus, this report highlights the need to develop consensus-based quality indicators in management of acute pain, which take into account both the methodologic quality and the relevance to clinical practice.
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Affiliation(s)
- Manela Glarcher
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria.
| | - Firuzan Sari Kundt
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
| | - Winfried Meissner
- Anesthesiology and Intensive Care, Head of Pain Unit, Head of Palliative Care Unit, Jena University Hospital, Germany
| | - Jürgen Osterbrink
- Head of Institute of Nursing Science and Practice & Director WHO Collaborating Centre for Nursing, Austria
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Vaismoradi M, Jordan S, Logan PA, Amaniyan S, Glarcher M. A Systematic Review of the Legal Considerations Surrounding Medicines Management. Medicina (Kaunas) 2021; 57:65. [PMID: 33450903 PMCID: PMC7828352 DOI: 10.3390/medicina57010065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 12/13/2022]
Abstract
This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant keywords relating to the legal considerations of medicines management in healthcare settings. The search process led to the identification of 6051 studies published between 2010 and 2020, of which six articles were found to be appropriate for data analysis and synthesis based on inclusion criteria. Research methods were varied and included qualitative interviews, mixed-methods designs, retrospective case reports and cross-sectional interrupted time-series analysis. Their foci were on the delegation of medicines management, pharmacovigilance and reporting of adverse drug reactions (ADRs) before and after legislation by nurses, physicians and pharmacists, medico-legal litigation, use of forced medication and the prescription monitoring program. Given the heterogenicity of the studies in terms of aims and research methods, a meta-analysis could not be performed and, therefore, our review findings are presented narratively under the categories of 'healthcare providers' education and monitoring tasks', 'individual and shared responsibility', and 'patients' rights'. This review identifies legal aspects surrounding medicines management, including supervision and monitoring of the effects of medicines; healthcare providers' knowledge and attitudes; support and standardised tools for monitoring and reporting medicines' adverse side effects/ADRs; electronic health record systems; individual and shared perceptions of responsibility; recognition of nurses' roles; detection of sentinel medication errors; covert or non-voluntary administration of medication, and patient participation.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, Bathurst 2795, Australia;
| | - Sara Amaniyan
- Student Research Center, Semnan University of Medical Sciences, Semnan 3514799442, Iran;
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
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Vaismoradi M, Jordan S, Vizcaya-Moreno F, Friedl I, Glarcher M. PRN Medicines Optimization and Nurse Education. Pharmacy (Basel) 2020; 8:E201. [PMID: 33114731 PMCID: PMC7712763 DOI: 10.3390/pharmacy8040201] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/27/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/11/2022] Open
Abstract
Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. ''Pro re nata'' (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses' roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Flores Vizcaya-Moreno
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
| | - Ingrid Friedl
- Hospital Graz II, A Regional Hospital of the Health Care Company of Styria, 8020 Graz, Austria;
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
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Glarcher M, Lex KM. Advanced Nursing Practice in Austria under consideration of outcome measurement. Z Evid Fortbild Qual Gesundhwes 2020; 155:11-16. [PMID: 32811773 DOI: 10.1016/j.zefq.2020.06.012] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Internationally, Advanced Practice Nurses (APN) are associated with improvements when measuring results in health care. Advanced Nursing Practice (ANP) refers to an extended nursing care with the aim of meeting the changing conditions in health care systems by providing evidence-based practice. APN outcomes are the endpoints of nursing interventions based on clinical experience, scientific knowledge, and practical skills. Due to the challenges in health care systems, Advanced Practice Nurses have become well established internationally in various fields. PROBLEM In Austria, the first nurses are currently trained in Advanced Nursing Practice on a master's level according to the International Council of Nurses core curriculum (ICN). However, national implementation and evaluation strategies are still missing. OBJECTIVE The aim of this short report is (i) to show the current situation of APNs in Austria, and (ii) to underline the importance of measuring APN outcomes in implementing this role for future developments in health care. METHOD A literature search was conducted in CINAHL (Cumulative Index to Nursing and Allied Health), PubMed, and the Cochrane Library in the period 09/2019 to 01/2020. RESULTS With the help of APNs and coordinated, holistic, patient-centered care, a higher quality of care for different patient groups is clearly evident. The cost-effectiveness and the positive experience of both patients and nursing staff have been demonstrated in international studies. In particular, the guidance and educational skills of APNs have been shown to improve health outcomes in vulnerable population groups. CONCLUSION With regard to the implementation of APNs in the health care system, more focus is needed on the measurement of outcomes in nursing research. Outcome research has been shown to help identify the unique effect of APNs in patient care and to highlight the health-related improvements through Advanced Nursing Practice for health policy and further developments in the health care system.
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Affiliation(s)
- Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.
| | - Katharina Maria Lex
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Abstract
PURPOSE The purpose of this paper is to describe instruments used for quality assessment in acute care. Quality care assessment is essential for improving care delivery. Quality instruments can be used to evaluate nurse and patient perspectives in multi-professional care. Therefore, valid and reliable measurement instruments are vital. DESIGN/METHODOLOGY/APPROACH A literature search identified several instruments that measure quality from a nurse and patient perspectives. The questionnaires were appraised in several steps with specific criteria: psychometric properties, underlying construct or test theory, study context, sample characteristics and target population. FINDINGS Overall, 14 instruments were evaluated, but only eight questionnaires represented nurse and patient views regarding quality. Instruments showed several disparities in their theoretical foundations and their psychometric properties. Two instruments did not provide validity data and one questionnaire did not report reliability data. PRACTICAL IMPLICATIONS To inform healthcare managers about acute care quality, the authors demonstrated the need for more valid and reliable measurements by using the Guidelines for Critiquing Instrument Development and Validation Reports to evaluate quality care instruments' psychometric properties. ORIGINALITY/VALUE There is a long tradition in quality care evaluations using questionnaires. Only a few instruments can be recommended for practical use.
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Affiliation(s)
- Manela Glarcher
- Department of Nursing Science and Gerontology, UMIT the Health and Life Sciences University, Hall in Tirol, Austria
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