Competency gap among graduating nursing students: what they have achieved and what is expected of them

BACKGROUND

Nurses' professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices.

METHODS

In a descriptive-comparative study, students' perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests.

RESULTS

The results of the study showed that the highest scores for students' acquired competencies and nursing faculties' expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups' mean scores was significant in all 5 core-competencies and 17 sub-core competencies (P < .001). Evidence-based nursing care was the highest mean difference (mean diff = 1) and the professional nursing process with the lowest mean difference (mean diff = 0.70).

CONCLUSION

The results of the study highlight concerns about the gap between expected and achieved competencies in Iran. Further research is recommended to identify the reasons for the gap between the two and to plan how to reduce it. This will require greater collaboration between healthcare institutions and nursing schools.

Development and Psychometric Assessment of "Self-Efficacy Scale" for Patients With Beta Thalassemia Major: A Mixed-Methods Study

Background and Purpose: Since self-efficacy is a significant factor influencing the self-management of chronic diseases, including thalassemia major, it is considered a key concept in chronic diseases. This study aimed to develop and psychometrically evaluate the self-efficacy scale for patients with thalassemia major. Methods: This was a mixed-methods study conducted in two phases. In phase 1, a qualitative study with a conventional content analysis design was conducted. In phase 2, which was a quantitative one, the psychometric analysis of the instrument's phrases was done. Results: The instrument has 35 items and 3 factors. The Cronbach's alpha coefficient and the intraclass correlation coefficient were .93 and .94, respectively. Conclusions: This study confirms the validity and reliability of the Beta Thalassemia Major Self-Efficacy Scale. With this tool, nurses can evaluate the self-efficacy of patients with thalassemia major.

Nursing students' experiences from clinical education using the TPSN model

BACKGROUND

The TPSN model is an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. This model is done to reduce the theoretical-practical gap in nursing. The present study aimed to explore the experiences of nursing students.

METHODS

In a conventional content analysis, 11 undergraduate nursing students, 7 graduate nursing students, and 4 doctoral students were selected. Data was collected through focus group discussions and individual interviews.

RESULTS

The findings from analyzing the students' experiences who had received education using this model resulted in four main categories: the feeling of being a nurse, an integrated and collaborative clinical education platform, the development of nursing clinical education, and educational challenges.

CONCLUSION

The TPSN model provides a suitable platform for nursing clinical education. This model helps students integrate theoretical knowledge with clinical practice and helps them act as professional nurses in the future.

Virtual care in the health care system: A concept analysis

BACKGROUND

Health care providers need a better understanding of virtual care to recognise and use it for service delivery.

AIM

To provide a more comprehensive definition of the concept of virtual care.

METHOD

This study was conducted based on Walker and Avant's concept analysis method. A comprehensive review of the published texts in English from 2012 to 2022 was performed using the PubMed, Web of Science, Scopus, ProQuest, Science Direct, Ovid, CINAHL and Google Scholar databases.

RESULTS

The main aspects and attributes of virtual care, including the use of any information and communication technology in various formats such as platforms, telephone calls, messages, email consultation, remote monitoring, secure and two-way digital communication between health care providers and patients, the possibility of providing remote care synchronously or asynchronously, more interaction between patients and caregivers, the possibility of transferring information between patients and health care providers and within the teams themselves, symptom management, sending diagnostic results in the form of video visits, and providing follow-up care, are attributes that distinguish virtual care from telehealth, telemedicine and other methods of providing remote healthcare services.

CONCLUSION

Considering the positive and negative consequences of implementing virtual care, the findings of this study developed a basis for an operational definition of the concept so that providers can understand the meaning of virtual care and consider it when providing virtual care to patients. The findings of this study can be used in many international and national contexts in the health care system and in future studies on interventions to increase the use of virtual care.

Adapting the Donabedian model in undergraduate nursing education: a modified Delphi study

BACKGROUND

Donabedian conceptual and multidimensional framework has been used in several studies in an educational context. In this study, we aimed to adapt the Donabedian three-component model (structure, process, and outcome) in undergraduate nursing education. This conceptual framework provides a comprehensive image of nursing education institutions and can help to evaluate institutions by measuring different aspects of their performance. A comprehensive understanding of the various elements of an educational institution helps to develop a complete, appropriate relevant set of performance indicators.

METHODS

This was a modified Delphi study. It had three rounds. The expert panel consisted of nursing faculty members and nursing Ph.D. students. In the first round, a questionnaire was designed based on interviews, focus groups, and a literature review. Experts rated their agreement with each element on a 5-point Likert scale in rounds two and three. The consensus level was set as 75%. The stability between rounds was also determined by calculating kappa coefficients. One Sample T-Test was also calculated for new items in round three.

RESULTS

All 55 items of the questionnaire were confirmed in the second round based on the consensus percentage of 75. Five new items were added to the third round based on comments in round two. Eventually, all elements except one were confirmed according to the consensus level, kappa values, means, and One-Sample T-Test in round three. The structure's key elements include staff (academic and non-academic); equipment; guidelines; resources and facilities; and students' demographics and characteristics. Process key elements include communication; education; evaluation; cooperation; and consultation. Outcome key elements include knowledge development; nursing image; alumni's outcome; students' outcome; related medical centers' performance; accreditation and evaluation results; and satisfaction.

CONCLUSIONS

Different elements of a nursing education institution at the bachelor's level were determined. The results of this study can help related bodies to develop and implement a comprehensive and systematic evaluation. These results can also be a basis for making this model useful in other nursing courses or education in other fields.

The effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer undergoing chemotherapy

PURPOSE

To determine the effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer (PwGC) undergoing chemotherapy.

METHODS

In this quasi-experimental study, we randomly allocated 152 PwGC who met the inclusion criteria as 1:1 ratio to control (N = 76) and intervention (N = 76) groups. The patients in the control group received routine post-chemotherapy care, while those in the intervention group received reminiscence therapy over the phone in addition to routine care. The participants of both groups completed Beck's Depression Inventory and Zung's Self-rating Anxiety Scale before the study, 6 weeks after the beginning of the study, and 3 months after the intervention.

RESULTS

Although the mean depression score before chemotherapy indicated moderate depression in both groups, the reminiscence therapy group showed a significant reduction in the depression score compared to the control group (P < 0.001) following intervention. The mean anxiety scores indicated mild to moderate anxiety in both groups, which was later placed within the normal range, there was a significant difference between the two groups. Intra-group comparison revealed that the mean depression and anxiety scores decreased significantly in the reminiscence therapy group (P < 0.001).

CONCLUSION

This study indicated that virtual reminiscence therapy can decrease anxiety and depression in PwGC undergoing chemotherapy. Therefore, it can be a supportive psychological method for these patients.

Competencies expected of undergraduate nursing students: A scoping review

AIM

Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work.

DATA SOURCES

We conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar.

REVIEW METHODS

We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA-ScR Checklist. Inclusion criteria included full-text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial.

RESULTS

Out of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development.

CONCLUSION

Considering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country.

IMPACT

These competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.

Comparison of the Iranian and Scandinavian bachelor of nursing curriculum (Sweden): A scoping review

BACKGROUND

The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care.

MATERIALS AND METHODS

The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases.

RESULTS

The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation.

CONCLUSION

It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.

Barriers to the implementation of virtual care programmes for patients with chronic wounds: Qualitative empirical research

AIM

To assess the barriers to the implementation of virtual care for patients with chronic wounds from wound therapists' perspective.

DESIGN

A qualitative study.

METHODS

The study was conducted in two consecutive phases: (1) literature review, (2) descriptive qualitative study. In the first phase, texts published in English until 2023 were identified using international databases. The entire text of the selected studies was evaluated independently by two reviewers. Data analysis was carried out using textual content analysis. In the second phase of the study, twelve participants from Iranian wound care clinics participated. Data were collected through focus group discussion and analysed using conventional content analysis. Integration of both phases was conducted in the data analysis stage.

RESULTS

The most important barriers in providing virtual care to patients with chronic wounds were identified into five categories including lack of policymaking in virtual care, ethical challenges in virtual information and communication technology, social, economic and cultural issues, IT users' insufficient knowledge and limitation of virtual care scope of practice.

CONCLUSION

The findings of the present study identified different barriers in the implementation of virtual care for patients with chronic wounds. In order to successfully develop a virtual care programme, it is necessary to adopt suitable policies regarding information and communication technology, provide the necessary legal frameworks, assign an adequate budget and consider the ethical, cultural, social and social issues.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Identifying barriers to developing a virtual care programme will help manage patients with chronic wounds at home.

IMPACT

This study accurately identifies barriers to providing virtual care for patients with chronic wounds and helps plan to address these barriers and facilitate the development of a virtual care programme for these patients at home.

REPORTING METHOD

This research has adhered to the SRQR reporting guideline.

NO PATIENT OR PUBLIC CONTRIBUTION

The involvement of patients or the public in the design, or conduct, or reporting, or dissemination plans of this research was not suitable.

The development and validation of a standardised eight-station OSCE for registration of undergraduate nursing students: A Delphi study

AIM

To develop and validate a set of OSCEs for use as a nationally applicable final exam of undergraduate nursing students' clinical and professional competencies.

BACKGROUND

Tertiary recommendations for nursing registration require student achievement of a prerequisite level of both nursing knowledge and skill. Assessment of nursing skills prior to provision of nursing registration is an increasingly important focus of university nursing education. Objective Structured Clinical Examinations (OSCEs) are an appropriate tool for assessing the competencies of nursing students, but the mode and content of OSCEs varies widely. Thus, for nationally-based registration, development of a standardized set of OSCEs to determine the clinical competence of nursing students is important.

DESIGN

A modified Delphi study, informed by a systematic scoping review of relevant literature.

METHODS

A two-phase study was conducted. Initially, a scoping review was conducted to establish internationally agreed competences for graduating nursing students. These were included in an online questionnaire send to national experts to develop a validated and accepted nursing competency framework and associated implementation strategies. This was round 1 of a three-round modified Delphi study. A Content Validity Index (CVI) was calculated and thematic analysis was used to analyze the experts' opinions.

RESULTS

Details of a set of OSCEs for final exam of undergraduate nursing students were developed and validated. These OSCEs included nine competencies addressed in eight 10-minute stations.

CONCLUSION

A 'best-practice' OSCE evaluation system, designed from both international literature and the opinions of nation-wide experts was achieved. This well-designed OSCE was shown to be a reliable and valid method for assessing the clinical competence of nursing students. It reflected global procedures as well as the local conditions and Iranian expectations. The results of this study can be used by nursing schools across the country. They can also be used to model equivalent development of locally relevant OSCEs in countries around the world.

Baccalaureate nursing education institutions' key performance indicators: a review of the existing indicators and qualitative analysis of expert interviews

BACKGROUND

Improvements in nurses' and midwives' education will increase workforce quantity and quality. Continual improvement of organization performance is based on continual measuring; Appropriate indicators must be selected to measure and appraise the performances. This study aimed to recognize and categorize key performance indicators (KPIs) for baccalaureate nursing education institutions' performance measurement.

METHODS

This study had two phases: (1) Interview: Seven semi-structured interviews were conducted with faculty members and nurses. (2) Narrative Literature review: schools' and universities' reports and web pages were assessed to recognize KPIs. The data analysis method was directed content analysis. The Donabedian Model components were used to guide the data analysis.

RESULTS

The total number of indicators retrieved was 468; 75 were from interviews with faculty members and nurses and 393 were from the literature review. Indicators were categorized into: Structure (staff; equipment, resources, and facilities; guidelines), Process (education; communication and collaboration; evaluation), and Outcome (survey and accreditation; national and international recognition; satisfaction; sustainability and financial efficiency; students; alumni; knowledge related to the field).

CONCLUSIONS

A number of indicators were identified that were categorized into various groups related to the performance of nursing schools. Further investigations are needed with different groups of stakeholders including students, professional associations, healthcare institutions, alumni, and clients. As well in some areas, new or composite indicators may need to be developed. Also, each institution needs to select appropriate indicators based on its context, policy goals, and infrastructure.

Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study

OBJECTIVE

Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors.

DESIGN

Cross-sectional study.

SETTING

Four faculties from the nursing faculties of East Azerbaijan province.

PARTICIPANTS

253 senior nursing students in Iran.

PRIMARY AND SECONDARY OUTCOME MEASURES

Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics.

RESULTS

Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001).

CONCLUSION

Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.

Translation, cross-cultural adaptation and evaluation of the Iranian Persian version of student survey on writing nursing care plan

AIM

The objective of this study was to validate the Iranian translation and cross-cultural adaptation of the Student Survey on Writing Nursing Care Plan (SSW-NCP).

BACKGROUND

To provide supporting evidence about the nursing students' skill in planning and documenting nursing care plans based on nursing process, Salvador et al. developed the SSW-NCP to measure the extent to which nursing students are qualified in writing nursing care plans. However, an Iranian version of the SSW-NCP is presently not available.

METHOD

The cross-cultural adaptation and linguistic translation of the SSW-NCP adhered to World Health Organization (WHO) guidelines. The reliability and validity process followed the COSMIN checklist.

RESULTS

The survey was well translated to Persian language and culturally adapted through confirming the relevancy, appropriateness and logical representation of all aspects on nursing process by bilingual experts and pre-tested on Persian-speaking nursing students. The Cronbach's Alpha coefficient (α) and test-retest stability assessing affirmed the reliability, and convergent validity of the adapted survey was confirmed through comparison to Influencing Factors of Nursing Students' Clinical Judgment (IFNSCJ). The adaptation process of the SSW-NCP resulted in a conceptually equivalent translated version, which is comparable to the original version and is acceptably valid and reliable.

IMPLICATIONS FOR NURSING MANAGEMENT

Knowing the proficiency of nursing students as future nurses in writing nursing care plans can provide accurate professional information for better educational and practical level programming and management that can enhance nursing practice.

PATIENT OR PUBLIC CONTRIBUTION

The target group of survey was nursing students who contributed and participated in the current study.

Evaluation and comparison of knowledge translation patterns in selected countries with Iran: A comparative study

BACKGROUND

One of the main issues related to the inefficiency of the health system is the lack of sufficient communication between researchers and health policymakers regarding the exchange of the latest findings and the use of inappropriate evidence to manage cases. The knowledge translation removes this disconnect.

MATERIALS AND METHODS

In this comparative study, to obtain appropriate data on the status of knowledge translation, refer to the databases of reputable centers and governments and the knowledge translation models were reviewed in the title of main articles, abstracts, guidelines, and reports of reputable international organizations between 2005 and 2020. The origin of the models was determined, then the countries with the largest number of models were selected and analyzed using Walt and Gilson's "Policy Triangle framework in four dimensions: context, content, process, and actors."

RESULTS

All the three countries have politically, socially, and economically made knowledge translation one of their policy priorities. Iran's centralized health system is a major obstacle. The USA and Canada have clear strategies and coherent and practical infrastructures that implement the knowledge translation in the form of operational plans. In contrast, in Iran, it has been enough to establish the knowledge translation centers at the level of universities and knowledge translation websites. In Iran, the Ministry of Health and universities of medical sciences play a direct role, but in Canada, they also use knowledge broker to apply knowledge.

CONCLUSION

Iran is building capacity in the field of knowledge translation. That the implementation of interventions with the cooperation of macro policymakers can strengthen it.

Identifying self-presentation components among nursing students with unsafe clinical practice: a qualitative study

BACKGROUND

Maintaining patient safety is a practical standard that is a priority in nursing education. One of the main roles of clinical instructors is to evaluate students and identify if students exhibit unsafe clinical practice early to support their remediation. This study was conducted to identify self-presentation components among nursing students with unsafe clinical practice.

METHODS

This qualitative study was conducted with 18 faculty members, nursing students, and supervisors of medical centers. Data collection was done through purposive sampling and semi-structured interviews. Data analysis was done using conventional qualitative content analysis using MAXQDA10 software.

RESULTS

One main category labelled self-presentation emerged from the data along with three subcategories of defensive/protective behaviors, assertive behaviors, and aggressive behaviors.

CONCLUSION

In various clinical situations, students use defensive, assertive, and aggressive tactics to maintain their professional identity and present a positive image of themselves when they make a mistake or predict that they will be evaluated on their performance. Therefore, it seems that the first vital step to preventing unsafe behaviors and reporting medical errors is to create appropriate structures for identification, learning, guidance, and evaluation based on progress and fostering a growth mindset among students and clinical educators.

The impact of institutionalizing the nursing process based on TPSN model on the quality and quantity of nursing diagnoses

AIM

Nursing diagnosis is the basis of applying nursing process and evidence-based care in nursing. This issue has been affected by the gap between theory-practice in nursing. The attending nursing teachers Project aims to create an organizational link between health care centres and nursing schools, reducing the gap between theory-practice and empowering nurses to apply nursing diagnosis.

DESIGN

The present study was part of the second cycle of an action research study conducted in the cardiology ward in 2019-2020.

METHODS

Interventions were performed in the form of Teacher, Patient, Student, Nurse Model to empower nurses in quantity and quality of nursing diagnosis.

RESULTS

The results indicated a significant increase in the number of nursing diagnoses recorded. Moreover, the qualitative criteria based on PES components were found to have changed significantly after the interventions. Empowering nurses in the form of this Project could suggest that creating proper structures between nursing schools and health care centres, full-time presence of faculty members in hospitals, and enhancing their roles in these institutes will lead to improvements in educational as well as health care systems.

Stress management protocol for nurses working in the COVID-19 wards

Purpose

Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences.

Methods

This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion.

Results

Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items.

Conclusion

This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Human dignity of patients in nursing: A concept analysis

To understand the concept of dignity in care and use it in practice, nurses need a clear understanding of the dignity of patients, which can help them improve quality of care and provide services of a higher standard. This study aims to clarify the concept of human dignity of patients in nursing. Walker and Avant's method (2011) was used for this concept analysis. Published literature from 2010 to 2020 was identified using national and international databases. The full text of the included articles was reviewed. The main dimensions and attributes include valuing the patient, respecting patients' privacy, autonomy, and confidentiality, having a positive mental image, having a sense of altruism, respecting human equality, observing patients' beliefs and rights, adequately educating patients, and paying attention to secondary caregivers. Nurses should consider the subjective and objective aspects of dignity in their daily care activities by cultivating a deeper understanding of the concept of dignity and its attributes. In this regard, nursing tutors, managers, and policymakers in healthcare should emphasise human dignity in nursing.

Clarification of ethical principle of the beneficence in nursing care: an integrative review

BACKGROUND

Ethics-based nursing practice can transform health care practices. As the biggest human capital in the health care system, nurses are obliged to follow ethical principles in this field. One of these ethical principles; is beneficence, which is considered the core of nursing care. This study aimed to investigate clarification of the principle of beneficence in nursing care and its related challenges.

METHODS

This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, and Scopus were searched using the keywords; "beneficence", "ethic", "nursing" and "care" in English and Persian in the time range of 2010 to 10 February, 2023. After applying inclusion criteria and assessing the articles using Bowling's Quality Assessment Tool, finally, 16 papers were included from 984.

RESULTS

After reviewing and evaluating the qualified articles, the findings were classified into four main categories: (1) nature, (2) applicability, (3) Relevant and influential factors, and (4) challenges related to the ethical principle of beneficence in nursing care.

CONCLUSION

Based on the results of this review it seems that paying attention to clarification the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle and finally, it leads to increasing the well-being and health of patients, reducing their mortality rate, increasing satisfaction and maintaining the respect and human dignity of patients.

Development and psychometric testing of a clinical reasoning rubric based on the nursing process

BACKGROUND

To facilitate the development of clinical reasoning skills in nursing students, educators must possess the ability to teach and evaluate them. This study aimed to describe the development and validation process of an analytic rubric of clinical reasoning skills based on the nursing process in undergraduate nursing students.

METHODS

A seven-step method was used for rubric development. The initial validation process of the rubric of clinical reasoning was performed with the participation of key stakeholders to assess its face and content validity as well as applicability in the classroom and bedside. An initial pilot test was performed based on scenario-based examinations in the nursing process training course so that convergent validity was used to show how closely the new scale is related to the previous measure for evaluating students' tasks. Internal consistency and inter-rater correlation coefficient measurement for reliability were assessed.

RESULTS

The rubric to assess clinical reasoning skills was developed into eight categories according to the five stages of the nursing process. Content and face validity of the rubric were done qualitatively and resulted in a clear, simple rubric relevant to clinical reasoning skills assessment. The convergent validity was confirmed by the conventional method. The reliability was approved by a high inter-rater correlation coefficient based on the assessment by two random independent raters.

CONCLUSION

The clinical reasoning meta-rubric developed in this study meets the purpose of the study. This analytical rubric can be applied to guide teaching and learning as well as evaluate clinical reasoning based on the findings. Testing the applicability confirmed its validity and reliability for assessing clinical reasoning skills in nursing process education during the undergraduate nursing program.

Iranian nursing applicants' perception of the nursing profession: A qualitative study

AIM

This study was conducted to describe the perceptions of nursing applicants about their chosen profession and to explore the factors which influenced their understanding.

DESIGN

A qualitative study with a conventional content analysis design.

METHODS

Participants were 19 nursing applicants enrolling in nursing schools in three provinces of western Iran. Data were collected using semi-structured interviews. The content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth.

RESULTS

The mean age of participants was 20 years (SD = 2.5), and 11 of them (57.9%) were females. Participants understood the nature of nursing work to encompass only a limited level of independence; they viewed it as a feminine profession, and as a job with spiritual rewards. The perceived content of nursing work included providing help and patient care in the hospital with a focus on performing procedural tasks. Applicants' perceptions of nurses' characteristics included strong physical endurance, communication skills, emotional strength and low intellectual skills. The professional status of nursing was perceived simultaneously as having high job security but limited potential for career advancement and professional growth. The factors reported to influence applicants' perceptions were related to the media, academic-career counsellors, personal factors, and family and friends.

A scoping review of virtual care in the health system: infrastructures, barriers, and facilitators

For virtual care models to be able to improve the safety and quality of care, it is essential to identify the strengths and weaknesses of virtual care. In this Scoping review, literature published on virtual care was identified using international databases. The results of the included studies were summarized using a predefined taxonomy. In total, 20 studies were included in the present review. Extracting the findings of the articles showed four main topics, including "virtual care delivery models," "Video conference software platforms to provide virtual care," "virtual care delivery challenges," and "virtual care implementation facilitators." Therefore, with the development of emerging digital technologies, unique opportunities to provide virtual care and improve the provision of health services have been created in the health care system worldwide. Multifunctional video conference software platforms using specific models for each scope of care practice should be considered.

Nursing Journal Club as a Tool to Facilitate Evidence-Based Practice: Participant’s Feedback

"Background and aim: Nursing journal clubs have a proven value in nursing education and continuing education, which has expanded widely in the promotion of evidence-based clinical care in recent years. This study aimed to evaluate the clinical nursing journal clubs from the viewpoints of nurses. Methods: This descriptive study was conducted from July 2019- October 2020. This study was conducted in two phases, consisting of designing the format and flowchart and implementing nursing journal clubs and the second phase was evaluation. Results: Format and executive flowchart prepared by the research team and reviewed and approved in the group. In terms of evaluation, minimum (33) and maximum (165) scores with a mean± SD total score of 123.49 ± 19.91 calculated for nursing journal clubs indicate an optimum quality. Conclusions: The qualities of nursing journal clubs were evaluated to be favorable. Accordingly, authorities and planners should consider appropriate actions to facilitate Nursing journal clubs, such as credit points in rank promotion for faculty members, and inclusive in continuing education privileges for nurses, to adapt these activities to the roles of the clinical faculty and the benefits of this educational method in nursing. "

What should be measured? Nursing education institutions performance: a qualitative study

OBJECTIVES

In this qualitative study, we specify important domains of a nursing education institution that need to be measured to represent its performance via students' perspectives, one of the most important stakeholders in higher education.

SETTING

This study was conducted in a nursing and midwifery faculty.

PARTICIPANTS

Participants were bachelor's, master's and Ph.D. students in nursing. Convenience sampling was used. The aim and methods of the study were explained to the students, and they were invited to participate in the focus groups. Four focus groups (n=27) were held.

RESULTS

Thirteen categories emerged that were assigned to three components of the Donabedian model. The structure component contained three categories: learning fields, equipment and facilities and human resources standards. The process component contained five categories: workshops for students and staff, student familiarity with the institution's rules and plans, teaching, students evaluation and evaluation of teaching staff by students and peers. And outcome components contained five categories: results of self-evaluation by students, graduates' outcomes, students' outcomes, students surveys results and related medical centres performance.

CONCLUSIONS

Based on the needs and ideas of this important group of stakeholders, we can proceed further. Once we specify what is important to be measured, then it is appropriate to develop or choose suitable and measurable performance indicators for each of the recognised categories.

Iranian nursing students' experiences of workplace violence: a qualitative study

BACKGROUND

Workplace violence against nursing students is a common phenomenon. This study aimed to investigate Iranian nursing students' experiences of workplace violence, including their reaction to violence and the consequences and the effects of such violence on the students.

METHODS

The study participants were undergraduate nursing students. The data were collected using semi-structured, in-depth face-to-face interviews. Data analysis was carried out with qualitative approach using conventional content analysis.

RESULTS

Four categories were extracted from the analysis of the interview transcriptions: vertical violence, horizontal violence, reaction to violence and consequences of violence. Nurses were the major imposers of violence against students and psychological and verbal violations were the most of used forms of violence. The students reacted to violence in the forms of counteracting, reporting, disregarding and considering as commonplace.

CONCLUSIONS

Workplace violence is a common phenomenon experienced by nursing students in this study, which causes devastating individual, educational, and professional impacts. Action plans including providing safe environment and appropriate support from nurses and educators should be developed in clinical settings to intervene and to prevent workplace violence.

Promoting evidence-based nursing through journal clubs: an integrative review

Background

The journal club has been proposed as a tool to fill the gap between theory and practice.

Aim

The present research is an integrative review of studies focussing on journal clubs.

Methods

An integrative review. We searched the databases during 2010-2019 to find papers using the keywords journal club, nursing, evidence-based practice. The modified version of Cooper's five-stage integrative review was applied.

Results

The results are presented in two sections - the benefits and challenges of nursing journal clubs and an outline of presentation guidelines. We also discuss the effectiveness of journal clubs in the promotion of evidence-based nursing.

Conclusions

The purpose of the nursing journal club is to review existing literature, discuss the latest information and evidence and identify practical changes required to ultimately improve patient outcomes. Further studies are needed to evaluate the effectiveness of journal clubs in patient care.

Developing a framework for the participation of nursing managers in the health policy-making process in Iran: A Delphi study

AIMS

The aim of this study was to develop a framework for nursing managers to participate in the health policy-making process.

BACKGROUND

Nursing managers must be involved in the health policy process to provide appropriate health services, focus on nursing professional excellence, and improve the performance of the health system.

METHODS

This multimethod research was based on the Delphi study and experts' panel. Faculty members of the nursing, health policy, health services management, and nursing managers working at hospitals were selected via purposive sampling. The data collection tool was a demographic form and an open-ended questionnaire in the first round and a structured questionnaire in the next round. In the two rounds of Delphi, experts discussed and rated items of nursing managers' participation framework in the health policy-making process. At the expert panel session, the framework was finalized with a 12-part checklist. The data were analysed quantitatively using SPSS software version 22.

RESULTS

A total of 28 items were entered into the Delphi study. Experts who met the inclusion criteria responded to rounds 1 (n = 20) and 2 (n = 16). Following the two rounds of the Delphi study, 27 items were selected and discussed by experts using a 12-part checklist related to the framework. The final participation framework was divided into five sections: Barriers, facilitators, advantages, disadvantages, and factors affecting the participation of nursing managers in the health policy-making process.

CONCLUSION

In our findings, the relationship between the components of the framework and policy cycle was shown, which should be considered to lay the groundwork for participation. This can lead to health promotion, accountability, and financial participation in the health system, which can improve the proactive involvement of nursing managers in the health policy-making process.

IMPLICATIONS FOR NURSING MANAGEMENT

The proposed framework can be utilized across the spectrum of nursing, including practice, leadership, and education to enhance the participation of nursing managers in health policy activity.

Exploration of knowledge, attitudes, and perceived benefits towards nurse managers' participation in the health policy-making process: a qualitative thematic analysis study

Background

Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes.

Objective

This study aimed at exploring the attitudes and perceived benefits of nurse managers' participation in the health policy-making process.

Methods

In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012).

Results

After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers' participation, advantages of nurse managers' participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process.

Conclusion

The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers' participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.

An introduction to the TPSN model: a comprehensive approach to reducing the theory-practice gap in nursing

Background

There are still concerns about the effectiveness of clinical education models which are done with the aim of reducing the theoretical-practical gap in nursing. In this article, we intend to describe an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. The basis of this work is the full-time presence of nursing teacher in the clinical settings and the development of their role to improve the education of students and nurses and the quality of nursing services.

Methods

This was a participatory action research. This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Clinical Learning Environment Inventory (CLEI), Job Satisfaction in Nursing Instrument questionnaires and Patient Satisfaction with Nursing Care Quality Questionnaire were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis.

Results

The academic-practice integration Model of TPSN is a dynamic and interactive model for accountability in nursing Discipline. Unlike the medical education model that includes patients, students, and physicians as the three points of a triangle, this model, which is shaped like a large triangle, places the person in need of care and treatment (patient, client, family, or society) in the center of the triangle, aiming to focus on the healthcare receiver. The model consists of three components (Mentoring component, Preceptorship component, and integrated clinical education component). Each of the components of this model alone will not be able to eliminate the ultimate goal of bridging the theory-practice gap.

Conclusions

A new and innovative model was proposed to reduce the theory-practice gap in the present study. This model increases the collaboration between educational institutions and healthcare settings compared with the previous models. The TPSN model helps students, nurses, and nursing instructors integrate theoretical knowledge with clinical practice and act as professional nurses.

Illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention in Iran

Background

Knowing of perception of the illness, and cardiovascular risk factors in patients with myocardial infarction is crucial in engaging in effective secondary prevention. This study aimed to examine illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention.

Methods

The participants comprised 131 patients undergoing a first-time percutaneous coronary intervention at a metropolitan, tertiary referral hospital in Tabriz, Iran. The convenience sampling method was employed to select the research sample within a six-month period. The instruments used were as follows: (1) Demographic and health information form, (2) The Brief Illness Perception Questionnaire (3) The Health Risk Assessment framework developed by the Centers for Disease Control and Prevention. The design of the study was descriptive, cross sectional. The continuous variables were analyzed using Independent t-test and analysis of variance (ANOVA); and categorical variables were compared using the chi-square test.

Results

Most participants had a positive family history of cardiovascular disease (54.2%), with 66.4% of participants having at least one cardiovascular risk factor such as diabetes (36.6%) hypertension (32.8%) and dyslipidemia (16%). Most participants were physically inactive (78.6%), about 48.9% were overweight, 34.4% suffered from obesity and 26% were smokers. Illness perception in this study was seen to be high (6.21), with highest scores occurring in the illness control dimension (6.83) and lowest scores occurring in the understanding dimension (3.77). There was a significant relationship between illness perception and physical activity, nutrition, sleep and general health. Direct significant relationships between biometric values (cholesterol, glucose, blood pressure); psychological factors (depression, anxiety and stress) and illness perception were also found to exist.

Conclusions

Low scores in two dimensions of illness perception may lead to psychological consequences such as stress, anxiety, and depression. The relationship between illness perception and some risk factors of cardiovascular disease such as physical activity, diet and biometric values, reveal the need for more attention to patient education and counselling.

Exploring Barriers to the Development of Home Health Care in Iran: A Qualitative Study

Changes in society’s needs have increased individuals’ desire to be independent and receive health care at home. Home health care (HHC) is one of the main components of realizing these ambitions. However, there is a serious concern about the state of development of the HHC industry in Iran and the quality of its services. This study aims to explore the barriers to the development of HHC in Iran. This qualitative study with a conventional content analysis approach was conducted in Tabriz, Iran, from October 2019 to March 2020. Twenty-one key stakeholders including nurses, home health directors, physicians, policy-makers, patients, and their families participated in the study. Participants were selected using purposive sampling. Data were collected using a focus group discussion (FGD) and 18 semi-structured in-depth interviews and analyzed using Graneheim and Lundman’s techniques. Data collection continued until saturation was reached. Three main themes emerged from the analysis: quality management challenges, insufficient infrastructure and policy, and political issues. The findings show that applying standard strategies to monitor the quality of services, paying attention to infrastructure, and having a clear framework for policy-making are beneficial for the development of the HHC industry. Health managers can monitor and upgrade the quality of HHC services by defining standards and assessment indicators, as well as providing comprehensive data. It is suggested that legislators consider the principles of community-based accountability, justice, and accessibility their top priority. Moreover, policymakers need to develop a roadmap to reform policies to create the conditions for the development of this industry.

Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards during the COVID-19 outbreak

Background

Surgical smoke (SS), which is produced by the use of high-temperature devices for cutting and coagulation of tissue during surgical procedures, is considered a serious threat to the health of operating room (OR) staff due to the presence of hazardous substances and possibility of transmitting various infections such as HPV, HIV, COVID-19 and so on. This study was conducted to determine the Attitude, preventive practice and perceived barriers among perioperative and anesthesia nurses toward surgical smoke hazards.

Methods

In this cross-sectional descriptive study, conducted at hospitals of Tabriz University of Medical Sciences (Iran) in 2021, 262 perioperative and anesthesia nurses were included by stratified random sampling. Data were collected using a demographic questionnaire and an SS questionnaire consisting of questions on attitude (17 item), practice (8 item), and barriers (13 item). Collected data were analyzed using SPSS16.

Results

The mean attitude and preventive practice scores (49.52 ± 12.36 and 15.8 ± 2.05, respectively) of the operating room nurses were reported at moderate and weak levels, respectively. There was a direct and significant relationship between attitude and practice scores (r = 0.129, P = 0.019). The main barriers to the prevention and dealing with the hazards of SS in ORs were reported in management (3.68 ± 1.06) and equipment (3.24 ± 0.66) dimensions, respectively.

Conclusion

It is recommended to adopt strategies to improve the attitude of OR staff regarding the preventive measures against surgical smoke hazards. Moreover, appropriate equipment and support of managers should be provided by explaining the policies and guidelines to prevent the complications of surgical smoke.

Impact of integrated teaching-learning method on oncology clinical decision-making ability and cognitive learning of nursing students

BACKGROUND

Innovative and student-centered teaching methods are required to improve critical thinking and clinical reasoning skills. The objective of this study was to determine the impact of an oncology internship training on learning outcomes of nursing students using an integrated teaching-learning method.

METHODS

A pre- and post-test quasi-experimental study was conducted among 107 undergraduate nursing students in fourth year who were allocated to two groups (intervention group = 51 and control group = 55) to receive an integrated teaching-learning method and routine method respectively. Data was collected using the Clinical Decision Making in Nursing Scale (CDMNS) and the students' cognitive learning test.

RESULTS

Difference in mean scores of cognitive learning test post-intervention was significant between the two groups (p < 0.001). Total CDMNS scores and its dimensions increased significantly for the intervention group post-intervention (p < 0.001). Analysis of covariance (ANCOVA) showed that when the effect of confounding variables, such as the student's Grade Point Average (GPA) and the pre-test scores of cognitive learning and decision-making scale were held constant, the effect of the independent variable (group) on students' cognitive learning test (p = 0.002) and CDMNS (p = 0.004) was significant.

CONCLUSIONS

Nursing students' cognitive learning and clinical decision-making scores were improved as a result of the integrated teaching-learning method. Nursing educators can use this method in clinical education to improve students' cognitive and meta-cognitive skills, thereby improving nursing care quality.

Compassionate Nursing Care Model: Results from a grounded theory study

Compassion, as an indicator for quality care, is highly valued by patients and healthcare professionals. Compassionate care is considered a moral dimension of nursing practice and an essential component of high quality care. This study aimed to answer these questions: (1) What are the facilitators and barriers of providing compassionate nursing care in the clinical setting? (2) Which strategies do nurses use to provide compassionate care? (3) What is the specific model of compassionate care for the nursing context? A grounded theory approach was used in this study. A total of 21 nurses working in diverse clinical settings participated in the study. Purposive and theoretical sampling was used to select the participants. Data were collected by in-depth face to face interviews and analyzed by the constant comparative method. Ethical approval was gained from the Ethical Review Board of Tabriz University of Medical sciences. The analysis resulted in the development of three main themes: (a) contextual factors affecting compassionate care, (b) the compassionate care actions, and (c) the consequences of compassionate care. The main dimensions of compassionate care are demonstrated in a Compassionate Nursing Care Model. Nurses' ability on providing compassionate care is influenced by individual and organizational factors that may facilitate or inhibit this type of care. Leadership and nurse managers should remove the barriers which diminish the nurses' ability to provide compassionate care and support them to engage in compassionate care programs. Identifying and recruiting compassionate nurses, developing their compassionate capacity, and providing role models of compassion could improve the flourishing of person-centered and compassionate care in clinical settings. The Compassionate Nursing Care Model (CNCM) provides a model to guide nursing care and research.

Cultural Factors and Social Changes Affecting Home Healthcare in Iran: A Qualitative Study

In Iran, home healthcare (HHC) is provided in a diverse socio-cultural context. Health professionals’ inadequate knowledge of the socio-cultural factors of the society can lead to poor quality HHC. Even so, the ways these factors influence HHC remain unclear. This study aimed to explore the effects of cultural factors and social changes on HHC in Iran. This qualitative study which follows a conventional content analysis approach was conducted in Tabriz, Iran. Eighteen individuals including nurses, home health directors, physicians, policy-makers, patients, and their families participated in the study. Participants were selected using purposive sampling. Data collection involved focus group discussion (FGD) and 16 semi-structured in-depth interviews. In order to analyze the data, Graneheim and Lundman’s techniques were used and data collection continued until saturation was reached. Five main themes emerged from the data analysis including cultural diversity issues, society’s understanding of HHC, shifting demographics affecting healthcare needs, transitioning from traditional to modern lifeways, and increasing unaffordability of healthcare. Health managers can improve the accessibility and acceptability of HHC services by identifying the socio-cultural needs of the society. Future research should develop and test patients and families’ cultural care models in the HHC setting.

Gaming disorder among students of Tabriz University of Medical Sciences: The frequency and related factors

Background: Gaming disorder has been identified as a health problem. Disorders in emerging adulthood might negatively affect individuals’ attitude toward the world, their communication with others, and formation of their personal identity. Thus, the present study was performed to identify the frequency of gaming disorder and its related factors among students of Tabriz University of Medical Sciences.

Methods: A total of 813 undergraduate students of Tabriz University of Medical Sciences participated in this descriptive correlational study in 2018. All students filled the personal-social information form and Social Readjustment Rating Scale, and gamers filled gaming behaviors form and Internet gaming disorder-20 test (IGD). Data were analyzed using descriptive statistics and Pearson correlation coefficient, t- test, ANOVA, chi-square, and multiple linear regression.

Results: A total of 394 (48.5%) students were currently playing games. The mean of IGD scores among the gamers was 45.47 ±13.93, and 17 (4.3%) of them were recognized as having gaming disorder. The frequency of the disorder among all students was 17 (2.1%). Being male, playing online games, and having access to all 3 gaming devices (computer, smart phone, and tablet) were recognized as determining factors of gaming disorder.

Conclusion: This study revealed that almost half of the university students were playing video and or on line games; however, a low percentage of the gamers had addictive gaming behaviors. The results indicated the necessity of applying modifications to individuals’ gaming methods as well as implementing the individual and family-centered interventions to prevent and manage gaming disorder.

Essential dimensions of professional competency examination in Iran from academic and clinical nurses' perspective: A mixed-method study

BACKGROUND

Planning for the issuance of professional competency examination has been put on the agenda of professional policymakers, but the ways of evaluating and conducting examinations and its dimensions are the main challenges. The present study aimed to explain the essential dimensions of professional competency examination in Iran from academic and clinical nurses' perspective.

MATERIALS AND METHODS

The present mixed-method study was performed at three stages, systematic review, qualitative, and quantitative stages. At the first stage, 56 articles and texts were collected from PubMed, CINHAL, Ovid, and ProQuest databases, by using the keywords, namely professional competency examination and assessment. Base on the inclusion criteria and eligibility assessment of article, six articles and one text on regulation were selected. At the second stage, the results of the literature review were approved by 20 nursing experts. Direct content analysis was used for data analysis. The results were prepared in the form of a questionnaire. At the last stage, the questionnaire was given to 2209 clinical, academic, nurse managers, and nurses.

RESULTS

Based on findings of the review literature, essential dimensions of the professional competency examination included a central theme of the client's needs with four categories. At the second stage, the Professional Competency Examination dimensions were approved by experts. At the third stage, a comparison of findings indicated that clinical nurses emphasized more on cardiopulmonary resuscitation, client safety, and implementation of procedures, while academic nurses emphasized on the client's needs, client education, and clients' physiological integrity.

CONCLUSION

The client's need is the most important dimension in the professional competency examination. The nurses will be successful in providing care if they can identify the clients' needs and provide care plans based on client needs and priorities.

Nurses' experiences during the COVID-19 pandemic in Iran: a qualitative study

BACKGROUND

Nurses are at the forefront of patient care during infectious disease pandemics and they play a key role in treating and preventing the upward trend of the disease. Hence, it is crucial to consider their experiences in designing action plans to combat coronavirus disease 2019 (COVID-19). Since there is not enough data in this regard, the current study aimed to investigate the nurses' experiences in caring for patients with COVID-19 in Iran.

METHODS

In this descriptive qualitative study, a total of 20 nurses were selected by purposive sampling. Semi-structured interviews were conducted and analyzed using qualitative content analysis to collect data.

RESULTS

Data analysis revealed four main themes, including 'duality in the form of care,' 'confusion and ambiguity in care planning', 'workload', and 'social isolation in spite of positive image.'

CONCLUSION

Our findings indicated that the nurses experienced a range of paradoxes during the COVID-19 pandemic; these paradoxes included distraction from providing care due to focus on marginal factors in spite of empathy and cooperation in nurses, the presence of volunteer support staff despite the lack of equipment, lack of scientific information and the unreliability of online information, overload in the hospital due to insufficient facilities and equipment, and the physical avoidance of people in the community in spite of social support for nurses in the media. The results of this study can lead to a clear understanding for managers and healthcare policymakers in the country and aid them in taking optimal measures to support nurses and improve the quality of nursing care against COVID-19.

Observance of preventive standards against COVID-19 transmission in operating rooms: A cross-sectional study

Background

Due to the highly contagious innate of the novel coronavirus, the surgical team is exposed to the disease during surgical care of patient with confirmed covid-19. Therefore, the necessary measures should be taken to protect surgical caregivers. This study was conducted to determine the status of compliance with the preventive standards against covid-19 transmission in the operating room.

Methods

This cross-sectional descriptive study was conducted on 183 surgical team members working in hospitals affiliated to Tabriz university of medical sciences in 2020. Participants were selected by stratified random sampling. The required data were collected by a researcher-made questionnaire according to the standard protocols of SAGES, EAES and AORN. In the first part of this questionnaire, the level of compliance with the standards of using personal protective equipment (PPE) was evaluated and in the second part, the level of compliance with the preventive strategies in the operating room was evaluated in three phases of Pre, Intra and Post-operative. The data was analyzed using SPSS16.

Results

preventive standards observance against COVID-19 was in moderate (55.3 ± 10.5) level and The level of compliance with the standards of using PPE by the surgical team was favorable (61.8 ± 8.1). There was a statistically significant relationship between the level of compliance with the standards of using PPE and the type of specialty (P = 0.004).

Conclusion

According to the results, the level of compliance with the principles of standards in applying protective measures against covid-19 was not favorable, so the operating room personnel is exposed to COVID-19 and the necessary measures and improvements should be considered in compliance with standards in operating room.

Emergency medical staffs' knowledge and attitude about organ donation after circulatory determined death (DCD) and its related factors

BACKGROUND

Adverse attitudes and insufficient knowledge about organ donation after Circulatory Determined Death (DCD) among emergency staff can have important consequences for the proper identification of potential DCD donors. This is aided by the constant application of donation after Circulatory Determined Death policies, and the relative strength of support for this type of donation. Therefore, this study was conducted to investigate the awareness and attitude of emergency personnel about organ donation after Circulatory Determined Death.

METHODS

This descriptive study was carried out with the participation of 49 physicians and 145 nurses working in the emergency departments of educational and medical centers of Tabriz University of Medical Sciences. Nurses were selected by simple random sampling, and all physicians working in the emergency departments were included in the study. The questionnaire of Knowledge and Attitude regarding Organ Donation after Circulatory Determined Death designed by Rodrigue et al. was used. Data were analyzed using descriptive statistics and independent samples t-test, one-way ANOVA, and chi-square test.

RESULTS

Most of the nurses (62.8%) and physicians (66.7%) had a high level of knowledge about organ donation after circulatory determined death. The mean attitude score was 101.84 (SD: 9.88) out of 170 for nurses and 106.53 (SD: 11.77) for physicians. Physicians who carried organ donation cards had a more positive attitude toward organ donation after circulatory determined death.

CONCLUSION

According to this study findings, knowledge and attitude of the emergency staff about organ donation was both high and positive. It is recommended to devise necessary guidelines for organ donation in Iranian emergency departments to assist in the training of colleagues in organ donation ensuring no necessary measures are missed. The results of this study would support the development of guidelines for the successful introduction of DCD in Iran.

Challenges of objective structured clinical examination in undergraduate nursing curriculum: Experiences of faculties and students

BACKGROUND

Assessment of clinical competence of nursing students is necessary to ensure safe practice and the realization of professional clinical standards. An Objective Structured Clinical Examination (OSCE) is commonly used internationally in nursing education programs to assess clinical competence, but is a new process in Iranian nursing curricula.

OBJECTIVE

The aim of this study was to explore and describe challenges associated with OSCE implementation based on the experiences of faculty members and nursing students, with the objective of further improving the assessment of clinical competence in nursing education.

DESIGN

This study used a qualitative approach that included thematic analysis of the transcribed interviews.

SETTING

Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences (TBZMED), Tabriz, Iran.

PARTICIPANTS

Purposive sampling was used to select eighteen faculty members and fifteen students from those interested. These participants represent a reasonable cross-section of those who had participated in the OSCE.

METHODS

A pre-developed interview guide was used to inform semi-structured in-depth interviews. These were recorded and analyzed using the 6-phase thematic analysis method as described by Braun and Clarke (2013). Themes were independently verified.

RESULTS

Challenges identified by participants around OSCEs as part of undergraduate nursing education were extracted from the interview data. Two main themes were evident from the data: 1) shortcomings in executive and technical infrastructure, 2) shortcomings in educational infrastructure. These themes reflected both student and faculty experiences. These also aligned with themes that commonly emerge in related literature.

CONCLUSION

The study findings illustrate several key challenges associated with organizing and implementing OSCEs and so provides unique insights into the development of strategies to implementing and promoting OSCEs in nursing education. We recommend that managers and authorities in nursing education focus on these challenges and explore processes to successfully introduce this exam for assessment of nursing student capacity.

Factors influencing nurses participation in the health policy-making process: a systematic review

Background

Nurses as the majority of the health care workforce help in the health systems strengthening. Nurses’ involvement in health policy making is clear; however, still few are involved in policy-making processes, even in the clinical context. The aim of the present systematic review was to identify factors influencing nurses participation in the health policy-making process.

Methods

The present systematic review was designed on studies conducted between 2000 and 2019. Four online databases including PubMed, EMBASE, SCOPUS and Science Direct were searched using comprehensive terms. Study selection, quality assessment, data extraction, and data analysis were independently done by two reviewers. Inclusion criteria included published studies in English language and between 2000 to 2019, participants such as nurses and the healthcare managers, mentioned influential factors, types of participants were included nurses and the healthcare managers, study designs and methods clearly defined. The methodological quality of included article was appraised using the checklists of CASP and MMAT. Finally the data were analyzed using content analysis.

Results

After quality assessment, 11 studies, according to inclusion criteria, were retrieved. Nine studies had a good, 2 a medium, and non-articles was poor methodological quality. Three main themes include nursing-related factors (4 sub- themes), management and organizational factors (8 sub-themes) and creating a positive work environment (3 sub-themes) identified as affecting factors on nurses participation in health policy.

Conclusion

Nurses can utilize this finding to develop empowering programs to play efficient roles and increase their participation in health policy making. Also, the extracted factors in this review can place nurses in suitable position and make them potential agents in changing the ways of policy-making. Further studies are required to survey the relation between these factors and nursing participation in health policy making.

Identification of the components for investigation of the psychological strength of nursing applicants: A qualitative study

Aim

There is a lack of clarity about the components which would signify appropriate psychological strengths among nursing student candidates. This study was conducted to identify such components from the viewpoint of the clinical nurses and nursing instructors.

Design

A qualitative study.

Methods

This study comprised qualitative research using a conventional content analysis approach. Participants were 25 nurses and nursing instructors. Data were collected in audio‐recorded and transcribed semi‐structured interviews and were analysed using MAXQDA10 software.

Results

Analysis revealed four main categories including "anger management," "Stress/distress management," "self‐belief" and "aptitude for hard work."

Conclusions

This study identified core components for future investigations into the psychological strengths of nursing applicants. This study provides specific testable hypotheses for future research endeavours. It is recommended that the researchers investigate the appropriateness of the components identified in this study to assess the psychological strength of the applicants in the longitudinal studies.

Disrupted mothering in Iranian mothers with breast cancer: a hybrid concept analysis

Background

Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model.

Methods

The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed.

Results

In the theoretical phase, the following attributes were determined: “disturbance in maternal identity and roles”, “maternal insensitivity and unresponsiveness: disconnection physically and psychologically”, “the career disruption process” and “biographical disruption”. The fieldwork phase explored three themes including “the unbalance between multiple roles”, “role failure”, and “reduced maternal sensitivity”. The final synthesis yielded that the main integrated elements of mothering disruption are “disease as threating maternal role and identity”, “inability to interpret and respond to child behaviors and needs”, and “support for transitioning from being patient toward maternal competency”.

Conclusion

With a deeper understanding of the term ‘disrupted mothering’ or ‘mothering disruption’, healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01346-w.

Nursing process from theory to practice: Evidence from the implementation of "Coming back to existence caring model" in burn wards

Aim

To develop the caring model and utilize and evaluate the effect of the model in the nursing student's learning process in burn wards.

Design

A longitudinal multiphase study.

Methods

In the first phase, "Coming back to existence caring model" was developed, in the second phase, to evaluate the program, 35 students in the first semester and 31 students in the second semester of the 2017–2018 academic year were selected randomly, and their logbooks were analysed.

Results

Components of the nursing process, based on the model, were wound management, care and documentation, early mobilization, discharge planning and patient education. The lowest nursing process utilization in both semesters was in the sexuality domain. The most nursing diagnosis was a risk for infection. In the discharge plan, education about how the patient communicates with others in the second semester was less than other educational content (61/3%). However, empowering students was remarkable.

Effect of Empowerment Program with and without Telenursing on Self-efficacy and Glycosylated Hemoglobin Index of Patients with Type-2 Diabetes: A Randomized Clinical Trial

Introduction: Developing new training methods for improving the health of diabetic patients has always been a concern for nurses. The present study aims to investigate the effects of empowerment-based interventions with or without telenursing on self-efficacy and HbA1c level in diabetic patients.

Methods: In this randomized clinical trial, 156 patients with type-2 diabetes were randomly assigned into two intervention groups (empowerment with/without telenursing) and one control group. All subjects in the intervention groups participated in two sessions of the empowerment program. However, only the group of empowerment with telenursing received telephone counseling for 12 weeks. The patients in the control group did not receive any intervention programs. Self-efficacy was measured by diabetes-specific self-efficacy scale. The HbA1c level was measured using Bionic kit. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, Ill., USA).

Results: After 14 weeks, while the changes in self-efficacy scores of the control group were not statistically significant, they were significant in the two intervention groups. Comparison of the two intervention groups showed that self-efficacy was higher in the group of empowerment with telenursing. It was only in the empowerment with telenursing group that the reduction of HbA1 c was significant.

Conclusion: Training based on empowerment models and emphasis on the strengths of clients in solving their own problems can play a major role in increasing self-efficacy and reduction of HbA1c level. In addition, a continuous training program, along with telephone follow-ups can result in higher self-efficacy and lower HbA1c level.