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Kett PM, Bekemeier B, Herting JR, Altman MR. Addressing Health Disparities: The Health Department Nurse Lead Executive's Relationship to Improved Community Health. J Public Health Manag Pract 2022; 28:E566-E576. [PMID: 34475368 DOI: 10.1097/phh.0000000000001425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
CONTEXT The nurse-trained local health department (LHD) lead executive has been shown to be positively associated with LHD performance; however, no other research has explored whether this association translates to improved community health. OBJECTIVE To investigate the relationship between the type of LHD leadership-whether or not the lead executive is a nurse-and changes in health outcomes. DESIGN This study used a multivariate panel time series design. Each model was estimated as a pooled time series and using time and unit fixed effects, with a 1-year lag used for all covariates and the main predictor. SETTING A national, county-level data set was compiled containing variables pertaining to the LHD, community demographics, and health outcomes for the years 2010-2018. PARTICIPANTS The unit of analysis was the LHD. The data set was restricted to those counties with measurable mortality rates during at least 8 of the 9 time periods of the study, resulting in a total of 626 LHDs. MAIN OUTCOME MEASURES The outcomes of interest were changes in 15- to 44-year-old all-cause mortality, infant mortality, and entry into prenatal care. RESULTS In models with combined time and unit fixed effects, a significant relationship exists between a nurse-led LHD and reduced mortality in the 15- to 44-year-old Black population (-5.2%, P < .05) and a reduction in the Black-White mortality ratio (-6%, P < .05). In addition, there is a relationship between the nurse-led LHD and a reduction in the percentage of the population with late or no entry to prenatal care. CONCLUSIONS The evidence presented here helps connect the known positive association between nurse lead executives and LHD performance to improvements in community health. It suggests that nurse leaders are associated with health improvements in line with addressing health inequities.
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Affiliation(s)
- Paula M Kett
- Department of Child, Family, and Population Health, School of Nursing (Drs Kett, Bekemeier, and Altman), and Department of Sociology, College of Arts and Sciences (Dr. Herting), University of Washington, Seattle, Washington
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Zhao P, Ma XL. Developing mental health nursing strategies for the inbound quarantined population in China during the COVID-19 global pandemic. Eur Rev Med Pharmacol Sci 2021; 25:7964-7970. [PMID: 34982459 DOI: 10.26355/eurrev_202112_27646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of the study was to develop mental health nursing strategies for the inbound quarantined population based on the results of a survey study and frontline nursing experiences. SUBJECTS AND METHODS A mixed research method was selected, we collected data by questionnaires from 128 quarantined people, and by semi-structured interviews from 5 registered nurses. Generalized anxiety disorder-7 (GAD-7), the patient health questionnaire-9 (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), Social Support Rating Scale (SSRS) were used in the quantitative research to identify the prevalence of psychological issues and risk factors. Semi-structured interviews were conducted in the qualitative study to conclude nursing experiences from RNs. RESULTS The overall prevalence of anxiety, depression, and insomnia were 34%, 41%, and 18% respectively. Binary logistic regression analysis showed that social support, urban residence, and chronic disease were associated with mental health problems in certain aspects. Three themes were emerged from the analysis of RNs interviews: personality, chronic diseases, and social support. CONCLUSIONS The prevalence of mental health issues in the inbound quarantined population was the same as the general population in the initial stage of COVID-19 outbreak, and significantly lower than people who lived in high-risk areas. Living in urban areas, with chronic diseases, and obtaining less social support are the risk factors. Finally, four nursing strategies were proposed by the research team for mental health well-being.
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Affiliation(s)
- P Zhao
- First Affiliated Hospital of Kunming Medical University, Wu Hua District, Kunming City, Yunnan Province, China.
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Dechasa DB, Worku T, Baraki N, Merga BT, Asfaw H. Burnout and associated factors among nurses working in public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia. A cross sectional study. PLoS One 2021; 16:e0258224. [PMID: 34714836 PMCID: PMC8555845 DOI: 10.1371/journal.pone.0258224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burnout is a syndrome of emotional exhaustion, low personal accomplishment and depersonalization experienced by a health professional and it is more common in nurses due to high workload and job stress that is mostly caused by working proximity to patients and taking care of them. Burnout compromises the provision of quality health care. Despite this, there is no information in Ethiopia on burnout among nurses in study area. OBJECTIVES To determine the magnitude of burnout and associated factors among nurses working in public hospitals of Harari regional state and Dire Dawa administration, eastern Ethiopia, February 1-29, 2020. METHODS Institutional based quantitative cross-sectional study was employed from February 1-29 among 412 randomly selected nurses who have been working in hospitals for the last 6 months. Simple random sampling method was employed and data was collected by self-administered, standardized, reliable and valid, questionnaire (Maslachs Burnout Inventory- Human Services Survey). Data was entered into EpiData Version 3.1 and exported to statistical package for social science version 20 for analysis. All covariate with P-value less than 0.25 in bivariable analysis were candidate for multivariable analysis. Level of statistical significance was declared at p-value < 0.05. RESULTS Among 412 nurses taking part in this study, 183(44.4%) of nurses with 95% CI, had experienced burnout. Married marital status [AOR:2.3,95%CI:(1.2-4.3)], poor current health status [AOR:4.8, 95% CI:(1.1-21.4)] and fair current health status [AOR:12, 95% CI:(4.5-32)], working greater than eight hour per-day[AOR:0.52, 95%CI:(0.29-0.92)], intention to leave a job [AOR:0.48,95%CI:(0.2-0.88), being working in emergency room [AOR:0.3,95%CI:(0.1-0.98)] and using a different medication related to work related health problems were factors associated with nurses' burnout. CONCLUSION The nurses' burnout in this study is high and it is attributed by marriage, perceiving health status as poor and fair, whereas, having the intention to leave job, being working in emergency room and using a medication in relation to work related health problems reduced risk of developing burnout. So, the concerned bodies should provide trainings which focus on stress copying mechanisms and assertiveness program.
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Affiliation(s)
- Deribe Bekele Dechasa
- School of nursing and midwifery, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Teshager Worku
- School of nursing and midwifery, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Negga Baraki
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- School of nursing and midwifery, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
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Salvato M, Binda F, Iotti M, Bosco P, Laquintana D. [The prediction of hospitalization in triage: a comparison of instruments and methods of evaluation. A systematic revision]. Assist Inferm Ric 2021; 39:139-146. [PMID: 33077983 DOI: 10.1702/3454.34431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
. The prediction fo Hospitalization in triage: a comparison of instruments and methods of evaluation. A systematic revision. INTRODUCTION Overcrowding in the emergency department causes called-boarding, in addition to the increase of the waiting times, high costs and unsatisfied patients. Boarded patients are those admitted to an inpatient unit in the hospital that continue to wait in the emergency department for a bed to become available. The adoption of tools and methods to help the clinician to predict the admission in the triage phase could significantly improve patients flow. AIM To analyze and compare different tools and methods and to predict the hospitalization in the triage phase for adult patients. METHODS A systematic review was conducted by querying the PubMed and Cochrane databases, limited to the last 10 years articles. RESULTS Ten longitudinal observational studies analyzed the variables associated with admission, predictive ability of the clinical judgment of the triage nurse, predictive ability of validated objective scores, and cross compared the various methods of predicting admission. The variable most associated with admission was advanced age; both the clinical judgment of the triage nurse and the various scores showed a good predictive ability; the association of the clinical judgment of the triage nurse with one of the scores would offer more accurate predictions. DISCUSSION The ability to predict admission in the triage, through the use of validated scores and the clinical judgment of the triage nurse, could be the first step to reduce the boarding phenomenon and to improve the flow in the emergency department.
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Yu CH, McCann M, Sale J. "In my age, we didn't have the computers": Using a complexity lens to understand uptake of diabetes eHealth innovations into primary care-A qualitative study. PLoS One 2021; 16:e0254157. [PMID: 34234368 PMCID: PMC8263251 DOI: 10.1371/journal.pone.0254157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Shared decision-making is a central component of person-centred care and can be facilitated with the use of patient decision aids (PtDA). Barriers and facilitators to shared decision-making and PtDA use have been identified, yet integration of PtDAs into clinical care is limited. We sought to understand why, using the concepts of complexity science. METHODS We conducted 60-minute in-depth interviews with patients with diabetes, primary care physicians, nurses and dietitians who had participated in a randomized controlled trial examining the impact of MyDiabetesPlan (an online goal-setting PtDA). Relying on a qualitative description approach, we used a semi-structured interview guide to explore participants' experiences with using MyDiabetesPlan and how it was integrated into the clinical encounter and clinical care. Audiotapes were transcribed verbatim, then coded independently by two analysts. FINDINGS 17 interviews were conducted (5 physicians, 3 nurses, 2 dietitians, 7 patients). Two themes were developed: (1) MyDiabetesPlan appeared to empower patients by providing tailored patient-important information which engaged them in decision-making and self-care. Patients' use of MyDiabetesPlan was however impacted by their competing medical conditions, other life priorities and socioeconomic context. (2) MyDiabetesPlan emphasized to clinicians a patient-centred approach that helped patients assume greater ownership for their care. Clinicians' use of MyDiabetesPlan was impacted by pre-existing clinical tools/workplans, workflow, technical issues, clinic administrative logistics and support, and time. How clinicians adapted to these barriers influenced the degree to which MyDiabetesPlan was integrated into care. CONCLUSIONS A complexity lens (that considers relationships between multiple components of a complex system) may yield additional insights to optimize integration of PtDA into clinical care. A complexity lens recognizes that shared decision-making does not occur in the vacuum of a clinical dyad (patient and clinician), and will enable us to develop a family of interventions that address the whole process, rather than individual components. TRIAL REGISTRATION ClinicalTrials.gov NCT02379078.
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Affiliation(s)
- Catherine H. Yu
- Division of Endocrinology & Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Maggie McCann
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanna Sale
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Aynalem ZB, Yazew KG, Gebrie MH. Evidence-based practice utilization and associated factors among nurses working in Amhara Region Referral Hospitals, Ethiopia. PLoS One 2021; 16:e0248834. [PMID: 33740000 PMCID: PMC7978364 DOI: 10.1371/journal.pone.0248834] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Applying evidence-based practice during care provision is essential because it improves the quality of care, reduces health care costs, and increases patient and family satisfaction. However, information on evidence-based nursing practice and associated factors were not well studied and documented in the study area. Hence, this study aimed to assess utilization and associated factors of evidence-based practice among nurses working in Amhara Region Referral Hospitals, Ethiopia. METHODS An institution-based cross-sectional study was conducted from March 18 to April 16, 2019, in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data were collected using a pretested and self-administered questionnaire. Data were entered into Epi Info version 7.1.2.0 and exported to SPSS version 22.0 for analysis. The bivariable analysis was used primarily and variables with p-value < 0.2 were further examined using a multivariable logistic regression model to control con-founders. Then, variables' p-value < 0.05 with 95% CI was used to determine associated factors. RESULTS From 684 proposed nurses, 671 of them completed the questionnaire giving 98.1% response rate. Of these, 55% (95% CI: 51.2, 58.9) of them had good evidence-based practice utilization. Variables including single (AOR = 1.662: 95% CI: 1.089-2.536), fewer work experience (AOR = 1.849: 95% CI: 1.049-3.257), good knowledge (AOR = 2.044: 95% CI: 1.406-2.972), effective communication skill (AOR = 2.537: 95% CI: 1.744-3.689), EBP training (AOR = 3.224 95% CI: 1.957-5.311), internet access (AOR = 1.655: 95% CI: 1.119-2.448) and evidence-based guideline availability (AOR = 1.827: 95% CI: 1.249-2.673) were found to be predictors of evidence-based practice utilization. CONCLUSIONS The study revealed that evidence-based practice utilization among nurses is low. Availing evidence-based guidelines in the work area, improving facilities' internet access, and building nurses' evidence-based practice competencies through either by giving separate training or incorporating as part of the curriculum would improve its utilization.
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Affiliation(s)
| | - Kassahun Gebeyehu Yazew
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mignote Hailu Gebrie
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hendriks I, Zhuravloyv D, Bovill J, Boer F, Hogendoorn P. Women in healthcare in Imperial Russia: The contribution of the surgeon Nikolay I Pirogov. J Med Biogr 2021; 29:9-18. [PMID: 30638429 PMCID: PMC7859675 DOI: 10.1177/0967772018818049] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Nikolay Ivanovich Pirogov, one of the greatest Russian surgeons of the 19th Century, was convinced of the importance of deploying nurses to care for the casualties of war. With the support of Grand Duchess Elena Pavlovna, sister-in-law of Tsar Nikolas I, Pirogov realised the idea during the Crimean war when Russia became the first country to send female nurses to the battle front. Later in the 19th century, large numbers of Russian women trained as nurses under the auspices of the Russian Red Cross, founded in 1867. In peacetime, their expertise was extremely valuable.
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Affiliation(s)
- Inge Hendriks
- Leiden University Medical Centre, Executive
Board, Leiden, Netherlands
| | | | - James Bovill
- Department of Anaesthesia, Leiden University
Medical Centre, Leiden, Netherlands
| | - Fredrik Boer
- Directorate of Quality and Patient Safety,
Leiden University Medical Center, Leiden, Netherlands
| | - Pancras Hogendoorn
- Department of Pathology, Leiden University
Medical Center, Leiden, Netherlands
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Diehl E, Rieger S, Letzel S, Schablon A, Nienhaus A, Escobar Pinzon LC, Dietz P. The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources. PLoS One 2021; 16:e0245798. [PMID: 33481918 PMCID: PMC7822247 DOI: 10.1371/journal.pone.0245798] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/07/2021] [Indexed: 01/11/2023] Open
Abstract
Workload in the nursing profession is high, which is associated with poor health. Thus, it is important to get a proper understanding of the working situation and to analyse factors which might be able to mitigate the negative effects of such a high workload. In Germany, many people with serious or life-threatening illnesses are treated in non-specialized palliative care settings such as nursing homes, hospitals and outpatient care. The purpose of the present study was to investigate the buffering role of resources on the relationship between workload and burnout among nurses. A nationwide cross-sectional survey was applied. The questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ) (scale 'quantitative demands' measuring workload, scale 'burnout', various scales to resources), the resilience questionnaire RS-13 and single self-developed questions. Bivariate and moderator analyses were performed. Palliative care aspects, such as the 'extent of palliative care', were incorporated to the analyses as covariates. 497 nurses participated. Nurses who reported 'workplace commitment', a 'good working team' and 'recognition from supervisor' conveyed a weaker association between 'quantitative demands' and 'burnout' than those who did not. On average, nurses spend 20% of their working time with palliative care. Spending more time than this was associated with 'burnout'. The results of our study imply a buffering role of different resources on burnout. Additionally, the study reveals that the 'extent of palliative care' may have an impact on nurse burnout, and should be considered in future studies.
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Affiliation(s)
- Elisabeth Diehl
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Rieger
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anja Schablon
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Luis Carlos Escobar Pinzon
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Giorgetta S, Pasquot L. [The image of the nurse in the first phase of Covid-19 sanitary emergency in Italy: a Content Analysis of national and local newspapers]. Prof Inferm 2021; 74:31-40. [PMID: 34089639 DOI: 10.7429/pi.2021.741031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Media play a key part in shaping nurses' social perception. Newspapers were chosen as the subject of this content analysis, as they are the main resource that Italians use to inform themselves. For this reason, ne wspapers are an appropriate resource to analyse the image of the nurse that, as found in literature, is seen as a dynamic phenomenon that changes according to different scenarios. Given the media focus on nurses during COVID- 19 it seems reasonable to analyse what nurse image was emerged. METHOD A Content Analysis with an inductive process was conducted. The analysis' objective was to evaluate the image of the nurse in national and local newspapers, published between the 30th of January and the 18th of May 2020. A triangulation methodology was used between the two researchers to ensure data quality. R ESULTS Five themes were identified. The risks for the nurse's psycho-physic wellbeing. Taking responsibility and human relations despite barriers. The acknowledgment of professional attributes. Uncertainty on the continuity of the nurses' social role emerged from the media. Nurses only wish to be appreciated for what they do. The agreement between the researchers on the themes has a Krippendor ff 's alpha between =0.713 and =0.985. CONCLUSIONS The media's interest highlighted the nurses' competence in assisting patients with COVID-19. However, there isn't in-depth analysis, of the contemporar y image of the nurse, specifically in relation to leadership. Positive and negative tropes are recalled. The superficiality and fragility of the mediatic phenomena emerged, as opposed to a real positive strengthening of the nurse's social perception.
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Affiliation(s)
- Stefano Giorgetta
- RN, Ospedale di Menaggio, Azienda Socio Sanitaria Territoriale Lariana, Virginia Casartelli 7, 22017 Menaggio (CO)
| | - Laura Pasquot
- RN, MSc, Adj Prof. Nursing Science, University of Milan, Carlo Pascal 36, 20133 Milano. Corresponding Author:
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Matis C, Ducloux D, Ougier-Bouilloux A, Guisado H. [Not Available]. Rev Med Suisse 2020; 16:2012-2014. [PMID: 33085263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Caroline Matis
- Infirmière responsable équipe mobile de consultation soins palliatifs, Service de médecine palliative, Département de réadaptation et gériatrie, HUG, Hôpital de Bellerive, 1245 Collonge-Bellerive
| | - Dominique Ducloux
- Infirmière spécialisée équipe mobile de consultation soins palliatifs, Service de médecine palliative, Département de réadaptation et gériatrie, HUG, Hôpital de Bellerive, 1245 Collonge-Bellerive
| | - Aude Ougier-Bouilloux
- Infirmière spécialisée équipe mobile de consultation soins palliatifs, Service de médecine palliative, Département de réadaptation et gériatrie, HUG, Hôpital de Bellerive, 1245 Collonge-Bellerive
| | - Huguette Guisado
- Infirmière adjointe responsable des soins, Service de médecine palliative, Département de réadaptation et gériatrie, HUG, Hôpital de Bellerive, 1245 Collonge-Bellerive
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Rivaz M, Asadi F, Mansouri P. Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units. Invest Educ Enferm 2020; 38:e12. [PMID: 33306902 PMCID: PMC7885543 DOI: 10.17533/udea.iee.v38n3e12] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). METHODS This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). RESULTS Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p < 0.001). CONCLUSIONS Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.
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Affiliation(s)
- Mozhgan Rivaz
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Iran,
| | - Fatemeh Asadi
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Iran,
| | - Parisa Mansouri
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Iran,
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Rivaz M, Kazemi SM, Mosallanezhad M. COVID-19: Threat or Opportunity? Invest Educ Enferm 2020; 38:e02. [PMID: 33306892 PMCID: PMC7885546 DOI: 10.17533/udea.iee.v38n3e02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic is spreading quickly. Despite scientists’ best efforts all over the world, there is not a vaccine or definite treatment for it and the novel coronavirus remains a threat to humanity with far-reaching, and in many cases, irredeemable consequences for the economic, political, social-psychological , and cultural aspects of humans’ lives.(1)The quick transmission and fatality of the disease, absence of herd immunity, lack of or inequitable distribution of resources, e.g. Personal Protective Equipment ( PPE), and the existing challenges in the implementation of social distancing result in a daily increase in the number of victims and, consequently, an ever-expanding workload in healthcare systems worldwide. Moreover, the increasing mortality and morbidity of COVID-19 and lack of hospital beds and ventilators have led to healthcare provider’s exhaustion and burnout.(1,2) Healthcare providers, especially nurses are the most vulnerable group in the face of the current disaster. Unfortunately, In the world, many front-line experts have lost their lives.(3)
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Affiliation(s)
- Mozhgan Rivaz
- Department of Nursing, Shiraz University of Medical Sciences, Iran,
| | | | - Mina Mosallanezhad
- Student research committee, Shiraz University of Medical Sciences, Iran,
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Rodrigues MENG, Belarmino ADC, Custódio LL, Gomes ILV, Ferreira Júnior AR. Communication in health work during the COVID-19 pandemic. Invest Educ Enferm 2020; 38:e09. [PMID: 33306899 PMCID: PMC7885535 DOI: 10.17533/udea.iee.v38n3e09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Report on communication and qualified listening in nursing work in the face of the COVID-19 pandemic. METHODS This descriptive, theoretical and reflexive report was developed by nurses between March 20th and May 25th 2020 at Emergency Care Services in the city of Fortaleza, Ceará, Brazil. Health communication served as the theoretical background for this research. RESULTS Two main thematic categories were highlighted: (i) Resignifications of communication in the work relationships of the health team and (ii) Guided listening to users by nurses at the Emergency Care Services during the pandemic. CONCLUSIONS The experience revealed an excerpt of what is found under the conditions of the current situation resulting from COVID-19. Communication turned into an essential tool to maintain professional relationships and culminate in collaboration and cooperation of the team in order to provide a close relationship with the user and promote the quality of health care processes.
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Olofinbiyi OB, Dube M, Mhlongo EM. A perception survey on the roles of nurses during triage in a selected public hospital in Kwazulu-Natal Province, South Africa. Pan Afr Med J 2020; 37:9. [PMID: 32983327 PMCID: PMC7501752 DOI: 10.11604/pamj.2020.37.9.22211] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/03/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION triage is gradually becoming an autonomous nursing role essential to patients' safety and the efficient delivery of emergency care. The increased need for more holistic and advanced care during triage makes the role of nurses during triage highly indispensable. However, several studies have shown that nurse-led triage has been so successful over the years in most African countries and in other developing countries. South African Triage Scale (SATS) is an example of triage tool that was designed in such a way that the lowest cadre nurse can successfully implement. The success recorded by this tool made most African countries and some other developing countries adopt the tool. The study was designed to explore the roles of nurses during triage in a selected public hospital in KwaZulu-Natal province. METHODS this study utilized a quantitative approach, in which a non-experimental survey involving convenience sampling technique was chosen as the most suitable sampling technique for the study. Recognition-primed decision model formed the framework of the study. Ethical clearance was obtained from University of KwaZulu-Natal Ethics Review Board and ethics principles were observed during the study. RESULTS the result of the study indicated that majority (100%) of the respondents perceived that nurses have lots of roles to perform during triage. They further unveiled that it is highly paramount for nurses to manage the waiting room and control overcrowding in the unit. CONCLUSION the study draws on the need for qualified and experienced nurses to be in charge of these roles in order to reduce the mortality and morbidity rates that usually occur during triage administration.
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Affiliation(s)
| | - Makhosazane Dube
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Euphemia Mbali Mhlongo
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
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Baye Y, Demeke T, Birhan N, Semahegn A, Birhanu S. Nurses' work-related stress and associated factors in governmental hospitals in Harar, Eastern Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0236782. [PMID: 32745142 PMCID: PMC7398531 DOI: 10.1371/journal.pone.0236782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Work-related stress causes poor quality of nursing care and increases the risk of medical errors. Research evidence is so limited to nurses’ work-related stress in eastern Ethiopia. Therefore, this study aimed to assess work-related stress and associated factors among nurses working in governmental hospitals in Harar, Eastern Ethiopia. Methods Institution-based quantitative cross-sectional study was conducted among 367 nurses from 15th to 30th March, 2015. Simple random sampling technique was applied to recruit study participants. Data were collected using structured self-administered questionnaire. Descriptive statistics, bivariate and multivariate logistic regressions were carried out. The statistical association was declared using adjusted odds ratio at 95% confidence interval (CI) and P-value of less than 0.05. Results A total of 398 study participants were involved in the study, and the response rate was 92.2% (367/398). More than half of 202(55%) of the participants were males. One third (33.8%, n = 124) of study participants’ age ranged between 26 to 34 years. The prevalence of work-related stress in the current study was 66.2%. Nurses, who reared child (AOR = 2.1, 95% CI: 1.2, 3.7), working in intensive care units (AOR = 4.5, 95% CI: 1.4, 17.7), work on rotation (AOR = 2.5, 95% CI: 1.4, 4.4), and nurses who had a chronic medical illness (AOR = 2.6, 95% CI: 1.2, 5.7) were significantly associated with nurses’ work-related stress. Conclusion Two-thirds of nurses who were working at government hospitals had work-related stress. Work-related stress was associated with child-rearing, working units, work on rotation, and chronic medical illness. We suggested the hospital's administration, and other concerned stakeholders should design a strategy to undertake necessary measures such as hiring more nurses to minimize workload and rescheduling work shift to alleviate work-related stress among nurses.
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Affiliation(s)
- Yohannes Baye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- * E-mail:
| | - Tesfaye Demeke
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigusie Birhan
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agumasie Semahegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Simon Birhanu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Bosun-Arije FS, Ling J, Graham Y, Hayes C. Organisational factors influencing non-pharmacological management of type 2 diabetes mellitus (T2DM) in public hospitals across Lagos, Nigeria: A qualitative study of nurses' perspectives. Diabetes Res Clin Pract 2020; 166:108288. [PMID: 32615277 DOI: 10.1016/j.diabres.2020.108288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/24/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence and incidence of Type 2 Diabetes mellitus (T2DM) are significantly increasing in Nigeria. Effective management of the condition, in clinical settings, can be achieved with a minimal financial cost, but this is often overlooked. It is crucial to understand organisational factors influencing non-pharmacological management of T2DM in Nigerian public hospitals for effective management of patients diagnosed with the condition. AIM To examine healthcare delivery services influencing patient management and seek approaches to heighten optimisation of patient health outcomes. METHODS Adopting a qualitative case study design, we used the Constant Comparative Method and semi-structured questions to interview17 nurses in public hospitals across Lagos. Using the five stages of the Framework Analysis process, the transcribed interviews were thematically analysed. RESULTS Nurses suggested that a complex, multifaceted system constituted organisational factors influencing T2DM management in public hospitals across Lagos, Nigeria. Specific factors identified were levels of available information and knowledge, relationship, policy and decision-making management. These factors were, in turn, linked to political, infrastructural, health professional and the environments within which patients were given health services. CONCLUSIONS The study revealed a significant gap in the organisation of care for individuals diagnosed with T2DM in public hospitals across Lagos. Timely and affordable strategies have been highlighted to secure effective care delivery to patients.
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MESH Headings
- Adult
- Attitude of Health Personnel
- Decision Making, Organizational
- Delivery of Health Care/organization & administration
- Delivery of Health Care/standards
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/nursing
- Diabetes Mellitus, Type 2/therapy
- Female
- Health Knowledge, Attitudes, Practice
- Health Services/standards
- Hospitals, Public/organization & administration
- Hospitals, Public/standards
- Hospitals, Public/statistics & numerical data
- Humans
- Male
- Middle Aged
- Nigeria/epidemiology
- Nurses/organization & administration
- Nurses/psychology
- Nurses/standards
- Nurses/statistics & numerical data
- Perception
- Practice Patterns, Nurses'/organization & administration
- Practice Patterns, Nurses'/standards
- Practice Patterns, Nurses'/statistics & numerical data
- Qualitative Research
- Socioeconomic Factors
- Surveys and Questionnaires
- Treatment Outcome
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Affiliation(s)
- Foluke Stella Bosun-Arije
- Manchester Metropolitan University, Faculty of Health, Psychology and Social Care, Department of Nursing, United Kingdom.
| | - Jonathan Ling
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Yitka Graham
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Catherine Hayes
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
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Anthony MR, Brett AL. Nurse leaders as problem-solvers: Addressing lateral and horizontal violence. Nurs Manag (Harrow) 2020; 51:12-19. [PMID: 32665502 DOI: 10.1097/01.numa.0000688928.78513.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Michelle R Anthony
- Michelle R. Anthony is a program coordinator at Columbia (S.C.) VA Health Care System. Anne Liners Brett is doctoral faculty at the University of Phoenix in Tempe, Ariz
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Zakumumpa H. Reimagining the role of the nursing workforce in Uganda after more than a decade of ART scale-up. Hum Resour Health 2020; 18:39. [PMID: 32471426 PMCID: PMC7257122 DOI: 10.1186/s12960-020-00479-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/11/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND The expanding roles and increasing importance of the nursing workforce in health services delivery in resource-limited settings is not adequately documented and sufficiently recognized in the current literature. Drawing upon the theme of 2020 as the International Year of the Nurse and the Midwife, we set out to describe how the role of nurses expanded tremendously in health facilities in Uganda during the era of anti-retroviral therapy (ART) scale-up that commenced in June 2004. METHODS We employed a mixed-methods sequential explanatory research design. Phase I entailed a cross-sectional health facility survey (n = 195) to assess the extent to which human resource management strategies (such as task shifting) were common. Phase II entailed a qualitative multiple case study of 16 (of the 195) health facilities for an in-depth understanding of the strategies adopted (e.g. nurse-centred HIV care). Descriptive analyses were performed in STATA (v 13) while qualitative data were analysed by thematic approach. RESULTS We found that nurses were the most represented cadre of health workers involved in the overall leadership of HIV clinics across Uganda. Most nurse-led HIV clinics were based in rural settings; however, this trend was fairly even across setting (rural/urban/peri-urban). While 181 (93%) health facilities allowed non-physician cadre to prescribe ART, a number of health facilities (n = 36) or 18% deliberately adopted nurse-led HIV care models. Nurses were empowered to be multi-skilled with a wide range of competencies across the HIV care continuum right from HIV testing to mainstream clinical HIV disease management. In several facilities, nursing cadre were the backbone of ART service delivery. A select number of facilities devised differentiated models of task shifting from physicians to nurses in which the latter handled patients who were stable on ART. CONCLUSION Overall, our study reveals a wide expansion in the scope-of-practice of nurses during ART scale-up in Uganda. Nurses were thrust in roles of HIV disease management that were traditionally the preserve of physicians. Our study underscores the importance of reforming regulatory frameworks governing nursing workforce scope of practice such as the need for developing a policy on task shifting which is currently lacking in Uganda.
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Affiliation(s)
- Henry Zakumumpa
- Makerere University, School of Public Health, P O Box 7072, Kampala, Uganda.
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Bain K, Hansen AS. Strengthening implementation success using large-scale consensus decision-making - A new approach to creating medical practice guidelines. Eval Program Plann 2020; 79:101730. [PMID: 31785473 DOI: 10.1016/j.evalprogplan.2019.101730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 09/10/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
A study involving over 2000 stoma care nurses in the development of best practice guidelines for the assessment of peristomal body profiles, patient engagement and patient follow-up was conducted in 2018. The study was designed to develop guidelines for stoma care treatment and product selection and to decrease the evidence to implementation gap. The project built on research evidence from a literature review of 77 articles. The results of the literature review were then used to inform a series of Delphi surveys sent out to stoma care nurses through Association and industry list-serves in 11 languages. The Delphi surveys were followed by a face2face professionally facilitated discussions among nurse-research experts. The project concluded with a facilitated consensus dialogue among 960 stoma care nurses from 25 countries, resulting in an implementation plan to ensure the guidelines become a normal part of routine patient care. The study resulted in a set of medical practice guidelines for stoma care nurses, designed to improve patient outcomes and patient quality of life, that were accepted and adopted into routine medical practice across 25 countries. This article describes the study and how the process used, coined the 'Modified Delphi Process' by the process designer, led to faster implementation than is generally experienced in the medical community.
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Buchan J, Campbell J, McCarthy C. Research to support evidence-informed decisions on optimizing the contributions of nursing and midwifery workforces. Hum Resour Health 2020; 18:23. [PMID: 32197652 PMCID: PMC7082898 DOI: 10.1186/s12960-020-0459-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- James Buchan
- Human Resources for Health, BMC, London, United Kingdom
- University of Technology, Sydney, Australia
| | - James Campbell
- Health Workforce Department, World Health Organization, Geneva, Switzerland
| | - Carey McCarthy
- Health Workforce Department, World Health Organization, Geneva, Switzerland
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Byrne AL, Baldwin A, Harvey C. Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One 2020; 15:e0229923. [PMID: 32155182 PMCID: PMC7064187 DOI: 10.1371/journal.pone.0229923] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/18/2020] [Indexed: 11/19/2022] Open
Abstract
AIM The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. METHOD/DATA SOURCES An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. REVIEW METHODS The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. RESULTS While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. CONCLUSION The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.
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Affiliation(s)
- Amy-Louise Byrne
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Adele Baldwin
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
| | - Clare Harvey
- Central Queensland University School of Nursing, Midwifery and Social Science, Townsville, Queensland, Australia
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George M, Hernandez C, Smith S, Narsavage G, Kapella MC, Carno M, Guttormson J, Disler RT, Hart DE, Chlan LL, Happ MB, Chen Z, Hetland B, Hutchinson AF, Jonsdottir H, Redeker NS, Schell-Chaple H, Fletcher M, Yorke J. Nursing Research Priorities in Critical Care, Pulmonary, and Sleep: International Delphi Survey of Nurses, Patients, and Caregivers. Ann Am Thorac Soc 2020; 17:1-10. [PMID: 31891300 PMCID: PMC6944344 DOI: 10.1513/annalsats.201909-705st] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The objective of this workshop was to determine current nursing research priorities in critical care, adult pulmonary, and sleep conditions through input from consumer (patient, family, and formal and informal caregivers) and nursing experts around the world. Working groups composed of nurses and patients selected potential research priorities based on patient insight and a literature review of patient-reported outcomes, patient-reported experiences, and processes and clinical outcomes in the focal areas. A Delphi consensus approach, using a qualitative survey method to elicit expert opinion from nurses and consumers was conducted. Two rounds of online surveys available in English, Spanish, and Chinese were completed. A 75% or greater threshold for endorsement (combined responses from nursing and consumer participants) was determined a priori to retain survey items. A total of 837 participants (649 nurses and 188 patients, family, and/or caregivers) from 45 countries responded. Survey data were analyzed and nursing research priorities that comprise 23 critical care, 45 adult pulmonary, and 16 sleep items were identified. This project was successful in engaging a wide variety of nursing and consumer experts, applying a patient-reported outcome/patient-reported experience framework for organizing and understanding research priorities. The project outcome was a research agenda to inform, guide, and aid nurse scientists, educators, and providers, and to advise agencies that provide research and program funding in these fields.
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Affiliation(s)
- Joyce Sensmeier
- Joyce Sensmeier is a senior advisor, informatics, at the Healthcare Information and Management Systems Society in Chicago, Ill., and a Nursing Management editorial board member
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Luciani M, Campbell KA, Whitmore C, Di Mauro S, Jack SM. How to critically appraise a qualitative health research study. Prof Inferm 2019; 72:283-293. [PMID: 32243743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Evidence-based nursing is a process that requires nurses to have the knowledge, skills, and confidence to critically reflect on their practice, articulate structured questions, and then reliably search for research evidence to address the questions posed. Many types of research evidence are used to inform decisions in health care and findings from qualita- tive health research studies are useful to provide new insights about individuals' experi- ences, values, beliefs, needs, or perceptions. Before qualitative evidence can be utilized in a decision, it must be critically appraised to determine if the findings are trustworthy and if they have relevance to the identified issue or decision. In this article, we provide practical guidance on how to select a checklist or tool to guide the critical appraisal of qualitative studies and then provide an example demonstrating how to apply the critical appraisal process to a clinical scenario.
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Affiliation(s)
- Michela Luciani
- RN, MScN, PhD, School of Nursing, Dept. of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy.
| | - Karen A Campbell
- RN MScN PhD student, School of Nursing, McMaster University,Hamilton, Ontario, Canada
| | - Carly Whitmore
- RN, PhD student, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Stefania Di Mauro
- RN, MScN PhD, School of Nursing, Dept. of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - Susan M Jack
- RN, PhD, School of Nursing, McMaster University, Hamilton, Ontario, Canada
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Barría P RM. Wildfires as a Public Health Problem: a Setting for Nursing in Disasters. Invest Educ Enferm 2019; 37:e01. [PMID: 31830399 PMCID: PMC7871501 DOI: 10.17533/udea.iee.v37n3e01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Climate change and global warming are phenomena that are progressively affecting the planet. Temperature changes have been posing mayor threats for different domains of human society. One of these threats is related to health due extreme temperatures, and natural disasters. Thus, it is constituted as a global threat to biodiversity and the human population, since not only affects ecosystems equilibrium but increasing wildfires as consequence of increased temperaturesand diminished precipitations. Moreover,wildfires have concentrated attention not only because of their ecological and environmental consequences but also for affecting production, economics, and health of people potentially exposed to environmental risks such fire, smoke, and others chemical products released from wood combustion process. How to cite this article: Barría RM. Wildfires as a Public Health Problem: a Setting for Nursing in Disasters. Invest. Educ. Enferm. 2019;37(3):e01.
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Brixner D, Rubin DT, Mease P, Mittal M, Liu H, Davis M, Ganguli A, Fendrick AM. Patient Support Program Increased Medication Adherence with Lower Total Health Care Costs Despite Increased Drug Spending. J Manag Care Spec Pharm 2019; 25:770-779. [PMID: 31081461 PMCID: PMC10398065 DOI: 10.18553/jmcp.2019.18443] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The U.S. health care system is currently evolving from a volume-based care to a value-based care approach, which is in part supported by the introduction of patient support programs (PSP). For patients treated with adalimumab (ADA), the addition of a dedicated, trained nurse to the PSP (HUMIRA Complete, rolled out nationally in 2015) provides further emphasis on value-based care. OBJECTIVE To determine the effectiveness of the HUMIRA Complete PSP, including the Nurse Ambassador component, in a real-world setting for patients receiving ADA across a broad range of approved indications (rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, psoriatic arthritis, ankylosing spondylitis, uveitis, and hidradenitis suppurativa). METHODS A longitudinal retrospective study was conducted using patient-level data from the HUMIRA Complete PSP data linked to the real-world, patient-level Symphony Health Solutions administrative claims database. Commercially insured patients were included who were aged ≥ 18 years with ≥ 2 diagnoses of an indicated disease who were biologically naive before initiating ADA or who had no claims for synthetic-targeted immune modulator therapy before their earliest ADA claim in the database between January 2015 and February 2017. The first claim had to have occurred in 2015 or later, and continuous medical and drug data coverage were required for ≥ 6 months before and ≥ 12 months after the first ADA claim and index date. PSP patients (with at least an initial and follow-up dedicated nurse call) were matched 1:1 to non-PSP patients based on pharmacy type, indication, and propensity score, estimated with covariates for age, sex, year of first ADA use, and baseline comorbidities. Adherence to ADA was compared using proportion of days covered along with discontinuation of ADA, defined as a gap in treatment greater than the previous days supply with no additional ADA claim, total costs, medical costs, and drug costs (2017 U.S. dollars) over 12 months. Baseline demographic and clinical characteristics were summarized descriptively. Differences between cohorts were assessed using t-tests for adherence and costs and log-rank tests for discontinuation. RESULTS 2,268 patients (1,134 per group) were included. Baseline characteristics were similar between cohorts after matching. Participation in the PSP was associated with 29.3% higher ADA adherence (64.8% vs. 50.1%; P < 0.0001) and 22.0% lower ADA discontinuation rate (51.4% vs. 65.9%; P < 0.0001). Disease-related medical costs and all-cause medical costs were significantly lower by 35% ($10,162 vs. $15,511; P = 0.005) and 29.2% ($25,074 vs. $35,419; P = 0.0004), respectively, for PSP versus non-PSP patients. Total costs were also lower by 9% ($62,421 vs. $68,706; P = 0.056), and drug costs were 12.2% higher ($37,347 vs. $33,287; P = 0.0016). CONCLUSIONS This retrospective study demonstrates that participation in the PSP augments value-based care by improving outcomes for patients with chronic diseases by helping them not only manage a complex treatment regimen but also lower annual health care costs. DISCLOSURES Design, study conduct, and financial support for this study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the manuscript; all authors contributed to the development of the publication and maintained control over the final content. Brixner reports consulting fees from AbbVie, AstraZeneca, Becton Dickinson, Millcreek Outcomes Group, Sanofi, and UCB Pharma. Rubin reports consulting fees from AbbVie, Abgenomics, Allergan, Forward Pharma, Genentech/Roche, Janssen Pharmaceuticals, Merck & Co., Napo Pharmaceuticals, Pfizer, Shire, Takeda, and Target Pharmaceuticals and research support from AbbVie, Genentech/Roche, Janssen Pharmaceuticals, Prometheus Laboratories, Shire, and Takeda. Mease reports grant/research support from AbbVie, Amgen, BMS, Celgene, Genentech, Janssen, Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB; consulting fees from AbbVie, Amgen, BMS, Celgene, Genentech, Janssen, Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB; and served on the speakers bureaus for AbbVie, Amgen, BMS, Celgene, Genentech, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, and UCB. Mittal and Ganguli are employees and stockholders of AbbVie. Liu has no financial conflict of interest. Davis is an employee of Medicus Economics, which reports payment from AbbVie to participate in this research. Fendrick reports personal fees from Merck, AstraZeneca, Trizetto, Amgen, Lilly, AbbVie, Johnson & Johnson, and Sanofi; grants from the National Pharmaceutical Council, PhRMA, the Gary and Mary West Health Foundation, the states of New York and Michigan, the Laura and John Arnold Foundation, the Robert Wood Johnson Foundation, and the Agency for Healthcare Research and Quality; and has equity in Zansors, Sempre Health, Wellth, and V-BID Health. Data from this study were presented in part at the Academy of Managed Care & Specialty Pharmacy Annual Meeting; April 25, 2018; Boston, MA.
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Affiliation(s)
- Diana Brixner
- University of Utah College of Pharmacy, Salt Lake City
| | - David T. Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois
| | - Philip Mease
- Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington
| | | | - Harry Liu
- RAND Corporation, Boston, Massachusetts
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Tiozzo E, Marchetti A, Nicolai I, Fosco C, Dall'Oglio I, Gawronski O, Guerrieri S, Spagnul C, Rubei D, Ciaralli I, Raponi M. Counseling for pediatric patients undergoing hematopoietic stem cell transplantation and their parents: A pilot descriptive study. Prof Inferm 2019; 72:213-220. [PMID: 31883572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to: (1) to assess the Quality of Life (QoL) of pediatric patients who had undergone Hematopoietic Stem Cell Transplantation (HSCT) and their parents; (2) to explore how patients and parents perceived a nurse counseling intervention; and (3) to explore how health professionals consider the nurse counselor's role. METHODS This was a pilot descriptive study using quantitative and qualitative data. RESULTS Parents' QoL was compromised in the domains of Social Functioning, Physical and Emotional roles. Patients' QoL was poor in all the domains except in Behavior and Family Cohesion. Patients and their parents considered the counseling as an effective help. Seven categories emerged from the analysis of qualitative data: support and taking charge, empathy, active communication and listening, evasion, sharing, awareness, and organizational availability. Regarding health professionals, five categories emerged from the analysis of the interviews and a focus group: support and taking charge, recovery in self-expression, support in relationship with patients and family, connecting role, and difficult integration within the team. CONCLUSIONS The nurse counselor could empower patients and parents to improve their attitudes towards care pathway. The nurse counselor can be an important resource in the context of HSCT, even if greater integration within the team is required.
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Affiliation(s)
- Emanuele Tiozzo
- PedRN, MSN, Nursing and Allied Health Professional Development, Continuing Education and Research Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anna Marchetti
- RN, MSN, PhD, Nursing and Allied Health Professional Development, Continuing Education and Research Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Isabella Nicolai
- PedRN, MSN-Counselling, Oncology and Hematology Department Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carla Fosco
- PedRN,MSN-Counselling Medical-Surgical Department of Pediatric Cardiology, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Immacolata Dall'Oglio
- PedRN, MSN, PhD, Nursing and Allied Health Professional Development, Continuing Education and Research, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Orsola Gawronski
- RN, MSN, PhD, Nursing and Allied Health Professional Development, Continuing Education and Research Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Sara Guerrieri
- RN, Hepatology and Gastroenterology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Chiara Spagnul
- RN, Pediatrics Unit Gesù Children's IRCCS, Rome, Italy Bambino Hospital
| | - Desiree Rubei
- PedRNOncology and Hematology Unit Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Italo Ciaralli
- PedRN, Oncology and Hematology Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimiliano Raponi
- MD, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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De Caro W. [Editorial.Advancend Nursing Practice. If not now, when?]. Prof Inferm 2019; 72:163-164. [PMID: 31883566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Chen WB, Spiker D, Wei X, Gaylor E, Schachner A, Hudson L. Who Gets What? Describing the Non-supervisory Training and Supports Received by Home Visiting Staff Members and its Relationship with Turnover. Am J Community Psychol 2019; 63:298-311. [PMID: 31099421 DOI: 10.1002/ajcp.12331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The early childhood home visiting field lacks a basic understanding of home visiting program staff members' receipt of on-the-job training from experts outside of their programs who are not their immediate colleagues or supervisors. To address this gap, we created a unique dataset by asking program leaders to log the external technical assistance (TA) that staff members received, and we collected a survey from 288 of the same staff members. We performed descriptive analyses to learn how many hours of TA staff members were receiving, what topics the TA most commonly addressed, and what formats (e.g., in-person or virtual/remote, individual, or group) the TA was most commonly provided in. We then associated characteristics of the TA received with staff and program characteristics, as well as with staff members' turnover. Multilevel analyses showed the TA supports that home visiting staff members received differed by role (home visitor or supervisor) and program characteristics, including home visiting model-Nurse Family Partnership (NFP) or Parents as Teachers (PAT)-program size, and maturity. About 23% of the home visiting staff members left their programs over the course of 18 months. PAT staff members were more likely to leave their programs than NFP staff members. We did not find that characteristics of TA received were predictive of staff members' turnover. Implications and the need for further research are discussed.
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Affiliation(s)
| | | | - Xin Wei
- SRI International, Menlo Park, CA, USA
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Hörberg A, Lindström V, Scheja M, Conte H, Kalén S. Challenging encounters as experienced by registered nurses new to the emergency medical service: explored by using the theory of communities of practice. Adv Health Sci Educ Theory Pract 2019; 24:233-249. [PMID: 30443693 PMCID: PMC6483944 DOI: 10.1007/s10459-018-9862-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 11/03/2018] [Indexed: 06/09/2023]
Abstract
The aim of this study was to explore challenging encounters experienced by registered nurses (RN) during their first year in the emergency medical service by using the social learning theory of communities of practice. During the first year in a new professional practice, a new RN experiences a transition during which the new professional identity is being formed. This is a challenging and demanding period of time. According to the learning theory of communities of practice by Lave and Wenger, individuals' learning and development in a new professional practice occurs through participation in social activity and is influenced by context. This study is based on the qualitative data from semi-structured interviews. Thirty-two RNs working in the Swedish emergency medical service were interviewed via telephone during the spring of 2017. A qualitative content analysis with deductive reasoning of the interviews was used. The analysis process generated the main category; New RNs participation is challenged by unpredictability and uncertainty in practice. The main category was based on three generic categories; Loneliness in an unpredictable context, Uncertainty about the team, and Uncertainty in action. The challenges new RNs encounter during the first year relate to all three dimensions of a community of practice; mutual engagement, joint enterprise and shared repertoire. The encountered challenges also relate to the EMS context. Taking into account all these aspects when designing support models for RN's professional development may be advantageous for creating positive development for RNs new to the EMS and/or similar practices.
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Affiliation(s)
- Anna Hörberg
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
- Academic EMS Stockholm, Stockholm, Sweden.
| | - Veronica Lindström
- Academic EMS Stockholm, Stockholm, Sweden
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Max Scheja
- Department of Education, Stockholm University, Stockholm, Sweden
| | - Helen Conte
- Department of Neurobiology Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Kalén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden
- Stockholm City Council, Stockholm, Sweden
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In questo numero. Recenti Prog Med 2019; 110:151. [PMID: 31066357 DOI: 10.1701/3154.31337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Wright K. A programmatic approach to sustained evidence-based practice. JBI Database System Rev Implement Rep 2019; 17:126-128. [PMID: 30730477 DOI: 10.11124/jbisrir-d-19-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Kylie Wright
- Director of Patient Safety and Quality, Liverpool Hospital Clinical Governance Unit, Liverpool Hospital, Liverpool, New South Wales, Australia
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Abstract
BACKGROUND Motivation is a significant concern for workforce management in healthcare organizations as it is linked to many important factors, such as performance, staff retention, and satisfaction. AIM To assess motivation level, assess sources of motivation, and identify the difference in motivation level in relation to nurses' characteristics. SETTING The study was carried out in one major tertiary hospital in Riyadh, Kingdom of Saudi Arabia. PARTICIPANTS A total convenient sample of 550 nurses were recruited. All participants are working under the umbrella of executive nursing administration. METHODS Data were collected using a self-administered questionnaire, which consisted of 30 items that focused on assessing a nurse's motivation sources and level. RESULTS In general, 346 nurses (62%) fully completed the survey. The average motivation level of nurses is 3.6 ± 0.5. Additionally, internal self-concept motivation was identified as the most predominant source of motivation (4.1 ± 0.6). Instrumental and goal internalization motivations ranked second (3.7 ± 0.6), whereas external self-concept (3.4 ± 0.7) and intrinsic (3 ± 0.7) motivations are the lowest sources of motivation. There is a significant difference in the motivation mean between males and females (P = 0.034). Another significant difference was revealed with different years of experience ( P = 0.021). CONCLUSION The high percentage of internal self-concept motivation among nurses signified that nurses needed more than enjoyment of their work atmosphere, social acknowledgment, higher salary, and good rationale to give maximum effort. Although these should be taken into consideration, more attention should be given to practices that improve a nurse's challenge, autonomy, internal value, and competency.
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Affiliation(s)
- Omar Abu Yahya
- Palliative Care Unit, Comprehensive Cancer Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
| | - Samantha Ismaile
- Higher Colleges of Technology (HCT), Sharjah Women College, Faculty - Health Sciences (Nursing), United Arab Emirates (UAE)
| | | | - Baraa M Hammoudi
- Hematopoietic Stem Cell Transplantation, Comprehensive Cancer Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
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Tognoni G. [Do roots have a future?]. Assist Inferm Ric 2019; 38:2-5. [PMID: 30933184 DOI: 10.1702/3129.31102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Palese A, Mattiussi E, Fabris S, Caruzzo BD, Achil I. [The 'Back to the Basics' movement: return to the past or sign of a 'mature' nursing?]. Assist Inferm Ric 2019; 38:49-52. [PMID: 30933192 DOI: 10.1702/3129.31110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Anokye N, Fox-Rushby J, Sanghera S, Cook DG, Limb E, Furness C, Kerry SM, Victor CR, Iliffe S, Ussher M, Whincup PH, Ekelund U, deWilde S, Harris T. Short-term and long-term cost-effectiveness of a pedometer-based exercise intervention in primary care: a within-trial analysis and beyond-trial modelling. BMJ Open 2018; 8:e021978. [PMID: 30337309 PMCID: PMC6196874 DOI: 10.1136/bmjopen-2018-021978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES A short-term and long-term cost-effectiveness analysis (CEA) of two pedometer-based walking interventions compared with usual care. DESIGN (A) Short-term CEA: parallel three-arm cluster randomised trial randomised by household. (B) Long-term CEA: Markov decision model. SETTING Seven primary care practices in South London, UK. PARTICIPANTS (A) Short-term CEA: 1023 people (922 households) aged 45-75 years without physical activity (PA) contraindications. (b) Long-term CEA: a cohort of 100 000 people aged 59-88 years. INTERVENTIONS Pedometers, 12-week walking programmes and PA diaries delivered by post or through three PA consultations with practice nurses. PRIMARY AND SECONDARY OUTCOME MEASURES Accelerometer-measured change (baseline to 12 months) in average daily step count and time in 10 min bouts of moderate to vigorous PA (MVPA), and EQ-5D-5L quality-adjusted life-years (QALY). METHODS Resource use costs (£2013/2014) from a National Health Service perspective, presented as incremental cost-effectiveness ratios for each outcome over a 1-year and lifetime horizon, with cost-effectiveness acceptability curves and willingness to pay per QALY. Deterministic and probabilistic sensitivity analyses evaluate uncertainty. RESULTS (A) Short-term CEA: At 12 months, incremental cost was £3.61 (£109)/min in ≥10 min MVPA bouts for nurse support compared with control (postal group). At £20 000/QALY, the postal group had a 50% chance of being cost saving compared with control. (B) Long-term CEA: The postal group had more QALYs (+759 QALYs, 95% CI 400 to 1247) and lower costs (-£11 million, 95% CI -12 to -10) than control and nurse groups, resulting in an incremental net monetary benefit of £26 million per 100 000 population. Results were sensitive to reporting serious adverse events, excluding health service use, and including all participant costs. CONCLUSIONS Postal delivery of a pedometer intervention in primary care is cost-effective long term and has a 50% chance of being cost-effective, through resource savings, within 1 year. Further research should ascertain maintenance of the higher levels of PA, and its impact on quality of life and health service use. TRIAL REGISTRATION NUMBER ISRCTN98538934; Pre-results.
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Affiliation(s)
- Nana Anokye
- Health Economics Research Group, Brunel University, London, UK
| | - Julia Fox-Rushby
- Department of Population Health Sciences, Guy’s Campus, King’s College London, London, UK
| | - Sabina Sanghera
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s University of London, London, UK
| | - Elizabeth Limb
- Population Health Research Institute, St George’s University of London, London, UK
| | - Cheryl Furness
- Population Health Research Institute, St George’s University of London, London, UK
| | | | | | - Steve Iliffe
- Population Health Research Institute, St George’s University of London, London, UK
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George’s University of London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Stephen deWilde
- Population Health Research Institute, St George’s University of London, London, UK
| | - Tess Harris
- Population Health Research Institute, St George’s University of London, London, UK
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Garg P, Eastwood J, Liaw ST, Jalaludin B, Grace R. A case study of well child care visits at general practices in a region of disadvantage in Sydney. PLoS One 2018; 13:e0205235. [PMID: 30307993 PMCID: PMC6181326 DOI: 10.1371/journal.pone.0205235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 09/22/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Well-Child Care (WCC) is the provision of preventive health care services for children and their families. Prior research has highlighted that several barriers exist for the provision of WCC services. OBJECTIVES To study "real life" visits of parents and children with health professionals in order to enhance the theoretical understanding of factors affecting WCC. METHODS Participant observations of a cross-sectional sample of 71 visits at three general practices were analysed using a mixed-methods approach. RESULTS The median age of the children was 18 months (IQR, 6-36 months), and the duration of visits was 13 mins (IQR, 9-18 mins). The reasons for the visits were immunisation in 13 (18.5%), general check-up in 10 (13.8%), viral illness in 33 (49.2%) and miscellaneous reasons in 15 (18.5%). Two clusters with low and high WCC emerged; WCC was associated with higher GP patient-centeredness scores, younger age of the child, fewer previous visits, immunisation and general check-up visits, and the solo general practitioner setting. Mothers born overseas received less WCC advice, while longer duration of visit increased WCC. GPs often made observations on physical growth and development and negotiated mothers concerns to provide reassurance to them. The working style of the GP which encouraged informal conversations with the parents enhanced WCC. There was a lack of systematic use of developmental screening measures. CONCLUSIONS GPs and practice nurses are providing parent/child centered WCC in many visits, particularly when parents present for immunisation and general check-ups. Providing funding and practice nurse support to GPs, and aligning WCC activities with all immunisation visits, rather than just a one-off screening approach, appears to be the best way forward. A cluster randomised trial for doing structured WCC activities with immunisation visits would provide further evidence for cost-effectiveness studies to inform policy change.
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Affiliation(s)
- Pankaj Garg
- Department of Community Paediatrics, Liverpool Hospital, Liverpool, New South Wales, Australia
- Specialist Disability Health Team, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Women’s and Children’s Health, UNSW, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Griffith University, Gold Coast, Queensland, Australia
- Department of Community Paediatrics, Sydney Local Health District, Croydon, New South Wales, Australia
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
| | - Siaw-Teng Liaw
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
- Academic General Practice Unit, Fairfield Hospital, Fairfield, New South Wales, Australia
| | - Bin Jalaludin
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
| | - Rebekah Grace
- Faculty of Human Sciences Department: Department of Educational Studies, Macquarie University, Sydney, Australia
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Abstract
INTEGRATION OF THE QUALITY APPROACH INTO NURSING PRACTICES, CHALLENGES AND IMPROVEMENT LEVERS.: The deployment of the care quality and safety approach is integrated into the strategic policies of healthcare facilities. Despite significant investment by management and a desire on the part of caregivers to provide quality care, certain tools and practices are still not widely used. A qualitative survey carried out with nurses and healthcare managers reveals the obstacles to the long-term survival of such an approach and the levers which can be used to develop this quality culture.
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Affiliation(s)
- Anne-Claire Duval
- Haute Autorité de santé, service Certification des établissements de santé, 5, avenue du Stade-de-France, 93218 Saint-Denis-La-Plaine, France.
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Abstract
Background Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared demographic, disease, and outcome characteristics for decedents who had been diagnosed with cancer by whether they did or did not see a navigator. Methods This retrospective study used patient-based administrative data in Nova Scotia (cancer registry, death certificates, navigation visits) to generate descriptive statistics. The study population included all adults diagnosed with cancer who died during 2011-2014 of a cancer or non-cancer cause of death. Results Of the 7694 study decedents, 74.9% had died of cancer. Of those individuals, 40% had seen a navigator at some point in their disease trajectory. The comparable percentage for those who did not die of cancer was 11.9%. Decedents at the oldest ages had the lowest navigation rates. Navigation rates, time from diagnosis to death, and time from last navigation visit to death varied by disease site. Conclusions This population-based study of cancer-patient navigation enrolees compared with non-enrolees is the first of its kind. Most findings were consistent with expectations. However, we do not know whether the rates of navigation are consistent with the navigation needs of the population diagnosed with cancer. Because more people are living longer with cancer and because the population is aging, ongoing surveillance of who requires and who is using navigation services is warranted.
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Affiliation(s)
| | - G.M. Johnston
- School of Health Administration, Dalhousie University; and
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
| | | | - G. Walsh
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
| | - M. McCallum
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS
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Dunn EE, Vranek K, Hynicka LM, Gripshover J, Potosky D, Mattingly TJ. Evaluating a Collaborative Approach to Improve Prior Authorization Efficiency in the Treatment of Hepatitis C Virus. Qual Manag Health Care 2018; 26:136-139. [PMID: 28665904 PMCID: PMC5499965 DOI: 10.1097/qmh.0000000000000137] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE A team-based approach to obtaining prior authorization approval was implemented utilizing a specialty pharmacy, a clinic-based pharmacy technician specialist, and a registered nurse to work with providers to obtain approval for medications for hepatitis C virus (HCV) infection. The objective of this study was to evaluate the time to approval for prescribed treatment of HCV infection. METHODS A retrospective observational study was conducted including patients treated for HCV infection by clinic providers who received at least 1 oral direct-acting antiviral HCV medication. Patients were divided into 2 groups, based on whether they were treated before or after the implementation of the team-based approach. Student t tests were used to compare average wait times before and after the intervention. RESULTS The sample included 180 patients, 68 treated before the intervention and 112 patients who initiated therapy after. All patients sampled required prior authorization approval by a third-party payer to begin therapy. There was a statistically significant reduction (P = .02) in average wait time in the postintervention group (15.6 ± 12.1 days) once adjusted using dates of approval. CONCLUSIONS Pharmacy collaboration may provide increases in efficiency in provider prior authorization practices and reduced wait time for patients to begin treatment.
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Affiliation(s)
- Emily E. Dunn
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
| | - Kathryn Vranek
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
| | - Lauren M. Hynicka
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
| | - Janet Gripshover
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
| | - Darryn Potosky
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
| | - T. Joseph Mattingly
- University of Maryland School of Pharmacy, Baltimore (Dr Dunn); Ambulatory Pharmacy, University of Maryland Medical Center, Baltimore (Dr Vranek); Department of Pharmacy Practice, University of Maryland School of Pharmacy, Baltimore (Drs Hynicka and Mattingly II); and Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore (Ms Gripshover and Dr Potosky)
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Sironi C. [Editorial. The State of Health in Italy and the role of nurses]. Prof Inferm 2018; 71:65-66. [PMID: 30029293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Sharpe DK, Hall JK, Ochije S, Bailey RK. Understanding forensic psychiatry in healthcare practices and collaboration between legal nurse consultants and physicians. Med Leg J 2018; 86:32-35. [PMID: 29206080 DOI: 10.1177/0025817217740299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME). This can help to assess the validity of malpractice claims, including issues of causation and degree of injuries claimed due to the incident(s) and recommend treatment strategies where appropriate. Reviews can cover a wide range of issues such as a person's past or current testamentary capacity, a prisoner or an accused person's mental health and/or mental impairment where necessary sending them for more assessment or treatment outside prison. This article argues that independent medical reviews are a useful tool that can assist the civil and criminal courts processes.
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Affiliation(s)
- Daphne K Sharpe
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, North Carolina, USA
| | - Jasmine K Hall
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, North Carolina, USA
| | - Sochima Ochije
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, North Carolina, USA
| | - Rahn K Bailey
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, North Carolina, USA
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Loriol M. [The meaning of nursing work, a fragile collective construction]. Rev Infirm 2018; 67:18-19. [PMID: 29426551 DOI: 10.1016/j.revinf.2017.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The meaning of nursing work depends on many personal, social and structural aspects: choices, standards, expectations, resources, training, team, management and organisation. It is a fragile construction, which must be re-examined every day to ensure nurses are not over-committed and to avoid burnout.
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Affiliation(s)
- Marc Loriol
- CNRS, Laboratoire Institutions et dynamiques historiques de l'économie et de la société (Idhes) Paris 1, Institut des sciences sociales et du travail (ISST), 16, boulevard Carnot, 92340 Bourg-la-Reine, France.
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Husdal R, Rosenblad A, Leksell J, Eliasson B, Jansson S, Jerdén L, Stålhammar J, Steen L, Wallman T, Svensson AM, Thors Adolfsson E. Resources and organisation in primary health care are associated with HbA 1c level: A nationwide study of 230958 people with Type 2 diabetes mellitus. Prim Care Diabetes 2018; 12:23-33. [PMID: 28964673 DOI: 10.1016/j.pcd.2017.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/01/2017] [Accepted: 09/08/2017] [Indexed: 01/14/2023]
Abstract
AIMS To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM). METHODS People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models. RESULTS After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01). CONCLUSIONS In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.
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Affiliation(s)
- Rebecka Husdal
- Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden; Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden.
| | - Andreas Rosenblad
- Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden
| | - Janeth Leksell
- Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
| | - Björn Eliasson
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Jansson
- School of Medical Sciences, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Lars Jerdén
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Jan Stålhammar
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden
| | - Lars Steen
- Drug and Therapeutics Committee, Sörmland County Council, Eskilstuna, Sweden
| | - Thorne Wallman
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | | | - Eva Thors Adolfsson
- Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden
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Jeihooni AK, Kashfi SH, Bahmandost M, Afzali Harsini P. Promoting Preventive Behaviors of Nosocomial Infections in Nurses: The Effect of an Educational program based on Health Belief Model. Invest Educ Enferm 2018; 36:e09. [PMID: 29898348 DOI: 10.17533/udea.iee.v36n1e09] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/23/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To determine the effect of educational program based on Health Belief Model (HBM) on promoting preventive behaviors of nosocomial infections in nurses. METHODS In this randomized controlled trial study, 120 nurses working in a hospital in Fasa City, Fars (Iran). Intervention group (n=60) received an educational program based on HBM while control group (n=60) did not received it. A questionnaire consisting of demographic information, HBM constructs (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, performance and cues to action) was used to measure changes toward the prevention of nosocomial infections before, immediately after intervention and four months later (of the end of the intervention). RESULTS Immediately and four months after the intervention, the intervention group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action and performance compared to the control group. CONCLUSIONS This study in nurses showed that the effectiveness of the Educational program based on HBM on promoting preventive behaviors of nosocomial infections. Hence, this model can act as a framework for designing and implementing educational interventions for the prevention of nosocomial infections.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Iran,
| | - Seyyed Hannan Kashfi
- Departament of Nursing, School of Nursing, Larestan University of Medical Sciences, Iran,
| | - Mina Bahmandost
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Iran,
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Denham N, Matthews B. Nurses Underscore Value of Collaboration when Implementing Health Technology. Biomed Instrum Technol 2018; 52:32-36. [PMID: 29350978 DOI: 10.2345/0899-8205-52.1.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Howell J. Forecast for 2018 Legislative Session. Mo Med 2017; 114:407-409. [PMID: 30228647 PMCID: PMC6139966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jeff Howell
- Jeff Howell, JD, is MSMA's General Counsel and Director of Governmental Relations
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Affiliation(s)
- Marilyn Harris
- Marilyn Harris, MSN, RN, NEA-BC, FAAN, is Retired Executive Director, current author and editor, Abington Memorial Hospital Home Care & Hospice, Willow Grove, Pennsylvania
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Belkhedim R. Relevance of bone marrow transplantation nursing training program at King Faisal Specialist Hospital and Research Centre for national and regional nurses. Hematol Oncol Stem Cell Ther 2017; 10:189-191. [PMID: 28837784 DOI: 10.1016/j.hemonc.2017.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/27/2017] [Indexed: 11/29/2022] Open
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