The Practice Environment Scale of the Nursing Work Index: An updated review and recommendations for use.
Int J Nurs Stud. 2017 Jun 12;74:76-84
Authors: Swiger PA, Patrician PA, Miltner RSS, Raju D, Breckenridge-Sproat S, Loan LA
OBJECTIVES: The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument.
DESIGN: A narrative review of quantitative studies.
DATA SOURCES: PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI.
REVIEW METHODS: Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations.
RESULTS: Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest.
CONCLUSION: The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality.
PMID: 28641123 [PubMed - as supplied by publisher]
Obtaining service user feedback for student nurses in the community setting.
Br J Community Nurs. 2017 May 02;22(5):248-251
Authors: Carr J, Pitt M, Midgley K, Baker H
Seeking service user feedback for student nurses who are engaged in community learning experiences is an important part of a mentor's role. This paper discusses what is currently advocated, the mentor's role in obtaining and managing feedback and makes recommendations to improve the process in the community practice setting.
PMID: 28467245 [PubMed - indexed for MEDLINE]
Cost-effective wound management: a survey of 1717 nurses.
Br J Nurs. 2017 Jun 22;26(12):S44-S49
Authors: Newton H
Delivering high-quality wound care requires a mix of knowledge and skills, which nurses aim to update by attending educational events such as conferences and study days. This article describes the data obtained from 30 educational study days, which took place across England, Scotland and Wales. It will explore nurses' knowledge in relation to the cost-effectiveness and clinical efficacy of current wound care practices, based on the answers of 1717 delegates that attended the events. It will also outline the results in relation to reducing expenditure on wound dressings and the importance of performing an accurate wound assessment.
PMID: 28640734 [PubMed - in process]
Student nurse preferences for their first clinical experience: a thematic analysis.
Br J Nurs. 2017 Jan 26;26(2):104-108
Authors: Gillespie M
Shifts in demographic profiles and in the understanding of how to best deliver health care have seen nurses increasingly caring for non-acute client groups outside traditional clinical settings. Evidence suggests that this does not always sit well with nurses, or with nurses in training. This study sought to investigate the influences on student nurse perceptions of the worth of working with various client groups. Thematic analysis of a focus group discussion led to the identification of several themes suggesting that unhelpful opinions are present in some students on entry to the programme; however, programme-related influences also contribute towards unhelpful attitudes. To create a more positive framing of working within such specialisms will require significant focus across nursing, nurse education and society in general.
PMID: 28132547 [PubMed - indexed for MEDLINE]
Service development of a nurse-led community-based PICC insertion service.
Br J Nurs. 2017 Jan 26;26(2):S22-S27
Authors: Bedford E, Waterhouse D
Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs). This article outlines the development of an out-of-hospital nurse-led PICC insertion service using the Sherlock 3CG(®) Tip Confirmation System (C.R Bard) to meet the needs of patients requiring long-term intravenous treatment from an OPAT service, and its impact on reducing treatment delays and the need for secondary care intervention.
PMID: 28132552 [PubMed - indexed for MEDLINE]
Contraceptive counselling of women seeking abortion - a qualitative interview study of health professionals' experiences.
Eur J Contracept Reprod Health Care. 2017 Feb;22(1):3-10
Authors: Kilander H, Salomonsson B, Thor J, Brynhildsen J, Alehagen S
OBJECTIVES: A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalś experiences of providing contraceptive counselling to women seeking an abortion.
METHODS: We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden. The interviews were recorded and transcribed verbatim and analysed using conventional qualitative content analysis.
RESULTS: Three clusters were identified: 'Complex counselling', 'Elements of counselling' and 'Finding a method'. HPs often experienced consultations including contraceptive counselling at the time of an abortion as complex, covering both pregnancy termination and contraceptive counselling. Women with vulnerabilities placed even greater demands on the HPs providing counselling. The HPs varied in their approaches when providing contraceptive counselling but also in their knowledge about certain contraception methods. HPs described challenges in finding out if women had found an effective method and in the practicalities of arranging intrauterine device (IUD) insertion post-abortion, when a woman asked for this method.
CONCLUSIONS: HPs found it challenging to provide contraceptive counselling at the time of an abortion and to arrange access to IUDs post-abortion. There is a need to improve their counselling, their skills and their knowledge to prevent repeat unintended pregnancies.
PMID: 27689407 [PubMed - indexed for MEDLINE]
Avoiding hospital admission in COPD: impact of a specialist nursing team.
Br J Nurs. 2017 Feb 09;26(3):152-158
Authors: Cox K, Macleod SC, Sim CJ, Jones AW, Trueman J
Chronic obstructive pulmonary disease (COPD) is a common, preventable and incurable disease. The costs of caring for patients with COPD is estimated to be more than £800 million a year for acute hospital admissions alone ( Department of Health, 2012 ). The hospital-at-home model is increasingly being adopted for COPD patients following British Thoracic Society (BTS) guidelines for the delivery of hospital admission-avoidance schemes ( BTS, 2007 ). The aim of this case-note review was to evaluate the safety and effectiveness of a specialist nurse-led acute respiratory assessment service working with COPD patients in the community. The review recorded patient flow through the service and documented assessments and treatments. It was able to document potential benefits and cost savings.
PMID: 28185492 [PubMed - indexed for MEDLINE]
The NMLN recently launched The Power of Conversation: Nursing and Midwifery Leadership in Action, which portrays four big group conversational events, the outcomes of which were configured around themes.
The association between nurses' coordination with physicians and clients' place of death.
Int J Palliat Nurs. 2017 Mar 16;23(3):136-142
Authors: Naruse T, Yamamoto N, Sugimoto T, Fujisaki-Sakai M, Nagata S
AIM: Over 60% of Japanese people hope to die at home; hence, assisting clients in achieving this outcome is an important responsibility of home care providers. This study investigated the effects of nurses' relational coordination with physicians on clients' place of death in home visiting nursing (HVN) agencies.
METHOD: Secondary analysis of a public survey conducted in 2015 by local governments in Kurume city, Fukuoka prefecture, Western Japan. Manager nurses from 17 HVN agencies provided data about themselves and their relational coordination with community physicians and 85 deceased clients.
RESULTS: Among 85 deceased clients, 52 (61.2%) had died at home. Four regression models showed significant positive effects of HVN nurse managers' relational coordination on clients' home death (the odds ratios (95% CI) were 2.488 (1.442-4.293), 2.111 (1.014-4.396), 2.562 (1.409-4.658) and 2.275 (1.079-4.796) in models 1-4, respectively.
CONCLUSION: Measuring relational coordination among HVN nursing managers and physicians indicated readiness for home death among HVN clients in an agency or community.
PMID: 28345476 [PubMed - indexed for MEDLINE]
The future of community nursing: Hospital in the Home.
Br J Community Nurs. 2017 Apr 02;22(4):174-180
Authors: Lee G, Pickstone N, Facultad J, Titchener K
With an increasing ageing population who often have multiple long-term conditions, there is a growing need to provide an alternative type of care to the traditional hospital-based model. 'Hospital in the Home' is a model that provides integrated care for patients in their home. The @home service was established in 2013 by Guy's and St Thomas' NHS Foundation Trust. The service provides health care in patients' home, supporting early discharge from hospital as well as preventing avoidable admissions and readmissions saving valuable hospital bed days and reducing length of stay. This article describes the service available with the use of a case study of a 78-year-old lady who was referred by the London Ambulance Service with exacerbation of chronic obstructive pulmonary disease (COPD). This case study highlights the ability to assess, treat and manage an acutely unwell patient with newly diagnosed heart failure in the community without the need for hospitalisation. This type of integrated care model with a multidisciplinary team is a feasible alternative to the traditional models of care in both the acute and community settings.
PMID: 28414540 [PubMed - indexed for MEDLINE]
Days out of role due to common physical and mental conditions: results from the Northern Ireland study of health and stress.
Soc Psychiatry Psychiatr Epidemiol. 2016 Nov;51(11):1539-1546
Authors: Ennis E, O'Neill S, Murphy S, Bunting B
PURPOSE: Days out of role due to health problems are a major source of lost human capital. We examined the relative importance of common physical and mental disorders in accounting for days out of role in Northern Ireland using the Northern Ireland Study of Health and Stress (NISHS) WHO World Mental Health (WMH) Survey.
METHODS: Face-to-face interviews were carried out with 4340 respondents (68.4 % response rate). Multiple regression analysis estimated associations of specific chronic physical disorders and mental disorders conditions and comorbidities with days out of role controlling for basic socio-demographics.
RESULTS: Overall, 16.8 % of respondents had at least one day totally out of role in the previous year. The strongest population-level effect was associated with arthritis, which accounted for 23.5 % of all days out of role. The strongest individual-level effects (days out of role per year) were associated with any anxiety disorder (32.3) arthritis (26.1) and pain (22.0). The 11 conditions accounted for 93 % of all days out of role, as measured by population attributable risk proportions (PARPs).
CONCLUSIONS: Common health conditions, including mental disorders, make up a large proportion of the number of days out of role and should be addressed to substantially increase overall productivity.
PMID: 27517674 [PubMed - indexed for MEDLINE]
Twitter as a Tool for Health Research: A Systematic Review.
Am J Public Health. 2017 Jan;107(1):e1-e8
Authors: Sinnenberg L, Buttenheim AM, Padrez K, Mancheno C, Ungar L, Merchant RM
BACKGROUND: Researchers have used traditional databases to study public health for decades. Less is known about the use of social media data sources, such as Twitter, for this purpose.
OBJECTIVES: To systematically review the use of Twitter in health research, define a taxonomy to describe Twitter use, and characterize the current state of Twitter in health research.
SEARCH METHODS: We performed a literature search in PubMed, Embase, Web of Science, Google Scholar, and CINAHL through September 2015.
SELECTION CRITERIA: We searched for peer-reviewed original research studies that primarily used Twitter for health research.
DATA COLLECTION AND ANALYSIS: Two authors independently screened studies and abstracted data related to the approach to analysis of Twitter data, methodology used to study Twitter, and current state of Twitter research by evaluating time of publication, research topic, discussion of ethical concerns, and study funding source.
MAIN RESULTS: Of 1110 unique health-related articles mentioning Twitter, 137 met eligibility criteria. The primary approaches for using Twitter in health research that constitute a new taxonomy were content analysis (56%; n = 77), surveillance (26%; n = 36), engagement (14%; n = 19), recruitment (7%; n = 9), intervention (7%; n = 9), and network analysis (4%; n = 5). These studies collectively analyzed more than 5 billion tweets primarily by using the Twitter application program interface. Of 38 potential data features describing tweets and Twitter users, 23 were reported in fewer than 4% of the articles. The Twitter-based studies in this review focused on a small subset of data elements including content analysis, geotags, and language. Most studies were published recently (33% in 2015). Public health (23%; n = 31) and infectious disease (20%; n = 28) were the research fields most commonly represented in the included studies. Approximately one third of the studies mentioned ethical board approval in their articles. Primary funding sources included federal (63%), university (13%), and foundation (6%).
CONCLUSIONS: We identified a new taxonomy to describe Twitter use in health research with 6 categories. Many data elements discernible from a user's Twitter profile, especially demographics, have been underreported in the literature and can provide new opportunities to characterize the users whose data are analyzed in these studies. Twitter-based health research is a growing field funded by a diversity of organizations. Public health implications. Future work should develop standardized reporting guidelines for health researchers who use Twitter and policies that address privacy and ethical concerns in social media research.
PMID: 27854532 [PubMed - indexed for MEDLINE]
How are we assessing near-peer teaching in undergraduate health professional education? A systematic review.
Nurse Educ Today. 2017 Mar;50:42-50
Authors: Irvine S, Williams B, McKenna L
BACKGROUND: Near Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT.
OBJECTIVE: To determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education.
METHODS: Quantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990-November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data.
RESULTS: Of 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding.
CONCLUSION: The studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported.
PMID: 28012361 [PubMed - indexed for MEDLINE]
Mentoring: Positively Influencing Job Satisfaction and Retention of New Hire Nurse Practitioners.
Plast Surg Nurs. 2017 Jan/Mar;37(1):7-22
Authors: Horner DK
The purpose of study was to determine whether mentoring based on Watson's Caring Model positively influences nurse practitioner (NP) job satisfaction. This nonexperimental mixed-methods study utilized an online survey, administered through Qualtrics containing demographic and mentoring variables. Job satisfaction results were obtained from the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS). Also, open-ended questions regarding mentoring were reported. There was a 54% response rate in which 37 of the 69 participants responded (n = 37), with statistical significance set at p < .05. All or 100% of participants reported that the mentor experience/relationship positively influenced job satisfaction. Scores from the MNPJSS ranged from 141 to 246, with a mean of 195.26 (SD = 28.29) corresponding to "minimally satisfied" or a mean of 4.44 on the 6-point scale. These results are similar to the MNPJSS score with a mean of 4.39. A mentoring experience can provide a positive environment, which can lead to increased job satisfaction. In turn, a higher level of satisfaction in the work environment can be associated with reduced turnover and improved retention and patient outcomes. Ultimately, a safer health care system will evolve and improve patient care and outcomes. Through Watson's Caring Model, a reciprocal relationship between the mentor and the mentee can provide a new NP hire a sense of community and direct availability. By experiencing a mentor relationship, job satisfaction can improve, which is a key factor in retaining NPs. As E-mentoring is a newer topic in nursing literature, further research is needed. Further studies could also review and develop one-on-one mentoring programs.
PMID: 28244960 [PubMed - indexed for MEDLINE]
Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students.
Nurse Educ Today. 2017 May 15;55:65-70
Authors: Foster K, Fethney J, McKenzie H, Fisher M, Harkness E, Kozlowski D
BACKGROUND: Emotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students' EI, there is minimal evidence on EI over time during pre-registration programs.
OBJECTIVES: To measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance.
DESIGN AND SETTING: Longitudinal repeated measures study between March 2010-February 2013 at a metropolitan university in Australia.
PARTICIPANTS: 111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7years (SD=7.36).
METHODS: EI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up).
RESULTS: Students' EI was found to increase across the program; one subscale of EI (managing others' emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time.
CONCLUSIONS: Pre-registration nurse education contributes to strengthening students' EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula.
PMID: 28528126 [PubMed - as supplied by publisher]
Clinical productivity of primary care nurse practitioners in ambulatory settings.
Nurs Outlook. 2017 Mar - Apr;65(2):162-171
Authors: Xue Y, Tuttle J
BACKGROUND: Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners' productivity in primary care practice.
PURPOSE: We examined nurse practitioners' clinical productivity in regard to number of patients seen per week, whether they had a patient panel, and patient panel size. We further investigated practice characteristics associated with their clinical productivity.
METHODS: We conducted cross-sectional analysis of the 2012 National Sample Survey of Nurse Practitioners. The sample included full-time primary care nurse practitioners in ambulatory settings. Multivariable survey regression analyses were performed to examine the relationship between practice characteristics and nurse practitioners' clinical productivity.
RESULTS: Primary care nurse practitioners in ambulatory settings saw an average of 80 patients per week (95% confidence interval [CI]: 79-82), and 64% of them had their own patient panel. The average patient panel size was 567 (95% CI: 522-612). Nurse practitioners who had their own patient panel spent a similar percent of time on patient care and documentation as those who did not. However, those with a patient panel were more likely to provide a range of clinical services to most patients. Nurse practitioners' clinical productivity was associated with several modifiable practice characteristics such as practice autonomy and billing and payment policies.
DISCUSSIONS: The estimated number of patients seen in a typical week by nurse practitioners is comparable to that by primary care physicians reported in the literature. However, they had a significantly smaller patient panel. Nurse practitioners' clinical productivity can be further improved.
PMID: 27773346 [PubMed - indexed for MEDLINE]
The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review.
Ann Intern Med. 2017 Mar 07;166(5):341-353
Authors: Mendelson A, Kondo K, Damberg C, Low A, Motúapuaka M, Freeman M, O'Neil M, Relevo R, Kansagara D
Background: The benefits of pay-for-performance (P4P) programs are uncertain.
Purpose: To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings.
Data Sources: PubMed from June 2007 to October 2016; MEDLINE, PsycINFO, CINAHL, Business Economics and Theory, Business Source Elite, Scopus, Faculty of 1000, and Gartner Research from June 2007 to February 2016.
Study Selection: Trials and observational studies in ambulatory and inpatient settings reporting process-of-care, health, or utilization outcomes.
Data Extraction: Two investigators extracted data, assessed study quality, and graded the strength of the evidence.
Data Synthesis: Among 69 studies, 58 were in ambulatory settings, 52 reported process-of-care outcomes, and 38 reported patient outcomes. Low-strength evidence suggested that P4P programs in ambulatory settings may improve process-of-care outcomes over the short term (2 to 3 years), whereas data on longer-term effects were limited. Many of the positive studies were conducted in the United Kingdom, where incentives were larger than in the United States. The largest improvements were seen in areas where baseline performance was poor. There was no consistent effect of P4P on intermediate health outcomes (low-strength evidence) and insufficient evidence to characterize any effect on patient health outcomes. In the hospital setting, there was low-strength evidence that P4P had little or no effect on patient health outcomes and a positive effect on reducing hospital readmissions.
Limitation: Few methodologically rigorous studies; heterogeneous population and program characteristics and incentive targets.
Conclusion: Pay-for-performance programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting.
Primary Funding Source: U.S. Department of Veterans Affairs.
PMID: 28114600 [PubMed - indexed for MEDLINE]
New Roles for Medical Assistants in Innovative Primary Care Practices.
Health Serv Res. 2017 Feb;52 Suppl 1:383-406
Authors: Chapman SA, Blash LK
OBJECTIVE: To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs.
DATA SOURCES/STUDY SETTING: Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes.
STUDY DESIGN: Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles. Conducted site visits from 2010 to 2012 and updated information in 2014.
DATA COLLECTION/EXTRACTION METHODS: Thematic analysis explored key topics: factors driving MA role innovation, role description, training required, and wage gains. Categorized outcome data in patient and staff satisfaction, quality of care, and efficiency.
PRINCIPAL FINDINGS: New MA roles included health coach, medical scribe, dual role translator, health navigator, panel manager, cross-trained flexible role, and supervisor. Implementation of new roles required extensive training. MA incentives and enhanced compensation varied by role type.
CONCLUSIONS: New MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services.
PMID: 27859097 [PubMed - indexed for MEDLINE]
Primary care nursing activities with patients affected by physical chronic disease and common mental disorders: a qualitative descriptive study.
J Clin Nurs. 2017 May;26(9-10):1385-1394
Authors: Girard A, Hudon C, Poitras ME, Roberge P, Chouinard MC
AIMS AND OBJECTIVES: To describe nursing activities in primary care with patients affected by physical chronic disease and common mental disorders.
BACKGROUND: Patients in primary care who are affected by physical chronic disease and common mental disorders such as anxiety and depression require care and follow-up based on their physical and mental health condition. Primary care nurses are increasingly expected to contribute to the care and follow-up of this growing clientele. However, little is known about the actual activities carried out by primary care nurses in providing this service in the Province of Quebec (Canada).
METHODS: A qualitative descriptive study was conducted. Data were obtained through semistructured individual interviews with 13 nurses practising among patients with physical chronic disease in seven Family Medicine Groups in Quebec (Canada).
RESULTS: Participants described five activity domains: assessment of physical and mental health condition, care planning, interprofessional collaboration, therapeutic relationship and health promotion.
CONCLUSION: The full potential of primary care nurses is not always exploited, and some activities could be improved. Evidence for including nurses in collaborative care for patients affected by physical chronic disease and common mental disorders has been shown but is not fully implemented in Family Medicine Groups. Future research should emphasise collaboration among mental health professionals, primary care nurses and family physicians in the care of patients with physical chronic disease and common mental disorders.
RELEVANCE TO CLINICAL PRACTICE: Primary care nurses would benefit from gaining more knowledge about common mental disorders and from identifying the resources they need to contribute to managing them in an interdisciplinary team.
PMID: 28000321 [PubMed - indexed for MEDLINE]
Interventions for prevention of bullying in the workplace.
Cochrane Database Syst Rev. 2017 01 30;1:CD009778
Authors: Gillen PA, Sinclair M, Kernohan WG, Begley CM, Luyben AG
BACKGROUND: Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying.
OBJECTIVES: To explore the effectiveness of workplace interventions to prevent bullying in the workplace.
SEARCH METHODS: We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE-System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles.
SELECTION CRITERIA: Randomised and cluster-randomised controlled trials of employee-directed interventions, controlled before and after studies, and interrupted time-series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation.
DATA COLLECTION AND ANALYSIS: Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the internal validity items from the Downs and Black quality assessment tool to evaluate included studies' risk of bias.
MAIN RESULTS: Five studies met the inclusion criteria. They had altogether 4116 participants. They were underpinned by theory and measured behaviour change in relation to bullying and related absenteeism. The included studies measured the effectiveness of interventions on the number of cases of self-reported bullying either as perpetrator or victim or both. Some studies referred to bullying using common synonyms such as mobbing and incivility and antonyms such as civility. Organisational/employer level interventionsTwo studies with 2969 participants found that the Civility, Respect, and Engagement in the Workforce (CREW) intervention produced a small increase in civility that translates to a 5% increase from baseline to follow-up, measured at 6 to 12 months (mean difference (MD) 0.17; 95% CI 0.07 to 0.28).One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD -0.17; 95% CI -0.33 to -0.01) but not in co-worker incivility victimisation (MD -0.08; 95% CI -0.22 to 0.08) or in self-reported incivility perpetration (MD -0.05 95% CI -0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD -0.63; 95% CI -0.92 to -0.34) at 6-month follow-up. Individual/job interface level interventionsOne controlled before-after study with 49 participants compared expressive writing with a control writing exercise at two weeks follow-up. Participants in the intervention arm scored significantly lower on bullying measured as incivility perpetration (MD -3.52; 95% CI -6.24 to -0.80). There was no difference in bullying measured as incivility victimisation (MD -3.30 95% CI -6.89 to 0.29).One controlled before-after study with 60 employees who had learning disabilities compared a cognitive-behavioural intervention with no intervention. There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three-month follow-up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three-month follow-up (RR 0.69; 95% CI 0.26 to 1.81). Multilevel InterventionsA five-site cluster-RCT with 1041 participants compared the effectiveness of combinations of policy communication, stress management training, and negative behaviours awareness training. The authors reported that bullying victimisation did not change (13.6% before intervention and 14.3% following intervention). The authors reported insufficient data for us to conduct our own analysis.Due to high risk of bias and imprecision, we graded the evidence for all outcomes as very low quality.
AUTHORS' CONCLUSIONS: There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well-designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow-up.
PMID: 28134445 [PubMed - indexed for MEDLINE]
Social Media and Population Health Virtual Exchange for Senior Nursing Students: An International Collaboration.
Stud Health Technol Inform. 2016;225:975-6
Authors: Procter PM, Brixey JJ, Honey ML, Todhunter F
The authors have all engaged in using social media with students as a means for collaboration across national and international boundaries for various educational purposes. Following the explosion of big data in health the authors are now moving this concept forward within undergraduate and postgraduate nursing curricula for the development of population health virtual exchanges. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. This development will allow for explorative exchange amongst students in three countries, enhancing their understanding of their own and the selected international population health needs and solutions through asking and responding to questions amongst the learning community involved. The connection of the students will be recorded for their use in reflection; of particular interest will be the use of information included by the students to answer questions about their locality.
PMID: 27332439 [PubMed - indexed for MEDLINE]
The New Issue of Social Media in Education and Health Behavior Change - Virtual Visit of Tele-Nursing.
Stud Health Technol Inform. 2016;225:625-6
Authors: Chen BL
Tele-Nursing is a kind of virtual visits, to our nursing professional developed as a new future, based on Who's policy that is to deal with nursing shortage in the worldwide. Then how to connect the clinical phenomena to synthesis concept is top urgent. The systemic review method and case manager interview to collect the clinical phenomena, the concepts analyzed by Norris Method to analyze the virtual visit. Finally the results of research finding were five categories which were available; security; science and technology derived consequences for nursing; to monitor quality of nursing care; support from social network. The Virtual Visit of Tele-Nursing's concept will be leading nursing knowledge to theory.
PMID: 27332282 [PubMed - indexed for MEDLINE]
Responding to the support needs of frontline public health nurses who work with vulnerable families and children: A qualitative study.
Contemp Nurse. 2017 May 13;:1-19
Authors: Austin J, Holt S
BACKGROUND: This paper reports on a research study to inform the development of a specialist role designed to lead and support front line public health nurses (PHNs) working with vulnerable families and at risk children in Ireland. PHNs in Ireland provide a programme of intervention that promotes optimum health and wellbeing for all children in their early years under the governance of the Health Service Executive. This universal access places the PHN as a central participant in the safeguarding of young children, particularly those working in disadvantaged communities where frequent exposure to difficult situations is a common factor.
AIMS: The aims of this study were to identify best practice, investigate the position of a leading role and to explore the implications of such change.
METHODS: This study was conducted using a qualitative research design to collect informative data through focus group and semi-structured individual interview formats. The sample of ten participants was purposively selected from line management in public health nursing, social work and a non-governmental children's organisation who work in some of the most disadvantaged areas in Dublin.
RESULTS: Supported by empirical evidence, findings from the data indicate that assistant directors of public health nursing with significant experience in child protection and welfare are in a key position to inform decisions pertaining to the provision of services for children.
CONCLUSION: This study concluded that access to support and appropriate supervision are fundamental resource requirements for PHNs who work with vulnerable families and at risk children. The study further recommended that the introduction of a specialist- leading role to support these public health nurses was essential to sustaining best practice.
PMID: 28504060 [PubMed - as supplied by publisher]
Nurse practitioners and intent to retire.
J Am Assoc Nurse Pract. 2017 Mar;29(3):130-135
Authors: Falk NL, Rudner N, Chapa D, Greene J
BACKGROUND AND PURPOSE: Demand for primary care services is rising. Nurse practitioners (NPs) serve vital roles in meeting primary care demands. Workforce planning requires understanding NP retirement intentions. This study examines factors that relate to NPs, aged 55 years and older, and their intent to retire within 5 years.
METHODS: We used the 2012 National Sample Survey of Nurse Practitioners to examine the relationship between NP demographic characteristics (gender, race/ethnicity, marital status, nursing degree), work environment characteristics (part-time vs. full-time status, primary or specialty care, earnings, job satisfaction), and intent to retire. Descriptive, bivariate, and multivariate analyses were conducted. A total of 3171 working NPs, 55 years of age and older, were included.
CONCLUSIONS: Fifty-nine percent of NPs 60 years and older and 15% of NPs 55-59 intend to retire in the next 5 years. Working part-time and having less than a master's degree were associated with intent to retire. Being "very satisfied" with one's job was related to lower odds of intent to retire versus being "satisfied." Being "dissatisfied" with one's job and working in primary care were related to intending to retire for the NPs 55-59.
IMPLICATIONS FOR PRACTICE: Given the relationship between higher job satisfaction and lower intent to retire, efforts to increase NPs' job satisfaction may result in less early retirement.
PMID: 27717220 [PubMed - indexed for MEDLINE]
Professional online community membership and participation among healthcare providers: An extension to nurse practitioners and physician assistants.
J Am Assoc Nurse Pract. 2016 Dec;28(12):639-645
Authors: Betts KR, O'Donoghue AC, Aikin KJ, Kelly BJ, Boudewyns V
BACKGROUND AND PURPOSE: Professional online communities allow healthcare providers to exchange ideas with their colleagues about best practices for patient care. Research on this topic has focused almost exclusively on primary care physicians and specialists, to the exclusion of advanced practice providers such as nurse practitioners and physician assistants. We expand this literature by examining membership and participation on these websites among each of these provider groups.
METHODS: Participants (N = 2008; approximately 500 per provider group) responded to an Internet-based survey in which they were asked if they use professional online communities to dialogue with colleagues and if so, what their motivation is for doing so.
CONCLUSIONS: Nearly half of the participants in our sample reported utilizing professional online communities. Select differences were observed between provider groups, but overall, similar patterns emerged in their membership and participation on these websites.
IMPLICATIONS FOR PRACTICE: Nurse practitioners and physician assistants utilize professional online communities in similar proportion to primary care physicians and specialists. Providers should be cognizant of the impact this use may have for both themselves and their patients. Researchers are urged to take into account the various professional roles within the healthcare community while developing research on this topic.
PMID: 27214569 [PubMed - indexed for MEDLINE]
Using Education Technology as a Proactive Approach to Healthy Ageing.
Stud Health Technol Inform. 2016;225:193-7
Authors: Rodger D, Spencer A, Hussey P
Bone Health in the Park was created in Ireland and is an online health promotion education resource focussing on bone health, healthy ageing and falls prevention. The programme was designed by an Advanced Nurse Practitioner in collaboration with an Education Technologist and primarily uses storytelling to promote education specifically on bone health and falls risk prevention for health care professionals, clients, families and informal carers. This paper reports on core deliverables from this programme from 2010 to 2015, and provides insight into their development, in addition to details on its clinical effectiveness by using technology enhanced learning to underpin health promotion initiatives.
PMID: 27332189 [PubMed - indexed for MEDLINE]
Glycemic control: Can nurse practitioners on interprofessional collaborative practice teams enhance clinical outcomes?
J Am Assoc Nurse Pract. 2016 Dec;28(12):652-658
Authors: Parker RA, Hook LD, Jones ME
BACKGROUND AND PURPOSE: Care coordination and specialized knowledge of prescriptive authority are fundamental to advanced nursing practice. Little research documents patient clinical outcomes in primary care when nurse practitioners are members of an interprofessional education and collaborative practice (IPECP) team. This cross-sectional study examined differences in glycemic control among Texas patients who received care by a Family Nurse Practitioner (FNP) and an IPECP team in one calendar year.
METHODS: A convenience sample of 120 adult volunteers with diabetes was followed in a community-based clinic by an FNP; of these, 34 received additional care by an IPECP team. Data on selected demographic indices and HgbA1c were derived from the health center's Electronic Medical Record using a retrospective review, and linkage with the federally funded IPECP Project database.
CONCLUSIONS: Patients with two or more FNP visits and two or more visits with the IPECP team had statistically significant reductions in HgbA1c levels at the end of 1 year.
IMPLICATIONS FOR PRACTICE: Actualizing point-of-care treatment adjustments is a particular strength of advanced practice nurses but potentially a missed opportunity on interprofessional teams. Further study is needed on clinical outcomes of nurse practitioner contributions to IPECP team care.
PMID: 27479873 [PubMed - indexed for MEDLINE]
Transition Program to Promote Incoming Nursing Student Success in Higher Education.
Nurse Educ. 2016 Nov/Dec;41(6):319-323
Authors: Latham CL, Singh H, Lim C, Nguyen E, Tara S
A new model for addressing first-generation and minority student issues when starting nursing school was implemented using an interactive, peer-developed, 2-day program to create a sense of community and relieve anxiety. The program focused on students' needs, engagement, networking, first-hand experience with resources and methods to reduce cultural dissonance. Participation included critiquing modeling of proper clinical attire, meeting with peer mentors, and locating important campus resources. The program, conducted by minority students under the supervision and guidance of faculty mentors, received excellent evaluations.
PMID: 27022684 [PubMed - indexed for MEDLINE]
Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies.
Prehosp Disaster Med. 2016 Dec;31(6):680-683
Authors: Hutton A, Veenema TG, Gebbie K
The International Council of Nurses (ICN; Geneva, Switzerland) and the World Association for Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) joined together in 2014 to review the use of the ICN Framework of Disaster Nursing Competencies. The existing ICN Framework (version 1.10; dated 2009) formed the starting point for this review. The key target audiences for this process were members of the disaster nursing community concerned with pre-service education for professional nursing and the continuing education of practicing professional nurses. To minimize risk in the disaster nursing practice, competencies have been identified as the foundation of evidence-based practice and standard development. A Steering Committee was established by the WADEM Nursing Section to discuss how to initiate a review of the ICN Framework of Disaster Nursing Competencies. The Steering Committee then worked via email to develop a survey to send out to disaster/emergency groups that may have nurse members who work/respond in disasters. Thirty-five invitations were sent out with 20 responses (57%) received. Ninety-five percent of respondents knew of the ICN Framework of Disaster Nursing Competencies, with the majority accessing these competencies via the Internet. The majority of those who responded said that they make use of the ICN Framework of Disaster Nursing Competencies with the most common use being for educational purposes. Education was done at a local, national, and international level. The competencies were held in high esteem and valued by these organizations as the cornerstone of their disaster education, and also were used for the continued professional development of disaster nursing. However, respondents stated that five years on from their development, the competencies also should include the psychosocial elements of nurses caring for themselves and their colleagues. Additionally, further studies should explore if there are other areas related to the disaster nursing practice (in addition to psychosocial concerns) that may be missing or not fully developed. Finally, the authors of this report recommend that future research explore how the ICN Framework of Disaster Nursing Competencies do or do not assist in maintaining best practices in this field and improve outcomes for victims of disaster. Hutton A , Veenema TG , Gebbie K . Review of the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies. Prehosp Disaster Med. 2016;31(6):680-683.
PMID: 27646611 [PubMed - indexed for MEDLINE]
Evaluation of ConPrim: A three-part model for continuing education in primary health care.
Nurse Educ Today. 2016 Nov;46:115-120
Authors: Berggren E, Strang P, Orrevall Y, Ödlund Olin A, Sandelowsky H, Törnkvist L
BACKGROUND: To overcome the gap between existing knowledge and the application of this knowledge in practice, a three-part continuing educational model for primary health care professionals (ConPrim) was developed. It includes a web-based program, a practical exercise and a case seminar.
AIM: To evaluate professionals' perceptions of the design, pedagogy and adaptation to primary health care of the ConPrim continuing educational model as applied in a subject-specific intervention.
METHODS: A total of 67 professionals (nurses and physicians) completed a computer-based questionnaire evaluating the model's design, pedagogy and adaptation to primary health care one week after the intervention. Descriptive statistics were used.
RESULTS: Over 90% found the design of the web-based program and case seminar attractive; 86% found the design of the practical exercise attractive. The professionals agreed that the time spent on two of the three parts was acceptable. The exception was the practical exercise: 32% did not fully agree. Approximately 90% agreed that the contents of all parts were relevant to their work and promoted interactive and interprofessional learning. In response to the statements about the intervention as whole, approximately 90% agreed that the intervention was suitable to primary health care, that it had increased their competence in the subject area, and that they would be able to use what they had learned in their work.
CONCLUSIONS: ConPrim is a promising model for continuing educational interventions in primary health care. However, the time spent on the practical exercise should be adjusted and the instructions for the exercise clarified. ConPrim should be tested in other subject-specific interventions and its influence on clinical practice should be evaluated.
PMID: 27621201 [PubMed - indexed for MEDLINE]
Participants' perceptions of an intervention implemented in an Action Research Nursing Documentation Project.
J Clin Nurs. 2017 Apr;26(7-8):983-993
Authors: Vabo G, Slettebø Å, Fossum M
AIMS AND OBJECTIVES: The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway.
BACKGROUND: Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue.
DESIGN: A qualitative descriptive design was used.
METHODS: An action research project was conducted between 2010-2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used.
RESULTS: Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success.
CONCLUSIONS: Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of electronic health record systems, and on the role of leadership when implementing changes in clinical practice.
RELEVANCE TO CLINICAL PRACTICE: Stronger cooperation among policymakers, electronic health record system vendors, and healthcare professionals is essential for improving electronic health record systems and documentation practices. Involvement of end-users in these improvements can make a difference in the way the systems are perceived in the clinical workflow.
PMID: 27192412 [PubMed - indexed for MEDLINE]
Healthcare students as innovative partners in the development of future healthcare services: An action research approach.
Nurse Educ Today. 2016 Nov;46:4-9
Authors: Norbye B
BACKGROUND: Health care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities.
ACTION RESEARCH DESIGN: Partners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods.
FINDINGS: Inter-professional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced "second opinions" for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Inter-professional learning in community settings provided a platform to improve both healthcare education and rural healthcare services.
CONCLUSION: This research contributes to knowledge of how students' placement in inter-professional teams can enhance students learning from, with and about each other. The student teams promoted new ways of approaching and delivering complex patient treatment and care in community healthcare service. Collaborative partnerships in inter-professional learning have potential in the wider international arena as a means for practice improvement.
PMID: 27427864 [PubMed - indexed for MEDLINE]
Using blogs for facilitating and connecting nurse educator candidates.
Nurse Educ Today. 2016 Oct;45:35-41
Authors: Papastavrou E, Hamari L, Fuster P, Istomina N, Salminen L
BACKGROUND: Social media includes blog applications, which can be used as online journals or diaries that encourages interaction and collaboration within an online community. The aim of this study was to explore and describe the use of blog writing as learning journals during a short course for nurse educator candidates about social media.
METHOD: A qualitative descriptive design was used. The participants were nurses, Bachelor, Master's and Doctoral students who intended to follow a career in education (N=24, female n=21, male n=3, Mean age 37) from four different countries of the European Union. The blogs written during the course were used as a data collection method and the data was analyzed with qualitative content analysis.
RESULTS: A total of 260 blogger posts and 372 peer comments were analyzed. Four main categories emerged from the analysis: 1) Course content, new knowledge, and changed views, 2) Reflection and critical thinking, 3) Encouraging and peer support and 4) Expressing feelings, experiences, and expectations.
CONCLUSION: Blogs are potential learning spaces in short courses in nurse educator education, especially in sharing feelings and experiences, enhancing an encouraging atmosphere, critical thinking, and reflection.
PMID: 27429401 [PubMed - indexed for MEDLINE]
Impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults: A Quasi-experimental study.
Nurse Educ Today. 2016 Nov;46:17-23
Authors: Koehler AR, Davies S, Smith LR, Hooks T, Schanke H, Loeffler A, Carr C, Ratzlaff N
BACKGROUND: With an aging population, it is critical that nurses are educated and prepared to offer quality healthcare to this client group. Incorporating gerontology content into nursing curricula and addressing students' perceptions and career choices in relation to working with older adults are important faculty concerns.
OBJECTIVES: To examine the impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults and career intentions.
DESIGN: Quasi-experimental, pre- and post-test design.
SETTING: Medium-sized state university in the Mid Western United States PARTICIPANTS: Data were collected from three student cohorts during the spring semesters of 2012 (n=98), 2013 (n=80) and 2014 (n=88) for a total of N=266 with an average response rate of 85%.
METHODS: A survey instrument was administered via Qualtrics and completed by students prior to, and following completion of the course.
RESULTS: There was an overall significant increase (p=0.000) in positive perceptions of working with older adults among nursing students following completion of the course. The majority of participants (83.5%) reported having previous experience with older adults. Those with previous experience had higher perception scores at pre-test than those without (p=0.000). Post-test scores showed no significant difference between these two groups, with both groups having increased perception scores (p=0.120). Student preferences for working with different age groups suggested an overall increase in preference for working with older adults following the course.
CONCLUSIONS: A course in gerontological nursing, incorporating learning partnerships with community dwelling older adults, promotes positive perceptions of working with older adults, independently of the quality of prior experience. There was some evidence that students changed their preferences of working with different age groups in favor of working with older adults. Further research should be conducted to determine the mechanisms through which this takes place.
PMID: 27475123 [PubMed - indexed for MEDLINE]
The impact of educational experiences on nursing students' knowledge and attitudes toward people with Alzheimer's disease: A mixed method study.
Nurse Educ Today. 2016 Nov;46:57-63
Authors: Kimzey M, Mastel-Smith B, Alfred D
BACKGROUND: As the population ages, the effects of Alzheimer's disease will be felt by all nurses. Providing proper care for people with Alzheimer's disease is difficult and requires specific skills, attitudes, and knowledge. Limited data exists regarding nursing students' attitudes and knowledge toward people with Alzheimer's disease, whether undergraduate education prepares students to care for this population, or the best methods to support students in learning in an innovative and interactive environment.
OBJECTIVES: The aim of this study was to determine the effect of different educational experiences on nursing students' knowledge and attitudes toward people with Alzheimer's disease and to explore nursing students' knowledge and attitudes surrounding the care of people with Alzheimer's disease.
DESIGN: A convergent mixed method design. A three group (Alzheimer's disease clinical experience, online learning module, and no dementia-specific intervention), pretest and posttest design served as the quantitative arm of the study. A focus group discussion with themes extracted served as the qualitative piece of the study.
SETTING: College of Nursing in North Texas.
PARTICIPANTS: Convenience sample of 94 senior level nursing students enrolled in the undergraduate nursing program's Community Health course.
METHOD: Students completed pre and posttest surveys which included Alzheimer's Disease Knowledge Scale, Dementia Attitudes Scale, and demographic questionnaire. Content analysis was conducted on focus group responses to qualitative interview questions.
RESULTS: The Alzheimer's disease clinical group experienced increased knowledge and improved attitudes toward people with Alzheimer's disease compared with students who completed the online module or had no dementia-specific intervention. Four themes emerged from focus group data: Basic Alzheimer's disease knowledge, need for Alzheimer's disease experiential learning, negative feelings related to behaviors, and appropriate responses to behavioral and psychological symptoms of dementia.
CONCLUSION: Experiential learning in the form of clinical placements increased knowledge and improved attitudes about Alzheimer's disease compared with an online module and no dementia-specific intervention.
PMID: 27598794 [PubMed - indexed for MEDLINE]
A pilot study exploring the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life and wellbeing among UK community nurses.
Nurse Educ Today. 2016 Nov;46:109-114
Authors: Durkin M, Beaumont E, Hollins Martin CJ, Carson J
BACKGROUND: Compassion fatigue and burnout can impact on performance of nurses. This paper explores the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life, and wellbeing among community nurses.
AIM: To measure associations between self-compassion, compassion fatigue, wellbeing, and burnout in community nurses.
METHOD: Quantitative data were collected using standardised psychometric questionnaires: (1) Professional Quality of Life Scale; (2) Self-Compassion Scale; (3) short Warwick Edinburgh Mental Wellbeing Scale; (4) Compassion For Others Scale, used to measure relationships between self-compassion, compassion fatigue, wellbeing, and burnout.
PARTICIPANTS: A cross sectional sample of registered community nurses (n=37) studying for a postgraduate diploma at a University in the North of England took part in this study.
RESULTS: Results show that community nurses who score high on measures of self-compassion and wellbeing, also report less burnout. Greater compassion satisfaction was also positively associated with compassion for others, and wellbeing, whilst also being negatively correlated with burnout.
CONCLUSION: High levels of self-compassion were linked with lower levels of burnout. Furthermore when community nurses have greater compassion satisfaction they also report more compassion for others, increased wellbeing, and less burnout. The implications of this are discussed alongside suggestions for the promotion of greater compassion.
PMID: 27621200 [PubMed - indexed for MEDLINE]
Predictors of cultural competence among nursing students in the Philippines: A cross-sectional study.
Nurse Educ Today. 2016 Nov;46:121-126
Authors: Cruz JP, Estacio JC, Bagtang CE, Colet PC
BACKGROUND: With the continued emigration of Filipino nurses and increasing globalization, there is a need for globally competent nurses. Thus, the development of cultural competence among nursing students is critical in their preparation to assume their future responsibilities in the profession.
OBJECTIVES: This study investigated the predictors of cultural competence among nursing students in the Philippines.
DESIGN: This is a descriptive, cross-section study.
PARTICIPANTS AND SETTING: This study included 332 Bachelor of Science in nursing students in three nursing schools situated in the northern Philippines.
METHODS: The Cultural Capacity Scale was used to gather data from the respondents. The demographic characteristics and cultural background of the students were entered in a regression analysis to predict their cultural competence.
FINDINGS: The respondents manifested appreciably good cultural competence with a mean score of 68.98±11.73. The ability to understand the beliefs of various cultural groups received the highest mean of 3.65±0.86, while the ability to identify the care needs of patients with diverse cultural backgrounds received the lowest (mean, 3.31±0.74). Living in an environment with culturally diverse people, prior diversity training, being in the latter years of the nursing program, and with experience of caring for patients from diverse cultures and special population groups, were identified as predictors, accounting for 68.1% of the variance of cultural competence.
CONCLUSIONS: Nursing education should devise strategies to ensure future culturally competent Filipino nurses. Considering the fact that most of the Filipino nurses will potentially work overseas, they should be well prepared to provide competent care that is culturally sensitive.
PMID: 27636832 [PubMed - indexed for MEDLINE]
Augmented Nurse Care Management in CKD Stages 4 to 5: A Randomized Trial.
Am J Kidney Dis. 2017 Apr 07;:
Authors: Fishbane S, Agoritsas S, Bellucci A, Halinski C, Shah HH, Sakhiya V, Balsam L
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients.
STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial.
SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice. All participants had late-stage CKD (stages 4-5 CKD). Patients were excluded only if they had significant cognitive impairment.
INTERVENTION: The care management intervention involved nurse care manager coordination aided by the use of a disease-based informatics system for monitoring patients' clinical status, enhancing CKD education, and facilitating preparation for end-stage kidney disease. The comparison control group received usual late-stage CKD care alone.
OUTCOMES: The primary outcome was rate of hospitalization.
MEASUREMENTS: Rates of preemptive transplantation, home dialysis, hemodialysis (HD) starts without a hospitalization, and HD therapy initiation rates with catheters or with functioning accesses.
RESULTS: 130 patients were randomly assigned. The hospitalization rate was significantly lower in the intervention group versus controls: 0.61 versus 0.92 per year, respectively (incidence rate ratio, 0.66; 95% CI, 0.43-0.99; P=0.04). Peritoneal dialysis or preemptive transplantation was the initial end-stage kidney disease treatment in 11 of 30 (37%) participants receiving the intervention versus 3 of 29 (10%) receiving usual care. Among HD starts, treatment was initiated without hospitalization in 11 of 19 (58%) participants in the intervention group versus 6 of 26 (23%) in the control group. At the time of HD therapy initiation, a catheter was present in 7 of 19 (37%) participants in the intervention group versus 18 of 26 (69%) in the control group. A functioning arteriovenous access was in place in 10 of 19 (53%) participants in the intervention group and 7 of 26 (27%) in the control group LIMITATIONS: Moderate sample size, limited geographic scope.
CONCLUSIONS: The augmented nurse care management intervention resulted in reduced hospitalizations in late-stage CKD and there were suggestions of improved end-stage kidney disease preparation. Given suboptimal outcomes in late-stage CKD, care management interventions could potentially improve patient outcomes.
PMID: 28396108 [PubMed - as supplied by publisher]
Prison nursing and its training.
Rev Esp Sanid Penit. 2016 Dec;18(3):110-118
Authors: Sánchez-Roig M, Coll-Cámara A
The main task of nurses is to take care of sick and healthy people and evaluate changes in their health conditions. The goal is to take the appropriate measures to help their recovery or guarantee a dignified death, and if possible, help them regain autonomy and independence. Nursing is present in different areas: primary health, mental health, accident and emergencies, intensive and coronary care, surgical care, paediatrics, geriatrics, public health, occupational health, teaching, etc. In our case, prison nursing, one of the least known branches of the profession, we wanted to investigate more deeply the work of nurses in prisons, which aspect of health care they are responsible for and to what type of population they are geared towards, as well as the necessary training to be able to work in such a particular environment. To conclude, we have seen that university degrees in general nursing do not include knowledge in this area, and that authors from different countries support the specialization of prison nursing and the need for nurses to be trained according to the health conditions of inmates and the characteristics of prisons.
PMID: 27831598 [PubMed - indexed for MEDLINE]
Clinical and cost effectiveness of nurse-led self-management interventions for patients with copd in primary care: A systematic review.
Int J Nurs Stud. 2017 Mar 31;71:125-138
Authors: Baker E, Fatoye F
BACKGROUND AND OBJECTIVE: Chronic obstructive pulmonary disease is increasing in prevalence and constitutes a major cause of morbidity and mortality globally. As well as contributing to a significant decline in health status in many patients, this condition creates a considerable burden on healthcare providers. Self-management interventions are frequently implemented in community settings to limit the impact of chronic obstructive pulmonary disease on everyday life of individuals and to manage pressure on health systems. Nurses are the most likely professional group to provide self-management support. This systematic review aims to evaluate the clinical and cost effectiveness of nurse-led self-management for patients with chronic obstructive pulmonary disease in primary care.
DESIGN: A systematic review was conducted to identify randomized controlled studies comparing nurse-led self-management interventions to usual care DATA SOURCES: Seven electronic databases, including British Nursing Index, MEDLINE, CINAHL, AMED, EMBASE, Cochrane Library and NHS Economic Evaluation Database, were searched for relevant studies.
REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used to guide the structure of the review. The relevance of citations was assessed based on inclusion criteria, with full texts retrieved as required to reach a decision. Data extraction was performed independently by two reviewers. The Cochrane risk of bias tool was used to undertake a quality review. A narrative summary method was used to describe review findings.
RESULTS: Twenty-six articles describing 20 randomised controlled trials were included in the analysis. Self-management interventions were heterogeneous, with a variable number of components, level of support, mode of delivery and length of follow up. The review demonstrated that nurse-led self-management programmes may be associated with reductions in anxiety and unscheduled physician visits and increases in self-efficacy, but definitive conclusions could not be reached. Few studies addressed economic outcomes and the diverse perspectives, time frames and settings made comparisons difficult. Evidence on cost-effectiveness was inconclusive.
CONCLUSIONS: Some nurse-led self-management programmes in this systematic review produced beneficial effects in terms of reducing unscheduled physician visits, lowering patients' anxiety and increasing self-efficacy, but there is insufficient evidence to reach firm conclusions on the clinical or cost-effectiveness of the interventions. Further research should aim to identify the optimal components of these programmes and to identify those patients most likely to benefit. The inclusion of economic analyses in future studies would facilitate decisions by policy makers on the implementation of self-management interventions.
PMID: 28399427 [PubMed - as supplied by publisher]
Characteristics of Nurse Directors That Contribute to Registered Nurse Satisfaction.
J Nurs Adm. 2017 Apr;47(4):219-225
Authors: Burke D, Flanagan J, Ditomassi M, Hickey PA
OBJECTIVE: The aim of this study was to explore RNs and nurse directors' (NDs') perceptions of leadership on units with high RN satisfaction scores.
BACKGROUND: Identifying the characteristics of NDs that contribute to RN satisfaction is important in the recruitment and retention of RNs and in the selection and role development of NDs.
METHODS: This study used a qualitative design using appreciative inquiry-guided data collection.
RESULTS: Nine RNs and 9 NDs met the inclusion criteria. Each group identified 4 themes.
CONCLUSIONS: Registered nurse and ND participants identified similar themes representative of leadership attributes and behaviors that contribute to RN satisfaction.
PMID: 28333790 [PubMed - indexed for MEDLINE]
Impact of Participation in Community-Based Research Among Undergraduate and Graduate Students.
J Allied Health. 2017;46(1):e15-e24
Authors: George CL, Wood-Kanupka J, Oriel KN
Participation in community-based research provides college students with a high-impact experience involving both research and service learning. Presently, the impact of participation in community-based research projects has been measured most often through the use of post-learning course evaluations and case studies. The authors describe the impact of participation in community-based research, at a small liberal arts college, on undergraduate education students and graduate physical therapy students using the Community-Based Research Student Learning Outcomes Survey. Results from 2 years of survey responses and open-ended responses suggest that participation in such an experience may impact professional and personal growth, educational experiences, and civic engagement. This study provides support for universities and colleges to continue offering high-impact learning experiences for students by utilizing community-based research experiences while collaborating between academic departments.
PMID: 28255600 [PubMed - indexed for MEDLINE]
Exploring healthcare assistants' role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study.
BMC Palliat Care. 2017 Jan 19;16(1):6
Authors: Jansen BW, Brazil K, Passmore P, Buchanan H, Maxwell D, McIlfatrick SJ, Morgan SM, Watson M, Parsons C
BACKGROUND: Pain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals' use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area.
METHODS: A qualitative approach was adopted, using key informant interviews with healthcare assistants caring for people with advanced dementia approaching the end of life in hospice, nursing home and acute care settings. Thematic analysis was the analytic approach taken to interpretation of interview data. Data were collected between June 2014 and September 2015.
RESULTS: Fourteen participants took part in the study. Participants' average length of caring experience was 15.4 years and most were female. Three key themes emerged: recognising pain, reporting pain, and upskilling. Participants were often the first to notice obvious causes of pain and to detect changes in patient norms which signified hidden causes of pain. Comprehensive knowledge of resident norms enabled participants to observe for behavioural and nonverbal indicators of pain and distinguish these from non-pain related behaviours. Pain reporting was heavily impacted by relationships with professional staff and the extent to which participants felt valued in their role. Positive relationships resulted in comprehensive pain reports; negative relationships led to perfunctory or ambiguous reporting. Participants emphasised a desire for further training and upskilling, including in the use and reporting of basic pain tools.
CONCLUSIONS: Healthcare assistants are frontline staff who have a key role in direct patient care, spending a considerable amount of time with patients in comparison to other health professionals. These staff are often first to notice changes in patients that may signify pain and to alert professional staff. However, to ensure the quality of these reports, further efforts must be made in reversing stigma attached to this role and in upskilling these members of the healthcare team.
PMID: 28103847 [PubMed - indexed for MEDLINE]