-
Nursing Open May 2021To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. (Review)
Review
AIM
To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators.
DESIGN
A qualitative design with a deductive approach was used.
DATA SOURCES
Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature.
REVIEW METHODS
Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
RESULTS
A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators.
CONCLUSION
This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators.
IMPACT
This review provides evidence-based results that health organizations can benefit from nursing care quality.
Topics: Cross-Sectional Studies; Humans; MEDLINE; Nursing Care; Nursing Research; Nursing Staff
PubMed: 34482649
DOI: 10.1002/nop2.654 -
Nursing Reports (Pavia, Italy) Sep 2023With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective... (Review)
Review
BACKGROUND
With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective leadership; particularly, transformational leadership (TFL) is shown to scientifically be the most successfully recognized leadership style in healthcare, focusing on relationship building while putting followers in power and emphasizing values and vision.
AIM
To examine how transformational leadership affects nurses' job environment and nursing care provided to the patients and patients' outcomes.
DESIGN
A systematic literature review was conducted. From 71 reviewed, 23 studies were included (studies included questionnaire surveys and one interview, extracting barriers and facilitators, and analyzing using qualitative synthesis).
RESULT
TFL indirectly and directly positively affects nurses' work environment through mediators, including structural empowerment, organizational commitment, and job satisfaction. Nurses perceived that managers' TFL behavior did not attain excellence in any of the included organizations, highlighting the necessity for additional leadership training to enhance the patient safety culture related to the non-reporting of errors and to mitigate the blame culture within the nursing environment.
CONCLUSION
Bringing more focus to leadership education in nursing can make future nursing leaders more effective, which will cultivate efficient teamwork, a quality nursing work environment, and, ultimately, safe and efficient patient outcomes. This study was not registered.
PubMed: 37755351
DOI: 10.3390/nursrep13030108 -
Journal of Advanced Nursing Apr 2021The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to... (Review)
Review
AIM
The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research.
DESIGN
Discussion Paper.
DATA SOURCES
Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR).
IMPLICATIONS FOR NURSING AND MIDWIFERY
Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency.
CONCLUSION
This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery.
IMPACT
With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.
Topics: Female; Humans; Midwifery; Pregnancy; Research Design; Research Personnel; Students
PubMed: 33543511
DOI: 10.1111/jan.14743 -
Nurse Education in Practice Nov 2021To identify the prevalence of mental health problems and sleep disturbances among nursing students during the COVID-19 pandemic. (Meta-Analysis)
Meta-Analysis Review
AIM
To identify the prevalence of mental health problems and sleep disturbances among nursing students during the COVID-19 pandemic.
BACKGROUND
As a future professional workforce, nursing students are expected to play a role in controlling the COVID-19 pandemic; however, physical and mental health problems may hinder their willingness to stay in the nursing profession. Evidence of the prevalence of the health problems among nursing students related to COVID-19 may allow educators to manage their students' health problems and make them feel more positive about their future careers.
DESIGN
Systematic review and meta-analysis. This study was prospectively registered with PROSPERO.
DATA SOURCES
Databases, including CINAHL, Embase, PubMed and Web of Science, were searched for all related journal articles, from database inception to June 29, 2021, published between 2020 and 2021.
METHODS
This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a PICOS search strategy. A DerSimonian-Laird random-effects model was used to estimate the prevalence and potential heterogeneity among the selected studies using the Cochran Q statistic and I-square test. Publication bias was assessed using the Egger intercept test.
RESULTS
Seventeen studies were included in the meta-analysis, representing 13,247 nursing students. During the COVID-19 pandemic, the prevalence of four health problems and sleep disturbances were identified. The health problem with the highest prevalence in nursing students was depression (52%). Other COVID-19-related health problems were fear (41%), anxiety (32%) and stress (30%) and sleep disturbances (27%).
CONCLUSIONS
The findings from this study showed that strategies are necessary to manage nursing students' teaching and learning during the COVID-19 pandemic or similar future situations. Our results suggest that preparing modified distance learning might reduce the prevalence of health problems related to the educational process. In addition, providing regular mental health assessments or online mental health services to students may improve their mental health and increase their well-being. Nursing education policies regarding clinical practice remain to be formulated to ensure the achievement of competencies to support future careers while considering the mental readiness and safety of students.
Topics: COVID-19; Humans; Mental Health; Pandemics; Prevalence; SARS-CoV-2; Sleep; Students, Nursing
PubMed: 34653783
DOI: 10.1016/j.nepr.2021.103228 -
Journal of Advanced Nursing Oct 2022To map the nursing skills required for different types of disasters. (Review)
Review
AIMS
To map the nursing skills required for different types of disasters.
DESIGN
This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute.
DATA SOURCES
A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review.
REVIEW METHODS
The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized.
RESULTS
We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills.
CONCLUSION
This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing.
IMPACT
This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.
Topics: Clinical Competence; Disasters; Earthquakes; Humans; Nurses; Triage
PubMed: 35989672
DOI: 10.1111/jan.15337 -
International Journal of Nursing Studies Oct 2022The contribution of registered nurses towards safe patient care has been demonstrated in many studies. However, most of the evidence linking staffing levels to outcomes... (Review)
Review
BACKGROUND
The contribution of registered nurses towards safe patient care has been demonstrated in many studies. However, most of the evidence linking staffing levels to outcomes is cross-sectional with intrinsic limitations including an inability to establish that presumed cause (staffing) precedes the effect. No reviews have summarised longitudinal studies considering nurse staffing and patient outcomes.
OBJECTIVES
To identify and assess the evidence for an association between nurse staffing levels, including the composition of the nursing team, and patient outcomes in acute care settings from longitudinal studies.
METHODS
We undertook a systematic review of studies where the association between nurse staffing with patient outcomes was assessed in a longitudinal design. Studies with repeated cross-sectional analyses were excluded unless a difference-in-difference design was used. We searched Medline, CINAHL, Embase and the Cochrane Library up to February 2022. We used the ROBINS-I tool to assess risk of bias. We synthesised results in a tabular form and a narrative grouped by outcome.
RESULTS
27 papers were included. Studies were conducted in a variety of settings and populations, including adult general medical/surgical wards and adult and neonatal intensive care units. Staffing measures were operationalised in a variety of different ways, making direct comparisons between studies difficult and pooled estimates impossible. Most studies were either at serious (n = 12) or critical (n = 5) risk of bias, with only 3 studies at low risk of bias. Studies with the most risk of bias were judged as likely to underestimate the effect of higher registered nurse staffing. Findings are consistent with an overall picture of a beneficial effect from higher registered nurse staffing on preventing patient death. The evidence is less clear for other patient outcomes with a higher risk of bias, but in general the proposition that higher registered nurse staffing is likely to lead to better patient outcomes is supported. Evidence about the contribution of other nursing staff groups is unclear.
CONCLUSION
The causal relationship between low registered nurse staffing and mortality is plausible and these estimates of relationships from longitudinal studies provide further support. To address residual uncertainties, future studies should be conducted in more than one hospital and using standardised measures when reporting staffing levels.
TWEETABLE ABSTRACT
Having more registered nurses on hospital wards is causally linked to reduced mortality - new review shows there is little room for doubt @ora_dall @workforcesoton @turnel.
Topics: Adult; Cross-Sectional Studies; Humans; Infant, Newborn; Longitudinal Studies; Nursing Staff, Hospital; Personnel Staffing and Scheduling; Workforce
PubMed: 35780608
DOI: 10.1016/j.ijnurstu.2022.104311 -
International Journal of Nursing Studies May 2019Nursing shortages have profoundly impacted hospitals and consequently increased financial expenditure, resulting in work overload, thus augmenting nurses' stress and...
BACKGROUND
Nursing shortages have profoundly impacted hospitals and consequently increased financial expenditure, resulting in work overload, thus augmenting nurses' stress and burnout levels. Studies have found that resilience helps nurses reduce the effects of stress and burnout. However, the factors associated with nurse resilience are yet to be determined.
OBJECTIVES
This systematic review aims to identify the associated personal and work-related factors of nurse resilience.
DESIGN
This systematic review has been registered in the international prospective register of systematic reviews (Registered Number: CRD 42018094080). Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.
DATA SOURCES
The systematic search was undertaken between March and April 2018 in five databases: CINAHL Plus, MEDLINE (Ovid), PsycINFO, EMBASE, and Scopus. The searched terms combined in each database were: resilience, hardiness, work, employ, occupation, job, and nursing.
REVIEW METHODS
Full-text English articles published between 2000 and 2018 were included. Studies were also included if they involved: (1) nurses who provided direct patient care, (2) resilience and its associated factors, (3) an empirical quantitative study, and (4) a quality assessment grade of 'good' or 'fair'. Two authors carried out the study eligibility and quality assessment independently. A narrative synthesis was utilised following the Job Demands-Resources model to identify the factors of job demands and resources, which were associated with nurse resilience.
RESULTS
A total of 38 articles met the criteria and were systematically reviewed and narratively synthesised. Various resilience scales utilised in these studies made it unfeasible to synthesise the evidence using a meta-analysis. Inconsistencies exist when examining personal and work-related factors. Job demands (stress, burnout, posttraumatic stress disorder, and workplace bullying) were negatively associated with resilience, while job resources (coping skills, self-efficacy, social support, job satisfaction, job retention, and general wellbeing) were positively related to resilience. Using a quality assessment tool, 23 studies were rated as 'Good', 15 were assessed as 'Fair', and 20 were found to have a risk of bias.
CONCLUSIONS
Understanding nurse resilience can proactively help nurses identify or prevent potential problems, thus fostering job resources and ultimately achieving personal and professional growth. Increased nurse resilience can help nurses reduce emotional exhaustion, increase work engagement, and enhance function when facing workplace challenges. This can assist nurses to establish strategies to deal with adversity and attenuate the effects of job demands. Further research is needed to explore nurse resilience and develop a consistent instrument for measuring resilience.
Topics: Adaptation, Psychological; Attitude of Health Personnel; Burnout, Professional; Humans; Job Satisfaction; Nursing Staff, Hospital; Resilience, Psychological; Workload
PubMed: 30925279
DOI: 10.1016/j.ijnurstu.2019.02.014 -
Nurse Education in Practice May 2023To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in... (Review)
Review
AIM
To synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settings BACKGROUND: Nurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings.
DESIGN
A qualitative systematic review and meta-synthesis METHODS: PubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012-25 Feb 2023. Qualitative studies of any design reporting nursing students' experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso's 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline.
RESULTS
The review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided.
CONCLUSIONS
While caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.
Topics: Humans; Students, Nursing; Pandemics; COVID-19; Terminal Care; Palliative Care; Death
PubMed: 37004470
DOI: 10.1016/j.nepr.2023.103625 -
Critical Reviews in Oncology/hematology Aug 2022Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive... (Review)
Review
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
Topics: Adult; Anxiety; Caregivers; Health Services Needs and Demand; Humans; Needs Assessment; Neoplasms; Social Support; Surveys and Questionnaires
PubMed: 35662585
DOI: 10.1016/j.critrevonc.2022.103728 -
Nurse Education Today Mar 2021Due to technological advancements and the current generation being more tech-savvy, the use of virtual worlds in nursing education and clinical practice is increasingly... (Review)
Review
BACKGROUND
Due to technological advancements and the current generation being more tech-savvy, the use of virtual worlds in nursing education and clinical practice is increasingly popular. We performed a systematic review on randomised controlled trials and quasi-experimental studies to examine the current evidence on the use of virtual worlds as a teaching tool and to ascertain the outcomes measured.
DESIGN
Systematic review of randomised controlled trials and quasi-experimental studies.
DATA SOURCES
Six electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, Web of Science, and ProQuest) were searched by title and abstract from each database's date of inception to December 2019.
REVIEW METHODS
The Joanna Briggs Institute's Critical Appraisal Tool was used to conduct critical appraisal of the selected articles.
RESULTS
Eighteen studies were included in the narrative summary. Studies were mostly conducted in developed countries and focused on nursing students. Advantages of virtual worlds include higher time-cost-effectiveness as compared to mannequin-based simulations and face-to-face lectures. Two major disadvantages were technological issues and the lack of realism.
CONCLUSIONS
Among the three learning outcomes (skills-based, cognitive, and affective), virtual worlds are the most effective in improving cognitive outcomes such as theoretical knowledge. This suggests that virtual worlds may be used as an alternative or complementary method to teach theoretical knowledge in nursing education.
Topics: Education, Nursing; Humans; Learning; Nurses; Students, Nursing; Virtual Reality
PubMed: 33203545
DOI: 10.1016/j.nedt.2020.104662