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Nurse Education in Practice Nov 2023To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency. (Review)
Review
AIM
To synthesize and analyze the literature on nursing clinical competence to assess the factors affecting nursing clinical competency.
BACKGROUND
Nursing competence affects not only patients but also nurses themselves. Competent nurses contribute to patient safety. Prioritizing clinical competency enables nurses to deliver high-quality care. Clinical nursing competency is influenced by various factors including education and training, experience, professional development, clinical judgment, decision-making skills and communication.
DESIGN
This was a systematic review.
METHODS
This study utilized an extensive literature search of online databases, including SCOPUS, Web of Science and PubMed. This review followed the guidelines provided by the Effective Practice and Organization of Care (EPOC) Cochrane Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS
This systematic review provided 20 valuable articles, with a total of 6273 participants across the 20 studies, including 18 cross-sectional studies and two descriptive-correlational studies, predominantly using quantitative research methods. The analysis revealed several key factors that significantly affect nurses' clinical competency. These factors included years of experience, workplace environment, theoretical knowledge and educational level, marital status, clinical training, job satisfaction, turnover intention, job stress and critical thinking.
CONCLUSIONS
Understanding and addressing these factors are crucial for enhancing nurses' clinical competence and ultimately improving patient outcomes. Further research and interventions should be directed towards promoting supportive work environments, continuous education and the development of critical thinking skills among nurses to optimize their clinical competencies.
Topics: Humans; Clinical Competence; Cross-Sectional Studies; Job Satisfaction; Communication; Nurses
PubMed: 37951064
DOI: 10.1016/j.nepr.2023.103826 -
Nursing Ethics 2023Research has shown that moral distress negatively impacts nurses, patients, and organizations; however, several scholars have argued that it can be an opportunity for...
BACKGROUND
Research has shown that moral distress negatively impacts nurses, patients, and organizations; however, several scholars have argued that it can be an opportunity for positive outcomes. Thus, factors that may mitigate moral distress and catalyze positive change need to be explored.
RESEARCH AIM
The purpose of this study was to explore the relationships among structural and psychological empowerment, psychiatric staff nurses' experience of moral distress, and strategies for coping with moral distress.
RESEARCH DESIGN
A descriptive cross-sectional correlational study.
PARTICIPANTS AND RESEARCH CONTEXT
A total of 180 registered nurses working in psychiatric hospitals in Japan participated. This study examined relationships among key variables using four questionnaires to assess structural and psychological empowerment, moral distress for psychiatric nurses, and coping strategies. Statistical analyses of correlations and multiple regressions were conducted.
ETHICAL CONSIDERATIONS
The study was approved by the institutional review board at the author's affiliated university.
FINDINGS
Psychiatric nurses perceived moderate levels of structural and psychological empowerment, and their experiences of moral distress were related to low staffing. Structural empowerment was negatively related to the frequency of moral distress but not the intensity. Contrary to expectations, psychological empowerment was not found to mitigate nurses' moral distress. Multivariate regression analyses revealed that the significant predictors of moral distress were the leaving issues unresolved coping style, the problem-solving coping style, and a lack of formal power, which explained 35% and 22% of the variance in the frequency and intensity of moral distress, respectively.
CONCLUSIONS
In psychiatric hospitals in Japan, nurses experience moral distress that compromises the quality of care they provide. Therefore, formal support for nurses in voicing and investigating their moral concerns is required to bestow formal power by establishing a ward culture that includes shared governance.
Topics: Humans; Stress, Psychological; Cross-Sectional Studies; Surveys and Questionnaires; Morals; Nurses
PubMed: 37226471
DOI: 10.1177/09697330231153915 -
Psychogeriatrics : the Official Journal... Jun 2024Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults...
BACKGROUND
Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults after graduation. This study aimed to evaluate the perceptions of second year nursing and midwifery students toward elderly people staying in nursing homes through metaphor analysis.
METHODS
This qualitative study has used the phenomenological approach. The sample of the study consisted of 128 nursing and midwifery students by purposive sampling method. Students were prompted to complete a sentence to express their perceptions about the elderly living in nursing homes: 'The elderly in the nursing home is similar to … because …' Participants were required to fill in their responses in two stages, providing metaphors in the first blank and reasons for their metaphors in the second blank.
RESULTS
The results indicated that five main themes and 12 sub-themes were obtained from student metaphors: (i) needing help in meeting their needs (need for care and need for love); (ii) the emotional burden of a life away from loved ones (loneliness, abandonment, and helplessness); (iii) exhaustion at the end of the road (end, loss, and unproductive); (iv) holding on to life again (friendship and beginning); and (v) post-traumatic growth (strong and experienced).
CONCLUSION
Students should question how to create opportunities and increase interaction for the elderly in the age of changing and developing technology before graduation and should be trained as professional individuals who are willing for this purpose.
PubMed: 38877689
DOI: 10.1111/psyg.13154 -
Issues in Mental Health Nursing Apr 2024Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a... (Review)
Review
Defining psychiatric and mental health nursing has been a challenge for decades, and it is still difficult to find a comprehensive definition. We have identified a possibility to clarify psychiatric and mental health nursing based on humanistic philosophy in a general psychiatric care context. The aim was therefore to identify and synthesize the theoretical frameworks from which psychiatric and mental health nursing models are developed. We systematically collected and evaluated articles based on Grounded Theory (GT) methodology regarding psychiatric or mental health nursing. The PRISMA statement for systematic reviews was used and the formal process of synthesis, as a three-step process of identifying first -, second - and third-order themes following the examples of Howell Major and Savin-Baden. The synthesis resulted in a model describing five core elements of psychiatric and mental health nursing: 'professional nursing', 'therapeutic relationships' and 'honest engagement', with time as the all-encompassing theme, including the patients' 'lifetime perspective'. Psychiatric and mental health nursing is a caring support towards recovery, where the patient's lifetime perspective must be in focus during the caring process with a relationship built on an honest engagement. Time is therefore essential for psychiatric and mental health nursing.
Topics: Humans; Psychiatric Nursing; Nurse-Patient Relations
PubMed: 38363803
DOI: 10.1080/01612840.2024.2305934 -
Journal of the American Psychiatric... Apr 2024Identifying and sharing psychiatric mental health (PMH) research priorities can help identify gaps in the literature, determine training needs for nurses, and assist... (Review)
Review
BACKGROUND
Identifying and sharing psychiatric mental health (PMH) research priorities can help identify gaps in the literature, determine training needs for nurses, and assist investigators in locating funding.
AIMS
The aims for this project included: (1) identify PMH nursing specialty research priorities from large, public funding entities; (2) compare the identified research priorities and scholarly articles published in 2020; and (3) outline future directions for advancing the science of PMH nursing.
METHODS
Strategic plans of funding entities for PMH research were reviewed for research priorities. Summarized priorities were then compared with publications from peer-reviewed PMH nursing journals. Work conducted in the United States was extracted and categorized as original research, evidence-based practice (EBP), or quality improvement (QI), then design and population.
RESULTS
Priorities from 13 funding entities comprised three domains (education, research, and practice), with nine areas, 30 topics, and subtopics. Eight journals produced 432 articles with 99 (23%) conducted in the United States. Among these journals, publications fitting research priorities ranged from 1 to 33 articles. Of the 99 articles, 85% were original research and 15% were either EBP or QI. Descriptive articles comprised 64% and 23% tested interventions. Populations studied included workforce; adults; infants, children, and adolescents; and parents.
CONCLUSIONS
All published articles by the U.S. PMH nurses matched the funding priorities, but not all funding priorities were addressed by 2020 publications. The majority of work was conducted outside of the United States and most published from the United States was descriptive, contrary to many United States funders' priorities for interventional research.
Topics: Child; Humans; United States; Adolescent; Psychiatric Nursing; Research; Workforce; Evidence-Based Practice
PubMed: 36171692
DOI: 10.1177/10783903221124160 -
Journal of Psychiatric and Mental... Apr 2024
Topics: Humans; Psychiatric Nursing
PubMed: 37622387
DOI: 10.1111/jpm.12971 -
International Journal of Mental Health... Oct 2023Patients with mood disorders are at high risk of suicidality, and emergency departments (ED) are essential in the management of this risk. This study aims to (1)...
Patients with mood disorders are at high risk of suicidality, and emergency departments (ED) are essential in the management of this risk. This study aims to (1) describe the suicidal thoughts and behaviours of patients with mood disorders who come to ED; (2) assess the psychometric properties of the Suicidal Behaviours Questionnaire-Revised (SBQ-R) in a psychiatric ED; and (3) determine the best predictors of suicidality for these patients. A total of 300 participants with mood disorders recruited for the Signature Bank of the Institut universitaire en santé mentale de Montréal (IUSMM) were retained. Suicidality was assessed using the SBQ-R. Other clinical and demographic details were recorded. Bivariate analyses, correlations and multivariate regression analyses were conducted. SBQ-R's internal consistency, construct and convergent validities were also tested. In the Patient Health Questionnaire-9 (PHQ-9), 53.3% of the sample stated they had suicidal or self-harm thoughts in the last 2 weeks. The mean score obtained at the SBQ-R was 8.3. Multivariate analysis found that SBQ-R scores were associated with depressive symptoms and substance use, especially alcohol, accounting for 44.3% of the model variance. Cronbach's alpha was 0.81 [0.78, 0.84] and factor loadings for items 1-4 were 0.68, 0.88, 0.54, and 0.85, respectively. The confirmatory factor analysis indicated that the model fit the data well. The SBQ-R is a brief and valid instrument that can easily be used in busy emergency departments to assess suicide risk. Depressive symptoms and alcohol use shall also be assessed, as they are determinants of increased risk of suicidality.
Topics: Humans; Suicidal Ideation; Suicide; Mood Disorders; Surveys and Questionnaires; Psychometrics; Reproducibility of Results
PubMed: 37150928
DOI: 10.1111/inm.13161 -
Iranian Journal of Nursing and... 2024Patient handover (handoff in America) is the transfer of information and accountability among nurses assigned to patient care. Introduction, Situation, Background,... (Review)
Review
Implementing the Verbal and Electronic Handover in General and Psychiatric Nursing Using the Introduction, Situation, Background, Assessment, and Recommendation Framework: A Systematic Review.
BACKGROUND
Patient handover (handoff in America) is the transfer of information and accountability among nurses assigned to patient care. Introduction, Situation, Background, Assessment, and Recommendation (ISBAR) is currently the most popular framework for framing handovers. However, research shows that incomplete handovers and information transfers among healthcare providers and nurses exist and are responsible for adverse patient events.
MATERIALS AND METHODS
The current systematic review aims to view contemporary literature on handover, especially but not exclusively in psychiatric settings, and to extract current conditions from Electronic Patient Records (EPRs) using the ISBAR framework. A total of fifty-five scientific papers were selected to support the scoping review. Eligibility criteria included structured research to analyze outcomes, completed by reviewing policy papers and professional organization guidelines on I/SBAR handovers.
RESULTS
Our systematic review shows that the application of ISBAR increases interprofessional communication skills and confidence and the quality of the transfer of clinical information about patients, resulting in increased patient safety and quality of care.
CONCLUSIONS
Implementing the knowledge and application of structured patient handover will respond to current recommendations for service improvement and quality of care. Furthermore, nurses who use ISBAR also reported its benefits as they feel they can deliver what is required for patient care information in a structured, fast, and efficient way. A further increase in the efficacy of handovers is reported by using EPR.
PubMed: 38333347
DOI: 10.4103/ijnmr.ijnmr_24_23 -
The Psychiatric Quarterly Dec 2023Since the 1960s, empirical research has focused on a better understanding of the characteristics of assaultive psychiatric patients. International research from 1960 to... (Review)
Review
Since the 1960s, empirical research has focused on a better understanding of the characteristics of assaultive psychiatric patients. International research from 1960 to 2017 indicated that male and female patients with schizophrenia and substance use disorder presented the greatest risk for assault with nursing personnel being at higher risk. This present review of studies sought to assess the latest research findings on assaultive patients for the most recent five-year period, 2017-2022. It was hypothesized that patients with schizophrenia and substance use disorders would present the greatest assault risk for nursing personnel. The studies in this review supported this hypothesis. Assaults by patients with schizophrenia and substance abuse has been a consistent finding worldwide for 62 years of published research. Explanations for these findings, the possible role of posttraumatic stress disorder (PTSD) in assaultive patients, and an updated methodological review are presented.
Topics: Humans; Male; Female; Violence; Schizophrenia; Crime Victims; Substance-Related Disorders; Patients
PubMed: 37667138
DOI: 10.1007/s11126-023-10050-x -
Archives of Psychiatric Nursing Dec 2023
PubMed: 38070994
DOI: 10.1016/j.apnu.2023.06.004