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Journal of Nursing Scholarship : An... Jan 2023Nursing-sensitive indicators (NSIs) measure factors influencing nursing care quality and patient outcomes. Established NSIs reflect general and select specialty nursing...
INTRODUCTION
Nursing-sensitive indicators (NSIs) measure factors influencing nursing care quality and patient outcomes. Established NSIs reflect general and select specialty nursing practices. However, a core set of NSIs for international pediatric oncology nursing practice does not currently exist. Without valid and reliable quality indicators, the impact of nursing care on children and adolescents with cancer cannot be effectively measured and improved. The purpose of this study was to develop a preliminary core set of NSIs for international pediatric oncology nursing that would be important, actionable, and feasible to measure across varied resource settings and countries.
DESIGN/METHODS
A multiphase sequential mixed methods research design, intersected with a classical Delphi method, was utilized. Through purposive snowball sampling, 122 expert pediatric oncology nurses from 43 countries participated. Round One: Panelists identified five potential NSIs and constructs. Open-ended responses were coded and categorized through descriptive content analysis and integrated into the next round. Round Two: Panelists selected their top 10 NSIs and constructs and ranked them by importance to patient care quality. Mean importance scores were calculated through reverse scoring; the top 10 NSIs and constructs were integrated into the next round. Round Three: Panelists ranked the top 10 NSIs and constructs by order of importance for this particular population, then rated each NSI/Construct for actionability and feasibility of measurement by Likert-scale. Rounds Two and Three were analyzed using descriptive statistics. Mixed methods meta-inferences were derived from the integration of Rounds One and Three findings.
RESULTS
Eighty-five (70%) panelists from 38 countries completed all Delphi survey rounds. The preliminary core set of NSIs and constructs identified by the expert panel, and ranked in order of importance, were as follows: safe chemotherapy administration and handling, infection prevention/control, pediatric oncology nursing orientation program, early warning score system/recognition of patient deterioration, chemotherapy/biotherapy education/course, pain assessment/management, symptom assessment/management, patient and family education, palliative/end of life care, and continuing nursing education/competency. All NSIs and constructs were rated as actionable; all but palliative/end of life care were rated as feasible to measure. Each of the 10 NSIs and constructs were nominated in Round One by at least one expert panelist from low- and middle-income and high-income countries, and at least one panelist from the Americas.
CONCLUSION
Preliminary core NSIs and constructs provide insight into common attributes of international pediatric oncology nursing practice that are important, actionable, and feasible for quality measurement.
CLINICAL RELEVANCE
NSIs have the potential to drive quality improvement, guide comparison with other institutions, promote knowledge-sharing, and advance pediatric oncology nursing outcomes around the world. These NSIs and constructs may also be relevant to other pediatric and adult oncology settings.
Topics: Adult; Adolescent; Humans; Child; Quality Indicators, Health Care; Delphi Technique; Nursing Care; Pediatric Nursing; Neoplasms
PubMed: 35790072
DOI: 10.1111/jnu.12798 -
Nursing Open Jun 2023This study was conducted to describe the perceptions of nursing applicants about their chosen profession and to explore the factors which influenced their understanding.
AIM
This study was conducted to describe the perceptions of nursing applicants about their chosen profession and to explore the factors which influenced their understanding.
DESIGN
A qualitative study with a conventional content analysis design.
METHODS
Participants were 19 nursing applicants enrolling in nursing schools in three provinces of western Iran. Data were collected using semi-structured interviews. The content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth.
RESULTS
The mean age of participants was 20 years (SD = 2.5), and 11 of them (57.9%) were females. Participants understood the nature of nursing work to encompass only a limited level of independence; they viewed it as a feminine profession, and as a job with spiritual rewards. The perceived content of nursing work included providing help and patient care in the hospital with a focus on performing procedural tasks. Applicants' perceptions of nurses' characteristics included strong physical endurance, communication skills, emotional strength and low intellectual skills. The professional status of nursing was perceived simultaneously as having high job security but limited potential for career advancement and professional growth. The factors reported to influence applicants' perceptions were related to the media, academic-career counsellors, personal factors, and family and friends.
Topics: Female; Humans; Young Adult; Adult; Male; Iran; Qualitative Research; Emotions; Friends; Perception
PubMed: 36710375
DOI: 10.1002/nop2.1629 -
Child Health Nursing Research Jan 2023This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness.
PURPOSE
This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness.
METHODS
A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program.
RESULTS
XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001).
CONCLUSION
Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.
PubMed: 36760110
DOI: 10.4094/chnr.2023.29.1.24 -
International Journal of Burns and... 2021The COVID-19 pandemic has changed the world and intensified health management in many parts of the world. Sensitivity in burn patients' care and prevalence of COVID-19... (Review)
Review
INTRODUCTION
The COVID-19 pandemic has changed the world and intensified health management in many parts of the world. Sensitivity in burn patients' care and prevalence of COVID-19 have a major impact on this group's healthcare system and infection control strategies. The purpose of this study is to review burn care strategies during the COVID-19 outbreak.
MATERIALS AND METHODS
The present study is a narrative review study. In writing this paper, to access information, the keywords of Coronavirus, COVID-19, burn, strategy, care, and SARS were used. Due to the emergence of COVID disease, searches in Science Direct, PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran, Springer, and Elsevier databases were performed without time limit. Research articles were purposefully selected and approved to be investigated based on the criteria for entering the research. A total of 14 articles had a full text related to the research scope. The researchers used qualitative content analysis to analyze the data. Data analysis was conducted as a comprehensive review of articles, qualitative conclusions, and results.
RESULTS
In this study, 14 articles related to burn care strategies in the COVID-19 epidemic were selected. Their results were reviewed in two areas of staff care strategies and burn patients during the COVID-19 outbreak. Findings indicate that appropriate prevention and protection strategies and measures should be followed to prevent the transmission of the COVID-19 virus to burn care professionals. In addition, burn patient care strategies were proposed in two levels of minor and moderate to severe burns, so that patients with burns receive adequate burn care during the COVID-19 outbreak.
CONCLUSION
Implementation of staff and burn patient care strategies during the COVID-19 pandemic is essential to treat burn patients and prevent the spread of the COVID virus.
PubMed: 34557331
DOI: No ID Found -
BMC Medical Education Jul 2020Interprofessional education (IPE) is deemed essential for interprofessional collaboration (IPC) in healthcare systems. IPC has positive effects for both patients and...
BACKGROUND
Interprofessional education (IPE) is deemed essential for interprofessional collaboration (IPC) in healthcare systems. IPC has positive effects for both patients and healthcare professionals. Especially in pediatrics, IPC is paramount for adequate care of patients and their families though there is a lack of data on the attitudes towards IPE and IPC and acquisition of respective competences in pediatric nursing and medical staff.
METHODS
Frequencies of interactions and attitudes towards IPE and IPC, with a focus on acquisition of competences for IPE and IPC, of nurses (N = 79) and physicians (N = 70) in a large pediatric university hospital were evaluated with an online questionnaire.
RESULTS
All participants worked as part of interprofessional teams, mostly consisting of nurses and physicians. The majority (94.9% (n = 75) of nurses and 100% (n = 70) of physicians) highly valued IPC. Medical doctors acquired most competences important for IPC during day-to-day work and reported a substantial lack of IPE. Nursing staff on the other hand did report significant interprofessional education during their training as well as ongoing interprofessional learning during day-to-day work. Nurses also appreciated IPE more.
CONCLUSIONS
Even though IPC is commonly reported in nurses and physicians working at a large pediatric university hospital there is a lack of structured IPE. A focus should be on IPE for nurses and physicians to enable them to effectively collaborate together. Political and local initiatives for IPE are gaining momentum but still need to be established nationally and internationally.
Topics: Attitude of Health Personnel; Clinical Competence; Health Personnel; Humans; Interprofessional Education; Interprofessional Relations; Nursing Staff; Pediatrics; Physicians; Surveys and Questionnaires
PubMed: 32615959
DOI: 10.1186/s12909-020-02128-y -
Frontiers in Pediatrics 2020Cultural factors have gradually become important considerations in health services, including in pain management for adult and pediatric patients. However, research on... (Review)
Review
Cultural factors have gradually become important considerations in health services, including in pain management for adult and pediatric patients. However, research on culturally based pain management in neonates remains limited. This mini review aims to provide an overview of procedural pain management in neonates based on cultural approaches from various countries. The review found that there are several analyses of pain management procedures for neonates developed from cultural practices, namely, acupuncture, foot massage and reflexology, Yakson touch therapy, and aromatherapy. The acupuncture method (invasive and non-invasive) is more widely studied using randomized controlled trials (RCTs) than the other methods because the techniques applied can be standardized and measured. There are indications of the positive impact of all the methods examined in this review, but the results of studies have not been consistent because of the diversity of outcome measurement methods used and because of the difficulty of creating standardized procedures to measure pain management methods that are based on cultural practices.
PubMed: 33014934
DOI: 10.3389/fped.2020.00540 -
Belitung Nursing Journal 2023Parents of newly diagnosed cancer children often experience significant concerns about the implications of the diagnosis. They find themselves in challenging...
BACKGROUND
Parents of newly diagnosed cancer children often experience significant concerns about the implications of the diagnosis. They find themselves in challenging decision-making situations, navigating through uncertain conditions following the disclosure. Uncertainty is a prevailing issue in healthcare, yet its interpretation and application within the context of health and nursing practice exhibit multiple meanings and variations.
OBJECTIVE
This study aimed to clarify the concept of parental uncertainty arising from having children with cancer.
METHODS
The concept analysis followed the steps outlined by Walker and Avant. A thorough literature search was conducted using the Embase, CINAHL, and MEDLINE databases to identify articles published between 1980 and 2022.
RESULTS
The literature search yielded 147 articles from various disciplines, including health, nursing, medicine, psycho-oncology, and management. After analysis, 20 articles were selected for inclusion. This study identified four key attributes of parental uncertainty associated with having a child with cancer: (1) emotional disturbance, (2) unpredictability, (3) insufficient information, and (4) problems with decision-making. The antecedents of parental uncertainty encompassed the complexity of the disease, the diagnostic and treatment processes, the hospital environment, communication, and support from credible authorities. The consequences of parental uncertainty included the pursuit of new information, parental adaptability to their role, and parental distress.
CONCLUSION
Understanding the four attributes of parental uncertainty, along with their antecedents and consequences, can facilitate the future development and operational translation of the concept of uncertainty in nursing practice. This concept is valuable in the evidence-based provision of nursing care to parents of children with cancer, enabling comprehensive recognition and assessment of parental uncertainty and the implementation of appropriate interventions that are sensitive to parental experiences. Ultimately, this approach promotes the adaptation of both the child and the parent.
PubMed: 37492752
DOI: 10.33546/bnj.2612 -
Journal of Pediatric Nursing 2023The increase in telehealth usage has sustained since the beginning of the COVID-19 pandemic. While Remote Patient Monitoring (RPM) programs are abundantly used in the...
BACKGROUND
The increase in telehealth usage has sustained since the beginning of the COVID-19 pandemic. While Remote Patient Monitoring (RPM) programs are abundantly used in the management of adults, pediatric RPM programs remain rare.
METHODS
An RPM department was developed to serve several, multi-specialty pediatric programs. This department uses a centralized nursing team that manages all patients enrolled in RPM programs. Each program is unique and created in partnership with the centralized nurses and the ambulatory care teams. The various programs allow for transmission of patient- and caregiver-generated health data and consistent communication between the patient or caregiver and the managing providers, allowing for real-time plan adaptation.
FINDINGS
Over 1200 patients have been managed through the 18 various RPM programs. Approximately 300 patients are monitored each month by the centralized nursing team. Patient and caregiver experience has been high due to resources offered including on-demand video visits and text messaging with the nursing team.
DISCUSSION
Multi-specialty RPM departments help to expand the reach of an institution and provide care to more patients. Quality improvement must be ongoing to ensure equity of participation and perceived benefit of the programs for both providers and patients and caregivers.
APPLICATION TO PRACTICE
Pediatric RPM programs can improve patient care delivery by decreasing days away from home while improving access to care. Ensuring equitable opportunity for patient participation is imperative in achieving success for an RPM department.
Topics: Adult; Humans; Child; Pandemics; COVID-19; Telemedicine; Monitoring, Physiologic; Ambulatory Care
PubMed: 36592607
DOI: 10.1016/j.pedn.2022.12.028 -
Journal of Emergency Nursing Sep 2021The need for virtual education for nursing staff has dramatically increased because of social distancing measures after the coronavirus disease pandemic. Emergency...
The need for virtual education for nursing staff has dramatically increased because of social distancing measures after the coronavirus disease pandemic. Emergency departments in particular need to educate staff on caring for patients with coronavirus disease while concurrently continuing to ensure education related to core topic areas such as pediatric assessment and stabilization. Unfortunately, many nurse educators are currently unable to provide traditional in-person education and training to their nursing staff. Our inter-professional team aimed to address this through the rapid development and implementation of an emergency nursing telesimulation curriculum. This curriculum focused on the nursing assessment and initial stabilization of a child presenting to the emergency department in status epilepticus. This article describes the rapid development and implementation of a pediatric emergency nursing telesimulation. Our objectives in this article are (1) to describe the rapid creation of this curriculum using Kern's framework, (2) to describe the implementation of a fully online simulation-based pediatric emergency training intervention for nurse learners, and (3) to report learners' satisfaction with and feedback on this intervention.
Topics: Child; Curriculum; Emergency Nursing; Emergency Service, Hospital; Humans; Nurses; Pediatric Nursing; Simulation Training; Telemedicine
PubMed: 33785197
DOI: 10.1016/j.jen.2021.01.013 -
Journal of Family Medicine and Primary... Sep 2022Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was...
BACKGROUND
Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was to investigate the readiness of medical staff in the field of effectiveness and evaluation of clinical care and nursing skills.
MATERIALS AND METHODS
This descriptive, cross-sectional study was performed on 99 medical staff working in hospitals from August 2020 to December 2021. The instrument used was a checklist for the effectiveness and evaluation of clinical care based on the findings of the nursing reports. Data were analyzed by statistical software.
RESULTS
The mean age of nurses was 37.5 years. Among the participants, 16.3% were male and 85.7% were female; 56.6% of nurses had completed clinical care. The overall performance of nurses in drug-related care and nursing processes was observed to be acceptable. Nurses were successful in performing many aspects of the nursing processes of repulsion, absorption, and dressing and showed good preparation. In relation to gavage, a high percentage of nurses performed the procedure well. However, in some cases, such as medication-related care, handwashing, and the use of personal protective equipment, where there is a possibility of touching the blood or other body fluids of the patients, the performance of nurses was moderate.
CONCLUSION
The findings of this research demonstrated that there are limitations, strengths, and weaknesses in terms of some aspects such as medication, care and nursing processes, compliance with standards, and infection control, which can be considered to improve the performance of nurses in the future.
PubMed: 36505529
DOI: 10.4103/jfmpc.jfmpc_461_22