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Wound Management & Prevention Oct 2020Patients in critical care units (CCUs) are at risk of the development of hospital-acquired pressure injuries (HAPIs). Research supports the use of a pressure injury... (Review)
Review
UNLABELLED
Patients in critical care units (CCUs) are at risk of the development of hospital-acquired pressure injuries (HAPIs). Research supports the use of a pressure injury prevention (PIP) bundle to standardize PIP strategies and reduce the incidence of HAPIs.
PURPOSE
This evidence-based practice initiative was undertaken to implement a PIP bundle to decrease HAPIs in an adult patient CCU.
METHODS
A literature review was conducted during the first month of the implementation of the initiative to identify best PIP and bundle implementation practices. Wound, ostomy, and continence nurses conducted educational sessions and mentored registered nurses who became PIP bundle resource nurses. Adoption of the bundle was validated using an audit tool and PIP rounds. The pre- and post-implementation HAPI indices, pressure injuries / patient care days × 1000, were compared.
RESULTS
Implementation of the PIP bundle resulted in a notable decrease in HAPIs on the unit. During the pre-intervention period, January 2017 to January 2018, there were 9 HAPIs (HAPI index 3.4). During the 10-month post-intervention period, 1 HAPI developed (HAPI index 0.48).
CONCLUSION
An evidence-based PIP bundle initiative was implemented in an adult patient CCU to standardize the process for HAPI prevention and reduce the number of HAPIs. Staff involvement and leadership support were vital to the success of the initiative. Integration of the bundle into practice resulted in a notable decrease in HAPIs.
Topics: Critical Care Nursing; Evidence-Based Practice; Humans; Incidence; Intensive Care Units; Outcome Assessment, Health Care; Patient Care Bundles; Pilot Projects; Pressure Ulcer
PubMed: 33048828
DOI: No ID Found -
Journal of Wound, Ostomy, and... 2015Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions,... (Review)
Review
Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions, creams, and/or ointments. These personal hygiene and skin care activities are integral parts of nursing practice, but little is known about their benefits or clinical efficacy. The aim of this article was to summarize the empirical evidence supporting basic skin care procedures and interventions and to develop a clinical algorithm for basic skin care. Electronic databases MEDLINE, EMBASE, and CINAHL were searched and afterward a forward search was conducted using Scopus and Web of Science. In order to evaluate a broad range of basic skin care interventions systematic reviews, intervention studies, and guidelines, consensus statements and best practice standards also were included in the analysis. One hundred twenty-one articles were read in full text; 41documents were included in this report about skin care for prevention of dry skin, prevention of incontinence-associated dermatitis and prevention of skin injuries. The methodological quality of the included publications was variable. Review results and expert input were used to create a clinical algorithm for basic skin care. A 2-step approach is proposed including general and special skin care. Interventions focus primarily on skin that is either too dry or too moist. The target groups for the algorithm are adult patients or residents with intact or preclinical damaged skin in care settings. The goal of the skin care algorithm is a first attempt to provide guidance for practitioners to improve basic skin care in clinical settings in order to maintain or increase skin health.
Topics: Algorithms; Dermatitis; Evidence-Based Nursing; Humans; Long-Term Care; Self Care; Skin Care
PubMed: 26165590
DOI: 10.1097/WON.0000000000000162 -
Seminars in Oncology Nursing Aug 2018To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing. (Review)
Review
OBJECTIVES
To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing.
DATA SOURCES
Communication strategies offered are based on the COMFORT Communication curriculum, an evidence-based communication training program.
CONCLUSION
Whole-patient assessment, a major component of palliative care, involves communication that includes eliciting the patient's story, addressing health literacy needs, being mindful of burnout, and relating to the patient and family.
IMPLICATIONS FOR NURSING PRACTICE
Quality communication skills are essential to oncology nursing, especially given their vital role in cancer care.
Topics: Communication; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse's Role; Nurse-Patient Relations; Oncology Nursing; Palliative Care; Quality of Health Care
PubMed: 30100368
DOI: 10.1016/j.soncn.2018.06.007 -
Seminars in Oncology Nursing Aug 2018To highlight the importance, challenges, and evolution of advance care planning for patients with cancer. (Review)
Review
OBJECTIVE
To highlight the importance, challenges, and evolution of advance care planning for patients with cancer.
DATA SOURCES
Peer-reviewed journal articles and clinical guidelines.
CONCLUSION
Advance care planning is fundamental to support the personhood of patients with advanced cancer. Patients must be encouraged by physicians and nurses to articulate what matters and provides meaning to them as they live, cope, and receive treatment for their cancer.
IMPLICATIONS FOR NURSING PRACTICE
Nurses can facilitate advance care planning and primary palliative care, to support patients and families to make informed and value-concordant decisions regarding cancer and end-of-life treatments.
Topics: Advance Care Planning; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse-Patient Relations; Oncology Nursing; Pain Management; Palliative Care; Quality of Health Care
PubMed: 30100366
DOI: 10.1016/j.soncn.2018.06.012 -
Seminars in Oncology Nursing Jun 2021To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice... (Review)
Review
OBJECTIVES
To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice care, including eligibility for concurrent care, insurance coverage and billing, barriers to accessing quality pediatric palliative and hospice care, and implications for oncology nursing practice.
DATA SOURCES
Peer-reviewed articles, clinical practice guidelines, professional organizations, and expert clinical opinion examining pediatric oncology, palliative care, and hospice care.
CONCLUSION
Understanding the goals of palliative and hospice care and the differences between them is important in providing holistic, goal-directed care.
IMPLICATIONS FOR NURSING PRACTICE
Oncology nurses play a pivotal role in supporting the goals of pediatric palliative care and hospice care and in educating patients and their families. Nurses form trusting relationships with pediatric oncology patients and their families and are in a position to advocate for best palliative care practices as disease progresses to end of life, including when appropriate concurrent care or hospice.
Topics: Adolescent; Child; Hospice Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Oncology Nursing; Palliative Care; United States; Young Adult
PubMed: 34175165
DOI: 10.1016/j.soncn.2021.151166 -
Journal of Clinical Nursing Apr 2020Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for... (Review)
Review
BACKGROUND
Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital-acquired pressure injuries.
DESIGN
This is a discursive paper using Walker and Avant's (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature.
METHODS
PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006-2016. A synthesis of the searches culminated into a new pressure injury risk model.
CONCLUSIONS
Gaps in previous models include lack of attention to the environment, contributing episode-of-care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode-of-care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development.
RELEVANCE TO CLINICAL PRACTICE
Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence-based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.
Topics: Evidence-Based Nursing; Hospitalization; Humans; Nursing Theory; Pressure Ulcer; Risk Assessment
PubMed: 31889342
DOI: 10.1111/jocn.15171 -
Revista Brasileira de Enfermagem 2020to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
OBJECTIVES
to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
METHODS
Grounded Theory and the theoretical/philosophical framework of Virginia Henderson were used. The research was conducted in Family Basic Health Units and in Specialized Services in the city of Campina Grande, Paraíba, Brazil. A total of 24 participants composed four sample groups. Data were collected through semi-structured interviews, between April and October 2015, and analyzed by the constant comparison method. The analysis occurred by initial coding, construction of diagrams and memos, axial coding, selective coding and reflection on the paradigm and on the emerging theory.
RESULTS
six categories emerged from the data. Nurses worrying about the care of children with obesity as a neglected area in Primary Health Care was the theoretical model.
FINAL CONSIDERATIONS
the phenomenon is related to the individuality of nursing care and the need for shared responsibilities.
Topics: Adult; Brazil; Female; Grounded Theory; Humans; Interviews as Topic; Male; Middle Aged; Nursing Care; Nursing Theory; Pediatric Nursing; Pediatric Obesity; Qualitative Research
PubMed: 32578728
DOI: 10.1590/0034-7167-2018-0881 -
Journal of Pediatric Oncology Nursing :... 2019The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided...
The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.
Topics: Adult; Communication; Female; Focus Groups; Humans; Middle Aged; Neoplasms; Nurse Administrators; Oncology Nursing; Palliative Care; Terminal Care
PubMed: 30939966
DOI: 10.1177/1043454219835448 -
BMC Palliative Care Jan 2023Although being recognized by the World Health Organization as an essential domain of palliative care, spiritual care is still one of the most neglected component of the...
Although being recognized by the World Health Organization as an essential domain of palliative care, spiritual care is still one of the most neglected component of the healthcare system. In this editorial, we set the context and invite contributions for a BMC Palliative Care Collection of articles titled 'Spirituality in Palliative Care'.
Topics: Humans; Palliative Care; Spirituality; Spiritual Therapies; Hospice and Palliative Care Nursing
PubMed: 36597069
DOI: 10.1186/s12904-022-01116-x -
Revista Brasileira de Enfermagem 2019to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. (Review)
Review
OBJECTIVE
to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer.
METHOD
integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017.
RESULTS
we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care.
FINAL CONSIDERATION
we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.
Topics: Evidence-Based Practice; Humans; Nursing Care; Oncology Nursing; Palliative Care; Pediatric Nursing
PubMed: 31017219
DOI: 10.1590/0034-7167-2018-0121