Experiences and challenges of enrolled nurses undertaking a Bachelor of Nursing Science programme in Namibia.

BACKGROUND:  Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched. OBJECTIVES:  This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia. METHOD:  A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach. RESULTS:  Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Jordanian Nurses' Perceptions of Disaster Preparedness and Core Competencies.

OBJECTIVE: This study aims to identify the Jordanian nurses' perception of their disaster preparedness and core competencies. METHODS: A descriptive, cross-sectional research design was used. The data was collected via an online self-reported questionnaire using the disaster preparedness evaluation tool and the core disaster competencies tool. RESULTS: A total of 126 nurses participated in the study. Jordanian nurses had moderate to high levels of core disaster competencies and moderate levels of disaster preparedness. Core disaster competencies and disaster preparedness levels differed based on previous training on disaster preparedness, and the availability of an established emergency plan in their hospitals. Lastly, a previous training on disaster preparedness and core disaster competencies were statistically significant predictors of disaster preparedness among Jordanian nurses. CONCLUSIONS: Organizational factors and environmental contexts play a role in the development of such capabilities. Future research should focus on understanding the barriers and facilitators of developing core disaster competencies and disaster preparedness among nurses.

Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey.

OBJECTIVE: To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals. RESEARCH METHODOLOGY/DESIGN: This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation. SETTING: Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China. RESULTS: In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (ß = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (ß = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support. CONCLUSION: ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators. IMPLICATIONS FOR CLINICAL PRACTICE: Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.

Online Learning to Improve Nurses' Knowledge, Attitudes, and Self-Efficacy About Managing Postoperative Pain in Older Adults.

BACKGROUND: Older adults undergoing total knee arthroplasty may develop chronic pain without effective postoperative pain management. Increasing nurses' knowledge, changing their attitudes, and developing their pain management self-efficacy could improve the effectiveness of pain management. AIM: To determine the effectiveness of an online learning program to help registered nurses to manage postoperative pain in older adults undergoing total knee arthroplasty. DESIGN: A quasi-experimental pre-test-post-test design with intervention and control groups. METHOD: Six inpatient units were randomly selected at a large tertiary care medical center. Sixty nurses were evenly divided between intervention and control groups to participate in online learning about postoperative pain management in patients undergoing total knee arthroplasty. The content was based on Kolb's experiential learning theory. Data were collected on nurses' knowledge and attitudes toward pain management and pain management self-efficacy at baseline and after completion. Data were analyzed using descriptive statistics, chi-square tests, paired t-tests, and independent t-tests. RESULTS: The knowledge and attitudes about pain management and pain management self-efficacy toward older adults undergoing total knee arthroplasty of nurses in the intervention group significantly improved compared to the baseline and were also significantly higher than in the control group. CONCLUSIONS: An online learning program improves nurses' understanding and ability to manage pain in older adults undergoing total knee arthroplasty. This was therefore an effective learning method.

The Effect of Pain Management Education on Nurses' Pain Knowledge and Attitudes.

BACKGROUND: Pain is a nursing diagnosis. As such, it should be evaluated and recorded regularly. Nurses should possess a high level of pain management knowledge and a positive attitude toward pain, as these are the most important factors affecting pain control and management in children. AIM: To evaluate the effect of the pain management training provided to pediatric nurses on their pain knowledge and attitudes. METHODS: The study, conducted as a pretest-posttest experiment with a control group, was carried out from January-March 2019 with 61 nurses in the institutions of the Ministry of Health in Turkey. The content of the pain management for children education consisted of the definition of pain, pain theories, factors affecting pain, pain in children, the effects of pain on children, pain symptoms in children, perception of pain according to the developmental levels of children, false beliefs, and facts about pain, pain assessment, and factors preventing pain control in children. Data were obtained using the Personal Information Form, the Pediatric Pain Information form, and an Attitude Scale. Data were analyzed using descriptive statistics, a chi-square test, a t test, and validity and reliability analyses. All ethical principles were adhered to. RESULTS: No significant difference was found between the nurses' pain knowledge and attitudes on the pretest scores in the experimental and control groups, while the mean posttest scores of the nurses in the experimental group increased significantly (p < .001). As for the pain and knowledge sub-dimensions of nurses in the experimental and control groups, no significant difference was found between the pretest scores for care, pain physiology, painless medication methods, pain relief with medication, pain psychology, and sociology. The mean posttest scores in all subdimensions increased significantly in favor of nurses in the experimental group (p < .001). CONCLUSIONS: Mean posttest scores of pain knowledge and attitude and subdimensions of the nurses in the experimental group increased significantly, indicating that nurses' knowledge deficiencies in the realm of strong pediatric pain management can be overcome by education, and that their attitudes can be improved.

Segurança do paciente sob a ótica de enfermeiros da estratégia saúde da família / Patient safety from the perspective of family health strategy nurses / La seguridad del paciente en la perspectiva de los enfermeros de la estrategia de salud de la familia

Objetivo: identificar o conhecimento dos enfermeiros que atuam na Estratégia Saúde da Família quanto à segurança do paciente. Método: estudo qualitativo exploratório, descritivo, realizado com 20 enfermeiros da Estratégia Saúde da Família de um município paranaense. A coleta de dados foi realizada entre julho e dezembro de 2021 com entrevistas semiestruturadas. Os dados foram categorizados e analisados com auxílio do software Iramuteq. Resultados: os enfermeiros relataram dificuldades no processo de trabalho e aspectos que influenciavam nas ações relacionadas à segurança do paciente: falta de profissionais, sobrecarga de trabalho, falhas na comunicação, trabalho em equipe e processo de formação, impacto da pandemia contra COVID-19, eventos adversos e cultura de notificação. Considerações finais: o estudo demonstrou a fragilidade dos enfermeiros em relação à segurança do paciente na Atenção Primária à Saúde e a necessidade de o tema ser amplamente discutido entre todos os componentes das equipes da Estratégia Saúde da Família(AU)

Objective: to identify the knowledge of nurses who work in the Family Health Strategy regarding patient safety. Method: exploratory, descriptive qualitative research, carried out with 20 nurses from the Family Health Strategy in a municipality in Paraná. Data collection was carried out from July to December 2021 with semi-structured interviews. Data was categorized and analyzed using the Iramuteq software. Results: nurses reported difficulties in the work process that potentially jeopardize patient safety. The following factors contribute to the patient safety concerns: shortage of professiomals, work overload, communication failures, teamwork and training process, impact of the pandemic against COVID-19, adverse events and reporting culture. Final considerations: the study demonstrated the fragility of nurses in relation to patient safety in Primary Health Care and the need for the topic to be widely discussed among all components of the Family Health Strategy teams(AU)

Objetivo: identificar el conocimiento de los enfermeros que actúan en la Estrategia Salud de la Familia en cuanto a la seguridad del paciente. Método: Investigación cualitativa, descriptiva, exploratoria, realizada con 20 enfermeros de la Estrategia Salud de la Familia en un municipio de Paraná. La recolección de datos se realizó entre julio y diciembre de 2021 por medio de entrevistas semiestructuradas. Los datos fueron categorizados y analizados utilizando el software Iramuteq. Resultados: los enfermeros declararon dificultades en el proceso de trabajo y aspectos que influyeron en las acciones relacionadas con la seguridad del paciente: falta de profesionales, sobrecarga de trabajo, fallas en la comunicación, trabajo en equipo y proceso de capacitación, impacto de la pandemia frente a la COVID-19, eventos adversos y cultura de notificación. Consideraciones finales: el estudio demostró la fragilidad de los enfermeros respecto a la seguridad del paciente en la Atención Primaria de Salud y la necesidad de que el tema sea ampliamente discutido entre todos los componentes de los equipos de la Estrategia Salud de la Familia(AU)

A qualitative study of the reasons for low patient safety incident reporting among Indonesian nurses.

OBJECTIVES: to investigate the reasons for low patient safety incident reporting among Indonesian nurses. METHODS: this qualitative case study was conducted among 15 clinical nurses selected purposively from a public hospital in Lampung, Indonesia. Interview guidelines were used for data collection through face-to-face in-depth interviews in July 2022. The thematic approach was used to analyze the data. RESULTS: in this present study, seven themes emerged (1) Understanding incident reporting; (2) The culture; (3) Consequences of reporting; (4) Socialization and training; (5) Facilities; (6) Feedback; and (7) Rewards and punishments. FINAL CONSIDERATIONS: these findings should be considered challenges for the patient safety committee and hospital management to increase patient safety incident reporting, particularly among nurses in the hospital.

Knowledge and Practice Behaviors Toward the Care of the Dying Among Chinese Oncology Nurses: A Cross-Sectional Survey.

The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients.

Suggestion for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination: a survey-based descriptive study.

PURPOSE: This study aims to suggest the number of test items in each of 8 nursing activity categories of the Korean Nursing Licensing Examination, which comprises 134 activity statements including 275 items. The examination will be able to evaluate the minimum ability that nursing graduates must have to perform their duties. METHODS: Two opinion surveys involving the members of 7 academic societies were conducted from March 19 to May 14, 2021. The survey results were reviewed by members of 4 expert associations from May 21 to June 4, 2021. The results for revised numbers of items in each category were compared with those reported by Tak and his colleagues and the National Council License Examination for Registered Nurses of the United States. RESULTS: Based on 2 opinion surveys and previous studies, the suggestions for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination in this study are as follows: 50 items for management of care and improvement of professionalism, 33 items for safety and infection control, 40 items for management of potential risk, 28 items for basic care, 47 items for physiological integrity and maintenance, 33 items for pharmacological and parenteral therapies, 24 items for psychosocial integrity and maintenance, and 20 items for health promotion and maintenance. Twenty other items related to health and medical laws were not included due to their mandatory status. CONCLUSION: These suggestions for the number of test items for each activity category will be helpful in developing new items for the Korean Nursing Licensing Examination.

How Does Triage by an Electronic Symptom Checker Match with Triage by a Nurse?

Omaolo© electronic symptom checkers (ESCs) have been developed to make triage for primary health care patients in Finland. Based on the analysis of the patient's responses to a set of questions, the ESC classifies him/her as emergent, urgent, not urgent, or advices on self-care. In this study the user answered the questions posed by the electronic symptom checker, after which a nurse assessed the urgency of the same user's symptom. The triage nurse was not allowed to know the result of the electronic symptom assessment until he or she had assessed the patient's condition. The level of triage was compared between ESC and nurse in each individual case. Findings from 825 individual cases were analyzed. The mean "exactly matched" for all symptom estimates was 52.6%. The mean "exactly matched" or "overconservative but suitable" for all symptom assessments was 66.6%. Safe assessments of electronic symptom checkers accounted for 98.6% of all assessments. A case was defined as "safe" if the recommendation for action given by the symptom assessment was at most one level less urgent than the nurse's triage assessment of the same case. The findings show that electronic symptom assessments are safe compared to the assessment of an experienced nurse.

Nurses' knowledge, attitudes, and willingness to practice hospice care: An analysis of influencing factors.

BACKGROUND: Hospice care is a multidisciplinary approach that focused on patients' quality of life, and nurses allocate more of their time with patients and patients' families than those nurses working in other disciplines. Nurses' knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China's hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses' willingness to practice hospice care are limited. METHODS: A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses' demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis. RESULTS: Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses' willingness to practice hospice care. CONCLUSION: This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses' knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.

Adherence to medication administration guidelines among nurses in a health facility in South-West Nigeria.

INTRODUCTION: medication error has become a global problem. Medication administration that is error free is important in achieving positive outcomes in patient's care. This study assessed adherence to medication administration guidelines among nurses in a health facility in South-West Nigeria. METHODS: a cross-sectional descriptive study was carried out on 75 nurses involved in oral medication administration. Data was collected using direct observation method with an observational checklist developed from literature. Data analysis was done using frequency, percentage, Mean and Standard Deviation. Test of relationship was carried out using Kruskal-Wallis Test and Mann Whitney Test at 0.05 (p<0.05) level of significance. RESULTS: almost an average (49.3%) of participants did not provide information about the medication. More than 1/3rd (38.7%) did not perform right assessment where necessary. The majority (76.0%) did not serve correct medication. Overall level of non-adherence was 48%. Adherence to medication administration guidelines was significantly related to age (χ2 = 9.673, p<0.05), marital status (χ2 = 9.426, p<0.05), years of experience (U=404.000 Z=2.7622, p<0.05), type of shift (χ2 = 6.314, p<0.05), nurses-patient ratio (χ2 = 11.598, p<0.05). CONCLUSION: some nurses did not adhere strictly to the guidelines of medication administration. Adherence to medication administration guidelines was related to age, marital status, years of experience, type of shift and nurse-patient ratio. Poor adherence to medication administration guidelines may jeopardize patient safety. There is need for development of a universal medication procedure/protocol and continuous education of nurses on medication administration practices.

The Effect of Educational Intervention on the Improvement of Nontechnical Skills in Circulating Nurses.

BACKGROUND: Nontechnical skills are necessary for clinicians' safe performance and prevention of errors in the operating room. Educational intervention is a useful way to improve these skills, which are a vital area for improvement. Circulating nurses are surgical team members whose work depends heavily on using nontechnical skills. This study is aimed at assessing the effect of an educational intervention on the improvement of circulating nurses' nontechnical skills. METHODS: This semiexperimental study was conducted on 300 circulating nurses divided into the intervention and no intervention groups each containing 150 participants. The nontechnical skills were assessed using the circulating practitioners' list of nontechnical skills. Then, the intervention group received training regarding these skills, and the two groups were evaluated again. After all, the data were entered into the SPSS 24 software and were analyzed using descriptive statistics and Wilcoxon and Mann-Whitney tests. Furthermore, Kendall's tau, independent sample t-test, and one-way ANOVA were used for assessment of relationship between median scores and demographics. RESULTS: The results revealed a significant improvement in the scores of all domains of nontechnical skills in the intervention group (p < 0.05). The highest and lowest improvements were observed in teamwork (42%) and situational awareness (16.7%), respectively. After the intervention, the scores of some of the behaviors were still below the average level or were not improved significantly. CONCLUSIONS: Circulating nurses' nontechnical skills can be improved by educational interventions. However, regarding the low scores or no improvements in the scores of some behaviors, other intervention types such as policymaking and correcting the existing hierarchies in the operating room can be useful to complete the educational interventions.

The Value of Nurses Specialized in Wound, Ostomy, and Continence: A Systematic Review.

OBJECTIVE: To critically appraise peer-reviewed evidence concerning the value, or implied sense of worth or benefit, of nurses specialized in wound, ostomy, and continence (WOC) care. DATA SOURCES: The Preferred Reporting Items for Systematic Reviews and Meta-analyses was used to systematically review current literature in a single database from 2009 to the date of search (July 2019). STUDY SELECTION: The initial search retrieved 2,340 elements; 10 studies were retained following removal of duplicate records, title and abstract reviews, and application of the inclusion/exclusion criteria. DATA EXTRACTION: Literature was graded and critiqued with regard to design and research quality and then synthesized using a narrative approach. DATA SYNTHESIS: Nine values that WOC nurses demonstrate were identified: improved quality of life for patients, teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, and leadership. CONCLUSIONS: Although current studies suggest that there is value in the WOC nurse role, in all areas of the trispecialty, there is a need for high-quality literature with higher-level designs focused on bias reduction.

Should nurses take a COVID-19 vaccine?

The issue as to whether health care professionals have a moral obligation to take a vaccine for a communicable disease is not new. Nonetheless, this issue takes on a fresh urgency within nursing practice in the context of the present COVID-19 pandemic, i.e., is there an ethical requirement for nurses to take a COVID-19 vaccine? This paper approaches the issue by using a hypothetical example of Nurse X who has inadvertently infected Patient Y. French's (1984a) Principle of Responsive Adjustment is adapted to claim that there would be a moral expectation that Nurse X takes a COVID-19 vaccine (unless there are justifiable reasons not to). The proposition is also made that, should Nurse X not take a COVID-19 vaccine, they could be morally associated with originally infecting Patient Y.

Mixed methods study evaluating the implementation of the WHO hand hygiene strategy focusing on alcohol based handrub and training among health care workers in Faranah, Guinea.

INTRODUCTION: The most frequent adverse health events in healthcare worldwide are healthcare-associated infection. Despite ongoing implementation of the WHO multimodal Hand Hygiene (HH) Improvement Strategy, healthcare-associated infection rate continues to be twofold higher in low- than in high-income countries. This study focused on continued evaluation of HH compliance and knowledge. The mixed method approach, with inclusion of patients and care-givers, provided insight into challenges and facilitators of the WHO HH Improvement Strategy, and highlighted improvement points. METHODS: An uncontrolled, before-and-after intervention, mixed methods study in Faranah Regional Hospital was conducted from December 2017 to August 2019. The intervention implemented the WHO HH Strategy including HH training for healthcare workers (HCWs), and the relaunch of the local production of alcohol-based handrub (ABHR). A baseline assessment of HH knowledge, perception and compliance of HCWs was done prior to the intervention and compared to two follow-up assessments. The second follow-up assessment was complemented by a qualitative component. RESULTS: Overall compliance six months post-intervention was 45.1% and significantly higher than baseline but significantly lower than in first follow-up. Knowledge showed similar patterns of improvement and waning. The perception survey demonstrated high appreciation of the intervention, such as local production of ABHR. HCW's were concerned about overconsuming of ABHR, however simultaneous quantitative measurements showed that consumption in fact was 36% of the estimated amount needed for sufficient HH compliance. Potential fields for improvement identified by HCWs to enhance sustainability were permanent ABHR availability, having a dedicated person with ownership over continuous simulation HH trainings including simulations to improve technique. CONCLUSION: The study shows that the WHO multimodal HH strategy has a positive effect on HCW compliance and knowledge. Improvement points identified by local staff like sensitization on appropriate ABHR amount per HH action should be considered for sustainable HH improvement.

The Importance of Board Certification.

The investment to support and obtain board certification demonstrates a nurse leader's commitment to their staff, the organization, and the communities they serve. It is important for nurse leaders to appreciate how organizational support of board certification can positively impact patient care and to be advocates for funding to support board certification for their staff. This month's Magnet® Perspectives column discusses the empirical evidence, as well as the professional value of certification.

Effect of a Universal Postpartum Nurse Home Visiting Program on Child Maltreatment and Emergency Medical Care at 5 Years of Age: A Randomized Clinical Trial.

Importance: The Family Connects (FC) program, a community-wide nurse home visiting program for newborns, has been shown to provide benefits for children and families through the first 2 years of life. Potential longer-term outcomes for child well-being remain unknown. Objective: To determine the effect of randomization to FC on child maltreatment investigations and emergency medical care through 5 years of age. Design, Setting, and Participants: In this randomized clinical trial, families of all 4777 resident births in Durham County, North Carolina, from July 1, 2009, to December 31, 2010, were randomly assigned to receive the FC program or treatment as usual. Impact evaluation was on an intent-to-treat basis and focused on a subsample of 549 families randomly selected from the full population and included review of hospital and Child Protective Services (CPS) administrative records. Statistical analysis was conducted from November 6, 2020, to April 25, 2021. Interventions: The FC programs includes 1 to 3 nurse home visits beginning at the infant age of 3 weeks designed to identify family-specific needs, deliver education and intervention, and connect families with community resources matched to their needs. Ongoing program engagement with service professionals and an electronic resource directory facilitate effective family connections to the community. Main Outcomes and Measures: Two primary trial outcomes were CPS-recorded child maltreatment investigations and emergency medical care use based on hospital records. Results: Of the 4777 randomized families, 2327 were allocated to the intervention, and 2440 were allocated to services as usual. Among the children in the full study population, 2380 (49.8%) were female, 2397 (50.2%) were male, and 3359 (70.3%) were from racial/ethnic minority groups; of the 531 children included in the impact evaluation follow-up, 284 (53.5%) were female, 247 (46.5%) were male, and 390 (73.4%) were from racial/ethnic minority groups. Negative binomial models indicated that families assigned to FC had 39% fewer CPS investigations for suspected child maltreatment through 5 years of age (95% CI, -0.80 to 0.06; 90% CI, -0.73 to -0.01; control = 44 total investigations per 100 children and intervention = 27 total investigations per 100 children); intervention effects did not differ across subgroups. Families assigned to FC also had 33% less total child emergency medical care use (95% CI, -0.59 to -0.14; 90% CI, -0.55 to -0.18; control = 338 visits and overnight hospital stays per 100 children and intervention = 227 visits and overnight hospital stays per 100 children). Positive effects held across birth risk, child health insurance, child sex, single-parent status, and racial/ethnic groups. Effects were larger for nonminority families compared with minority families. Conclusions and Relevance: The findings of this randomized clinical trial suggest that, when implemented with high quality and broad reach, a brief postpartum nurse home visiting program can reduce population rates of child maltreatment and emergency medical care use in early childhood. Trial Registration: ClinicalTrials.gov Identifier: NCT01406184.

Correctional Nurses on the Front Lines of the COVID-19 Pandemic: Omaha System Guidelines Documentation Case Study.

During a pandemic, basic public health precautions must be taken across settings and populations. However, confinement conditions change what can be done in correctional settings. Correctional nursing (CN) care, like all nursing care, needs to be named and encoded to be recognized and used to generate data that will advance the discipline and maintain standards of care. The Omaha System is a standardized interprofessional terminology that has been used since 1992 to guide and document care. In 2019, a collaboration between the newly formed American Correctional Nurses Association and the Omaha System Community of Practice began a joint effort with other stakeholders aimed at encoding evidence-based pandemic response interventions used in CN. The resulting guidelines are included and illustrated with examples from CN practice.

Study on clinical nursing pathway to promote the effective implementation of sepsis bundle in septic shock.

BACKGROUND: There is still a certain gap between the effective implementation and requirements of sepsis bundle. Our aim is to establish the clinical nursing pathway of the cluster treatment of septic shock in the Intensive Care Unit and promote effective implementation of the cluster treatment of septic shock. METHODS: By means of evidence-based method, quality control index requirements and on-site investigation, the implementation process of clinical nursing pathway of the cluster treatment within 6 h of diagnosis of septic shock was established. RESULTS: After the implementation of clinical nursing pathway, the completion rate of septic shock cluster treatment was 81.4% (66.4%) in 1 h, 89.4% (77.0%) in 3 h, 95.5% (82.3%) in 6 h (P < 0.05), which was significantly improved in the experimental group compared with the control group. CONCLUSIONS: The clinical nursing pathway of septic shock cluster treatment is guided by evidence-based nursing, which emphasizes standardization and standardization of septic shock cluster treatment nursing under the guidance of the guideline, and can promote the effective implementation of septic shock cluster treatment, significantly improve efficiency of septic shock treatment and the quality of medical care.