Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study.

AIM: This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic. BACKGROUND: Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries. METHOD: This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0. RESULTS: The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses. DISCUSSION: Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Analysis of medication administration in relation to food and beverages in inpatients.

Proper medication administration in relation to beverage or food is one of the essential tools to achieve the pharmacotherapy goals. It is not known whether this is also considered in the care of inpatients. The aim of this study was to describe and analyse the current practice of medication administration in relation to food and beverages to patients hospitalized in four hospitals in the Czech Republic. This study was conducted based on the results of the first phase of a prospective observation study focused on the safety of medication administration performed by nurses. All data, including the timing of medication administration in relation to food and the data on beverages used, were obtained by the method of direct observation. The team of observersaccompanied the nurse during medication administration. The appropriateness of the medication administration in relationto food/beverages was assessed according to the summary of product characteristics and the published literature. In total, the administration of 5718 oral medications and 198 insulins were analysed. Unproper food timing wasobserved in 15.7% of oral medication administrations and 26.8% of insulin administrations. The highest number ofunproper food timing occurred in the proton pump inhibitors, antihypertensives, and prokinetics. Tea (63.4%) was the most used beverage. Errors with clinically serious impact have been observed in some groups of drugs. The necessity of a systemic approach in management of medication administration is required including interdisciplinary cooperation.

Perceptions of nurses on the scope of culturally competent care in critical care: A qualitative study.

BACKGROUND: The cultural competence of nurses is crucial in providing nursing care for patients from different cultures. The absence of cultural competence can negatively impact the entire course of care; however, implementing cultural competence in critical care unit can be complicated. AIMS: This study aimed to determine nurses' perceptions regarding cultural competence in critical care units. STUDY DESIGN: This study used a qualitative design with semi-structured interviews with nurses (n = 10) working in critical unites. Data were collected from February to June 2022 and then categorized and evaluated. Atlas.ti was used for the inductive thematic content analysis. RESULTS: Three key areas identified were as follows: (1) nurses and culturally competent care in critical care, (2) cultural challenges in practice and (3) suggestions for improving culturally competent care. The participants expressed that culturally competent care in critical care units has specific limitations because of the nature of the intensive care units (ICUs). Additional learning included opportunities to improve culturally competent care, such as raising cultural awareness, developing language skills and promoting culturally competent care. CONCLUSIONS: Providing culturally competent care in critical care units is an understudied area. Identifying barriers and cultural challenges is one strategy nurses can use to improve culturally competent ICU care. RELEVANCE TO CLINICAL PRACTICE: Creating cultural awareness by training nurses in their own culture, in cultural diversity, and in overcoming prejudices and stereotypes is an essential step towards increasing cultural competence. Understanding nurses' perceptions on this topic can provide valuable insights into the challenges and opportunities for providing culturally sensitive care in a critical care setting.

Social predictors of breastfeeding and the impact of interventions on breastfeeding of preterm infants: A longitudinal study.

INTRODUCTION: The multifaceted benefits of breastfeeding for mothers and infants include enhanced neurodevelopment and immune function in preterm infants. However, more research is needed to understand the unique factors affecting breastfeeding practices in preterm infants. This study aimed to identify key social predictors of breastfeeding in preterm infants and assess the effectiveness of specific interventions on their feeding practices during the first six months postpartum. METHODS: A prospective, monocentric, longitudinal study involving a cohort of 201 preterm infants was executed at the Neonatology Department, Ceske Budejovice Hospital, Czech Republic, from January 2020 to January 2023. The STROBE guidelines were used. RESULTS: The study results elucidated a transition from breastfeeding to bottle feeding and formula within the infants' first six months. Notable social predictors of breastfeeding encompassed factors such as the number of children in the household, the mother's marital status, and the nature of housing. Certain interventions, including immediate skin-to-skin contact between mother and child, and initiation of nutritive feeding within the first half-hour post-birth, significantly influenced the probability of breastfeeding. CONCLUSIONS: The data underscored that social predictors and nursing interventions substantially shape the breastfeeding practices of preterm infants during the first six months postpartum. Inequities in health outcomes among premature infants can be effectively curbed through comprehensive care models that account for socioeconomic factors influencing breastfeeding.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT).

BACKGROUND: A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity. METHODS: This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool. RESULTS: Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care. CONCLUSION: The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

THE HEALTH SYSTEM OF THE FIRST CZECHOSLOVAK REPUBLIC AND ITS ROLE IN COMBATING CONTAGIOUS DISEASES IMMEDIATELY AFTER THE FIRST WORLD WAR (THE 1920s)

A complex epidemiological situation marked the health system at the time of the establishment of the Czechoslovak Republic. Reducing the number of infectious diseases was an essential task of the State Administration of Health. It required new legislation and various steps directed at reducing infectious diseases. Serious infectious diseases, such as scarlet fever, diphtheria, typhoid, dysentery, smallpox, and malaria, were among the most significant health problems in Czechoslovakia. In 1920, Act No. 412 Coll. regarding compulsory smallpox vaccination was issued, as well as government Regulation No. 298, which describes vaccination obligations and stipulated proper isolation of patients with infectious diseases. Other steps that led to improvements included establishing the National Institute of Health and mobile disinfectant units. Conclusion: The systematic development of new legislation contributed to the new Republic's proficiency at the task and the gradual reduction in the number of infectious diseases.

Self-reported medication administration errors in clinical practice of nurses: a descriptive correlation study.

BACKGROUND: Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic. MATERIAL AND METHODS: A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA). RESULTS: The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE. CONCLUSIONS: The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.

Reasons for medication administration errors, barriers to reporting them and the number of reported medication administration errors from the perspective of nurses: A cross-sectional survey.

The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors. BACKGROUND: Providing quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education. DESIGN: A descriptive and cross-sectional design was used for this study. METHODS: Sociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson's and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used. RESULTS: Among the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001). CONCLUSION: Patient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.

Opinions of citizens of the Czech Republic on the role of nurses in primary care during the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVE: In spite of the general current decrease in COVID-19 incidence, the epidemiological situation on the territory of the Czech Republic is still unfavourable. Nurses play an essential role in the fight against this disease. MATERIAL AND METHODS: A non-standardized questionnaire was used to discover the expectations regarding nursing care provided during the COVID-19 pandemic. The sample of respondents was constructed using quota selection. The sample consisted of 1,815 respondents. RESULTS: The study identified a significant correlation between the age of respondents and the method used to contact general practitioners (p < 0.001). The oldest respondents (65+) more likely contacted GPs by phone. Respondents with basic education used outpatient services more often before than during the pandemic (p < 0.05). The behaviour of nurses was considered as professional and accommodating. The oldest respondents (65+) reported nurses did not to make them feel rushed. Other age groups rated nurses more critically (p < 0.01). Respondents, especially women, described the psychological burden on nurses during the COVID-19 pandemic as demanding (p < 0.01). Women, more than men, reported that nurses lacked protective equipment during the pandemic (p < 0.05). The use of an online system was significantly influenced by respondent education (p 0.001). Respondents with lower education were less likely to welcome this option. CONCLUSIONS: Due to the persisting COVID-19 incidence on the territory of the Czech Republic, citizens` opinions of the position of nurse in primary care in the period of COVID- 19 pandemics need to be known.The behaviour of nurses was considered to be accommodating and satisfactory.

Socially assistive robots in health and social care: Acceptance and cultural factors. Results from an exploratory international online survey.

AIM: This study explored the views of an international sample of registered nurses and midwives working in health and social care concerning socially assistive robots (SARs), and the relationship between dimensions of culture and rejection of the idea that SARs had benefits in these settings. METHODS: An online survey was used to obtain rankings of (among other topics) the extent to which SARs have benefits for health and social care. It also asked for free text responses regarding any concerns about SARs. RESULTS: Most respondents were overwhelmingly positive about SARs' benefits. A small minority strongly rejected this idea, and qualitative analysis of the objections raised by them revealed three major themes: things might go wrong, depersonalization, and patient-related concerns. However, many participants who were highly accepting of the benefits of SARs expressed similar objections. Cultural dimensions of long-term orientation and uncertainty avoidance feature prominently in technology acceptance research. Therefore, the relationship between the proportion of respondents from each country who felt that SARs had no benefits and each country's ratings on long-term orientation and uncertainty avoidance were also examined. A significant positive correlation was found for long-term orientation, but not for uncertainty avoidance. CONCLUSION: Most respondents were positive about the benefits of SARs, and similar concerns about their use were expressed both by those who strongly accepted the idea that they had benefits and those who did not. Some evidence was found to suggest that cultural factors were related to rejecting the idea that SARs had benefits.

Safety of drug administration from the perspective of hospitalized patients in selected hospitals of the South Bohemia Region.

Drug administration is one of the riskiest areas of healthcare provision, accompanied by several possible mistakes. Patient and family involvement is crucial for patient safety in a hospital environment. The research study aimed to evaluate the subjective perception of the safety of the drug administration process from hospitalized patients point of view and their involvement in drug administration. A structured questionnaire of its own design was used to obtain data. Three hundred twenty-nine respondents from 4 hospitals in the South Bohemian Region in the Czech Republic were included in the research, including patients hospitalized in the internal medicine, surgery, and follow-up and rehabilitation care departments. We found different perceptions and individual understandings of the safety of the drug delivery process by other groups of patients. Interest in participating in drug administration also varies between groups of patients. Women control the medication given to them by the nurse to a much greater extent than men. Patients under the age of 60, patients with higher professional and university education, and patients from the surgical department would like to be more involved in deciding which aplikovadrugs to use. Patients with a low level of education want to involve their family members more in their treatment decisions. Both healthcare professionals and patients should be led by hospital management to increase patient involvement in the hospitalization process.

Evaluation of medication errors in the hospital environment.

INTRODUCTION: Healthcare is inherently associated with a risk to patient health. One risk is associated with medication-related errors, which are commonly reported adverse events. By analyzing the root causes of medication errors, effective preventive measures can be proposed to reduce their likelihood. This study aimed to identify the reasons of medication administration errors, determine the number of medication administration errors reported, and describe the barriers hindering reporting. METHODOLOGY: The study used a standardized Questionnaire Medication Administration Error Survey (MAE survey) that was quantitatively analyzed. The study involved 112 nurses from four hospitals in the South Bohemian Region. RESULTS: Risk factors that increase the likelihood of medication administration errors include similarity of drug names (3.7 ± 1.3) and packaging (3.9 ± 1.5), frequent prescription changes for patients (3.2 ± 1.5), illegibility of written prescriptions (3.1 ± 1.6), a lack of clarity of medical records (2.6 ± 1.5). Only a proportion of medication administration errors are reported by nurses (16% to 21%). The reluctance of nurses to report medication administration errors is linked to fear of being blamed for the deterioration of the patients health (3.3 ± 1.7), fear of the doctors reaction to a medication administration error (2.6 ± 1.4), and repressive responses from hospital management to reported misconduct (2.9 ± 1.5). CONCLUSION: Measures to reduce the likelihood of medication administration errors include building a non-punitive system for reporting adverse events and medication errors, introducing electronic prescription systems, promoting open communication within the team, involving clinical pharmacists in the pharmacotherapy process, and regular comprehensive training of nursing staff.

Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey.

AIM: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. METHOD: A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated. RESULTS: Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. CONCLUSION: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.

Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011-2021.

Aim: Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective. Objective: This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice. Design: A scoping review of the literature. Method: The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021. Results: The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods. Conclusion: Educational training for cultural competence is necessary for today's nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.

Causes and interventions of medication errors in healthcare facilities.

A medication error is one of the most common causes of patients complications or death in healthcare facilities. In the United States, 7,000 out of 9,000 patients die because of medication errors each year. Known factors are generally divided into four groups - human factor, intervention, technical factor, and system. Our study includes 17 studies from the OVID, Web of Science, Scopus, and EBSCO databases, in the range of 2015-2020. After a selection of professional publications, 2 categories were created - factors leading to medication errors and interventions to reduce medication error and testing their effectiveness. It has been found that human factor always plays a role, often supported by a poorly set-up system. The most mistakes are made in documentation, administration technique or accidental interchange of patients. The most frequently mentioned factors include nurses overload, high number of critically ill patients, interruptions in the preparation or in the administration of medications, absence of the adverse event reporting system, non-compliance with guidelines, fear, and anxiety. Another evidence of medication error is in the application of intravenous drugs, where an interchange of drugs or patients due to interruption occurs as well. Sufficient education of nurses and an adequate system of preparation and administration of drugs, for example using bar codes, are considered as an appropriate intervention.

Impact of Selected Geriatric Syndromes on the Quality of Life in the Population Aged 60 and Older.

BACKGROUND: Geriatric syndromes represent a critical domain in the population more than 60 years old. Basic syndromes include frailty, sarcopenia, loss of body mass, and a mild cognitive disorder. These are significant problems which can affect the quality of life. In our study, the Rapid Geriatric Assessment (RGA) tool was used to assess the geriatric syndromes, and the WHOQOL-BREF was used to assess the quality of life to survey 498 respondents from a population aged 60 and older. In all the assessments, the distribution of variables was tested, a nonnormal distribution of variables was identified, and subsequently, nonparametric tests were performed to identify the differences between groups. The study showed that the domain of physical health and the psychological domain were most affected. The results have shown that individual geriatric syndromes affect certain domains of the quality of life of the population above 60 with various intensity.