Information management of full-cycle inpatient bed reservation for cancer patients under the normalised prevention and control of the COVID-19 pandemic.

BACKGROUND: During the prolonged COVID-19 pandemic, hospitals became focal points for normalised prevention and control. In this study, we investigated the feasibility of an inpatient bed reservation system for cancer patients that was developed in the department?s public WeChat account. We also explored its role in improving operational efficiency and nursing quality management, as well as in optimising nursing workforce deployment. METHODS: We utilised WeChat to facilitate communication between cancer patients and health care professionals. Furthermore, we collected data on admissions, discharges, average number of hospitalisation days, bed utilisation rate, and the number of bed days occupied by hospitalised patients through the hospital information system and nurses? working hours and competency levels through the nurse scheduling system. The average nursing hours per patient per day were calculated. Through the inpatient bed reservation system, the number of accepted admissions, denied admissions, and cancelled admissions from the reservation system were collected. The impact of the bed reservation system on the department?s operational efficiency was analysed by comparing the number of hospitalisation discharges before and after reservations, as well as the average hospitalisation and bed utilisation rates. By comparing nurses? working hours per month and average nursing hours per patient per day, the system?s impact on nurses? working hours and nursing quality indicators was analysed. RESULTS: The average hospitalisation length, bed utilisation rate, and nurses? working hours were significantly lower, and the average number of nursing hours per patient per day was significantly higher after the implementation of the reservation system. The full-cycle bed information management model for cancer patients did not affect the number of discharged patients. CONCLUSION: Patients? ability to reserve bed types from home in advance using the department?s official WeChat-based inpatient bed reservation system allowed nurses to prepare for their work ahead of time. This in turn improved the operational efficiency of the department and nursing quality, and it optimised the deployment of the nursing workforce.

Enhancing traumatic brain injury emergency care: the impact of grading and zoning nursing management.

OBJECTIVE: This research aimed to evaluate the impact of grading and zoning nursing management on traumatic brain injury (TBI) patients' emergency treatment outcomes. METHODS: This randomized controlled trial included 200 TBI patients. They were treated with a conventional care (control group, n = 100) and a novel grading and zoning approach (study group, n = 100), respectively. This innovative model organized care into levels based on urgency and complexity, facilitating targeted medical response and resource allocation. Key metrics compared included demographic profiles, consultation efficiency (time metrics and emergency treatment rates), physiological parameters (HR, RR, MAP, SpO2, RBS), and patient outcomes (hospital and ICU stays, complication rates, and emergency outcomes). RESULTS: The study group demonstrated significantly improved consultation efficiency, with reduced times for physician visits, examinations, emergency stays, and specialist referrals (all p < 0.001), alongside a higher emergency treatment rate (93% vs. 79%, p = 0.004), notably better physiological stability, improved HR, RR, MAP, SpO2 and RBS (p < 0.001), shorter hospital and ICU stays, fewer complications, and superior emergency outcomes. CONCLUSION: Grading and zoning nursing management substantially enhances TBI patients' emergency care efficiency and clinical outcomes, suggesting a viable model for improving emergency treatment protocols.

Regulatory focus as a mediator in the relationship between nurses' organizational silence and professional identity.

AIMS: This work aims to analyse the current state of the professional identity of Chinese nurses; examine the relationship amongst regulatory focus, organizational silence and professional identity and determine how regulatory focus affects the relationship between professional identity and organizational silence. DESIGN: This study conducted a cross-sectional survey. METHODS: From June to August 2023, 420 nurses from six hospitals in Hunan Province, China, were selected through convenience sampling and surveyed by using a general information questionnaire, the regulatory focus scale, the organizational silence scale and the professional identity scale. The relationship amongst the regulatory focus, organizational silence and professional identity of nurses was examined by utilizing SPSS 25.0 and the mediating role of regulatory focus between organizational silence and nurses' professional identity was examined by applying AMOS 24.0. RESULTS: Nurses had a moderate level of professional identity. Professional identity was positively correlated with regulatory focus and negatively correlated with organizational silence. Regulatory focus was negatively correlated with organizational silence. Mediation effect studies revealed that organizational silence and professional identity were partially mediated by regulatory focus. CONCLUSION: In accordance with research showing that nurses' organizational silence can indirectly affect professional identity via regulatory focus, clinical nursing managers should concentrate on the interaction amongst these three variables to strengthen professional identity. IMPACT: The results of this study serve as a reminder to nurses to select a preventive or promotive focus based on their career objectives and to effectively express their views to enhance their professional identity. This also reminds nursing managers assess nurse-led regulatory focus, identify their underlying qualities and understand their professional aspirations and career orientation, create a good atmosphere for advice and encourage nurses to express their views, so as to improve nurses 'professional identity. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Thriving at work as a mediator of the relationship between psychological resilience and the work performance of clinical nurses.

OBJECTIVE: This study aims to investigate the relationship between psychological resilience, thriving at work, and work performance among nurses, as well as analyse the mediating role of thriving at work in the relationship between psychological resilience and the work performance of nurses. The findings are intended to serve as a reference for nursing managers to design tailored work performance intervention programs. METHOD: Using convenience sampling, 308 clinical nurses were selected from a tertiary hospital in Changsha City, Hunan Province, China, from February to April 2023. The Connor-Davidson Resilience Scale (CD-RISC), the Thriving at Work Scale, and the Work Performance Scale were employed for the questionnaire survey. Pearson correlation analysis was used to explore the relationship between psychological resilience, thriving at work and work performance. The SPSS 26.0 software's 'Process' plugin was utilised for mediation effect analysis. RESULTS: Significantly positive correlations were found between psychological resilience and thriving at work (r = 0.806, P < 0.01), thriving at work and work performance (r = 0.571, P < 0.01) as well as psychological resilience and work performance (r = 0.572, P < 0.01). Psychological resilience significantly predicted work performance positively (ß = 0.558, t = 11.165, P < 0.01), and this prediction remained significant when thriving at work (the mediating variable), was introduced (ß = 0.371, t = 4.772, P < 0.01). Psychological resilience significantly predicted thriving at work positively (ß = 0.731, t = 20.779, P < 0.01), and thriving at work significantly predicted work performance positively (ß = 0.256, t = 3.105, P < 0.05). The mediating effect size of thriving at work between psychological resilience and work performance was 33.49% (P < 0.05). CONCLUSION: Thriving at work plays a partial mediating role between psychological resilience and work performance. The level of work performance among clinical nurses was relatively high. Nursing managers can enhance thriving at work by fostering psychological resilience among clinical nurses, thereby further improving their work performance to ensure high-quality and efficient nursing care.

The relationship of perceived nurse manager competence with job satisfaction and turnover intention among clinical nurses: an analytical cross-sectional study.

BACKGROUND: Nursing managers have the potential to significantly impact the outcomes of nurses, patients, and organizations. Their competencies for effective performance are crucial. The global nursing workforce is facing a severe shortage of nurses. Dissatisfaction with management is one of the most important reasons for nurses' inclination to leave their jobs. Therefore, this study examines the relationship between nursing managers' competencies, job satisfaction and intention to leave among clinical nurses. METHODS: An analytical cross-sectional study was conducted on 354 nurses in five hospitals affiliated with Ardabil University of Medical Sciences from May to August 2023. This research used web-based software to design demographic information forms, nurse manager competency scale, turnover intention, and single-item job satisfaction questionnaires. The significance level for the study was set at p < 0.05. RESULTS: This study revealed that participants had an average score of 3.06 out of 5 in perceived nurse manager competence. Only one-fourth of the participants (25.7%) were satisfied with their current job, and less than half (46.9%) intended to leave. Employee support and development, change and resource management, supervision and quality monitoring, and personal mastery positively influenced nurses' job satisfaction. These competencies hurt employees' intention to leave their jobs. CONCLUSIONS: The research findings indicate that nursing managers in Iran have lower competency than in previous studies. Developing and strengthening these competencies is very important, as it significantly improves job satisfaction and reduces nurses' tendency to leave their jobs. Additionally, the results show that nursing managers who excel in supporting and developing staff, resource management, quality supervision, and personal mastery positively impact nurses' job satisfaction. However, these competencies can also help reduce employees' intention to leave their jobs. Retaining and maintaining nurses in the healthcare field is of utmost importance.

Factors associated with work engagement among specialist nurses in china: a cross-sectional study.

BACKGROUND: The positive impacts of work engagement among specialist nurses on retention, organizational commitment, and quality of care are well-documented. However, there is a lack of research on the specific differences in work engagement among specialist nurses. Therefore, the purpose of this study is to assess the level of work engagement among specialist nurses in China and identify its influencing factors. METHODS: A descriptive cross-sectional study was conducted in China from April to July, 2023, with 724 nurses selected from 22 hospitals through convenience sampling involved. The survey was conducted by using self-administered general information questionnaires and work engagement scales. Questionnaire Star was employed as the online data collection tool. The collected data was analyzed by using descriptive statistics and stepwise regression analysis to draw meaningful conclusions from the study. RESULTS: Among specialist nurses in Xiamen, China, who had a response rate of 97.10%, an average work engagement score is 140.35 (SD=18.17), with the highest score for the work attitude at 4.65 (SD=0.52) and the lowest score for the work recognition at 4.09 (SD=0.85). It was shown through regression analysis that factors such as career satisfaction, involvement in challenging case discussions, marital status, gender, presence of promotion advantage and title accounted for 14.5% of the total variance in the model and were significant explanatory variables that could predict work engagement. CONCLUSION: It is shown that specialist nurses in Xiamen, China have a high level of work engagement. It is imperative for nursing managers to prioritize the work engagement of specialist nurses, provide the specialist nurses with ample development opportunities and room for growth, and effectively promote the overall development of specialist nurses by improving work engagement in various aspects.

Effect of authentic leadership and mindfulness educational program on nursing managers' competencies: a quasi-experimental study.

BACKGROUND: Authentic leadership is an emerging perspective in leadership that focuses on leaders' values and beliefs. while the mindfulness perspective permits nurse managers to be fully present, aware of themselves and their impact on others, and aware of their reactions in stressful situations. so, authentic leadership and mindfulness if combined create nurse managers who have clearer, more focused thinking, and a growth mindset that help subordinates improve and grow. as well as mindfulness-based interventions help them to improve interpersonal relationships with patients and colleagues, and to take better care of themselves and others. AIM: The present study aims to; explore the effect of authentic leadership and mindfulness educational program on nursing managers' competencies in hospital. METHODS: A quasi-experimental design (Quantitative pre-, post-, and follow-up design) was used to conduct the study at Shirbeen General Hospital, Egypt. The study subjects consist of a purposive sample of 70 nurse managers and 226 nurses. Three tools used for data collection consisted of; the authentic leadership questionnaire, the five Facet Mindfulness Questionnaire, and the managerial competencies of Nurse Managers. Data analysis was performed using SPSS version 20, Qualitative categorical variables were compared using the chi-square test. A significant level value was considered when the p-value ≤ 0.05, and Cohen's d was used to measure the effect size which indicated there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores. RESULTS: The current study revealed that there were significant differences between nurse managers' knowledge, authentic leadership, mindfulness, and managerial competencies (P = 0.001) pre-, post-, and after 3 months of the program. As determined by Cohen's d test, there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores. CONCLUSION: The educational program about authentic leadership and mindfulness had a positive effect on nurse managers' managerial competencies. TRIAL REGISTRATION NUMBER (TRN): The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University, Egypt (code number: NUR 13/3/2022-11).

Identifying quality indicators for home care services: a modified Delphi and Analytic Hierarchy Process study.

BACKGROUND: As the recipients of home care services, patients have the most direct and profound experience of service quality. There is limited knowledge as to quality indicators for home care services from patients' perspective. This study aimed to identify quality indicators for home care services based on the Service Quality model and determine the weights of these indicators. METHODS: A two-round Delphi survey and Analytic Hierarchy Process consultation were conducted to gather opinions from national experts on quality indicators for home care services developed on the basis of the Service Quality model. Consensus was defined as at least 80% agreement on the importance (important and very important) of indicators among experts. The Analytic Hierarchy Process was used to calculate the weight coefficients of the identified indicators. RESULTS: The response rate was 95.0% and 97.4% in the first and second round, respectively. After two rounds, five first-level (tangibility, reliability, responsiveness, assurance and empathy) and 23 second-level indicators were identified. The Kendall's W values were 0.54 and 0.40 for the first-level and second-level indicators (p < 0.001). The weight coefficients for the first-level and second-level indicators were 0.110-0.298 and 0.019-0.088, respectively. CONCLUSION: Quality indicators for home care services were identified based on the Service Quality model. These indicators can be used to evaluate the service quality of home care from patients' perspective and facilitate to determine work priorities and improve the quality of home care.

A qualitative study of head nurses' experience in China: forced growth during patient safety incidents.

BACKGROUND: In patient safety accidents, nurse managers are indirectly victimized by the pressures from many aspects and become the second victim. This study delves into the experiences of nurse managers in China, aiming to uncover their cognition and provide reference for relevant managers. METHODS: A descriptive phenomenological approach was used to gain insight into the inner reality of nurse leaders' experiences and management perceptions of experiencing patient safety incidents. The data of 15 nurse leaders who experienced patient safety incidents in Bethune Hospital, Shanxi Province, China, were collected via face‒to‒face semi-structured interviews, and the data were analyzed via the 7-step analysis method of Colaizzi. RESULTS: On the basis of the content of the interviews, three themes were identified, the emotional experience of experiencing patient safety events, role dilemmas, the obstruction and conceptual reshaping of nursing management. Eight subthemes as follows: physical and mental health-related symptoms due to passive coping and life and work disorder, self-relief, playing multiple roles with lack of role adjustment ability, blurred role positioning and initial signs of job burnout, event replay is impeded, Inaccurate analysis of safety incidents, subversion and remolding of the nursing management concept. Finally, it can be abstracted as "forced growth in patient safety events". CONCLUSION: Patient safety incidents can lead to negative impacts, role dilemmas, and management confusion for head nurses, but they also promote purposeful rumination, meditation, and growth. Medical institutions should pay attention to special groups that are second victims of head nurses and construct a safety event support system for nurse leaders to improve the post-training and education system for nurse leaders, help them better adapt to their roles, break through their role dilemmas, improve their post-competence, and construct an effective safety event management system.

Construction of sensitive quality indicators for rapid rehabilitation care of patients after combined pancreaticoduodenectomy.

AIM: To construct evidence-based sensitive quality indicators for patients' rapid rehabilitation care after combined pancreaticoduodenectomy (PD) and to provide a reference for clinical nursing professionals to scientifically evaluate the quality of patients' rehabilitation post-PD. BACKGROUND: Since PD is associated with higher surgical risk and anastomotic complications, it leads to higher complication rates and longer postoperative recovery cycles. This reiterates the need for rapid recovery of patients after PD; however, the evaluation of sensitive nursing care indicators regarding rapid recovery post-PD has not yet been established to date. METHODS: Based on the Donabedian structure-process-result theory model, we used available literature, semi-structured interviews, the Delphi method, and hierarchical analysis to establish a sensitive indicator system for patients' rapid rehabilitation after PD and evaluate the importance of such indicators. RESULTS: There were two rounds of expert correspondence, and the effective recovery rate of the questionnaires of these rounds was 100%. The expert authority coefficients, as well as the Kendall coordination coefficients of the expert opinions, were 0.859 and 0.872 as well as 0.423 and 0.431, with statistically significant differences (p < 0.05), respectively. Consequently, we developed a sensitive quality index system for patients' rapid rehabilitation care after combined PD, including 3 first-level, 12 s-level, and 23 third-level indexes, respectively. CONCLUSION: The constructed sensitive quality index system developed for patients' rapid rehabilitation nursing care after combined PD is standardized, practical, and aligned with the specialty characteristics. Furthermore, this might help greatly in improving the quality and safety of patients' rapid rehabilitation nursing care after combined PD, standardizing nursing management skills, and enhancing nursing quality.

Managerial ethical principles and behaviours for nurse managers: A Delphi method.

BACKGROUND: Managerial ethical principles and behaviours guide the roles, duties, responsibilities, behaviours, and relationships of nurse managers in healthcare institutions. RESEARCH OBJECTIVES: The aim of this study was to establish the managerial ethical principles and behaviours for nurse managers. RESEARCH QUESTION: What are the managerial ethical principles and behaviours for nurse managers? RESEARCH DESIGN: The Delphi method, one of the qualitative research methods, was used in this study. The Delphi process consisted of two rounds. Data were collected by e-Delphi technique. PARTICIPATIONS: 42 experts were included in the first Delphi round and 39 in the second Delphi round. These experts consisted of nurse managers, academicians studying in the field of ethics and nursing management. ETHICAL CONSIDERATIONS: Participation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee of the university at which the researcher worked (Approval date: 24.07.2020, Decision No: 2020/12-16). FINDINGS: At the end of the Delphi rounds, eight managerial ethical principles and 29 ethical behaviours of these principles were identified. The distribution of these behaviours and principles were: justice (six behaviours), equality (two behaviours), honesty (two behaviours), fairness (two behaviours), responsibility (eight behaviours), confidentiality (two behaviours), clarity (two behaviours), and humanity (five behaviours). CONCLUSION: These managerial ethical principles and behaviours are intended to guide nurse managers when providing nursing services but should be updated accordingly in line with changing conditions and developments.

Management of Pediatric Convulsive Status Epilepticus From the Perspective of Emergency Nurses: A Cross-sectional, Multicenter Study.

INTRODUCTION: Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey. METHODS: A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis. RESULTS: Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents. DISCUSSION: As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.

Enhancing Postanesthesia Care Unit Management Based on Noise Reduction Strategies Grounded in Comfort Theory.

PURPOSE: To explore the management improvement measures and application effects of reducing noise in postanesthesia care unit (PACU) based on Comfort Theory. DESIGN: Randomized controlled clinical trial. METHODS: A total of 1,300 patients who underwent general anesthesia or combined nerve block anesthesia and were transferred to the PACU in May and August 2021 were divided into a control group (630 cases) and a study group (670 cases) based on time. The control group received routine PACU management, and management based on Comfort Theory to reduce the noise in the PACU was implemented with the study group, including physiological comfort, psychological and spiritual comfort, social and cultural comfort, and environmental comfort. The overall noise level in PACU, retention time in PACU, incidence of nursing adverse events, and patient satisfaction were compared before and after implementation. FINDINGS: In the observation group, the noise values of the four time periods in the PACU were significantly decreased, the retention time was (59.92 ± 22.0) minutes, the incidence of nursing adverse events and vomiting was 0.1%, and the patient satisfaction was 99.8%, which were significantly better than those in the control group, and the differences were statistically significant (P < .05). CONCLUSIONS: The management of noise reduction in PACU based on Comfort Theory can significantly reduce the noise level in PACU, effectively shorten the PACU retention time, reduce the incidence of nursing adverse events, and improve the nursing satisfaction of patients.

Missed Nursing Care as a Mediator in the Relationship between Career Calling and Turnover Intention.

AIM: To explore the role of missed nursing care in mediating the relationship between career calling and intention to leave among nurses. INTRODUCTION: Increasing nurse turnover is still a major concern in the global healthcare system. The most reliable indicator of turnover is turnover intention. It is crucial to understand its affecting elements to suggest measures to lower nurses' turnover intention. BACKGROUND: Turnover intention has been linked to career calling and missed nursing care. Little empirical research has investigated the possibility that missed nursing care mediates between career calling and turnover intention. METHODS: A cross-sectional survey of 347 nurses was conducted. The survey instruments included the General Information Questionnaire, Calling Scale, Missed Nursing Care Scale and Turnover Intention Questionnaire. Structural equation models were used to build the model. This study made use of the STROBE checklist. RESULTS: For 43.8% of nurses, turnover intention was high or very high. Missed nursing care and turnover intention were negatively correlated with career calling. Missed nursing care and turnover intention were positively related. Missed nursing care mediated the relationship between career calling and turnover intention. DISCUSSION: Career calling and missed nursing care can both influence turnover intention. Career calling can reduce the likelihood of turnover by preventing missed nursing care. CONCLUSION: Missed nursing care mediated the relationship between career calling and intention to leave. IMPLICATIONS FOR NURSING AND NURSING POLICY: Nursing managers should improve nurses' career calling through professional education and minimize missed nursing care by using electronic nursing reminder devices to reduce turnover intention.

The effect of nurses' perceived workplace incivility on their presenteeism and turnover intention: The mediating role of work stress and psychological resilience.

AIM: This study aims to determine the effects of nurses' perceived workplace incivility on nurses' presenteeism and turnover intention and to reveal the mediating role of work stress and psychological resilience in the possible impact. BACKGROUND: Nurses directly contribute to the treatment of patients. The problems nurses encounter in the workplace can negatively affect nurses' attitudes towards work. Therefore, the problems faced by nurses should be determined. METHODS: This study complies with the STROBE checklist. This cross-sectional survey was conducted with 302 nurses working in a university hospital in the Konya province of Turkey. Data were collected in May-July 2021. The questionnaire consisted of six parts: sociodemographic characteristics form, workplace incivility scale, psychological resilience scale, work stress scale, turnover intention scale and presenteeism scale. The data were analysed using descriptive statistical methods and partial least-squares path analysis. RESULTS: It was determined that workplace incivility positively and significantly affected turnover intention, presenteeism and work stress. In contrast, it negatively and significantly affected psychological resilience. In addition, psychological resilience played a mediating role in the effect of workplace incivility on presenteeism. CONCLUSION: The results reveal that the behaviours of incivility encountered by nurses in the workplace increase their presenteeism and turnover intention, and work stress further strengthens these effects. The psychological resilience of nurses is a factor that can help them eliminate their negative emotions and attitudes. Therefore, it is recommended that nursing and health managers first identify the stress factors in the workplace and be determined to fight them. In addition, organizing training and providing psychological support to increase nurses' psychological resilience may enable nurses to develop more positive feelings about their jobs and workplaces. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health managers must determine workplace incivility behaviours and inform all employees about these behaviours, their consequences and how to deal with such incivility. In addition, nursing and health managers must determine the stress factors in the workplace and be adamant about combating these factors. In addition, nursing and health managers must give importance to training that will increase the psychological resilience of nurses.

Prone position ventilation for the relief of acute respiratory distress syndrome through improved pulmonary ventilation: Efficacy and safety.

BACKGROUND: At present, there is a preliminary clinical consensus that prone position ventilation (PPV) is beneficial to the treatment of acute respiratory distress syndrome (ARDS), and further research on the details of treatment and patients' benefits will help to assess its effectiveness and safety. AIM: To evaluate the timing, efficacy, and safety of different mechanical ventilation positions (MVP) in treating ARDS. STUDY DESIGN: The results of clinical trials were directly or indirectly compared by network meta-analysis to compare the effects of different MVP. Two authors independently searched the papers published in PubMed, Embase, Cochrane Library, China Knowledge Infrastructure (CNKI), China Biomedical Discs (CBM), WanFang, and VIP database from January 2000 to August 2022. The outcome indicators were oxygenation index, mechanical ventilation time, ICU hospitalization time, in-hospital mortality, and incidence of adverse events. Two authors independently screened the literature, evaluated the quality of the studies, and completed the data extraction. Stata 14.0 was used to conduct a network Meta-analysis, and the intervention measures were ranked according to the surface under the cumulative ranking curve (SUCRA). Funnel plots were drawn to evaluate publication bias. RESULTS: According to the inclusion and exclusion criteria, 75 studies (including 6333 patient data) were finally included. According to the analysis results, PPV was the best for improving the oxygenation index. The SUCRA values of mechanical ventilation time, ICU hospitalization time, and in-hospital mortality were ranked as PPV > lateral position ventilation (LPV) > supine position ventilation (SuPV) > semireclining position ventilation (SePV). The SUCRA values in the incidence of adverse events were ranked as LPV > PPV > SuPV > SePV. All outcome measures had good consistency and low statistical heterogeneity. Funnel plot analysis shows that papers reported within three days of mechanical ventilation time, over five days of mechanical ventilation time, and in-hospital mortality were more likely to have publication bias. CONCLUSIONS: PPV has the best effect on improving the oxygenation index, reducing mechanical ventilation time, shortening ICU hospitalization time, and reducing in-hospital mortality. Early and long-term use of PPV to improve pulmonary ventilatory function will be the key to improving patients' survival and quality of life with ARDS. RELEVANCE TO CLINICAL PRACTICE: PPV significantly affects patients with ARDS, which can shorten the treatment time and reduce hospital costs. During the treatment, nursing observation should be strengthened to prevent adverse events.

Policy Reform on the Qualification Pathway of Internationally Educated Nurses in Greenland and Its Relationship With the Danish System: A Qualitative Discourse Analysis.

The nursing profession in Greenland, particularly in rural and remote areas, faces challenges due to geographical limitation and a lack of interdisciplinary collaboration. The registration process and status of internationally educated nurses (IENs) in Greenland are unclear. This article aimed to analyze existing policies and propose recommendations for an independent registration process for IENs in Greenland. A qualitative discourse analysis was used to critically discuss existing policies and regulations governing nursing registration in Greenland. Relevant legislation, government reports, and official documents were reviewed. Legislative regulations protect the title of registered nurse in both Greenland and Denmark. To work in Greenland, an IEN must have a residence permit. With recent health agreements between Greenland and Denmark, both countries have streamlined the permit acquisition process for foreign healthcare professionals, making it more accessible. However, the process of acquiring a license to work as a registered nurse for IENs lacks clarity. Policy reform is needed to establish a group of diverse nurse experts under the National Board of Health responsible for the assessment and registration of IEN qualifications. There is also a need for a bridging education program or national licensure examination which could facilitate faster IEN recognition. Mutual recognition of nurse licenses between Greenland and Denmark should be established to ensure efficient healthcare delivery and maintain professional standards. Embracing IENs can address nursing shortages and improve healthcare services in Greenland.

Knowledge, attitude, and practice of pediatric nurses in prevention of central venous access device-related thrombosis in hospitalized children: a nationwide cross-sectional survey.

Central venous access device-related thrombosis (CRT) is a common complication in hospitalized children. The pediatric nurses' knowledge, attitude, and practice are of great significance for CRT prevention in hospitalized children. The purpose of this study was to elaborate on the level and influencing factors of pediatric nurses' knowledge, attitude, and practice on the prevention related to CRT in hospitalized children. This national cross-sectional study was carried out in China from January 16, 2021, to April 23, 2021. A multi-stage sampling method was adopted, and 1060 pediatric nurses from 21 hospitals participated in this study. The current situation and influencing factors of pediatric nurses' knowledge, attitude, and practice were investigated by descriptive statistics, approximate t test or independent-sample t test, nonparametric Kruskal-Wallis H test, one-way analysis of variance, and multiple linear regression analysis. The relationship among pediatric nurses' knowledge, attitude, and practice was explored by the Pearson correlation analysis. Among all pediatric nurses involved in this study, 25% had insufficient knowledge, 18% had negative attitudes, and 24% had poor behaviors. The main influencing factors on the knowledge, attitude, and practice included the highest education level of pediatric nurses (ß = 0.10, P = .001), whether received training related to CRT prevention (ß = 0.09-0.14, P < .01), whether CRT-related knowledge was enough for dealing with clinical work (ß = 0.18-0.21, P < .001), and the importance of hospitals/departments on children CRT prevention (ß = 0.16-0.24, P < .001). There was a positive correlation between knowledge, attitude, and practice (r = 0.24-0.77, P < .01).    Conclusion: Pediatric nurses' CRT-prevention knowledge and practice are unsatisfactory, while their preventive attitude toward CRT prevention is optimistic. This study assists the formulation of comprehensive intervention strategies for pediatric nurses in preventing CRT in hospitalized children by hospital-related organizations and nursing managers, so as to improve the participation of pediatric nurses in CRT prevention and reduce the occurrence of CRT for hospitalized children. What is Known: • As a common complication in hospitalized children, CRT can induce many potentially serious complications. • A professional nursing team is an important prerequisite for reducing CRT incidence. What is New: • The levels of pediatric nurses' knowledge and practice are not satisfactory, while pediatric nurses' preventive attitude toward CRT prevention is optimistic. • Hospital-related organizations and nursing managers should highlight the importance of CRT prevention and encourage pediatric nurses to improve their expertise and strengthen the training related to CRT prevention.

Women's power in hospital-based nursing: A critical qualitative study.

AIM: To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered. DESIGN: Critical qualitative research design. METHOD: Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis. RESULTS: Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. These themes include supportive leaders, positive unit culture, successful advocacy, personal factors, societal gender roles and sexism. CONCLUSION: Empowered nurses can revolutionize health care. The themes developed in this study will help nurse leaders and nurses alike increase nurses' ability to use their power and feel empowered in the workplace. IMPACT: Nurse leaders should strive to be supportive of their nurses and build a positive work environment while also providing consistent consequences for sexist actions of staff. Nurses should take opportunities to advocate for their patients, be autonomous and build their knowledge base to improve empowerment. As nurse leaders and nurses alike work together to improve health care, nurse experience, patient and clinical outcomes will be improved. PATIENT OR PUBLIC CONTRIBUTION: The nurses interviewed for this study contributed their experiences and insights during data collection. Some also contributed rigour to the data analysis process by participating in member checking.

Nurse managers' support of fundamental care in the hospital setting. An interpretive description of nurse managers' experiences across Australia, Denmark, and New Zealand.

AIMS: To explore the role of ward-based nurse managers in supporting nurses to undertake high-quality fundamental care. DESIGN: A qualitative study guided by the principles of interpretive description. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ). METHODS: Nurse managers in three urban, publicly funded hospitals in Australia, Denmark and New Zealand, were invited to participate in group interviews to discuss how they support fundamental care in their clinical areas. Six group interviews were conducted between February 2017 and March 2020 involving 31 participants. RESULTS: Six interrelated themes were identified: Difficulty expressing how to support the nurse-patient relationship; Establishing expectations for care delivery without clear strategies for how this can be achieved; Role modelling desired behaviours; Significance of being present to support care quality; The importance of engaging and supporting staff in their work; and Recognizing the challenges of prioritizing care needs. CONCLUSION: This study indicates that nurse managers are not universally clear in explaining how they support their staff to provide fundamental care. If fundamental care is not clearly understood and communicated in the nursing team, then there are risks that fundamental care will not be prioritized, with potential negative consequences for patient care. Nurse managers may benefit from additional resources and guidance to help them to support fundamental care delivery in their clinical areas. IMPACT: Previous research exploring fundamental care and missed care highlights the importance of the role of the nurse manager in influencing nursing care. This study demonstrates that though nurse managers have a passion for supporting their staff to deliver fundamental care, clear strategies to achieve this are not always evident. This study suggests that scholarship around leadership to promote and facilitate fundamental care is crucial to improving nursing practice and patient outcomes.