Electronic nursing documentation interventions to promote or improve patient safety and quality care: A systematic review.

AIM: To review the evidence on the effects/impact of electronic nursing documentation interventions on promoting or improving quality care and/or patient safety in acute hospital settings. BACKGROUND: Electronic documentation has been recommended to improve quality care and patient safety. With the gradual move from paper-based to electronic nursing documentation internationally, there is a need to identify interventions that can effectively improve quality care and patient safety. EVALUATION: We conducted a systematic review on the effectiveness of electronic nursing documentation interventions on promoting or improving quality care and/or patient safety in acute hospital settings. KEY ISSUES: Six articles reporting on six individual studies met all eligibility criteria. They were uncontrolled pre/post intervention studies reporting positive impacts on at least one or more outcomes. Most outcomes related to documentation practice and documentation of content. CONCLUSION: Some evidence from our review indicates that implementing electronic nursing documentation in acute hospital settings is time saving, reduces rates of documentation errors, falls and infections. IMPLICATIONS FOR NURSING MANAGEMENT: A planned approach from management over time to allow nurses adapt to new electronic systems of documentation would seem a good investment in terms of efficiency of work time, possibly resulting in more time for clinical care.

Experiences of registered general nurses who care for patients presenting with self-harm to the emergency department in Ireland.

BACKGROUND: There are a substantial number of self-harm presentations to emergency departments (EDs) yearly throughout Ireland. Nurses often struggle with the psychosocial nursing interventions required when caring for patients who present following self-harm. AIM: To explore the experiences of registered general nurses (RGN) who care for patients presenting with self-harm to the ED in Ireland. METHOD: A qualitative descriptive study design was used to explore experiences of RGNs in caring for patients with self-harm in the emergency department. Data was collected using one to one interviews with a purposive sample of nine RGNs working in ED. Transcripts were analysed using Burnard's thematic content analysis framework. RESULTS: Three themes emerged: 1) waiting for assessment/treatment in an unsuitable environment 2) caring for self-harming patients from a nursing perspective and 3) nurses' perceptions of self-harming patients. CONCLUSION: Overall ED nurses hold a positive attitude towards patients who self-harm but acknowledge that barriers and challenges do exist when caring for this patient group. This study highlights the need for specific training on caring for patients who present to ED following self-harm.

Nursing and midwifery students' stress and coping during their undergraduate education programmes: An integrative review.

OBJECTIVES: The aim of this review is to examine the literature related to the sources of stress, coping mechanisms and interventions to support undergraduate nursing and midwifery students to cope with stress during their undergraduate education. DESIGN: Integrative literature review. DATA SOURCES: The databases CINAHL, PubMed and PsycINFO were searched for articles published between 2010 and 2016. Search terms in various combinations were used for example; student nurse, student midwife, undergraduate, stress, coping and interventions. REVIEW METHODS: An integrative review based on Whittemore and Knafl's approach was used to conduct the review. RESULTS: The search generated 25 articles that met the inclusion criteria. The key sources of stress emanated from clinical, academic and financial issues but predominantly from the clinical environment. Students used a variety of coping strategies, both adaptive and maladaptive. These appear to be influenced by their past and present circumstances such as, their needs, what was at stake and their options for coping. Interventions for student nurses/midwives to cope with stress were varied and in the early stages of development. Mindfulness showed some promising positive results. Interventions focussed on the individual level excluding the wider social context or organisation level. CONCLUSIONS: Stress is pervasive in all aspects of undergraduate nursing and midwifery education. Nursing and midwifery educators need to be aware of this impact and provide appropriate support to students in both the clinical and academic environments. Further research is needed to capture the experience of stress from the students' perspective as well as the barriers and facilitators to supporting students from the preceptors'/mentors' perspectives. Finally, more intervention studies are needed to identify and compare what interventions are effective in supporting students to cope with stress during their undergraduate education.

Coping with stressful events: A pre-post-test of a psycho-educational intervention for undergraduate nursing and midwifery students.

BACKGROUND: Knowledge of coping mechanisms is important for nursing and midwifery students to cope with stressful events during undergraduate education. OBJECTIVES: To evaluate the impact of a psycho-educational intervention "Coping with Stressful Events" with first year undergraduate nursing and midwifery students. DESIGN: A quasi-experimental, one-group pre-post-test. SETTINGS: One school of nursing/midwifery in one university in Ireland. PARTICIPANTS: A convenience sample of all first year undergraduate nursing and midwifery students (n=197). Of these 166 completed the pretest and 138 students completed the post test. METHODS: Using the COPE Inventory questionnaire (Carver et al., 1989) data was collected pre and post-delivery of the psycho-educational intervention "Coping with Stressful Events" by two research assistants. Data were analysed using the IBM SPSS Statistics version 22 (NY, USA). RESULTS: Results demonstrated improved coping skills by students. There were statistically significant differences between pre and post intervention for some coping subscales. For example, the mean subscale scores were lower post-intervention for restraint and mental disengagement, and higher for use of emotional and instrumental social support indicating improved coping strategies. CONCLUSIONS: This intervention has the potential to influence undergraduate nursing and midwifery students coping skills during their first year of an undergraduate programme.

The perceived effectiveness of a pre-admission visit for children (and their parents) undergoing day surgery procedures.

The purpose of this paper is to present the findings of an evaluation study which examines the perceived effectiveness of a pre-admission visit for children (and their parents) undergoing day surgery procedures in the Republic of Ireland. This follow on paper provides the findings of an evaluation study subsequent to the pre-admission, practice development initiative published in the Journal of Perioperative Practice, June 2010, 20 (6) 203-206.

Setting up pre-admission visits for children undergoing day surgery: a practice development initiative.

The hospital experience can bring about a range of negative emotions for children. The literature clearly states that children who are prepared for surgery recover faster and have fewer negative effects. Pre-admission programmes seek to prepare children (and their parents) for surgery. This paper describes in detail how a pre-admission programme was established for children and their families who were scheduled for day case surgery.

Field visit placements: An integrated and community approach to learning in children's nursing.

This paper reports on the development of a new initiative, field visit placements towards and integrated and community approach to learning for nursing students. To date, limited literature exists on the potential of community field visits as meaningful learning opportunities for nursing students. Drawing on our experiences, the structure and processes involved in implementing field visits are described in this paper. Students evaluated the field visits positively indicating that they provided a wealth of learning opportunities that enhanced their knowledge and awareness of services available to children and their families in the community. The potential of field visits to promote an integrated and community approach to placements in children's nursing is discussed.

The lived experiences of newly qualified nurses on clinical placement during the first six months following registration in the Republic of Ireland.

AIM: To explore the lived experiences of newly qualified nurses on clinical placement, during the first six months following registration, in the Republic of Ireland. BACKGROUND: The subject of the experiences of newly qualified nurses is not generally well researched, although anecdotal articles are plentiful. In particular, the lived experiences of newly qualified diploma nurses in the Republic of Ireland are not reflected in the research literature. However, available literature on the subject clearly demonstrates that being a newly qualified staff nurse is particularly stressful and many nurses feel unprepared for the staff nurse role. DESIGN: A phenomenological, Heideggerian, hermeneutic approach was used for this study. METHODS: Ten diplomate staff nurses were interviewed and the data were analysed using a thematic analysis framework. RESULTS: Newly qualified nurses in the Republic of Ireland describe their initial experiences of being on the ward as stressful. This stress is primarily related to the multi-dimensional responsibilities associated with the new role and to managerial/organizational/clinical skills deficits. The allocation of students and dealing with situations that they felt unprepared for added to their anxieties. However, diplomate nurses were willing to acknowledge these limitations and seek help when appropriate. Feeling valued, making a difference and financial reward were cited as being the positive aspects of the new role. RELEVANCE TO CLINICAL PRACTICE: The preregistration nurse education curriculum needs to be developed further to help alleviate the problems associated with the initial transition to the staff nurse role. In addition, effective supportive systems need to be introduced for newly qualified nurses to help ensure that they are prepared for and supported in their professional role.