Comparison of Task-Layered Clinical Orientation to Traditional Orientation in a RN Residency Program.

OBJECTIVE: The purpose of this study was to compare outcomes of using a task-layered clinical orientation when compared with the original patient-layering approach. BACKGROUND: Use of task-layering to orient new graduate nurses to the clinical world of nursing has been theorized to provide a decrease in cognitive load and allow for more streamlined clinical orientation. METHODS: The method of this study was a nonrandomized, comparative design to measure the outcomes of length of orientation, new graduate perceptions about level of confidence/comfort with professional nurse responsibilities/skills, stress, satisfaction, and perceptions about orientation. RESULTS: Analysis revealed no statistical significance between the 2 groups. However, the task-layered clinical orientation group completed orientation earlier than the traditional patient-layered group. CONCLUSIONS: The task-layered approach to clinical orientation provided as good of outcomes as traditional orientation strategy and may result in cost savings due to decrease in total clinical orientation days.

A Comparison of Evidence-Based Practice Training With and Without Postimmersion Follow-up.

OBJECTIVE: The aim of this study was to determine best practice for evidence-based practice (EBP) education that leads to implementation. BACKGROUND: Current methods of teaching EBP do not reliably translate to implementation. METHODS: Participants in an EBP immersion were compared with participants in EBP immersion plus a follow-up EBP course. RESULTS: The EBP immersion group implemented 18% of their initiatives. The EBP immersion plus the follow-up EBP course implemented 35% of their initiatives, and an additional 22% were in the process of implementation. CONCLUSION: Evidence-based practice education may not be sufficient in promoting EBP implementation. Additional ongoing support may be needed to bring EBP initiatives through implementation.

Construction and application of procedural pathways combined with information management in nursing staff skills training system.

OBJECTIVE: To explore the application effect of procedural pathways combined with information management in the construction of nursing staff skills training system. METHODS: This was a quasi-experimental study with a control group and an experimental group. A total of 300 newly admitted nurses or nurses who required training within three years of admission were selected as the experimental group, and 267 nurses who were trained in the same hospital during the same period in 2020 were selected as the control group. The experimental group received skills training using a system that combines procedural pathways with information management, while the control group received traditional teaching mode. The outcome measures included theoretical score, operation score, nurse competency, patient satisfaction, and nursing-related adverse events. The data were analyzed using t-test, chi-square test, and rank-sum test. RESULTS: The experimental group had higher scores in theoretical assessment, skills assessment, nurse competency, and patient satisfaction, and lower incidence of nursing-related adverse events than the control group (P < 0.05). CONCLUSION: The strategy of procedural pathways combined with information management provides a new perspective and method for nursing operation skills training, effectively improves clinical nursing quality and ensures patient safety.

The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial.

INTRODUCTION: Nurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses' stress and anxiety levels. MATERIALS AND METHODS: This study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21. RESULTS: Before the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001). CONCLUSIONS: The micro-learning-based mHealth application for resilience training significantly reduced ICU nurses' stress and anxiety, recommending its adoption as an innovative educational method. TRIAL REGISTRATION: The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).

Design and content validation of a checklist about infection-prevention performance of intensive care nurses in simulation-based scenarios.

OBJECTIVE: To design, develop and validate a new tool, called NEUMOBACT, to evaluate critical care nurses' knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention through simulation scenarios involving central venous catheter (CVC), endotracheal suctioning (ETS) and mechanically ventilated patient care (PC) stations. BACKGROUND: Simulation-based training is an excellent way for nurses to learn prevention measures in VAP and CRB. DESIGN: Descriptive metric study to develop NEUMOBACT and analyse its content and face validity that followed the COSMIN Study Design checklist for patient-reported outcome measurement instruments. METHODS: The first version was developed with the content of training modules in use at the time (NEUMOBACT-1). Delphi rounds were used to assess item relevance with experts in VAP and CRB prevention measures, resulting in NEUMOBACT-2. Experts in simulation methods then assessed feasibility, resulting in NEUMOBACT-3. Finally, a pilot test was conducted among 30 intensive care unit (ICU) nurses to assess the applicability of the evaluation tool in clinical practice. RESULTS: Seven national experts in VAP and CRB prevention and seven national simulation experts participated in the analysis to assess the relevance and feasibility of each item, respectively. After two Delphi rounds with infection experts, four Delphi rounds with simulation experts, and pilot testing with 30 ICU nurses, the NEUMOBACT-FINAL tool consisted of 17, 26 and 21 items, respectively, for CVC, ETS and PC. CONCLUSION: NEUMOBACT-FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation. RELEVANCE FOR CLINICAL PRACTICE: Our validated and clinically tested tool could facilitate the transfer of ICU nurses' knowledge and skills learning in VAP and CRB prevention to critically ill patients, decreasing infection rates and, therefore, improving patient safety. PATIENT OR PUBLIC CONTRIBUTION: Experts participated in the Delphi rounds and nurses in the pilot test.

How does training given to pediatric nurses about artificial intelligence and robot nurses affect their opinions and attitude levels? A quasi-experimental study.

PURPOSE: This study was conducted to investigate the effect of training provided to pediatric nurses on their knowledge and attitude levels about artificial intelligence and robot nurses. DESIGN AND METHODS: In this study, a single-group pre- and post-test quasi-experimental design was used. Data were collected from pediatric nurses working in Training and Research Hospital located in western Turkey. Forty-three pediatric nurses participated in the study. The study data were collected using the "Pediatric Nurses' Descriptive Characteristics Form", "Artificial Intelligence Knowledge Form", and "Artificial Intelligence General Attitude Scale". RESULTS: The mean scores of the participating pediatric nurses obtained from the Artificial Intelligence Knowledge Form before, right after and one month after the training were 41.16 ± 14.95, 68.25 ± 13.57 and 69.06 ± 13.19, respectively. The mean scores they obtained from the Positive Attitudes towards Artificial Intelligence subscale of the Artificial Intelligence General Attitude Scale before and after the training were 3.43 ± 0.54 and 3.59 ± 0.60, respectively whereas the mean scores they obtained from its Negative Attitudes towards Artificial Intelligence subscale were 2.68 ± 0.67 and 2.77 ± 0.75, respectively. CONCLUSIONS: It was determined that the training given to the pediatric nurses about artificial intelligence and robot nurses increased the nurses' knowledge levels and their artificial intelligence attitude scores, but this increase in the artificial intelligence attitude scores was not significant. PRACTICE IMPLICATIONS: The use of artificial intelligence and robotics or advanced technology in pediatric nursing care can be fostered.

Evaluating the Oncology-Related Education Needs of Emergency Nurses.

INTRODUCTION: Treatment for patients with cancer in the emergency department ranges from treating life-threatening emergencies to symptom management or issues unrelated to their cancer, but for which cancer and its treatment may be complicating factors. Nurses are expected to manage the care of this population and be aware of risk factors for complications that may be unique to cancer patients. To date, education for emergency nurses regarding oncologic emergencies and the care for patients with cancer has been limited. METHODS: We conducted a cross-sectional needs assessment to establish emergency nurses' educational needs (knowledge, skills, and attitudes) related to the care of patients with cancer and to evaluate if there are different educational needs for emergency nurses associated with the care of the cancer patient by practice setting type. RESULTS: Of 237 nurses surveyed, only 28% of nurse respondents indicated receiving any cancer-specific education or training. Overall, scores on a knowledge assessment were relatively low (mean 53%; range 9.5-85.7%; SD 13%). Nurses reported variable confidence and skills, with the weakest areas being in the triage of complications and oncologic emergencies, assessment of complications related to cancer treatment, and end-of-life conversations. Nearly all of the respondents (97%) indicated a need for oncologic education for emergency nurses with moderate-high priority in relation to other educational needs. DISCUSSION: Our findings suggest that emergency nurses need a stronger foundation of the knowledge and skills required to care for patients with cancer. Results from this study can inform future curriculum development efforts.

Knowledge and attitudes regarding pressure injuries among assistant nurses in a clinical context.

This study aimed to evaluate assistant nurses' knowledge of and attitudes towards pressure injuries in a clinical setting. It employed a cross-sectional design, using two validated surveys: PUKAT 2.0 and APUP, alongside open-ended questions. A convenience sample of 88 assistant nurses from five wards across two departments at a 600-bed university hospital in Sweden participated. Participants answered the questionnaire and open-ended questions, followed by a learning seminar led by the study leader covering PUKAT 2.0 knowledge questions. The seminar ended with an evaluation of this training approach. Results revealed a significant knowledge gap in pressure injury prevention among assistant nurses, with a mean PUKAT 2.0 knowledge score of 33.8 and a standard deviation of ±11.7 (a score of 60 is deemed satisfactory). Only 3.4% (n = 3) of participants achieved a satisfactory knowledge score. However, attitudes towards pressure injury prevention, assessed by the APUP tool, were generally positive among the majority of the participants. Open-ended questions and evaluations of the seminar showed assistant nurses' desire for pressure injury prevention training and their appreciation for the seminar format. Further studies need to evaluate recurrent training procedures and departmental strategies aimed at reducing the knowledge gap among healthcare staff.

Trainee ANPs' experiences of having a clinical practice facilitator introduced into a Hospital at Night team.

BACKGROUND: The role of the advanced nurse practitioner (ANP) within Hospital at Night (H@N) teams has emerged in line with the demands of the service and the needs of patients in the out-of-hours period. The majority of ANPs with H@N teams are recruited as trainees. There is a high volume of trainees needing support against a low number of experienced ANPs. Introduction of the clinical practice facilitator (CPF) role is one way of addressing these issues. Within this evaluative study of one H@N service, the CPFs are experienced ANPs who have received additional training in the delivery of practice assessment and learner feedback. AIM: To explore the experiences and perceptions of those trainee ANPs who have had or are currently receiving support and supervision from the CPFs in an H@N service in one Scottish NHS health board. METHOD: The CPFs undertook a service evaluation following introduction of the role. Purposive sampling was undertaken whereby a descriptive questionnaire was sent to 22 eligible participants. RESULTS: 16 questionnaires were returned. Qualitative data from the questionnaire generated several themes from the participants' responses: validation of competencies, supporting wellbeing, accessibility of support, designated prescribing practitioner role and support post-qualification. CONCLUSIONS: CPFs are ideally placed to meet the required needs of trainees. Organisational commitment is key to ensuring ANPs are in optimal positions to provide support and supervision for the next generation of trainees.

Rehabilitation Nurses' Knowledge About Pain in Older Adults in Malta.

PURPOSE: Rehabilitation nurses require adequate knowledge about pain to improve patient experience and quality of care. We explored nurses' knowledge and attitudes towards pain in older adults in a large rehabilitation hospital in Malta. DESIGN: A cross-sectional study. METHODS: In total, 130 nurses received a short survey, which gathered sociodemographic data, information regarding usual pain management, and prior education on pain. A modified version of the Knowledge and Attitudes Survey Regarding Pain (KASRP) with 18 questions was used, alongside the 24-item Pain in the Older Adults' Knowledge Survey (POAKS). Non-parametric tests identified factors associated with KASRP and POAKS scores. RESULTS: Overall, 89 nurses completed the survey (response rate 68%). The median modified KASRP score was 50% (IQR 3.00), with only two nurses achieving the proposed "adequate" score of >80%. The median POAKS score was 79% (IQR 4.00). The only determinant of performance was nationality, with Maltese nurses performing better in POAKS than non-Maltese nurses (median 20.00 (3.00) vs. 16.50 (5.00); p = .003), indicating a possible language-related performance issue. Nurses scored poorly in some questions relating to analgesia administration, particularly opioids, as well as pain indicators and pain assessment. CONCLUSIONS: Rehabilitation nurses have fair knowledge of pain management in older people but require further education, particularly in opioid indications for pain management, pain expression, and assessment.

Time-to-Task in Interval Simulated Cardiopulmonary Resuscitation Training: A Method for Maintaining Resuscitation Skills.

PURPOSE: The literature supports interval simulation training as a means of improving nurses' cardiopulmonary resuscitation (CPR) skills. The aim of this project was to improve the time-to-task skills in single-rescuer basic life support (BLS) in an outpatient surgery center through interval simulation training. DESIGN: Quality Improvement project. METHODS: Twenty-nine nursing staff were included in this pretest/post-test within subjects interventional design quality improvement project. A 2-minute pretest cardiac arrest simulation was performed in the outpatient surgery center where time-to-task and quality of CPR data were collected. The pretest was followed by a lecture and CPR training. Three months later, the simulation was post-tested in an identical scenario with measures of time-to-task and quality of CPR. FINDINGS: The mean times for code bell activation and initiation of CPR decreased significantly following the interval simulation training (P < .05). A clinically significant decrease was seen in the mean time-to-task placement of a backboard on code team arrival. CONCLUSIONS: Interval simulation training is an effective means of maintaining CPR skills in the outpatient surgery center setting.

Using wound cartoon visual education to enhance nurses' knowledge of wound care.

Cartoon education methods have been used effectively as a teaching tool and were considered potentially useful to improve nurses' knowledge and professional skills to ensure quality patient care. Therefore, this study aimed to enhance nurses' knowledge of wound care using the cartoon visual education program. After the 4 weeks, nurses were given questionnaires about knowledge of wound care, self-efficacy, situation anxiety, and trait anxiety to understand the nurse's situation before and after the teaching program analysis. Significant differences were observed in their education level, rank, marital status, and whether or not they had children, and received wound education. Linear regression results show significant differences in wound care knowledge and situational anxiety. The study indicates that cartoon visual education is enhancing nursing staff's knowledge of wound care and mitigating situational anxiety and thus can improve the quality of wound care by nursing staff and is used to standardise wound care education, resulting in better wound care services.

The impact of nursing staff education on diabetes inpatient glucose management: a pilot cluster randomised controlled trial.

BACKGROUND: An increasing number of patients in hospital have diabetes, with most of them cared for by non-specialist staff. The effect of diabetes education for staff on patient outcomes, as well as the most effective method of staff education is unclear. Therefore, the aim of this study was to compare diabetes outcomes in medical wards where nursing staff were offered one face-to-face (F2F) session followed by access to online education (online), F2F education only, or standard care (control). METHODS: We conducted a pilot cluster randomised controlled trial involving 16-weeks baseline/rollout followed by a 28-week post-intervention period across three medical wards (clusters) in a Sydney Teaching Hospital. The online ward provided an online competency-based diabetes education program and 1-h F2F teaching from a diabetes nurse educator (DNE), the F2F ward provided four separate 1-h teaching sessions by a DNE, with no additional sessions in the control ward. The primary outcome was length of stay (LOS); secondary outcomes included good diabetes days (GDD), hypoglycaemia and medication errors. Poisson and binary logistic regression were used to compare clusters. RESULTS: Staff attendance/completion of ≥ 2 topics was greater with online than F2F education [39/48 (81%) vs 10/33 (30%); p < 0.001]. Among the 827/881 patients, there was no difference in LOS change between online [Median(IQR) 5(2-8) to 4(2-7) days], F2F [7(4-14) to 5(3-13) days] or control wards [5(3-9) to 5(3-7) days]. GDD improved only in the online ward 4.7(2.7-7.0) to 6.0(2.3-7.0) days; p = 0.038. Total patients with hypoglycaemia and appropriately treated hypoglycaemia increased in the online ward. CONCLUSIONS: The inclusion of online education increased diabetes training uptake among nursing staff. GDD and appropriate hypoglycaemia management increased in the online education wards. TRIAL REGISTRATION: Prospectively registered on the Australia New Zealand Clinical Trials Registry (ANZCTR) on 24/05/2017: ACTRN12617000762358 .

Occurrence and types of medication error and its associated factors in a reference teaching hospital in northeastern Iran: a retrospective study of medical records.

BACKGROUND: Medication errors are categorized among the most common medical errors that may lead to irreparable damages to patients and impose huge costs on the health system. A correct understanding of the prevalence of medication errors and the factors affecting their occurrence is indispensable to prevent such errors. The purpose of this study was to investigate the prevalence and types of medication errors among nurses in a hospital in northeastern Iran. METHODS: The present descriptive-analytical research was conducted on 147 medical records of patients admitted to the Department of Internal Medicine at a hospital in northeastern Iran in 2019, selected by systematic sampling. The data were collected through a researcher-made checklist containing the demographic profiles of the nurses, the number of doctor's orders, the number of medication errors and the type of medication error, and were finally analyzed using STATA version 11 software at a significance level of 0.05. RESULTS: Based on the findings of this study, the mean prevalence of medication error per each medical case was 2.42. Giving non-prescription medicine (47.8%) was the highest and using the wrong form of the drug (3.9%) was the lowest medication error. In addition, there was no statistically significant relationship between medication error and the age, gender and marital status of nurses (p > 0.05), while the prevalence of medication error in corporate nurses was 1.76 times higher than that of nurses with permanent employment status (IRR = 1.76, p = 0.009). The prevalence of medication error in the morning shift (IRR = 0.65, p = 0.001) and evening shift (IRR = 0.69, p = 0.011) was significantly lower than that in the night shift. CONCLUSION: Estimating the prevalence and types of medication errors and identified risk factors allows for more targeted interventions. According to the findings of the study, training nurses, adopting an evidence-based care approach and creating interaction and coordination between nurses and pharmacists in the hospital can play an effective role in reducing the medication error of nurses. However, further research is needed to evaluate the effectiveness of interventions to reduce the prevalence of medication errors.

Nurses' perceptions in caring for people with dementia in Dutch acute hospitals.

AIMS AND OBJECTIVES: Overall, this study aimed to describe nursing care for patients with dementia in acute hospitals, with the objectives of describing the provided nursing care (a), nurses' attitudes and perceptions in caring for patients with dementia (b), and exploring how nurses deal with challenging behaviour (c). Additionally, we determined background variables associated with caring for people with dementia. BACKGROUND: Due to comorbidities, people with dementia are frequently admitted to acute care hospitals. Here, they are at high risk of complications. Nurses strive for good care but regularly experience insufficient knowledge and skills regarding caring for people with dementia. DESIGN: A cross-sectional survey study design. METHODS: Data were collected in seven Dutch acute hospitals and through social media. In total, 229 hospital nurses completed the questionnaire. We used the Geriatric In-Hospital Nursing Care Questionnaire and two subscales of Hynninen on managing challenging behaviour. This report followed the STROBE checklist. RESULTS: Nurses express that they often apply general preventive interventions not explicitly related to dementia care. In general, nurses have mixed feelings about the nursing care provided in their department. For challenging behaviour, a variety of approaches, including restrictive measures and medication, is applied. The nurses' attitudes and perceptions are influenced by the type of hospital where the nurses work, the level of education, the number of hours nurses work, and if the nurses completed a course on dementia in the last year. CONCLUSIONS: Despite a positive attitude, nurses do not have the specific knowledge and skills needed to provide proper care. Nurses who recently completed a course on dementia had more positive attitudes and perceptions towards caring for patients with dementia. RELEVANCE TO CLINICAL PRACTICE: The results of this research can be used to improve the quality of nursing care for patients with dementia in acute hospitals.

The influence of professional identity on work engagement among nurses working in nursing homes in China.

AIM: To assess the influence of professional identity on work engagement among nurses working in nursing homes in China. BACKGROUND: China is faced with an increasingly ageing population. There is a shortage of adequately trained nursing personnel and a high turnover rate among nurses. Work engagement is a key factor in improving nurses' performance and improving professional identity is critical to increase work productivity and satisfaction. METHODS: We conducted a cross-sectional survey of 272 nurses working in nursing homes. And the data were analysed by descriptive analyses, univariate analysis and Multiple regression analyses. RESULTS: The overall average work engagement score was 3.99 ± 1.04. Professional identity was the only factor that significantly influenced the 'vigour' and 'absorption' of nurses. Age, ethnicity and professional identity were significant predictors of 'dedication'. CONCLUSIONS: A positive professional identity can lead to a better work engagement among nurses working in nursing homes in China. IMPLICATIONS FOR NURSING MANAGEMENT: To enhance the work engagement of nurses working in nursing homes, nursing leaders should create a respectful and equal work environment, create a favourable image of the industry and the profession and strengthen training to improve the professional identity.

Critical care nurses' experiences of nursing intoxicated patients after abuse of drugs.

BACKGROUND: Patients intoxicated after abusing illicit drugs constitute a significant proportion of patients cared for in intensive care units. Intensive critical care nurses who nurse accidentally intoxicated patients face complex and demanding situations, and there is a lack of studies regarding this topic. AIMS AND OBJECTIVES: To illuminate Swedish intensive critical care nurses' experiences of nursing accidentally intoxicated patients after abuse of illicit drugs. DESIGN: A qualitative design with an inductive approach was used. METHODS: Semi-structured interviews were conducted with eight intensive critical care nurses at an intensive care unit in Sweden. Data were analysed using qualitative content analysis. FINDINGS: The themes found illuminate intensive critical care nurses' experiences of nursing accidentally intoxicated patients after their abuse of illicit drugs: feeling empathy and a wish to provide dignified care; dreading nursing the patient and feeling a lack of empathy; feeling frustration and questioning the care; lacking knowledge about a complex and challenging situation. CONCLUSIONS: It is essential to respond to intoxicated patients with empathy and dignity. Intensive critical care nurses should learn how to identify factors that lead to provocation and agitation in order to reduce the occurrence of dangerous situations in intensive care units. RELEVANCE TO CLINICAL PRACTICE: To create a caring environment where the interaction becomes more positive and harmonious, an intensive care nurse needs a deep understanding of what a drug abuse disorder means. Moreover, the ability to see the person behind the abuse and to provide non-judgemental support is required. What is known about this topic Patients intoxicated after abuse of illicit drugs constitute a significant proportion of patients cared for in ICUs worldwide. Intensive critical nurses who nurse accidentally intoxicated patients face complex and demanding situations, and few studies have addressed this topic. What this paper contributes It is essential to respond to intoxicated patients who are admitted to the ICU with empathy and dignity, as well as to learn how to identify factors that lead to provocation and agitation in order to reduce the occurrence of dangerous situations. Education is warranted and must be enhanced, including knowledge about drug abuse and training in communication and empathy Nursing should include an understanding of what the disease of drug abuse means and the development of the ability to see the person behind the abuse and to provide non-judgemental support.

Ward nurses' experiences and perceptions of the critical care outreach service: A qualitative study undertaken in a large teaching hospital in the West of Ireland.

BACKGROUND: The critical care outreach service (CCOS) was established in a large teaching hospital in the West of Ireland in 2014 to provide an extension of CCOS between the intensive care unit (ICU) and the wards outside ICU. With the ever-increasing pressure on ICU resources, CCOS seems to offer an additional service to patients who are critically ill and deteriorating in hospital wards. AIM: The aim of this study is to explore ward nurses' experiences and perceptions of the CCOS. STUDY DESIGN: A qualitative descriptive methodology aimed to obtain a descriptive account of ward nurses' experiences of the CCOS. Data were collected using semi-structured interviews. Twelve nurses from the West of Ireland participated in the study. Braun and Clarke's six-step thematic analysis was used to analyse the data. RESULTS: Three core themes identified in this study included clinical support and decision-making; sharing knowledge and skills, and communication. All 12 nurses identified the positive impacts that they felt the current outreach service provided to them on a daily basis. CONCLUSIONS: Study findings indicate that nurses value the role of the CCOS in supporting the care of the critically ill and deteriorating patients at ward level. The CCOS has become invaluable to the ward nurses in their daily practice especially at a time when resources are lacking and patient acuity is on the rise.

The relationship between obesity and nursing care problems in intensive care patients in Austria.

OBJECTIVES: To describe the characteristics and nursing care problems of intensive care patients in Austria stratified by obesity. BACKGROUND: Obese people in intensive care units (ICUs) present nurses with special challenges. Therefore, nurses need to receive education and training regarding how to treat obese patients to provide them with the best care. Most studies on obesity in ICU patients have not specifically addressed the problems and challenges from the nurses' perspective. This may be because nursing science programmes in Europe rarely introduce the topic of obesity. DESIGN: This was a secondary data analysis of a longitudinal study. METHODOLOGY: The "Nursing Quality Measurement 2.0" is the Austrian version of the "International Prevalence Measurement of Care problems". It is an annual cross-sectional study, which has been carried out since 2009. Data from all ICU patients for 2009 to 2018 were extracted and combined into one file (n = 460). The main outcome measures were obesity and various nursing care problems, including care dependency. RESULTS: Of the ICU patients. 25% were obese. Obese ICU patients suffered significantly more often from diabetes mellitus and endocrine, nutritional, or metabolic diseases than non-obese patients. About 30% of the ICU patients were totally care dependent, and 85.6% of the ICU patients were at risk of developing pressure ulcers, whereas the risk was higher for non-obese than obese patients. ICU patients with a risk of pressure ulcer (measured with the Braden Scale) had a reduced risk of being obese (OR = 0.544). CONCLUSION: Overall, the prevalence of nursing care problems found in this study was high. No significant differences in the prevalence of nursing care problems between obese and non-obese patients were found. However, because of the increase in the number of obese patients in all nursing settings, a stronger focus on obesity research in the area of nursing science is recommended.

Nursing staff confidence and knowledge when caring for people with self-harm injuries: a service improvement study.

The knowledge and confidence of nursing staff can impact re-harming rates of patients with self-harm injury. This service improvement study sought to address the knowledge, confidence and practice issues for staff nurses and healthcare assistants (HCAs) caring for patients who had presented to the emergency department (ED) with self-harm injury. The knowledge and confidence of nursing staff was reported using Likert-style questionnaires in a longitudinal study, framed within one Plan, Do, Study, Act (PDSA) cycle. Attitudes and challenges to patient care were also sought to inform future practice. The findings, based on the responses of 10 nurses and 5 HCAs, showed an increase in knowledge and confidence among both staff groups following the education session. Of the 15 who participated, 5 provided feedback to a reflective questionnaire to assess their views 30 days after the intervention. Quantitative data revealed a perception in an increase in the standard of care. The study found that both knowledge and confidence in supporting individuals presenting with self-harm in the ED improved at 30 days post-educational intervention. The numbers in the study were small and challenge transferability, however, service improvement theory is concerned with identifying measures of success rather than statistical reliability.