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BACKGROUND: Clinical nurses frequently endure substantial work-related stress, adversely affecting their well-being and potentially compromising patient care quality and safety. The integration of a 5G-based medical private network into smart nursing systems and mobile devices offers a promising solution to reduce this stress. This study evaluates the impact of a Smart Nursing Information System based on a 5G Medical Private Network and its Supporting Mobile Hardware (SNIS-SMH) on mitigating work-related stress among clinical nurses. The goal is to provide a scientific basis for nursing management, reduce error incidents, advance nursing procedures, and enhance productivity. RESULTS: A total of 226 nurses completed the study. The SNIS-SMH group showed significantly lower total work stress scores (66.16 ± 9.82) compared to the control group (70.65 ± 11.32, P = 0.002). In specific dimensions, the SNIS-SMH group had lower scores for nursing profession and work (14.17 ± 2.37 vs. 15.00 ± 3.06, P = 0.023), workload and time distribution (10.56 ± 2.45 vs. 12.42 ± 2.55, P < 0.001), and patient care (22.55 ± 3.34 vs. 23.70 ± 4.06, P = 0.021). No significant differences were found in the work environment and resource, and management and interpersonal relationships dimensions. CONCLUSIONS: The SNIS-SMH system significantly alleviated work-related stress among clinical nurses, particularly in nursing duties, workload and time distribution, and patient care.
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Hospitales , Enfermeras y Enfermeros , Estrés Laboral , Humanos , Adulto , Femenino , China , Masculino , Enfermeras y Enfermeros/psicología , Carga de Trabajo , Personal de Enfermería en Hospital/psicología , Informática Aplicada a la EnfermeríaRESUMEN
OBJECTIVES: The objective of this study was to evaluate the impact of a comprehensive intervention using nursing-sensitive quality indicators on pregnant women with hepatitis B and their newborns. DESIGN: A randomized controlled monocentric trial was conducted from January 2020 to May 2022. Participants/Materials: 80 pregnant women diagnosed with hepatitis B were randomly assigned to either a control group (n = 40) or an experimental group (n = 40). The experimental group received care-sensitive quality indicators during treatment. SETTING: This study was conducted in the Department of Traditional Chinese Medicine, Nantong Third People's Hospital, affiliated with Nantong Hospital 3 of Nantong University, Jiangsu, China. METHODS: Participants in the experimental group received daily tenofovir from late pregnancy to early postpartum, and newborns received hepatitis B vaccine and immunoglobulin within 24 h of birth. Healthcare personnel underwent 6 months of training on care-sensitive quality indicators. The effectiveness of the intervention was assessed using various indicators such as health education coverage, antiviral medication compliance, follow-up rates, and psychological health. RESULTS: The results showed that after comprehensive intervention, the coverage rate of health education increased from 82.50% before intervention to 92.50% (p = 0.033), and adherence to antiviral medication improved from 82.50% to 97.50% (p = 0.000). The follow-up rate for hepatitis B mothers also significantly increased from 80.00% to 95.00% (p = 0.001). In addition, the incidence of negative emotions such as anxiety and depression among pregnant women significantly decreased from 57.50% to 30.00% (p = 0.000). These findings demonstrate the effectiveness of comprehensive interventions in improving health education coverage and participation, enhancing adherence to antiviral medication, and effectively reducing the psychological burden of pregnant women. Moreover, after the intervention, the awareness of mother-to-child transmission prevention for hepatitis B significantly increased from 82.36 points before intervention to 94.32 points after intervention (p = 0.000). At the same time, adherence to neonatal immunization increased from 80.00% to 95.00%, and satisfaction with nursing services improved from 90.66 points to 98.64 points (p = 0.000). These results indicate that comprehensive interventions significantly enhance knowledge related to mother-to-child transmission prevention, increase immunization adherence, and improve satisfaction with nursing services. LIMITATIONS: The study's limitations include a small sample size and a single-center location, which may affect the generalizability of the results. Future research should involve more extensive, multicenter studies to validate the findings. CONCLUSIONS: Comprehensive interventions that incorporate nursing-sensitive quality indicators significantly enhance the effectiveness of prevention strategies for hepatitis B transmission from mother to child. These findings underscore the importance of comprehensive care strategies in improving health outcomes for pregnant women with hepatitis B and their newborns.
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AIMS: The study aims to conduct a thematic synthesis approach of existing qualitative research to synthesise the real experiences of nurses dealing with compassion fatigue. This integration seeks to provide a comprehensive overview, identify common themes, and offer theoretical support for developing effective intervention strategies to mitigate compassion fatigue in healthcare settings. DESIGN: A thematic synthesis approach was utilised, synthesising qualitative studies on nurses' experiences of compassion fatigue. DATA SOURCES: Data were collected from major academic databases, including PubMed, CINAHL, Scopus, and Web of Science. A total of 15 studies met the inclusion criteria. REVIEW METHODS: This study systematically reviewed 11 qualitative research articles from China, the United States, Japan, Spain, Iran and Finland, involving 1076 nurses, to analyse and integrate the phenomenon of compassion fatigue among nurses and extract common themes. RESULTS: The analysis revealed that the leading causes of compassion fatigue include insufficient time and resources, psychosocial stressors, compassion overload and organisational and environmental factors. The manifestations of compassion fatigue primarily consist of work-related difficulties and impacts on family life, emotional and physical exhaustion and a mix of positive and negative emotions. Coping strategies focus on self-care and emotional regulation, symptom recognition and response strategies and organisational interventions and training. CONCLUSION: This study's findings provide theoretical support for healthcare institutions to develop effective intervention strategies to alleviate compassion fatigue among nurses and improve the quality of care. IMPACT: The study contributes to the body of knowledge by systematically synthesising qualitative evidence on compassion fatigue among nurses. The results have practical implications for nursing management and policy, emphasising the need for supportive measures to protect nurses from compassion fatigue and ensure sustainable care practices. PATIENT OR PUBLIC CONTRIBUTION: This research does not directly involve patients or public participants but focuses on synthesising the experiences of nurses as reported in existing studies, thereby indirectly contributing to improving patient care by addressing the well-being of healthcare providers.
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Nurses are required to decide on priorities; however, how they prioritize the interventions toward patients with delirium is still unclear. Therefore, expanding the knowledge on (a) how nurses prioritize interventions to manage episodes of delirium and (b) the underlying prioritization patterns were the aims of this study. The Q-methodology was applied in 2021. A systematic review to identify the recommended interventions for patients with delirium was performed, and a nominal group technique was used to select those interventions that are applicable in daily practice (35 out of 96 identified). Then, using a specific scenario, 56 clinical nurses working in hospital medical (n = 31), geriatric (n = 15), and postacute (n = 10) units were asked to order the 35 interventions (from -4 the lowest to +4 the highest priority) using a Q-sort table. Averages (confidence interval at 95%) were calculated at the group level, and a by-person factor analysis was applied to discover underlying patterns of prioritization at the overall and at the individual levels. At the group level, "Ensuring a safe environment (e.g., reducing bed height)" was ranked as the highest priority (2.29 out of four); at the individual level, three prioritization patterns accounting for a total variance of 50.21% have emerged: "Individual needs-oriented" (33.82% variance explained; 41 nurses); "Prevention-oriented" (8.47%; five nurses); and "Cognitive-oriented" (7.92%; six nurses). At the group level, nurses prioritize safety while caring for patients with delirium; however, at the individual level, they follow three different patterns of prioritization oriented toward diverse aspects, suggesting uncertainty in the actions to be taken-with potential implications for patients.
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Delirio , Humanos , Delirio/enfermería , Femenino , Masculino , Personal de Enfermería en Hospital/psicología , Adulto , Persona de Mediana EdadRESUMEN
BACKGROUND: Excessive workload in emergency departments (ED) negatively affects patient safety, often leading to missed critical tasks due to time constraints. The Workload Assessment of Nurses on Emergency (WANE) scale developed in Belgium offers a detailed measurement of nursing workload, but its complexity makes it hard to use in practice. Our study aims to find a simpler method for assessing nursing workload in EDs. METHODS: A multicentre cross-sectional study was performed in four Belgian EDs between September 2022 and March 2023. Nursing workload was assessed using the WANE scale in each hospital, during 4-hour time periods. The associations between WANE scores, and nurses' subjective workload assessment, number of patients, patient triage levels, post-triage destination area and the Jones Dependency Tool Score were examined employing multiple linear regression models. RESULTS: 161 nurses, caring for 591 patients, were included. 67% of the variation in 'direct' care time could be explained with a model based on triage level and two items of the Jones Dependency Tool (ABC perturbation and mobility). The number of new patients admitted and nurses' perceived workload were also highly associated with the total nursing care time TNCT. The actual number of patients in the ED at any time explained 78% of the variation in TNCT. Each additional patient increases the TNTC by 45.22 min. CONCLUSIONS: Simple indicators might be used to evaluate the nursing care time in Belgian EDs. A retrospective method is suggested, using the total number of patients over a defined period of time. This study reveals a path to a predictive method to calculate the direct care time for each patient with three simple indicators, available from nursing triage stage.
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BACKGROUND: Parastomal hernia or bulging is a long-recognised complication in relation to a stoma. Around half of patients develop a parastomal bulge and up to 75% experience symptoms. Only a minority is offered surgical treatment; thus, most patients manage the bulge on their own or by interventions provided by stoma care nurses. AIMS AND OBJECTIVES: To identify and present the available information on nursing interventions for the management of symptoms caused by the parastomal bulge. METHODS: This scoping review followed the framework by the Joanna Briggs Institute, conducting searches in 11 databases and through stoma organisations. Literature on nursing management of parastomal bulges was included. Two authors independently screened and selected the studies, with data-charting performed by one author and verified by another. The PAGER framework depicted the state of the evidence and the PRISMA-ScR checklist guided the process. RESULTS: Of 8361 screened publications, 44 were included. Management of the parastomal bulge and related symptoms were described in eight nursing interventions: appliances, support garments, irrigation and regulation of stool, strangulation, disguise and intimacy, physical activity, support and education, record keeping, follow-up and referral. Most evidence was based on expert opinion with only â of papers using study designs, such as cross-sectional, qualitative, review, before and after study, Delphi and RCT. CONCLUSION: This scoping review highlights the complexity of providing nursing interventions for parastomal bulging. It shows that one intervention can manage multiple symptoms and potentially several symptoms simultaneously, whereas several interventions may be needed to address a single symptom. Therefore, decisions on interventions must be based on the underlying cause of the problem. Due to the limited number of studies on the effects of nursing interventions, more rigorous research is needed in the future. RELEVANCE TO CLINICAL PRACTICE: The results can be used as an inspirational guide for clinical practice.
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AIM AND OBJECTIVES: To construct a set of scientific and feasible nursing management protocols for early fluid resuscitation in acute pancreatitis (AP) patients that can be used to guide clinical practice and enhance the treatment efficacy in these patients. BACKGROUND: Fluid resuscitation is a key means of early treatment for AP patients and has become a clinical consensus. Nurses are important practitioners of fluid resuscitation, and there is a lack of specific enforceable nursing management programs. METHODS: Through literature research, on-site research, semi-structured interviews, and other preliminary preparations of the first draft of the nursing management program for early fluid resuscitation in acute pancreatitis, the Delphi method was used to conduct two rounds of correspondence with medical and nursing experts, and then statistically analyzed. RESULTS: Fifteen and 14 questionnaires were distributed in two rounds, respectively, and 15 and 14 questionnaires were recovered, respectively. The positive coefficient of experts was 100%, the authority coefficient was 0.970 and 0.975, respectively; the coefficient of variation coefficient was 0.05-0.21 and 0.00-0.20, respectively; the expert coordination coefficients of all levels of indices in this study are 0.166-0.335 and 0.189-0.364, respectively. The P values of the first, second, and third level indices are < 0.05 according to the test of Kendall's harmony coefficient. A total of 5 primary indicators, 11 secondary indicators, and 36 tertiary indicators were used to construct the Nursing Management Program for Early Fluid Resuscitation in Acute Pancreatitis. CONCLUSIONS: The constructed nursing management plan for early fluid resuscitation in acute pancreatitis patients puts forward clear requirements and standards for nursing care in the early stage of AP treatment. This plan is scientific, represent good clinical practice, are feasible for nurses to follow, and construct a standardized protocol for the management of early fluid resuscitation in patients with acute pancreatitis.
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BACKGROUND: Healthcare systems globally are confronted with a shortage of nurses. Various strategies to address this have been applied, including active recruitment of internationally qualified nurses. Nurse managers may have a central role in supporting workplace integration. This study aimed to explore how domestically qualified nurses and internationally qualified nurses viewed the role of nursing management and its impact on workplace integration. METHOD: Semi-structured interviews with 21 domestically and 14 internationally qualified nurses were conducted. Nurses were selected using purposive sampling. Snowball sampling was applied to reach a sufficient sample size. Interviews were pseudonymized and transcribed. Transcripts were coded according to Qualitative Content Analysis with data structured into themes and subthemes. RESULTS: Five key themes related to impact of nursing management on workplace integration were identified: (a) Appropriate Placement, (b) Recruitment Process, (c) Leadership Support, (d) Workforce Shortage, and (e) Additional Burden/ Increased Workload. Active support by nursing leadership and the opportunity for shared-decision making was seen as a key factor. Increased workload, additional time and resources requirements associated with orientation of internationally qualified nurses and pressures from staff shortages were highlighted as hindrances. Inappropriate placement of internationally qualified nurses was perceived as key hindrance that could be addressed by nursing management. An imbalanced ratio between domestically and internationally qualified nurses was perceived as challenging by domestically qualified nurses. CONCLUSION: Integration of internationally qualified nurses to clinical practice brings several challenges that may be positively impacted by nursing management through appropriate placement of internationally qualified nurses, supportive nurse managers and adequate preparation of domestically qualified nurse mentors/preceptor. IMPLICATIONS FOR PRACTICE: Nurse managers should ensure that internationally qualified nurses' work experience matches local clinical unit vacancies before hiring them. Peer support is a supportive factor for internationally qualified nurses. Nurse managers should find a balanced ratio between internationally and domestically qualified nurses in the roster. Introducing mentors or preceptors at ward level may be a strategy decrease work-related stress in both nursing groups. REGISTRATION NUMBER: The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register (DRKS00017465).
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OBJECTIVE: This study investigates the influence of structural empowerment and psychological capital on nurse work engagement within the context of rising healthcare demands and nursing staff shortages. METHODS: A cross-sectional descriptive study involving 778 registered nurses from six tertiary hospitals in Hangzhou, China, was conducted. Data were collected using multiple tools, including a demographic questionnaire, the CWEQ-II (Conditions for Work Effectiveness Questionnaire II), the PCQ (Psychological Capital Questionnaire), and the UWES-9 (Utrecht Work Engagement Scale-9). SPSS 27.0 was used for Pearson correlation and regression analyses, while structural equation modeling (SEM) in AMOS was employed to explore relationships among variables. Model fit was evaluated using chi-square, CFI, AGFI, and RMSEA indices. RESULTS: Structural empowerment and psychological capital were significantly and positively correlated with nurses' work engagement. Regression analysis indicated that structural empowerment (support, resources, opportunity, and information) and psychological capital (optimism, resilience, self-efficacy, and hope) were significant positive predictors of work engagement (p < 0.01), jointly accounting for 69% of its variance. SEM analysis further revealed that structural empowerment indirectly influenced work engagement through psychological capital, with significant path coefficients (P < 0.001) and a good model fit (χ²/df = 3.727, P = 0.000, RMSEA = 0.059). CONCLUSION: Structural empowerment and psychological capital are crucial factors in enhancing nurse work engagement, effectively supporting nurses' workplace performance. Management should focus on fostering psychological capital and enhancing structural empowerment to improve care quality and job satisfaction. This study provides empirical evidence for nursing management practice and suggests that future research should explore dynamic relationships among these variables in various populations and settings.
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BACKGROUND: The ability to thrive at work has been demonstrated to be closely linked to the development of nurses.Effective utilization of strengths and maintaining hope are essential elements for clinical nurses' ability to flourish in their roles. Nevertheless, the relationship between strengths use, hope, and thriving at work remains underexplored. This study aimed to identify distinct subgroups of clinical nurses based on their strengths use and to examine the mediating effect of hope between strengths use and thriving at work. The findings are intended to inform clinical managers on strategies to enhance nurses' work performance and care quality. METHODS: A convenience sample of 568 clinical nurses from two tertiary hospitals in Guangzhou City, Guangdong Province, China, was recruited between January and March 2024. The survey collected sociodemographic data and included the Adult Dispositional Hope Scale, Strengths Use Scale, and Thriving at Work Scale. Potential categories of nurse strengths use characteristics were identified using potential profile analysis, and potential relationships between variables were determined using Pearson correlation analysis, Bayesian factor robustness analyses, and Mediation analysis. RESULTS: LPA identified three distinct groups based on strengths use: low (30.8%), moderate (64.9%), and high (13.2%).The significant mediating effect of hope in the relationship between strengths use based on latent profile analysis and thriving at work was observed (SE = 0.61,95%CI = -10.01, -7.62; SE = 0.76,95%CI = -18.91, -15.91, respectively). CONCLUSIONS: There exists heterogeneity in nurses' strengths use. Hope plays a significant role in mediating the relationship between strengths use and thriving at work. It is recommended that nursing administrators or leaders pay attention to differences in individual levels of strengths use, encourage strengths-based practices and design interventions that foster hope, thereby promoting greater thriving in their professional roles.
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BACKGROUND: Enhancing the research abilities of clinical nurses is a pivotal aspect of nursing management. The purpose of this survey is to assess the current state of research abilities among pediatric nurses and to identify the associated influencing factors, thereby providing empirical support for the improvement of research competencies in pediatric nurses. METHODS: Pediatric clinical nurses at a tertiary children's hospital in Nanjing, China from May 1st to 31st, 2024 were included for survey. Self-assessment scale for nursing staff's scientific research ability was utilized to assess the comprehensive research ability. Pearson correlation analysis and multiple linear regression analysis were conducted to evaluate the influencing factors. RESULTS: A total of 436 pediatric nurses were included. The total score for the nurses' research ability was (47.03 ± 13.66), the research abilities of pediatric clinical nurses were at a low level. Pearson correlation analysis showed that educational level(r = 0.563), professional title(r = 0.528) and the frequency of receiving scientific research training(r = 0.481) and the frequency of reading nursing-related scientific journals(r = 0.459) were all correlated with the scientific research ability score of pediatric nurses (all P < 0.05). Multiple linear regression analysis indicated that educational level, professional title and the frequency of receiving scientific research training were the independent factors influencing the scientific research ability of pediatric nurses (all P < 0.05). CONCLUSIONS: The research abilities of pediatric nurses are currently at a lower level and influenced by a multitude of factors. Clinical nurse managers should implement targeted research ability training for pediatric nurses with different educational qualifications and professional titles.
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BACKGROUND: Compassion fatigue is a common issue nursing students face during clinical internships. Prolonged exposure to patients' suffering and trauma can lead to emotional exhaustion and psychological stress. Compared to formal healthcare workers, nursing students have less professional experience and weaker emotional regulation abilities, making them more vulnerable to secondary trauma and other negative emotions, which exacerbates compassion fatigue. Early identification and intervention in compassion fatigue are crucial for improving the mental health of nursing students and the quality of care they provide. OBJECTIVE: This study aims to develop a predictive model for compassion fatigue in nursing students using various statistical and machine learning methods, identify key influencing factors, and provide scientific evidence for nursing educators and administrators. METHODS: A cross-sectional survey collected valid questionnaire data from 512 nursing students. LASSO regression was used to select critical variables, and models such as logistic regression, random forest, and XGBoost were applied for prediction. Model performance was evaluated, and SHAP values were used to interpret the importance of model features. RESULTS: The logistic regression model performed best on the test set with an AUC value 0.77. Key predictive factors included psychological resilience, peer support, secondary trauma, and empathy satisfaction. CONCLUSION: This study successfully developed a predictive model for compassion fatigue in nursing students, with the logistic regression model showing high accuracy. The critical factors identified provide theoretical support for early interventions, aiding in more targeted nursing management and enhancing the mental well-being of nursing students. TRIAL REGISTRATION: Not applicable. This study is an observational study aimed at investigating compassion fatigue among students, without involving any interventions or treatment methods. Therefore, this study does not meet the definition of a clinical trial and does not require registration of a clinical trial number.
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BACKGROUND: The Transition Shock Scale for Undergraduate Nursing Students assesses transition to undergraduate nursing students. The TSS is a tool used in various countries and has been translated into Chinese; however, associate degree nurses dominate China's nursing workforce, it needs to be validated in associate degree nursing interns. This study aimed to analyze the TSS (Chinese version) validity and reliability in Chinese associate degree nursing interns. METHOD: This methodological validity study investigated internal consistency and reliability. The critical ratio (CR) method and correlation analysis are used for item screening of the scale. Eight experts in nursing management and nursing education were invited to assess the scale's content validity. Construct validity was assessed using Pearson's correlation between domains, exploratory factor analysis, and Confirmatory Factor Analysis. This methodological validity study investigated internal consistency and reliability using Cronbach's alpha and intraclass correlation coefficients (ICC). The level of significance was set at 5%. RESULTS: This study included 800 associate degree nursing interns from 8 Hunan Province, China hospitals. Validity analysis showed positive and significant correlations between all TSS (Chinese version) domains, ranging from 0.344 to 0.772. The internal consistency and reliability of the total TSS (Chinese version) score were high (Cronbach's alpha = 0.925; intraclass correlation coefficient = 0.908). The content validity assessment showed that the I-CVI ranged from 0.875 to 1.000, and the S-CVI was 0.951. Exploratory factor analysis was performed by orthogonal rotation of the data using principal component analysis and maximum variance, and three common factors with eigenroots greater than 1.0 were extracted, with a cumulative variance contribution of 61.095%. Furthermore, confirmatory factor analysis demonstrated the following values of goodness of fit: RMSEA = 0.062, CFI = 0.953, TLI = 0.939, SRMR = 0.0389, χ2/df = 4.064. Thus, the TSS (Chinese version) discriminant and concurrent validities were confirmed. CONCLUSION: TSS (Chinese version) contains 6 dimensions and 18 items, which has good reliability and validity among associate degree nursing interns, and can be used as an evaluation tool for transition shock in associate degree nursing interns.
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BACKGROUND: Innovative Behavior (IB) is a key prerequisite for nurses in solving clinical problems. However, existing research on IB among clinical nurses is relatively limited. OBJECTIVE: To identify profiles and characteristics of IB among clinical nurses and explore the associated predictors, as well as the relationships with research outputs. METHODS: A multicenter cross-sectional study was conducted on 354 clinical nurses in Shanghai from April 2023 to May 2023 (response rate 98.06%). IB was measured by the Innovative Behavior Scale for Nurses (IBSN), future time perspective was measured by the Future Time Perspective Scale (FTPS), and work engagement was measured by the Utrecht Work Engagement Scale-9 (UWES-9). Socio-demographic and professional data and research output indicators were measured by a self-designed questionnaire. We used latent profile analysis (LPA) by Mplus 7.0 to identify latent classes of IB. Ordinal logistic regression analysis was used to analyze the relevant predictors on the different profiles. And then Pearson's chi-squared was used to analyze the association between IB level and research output. RESULTS: Among the respondents, individuals aged 25 to 35 accounted for 55.9%, and females comprised 94.6%. IB of clinical nurses can be identified into 3 groups: low-level (n = 108, 30.51%), moderate-level (n = 149, 42.09%), and high-level (n = 97, 27.40%) groups. Based on the results of LPA, marital status, education level, work experience, monthly income, night shifts, future time perspective scores, and work engagement scores can be the predictors of IB among different profiles. Statistically significant associations were found between IB level and research productivity, including publishing academic papers (χ2 = 15.307, p < 0.001), registering patents (χ2 = 17.163, p < 0.001), and winning Sci. & Tech awards (χ2 = 27.814, p < 0.001). CONCLUSION: According to our research, clinical nurses have three unique IB profiles. The current level is predominantly at a moderate level, with less than 30% demonstrating a high level of innovation. It revealed that better socio-demographic status and professional characteristics, future time perspective, and work engagement positively influenced innovative behavior among clinical nurses. The findings also highlight the potentially important role of IB in contributing to nurses' research output. PRACTICAL IMPLICATIONS: As far as we know, it might be the first study to employ LPA to clarify the heterogeneity in the levels of IB and their specific distribution among nurses. Our findings may provide a new viewpoint for promoting IB among clinical nurses. Nursing administrators should pay attention to IB of clinical nurses and develop targeted interventions to enhance their IB levels.
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This study aimed to explore the influence of the hospital ethical atmosphere and job-esteem on the moral courage of psychiatric nurses, providing a reference for nursing managers and psychiatric nurses to enhance moral courage. A total of 375 psychiatric nurses from public hospitals in Jilin Province and Jiangsu Province were selected using a convenience sampling method. The study utilized a general data questionnaire, the Nurses Moral Courage Scale, the Hospital Ethical Climate Survey, and the Job-Esteem Scale for Nurses in Hospitals to gather data. The average moral courage score of psychiatric nurses was 58.24 ± 15.82. Hierarchical regression analysis indicated that professional title, years of experience in psychiatry, hospital ethical atmosphere, and job esteem significantly influenced the moral courage of psychiatric nurses, accounting for 34.4% of the total variance. The level of moral courage among psychiatric nurses was moderate. Nursing managers can enhance the moral courage of nurses by improving the ethical atmosphere within hospitals and supporting nurses in boosting their job esteem.
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Coraje , Enfermería Psiquiátrica , Humanos , Femenino , Adulto , Encuestas y Cuestionarios , Enfermería Psiquiátrica/métodos , Enfermería Psiquiátrica/ética , Enfermería Psiquiátrica/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Actitud del Personal de Salud , Satisfacción en el Trabajo , China , Ética en Enfermería , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Estudios Transversales , Principios Morales , AutoimagenRESUMEN
Meconium ileus (MI) is the result of the accumulation of thick, dry, inspissated meconium that creates a bowel blockage, most commonly in the terminal ileum. These pockets of meconium prevent passage of stool beyond the point of obstruction, which leads to distention of the proximal bowel, bowel wall thickening, and distal microcolon. Occurring most commonly (90%) in conjunction with cystic fibrosis (CF), the occurrence of MI without CF is rare. The literature describes the incidence of MI associated with CF occurring in as many as 24.9% of those who have a pair (homozygous) of the most common CF gene mutation, Delta F508. The incidence of MI decreases with other CF mutations, of which there are over 2,000. The morbidity and mortality risks are related to whether the MI is simple or complex. Simple MI can be managed clinically with contrast enemas to relieve the obstruction and restore bowel function, while complex MI requires surgical intervention for possible bowel necrosis, perforation, peritonitis, strictures, and/or volvulus that can occur in utero or after birth. This article presents a case report of a 32-week-gestation female infant with gross abdominal distention beginning on day of life 1. The differential diagnosis, necessary testing, and required treatment that led to the final diagnosis will be presented. Additionally, radiographic modalities used to confirm the diagnosis are discussed. Finally, nursing management of the infant with simple or complex MI and short- and long-term challenges for infants and their families will be addressed.
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Fibrosis Quística , Íleo Meconial , Humanos , Íleo Meconial/diagnóstico , Íleo Meconial/terapia , Recién Nacido , Femenino , Fibrosis Quística/complicaciones , Fibrosis Quística/diagnóstico , Fibrosis Quística/fisiopatología , Diagnóstico Diferencial , MeconioRESUMEN
AIM: To investigate the challenges and needs of new nurse managers transitioning from staff nurses to manager roles. BACKGROUND: Nursing managers are often selected based on clinical expertise, not proven leadership skills. Their complex roles and evolving healthcare policies result in heightened expectations from society, institutions, patients, and staff. The often-overlooked transition phase from staff nurse to manager presents distinct challenges and needs. Clarifying these aspects is crucial for developing effective nursing policies and improvement initiatives. METHODS: A phenomenological qualitative study was conducted at a tertiary hospital in Beijing, following the COREQ guidelines from April to June 2023. Fourteen new nurse managers were interviewed using a semi-structured interview guide based on the role theory. Data were analyzed using Nvivo 12.0 and Colaizzi's thematic analysis. RESULTS: Four themes emerged, including role ambiguity (adjustment difficulties, unclear expectations, poor handling), role conflict (inconsistencies between work and family, management, competencies), role learning (self-improvement, external support, resilience), and role behaviors (summarizing experiences, time management, promoting coworkers, research capability). DISCUSSION: Identifying the difficulties and needs of new nurse managers during their role transition can help healthcare organizations develop tailored training, external support, positive psychology, and academic advancement strategies. CONCLUSIONS: New nurse managers face significant transition obstacles, necessitating comprehensive support. This prompts healthcare organizations to adopt best practices for facilitating role adaptation and talent development. IMPLICATIONS FOR NURSING AND HEALTH POLICY: To ensure the successful adaptation of new nurse managers, comprehensive and tailored strategies should be developed based on identified transition challenges and needs. This support will enhance their competencies and stress management. Nursing policymakers should encourage new nurse managers to participate in the formulation of policies and training programs.
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Enfermeras Administradoras , Rol de la Enfermera , Investigación Cualitativa , Humanos , Enfermeras Administradoras/psicología , Rol de la Enfermera/psicología , Femenino , Adulto , Masculino , Liderazgo , Personal de Enfermería en Hospital/psicología , BeijingRESUMEN
AIM: This study explored the relationship between workplace bullying, authentic leadership, workplace friendship and nurses' health conditions and identified the predictors of nurses' health. It also explored whether authentic leadership moderated the impact of workplace bullying on their health. METHODS: This study used a cross-sectional and correlational design following the STROBE guidelines. The main research tools were structured questionnaires, including sociodemographic variables, Authentic Leadership Questionnaire, Workplace Friendship Questionnaire and CHQ-12. This study recruited 244 nursing staff members from a regional teaching hospital. RESULTS: The multiple linear regression analysis showed that excessive workload, high workplace bullying, low authentic leadership and low workplace friendship were predictors of nurses' health. CONCLUSION: Authentic leadership significantly moderated the impact of workplace bullying on nurses' health based on hierarchical regression analysis. IMPLICATIONS FOR NURSING MANAGEMENT AND SOCIAL POLICY: Hospital administrators should review the perpetrators' responsibilities and assist the victims to obtain psychological counselling, regularly hold leadership training to enhance the leadership skills of nursing managers and organise social activities for nurses to foster workplace friendships.
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Acoso Escolar , Liderazgo , Personal de Enfermería en Hospital , Lugar de Trabajo , Humanos , Estudios Transversales , Acoso Escolar/estadística & datos numéricos , Acoso Escolar/psicología , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/estadística & datos numéricos , Femenino , Adulto , Masculino , Encuestas y Cuestionarios , Lugar de Trabajo/psicología , Persona de Mediana Edad , Relaciones InterprofesionalesRESUMEN
ABSTRACT: Osteomyelitis is characterized by inflammation of the bone tissue, typically caused by microorganisms such as bacteria. It can be challenging to treat and may lead to unnecessary antibiotic therapies. Prompt identification of osteomyelitis and implementation of effective treatments are necessary to eradicate this infection. This article discusses the pathophysiology, clinical presentation, diagnosis, and nursing management of osteomyelitis, focusing on native bone infection.
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Antibacterianos , Osteomielitis , Osteomielitis/enfermería , Osteomielitis/diagnóstico , Osteomielitis/tratamiento farmacológico , Humanos , Antibacterianos/uso terapéutico , Diagnóstico de EnfermeríaRESUMEN
BACKGROUND: Catheter-related bloodstream infection (CR-BSI) stands as one of the leading causes of hospital-acquired infections, often resulting in high healthcare expenditure and mortality rates. Despite efforts, reducing the incidence of CR-BSI remains a significant challenge. OBJECTIVE: This study aimed to assess the impact of a multidisciplinary organizational intervention on reducing intravenous CR-BSI. METHODS: A quality improvement team was established to implement various interventions, utilizing the FOCUS-PDCA continuous quality improvement model and fishbone diagram for analysis and improvement. RESULTS: After the interventions, operational indicators for catheter insertion, maintenance, and removal improved from 82.50% ± 1.15%, 83.60% ± 1.60%, and 81.60% ± 1.80-95.30% ± 1.00%, 96.20% ± 1.62%, and 97.25% ± 0.50%, respectively. Additionally, catheter dwell time decreased from 7.50 ± 0.85 days to 3.50 ± 0.75 days, and the quarterly infection rate was reduced from 2.328% ± 1.85-0.305% ± 0.95% following the implementation of the intervention. DISCUSSION: Despite the available evidence, there remains a noticeable gap between the ideal evidence-based practices and their practical implementation. We aim to eradicate CR-BSIs within the surgical intensive care units (ICUs) of hospitals. To achieve this goal, we have introduced a comprehensive quality improvement framework designed not only to benefit our own ICU but also to serve as a model for implementation in other similar healthcare settings.