A cross-sectional multisite exploration of Italian paediatric nurses' reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT-Ped.

AIM: To explore Italian paediatric nurses' reported burnout and its relationship to their perceptions of safety and adverse events. DESIGN: A cross-sectional study using the RN4CAST@IT-Ped database with a web-based survey design. METHODS: The RN4CAST@IT-Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events. RESULTS: Nurses (N = 2,243) reported high levels of burnout. Most rated clinical safety as high. The risk of adverse events ranged from 1.3-12.4%. The degree of burnout appeared to influence the perception of safety and adverse events. CONCLUSION: The association between nurses' burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses' well-being, thus leading to burnout. Regardless, the association between nurses' burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses. IMPACT: The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses' well-being as this also influences quality and safety.

Intensive Care Nurses' Experience of Caring in Greece; A Qualitative Study.

BACKGROUND: Whilst nurses and critical care services have been at the forefront of the COVID-19 pandemic, it has become more apparent that intensive care nurses are presented with challenging ethical and clinical decisions and are required to care for individuals with critical illnesses under high-pressure conditions. This is not a new phenomenon. The aim of this study, which was conducted before the outbreak of COVID-19, was to explore the experience of caring through the narratives of intensive care nurses in Greece. METHODS: A qualitative study was conducted through in-depth, semi-structured interviews with nineteen ICU nurses in Athens. Transcripts were subjected to Braun and Clarke's thematic analysis and organised with Atlas.ti v8 QDA software. RESULTS: The intensive care nurses' experience of caring in Greece encompassed four themes: (A) being "proximal", "co-present" and caring with empathy, (B) being "responsible" for your patient and negotiating with the doctors, (C) technology and "fighting with all you've got", and (D) "not being kept informed" and disappointment. CONCLUSIONS: The narratives of this study highlight that ICU nurses in Greece provide patient-centred and compassionate care. Nurse leaders should develop appropriate healthcare policies so as to ensure the adequate provision of staff, specialist education, and support to nurses working in critical care. Failure to address these issues may lead to poor quality of care and negative patient outcomes.

Digital Competencies for Nurses: Tools for Responding to Spiritual Care Needs.

Users show a growing interest in expanding the implementation of digital tools as a support of technical and management issues in healthcare. This medical care has focused on telemedicine but does not include the recognition of needs as an important part of patient-centred healthcare. Nurses interact with patients at critical times in their life journeys, including birth and death, which are historical events linked with religious beliefs. Furthermore, large migration flows have led to multicultural societies in which religion and spirituality are experienced in distinct ways by different people. Finally, most healthcare professionals lack the proper skills to handle the spiritual needs of their patients, especially for core and digital competences. This article shows the results of qualitative research applying as a research tool an open-ended questionnaire, which allows detecting the educational needs for nurses' interventions aimed at providing spiritual support to their patients using digital tools. The results obtained reveal that nurses need education and training on fundamental spiritual concepts and digital competencies to meet the multiple demands of their patients' spiritual needs. Finally, we present an open digital educational proposal for the development of competencies for nurses and other health professionals to provide spiritual care with the support of digital tools.

Embracing healthcare technology - What is the way forward for nurse education?

Digital technology is regarded as increasingly important in the provision of safe, consistent and optimal health care in the future. However considerable challenges exist in relation to how it can best be used and integrated to support, transform and facilitate user engagement and provide individualised care. Many forms of digital health technology exist already that have improved diagnosis and treatment in terms of early diagnosis and treatment. That said, healthcare, and nursing in particular, remains largely at the periphery of the digital technology transformation and as a result is failing to capitalise on its potential for improving health care and services. Awareness of the level of change in terms of professional and cultural ideology is needed when introducing technology in health care. Participation in the introduction, adaptation and acceptance process by all staff using soft and hard data to create a vision, set clear goals and develop a mutually agreed implementation strategy is essential for success. A positive approach by management towards the use and benefits of digital technology for improving and transforming healthcare in conjunction with education support has been effective in some UK and US projects. Education needs to commence at undergraduate level and continue across the nursing career trajectory. This will help nurses to re-conceptualise how both patients and health care professionals can benefit and that technology can serve to enhance and support patient centred communication rather than limit it.

The usefulness of learning contracts in nurse education: the Irish perspective.

This paper explores current literature on the topic of learning contracts. Learning contracts emerge as a useful teaching and learning aid that foster independent learning among students. Students report freedom in learning and an increased sense of resp onsibility. Limitations of contract learning include the possibility of increased student stress and difficulty using the contract with students who have a traditional expectation of the educational system. From the teachers perspective, the contracts al low students to take more responsibility for learning, however they are a time consuming exercise that could prove unmanageable with large class sizes, particularly if the student/teacher ratio is not sufficient. Using the available literature on the top ic the author describes the introduction of contract learning to clinical placements for general diploma nursing students in the first year of their training. The response from the students is positive and from the teacher's perspective, they are creativ e learning devise that enhance student learning.