A Mindfulness-Based Intervention for Acute Care Nursing Staff: A Pilot Study.

Purpose:The purpose of this study was to determine if a mindfulness-based smartphone application, used for 5 minutes a day for 30 days, could address burnout among acute care nursing staff. Methods: A pretest-posttest design with a midpoint evaluation was utilized. The sample included 31 nursing staff from cardiovascular acute care units. The Copenhagen Burnout Inventory, Cognitive and Affective Mindfulness Scale-Revised, Perceived Stress Scale, and Brief Resilience Scale were used to measure the impact of the intervention on participants. Findings: In a repeated measures analysis, there were no statistically significant changes in scores on the Brief Resilience Scale across the three timeframes (F = 0.64, df = 1.42, p = .49). There were significant reductions over time for perceived stress (F = 10.56, df = 1.74, p = .002) and personal burnout (F = 11.8, df = 1.10, p = .007), and increased scores on mindfulness (F = 4.76, df = 1.57, p = .039). Conclusions: The utilization of a mindfulness-based smartphone application may promote the health and well-being of cardiovascular nurses in acute care units. Mindfulness-based smartphone apps should be considered as a method of self-care, along with other holistic approaches to improve well-being.

Piloting a Mindfulness App for Use by Nursing Staff at Work.

This article discusses the findings of a 5-week pilot using a mindfulness app among medical-surgical nursing staff in an acute care setting during a 12-hour shift. Informational sessions on compassion fatigue, mindfulness, and the process were implemented with leadership providing daily support. The postimplementation survey demonstrated increased calmness and reduced stress. Barriers identified involve perceived time constraints. Awareness is needed on compassion fatigue, interventions to combat, and modifications to promote the culture of self-care.

"I made you a small room in my heart": how therapeutic clowns meet the needs of older adults in nursing homes.

Therapeutic clowns are increasingly common in nursing homes, where residents often encounter factors that can undermine their quality of life and dignity. We aimed to understand the strategies of successful therapeutic clowning with a diverse older adult population, and the unique contributions of elder-clowning to the nursing home experience. Using an interpretivist descriptive methodology, twenty-three (n=23) experienced therapeutic clowns from eight countries were interviewed to understand the needs of nursing home residents met by elder-clowns, and strategies and techniques the clowns use to address them. Participants identified five major needs: to escape routine; for reassurance of worth; for meaningful, personalized social interaction unrestricted by communication barriers; to have culturally meaningful opportunities for reminiscence; and to have a space where residents could be unapologetically themselves. The artistic and emotional strategies used by the therapeutic clowns to address these needs illustrate how creativity, imagination and relational presence can provide nursing home residents with a sense of being known and belonging. Elder-clowns also positively affect the nursing home staff and enrich the interpersonal interactions in the residence. Through their focus on the social and emotional needs of residents, elder-clowns can play an important and distinct role in creating an optimal nursing home experience.

A global exploration of palliative community care literature: An integrative review.

AIM: This review sought to discover how community nurses globally provide palliative care, with specific focus on how they manage the personal and professional stressors associated with caring for dying clients in the home. DESIGN: An integrative review methodology was used to gain insight into how community palliative care is delivered worldwide. BACKGROUND: The provision of home palliative care by community nurses gives clients the ability to spend their final days in familiar surroundings. Research has focussed on the provision of palliative care in the inpatient setting, with little known about the community setting. METHODS: Data were collected through a literature search, then a critical analysis approach was used to evaluate the strengths of palliative care literature by analysing recurrent themes to stimulate further research on the topic. DATA SOURCES: The following databases were used to conduct the literature search: CINAHL, Medline, Pubmed, Scopus, Ovid. RESULTS: The results highlighted the importance of building a skilled palliative community nursing workforce and the need to offer specialised palliative care training to nurses, particularly around difficult conversations and service coordination. CONCLUSION: The literature identified the challenges implicit within the community nursing role in delivering palliative care, but it did not identify the factors that enhance the nurses' ability to manage the stressors associated with this role. The input of nurses must be sought to understand the development of resilience. IMPLICATIONS FOR THE PROFESSION: Community palliative care nursing requires time spent with clients and family members who are suffering, therefore predisposing nurses to stress. Effort must be made to provide palliative care nurses with support to enhance professional resilience.

Influence of Group Training Based on Psychological Capital Theory on Nursing Staff's Occupational Benefits and Job Satisfaction in an Infusion Preparation Center.

Context: While they play an increasingly important role in medication safety, nursing staff in an infusion preparation center also face high work intensity and high occupational-exposure risks. Psychological capital for nurses manifests as ab ability to overcome difficulties; nurses' perceptions of occupational benefits can enable them to think and function in a constructive and rational way in a clinical environment; and job satisfaction can influence the nursing quality. Objective: The study intended to investigate and analyze the influence of group training based on psychological capital theory on the nursing staff's psychological capital, occupational benefits, and job satisfaction in an infusion preparation center. Design: The research team performed a prospective, randomized controlled study. Setting: The study took place at the First Medical Center of the Chinese People's Liberation Army (PLA) General Hospital in Beijing, People's Republic of China. Participants: Participants were 54 nurses working in the infusion preparation center at the hospital between September 2021 and November 2021. Intervention: The research team randomly divided the participants into an intervention and a control group, each with 27 participants, using a random number list. Nurses in the intervention group received group training based on the psychological capital theory, while those in the control group received a routine psychological intervention. Outcome Measures: At baseline and postintervention, the study compared the scores for psychological capital, occupational benefits, and job satisfaction between the two groups. Results: At baseline, no statistically significant differences existed between the intervention and control groups on their scores related to psychological capital, occupational benefits, or job satisfaction. Postintervention, the intervention group's scores were significantly higher (1) for psychological capital-hope (P = .004), resilience (P = .000), optimism (P = .001), self-efficacy (P = .000) and total psychological capital score (P = .000); (2) for occupational benefits-career perception (P = .021), sense of belonging to a team (P = .040), and career benefit total score (P = .013); and (3) for job satisfaction-occupational recognition (P = .000), personal development (P = .001), relationships with colleagues (P = .004), the work itself (P = .003), workload (P = .036), management (P = .001), family and work balance (P = .001), and total score for job satisfaction (P = .000). Postintervention, no significant differences existed between the groups (P > .05): (1) for occupational benefits-identity of relatives and friends, self-growth, or nurse-patient relationships or (2) for job satisfaction-salary and benefits. Conclusions: Implementing group training based on psychological capital theory can improve the psychological capital, occupational benefits, and job satisfaction of nurses in the infusion preparation center.

Neonatal palliative care: Assessing the nurses educational needs for terminally ill patients.

BACKGROUND: For terminally sick neonates and their families, it's crucial to provide holistic nursing care that incorporates both curative and palliative care as much as feasible. It is well known that the biggest obstacle to delivering palliative care for neonatal children is a lack of training for nurses. Aim: The aim of this research is to investigate the experiences of nurses who provide care for neonates who are terminally ill as well as their educational requirements for neonatal palliative care. METHOD: A cross-sectional descriptive study was conducted among 200 nurses working in a tertiary center providing care for terminally ill neonates in Saudi Arabia. Data was collected from using Neonatal Palliative Care Questionnaire (QNPC) from January 2021 to March 2021. RESULTS: Two hundred nurses were surveyed (the response rate was 79%). The mean age of the 158 participants was 35.67 (standard deviation (SD): 7.43), and the majority were female (151; 95.6%). The majority were bachelor's holders (119; 75.3%), with more than 5 years of experience in providing care for neonates (100; 63.3%). Most of the participants reported not receiving any education about palliative care (115; 72.8%). Nurses reported a moderate level of experience in all areas of neonatal palliative care. The total mean score of palliative care experiences of neonates was 3.42 (SD: 1.35). However, the majority of nurses reported little experience discussing the transition period to palliative care for neonates 2.95 (SD: 1.93), the discussion of code status (DNR) during terminal illness of neonates 3.11 (SD: 1.54) and spiritual support 2.90 (SD: 1.55). CONCLUSION: The assessment of the fundamental skills of neonatal palliative care by nurses was insufficient. To enhance the quality of care, it is crucial to incorporate education on neonatal palliative care into programs for nursing staff development.

Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing.

BACKGROUND: Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. This approach could help palliative care staff to manage work-related stress and promote wellbeing. AIM: To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. DESIGN: A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy based intervention for staff, consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. SETTING/PARTICIPANTS: Participants were recruited from Marie Curie hospice and nursing services in Scotland. RESULTS: Twenty five staff commenced and 23 completed the intervention (93%). Fifteen participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen's d = 0.7) and mental wellbeing (Cohen's d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. CONCLUSION: Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.

Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia.

BACKGROUND: Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS: This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION: It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION: Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.

Existential and Spiritual Attitudes of Polish Medical and Nursing Staff towards Death.

Issues related to death are difficult areas of human existence and are most often considered in terms of ethical or non-ethical behaviour. The aim of the research was to examine the attitudes of Polish medical and nursing personnel towards death. The research was conducted among medical (110 people) and nursing staff (110 people) working in Polish hospitals and representing 16 regions. The Questionnaire About Attitudes to Death (DAP-R-PL) was used. The attitude of medical staff, taking into account the holistic approach to the patient in his existential-spiritual dimension, is an extremely important element of professional care. The study outlines the attitudes of medical and nursing staff towards death. Medical personnel under examination demonstrate a mature attitude towards death. In light of this research, health care workers show great commitment to helping dying people with existential and spiritual needs.

Advancing Diversity in Nursing Education: A Groundwater Approach.

There have been increased calls for a diverse nursing workforce to resolve health inequities. While the diversity of the nursing workforce slowly improves, it lags in comparison to the diversity of the United States population. The lack of diversity in academic nursing is the root cause of the lack of a diverse nursing workforce. A groundwater approach, as developed by the Racial Equity Institute, is used to analyze systemic barriers in nursing education that hinder achieving student diversity. Using this approach, recommendations are offered to educators and regulatory organizations to change policies and practices. Inclusive educational policies and teaching practices should be adopted to recruit and retain diverse students and faculty. Nursing education accrediting bodies must implement standards requiring programs to adopt holistic admission reviews and measurable diversity outcomes for students, faculty, and staff. The National Council of State Boards of Nursing must establish a common national licensure passing standard that is based either on graduation date or upon the first attempt and includes multiple attempts within a given time frame. A groundwater approach requires a mindset shift to focus on the environment and changes in practice and policy to overcome the current structural barriers in nursing education if there is ever to be a diverse nursing workforce.

Las terapias alternativas como solución al cuidado de problemas crónicos de salud / Alternative Therapies as a Solution for the Care of Chronic Health Problems

Introducción: Los problemas de salud crónicos son considerados enfermedades multidimensionales, por lo que demandan del personal de enfermería una atención integral y holística. Una opción para brindar un cuidado holístico y autónomo son las terapéuticas alternativas y complementarias. Objetivo: Sistematizar las terapias alternativas como solución al cuidado de problemas crónicos de salud. Métodos: Revisión sistemática de documentos publicados desde 2005 hasta 2020 en español e inglés, con una clara metodología y referencial teórico seleccionado durante el 2020. La pregunta se elaboró a través de la estrategia PICO. Se utilizaron las palabras claves identificadas en DeCS y operadores booleanos: "atención de enfermería" AND "terapias complementarias" AND "enfermedades crónicas" y en inglés, las identificadas por MeHS: "Complementary therapies" AND "Nursing care" AND "Chronic disease". La búsqueda fue realizada en las bases de datos: Pubmed, Clinical Key, SciELO, Dialnet, Index, Google Scholar. Se utilizó el diagrama de flujo (PRISMA) para contribuir a la formulación de la estrategia de búsqueda. Mediante los métodos de análisis documental, síntesis y sistematización se dio la posibilidad de organizar e interpretar los conocimientos presentes en las bibliografías encontradas. Conclusiones: Las terapias alternativas como una solución a los problemas de salud, es una herramienta que puede ser usada por el personal de enfermería, para aumentar la gama de cuidados que se les brindan a las personas con problemas de salud crónicos(AU)

Introduction: Chronic health problems are considered multidimensional diseases; therefore, they demand, from the nursing staff, a comprehensive and holistic care. One option to provide holistic and autonomous care is alternative and complementary therapies. Objective: To systematize alternative therapies as a solution for the care of chronic health problems. Methods: A systematic review of documents published from 2005 to 2020 in Spanish and English was developed, with a clear methodology and theoretical references selected during 2020. The question was elaborated through the PICO strategy. In Spanish, the following keywords, identified in the DeCS, as well as Boolean operators were used: "atención de enfermería" AND "terapias complementarias" AND "enfermedades crónicas". In English, the corresponding keywords found in the MeHS were taken into account: "Complementary therapies" AND "Nursing care" AND "Chronic disease". The search was carried out in the Pubmed, Clinical Key, SciELO, Dialnet, Index and Google Scholar databases. The PRISMA flow diagram (Preferred Reporting Items for Systematic Review and Meta-Analyses) was used to contribute to the formulation of the search strategy. The methods of documental analysis, synthesis and systematization permitted to organize and interpret the knowledge present in the theoretical references found. Conclusions: Alternative therapies, as a solution to health problems, are a tool that can be used by the nursing staff, in order to increase the range of care provided to people with chronic health problems(AU)

Addressing Nursing Personnel Burnout in Long-Term Care: Implementation of a Gratitude Journal.

Burnout affects health care providers and leads to adverse consequences. A 21-day gratitude journaling activity implemented in a Midwest long-term care setting was a personal, low-cost, and low-tech intervention requiring minimal time commitment to address burnout. The Maslach Burnout Inventory was utilized to assess burnout pre- and post-intervention of a gratitude journal.

Desafios de enfermeiras obstétricas na assistência ao parto e nascimento: estudo descritivo e exploratório / Challenges of midwives in labor and birth care: a descriptive and exploratory study

OBJETIVO: identificar e analisar os desafios apresentados por enfermeiras obstétricas, quanto à inserção na assistência ao parto e nascimento. MÉTODO: estudo descritivo, exploratório, abordagem qualitativa, com realização de três grupos focais com 16 enfermeiras obstétricas do curso de aprimoramento, entre agosto e novembro de 2019. Os depoimentos foram gravados e submetidos à análise de conteúdo na modalidade temática. RESULTADOS: destacaram-se como desafios das enfermeiras obstétricas a demanda de trabalho e a sobrecarga com atividades burocráticas; os conflitos com a equipe de saúde na assistência compartilhada; o processo de autonomia limitada da enfermeira obstétrica; e a intensa necessidade de validar a própria competência técnica diante da equipe de saúde. CONCLUSÃO: ampliar os processos de trabalho e a gestão em saúde compartilhada em equipe interprofissional, alinhados às evidências científicas, favorece o aprimoramento de saberes e o diálogo coletivo.

OBJECTIVE: to identify and analyze the challenges faced by obstetric nurses regarding their insertion in labor and birth care. METHOD: descriptive exploratory study, with a qualitative approach, involving three focus groups with 16 nurse midwives from an improvement training, held between August and November 2019. The statements were recorded and submitted to a content analysis in the thematic modality. RESULTS: the main activities that stood out as challenges faced by obstetric nurses were the work demand, the overload of bureaucratic activities, conflicts with the health team in shared care, the process of limited autonomy of the obstetric nurse, and the intense need to validate one's own technical competence before the health team. CONCLUSION: expanding work processes and shared health management in an interprofessional team, in line with scientific evidence, favors the improvement of knowledge and collective dialogue.

[Outsourcing of nursing staff costs in psychiatry? : A secondary data analysis of possible effects on the remuneration system in psychiatry]. / Ausgliederung der Pflegekosten in der Psychiatrie? : Eine Sekundärdatenanalyse möglicher Auswirkungen auf das PEPP-System.

BACKGROUND: Nursing staff were excluded from the German DRG system for somatic hospital treatment and will be funded separately in the future. In psychiatry and psychosomatic medicine, binding personnel requirements have been defined but there has been no regulation of how these personnel requirements are adequately financed. OBJECTIVE: The objective of this study was to analyze the costs of inpatient psychiatry and psychosomatic medicine and to evaluate possible effects of funding nursing staff separately. MATERIAL AND METHODS: This analysis is based on aggregated daily treatment costs of selected hospitals (data year 2018), which annually submit their performance and cost data to the Institute for the Hospital Remuneration System (InEK) for the empirical further development of the remuneration system. RESULTS: Nursing staff represent the largest cost factor in inpatient psychiatry and psychosomatic medicine. Excluding nursing staff drastically reduces the variance of psychiatric DRG renumeration and even exceeds its proportion of the total costs. After outsourcing nursing costs, psychiatric DRGs achieve only a very limited cost separation. CONCLUSION: The binding personnel requirements necessitate adequate financing of nursing staff. This raises the debate about the further development of psychiatric remuneration. The question arises as to whether the effort associated with using the psychiatric DRG system justifies its usefulness as an instrument for budgeting when core functions such as cost separation are only given to a limited extent. Alternative approaches to budgeting should also be examined for putting costs and benefits in a better ratio.

Nursing care toward older adults with dementia: An integrative review.

BACKGROUND: Dementia among older adults is receiving increase attention due to its neurodegenerative pathologies and poses a significant challenge for healthcare services systems. Caring for older adults with dementia is frequently challenging. This integrative review appraised and synthesised the existing literature describing the nursing care given to older adults with dementia. METHODS: An integrative review was used using six electronic databases (CINAHL, Medline, Science direct-Elsevier, Proquest, Pubmed and Web of Science). The search terms that were included in various combinations using mesh terms were as follows: nurse* OR nursing staff* AND caring OR care OR caring behavior OR affectionate OR compassionate AND older person* OR aging* OR elder* OR geriatric patient* OR older adult* OR gerontology* OR aged* OR old age. A standardised review by Kmet et al. instrument was utilised for appraising the quality of selected 13 articles. RESULTS: The results were presented based on the two major themes: challenges in providing care and identifying and managing older adults' difficult behaviours. CONCLUSION: The findings of an integrative review can be used as a foundation for formulating recommendations for how dementia care by nurses can be improved and highlighting where policy development and further research are needed.

"They Stay With You": Nursing Home Staff's Emotional Experiences of Being in a Close Relationship With a Resident in Long-Term Care who Died.

Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff (n = 6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident's death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with "special residents" in long-term care. To support holistic practice, awareness is needed of the emotional impact of relationships on health professionals. Suppressing feelings puts staff at risk of moral distress, compassion fatigue, and burnout, as well as higher turnover and absenteeism. Managers should facilitate discussions on professionals' ideals of relationship-based practice, including processing of, and reflection on, emotional experiences in long-term care. Rituals to mark a resident's death can provide further emotional containment.

Density of nurses and midwives in sub-Saharan Africa: Trends analysis over the period 2004-2016.

AIM: To analyse the trends of density rates of nurses and midwives per population in sub-Saharan Africa over the period from 2004 to 2016. BACKGROUND: Nursing, the largest health care workforce, is actively contributing to the achievement of the Sustainable Development Goals. The African continent is one of the most affected areas by the differences in the density of nurses and midwives indicator. METHODS: Joinpoint regression analysis was applied to identify significant changes in trends of the density of nurses and midwives from the 50 countries of sub-Saharan Africa. RESULTS: From 2004 to 2013, the density of nurses and midwives in sub-Saharan Africa increased significantly from 5.6 to 12.44 per 10,000 population, although it exhibited a increasing trend of a magnitude of 8.3% until 2013 that does not continue from that year. CONCLUSIONS: Only seven countries show an increasing trend, although in the case of the rest, they do not present any trend that suggests a change in this indicator in the short term. IMPLICATIONS FOR NURSING MANAGEMENT: From a macrolevel nursing management point of view, our study shows the importance of implementing actions that contribute to the increase of the nursing workforce in Africa, essential to achieve the Sustainable Development Goals.

NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention.

BACKGROUND: Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. METHODS: A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. RESULTS: As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. CONCLUSIONS: The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.