Nursing Students' Perceptions of a Novel Education Approach to Prevention and Control of Healthcare-Associated Infections: Insights from PrevInf Pilot Study.

BACKGROUND: Healthcare-associated infections (HAIs) pose a significant global threat, particularly in developing regions such as Southeast Asia. International bodies emphasize the role of formal undergraduate training in the prevention and control of HAIs. To address this, we aimed to explore the perceptions of Southeast Asian nursing students regarding a novel educational approach developed by a European-Southeast Asian project consortium. METHODS: A pilot study was conducted in four nursing higher education institutions from Cambodia and Vietnam. First, local nursing educators conducted a 2 h classroom-based training session. Then, students were invited to participate for the first time in one of twelve evidence-based simulation scenarios developed by the research team, covering a range of nursing care situations related to the prevention and control of HAIs. After attending both components, students were asked to complete a paper-based questionnaire and rate their agreement with a set of statements on the appropriateness and meaningfulness of both components. RESULTS: A total of 430 nursing students enrolled in the pilot study; 77.4% were female, with an average age of 19.8 years. The PrevInf educational intervention received positive feedback from participating students across settings, with strong agreement on the importance of proactiveness in competency development (M = 5.9, SD = 1.4). Notable differences between Cambodian and Vietnamese students were observed in terms of their receptiveness to the pre-selected teaching materials (p = 0.001) and strategies (p = 0.01) used by the nursing educators during their experience with the simulation scenarios. CONCLUSIONS: The PrevInf educational intervention shows promise in engaging Southeast Asian nursing students and fostering a deeper understanding of the prevention and control of HAIs. Further studies are warranted to refine the learning content and standardize the pedagogical strategies used by nursing educators across settings. This study was not registered.

Adaptation and Validation of the Self-Administered Foot Health Assessment Instrument for Portuguese Undergraduate Nursing Students.

Background and Purpose: To translate and adapt the Self-Administered Foot Health Assessment Instrument from English to European Portuguese and explore its reliability and validity among undergraduate nursing students in Portugal. Methods: The study was divided into two phases. First, the translation and cross-cultural adaptation followed Beaton's guidelines, with a pretesting of the final version with 30 students. The validation process used the content validity index with a minimum of 75% agreement between experts and Cronbach's alpha for internal consistency. The second step provided the results of the principal component analysis and confirmatory factor analysis, which were performed to study the overall fit of the model and item correlations. The STROBE checklist was used. Results: The Portuguese version, Instrumento de Auto-Avaliação da Saúde do Pé (IAASP), showed an overall acceptable evidence regarding content validity and internal consistency. The factor analysis results suggested removing the "Foot pain" dimension from the original scale. Conclusions: IAASP is suggested to maintain the original 22-item structure, with four domains, "Skin health," "Nail health," "Foot structure," and "Foot pain," being an initial reliable version with interest to measure the current foot health of nursing students. Future studies should contribute to IAASP's continuous improvement.

Nurses' Adherence to the Portuguese Standard to Prevent Catheter-Associated Urinary Tract Infections (CAUTIs): An Observational Study.

Urinary tract infections are among the most prevalent types of healthcare-associated infections (HAIs) in hospitals and nursing homes, and they are primarily a result of unnecessary catheter usage and inadequate care. In Portugal, epidemiological data indicate that catheter-associated urinary tract infections (CAUTIs) remain widespread in clinical settings, resulting in increased morbidity and mortality rates among vulnerable populations. This study aimed to assess urinary catheter use in an oncology ward in Portugal and to evaluate nurses' adherence to the government-endorsed standards for preventing CAUTIs. An observational study was conducted over a four-month period with daily assessments of nurses' practices during urinary catheter insertion and maintenance using a government-endorsed auditing tool. Data were collected through on-site observations and nurses' feedback. The findings revealed a urinary catheter utilization rate of 17.99%. However, there was a lack of complete adherence to government-endorsed standards among oncology nurses (0%). These results indicate that current practices lack evidence-based standardization. Therefore, there is a need to develop and implement quality improvement initiatives to enhance patient safety and experiences.

Cancer Patients with Chronic Pain and Their Caregivers during COVID-19: A Descriptive Study.

BACKGROUND: The sanitary measures imposed by COVID-19 intensified challenges in the pain management of cancer patients. METHODS: A descriptive study was conducted in a chronic pain unit of an oncological hospital aiming to explore the experiences of cancer patients with chronic pain and their caregivers during the pandemic period, as well as identify strategies to improve care in chronic pain management. An electronic questionnaire was developed containing sociodemographic variables, the Depression, Anxiety and Stress Scale-21, and open-ended questions exploring the experiences and circumstances of pain management. RESULTS: A total of 30 patients and 13 caregivers filled in the questionnaire. Patients revealed a higher level of depression, anxiety, and stress than caregivers, without statistically significant differences. Both groups mentioned having experienced difficulties in self-care, particularly in relation to sleep, nutrition, and recreation. In total, 83.7% patients needed pain relief medication related to uncontrolled pain. Both mentioned that they would have benefited from a digital application to ease the communication with the healthcare professionals of the chronic pain unit, as well as non-pharmacological interventions, such as therapeutic massage. CONCLUSIONS: Recognizing that chronic pain leads to significant limitations, it is essential to implement and anticipate objective and effective responses in pain management.

Nursing Practices and Sensitive Outcomes Related to Peripheral Intravenous Catheterization in Portugal: A Scoping Review.

Implementation of evidence-based practice (EBP) is essential for ensuring high-quality nursing care. In Portugal, nurses are responsible for care delivery to patients who require peripheral intravenous access. However, recent authors emphasized the predominance of a culture based on outdated professional vascular access practices in Portuguese clinical settings. Thus, the aim of this study was to map the studies conducted in Portugal on peripheral intravenous catheterization. A scoping review was conducted based on the Joanna Briggs Institute recommendations, with a strategy adapted to different scientific databases/registers. Independent reviewers selected, extracted, and synthesized the data. Of the 2128 studies found, 26 were included in this review, published between 2010 and 2022. Previous research shows that Portuguese nurses' implementation of EBP was found to be relatively low overall, while most studies did not attempt to embed EBP change into routine care. Although nurses are responsible for implementing EBP at an individual patient level, the studies conducted in Portugal report nonstandardized practices among professionals, with significant deviations from recent evidence. This reality, combined with Portugal's absence of government-endorsed evidence-based standards for peripheral intravenous catheter (PIVC) insertion and treatment and vascular access teams, may explain the country's unacceptably high incidence of PIVC-related complications reported over the last decade.

Nurses' Involvement in the Development and Usability Assessment of an Innovative Peripheral Intravenous Catheterisation Pack: A Mix-Method Study.

Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. METHODS: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. RESULTS: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = -2.482, p = 0.013) and avoided omissions while preparing the required material (Z = -1.977, p = 0.048). The participating nurses emphasised the pack's potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. CONCLUSIONS: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.

Evidence-Informed Development of a Bundle for Peripheral Intravenous Catheterization in Portugal: A Delphi Consensus Study.

Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses' clinical decision-making in this scope. METHODS: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward's nurses. RESULTS: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter's functionality and performance at each shift. CONCLUSION: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.

Baropodometric Assessment of the Podiatric Profile of Nursing Students in Clinical Settings: A Study Protocol.

Introduction: Nursing students are exposed to increased risks of developing foot and ankle disorders due to prolonged standing and walking positions during clinical settings. This can lead to high dropout rates from nursing degree, thus contributing to a future shortage in nursing professionals. This protocol aims to develop a study to understand the influence of prolonged standing and walking positions on nursing students' foot health, and specifically to study the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms. Methods and Analysis: A prospective observational cohort study will be conducted with 194 nursing students. Participants will be asked to walk through a baropodometric platform before and after a 5-month clinical training session. Assessment will focus on the change in podiatric profile, namely foot posture and foot function, at 5 months, and changes in foot health at 5 months. The study will start in January 2022 and it's expected to end by June 2022. Discussion: The study aims to perform an innovative assessment of nursing students' podiatric profile, which will allow for a comprehensive description of foot/ankle changes and their relationship with prolonged standing and walking contexts. Ethics and Dissemination: The study was approved by The Ethical Committee of the Health Sciences Research Unit: Nursing (UICISA: E), of the Nursing School of Coimbra (ESEnfC), with the approval code nr. P799_07_2021. The study was also recorded in ClinicalTrials.gov on the number NCT05197166. Findings will be used to publish articles in peer-review scientific journals and oral communications and posters at scientific meetings.

Nurses' Practices in the Peripheral Intravenous Catheterization of Adult Oncology Patients: A Mix-Method Study.

A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses' practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses' adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.