[Preliminary Study on the Relationship Between Organizational Climate, Leadership Style, and Job Satisfaction in the Context of Nurse Practitioners].

BACKGROUND: Job satisfaction in nurse practitioners is influenced by the level of autonomy and empowerment they perceive within their practice environment. Little in-depth research has been done to explore the relationship among organizational climate, leadership style, and job satisfaction in the context of nurse practitioners. PURPOSE: This study was developed to explore the relationship among organizational climate, leadership style, and job satisfaction in nurse practitioners with the goal of enhancing their job satisfaction. METHODS: A cross-sectional correlational approach and snowball sampling method were employed to recruit 400 qualified nurse practitioners to complete an online survey. This survey was a structured questionnaire consisting of the Practice Organizational Climate Scale, Leadership Style Scale, and Job Satisfaction Scale. Statistical analyses used included the independent t test, one-way ANOVA, Pearson's correlation, and multiple linear regression analysis. RESULTS: Most of the participants were 31 to 50 years old. A significant and positive correlation was identified among overall organizational climate, leadership style, and job satisfaction. In terms of organizational climate components, only professional visibility was not found to significantly correlate with job satisfaction. Transformational leadership, servant leadership, independent work, and relationships with support and management departments collectively explained nearly 72.4% of overall job satisfaction. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings demonstrate job satisfaction in nurse practitioners to be significantly influenced by organizational climate and leadership style. Thus, fostering a positive organizational climate and enhancing transformational and servant leadership styles may be expected to improve job satisfaction in this group substantively. Therefore, it is recommended healthcare institutions focus on improving the organizational climate, providing more autonomy and support, and enhancing leadership training for supervisors with the goal of increasing overall job satisfaction and retention rates among nurse practitioners.

Navigating the Complexities of Nursing Documentation When Patients Have Access to the Content: A Qualitative Study.

AIM: To explore how Danish registered nurses (RNs) in hospitals experience documenting nursing care in electronic patient records when the content is accessible to patients. METHODS: In a qualitative research design, data were generated in six focus groups conducted in late 2022 and early 2023, comprising 31 RNs employed in inpatient wards at a university hospital in Denmark. Subsequently, qualitative content analysis was applied to the gathered data. RESULTS: The findings include three themes: (1) weighing one's words, (2) building trust or triggering conflicts and (3) risking loss of knowledge. Together, these three themes illustrate the complexities that RNs navigate when patients have access to the content of nursing documentation. CONCLUSION: Patients' access to nursing documentation requires RNs to navigate a complex interplay of factors, including awareness of language-use, influence on the nurse-patient-relative relationships, and the risk of losing essential knowledge. Therefore, although patients' access to nursing documentation can induce a positive change in terms of strengthening the professional focus on documentation, it can also result in changes in documentation practices in ways that may compromise nursing documentation as a working tool. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The findings emphasize an urgent need to explore and discuss how sensitive nursing observations can be shared in a safe and appropriate way when patients have access to the documentation. Furthermore, to prevent misunderstandings and conflicts with patients, it is essential to focus on and prioritize patient involvement in nursing documentation. IMPACT: RNs navigate complex practices when patients have direct online access to nursing documentation content. It is crucial to clarify which content nursing documentation should entail and how sensitive nursing observations can be shared in a safe and appropriate way. REPORTING: The COREQ checklist was used for reporting.

Implementation of Positive Advanced Recovery Connections in Primary and Secondary Mental Health Care-A Registered Advanced Nurse Practitioner-Led Initiative.

AIM(S): This study reports on the implementation of a registered advanced nurse practitioner intervention. Aims include improving access, service user outcomes and integration between primary and secondary care. DESIGN: This paper reports the quantitative results of a mixed methods implementation study. Qualitative data are reported separately. The PARiHS framework informs the implementation process itself, with considerations for nurses and other healthcare professionals explored. METHODS: The CORE-OM 34 item rating scale was administered both pre- and post-intervention. Service user attendances in secondary care was monitored. RESULTS: Findings suggest that the intervention was associated with clinically significant improvements in global or generic distress, reported by service users, as evidenced by changes in the CORE-OM scores. Access to care was recorded at an average of 3.6 days. Implementation science supported effective and safe implementation with clear governance structures. CONCLUSION: Registered advanced nurse practice in mental health clinics which provide full episodes of care results in improved integration and may be associated with positive patient outcomes. Implementation science is taught on Irish nursing programmes and this is important if innovative services are to be embedded in the healthcare system. IMPACT: The development of a model of care for mental health Registered Advanced Nurse Practitioners at the interface of primary and secondary care settings may be merited. Positive Advanced Recovery Connections may be associated with improving mental health outcomes and bolstering integration of primary and secondary care services. The utilisation of implementation science highlights the need for collaboration with all stakeholders to overcome barriers and recognise facilitators to attain the necessary model of integrated care. PATIENT AND PUBLIC CONTRIBUTION: Peer recovery input was provided by members of the service Recovery College, with participation evident in all stages of the project. The psychosocial assessment template was also co-designed.

Prevalence and Practice Characteristics of Advanced Practice Providers in Upper-Extremity Surgery, 2013-2021.

PURPOSE: This study evaluated the prevalence, characteristics, and reimbursement of advanced practice providers, including nurse practitioners and physician assistants, who provide care related to the diagnosis and treatment of diseases and conditions of the hand, wrist, and upper extremities in the United States from 2013 to 2021. METHODS: Our analysis was a retrospective cohort study evaluating the diagnostic, procedural, and therapeutic services provided by advanced practice providers from 2013 to 2021 using the Medicare Provider Utilization and Payment Data Public Use Files from the Centers for Medicare and Medicare Services. The reported provider type and billing codes were used to identify health care professionals providing upper-extremity care such as ordering radiographs, applying casts and splints, and performing procedures on the hand, wrist, or other anatomic regions of the upper extremity. Trends over the study period and available data about services provided were analyzed. RESULTS: From 2013 to 2021, providers of upper-extremity care included 19,525 (64.7%) doctor of medicine or doctor of osteopathic medicine upper-extremity surgeons, 7,612 (25.2%) physician assistants, and 3,042 (10.1%) nurse practitioners. The nonsurgeon providers were more likely to be women and provide care in micropolitan areas with less than 50,000 people compared with upper-extremity surgeons. Overall, the number of advanced practice providers who billed for upper-extremity care increased by 170.9% from 1,965 in 2013 to 5,324 in 2021. Based on these trends, the growth of APPs providing upper-extremity care is expected to continue. CONCLUSIONS: There is a growing prevalence of advanced practice providers in upper-extremity care, and this trend is expected to continue. CLINICAL RELEVANCE: With a growing need for upper-extremity care and predicted shortages in the surgeon workforce, the scope of practice and integration of advanced practice providers merits further discussion and evaluation.

Charting the Course of the Nursing Professional Identity: A Qualitative Descriptive Study on the Identity of Nurses Working in Care for Older Adults.

AIMS: To explore and describe the meaning of nurses working in care for older adults give to the nursing professional identity. DESIGN: A qualitative approach was taken. METHODS: Semi-structured interviews were conducted with 50 bachelor and vocational-educated nurses working in care for older adults. Interviews were conducted between December 2019 and May 2020. Data were analysed and interpreted through inductive content analysis. RESULTS: Five themes embody the meaning of the nursing professional identity of nurses who work in care for older adults. The five themes are: born to care: a lifelong motivation to nursing; nursing through the noise: dedication in a demanding profession; the silent backbone: caught in the crossfire of interdisciplinary teams; learning under pressure: the demand for expanded nursing expertise and against the current: the barriers to advocacy in nursing. CONCLUSION: The professional nursing identity of nurses working in care for older adults is multi-faceted. A personal dedication to patient care, where patients 'human' aspect is heavily valued, commits nurses to their profession and underscores their dedication to upholding the quality standard in nursing practice. IMPLICATIONS FOR THE PROFESSION: The older adults' nursing identity highlights that nursing deserves acknowledgement as a professional occupation. Nurses should speak to the public about their professional roles to improve the public view of older adult nursing. IMPACT: A clear understanding of the older adult nursing professional identity clarifies specific roles, experiences and expectations. This can help attract and retain nurses whose views of older adult nursing align with the nursing professional identity. This could help resolve nurse turnover and reduce shortages in older adult care. REPORTING METHOD: We adhered to Consolidated Criteria For Reporting Qualitative Research guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Successful use of point-of-care ultrasound for an elderly patient with heart failure in a primary care setting: a case report.

Background: Appropriate assessment of fluid status of patients with heart failure (HF) is challenging in outpatient settings, e.g. primary care, especially among elderly HF patients with multiple comorbidities. The use of handheld ultrasound devices for point-of-care ultrasound (POCUS) has increased. Case summary: An 80-year-old male had HF with preserved ejection fraction with New York Heart Association (NYHA) classification II. He had multiple comorbidities including chronic obstructive pulmonary disease and been followed up in both a nurse-led HF clinic and a nurse-led chronic obstructive pulmonary disease clinic in primary care. During a scheduled visit to the nurse-led HF clinic in primary care, he exhibited orthopnoea and moderate leg oedema. A HF nurse, using a handheld ultrasound device (Vscan, GE Healthcare), detected B-lines in the left lung, indicating the presence of fluid in the left lung, and an enlarged and non-varying inferior vena cava (IVC) during the POCUS examination. Based on these results, the HF nurse concluded that the patient was experiencing decompensated HF, rather than a chronic obstructive pulmonary disease exacerbation. As a result, his loop diuretics were promptly increased. The patient and his wife received advice on self-care from the HF nurse and the chronic obstructive pulmonary disease nurses. At a follow-up visit 2 weeks later, his breathlessness and swelling were reduced, with no B-lines or dilated IVC found during the POCUS examination. Discussion: The POCUS can be a good decision support tool for not only physicians but also other healthcare professionals to identify worsening HF and to monitor treatment responses in HF patients in primary care settings.

Secondary Traumatic Stress and Coping Experiences in Psychiatric Nurses Caring for Trauma Victims: A Phenomenological Study.

AIM: In this study, it was aimed to evaluate the secondary traumatic stress and coping experiences of psychiatric nurses who care for people who have experienced psychological trauma with a phenomenological approach. MATERIALS AND METHODS: In this study, semi-structured in-depth interviews were conducted with 18 psychiatric nurses residing in Turkey using the phenomenological research method. The criterion sampling method was used to reach the sample group. Interviews continued until data saturation was achieved, and all interviews were audio-recorded and then transcribed. The data were analysed using thematic analysis. The study was conducted and reported using the COREQ checklist. FINDINGS: In the analysis of the data, three themes (difficulties in caring for people who have experienced trauma, the effects of caring for people who have experienced trauma on the individual and coping, reflections of secondary trauma on the profession) and seven sub-themes (mental, physical, social, psychosocial difficulties and coping, quality of care, professional and organisational aspects) were identified. CONCLUSION: As a result of the study, it was determined that secondary traumatic stress was observed in psychiatric nurses caring for individuals who experienced psychological trauma. It was determined that caring for people who have experienced psychological trauma can negatively affect nurses psychosocially, and individuals have difficulty coping. In line with the results of the study, it is thought that necessary intervention programs should be created for nurses experiencing secondary traumatic stress.

Evaluation of the International Scope of Practice of Nonphysician Anesthesia Providers Between 2012 and 2022.

In 2012, representatives of the 44 International Federation of Nurse Anesthetists (IFNA) member countries were surveyed about their scope of practice. Ten years later, the researchers repeated the study to evaluate the professional development of nonphysician anesthesia providers. The survey was prepared by the IFNA Practice Committee and explored demographics, training, anesthesia team members, and daily activities of the nonphysician anesthesia providers (NPAPs). The online survey was sent to all IFNA Country National Representatives. In 2022, 22 out of 44 countries had more than one type of NPAP including five countries that had anesthesia technicians. NPAPs work in operating theatres (94.4%), postanesthesia care units (81.9%), intensive care units (46%), acute (51%), chronic pain (28%), air ambulance (28%), resuscitation (69%), or trauma team (42%), preoperative screening (57%). Formal recognition of the profession and the requirement of licensure to practice has increased. Education levels have increased substantially, which resulted in more indirect supervision. Direct supervision by physicians is related to education levels and limited scope of practice. The NPAP workforce is growing toward IFNA standards, but it has become a more diversely educated workforce. NPAPs who are educated at a bachelor or higher level and require officially recognized licensure to practice, have an extensive scope of practice.

Shared Experiences of Nurse Anesthesiology Faculty During the COVID-19 Pandemic.

The COVID-19 pandemic impacted all aspects of healthcare, including the education of certified registered nurse anesthesiologists. While the literature contains reports of the impact of COVID-19 on physician anesthesiologist faculty, there was no research identified describing the impact on nurse anesthesiologist faculty. The purpose of this study was therefore to describe and explore the impact of the COVID-19 pandemic on nurse anesthesiology faculty. This qualitative ethnographic study used small focus groups and semistructured and probing questions to examine the phenomenon of interest. Through thematic analysis of the narrative, five overarching themes were identified: 1) ability to adapt to adversity, 2) disruption leads to change, 3) perceived positive outcomes, 4) previously untapped resources, and 5) curricular innovation and integrity.

Cultural translation of the ethical dimension: a study on the reliability and validity of the Chinese nurses' professional ethical dilemma scale.

BACKGROUND: Quantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS). METHODS: In 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis-both Exploratory (EFA) and Confirmatory (CFA)-alongside assessments of internal consistency and test-retest reliability were employed. RESULTS: Expert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS. CONCLUSION: The Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China.

REVIVE Is an Evidence-Based Approach for Nurses to Universally Apply Trauma-Informed Care in Maternity Settings.

The principles of trauma-informed care-safety, compassion, collaboration, communication, autonomy, and empowerment-are also the domains most vulnerable to implicit bias and most cited in adverse outcomes in maternal health. Perinatal nurses must practice trauma-informed care universally and thereby foster and advance person-centered care for all individuals with respect to race, ethnicity, religion, or lived experiences. In this article, we present evidence-based nursing interventions, collectively called REVIVE, that are known to promote principles of trauma-informed care. Taken together, the REVIVE interventions may improve health outcomes and reduce disparities in maternal health outcomes because they are proactive nursing interventions independent of implicit bias. REVIVE is described here and intended for use by individual nurses or health care teams to implement and evaluate in different maternity settings.

Association of hospital safety climate and compliance with occupational safety practices among nurse interns: A cross-sectional study using canonical correlation analysis.

Background and Aims: Nurse interns may be at a similar or higher risk than registered nurses. The key elements and mechanisms involved in the effects of safety climate on safety performance are not well understood. This study explores the relationship between the perceived hospital safety climate and compliance with occupational safety practices among nurse interns. Methods: A cross-sectional study was conducted among 178 nurse interns in three tertiary university hospitals in Chongqing city, China. The Chinese version of the Hospital Safety Climate Scale (HSCS) was used to measure the perceived hospital safety climate of nurse interns. Compliance behavior was measured using the Compliance with Occupational Safety Practice Scale (COSPS). Canonical correlation analysis and multiple linear regression modeling were used to examine their relationship. Results: Total scores for the HSCS and COSPS were 92 (80,100) and 185 (175,185) [M (P25, P75)], respectively. Canonical correlation coefficients for canonical variates 1 and 2 were 0.636 (p < 0.001) and 0.414 (p < 0.001), respectively. Nurse interns' compliance with occupational safety practices was mainly influenced by management support, feedback/training, personal protective and engineering control equipment availability, and absence of job hindrance. Multiple linear regression showed that management support of HSCS accounted for 37.1% of the variance in compliance (ß = 0.283, p = 0.039). Conclusion: Nurse interns reported high levels of perceived hospital safety climate and compliance with occupational safety practices. Younger nurse interns reported a lower level of perceived hospital safety climate. Nurse educators can improve interns' compliance by promoting better management support, feedback/training, personal protective and engineering control equipment availability, and fewer job hindrance.

Exploring Lived Experiences of Vulnerability in Nursing Management during the Coronavirus Disease 2019 Pandemic: A Phenomenological Study of Nurse Managers and Nurses.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective: This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods: In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results: One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion: The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management.

Using single-dose liposomal amphotericin B for cryptococcal meningitis induction therapy: nurse pearls and practical perspectives.

Background: In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with cryptococcal meningitis in research settings. However, liposomal amphotericin B (AmBisome) is now available via the efforts of UNITAID. We sought to describe our nursing experience using AmBisome within a clinical trial for cryptococcal meningitis. Methods: We describe the experience of using single-dose 10mg/kg liposomal amphotericin B from the perspective of a research nurse in Uganda. Second, we described the process of preparing and administering amphotericin. Third, we assessed the nursing time required for the administration of daily amphotericin B versus single-dose liposomal amphotericin. Fourth, we discuss the major challenges faced while using liposomal amphotericin B. Results: We provide estimates for the nursing time required for reconstituting, filtering, diluting and administering liposomal amphotericin B and a visual aid for nursing tasks. Based on five trained nurses, the process of reconstitution and filtration lasts an average of 52 minutes (Range: 40 to 60 minutes), to reconstitute a mean of 11 (range: 8 to 15) 50mg vials (median weight 55kg). Overall, less nursing time was required for single-dose administration than for daily amphotericin B dosing. From a nursing perspective, liposomal amphotericin B was preferable to amphotericin B deoxycholate due to its reduced infusion reactions and other toxicities. Conclusions: Single-dose liposomal amphotericin B is a better alternative to daily amphotericin B. In addition to less toxicity, nosocomial infections, reduced hospital stay, and the potential for lower hospitalisation costs, the nursing implications should not be discounted. Quality nursing care is a finite resource in low- and middle-income countries, and single-dose amphotericin B reduced the nursing time required for the care of patients with cryptococcal meningitis.

In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with cryptococcal meningitis in research settings. However, liposomal amphotericin B is now available via the efforts of UNITAID. Liposomal amphotericin B is known to be less nephrotoxic than amphotericin B deoxycholate. We demonstrated that liposomal amphotericin B is a better alternative to amphotericin B deoxycholate with less toxicity, nosocomial infections, reduced hospital stay, and the potential for lower costs of hospitalisation for both the patient and the healthcare system given the single, 10 mg/kg regimen. Despite the perceived high cost of liposomal amphotericin B and the tedious reconstitution process requiring training and adequate manpower, we believe that single-dose liposomal amphotericin B has enough advantages over the deoxycholate formulation to compel Ministries of Health to consider procuring liposomal amphotericin B as the drug of choice for the management of HIV-associated cryptococcal meningitis. The rollout will require training to facilitate widespread implementation, and we hope that this paper will serve to facilitate this training for nurses who will be using liposomal amphotericin B.

Nurses' returning to work after cancer: A focus group study.

BACKGROUND: Nurses diagnosed with cancer face unique challenges when returning to work, yet there is limited understanding of their transition. PURPOSE: To explore nurses' return-to-work experiences post cancer diagnosis and clarify related facilitators and challenges. METHODS: This focus group study employed a content analysis with constant comparative approach and member checking. This study recruited nurses treated for any type of cancer who had experience returning to clinical positions. FINDINGS: Five focus groups with 17 female nurses (mean age=51.8) were performed; 47.1% had breast cancer. Four main themes were identified: (a) motivation, incentives, and the need to return to work; (b) setbacks hindering the return; (c) navigating new work dynamics; and (d) evolving professional role during the return to work. DISCUSSION: This study illustrates personal and professional growth and struggles that attend returning to work as a nurse with cancer. This insight informs strategies to support continuing these nurses' careers.

The association between nurse practitioner race and ethnicity and intent to leave in primary care practices.

BACKGROUND: Retaining nurse practitioners (NPs) from diverse racial and ethnic groups is critical to achieving health equity as NPs disproportionately care for minoritized populations. Yet, little is known about intent to leave (ITL) among these NPs. PURPOSE: To examine whether NP race and ethnicity were associated with ITL and if this relationship was affected by the work environment. METHODS: Survey data from 1,232 NPs across six states were used. NPs completed measures of their ITL, work environment quality, and demographics. Regression models were used to determine if NP race and ethnicity resulted in differential reports of ITL. FINDINGS: Minoritized NPs had significantly higher cumulative odds of ITL compared with White NPs. DISCUSSION: Minoritized NPs had higher ITL, and the work environment did not demonstrate a protective effect against ITL. Future research should identify work environment features that may help retain a diverse NP workforce.

Trauma nursing practitioners' preferences for training for trauma specialist nurses based on job competencies.

INTRODUCTION: Optimizing trauma nurse training is of great significance in enhancing nurses' professional skills, strengthening their emergency response capabilities, facilitating career development, and improving patient rescue success rates. This study aims to investigate the preferences of trauma nursing practitioners for trauma specialist nurse training based on job competency. METHODS: 631 Trauma nursing practitioners from 20 hospitals in Guizhou Province, China, participated in this cross-sectional study. The instruments used were the General Information Questionnaire and the Self-designed training preference questionnaire for trauma specialist nurses based on job competency theory. Questionnaires are distributed and collected through online questionnaires. RESULTS: 93.03% of trauma nursing practitioners expressed their willingness to participate in trauma nurse specialist training, of which 80.35% had high-level training needs. 78.92% of trauma nursing practitioners expressed their hope to receive trauma nurse specialist training through operational demonstration training, online live broadcasts, and scenario simulation drills. Among the various dimensions of job competency, the highest demand was for professional knowledge, skills, and ability. CONCLUSION: Trauma nursing practitioners highly value and recognize the professional training of trauma nurse specialists and prefer training methods that are highly practical and can directly improve clinical skills. The research results provide an important basis for further optimizing the training program for trauma nurse specialists.

Reliability of the risk of bias assessment in randomized controlled trials for nursing: A cross-sectional study.

AIM: To evaluate the percentage and reasons for disagreements in the risk of bias (RoB) assessments for randomized controlled trials (RCTs) included in more than one Cochrane review in the field of nursing. BACKGROUND: Disagreement in RoB assessments reduces the credibility of the evidence summarized by systematic reviews (SRs). There is no study that evaluates the reliability of RoB assessments in nursing studies. DESIGN: Secondary data analysis based on research reports. METHODS: RCTs included in more than one review in the nursing have been included. The disagreement of the assessment was analysed, and the possible reasons for disagreements were investigated. RESULTS: Twenty-three RCTs were included in more than one review. The agreement of assessment ranged from 36.84% for "selective reporting" to 91.30% for "random sequence generation". "Allocation concealment" showed the optimal agreement (84.21%). The items "blinding of participants and personnel", "blinding of outcome assessment" and "incomplete outcome data" showed poor agreement, with 50.00%, 58.82% and 66.67%, respectively. Most disagreements came from extracting incomplete or different RCTs' information. CONCLUSIONS: The level of agreement of the assessment between reviews has varied greatly in the field of nursing. More complete and accurate information of RCTs needs to be collected when conducting a SR.

Examining the impact of internet-enabled nursing practices, guided by specialist nurses on patients with hypertension and their caregivers.

PURPOSE: To aim of this study is to assess the impact of an internet-enabled nursing model, led by specialized nurses within a framework of multidisciplinary collaboration, on both, patients diagnosed with hypertension, and their respective caregivers. METHODS: A total of 158 patients with hypertension, along with their corresponding caregivers, were meticulously selected and paired. By using a random number table method, participants were allocated into either a control group or an observation group. The control group received conventional health education, blood pressure monitoring, and routine telephone follow-ups administered by designated nurses. Conversely, patients in the observation group underwent treatment within an internet-enabled nursing model, led by specialist nurses within a multidisciplinary collaborative framework. Parameters including systolic and diastolic blood pressure readings of the patients, as well as their scores in compliance with the hypertension treatment, quality of life, and caregiving proficiency of family members, which were meticulously documented prior to intervention (T0), as well as at 3- and 6-month intervals post-intervention (T1 and T2). RESULTS: Statistically significant differences were observed in both systolic and diastolic blood pressure levels among patients, as well as in their scores reflecting compliance with hypertension treatment, quality of life, and caregiving proficiency of family members, when comparing pre- and post-intervention periods within each group, across groups, and within the interaction effect (p < 0.05). Also, there were statistically significant differences in the aforementioned parameters between the two groups at adjacent time points (p < 0.05). Specifically, patients within the observation group exhibited notable reductions in systolic and diastolic blood pressure levels at both T1 and T2, alongside heightened scores indicative of enhanced compliance with hypertension treatment, enhanced quality of life, and increased caregiving proficiency among family members, when compared to patients within the control group (p < 0.05). CONCLUSION: The implementation of an internet-enabled nursing model, overseen by specialized nurses within a framework of multidisciplinary collaboration, demonstrates superior efficacy in preserving the stability of blood pressure among patients with hypertension. This model significantly enhances patient compliance with treatment regimens, enhances their overall quality of life, and fosters heightened caregiving proficiency among their respective caregivers.