Enhancing nurses' perceptions of having a place to reduce turnover intentions.

AIM: To investigate whether education, tenure, being an advanced practice nurse, skill level, and time pressure impact perceptions of "having a place" and, further, turnover intentions. BACKGROUND: Nursing shortages persist worldwide. Nurses' turnover intentions are negatively related to their perceptions of "having a place" (i.e., the feeling that the nursing workplace is their territory). However, the sources of nurses' perceptions of the perception of "having a place" remain unknown. METHODS: Our research employed a cross-sectional and correlational design. This research was conducted at a large-scale hospital in northern Taiwan from December 2021 to January 2022. We used personnel data pertaining to 430 nurses as well as scales for time pressure, "having a place" and turnover intentions to assess nurses' intention to leave their place of employment. The inclusion criteria focused on full-time nurses who worked for the hospital under investigation. Most of our participants were women. The STROBE statement was used as the EQUATOR checklist (supplemental file). RESULTS: "Having a place" was positively related to educational level, tenure, and skill level, while being an advanced practice nurse was negatively associated with perceptions of "having a place," which in turn were negatively related to turnover intention among nurses. CONCLUSION: Our study is the first to examine the antecedents of nurses' perceptions of "having a place," which include education, tenure, and skill level. IMPLICATIONS FOR NURSING POLICY: Nursing policymakers could encourage nurses to pursue higher degrees and update their nursing skills while instilling perceptions of "having a place" in nurses with a brief tenure and advanced practice nurses.

Enhancing Nurse-Robot Engagement: Two-Wave Survey Study.

BACKGROUND: Robots are introduced into health care contexts to assist health care professionals. However, we do not know how the benefits and maintenance of robots influence nurse-robot engagement. OBJECTIVE: This study aimed to examine how the benefits and maintenance of robots and nurses' personal innovativeness impact nurses' attitudes to robots and nurse-robot engagement. METHODS: Our study adopted a 2-wave follow-up design. We surveyed 358 registered nurses in operating rooms in a large-scale medical center in Taiwan. The first-wave data were collected from October to November 2019. The second-wave data were collected from December 2019 to February 2020. In total, 344 nurses participated in the first wave. We used telephone to follow up with them and successfully followed-up with 331 nurses in the second wave. RESULTS: Robot benefits are positively related to nurse-robot engagement (ß=.13, P<.05), while robot maintenance requirements are negatively related to nurse-robot engagement (ß=-.15, P<.05). Our structural model fit the data acceptably (comparative fit index=0.96, incremental fit index=0.96, nonnormed fit index=0.95, root mean square error of approximation=0.075). CONCLUSIONS: Our study is the first to examine how the benefits and maintenance requirements of assistive robots influence nurses' engagement with them. We found that the impact of robot benefits on nurse-robot engagement outweighs that of robot maintenance requirements. Hence, robot makers should consider emphasizing design and communication of robot benefits in the health care context.

How do three components of professional commitment influence nurse-reported patient-centred care and care quality?

AIMS AND OBJECTIVES: To test how the three components of professional commitment (i.e. affective, continuance and normative professional commitment) are associated with nurse-reported patient-centred care and care quality. BACKGROUND: Patient-centred care and care quality are the two critical care outcomes. However, no study has yet examined how the three components of professional commitment are related to nurse-reported patient-centred care and care quality, showing a research gap. DESIGN: This study adopted a two-wave design (first wave in 2017 and second wave in 2019), which is known to reduce the possibility of reverse causality, and which was conducted in a large hospital in Northern Taiwan. METHODS: Proportionate random sampling was used. Full-time nurses were surveyed, while nursing students, interns, nurse practitioners and nursing supervisors were excluded. The first wave included 524 nurses, and 438 nurses were retained in the second wave. We used confirmatory factor analysis to verify the psychometric properties of the measures. Structural equation modelling was used to implement hypothesis testing. We used the Professional Commitment Scale of Meyer et al. (Journal of Applied Psychology, 1993, 78, 538), the Patient-Centered Care Scale of Laird-Fick et al. (Patient Education and Counseling, 2011, 84, 90) and the Care Quality Perceptions Scale of Teng et al. (Journal of Nursing Management, 2010, 18, 275). The STROBE statement was chosen as the EQUATOR checklist. RESULTS: Affective professional commitment was positively associated with nurse-reported patient-centred care (ß = .18, p = .002 and .01), which was positively associated with nurse-reported care quality (ß = .85, p < .001). Affective and normative professional commitment were also positively associated with nurse-reported care quality (ß = .17, p < .001). CONCLUSIONS: Our findings offer insights for nursing managers that nurses' affective and normative professional commitment could help upgrade care outcomes. Hospital managers should consider professional commitment as relevant to their workforce. RELEVANCE TO CLINICAL PRACTICE: Nursing managers could publicise reports documenting nurses' significant contributions to public health. This could strengthen affective professional commitment among nurses.

How robots impact nurses' time pressure and turnover intention: A two-wave study.

AIMS: To examine the relationships among effort ensuring robots' smooth operation (EERSO), time pressure, missed care, and nurses' turnover intention, and how robot performance moderates such relations. BACKGROUND: Robots may reduce nurses' workload but typically still require some effort of nurses for robots' smooth operation. However, the negative impact of EERSO on nurses' workplace outcomes is unknown. METHODS: This study used a two-wave follow-up design. Data were collected in a medical center in Taiwan, with first wave collected in 2019 and second wave collected between 2019 and 2020. A total of 331 participants were followed through the two waves. RESULTS: EERSO is positively linked to missed care and time pressure. Time pressure is also positively linked to missed care and turnover intention. Positive robot performance weakens the positive link between EERSO and time pressure. CONCLUSION: Using robots may help reduce nurses' workload, but it also requires nurses' efforts to maintain robots' continuous operation, that is, EERSO. It may adversely impact nursing professional workplaces. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should reduce nurses' time pressure whilst suggest hospital managers to seek robots that require minimal EERSO.

Relationship between psychological ownership of the nursing profession and turnover intention: A correlational survey among Taiwanese nurses.

AIMS: The aim of this study is to examine the relationship between psychological ownership of the nursing profession and turnover intention. BACKGROUND: There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated. METHODS: This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical centre in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale and developed Having a Place Scale. RESULTS: Psychological ownership comprises three dimensions: self-efficacy, nurse identity and 'having a place' in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and 'having a place' are negatively related to nurses' intention to leave a hospital (r = -.23 and -.31, p < .001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r = -.38, p < .001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r = .76, p < .001). CONCLUSION: The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can enhance nurses' self-efficacy and sense of 'having a place' to retain nurses in hospitals, while enhancing nurse identity to retain nurses in the profession.

How Robots Help Nurses Focus on Professional Task Engagement and Reduce Nurses' Turnover Intention.

PURPOSE: To examine how robot-enabled focus on professional task engagement and robot-reduced nonprofessional task engagement are related to nurses' professional turnover intention. DESIGN: We adopted a two-wave study design. METHODS: We collected the first wave of data in a large hospital in Taiwan during October and November 2019 and the second wave between December 2019 and February 2020. We used the data collected from 331 nurses who participated in both waves. FINDINGS: We found that robot-enabled focus on professional task engagement is positively related to nurses' overall job satisfaction and perceived health improvement. Robot-reduced nonprofessional task engagement is positively related to nurses' perceived health improvement. Both overall job satisfaction and perceived health improvement are negatively related to nurses' professional turnover intention. CONCLUSIONS: Robots' ability to focus nurses' efforts in professional tasks may help improve nurses' health and overall job satisfaction, and by extension reduce their turnover intention. CLINICAL RELEVANCE: Nurse managers could suggest hospitals introduce robots, particularly those that can share nurses' nonprofessional workload. This, meanwhile, could focus nurses' efforts on professional task engagement.

Reducing turnover intention to improve care outcome: A two-wave study.

AIMS: To ascertain how professional turnover intention impacts nurse-assessed care outcomes, including patient-centered care and care quality. BACKGROUND: Patient-centered care and care quality are critical to care outcomes. However, we do not know whether care outcomes would be improved by reducing nurses' professional turnover intention. DESIGN: We implemented a two-wave correlational follow-up design. METHODS: This study was conducted in a large-scale general in Taiwan during January and February 2018, and January and February 2019. We successfully obtained responses from 448 nurses in 2018 and subsequently followed up (in 2019). Most were women (97.5%), reflecting the profile of the local nurse population. Structural equation modeling was used to test hypotheses. RESULTS: Our findings indicate that nurses' professional turnover intention is negatively related to nurse-assessed, patient-centered care. Nurses' professional turnover intention is also negatively related to all the five perceptions of nurse-assessed care quality: that is, assurance, reliability, responsiveness, empathy, and tangibles. Moreover, years of working as a nurse is also positively related to nurse-assessed, patient-centered care and all the five perceptions of nurse-assessed care quality. CONCLUSION: This study examined nurses' professional turnover intention as an antecedent of nurse-assessed, patient-centered care and care quality. Our study shows that professional turnover intention may predict care outcomes. Overall, our study suggests that professional turnover intention not only impacts workforce stability but also impacts health-care outcomes. IMPACT: Our findings suggest that reduction of nurses' turnover intentions could benefit care outcomes. Hospital managers should know that nurses' turnover negatively impacts care outcomes.

Flexible Textile-Based Pressure Sensing System Applied in the Operating Room for Pressure Injury Monitoring of Cardiac Operation Patients.

Pressure injury is the most important issue facing paralysis patients and the elderly, especially in long-term care or nursing. A new interfacial pressure sensing system combined with a flexible textile-based pressure sensor array and a real-time readout system improved by the Kalman filter is proposed to monitor interfacial pressure progress in the cardiac operation. With the design of the Kalman filter and parameter optimization, noise immunity can be improved by approximately 72%. Additionally, cardiac operation patients were selected to test this developed system for the direct correlation between pressure injury and interfacial pressure for the first time. The pressure progress of the operation time was recorded and presented with the visible data by time- and 2-dimension-dependent characteristics. In the data for 47 cardiac operation patients, an extreme body mass index (BMI) and significantly increased pressure after 2 h are the top 2 factors associated with the occurrence of pressure injury. This methodology can be used to prevent high interfacial pressure in high-risk patients before and during operation. It can be suggested that this system, integrated with air mattresses, can improve the quality of care and reduce the burden of the workforce and medical cost, especially for pressure injury.

Relationship among upgrades in academic qualifications, practice accreditations, self-efficacy, outcome expectations and nurses' career interest.

AIMS: This study examined the relationship among upgrades in academic qualifications, practice accreditations, self-efficacy, outcome expectations and nurses' career interest. BACKGROUND: Interest in the nursing career could help retain nurses in the nursing profession. A global nurse shortage warrants further research to understand what drives interest in the nursing career. METHODS: A cross-sectional design was employed. Data were collected in a medical centre in Northern Taiwan between February and March 2017, using employee records and a survey instrument. Proportionate random sampling was used to identify full-time registered nurses, of whom 524 provided useable responses. Employee records were used to measure nurses' upgrades in academic qualifications and practice accreditation. RESULTS: Upgrades in academic qualifications and upgrades in practice accreditation are positively related to outcome expectations. Both self-efficacy and outcome expectations are positively related to career interest. CONCLUSION: The pursuit of upgrades in academic qualifications and practice accreditation could enhance nurses' outcome expectations, thus enhancing their interest in a nursing career. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital managers could develop policies, procedures and programmes to encourage nurses to enhance their academic qualifications or practice accreditation, helping enhance their interest in remaining in the nursing career.

How career facilitators and barriers influence nurses' professional turnover intention.

AIMS: Our study investigates the influence of career facilitators and barriers on nurses' improvement of their professional capabilities and their professional turnover intention. BACKGROUND: Reducing nurses' professional turnover intention could help alleviate the global nursing shortage. Nevertheless, little research has addressed how career facilitators and barriers, nurses' improvement of their professional capabilities and professional turnover intention are related, indicating a gap. DESIGN: This study used a cross-sectional design. METHODS: We surveyed 502 out of 2,660 full-time nurses who worked for a medical centre in Taiwan between January-March 2018. Our items were adapted from Cunningham et al. and Teng et al. and had adequate reliability and validity. Structural equation modelling was used to test the study hypotheses. RESULTS: Human capital, social capital, and discrimination were positively related to intention to improve professional capabilities. Moreover, intention to improve professional capabilities was positively related to action to improve professional capabilities, which was negatively related to professional turnover intention. CONCLUSION: Most of the career facilitators and even barriers, boost the improvement of professional capabilities and are useful for retaining nurses in the nursing profession. IMPACT: Findings of this study should have an impact on nursing managers by offering them means to retain nurses, for example, enhancing human capital and social capital among nurses to reduce their turnover intention.

Body Posture Angle Affects the Physiological Indices of Patients With Liver Cirrhosis Ascites.

The study objective was to compare the effect of different angles of lying positions on the physiological indices of patients with cirrhosis ascites. Chronic liver disease and cirrhosis were ranked 9th among the top 10 causes of death. Ascites is the most common cirrhosis comorbidity. Body posture can affect pulmonary ventilation and arterial oxygen partial pressure, making it an important clinical nursing intervention significantly affecting patient recovery. This was a quasi-experimental study design. From a medical center in Taiwan, 252 patients with cirrhosis ascites were recruited. Subjects were randomly divided into three groups by bed angle: 15°, 30°, and 45°. Physiological indices were measured at 5, 10, 15, 20, 25, and 30 minutes to determine any changes in heart rate, respiration rate, and oxygenation saturation. Data analysis included descriptive statistics and the generalized estimating equation for statistical analysis with significance set at α= 0.05. After controlling for confounding variables, the three groups differed significantly in heart rate at 20, 25, and 30 minutes, oxygenation saturations at 15 and 20 minutes, and respiration rate at 5 and 10 minutes (α< 0.05). Body posture can affect pulmonary ventilation and arterial oxygen partial pressure and is thus an important clinical nursing intervention that significantly affects the recovery of patients. When caring for patients with cirrhosis ascites, nurses should help patients to choose the most comfortable angle for them with no particular restrictions. Our results can be used to guide nurses in making a plan for health education and nursing that improves the quality of care for patients with chronic liver disease and cirrhosis patients with ascites.

[The Effectiveness of Pulmonary Rehabilitation for Critical-Care Ventilator Patients: A Systematic Review].

BACKGROUND: Prolonged of use mechanical ventilators results in respiratory muscle atrophy and difficulties in weaning, which increase mortality rates and psychlogical distress. While pulmonary rehabilitation has been shown to improve respiratory muscle strength, the effects of this intervention in critical-care patients who use mechanical ventilation remain uncertain. PURPOSE: The present paper uses a systematic review of the literature to evaluate the effects of pulmonary rehabilitation on the rate of ventilator weaning and on the physical performance of ventilator patients receiving critical care. METHODS: A systematic review was used. Searches were conducted in databases including: Cochrane Library, Embase, MEDLINE, PubMed and Airit Library. Keywords that were used included: "mechanical ventilation", "pulmonary rehabilitation", "exercise", "weaning", and "activities of daily living". The search focused on articles that were published prior to February 2015. Based on inclusion and exclusion criteria, 7 articles addressing relevant randomized controlled trials were extracted. RESULTS: All of the 7 studies supported that pulmonary rehabilitation interventions improve mechanical ventilation weaning and functional independence activities. Several studies were limited by small sample size and differences in the types of rehabilitations used. Thus, the generalizability of the findings of this review is limited. and further research is required to verify the effects of pulmonary rehabilitation. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this systematic review support that pulmonary rehabilitation interventions improved the weaning rate, activities of functional independence, and maximal inspiratory pressure (MIP) in critical patients who had used mechanical ventilators for over 48 hours. Under hemodynamic-stablized and pressure-support mode, inspiratory muscle training is suggested as useful for patients with limited ability to participate in rehabilitation programs.

The effectiveness of the newly designed thermal gown on hypothermic patients after spinal surgery.

AIMS AND OBJECTIVES: To develop the newly designed thermal gown to test the effectiveness in relieving postoperative hypothermia as compared to traditional cotton cloth. BACKGROUND: Hypothermia is a common problem after spinal surgery. A patient's safety and comfort are significant. Currently, most research is focused on instruments that relieve a patient's hypothermia. Studies have rarely considered a patient's comfort while caring for their body temperature. DESIGN: This study employed an experimental design. The participants were assigned randomly to two groups: the experimental group (N = 50) and the control group (N = 50). METHODS: The experimental group received the newly designed thermal gown intervention. The control group received the standard postanaesthesia care unit re-warming intervention. The material used to collect data included demographic data, postoperative management and comfort level. Nurses measured patients' vital signs and asked for patients' subjective comfort level on admission to the postanaesthesia care unit every 10 minutes until their discharge from the postanaesthesia care unit. RESULT: The accumulated percentage for thermal gown group patients in reaching 36 °C during the first 20 minutes of admission was significantly higher than that of the cotton cloth group. The thermal gown group individuals showed significantly higher comfort levels (score = 4) at 10 minutes, when compared to the cotton cloth group. CONCLUSION: Results suggested that the newly designed thermal gown had effectively improved postoperative temperature and comfort level with an evidence-based intervention. RELEVANCE TO CLINICAL PRACTICE: Maintaining a patient's body temperature is a major task for nurses working in the post-anaesthesia care unit. With the newly designed thermal gown, the duration of a patient's stay in the postanaesthesia care unit was shortened and the patient's comfort was increased.

[A Project to Improve the Time-Effectiveness of Routine Morning Blood Tests].

BACKGROUND & PROBLEMS: Morning blood sampling, conducted around 4am to 5am, is routinely ordered due to nothing-by-mouth (NPO) requirements and clinical practice norms. However, this routine may interrupt the normal sleep of patients and decrease the satisfaction of patients with the care received. However, our night-shift staff is not able to take all blood samples during this time, resulting in a high rate of overdue reporting. PURPOSE: To reduce the overdue rate of laboratory result from 62.3% to less than 19.3%. RESOLUTION: In 2013, we performed interventions including the process reengineering of blood sampling to meet the needs of laboratory result flows and the upgrading of equipment in our neurology ward. The reengineering strategies used included the redistribution of blood sampling times in order to decrease testing for unnecessary items. The equipment upgrades improved the ability of the carrier in the pneumatic tube systems to carry the chilled blood samples. An independent two-sample t-test was used to compare the overdue rate before and after the interventions. RESULTS: The overall overdue rate for the blood sampling to laboratory flow improved from 62.3% before the intervention to 18.0% (t = 7.07, p < .001) after the intervention. Furthermore, the overdue rate for the testing done at the stat laboratory improved from 66.9% to 21.3% (t = 7.36, p < .001), while the overdue rate for the testing done at the non-stat laboratory improved from 52.4% to 17.8% (t = 5.37, p < .001). Besides, the satisfaction of both inpatients and nurses with regard to blood-sampling flow improved from 51% and 54.2%, respectively to 93% (t = 51.10, p < .001) and 94% (t = 12.26, p <.001). CONCLUSIONS: Our process reengineering strategies and the upgrading of the pneumatic tube system successfully reduced the overdue rate for the blood sampling and increased the satisfaction of inpatients.

[The Experiences of Obstructive Sleep Apnea in Women].

BACKGROUND: Obstructive sleep apnea (OSA) is a potentially lethal respiratory sleep disorder. However, few studies have studied OSA women. PURPOSE: The purpose of the current study was to explore the life experiences of women with OSA. METHODS: A qualitative study using the grounded theory method was used to establish a descriptive theory. RESULTS: The results were expressed in terms of three stages with related categories. Stage 1: No interest days due to poor sleep, including "uncontrollable sleep", "perceived health deteriorates", and "poor female image harmed by snoring"; Stage 2: Indecision and disappointments during treatment seeking, including "doctor shopping", "being urged by others to seek medical help", and "being shocked by the severity of disease"; and Stage 3: Accepting a new lifestyle with a continuous positive pressure respirator, including "adaptation of the new sleep", "adequate sleep", and "secret worry of being an OSA woman". CONCLUSIONS: Based on the findings of the present study, medical knowledge and treatments related to OSA should be widely promoted with appropriate professional education and counseling services in order to enhance the awareness of patients and to facilitate their acceptance of the healing process using a continuous positive airway pressure respirator.

[Effects of head posture on oxygenation saturation, comfort, and dyspnea in patients with liver cirrhosis-related ascites].

BACKGROUND: Chronic liver disease and cirrhosis are collectively ranked as the ninth most prevalent cause of death in Taiwan. Ascites is the most common comorbidity associated with liver cirrhosis. Different body postures affect pulmonary ventilation and arterial oxygen partial pressure. Thus, ensuring proper body posture in patients is an important clinical nursing intervention that significantly affects the recovery of patients. PURPOSE: This study investigates the effects of head posture on oxygenation saturation, comfort, and dyspnea in patients with liver cirrhosis-related ascites. METHODS: A quasi-experimental study design was used. A total of 252 participants were recruited from a medical centre hospital in Taiwan. Participants were allocated randomly into three groups of bed-elevation angles: 15 degrees, 30 degrees, and 45 degrees. The physiological indices were measured at 5, 10, 15, 20, 25, and 30 minutes in order to investigate the change in oxygenation saturations that were attributable to the different angles. Data were analyzed using descriptive statistics. The generalized estimating equation (GEE) was used for statistical analysis, with the level of significance set at: α = .05. RESULTS: After controlling for confounding variables, the results showed that patients in the three groups earned similar scores for the degree of difficulty in the oxygen values. The supine group earned significantly different scores than the other two groups in terms of blood oxygen values related to time to change the angle of the three groups at five minutes after adjusting the angle (p < .01). This study found no differences among the three groups in terms of comfort. In terms of breathing, this study found a significant difference between 45-degree and 15-degree supine dyspnea (p < .05). Therefore, patients with ascites at 15 degrees supine and with better access to better oxygen saturation had superior results to their peers at 30 degrees and 45 degrees supine. Furthermore, this group was less likely to perceive breathing difficulties. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study may guide health education and care for nurses in order to improve the quality of care for patients with chronic liver disease / cirrhosis with concomitant ascites.

The comparison of two recovery room warming methods for hypothermia patients who had undergone spinal surgery.

PURPOSE: The purpose of this study was to compare the time needed to reach a specified temperature and the efficiency of two warming methods-warm cotton blankets and a radiant warmer-for hypothermia patients in a postanesthetic care unit (PACU) after spinal surgery. DESIGN: This study was conducted according to a quasi-experimental design. Data were collected from a medical referral center in northern Taiwan. A total of 130 post-spinal surgery patients with hypothermia were recruited in the study. METHODS: Of the 130 patients in the PACU, 65 were warmed by the radiant warmer (group R); whereas the other 65 patients were warmed by warm cotton blankets (group B). Tympanic temperature was measured for each patient every 10 min until it reached 36 °C in the PACU. Analysis of covariance and generalized estimating equation regression analysis were performed to compare the time needed to reach a specified temperature and the efficiency of the two warming methods, respectively. FINDINGS: Both groups were similar in their baseline characteristics. After adjusting for temperature upon arrival at the PACU, group R needed a significantly shorter time for rewarming to 36 °C than group B (F [1, 125]= 58.17, p < .001). The results of the generalized estimating equation also showed that the radiant warmer was more efficient than warm cotton blankets in increasing patients' body temperatures to 36 °C (χ2 = 37.44, p < .001). None of the patients appeared to have wound infections, and there were no differences in the length of hospital stay or medical costs for current hospitalization in both groups. CONCLUSIONS: Using the radiant warmer may be a more efficient method than providing warm cotton blankets for warming post-spinal surgery hypothermia patients in the PACU. CLINICAL RELEVANCE: For hospitals that are unable to use forced-air warming to warm postsurgical hypothermia patients in the PACU, the radiant warmer is a more efficient device to rewarm patients.

The Fall Risk Screening Scale Is Suitable for Evaluating Adult Patient Fall.

(1) Background: This study aimed to test the feasibility of utilizing the screening tool for fall risk assessment in adult inpatient and verify its accuracy in a medical center in Taiwan. (2) Methods: This study retrospectively collected all adult fall cases among inpatients occurring in the general wards of a medical center between 1 January 2013 and 31 December 2015. This inpatient fall risk screening scale was measured by the sensitivity, specificity, and accuracy. (3) Results: There were 1331 (0.4%) falls among a total of 357,395 inpatients during this period. Factors predictive of falling risk included: age, consciousness, body shift assistance, use of fall risk medications, fall history, dizziness or weakness, toileting, and impaired mobility. Using the eight-factor assessment, two was the best cutoff point for identifying the fall risk group, with area under Receiver Operating Characteristic (ROC) curve (AUC) = 0.817, sensitivity = 80.93%, specificity = 73.0%, accuracy = 73.03%, and likelihood ratio = 11.48. (4) Conclusions: The accuracy of the eight-item fall risk assessment tool created for this study was validated. These results can serve as a reference for institutions to develop more effective fall risk assessment scale for inpatients, enabling clinical nurses to identify and more comprehensively assess the groups at highest risk for falling during their hospital stay.

The Post-Traumatic Growth of Primary Caregivers of Patients after Liver Transplantation.

Liver transplantation is a very important surgery. In many cases, it involves two loved ones (receiver and donor in the same family) and causes stress and feelings of burden in family caregivers. The purpose of this study was to investigate post-traumatic growth in primary caregivers of liver transplant patients. A cross-sectional research design was adopted to recruit 84 participants. The Perceived Stress Scale, Short-Form Coping Strategies Scale, and Post-traumatic Growth Scale were used. The results revealed that the total score of perceived stress of the main caregivers of liver transplantation was 27.27 ± 6.63; problem-oriented coping and emotion-oriented coping were used as the main coping strategies, and the traumatic growth score was 42.01 ± 13.84. All three variables were significant predictors of post-traumatic growth (F = 13.71, p < 0.05), explaining 38% of the total variance. This study can help nurses understand the post-traumatic growth status and related factors of the main caregivers of liver transplant patients. It can also help caregivers understand their own perceived pressure and then take relevant care measures to reduce the degree of physical and mental load and achieve a balanced state.

The Effects of a Scenario-Based Spiritual Care Course on Spiritual Care Competence among Clinical Nurses: A Quasi-Experimental Study.

Across their lifespans, and in many clinical settings, patients have spiritual care needs. Many nurses lack competence related to providing spiritual care. Popular educational strategies, such as simulated educational programs and objective structured clinical examinations (OSCE), have not been widely adopted in nursing spiritual care education. The purpose of this study was to explore the effects of a scenario-based spiritual care course on spiritual care competence in nurses. This quasi-experimental study employed a repeated-measures pre-test/post-test design with assessments immediately before, immediately after, and 3 months post-intervention. Nurses providing direct patient care in diverse clinical settings were recruited from a large medical foundation in northern Taiwan. The intervention was a one day scenario-based spiritual care course and OSCE. The experimental group (n = 53) and controls (n = 85) were matched for their similar units, ages, working experience, and clinical ladder status. The Spiritual Care Competence Scale (SCCS), Spiritual Perspective Scale (SPS), Spiritual Care Perspective Scale-Revised (SCPS-R), and reflection logs were completed by both experimental and control groups. The Course Satisfaction Scale, OSCE Checklist, and Standardized Patient Feedback Scale (SPFS) were completed by the experimental group only. The experimental group had significantly higher SPS scores and self-evaluated SCCS scores, and lower SCPS-R scores (more positive spiritual perspectives), than controls at 3 months post-intervention. The experimental group showed significant within-subject effects at three time points on SPS scores, SCPS-R scores, and self-evaluated SCCS scores. Mean global performance of OSCE was 3.40 ± 0.91, and SP feedback indicated strengths and areas for improvement. In conclusion, the scenario-based spiritual care course effectively enhanced nurses' spiritual care competence, competence, and skills. Blended education techniques can therefore enhance nurses' ability to support patients with spiritual care needs.