E-Learning in Nursing and Midwifery during the COVID-19 Pandemic.

As the COVID-19 pandemic continues to spread, e-learning has increased. This is a challenge for nursing and midwifery students, as clinical training is an essential part of their education. The aim of this review was to identify the advantages and limitations of e-learning for nursing and midwifery students during the COVID-19 pandemic. A systematic review of the literature was conducted following the PRISMA guidelines. The international databases PubMed, CINAHL/MEDLINE, Web of Science, and ScienceDirect were searched. Articles were critically appraised. Thematic analysis was used to synthesise the data. The search resulted in 91 hits. Thirteen studies were included in the final analysis. Three main themes were identified: (1) the benefits of e-learning; (2) the challenges/limitations of e-learning; and (3) recommendations for e-learning. E-learning in nursing and midwifery is an effective alternative learning process during the COVID-19 pandemic. Students perceive several benefits and challenges related to internet access, technical equipment, financial aspects, and work and family commitments.

Perceptions of Patient Safety Culture among Triage Nurses in the Emergency Department: A Cross-Sectional Study.

The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. "Job Satisfaction" received the highest score (63.18%; SD = 17.19), while "Working Conditions" received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.

Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings.

Poor sleep quality is prevalent among older adults, but limited data document associations between frailty and quality of life comparing individuals living in the community with those in nursing homes. This cross-sectional study (conducted between August and November 2019) included 831 older adults (mean age 76.5 years) from Slovenia's community and nursing home settings. The results showed comorbidity in 38% of community-dwelling older adults and 31% of older adults in nursing homes. The prevalence of frailty among community-dwelling older adults was 36.5%, and among older adults in a nursing home was 58.5%. A total of 76% of community-dwelling older adults and 95.8% of nursing home residents reported poor sleep quality. Sleep quality and frailty predict 42.3% of the total variability of quality of life for older adults in nursing homes and 34.8% for community-dwelling older adults. The study's results indicate that the quality of life can be affected by factors (e.g., worse sleep quality and frailty) among older adults, regardless of being a resident or from the community. Understanding how sleep quality is affected by social, environmental, and biological factors can help improve sleep quality and potentially the quality of life of older adults.

Factors contributing to patient safety during triage process in the emergency department: A systematic review.

BACKGROUND: Triage is a dynamic environment in which large numbers of people can present. It presents a vulnerable assessment point, as a triage nurse must assess a patient's urgency level and analyse their health status and expected resource needs. Given the critical nature of triage, it is necessary to understand the factors contributing to patient safety. OBJECTIVES: To identify and examine the factors contributing to patient safety during the triage process. METHODS: A systematic review of the literature was undertaken, and a thematic analysis of the factors contributing to patient safety during the triage process. PubMed, CINAHL, Web of Sciences, Science Direct, SAGE, EMBASE and reference lists of relevant studies published in English until March 2022 were searched for relevant studies. The search protocol has been registered at the PROSPERO (CRD42019146616), and the review was conducted using the PRISMA criteria. RESULTS: Out of 5366 records, we included 11 papers for thematic synthesis. Identified factors contributing to patient safety in triage are related to the emergency's work environment, such as patient assessment, high workload, frequent interruptions and staffing, and personal factors such as nurse traits, experience, knowledge, triage fatigue and work schedule. CONCLUSIONS: This review shows that patient safety is influenced by the attitude, capabilities and experiences of triage nurses, the time when nurses can dedicate themselves to the patient and triage the patient without disruption. It is necessary to raise awareness among nursing administrators and healthcare professionals to provide a safe triage environment for patients. RELEVANCE TO CLINICAL PRACTICE: This review highlights the evidence on the factors contributing to patient safety in the triage process. Further research is needed for this cohort of triage nurses in the emergency department concerning ensuring patient safety. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was required to design or undertake this review.

Experiences with dignity among older people confined to beds living in a nursing home: A qualitative descriptive study.

AIM: The aim of this study is to explore the concept of dignity from the experience of older people with limited mobility and confined to beds while living in a nursing home. BACKGROUND: Nursing staff have an important impact on the dignity of those older people confined to beds in nursing homes. Individuals' uniqueness with respecting dignity should be ensured. METHODS: A qualitative descriptive study was conducted. The study was carried out with 19 older people who were immobile and confined to bed and living in nursing homes. The individual in-depth interviews were conducted between July and October 2021. Inductive thematic analysis was used to synthesize data. RESULTS: The main theme 'Dignity of older people confined to bed' emerged from subthemes 'Emotions', 'Lived experience' and 'Failure to maintain care'. The participants expressed their dissatisfaction towards the nursing staff's disrespectful care, which evoked feelings of insignificance and inferiority. CONCLUSION: Undignified and disrespectful nursing care can cause feelings of suffering, sadness and anger in older people confined to their beds. Nurses must listen to this group of older people and learn from their experiences. Compassionate, person-centred care with kindness and empathy should be provided by all those providing and receiving care in nursing homes. IMPLICATIONS FOR NURSING MANAGEMENT: To provide dignified care, nursing staff must understand the importance of person-centred, individually oriented nursing care for older people living with immobility in nursing homes.

Development of a slovenian version of the pittsburgh sleep quality index (PSQI-SLO) for use with older adults.

BACKGROUND: Poor sleep quality predicts poor quality of life, poor self-rated health, and chronic diseases and mental disorders among older adults. The Pittsburgh Sleep Quality Index (PSQI) is the most widely used self-report measure of sleep quality in older adults. OBJECTIVES: This study aimed to assess internal reliability, face validity, content validity and internal consistency of the Slovenian version of the PSQI (PSQI-SLO) for sleep quality in older adults. METHODS: A cross-sectional study was used to evaluate content and face validity as well as reliability (ɑ, ω and item-total correlations). Residents of 13 nursing homes and community-dwelling older adults from all regions of Slovenia were sampled. A total of 831 participants aged 65 years and older participated in the study between March and August 2019. RESULTS: All items were successfully translated to Slovenian. A minor cultural adaptation was made to improve the clarity of the meaning of all items. None of the items had an item content validity index (I-CVI) score lower than 0.50. Kappa indices were excellent for half of the items and good for the remainder. Internal consistency agreed with prior research (ɑ = 0.74). Intraclass correlation coefficient for global PSQI-SLO was 0.62 (p < 0.001). The total score of PSQI-SLO (8.09 ± 3.64 (95%, CI = 7.85-8.34)) was expected and comparable. Fifty-eight and four tenths' per cent (95%, CI = 55%-62%) had at least one chronic disease and 40% (95%, CI = 37%-42%) lived in a nursing home. CONCLUSIONS: PSQI-SLO showed adequate internal consistency and test-retest reliability, and adequate construct and criterion validity. The instrument can be important in assessing older adults' subjective sleep quality in nursing homes, home environment and clinical settings.

Family members' experiences with the spiritual care of older people living with dementia in nursing homes: A phenomenological hermeneutical study.

AIM: To illuminate family members experiences with the spiritual care provided to their family members living with dementia in nursing homes. DESIGN: A qualitative research design utilizing phenomenological hermeneutical approach. METHODS: Data were gathered by conducting twelve in-depth interviews with family members of older people living with dementia in nursing homes and analysed using the phenomenological hermeneutical analysis. The COREQ guidance was used for reporting of this study. RESULTS: Finding revealed that family members were worried and fearful when nursing care was routinely provided with little consideration given to spiritual needs and lacking compassion. Findings affirm that "riendliness" is an essential aspect of respectful caring from the family members' perspective. Family members want compassionate, loving, caring and dignified nursing care for their relative living with dementia in the nursing homes.

Diabetes management of older adults in nursing homes: A retrospective study.

AIM: To examine the diabetes management of older adults in nursing homes. BACKGROUND: Diabetes is an increasing problem in nursing homes, and diabetes care is defined as a neglected clinical area. METHODS: A retrospective collected data review of 166 older adults with known diabetes from four nursing homes. RESULTS: 65% older than 75 years had HbA1c levels lower than 7.5% (58 mmol/mol), 74% older than 85 years had HbA1c levels lower than 8% (64 mmol/mol). The HbA1c levels were 7.3% (56 mmol/mol) for those who had three and more chronic disorders and 6.8% (51 mmol/mol) for those who had less than three chronic disorders. Individuals treated with insulin had higher HbA1c levels (p < .001) and glycaemia (p = .002). Age was associated with a number of chronic disorders (p = .031), a number of regularly prescribed medications (p = .038) and a number of medications as needed (p = .009). CONCLUSIONS: More than half to three quarters have diabetes well-managed. Nevertheless, there is still some potential for improving diabetes care, and these findings warrant further research for improving diabetes management of older adults in nursing homes. IMPLICATIONS FOR NURSING MANAGEMENT: Interventions designed to promote a healthy lifestyle, documenting individuals' target level and regular monitoring of glycaemia and HbA1c levels may help to improve diabetes management, which may result in better well-being and quality of life for older adults with diabetes in nursing homes.

A qualitative study of family members' experiences of their loved one developing dementia and their subsequent placement in a nursing home.

AIM: To investigate the family members' experiences with receiving help and support while their loved one develops dementia and their subsequent placement in nursing homes. BACKGROUND: As the dementia disease progresses, some family members will struggle with the option of nursing home placement. This situation can precipitate feelings of anger, disappointment and guilt, all of which can be overwhelming. METHODS: A qualitative descriptive study with in-depth interviews (n = 19) was carried out in several nursing homes of Slovenia's North Eastern Region. RESULTS: Inductive thematic analysis identified two main themes: (i) developing the diagnosis and (ii) accommodation process. Family members noticed the progressive behavioural changes in their loved ones. While they were searching for help at the primary health care level, they experienced a lack of help and support. CONCLUSIONS: When family members detect behavioural changes in their loved ones, the primary health care team should establish an early diagnosis of dementia and provide adequate decision-making support. IMPLICATIONS FOR NURSING MANAGEMENT: The findings are useful to prepare guidance for a family member to inform them of the types of support available and from which associations and organisations. To achieve adequate management support, primary health care teams need to be aware of family member experiences.

Self-reflection during first clinical practice: The experiences of nursing students.

BACKGROUND: Self-reflection can be used as a tool for describing student experiences and have a significant impact on their learning. It enables nursing students to develop the ability to identify and analyse their problems and find possible solutions. OBJECTIVE: To present students' self- reflection in their first clinical practice as their first stage of our nursing study program. METHODOLOGY: The research was based on a naturalistic philosophical paradigm using a qualitative methodological approach. The research took place at one of the Slovenian universities with an undergraduate nursing education program. Purposive sampling was chosen. The data were obtained through written self-reflection diary entries collected between March and June 2016. A thematic analysis was selected for data analysis. Ensuring that all ethical considerations were covered, seventeen students in the first clinical practice were included. FINDINGS: Three main thematic themes were identified that define the experience of students in their first clinical practice: (1) emotional experience, (2) interpersonal relationships, (3) learning. CONCLUSIONS: The research has found that the experiences and the perceptions of students in the first clinical practice are mainly expressed emotionally. Self-reflection helps students to express emotions and feelings to reliving and to identifying problems and also, to understanding themselves better. Further research should be focused on the importance of the students' self-reflections in their professional and personal growth.