Analysis of education and previous nursing experience of certified PNPs in the United States.

BACKGROUND: Educational programs to prepare nurse practitioners (NPs) were historically built upon foundational nursing experience. Originally prepared as certificate programs in 1965, the educational requirements for nurse practitioners (NPs) rapidly shifted from certificate programs to the Master's degree (DellaBella, 2015; Fairman, 2008). As Doctor of Nursing Practice (DNP) degree programs increase in number, it is unknown whether this foundational nursing experience has changed, or if it differs by certification type for pediatric nurse practitioners (PNPs). This study aimed to evaluate the educational preparation and prior nursing experience of primary care and acute care certified PNPs. METHODS: A national survey of members of the Pediatric Nurse Practitioner Certification Board (N = 17,530) was completed (Mudd et al., 2022). A sub-analysis of this data was conducted (n = 1974). RESULTS: There was no statistical evidence among either primary or acute care PNPs of an association between previous nursing experience and type of degree preparation (Master's or DNP). There was only a weak association between educational preparation and experience among acute care nurse practitioners. Most respondents were prepared at the Master's level, and 85% of all respondents had >1 year of nursing experience prior to returning for additional PNP education. DISCUSSION: This study adds to the literature as it describes the educational preparation and foundational nursing experience of primary and acute care PNPs. It can serve as a benchmark as the move to the DNP continues for Advanced Practice Registered Nurse preparation.

Role cognition of assigned nurses supporting Hubei Province in the fight against COVID-19 in China: a hermeneutic phenomenological study.

Aims: During the COVID-19 epidemic, nurses played a crucial role in clinical treatment. As a special group, front-line nurses, especially those assigned to support Hubei Province in the fight against COVID-19 between February and April 2020, brought diverse experiences from different provinces in China in taking care of COVID-19 patients and role cognition. Therefore, our purpose is to explore the real coping experience and role cognition of front-line nurses during the novel coronavirus outbreak to provide relevant experience references for society and managers in the face of such major public health emergencies in the future. Design: This qualitative study was performed using the phenomenological hermeneutics method. Method: This is a qualitative phenomenological study. Semi-structured in-depth interviews were used to collect data. The interviewees were 53 front-line nurses who assisted and supported the fight against COVID-19 in Hubei Province during the COVID-19 epidemic. Data were collected through individual online and telephone interviews using a semi-structured interview during March 2020. The COREQ guidance was used to report this study. Results: The findings revealed that front-line nurses assisting in the fight against COVID-19 developed a context-specific role cognition of their work and contribution to society. The qualitative analysis of the data revealed 15 sub-categories and 5 main categories. These five themes represented the different roles identified by nurses. The roles included expectations, conflicts, adaptation, emotions, and flow of blessing. Belief in getting better, a sense of honor, and training could help them to reduce feelings of conflict in this role and adapt more quickly. Discussion: This article discusses the real coping experience and role cognition of front-line nurses during the novel coronavirus epidemic. It provides relevant experience references for society and managers to face similar major public health emergencies in the future. This study makes a significant contribution to the literature because it demonstrates how non-local nurses sent to Hubei to work perceived their roles as part of a larger narrative of patriotism, duty, solidarity, and hope.

Empowering nurses: exploring self-managed organizations in Indian healthcare.

BACKGROUND: Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. METHOD: This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. RESULTS: The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. CONCLUSION: In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.

Factors related to intensive care unit Nurses' work engagement: A web-based survey.

A questionnaire survey on the personal and work factors related to work engagement among intensive care unit nurses concerning their recovery experiences and the nursing practice environment was conducted using a web-based tool. Two individual factors (demographics and experience on recovery from job stress) and four work factors (work employment type, nursing method, COVID-19 nursing experience, and nursing practice environment) were surveyed. Data from 244 participants were obtained, and survey items were analyzed using a multiple regression analysis with work engagement as the dependent variable. The results show that 3-5 years of nursing experience is significantly associated with lower work engagement. Conversely, certifications for higher-level and specialized nursing, mastery experience such as learning new things, 1-9 days/month of COVID-19 nursing experience, and suitable nursing practice environment were significantly associated with higher work engagement. These factors are considered important for improving the work engagement of intensive care unit nurses.

Nursing Dilemmas in Chemotherapy-Induced Peripheral Neuropathy: A Qualitative Study of a Tertiary Hospital in China.

Purpose: This study investigated the experience of oncology nurses caring for chemotherapy-induced peripheral neuritis patients. Patients and Methods: Through phenomenological research method, 11 nurses in a tertiary hospital in Shanghai were interviewed using face-to-face semi-structured interviews. Data analysis was conducted with the thematic analysis approach. Results: This analysis revealed the experiences of oncology nurses in caring for patients with CIPN and identified three themes: 1) stress in the nursing of CIPN (inadequate knowledge of CIPN among oncology nurses, oncology nurses' CIPN nursing skills need to be improved, negative emotions of oncology nurses at work); 2) environmental dilemmas in nursing of CIPN (lack of effective care norms, busy schedules, doctors pay little attention to CIPN); 3) oncology nurses' desire to improve their knowledge of CIPN to meet care needs. Conclusion: Based on the perspective of oncology nurses, the care dilemma of CIPN is mainly influenced by individual and environmental factors. It is recommended to enhance the attention of oncology nurses to CIPN, set specific and feasible training courses, explore CIPN assessment tools that meet our clinical practice, and construct CIPN care programs to improve CIPN clinical care ability and reduce patient suffering.

Nursing during the COVID-19 pandemic: A reflective thematic analysis of how the hamster wheel shifted personal and professional control.

AIM: The aim of this national study was to examine the experience of nurses 9-12 months after the onset of the pandemic. DESIGN: This article reports the reflective thematic analysis of the qualitative portion of a mixed methods study of the experiences of 1319 Canadian nurses between February to May 2021. METHODS: Data gathering occurred through open-text box questions in an online survey. RESULTS: Three overarching themes were found: (1) the hamster wheel, (2) the shifting sense of control, and (3) the inability to leave the pandemic at work. CONCLUSION: This research presents a national perspective of nurses which contributes to the wider global narrative. The experience of redeployment, nurses as decision-makers, communication and leadership challenges were all factors impacting mental health and intraprofessional collaboration. IMPLICATIONS FOR THE PROFESSION: The findings revealed the immense pressure, mental health concerns, and professional implications for nurses in all domains. PUBLIC OR PATIENT CONTRIBUTIONS: No public or patient contributions.

Clinical experiences of final-year nursing students during the COVID-19 pandemic: A systematic review and meta-synthesis.

OBJECTIVES: This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students. DESIGN: A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. DATA SOURCES: Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic. REVIEW METHODS: Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings. RESULTS: Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic. CONCLUSIONS: The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.

Whole-process nursing management for laparo-gastroscopic esophagectomy.

Background: Advances in surgical, anesthesia, and nursing techniques have allowed the development of laparo-gastroscopic esophagectomy (LGE) as a minimally invasive treatment of esophageal cancer. This study summarizes the experience of patient whole-process nursing management for patients who received LGE. Methods: The implementation of LGE at Zhongshan Hospital, Fudan University, was initiated in June 2020. The procedure is indicated for patients with thoracic conditions that can compromise the outcomes of traditional surgical procedures, and is performed coordinately by thoracic surgeons and endoscopists. A whole-process nursing protocol covering peri-operative patient management was proposed based on the LGE procedure. The operative outcomes were analyzed in this study. Results: The data of 10 consecutive patients who received LGE and the whole-process nursing protocol were analyzed, and all patients were compliant with the nursing protocol. Intra-operatively, there were no complications or conversions to other surgical methods. Post-operatively, pulmonary complications occurred in 2 cases [1 patient experienced aspiration, underwent preventive tracheotomy, and was discharged on postoperative day (POD) 10; 1 patient developed a left pleural effusion requiring puncture and drainage, and was discharged on POD 7]. The 30-day mortality was not recorded from the primary LGE cohort. Conclusions: The whole-process nursing protocol showed safety and feasibility for patients who underwent LGE. In the future, more specialized and whole-process nursing management will be carried out for patients undergoing such operations.

Daily reality of violence in a rural emergency department: Is violence becoming the new normal?

OBJECTIVES: Violence in emergency healthcare is a persistent and concerning problem. The objective of the present study was to explore and understand rural nurses' views on the daily experience and impact of violence, and its perpetrators. METHODS: The present study took a descriptive exploratory approach. Two focus groups were held with nurses from an ED at a rural hospital in New South Wales, Australia. RESULTS: Violence occurred regularly and had a significant impact on staff. Nurses go to work expecting to search patients for weapons and be physically and verbally abused. Tolerating and being able to manage violence has become a rite of passage. CONCLUSIONS: The present study shows that rural workers, like metropolitan workers, feel experiences of violence are a routine part of their roles. Violence in healthcare is a societal issue, that cannot be solved without a multifactor approach that considers the characteristics of the perpetrators.

A study on nursing effect of integrated traditional Chinese and Western medicine management mode on COVID-19.

AIM: This study aims to explore the effect of integrated traditional Chinese and Western medicine management mode on nursing care of patients with coronavirus disease 2019 (COVID-19). METHODS: The study included 142 COVID-19 patients hospitalized in Huoshenshan Hospital from February to March 2020. Nursing measures in the treatment (n = 111) and control (n = 31) groups included integrated management care and usual care. The integrated management model had eight components: WeChat group management, early Traditional Chinese Medicine (TCM) treatment, emotional nursing, music therapy, observation of tongue coating and pulse, vital Qi strengthening, preventing recurrence after recovery, and an individualized follow-up scheme. The endpoints included clinical outcome, recovery time of clinical symptoms and signs, days of hospital stay, and survival without intensive care unit (ICU) admission. RESULTS: Recovery time from clinical symptoms such as fever, cough, shortness of breath, muscle aches, and fatigue in the treatment group was shorter than that in the control group. Less time was required to show negative chest computed tomography findings in the treatment group than in the control group (13.0 ± 2.8 vs. 16.7 ± 3.9, p < .025). The lengths of hospital stay in the two groups were 16.4 ± 7.3 days (treatment group) and 24.4 ± 4.8 days (control group) (p < .001). Kaplan-Meier curves for survival without ICU transfer showed statistical difference between the two groups (χ2 = 5.427, p = .020). CONCLUSIONS: Our study shows that the integrated management mode can relieve the symptoms of patients faster, shorten hospital stay and disease course, and reduce the rate of ICU transfers.

Nurses' barriers to caring for patients with COVID-19: a qualitative systematic review.

AIM: The aim of this qualitative systematic review is to identify and synthesize qualitative studies of frontline nurses' experiences and challenges when caring for patients with COVID-19 in hospitals. BACKGROUND: This review is the first qualitative systematic review of nurses' experiences since the beginning of the COVID-19 pandemic in 2020. Understanding nurses' experiences with COVID-19 is important because nurses are among the most vital of healthcare workers. METHODS: This study used a qualitative systematic review methodology with thematic synthesis to analyse the included studies. Five databases (CINAHL, PubMed, Ovid, Web of Science, and PsycINFO) were searched from January to mid-August 2020, and 25 abstracts were screened. Based on inclusion criteria, this qualitative systematic review included nine studies. RESULTS: Five themes were identified as barriers to COVID-19 care by 133 hospital-based nurses: limited information about COVID-19, unpredictable tasks and challenging practices, insufficient support, concerns about family, and emotional and psychological stress. CONCLUSIONS: The five barriers identified in this review should be overcome to improve nurses' experiences and, in turn, the quality of care patients with COVID-19 receive. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings from this review can be used to reform current healthcare and hospital-support systems for populations with COVID-19. They can also be used to point towards areas of research interested in improving frontline nursing. Finally, nursing leaders, healthcare policymakers and governments should use these findings to better support the nursing workforce in the current or a future pandemic.

Nursing experiences of COVID-19 outbreak in Iran: A qualitative study.

AIM: The global outbreak of coronavirus in 2020 was considered as a serious risk for healthcare providers, especially nurses. This study aimed to investigate nurses' perceptions and experiences of COVID-19 outbreak in Iran. DESIGN: This thematic analysis study was conducted in March 2020. METHOD: Semi-structured interviews were conducted with 24 nurses in Qazvin, Arak, Shiraz and Kashan cities of Iran. RESULTS: It was found out that all the participants had faced a mysterious world created by the virus. No one had clear understanding of the new virus and knew how to tackle with such a virus. In this case, the main experiences were related to defected preparedness, the worst perceived risk, family protection, social stigma and sacrificial commitment. Urgent preparedness of facilities in such outbreaks is inevitable. Accordingly, psycho-social support of nurses and their families and strengthening their sacrificial commitments are proposed in these conditions.

Transition into remote and rural nurse education and careers: a qualitative study of student nurses.

BACKGROUND: Global nurse shortages present a threat to the sustainability of remote and rural healthcare. Interventions have been developed to support recruitment and retention of nurses that focus on providing pre-nursing experience for school pupils who intend to pursue nursing careers. However, there is a lack of evidence around how pre-nursing experience supports transition into nurse education. AIMS: This study aims to explore the impact of a pre-nursing scholarship for school pupils in remote and rural areas of Scotland on experiences of transition into nurse education. METHODS: This was a qualitative study involving semi-structured telephone and face-to-face interviews with pre-nursing scholarship participants. RESULTS: An authentic pre-nursing experience supported school pupils' transition to nurse education. First, it increased students' self-efficacy, both in their decision to choose nursing as a career and their ability to nurse. Second, it helped students to realise that the opportunity to study closer to home was available to them. Third, it supported students' educational and social integration, helping them feel prepared for university teaching and learning approaches and the social experience of being a student. CONCLUSIONS: Pre-nursing experience can support transition into nurse education and contribute to career pathways that support recruitment and retention of nurses in remote and rural areas.

Experiences of people living with disorders of sex development and sex reassignment: Meta-ethnography of qualitative studies.

AIM: The aim of this study was to synthesize the experiences of people with disorders of sex development. BACKGROUND: The quality of life of people with disorders of sex development depends largely on the availability of good psychosocial and psychosexual management. There is a lack of qualitative systematic reviews of the literature on the experiences of people with disorders of sex development. DESIGN: The seven steps of qualitative meta-ethnography were employed in this review. DATA SOURCES: The following electronic databases were systematically searched until January 2017: Science Direct, Scopus, Sage online, CINAHL, PsycINFO, Medline, Wiley Online Library, and Google Scholar. Search terms for this review were "disorders of sex development," "intersex," "ambiguous genitalia," "experiences," "qualitative study," and "method". REVIEW METHOD: A 13-item scale was applied to evaluate the quality of the selected studies and synthesized using the principles of meta-ethnography. FINDINGS: Twelve studies met the eligibility criteria. Six major themes described the experiences of people with disorders of sex development. These included a range of physical, psychological, social, and sexual experiences which affect their quality of life. Different coping strategies were employed by individuals who live with the lifelong condition. CONCLUSION: Disorders of sex development affect the quality of life of people living with these disorders. Nurses are tasked with providing holistic care for people with disorders of sex development in order to improve their quality of lives. As such, there is a need to explore the experiences of nurses in the management of disorders of sex development.

Clinical Efficacy of Trimetazidine and Holistic Management in the Treatment of Coronary Heart Disease.

BACKGROUND: To investigate the clinical efficacy of trimetazidine and holistic management in the treatment of coronary heart disease. METHODS: A total of 128 cases of patients with coronary heart disease were admitted in The Second Affiliated Hospital of Dalian Medical University from October 2014 to June 2017. These patients were divided into control group and experimental group, with 64 patients each. The patients in the control group underwent conventional treatment. On this basis, the patients in the experimental group were treated with trimetazidine. Both groups underwent holistic management. The clinical conditions, echocardiography indexes, life quality, and mental states of patients were compared between the two groups. RESULTS: The total efficient rate of patients in the control group was significantly lower than that of the experimental group, and the difference was statistically significant (P<0.05). After treatment, the left ventricular ejection fraction of patients in the experimental group was higher than that of the control group; the left ventricular end diastolic diameter and left ventricular posterior wall thickness of patients in the experimental group were lower than those of the control group, and the differences were statistically significant (P<0.05). The physiological health score, mental health score, Hamilton Depression Scale and Hamilton Anxiety Rating Scale of patients were significantly decreased compared with the control group, and the differences were statistically significant (P<0.05). CONCLUSION: The efficacy of trimetazidine in the treatment of coronary heart disease is definite. The assisting holistic management can significantly improve the mental status and life quality of patients by enhancing the cardiac function, which has clinical reference and promotion values.

Complexities and Challenges of Singapore Nurses Providing Postacute Home Care in Multicultural Communities: A Grounded Theory Study.

INTRODUCTION: Studies are needed to inform the preparation of community nurses to address patient behavioral and social factors contributing to unnecessary readmissions to hospital. This study uses nurses' input to understand challenges faced during home care, to derive a framework to address the challenges. METHODS: Semistructured interviews were conducted to saturation with 16 community nurses in Singapore. Interviews were transcribed verbatim and transcripts independently coded for emergent themes. Themes were interpreted using grounded theory. RESULTS: Seven major themes emerged from 16 interviews: Strained social relationships, complex care decision-making processes within families, communication barriers, patient's or caregiver neglect of health issues, building and maintaining trust, trial-and-error nature of work, and dealing with uncertainty. DISCUSSION: Community nurses identified uncertainty arising from complexities in social-relational, personal, and organizational factors as a central challenge. Nursing education should focus on navigating and managing uncertainty at the personal, patient, and family levels.

Effect of syndrome and its nursing application of Poractant Alfa Injection in treatment of neonatal respiratory distress / 中国生化药物杂志

Objective To observe and analyze the Poractant Alfa Injection treatment of neonatal respiratory distress syndrome and the effect of nursing. Methods A total of 60 cases of neonatal respiratory distress syndrome were used as the research object, the patients were divided into two groups of test analysis, study group and control group of 30 patients, two groups of children were using Poractant Alfa Injection for treatment, the control group with routine nursing, the study group using humanized nursing, nursing effect comparison. Results After treatment and nursing, blood gas monitoring index in the study group, mechanical ventilation parameters were better than the control group, P<0.05, the difference was statistically significant. At the same time the study group with family satisfaction with care and compared with the control group increased significantly (P<0.05). Conclusion For children with neonatal respiratory distress syndrome during the treatment by Poractant Alfa Injection, The effect of humanistic nursing is more obvious, which can effectively improve the clinical symptoms of children, and the implementation of nursing intervention can also improve the satisfaction of the families of the children and the effect of treatment.

Effect of syndrome and its nursing application of Poractant Alfa Injection in treatment of neonatal respiratory distress / 中国生化药物杂志

Objective To observe and analyze the Poractant Alfa Injection treatment of neonatal respiratory distress syndrome and the effect of nursing. Methods A total of 60 cases of neonatal respiratory distress syndrome were used as the research object, the patients were divided into two groups of test analysis, study group and control group of 30 patients, two groups of children were using Poractant Alfa Injection for treatment, the control group with routine nursing, the study group using humanized nursing, nursing effect comparison. Results After treatment and nursing, blood gas monitoring index in the study group, mechanical ventilation parameters were better than the control group, P<0.05, the difference was statistically significant. At the same time the study group with family satisfaction with care and compared with the control group increased significantly (P<0.05). Conclusion For children with neonatal respiratory distress syndrome during the treatment by Poractant Alfa Injection, The effect of humanistic nursing is more obvious, which can effectively improve the clinical symptoms of children, and the implementation of nursing intervention can also improve the satisfaction of the families of the children and the effect of treatment.

Application of the systematic nursing management of "one specialty with four kinds of standardizations" in transrectal ultrasound guided prostate biopsy / 中华泌尿外科杂志

Objective To discuss the application of the systematic nursing management of "one specialty with four standardizations" in transrectal ultrasound guided prostate Biopsy. Methods We have set up the "one specialty with four standardizations" method and accomplished the systematic nursing management in the management of transrectal ultrasound guided prostate biopsy in Changhai Hospital from September 2014 to February 2015. One specialty means to set up the prostate biopsy full-time nurses and the four standardizations means the standardization of selecting criteria, appointment procedures, working process and the post-biopsy work.Results The whole procedure of prostate biopsy has been simplified and clarified. This management helped to shorten the time for making the appointment, reduce the incidences of postoperative complications significantly and increase the patients satisfaction. It helped to build a well-defined responsibility for all the medical staff in prostate biopsy and make sure the reasonable medical resource distribution and the efficiency of medical work. It also maximized the health rights of the patients and medical safety. During the period when the "one specialty with four standardizations" nursing management was in effect, no biopsy related adverse event, disputes or protests occurred. Both the patients and the relatives satisfaction degree have been raised significantly.Conclusions The "one specialty with four standardizations" nursing management in prostate biopsy helps to simplify the appointment procedure and this management turned out to be safe and effect. It has achieved preferable results in clinical application and worth further spreading.

[Nursing Experience With a Patient With Gastrostomy Leakage Resulting in Moisture-Associated Skin Damage].

Leakage is a common complication of gastrostomy. Exposure of the skin surrounding the gastrostomy tube to moisture or chemical irritants may cause moisture-associated skin damage (MASD) and seriously affect the patient's quality of life. This case study describes a nursing experience with gastrostomy leakage that resulted in MASD. An assessment conducted from July 29, 2015 to August 20, 2015 revealed that heavy gastronomy leakage had caused extensive skin erosion, ulceration, hyperplasia, and superficial infection. Simultaneously, the patient was required to conduct complex stoma care, which resulted in physical and psychological exhaustion. Changes in traditional tube and wound care were discussed on multiple occasions with an interdisciplinary healthcare team. Based on the evidence-based literature, we provide gastrostomy and MASD management strategies. Through team collaboration, we prevented gastric contents from contacting the patient's skin directly, improved patient comfort, controlled effluent and skin infections, maintained fluid and electrolyte balances, and acce-lerated the healing of the damaged skin. We recommend that healthcare professionals caring for patients with gastrostomy leakage be provided with early skin protection programs to learn the standard methods for identifying and correcting leakage factors, containing effluent, and adequately stabilizing the gastrostomy tube in order to reduce the impact on the patient's quality of life. In addition, patient education on tube and skin care should be provided to prevent the reoccurrence of complications.