ABSTRACT
BACKGROUND: As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background. OBJECTIVES: Explore views on perceived training needs among professionals around the world and how these related to country cultures. DESIGN: Cross-sectional, descriptive, mixed-methods international online survey. METHODS: Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses. RESULTS: A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences. CONCLUSIONS: Future research should further explore other factors such as the level of digital maturity of the workplace. IMPACT STATEMENT: Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care.
Subject(s)
Robotics , Humans , Artificial Intelligence , Cross-Sectional Studies , Health Personnel , CultureABSTRACT
The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. OBJECTIVE: To learn about the experience of nurses in caring for people with coronavirus in critical care units. METHOD: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. RESULTS: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". DISCUSSION: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. CONCLUSIONS: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.
Subject(s)
COVID-19 , Critical Care Nursing , Critical Care , Humans , Intensive Care Units , PandemicsABSTRACT
La pandemia por COVID-19ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos.Objetivo: Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos.Método: Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso.Resultados: En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien».Discusión: Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados.Conclusiones: Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.
The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units.Objective: To learn about the experience of nurses in caring for people with coronavirus in critical care units.MethodA qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis.Results: This article shows the findings around the theme the value of human resources which is nuanced through sub-themes it's not the beds, it's the expert staff, shouldering the patient's burden, and suffering because they have not cared well.Discussion: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge.Conclusions: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.
Subject(s)
Humans , Female , Pandemics , Critical Care , Health Personnel , Nurses , Intensive Care Units , Betacoronavirus , Women , Nursing , Interviews as Topic , Health Workforce , Stress, Psychological , Qualitative ResearchABSTRACT
The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. Objective: To learn about the experience of nurses in caring for people with coronavirus in critical care units. Method: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. Results: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". Discussion: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. Conclusions: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.
ABSTRACT
BACKGROUND: The assessment of the acquisition of clinical competencies is a critical issue for nursing students. 360-degree evaluations are a widespread practice in professional competency assessment and can be applied to the learning/teaching process of future nurses. OBJECTIVES: To determine the effectiveness of the implementation of a 360-degree evaluation proposal for assessing the competencies acquired by third-year nursing students during their clinical placements. DESIGN: A mixed-methods design was used with a primary component (a cross-sectional descriptive observational design) and a parallel qualitative component. PARTICIPANTS: Sixty-seven third-year nursing students from a public university in Madrid, Spain, who were undertaking their clinical placements during seven weeks in medical/surgical units in hospital settings. METHODS: This study was conducted between September 2017 and May 2018. Quantitative data were obtained using assessment tools specifically developed for this 360-degree evaluation proposal. Qualitative information was collected from two focus groups, one with students and one with teaching staff. A descriptive analysis of the quantitative data was conducted. Qualitative data were studied using a thematic analysis. RESULTS: The mean scores for each of the items in the 360-degree evaluation were high, with the highest grades being observed in the evaluations made by peers and patients (a mean of 9.1 out of 10.0). On average, the 360-degree evaluation method yielded grades 0.067 percentage points higher than did the previous evaluation method (pâ¯≤â¯0.001). Students and teaching staff encountered difficulties in the evaluations made by users/families and other members of the healthcare team (nursing assistants and physicians), although they rated the overall proposal as being very powerful in terms of educational value. CONCLUSIONS: The 360-degree evaluation method is an innovative, motivating, and integrating approach to the acquisition of competencies with a focus on excellence.
Subject(s)
Education, Nursing, Baccalaureate , Students, Nursing , Clinical Competence , Cross-Sectional Studies , Humans , Learning , SpainABSTRACT
AIM: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. BACKGROUND: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. METHODS: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. RESULTS: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. CONCLUSIONS: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.
Subject(s)
Empathy , Midwifery , Cross-Sectional Studies , Female , Humans , Leadership , Pregnancy , Surveys and QuestionnairesABSTRACT
BACKGROUND: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM: The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS: An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS: The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS: Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY: Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).
Subject(s)
Education, Nursing , Empathy , Nurse's Role , Cross-Sectional Studies , Humans , Surveys and QuestionnairesABSTRACT
La medicina actual ha realizado grandes progresos en el último siglo consiguiendo que se viva más tiempo y mejor que antes. Pero este avance no se ha trasladado al campo de la muerte. El buen morir es hoy privilegio de unos pocos. El moribundo reclama su derecho a un fin digno. Su petición es, habitualmente, desoída por los profesionales sanitarios. La Ley de Autonomía del paciente, con la regulación del Testamento Vital o Voluntades anticipadas supone un giro en este sentido. El objetivo del presente artículo es dar a conocer la normativa actualmente vigente relacionada con el testamento vital o últimas voluntades mediante una revisión crítica de la legislación existente
Current medical practice has made great process over the past century which permits people to live longer and better than before. But this improvement has not been transferred to the field of death. To die with dignity today is a privilege only a few have. Those close to death claim their right to a death with dignity. Their petition usually goes unheard by the medical profession. The patients´ autonomous law, which regulates last will and testaments or anticipated final wishes, is a step in this direction. The objective of this article is to publicize the current legal regulations related to ast wills and testaments or last wishes by means of a critical review of teh existing legislation
