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2.
Infect Drug Resist ; 17: 1937-1950, 2024.
Article in English | MEDLINE | ID: mdl-38770367

ABSTRACT

Objective: This study seeks to assess the influence of an educational program on enhancing the knowledge, attitudes, and practices of NICU nurses regarding MDROs. Methodology: Quasi-experimental design that investigated the efficacy of an educational intervention in shaping the knowledge, attitudes, and practices of mothers working as nurses in NICU toward MDROs was used. A total of 168 nurses participated, divided into 84 intervention groups and 84 non-educational groups. Results: The analysis of overall knowledge scores before and after the educational interventions revealed a significant improvement in post-education knowledge scores (Mean = 16.94) compared to pre-education scores (Mean = 12.9929; t(83) = 40.119, p < 0.001). Attitude scores exhibited a notable improvement post-education, with mean scores increasing from 46.64 in the pretest to 58.45 in the posttest. The total attitude shift was statistically significant (t(83) = 104.23, p < 0.001 0). Regarding overall practice, the data suggests a positive impact of education on neonatal nurses' practices related to antibiotic usage (t(3) = 149.31, p < 0.001). A significant positive correlation was found between post-knowledge and post-attitude (r = 0.251, p = 0.021). Conclusion: Based on the study findings, the MDROs educational program demonstrated its effectiveness in improving nurses' knowledge and attitudes toward MDROs, serving as a valuable educational resource for nurses. Given the increasing demand for nurses with MDROs knowledge, attitude, and practice in NICU, and considering the documented positive impact on protecting neonates from fatal infections, enhancing nurses' knowledge, attitudes, and practices toward MDROs has become imperative.

3.
SAGE Open Nurs ; 10: 23779608241253977, 2024.
Article in English | MEDLINE | ID: mdl-38770424

ABSTRACT

Introduction: The literature indicates that pandemics significantly impact the mental health of frontline health workers. While the effects of COVID-19 on the mental health of frontline nurses have been studied, their lived experiences remain insufficiently explored. Objective: This study aims to investigate the lived experience of nurses who were deployed to support Wuhan during the COVID-19 pandemic. Methods: This study adopted a qualitative study design. A purposive sample of fifteen nurses were recruited from a group of nurses who supported Wuhan during COVID-19 pandemic. The data was collected during May and June 2020. Data collection occurred in May and June 2020, employing semistructured interviews conducted via telephone. Interpretative phenomenological analysis (IPA) was utilized to analyze the collected data by two independent researchers. This report follows the COREQ checklist. Results: Frontline nurses supporting Wuhan likened their experience to being on a battlefield. Four superordinate themes emerged: (1) mobilization for combating COVID-19; (2) rapid adaption to a dynamic high-stress environment; (3) navigating psychological distress; and (4) the journey home. Conclusion: This study offers comprehensive insights into the lived experience of nurses deployed from other provinces to assist COVID patients in Wuhan. The findings indicate that despite facing a variety of challenges, these frontline nurses were capable of rapid adaptation and successfully fulfilled their roles. Recommendations for future preparedness in public health emergencies are provided. Additionally, follow-up research is warranted to explore the long-term effects of frontline experience on the mental health of the nurses and their family members.

4.
Int J Nurs Stud ; 156: 104777, 2024 Apr 19.
Article in English | MEDLINE | ID: mdl-38772288

ABSTRACT

BACKGROUND: A favourable nursing practice environment and adequate nurse staffing have been linked to reduced patient mortality. However, the contribution of nursing care processes such as patient surveillance and escalation of care, on patient mortality is not well understood. OBJECTIVE: The aim of this study was to investigate the effect of the nursing practice environment, nurse staffing, missed care related to patient surveillance and escalation of care on 30-day inpatient mortality. DESIGN: A multi-source quantitative study including a cross-sectional survey of nurses, and retrospective data extracted from an audit of medical and admission records. SETTING(S): A large tertiary teaching hospital (600 beds) in metropolitan Sydney, Australia. METHODS: Data on the nursing practice environment, nurse staffing and missed care were obtained from the nursing survey. Patient deterioration data and patient outcome data were collected from the medical and admission records respectively. Logistic regression models were used to examine the association between the nursing practice environment, patient deterioration and 30-day inpatient mortality accounting for clustering of episodes within patients using generalised estimating equations. RESULTS: Surveys were completed by 304 nurses (84.5 % female, mean age 34.4 years, 93.4 % Registered Nurses) from 16 wards. Patient deterioration data was collected for 30,011 patient deterioration events and 63,847 admitted patient episodes of care. Each additional patient per nurse (OR = 1.22, 95 % CI = 1.04-1.43) and the presence of increased missed care for patient surveillance (OR = 1.13, 95 % CI = 1.03-1.23) were associated with higher risk of 30-day inpatient mortality. The use of a clinical emergency response system reduced the risk of mortality (OR = 0.82, 95 % CI = 0.76-0.89). A sub-group analysis excluding aged care units identified a 38 % increase in 30-day inpatient mortality for each additional patient per nurse (OR = 1.38, 95 % CI = 1.15-1.65). The nursing practice environment was also significantly associated with mortality (OR = 0.79, 95 % CI: 0.72-0.88) when aged care wards were excluded. CONCLUSIONS: Patient mortality can be reduced by increasing nurse staffing levels and improving the nursing practice environment. Nurses play a pivotal role in patient safety and improving nursing care processes to minimise missed care related to patient surveillance and ensuring timely clinical review for deteriorating patients reduces inpatient mortality. TWEETABLE ABSTRACT: Patient mortality can be reduced by improving the nursing practice environment & increasing the number of nurses so that nurses have more time to monitor patients. Investing in nurses results in lower mortality and better outcomes. #PatientSafety #NurseStaffing #WorkEnvironment #Mortality.

5.
J Nurs Scholarsh ; 2024 May 21.
Article in English | MEDLINE | ID: mdl-38773783

ABSTRACT

PURPOSE: To use machine learning to examine health equity and clinical outcomes in patients who experienced a nurse sensitive indicator (NSI) event, defined as a fall, a hospital-acquired pressure injury (HAPI) or a hospital-acquired infection (HAI). DESIGN: This was a retrospective observational study from a single academic hospital over six calendar years (2016-2021). Machine learning was used to examine patients with an NSI compared to those without. METHODS: Inclusion criteria: all adult inpatient admissions (2016-2021). Three approaches were used to analyze the NSI group compared to the No-NSI group. In the univariate analysis, descriptive statistics, and absolute standardized differences (ASDs) were employed to compare the demographics and clinical variables of patients who experienced a NSI and those who did not experience any NSIs. For the multivariate analysis, a light grading boosting machine (LightGBM) model was utilized to comprehensively examine the relationships associated with the development of an NSI. Lastly, a simulation study was conducted to quantify the strength of associations obtained from the machine learning model. RESULTS: From 163,507 admissions, 4643 (2.8%) were associated with at least one NSI. The mean, standard deviation (SD) age was 59.5 (18.2) years, males comprised 82,397 (50.4%). Non-Hispanic White 84,760 (51.8%), non-Hispanic Black 8703 (5.3%), non-Hispanic Asian 23,368 (14.3%), non-Hispanic Other 14,284 (8.7%), and Hispanic 30,271 (18.5%). Race and ethnicity alone were not associated with occurrence of an NSI. The NSI group had a statistically significant longer length of stay (LOS), longer intensive care unit (ICU) LOS, and was more likely to have an emergency admission compared to the group without an NSI. The simulation study results demonstrated that likelihood of NSI was higher in patients admitted under the major diagnostic categories (MDC) associated with circulatory, digestive, kidney/urinary tract, nervous, and infectious and parasitic disease diagnoses. CONCLUSION: In this study, race/ethnicity was not associated with the risk of an NSI event. The risk of an NSI event was associated with emergency admission, longer LOS, longer ICU-LOS and certain MDCs (circulatory, digestive, kidney/urinary, nervous, infectious, and parasitic diagnoses). CLINICAL RELEVANCE: Machine learning methodologies provide a new mechanism to investigate NSI events through the lens of health equity/disparity. Understanding which patients are at higher risk for adverse outcomes can help hospitals improve nursing care and prevent NSI injury and harm.

6.
J Emerg Nurs ; 2024 May 22.
Article in English | MEDLINE | ID: mdl-38775771

ABSTRACT

INTRODUCTION: Sexual assault nurse examiners are crucial care providers in cases of sexual assault. However, it is not clear whether sexual assault nurse examiner availability differs throughout the 13 states that comprise the Appalachian region of the United States. Therefore, this cross-sectional analysis identified sexual assault nurse examiner availability in 13 states and determined differences in availability by both county-level Appalachian status and county-level rurality status. METHODS: Data were downloaded from 2 public sexual assault nurse examiner registries for the included 13 states. Descriptive statistics of sexual assault nurse examiner certification type and availability by state were calculated. In addition, bivariate analyses of sexual assault nurse examiner availability by rurality and by Appalachian status were performed using 2-sample z-tests for equality of proportions. RESULTS: State-level sexual assault nurse examiner availability ranged from 0.34 to 0.86 sexual assault nurse examiners per 100,000 residents. Sexual assault nurse examiner availability in these 13 states did not differ by Appalachian status. However, rural areas had significantly lower sexual assault nurse examiner availability than urban areas in these 13 states. DISCUSSION: These data support previous literature on the need for stronger sexual assault nurse examiner programs in rural areas in the United States. Future research should take sexual assault prevalence into account to determine whether local sexual assault nurse examiner access needs, as well as appropriate support for sexual assault nurse examiners, are being met throughout Appalachian states.

7.
Iran J Nurs Midwifery Res ; 29(2): 166-179, 2024.
Article in English | MEDLINE | ID: mdl-38721234

ABSTRACT

Background: The present study was conducted to evaluate the level of social health and related factors in nurses. Materials and Methods: This systematic review and meta-analysis were done based on searching English and Persian articles published in PubMed, Scopus, Web of Science, Science Direct databases, Google Scholar, Scientific Information Database, Iranmedex, and Magiran from inception to January 2022. The mean (SD) of nurses' social health scores, their various dimensions, and related factors were extracted from the retrieved articles. Data analysis was performed using Review Manager software, and p < 0.05 was considered significant. Results: A total of 36 studies were reviewed for systematic review and 34 studies for meta-analysis. The total mean (SD) of social health in 9281 nurses was 57.13 (6.82) (on a scale of 0-100) with a 95% confidence interval of 50.31-63.95. Social health of nurses showed a statistically significant relationship with some demographic-personal factors and occupational-organizational factors. Conclusions: The level of nurses' social health was moderate which needs to be improved. To improve the performance of professional roles and the nursing care quality, it is necessary for healthcare system managers, especially nursing managers, to consider individual and organizational factors affecting nurses' social health in planning and decision making and try to increase nurses' social health. Some of the limitations of this study were that only reviewing quantitative cross-sectional studies and couldn't combine words when searching in Iranian databases.

8.
Iran J Nurs Midwifery Res ; 29(2): 159-165, 2024.
Article in English | MEDLINE | ID: mdl-38721247

ABSTRACT

Background: Injuries caused by sharp objects are a major health risk for nurses. These injuries can be extremely dangerous and lead to various diseases. The purpose of this study was to establish the pooled prevalence of Needle Stick Injuries (NSIs) among nurses in Iran. Materials and Methods: This study was a systematic review and meta-analysis. Eligible articles were searched from five electronic databases (Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus) and one search engine. A random effects model was conducted to estimate the pooled prevalence. The heterogeneity of the sample was tested using the I2 index, and the meta-regression function was used to evaluate variables suspected of heterogeneity at the 0.05 significance level. Finally, 21 articles were analyzed using the Comprehensive Meta-Analysis software (ver. 2.2.064). Results: Based on the random-effects model, the frequency of NSIs among Iranian nurses is 18.70% (95% CI: 15.10%-22.90%). The highest frequency is recorded in a teaching hospital in Tehran in 2007 (19.80%; 95% CI: 16.40%-23.70%), and the lowest frequency was recorded in a teaching hospital in Tehran in 2008 (17.90%; 95% CI: 14.60%-21.80%). Sample size, mean age, and work experience were significantly associated with and mean and frequency of NSIs in nurses (p < 0.05). Conclusions: NSIs occur in about one-fifth of nurses in Iranian hospitals. In addition to its cost burden, the increase in NSIs has negative consequences for nurses. Therefore, health policymakers and managers must take serious action to reduce these injuries.

9.
Iran J Nurs Midwifery Res ; 29(2): 263-267, 2024.
Article in English | MEDLINE | ID: mdl-38721242

ABSTRACT

Background: The magnitude of postpartum depression in Jordan during the COVID-19 pandemic is under-documented, and little is known about its potential social, demographic, and clinical correlates. This study aimed to explore the prevalence and related factors of postpartum depression among Jordanian mothers with a history of COVID-19 during pregnancy or after childbirth. Materials and Methods: This cross-sectional descriptive study was carried out in March-June 2021 among a convenient sample of 109 women with a history of COVID-19 during pregnancy or after childbirth, who were at a leading hospital equipped to care for COVID-19 cases in North Jordan. An online survey using the Edinburgh Postnatal Depression Scale (EPDS) was used to collect information from mothers with a history of COVID-19-positive tests. Results: Among the total number of women who participated in the study (n = 109), 73 women had postpartum depression. The prevalence of postpartum depression in the present study was 67%. In addition, the study found a positive statistically significant correlation between EPDS scores and being a smoker, delivery method, experiencing severe COVID-19 symptoms, and being hospitalized. Conclusions: During the COVID-19 pandemic, women had a high level of postpartum depression. It would be necessary to follow further the confirmed cases of COVID-19, and mothers should be screened for depressive symptoms during pregnancy and followed up for antenatal and postnatal care.

10.
Glob Ment Health (Camb) ; 11: e54, 2024.
Article in English | MEDLINE | ID: mdl-38721485

ABSTRACT

Background: Chinese nurses working with immense stress may have issues with burnout during COVID-19 regular prevention and control. There were a few studies investigating status of burnout and associated factors among Chinese nurses. However, the relationships remained unclear. Objectives: To investigate status and associated factors of nurses' burnout during COVID-19 regular prevention and control. Methods: 784 nurses completed questionnaires including demographics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, Impact of Event Scale-revised, Perceived Social Support Scale, Connor-Davidson Resilience Scale, General Self-efficacy Scale and Maslach Burnout Inventory. Results: 310 (39.5%), 393 (50.1%) and 576 (73.5%) of respondents were at high risk of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). The risk of EE, DP and reduced PA were moderate, high and high. Nurses with intermediate and senior professional rank and title and worked >40 h every week had lower scores in EE. Those worked in low-risk department reported lower scores in PA. Anxiety, post-traumatic stress disorder (PTSD), self-efficacy and social support were influencing factors of EE and DP, while social support and resilience were associated factors of PA. Conclusion: Chinese nurses' burnout during COVID-19 regular prevention and control was serious. Professional rank and title, working unit, weekly working hours, anxiety, PTSD, self-efficacy, social support and resilience were associated factors of burnout.

11.
Br J Nurs ; 33(9): 418-423, 2024 May 09.
Article in English | MEDLINE | ID: mdl-38722014

ABSTRACT

Arthritis is the leading cause of disability in Ireland with knee osteoarthritis the most common presentation. One in five women and one in 10 men over the age of 60 in Ireland are diagnosed with osteoarthritis. The causative factors are multifactorial, but the increasing incidence of obesity is contributing greatly to the occurrence of osteoarthritis of the weight-bearing joints. The rheumatology advanced nurse practitioner is an autonomous clinical practitioner and potential solution to the growing numbers of people needing interventions for osteoarthritis, due to their ability to assess, diagnose, treat, and discharge these patients who ordinarily would be assessed from a medical waiting list. As obesity is becoming increasingly prevalent, it is important to address this with the patient cohort to try to reduce the burden of disease and treat not only the symptomatic knee osteoarthritis but the causative factors and provide patient-centred care.


Subject(s)
Nurse Practitioners , Nurse's Role , Obesity , Osteoarthritis, Knee , Humans , Osteoarthritis, Knee/nursing , Ireland/epidemiology , Obesity/complications , Obesity/nursing , Obesity/epidemiology , Rheumatology , Male , Female , Middle Aged , Advanced Practice Nursing
12.
Nurse Educ Pract ; 77: 103947, 2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38723418

ABSTRACT

OBJECTIVE: This research aimed to examine students' emotions, opinions, and suggestions regarding the "Applied Scientific Research" course. METHOD: The study was conducted in a province in eastern Turkey between June and July 2023. Data were collected from 9 postgraduate students attending the "Scientific Research" course at a university's Institute of Health Sciences using a 'Descriptive Information Form' and a 'Semi-Structured Questionnaire'. Content analysis was employed for the qualitative data evaluation. RESULTS: The participants' ages ranged from 25 to 32. Six participants were female, five were academicians, and five were doctoral students. Six participants had taken a statistics or research course before the scientific research course. Additionally, seven had attended scientific conferences, five followed a scientific publication regularly, five had conducted scientific research before, and five had not published scientific research before taking the course. Through the analysis of data obtained from participant interviews, three themes, namely "Effects of Activities in the Course," "Reasons for Recommendations and Preferences," and "Outcomes of the Course," were identified. Six sub-themes and 18 codes were generated, including "Most Challenging Activity," "Least Challenging Activity," "Recommendations for the Course," "Reasons for Choosing the Course," "Contributions of the Course," and "Feelings Towards the Course." CONCLUSION: The research results indicate that students improved their skills in conducting scientific research, writing articles, and getting published after taking the course. Furthermore, the course evoked positive feelings in students and increased their perceived competence.

13.
Nephrol Nurs J ; 51(2): 135-141, 2024.
Article in English | MEDLINE | ID: mdl-38727589

ABSTRACT

This article examines the critical role of nursing leadership in the transition of nephrology care toward value-based models, highlighting how interdisciplinary care teams and population health management strategies are instrumental in improving patient outcomes and achieving health equity in kidney care. By reviewing both historical and present value-based care models in nephrology, this article showcases the evolution of care delivery and the strategic alignment of health care practices with value-based objectives. We introduce "HEALTH" as an innovative blueprint for nephrology nursing leadership, encapsulating key strategies to enhance kidney health care within the framework of value-based models. The acronym HEALTH stands for Holistic Care Integration, Equity and Tailored Care, Analytics and Machine Learning, Leverage Federal Programs, Training and Education, and Habit of Improvement, each representing a cornerstone in the strategic approach to advancing nephrology care. Through this lens, we discuss the impact of nursing leadership in fostering a culture of continuous improvement, leveraging technological advancements, and advocating for comprehensive and equitable patient care. This article aims to provide a roadmap for nursing leaders in nephrology to navigate the complexities of health care delivery, ensuring high-quality, cost-effective care that addresses the needs of a diverse patient population.


Subject(s)
Leadership , Nephrology Nursing , Humans , Nurse's Role , Delivery of Health Care/organization & administration
14.
J Perianesth Nurs ; 2024 May 08.
Article in English | MEDLINE | ID: mdl-38727654

ABSTRACT

PURPOSE: Anesthesia nurses play an important postsurgical role during the anesthesia recovery period, which is characterized by a high incidence of complications related to anesthesia and surgery. Strengthening staff allocation and skill management in the postanesthesia care unit (PACU) is therefore particularly important in managing length of stay. We aimed to investigate the effect of two schedule modes for anesthesia nurses on PACU efficiency. DESIGN: A retrospective observational cohort study. METHODS: We conducted a retrospective study in a large tertiary academic medical center. In 2018, the PACU operated with traditional scheduling and the nurse-to-patient ratio was 1.2:1. The PACU implemented intensive scheduling and this ratio was adjusted to 1:1 in 2019 by adjusting the anesthesia nurse allocation scheme. We compared the number of admitted patients, length of PACU stay, the incidence of anesthesia-related complications, and nurse satisfaction with the two modes. FINDINGS: The total number of admitted patients was 10,531 in 2018 and 10,914 in 2019. PACU admitted 401 more patients in 2019 than in 2018, even with two fewer nurses per day. Nevertheless, the median length of PACU stay in 2019 was statistically significantly shorter than in 2018 (29 [22-40] vs 28 [21-39], P < .001], while the incidence of anesthesia-related complications including postoperative pain, nausea and vomiting, hypertension, and shivering were comparable in the 2 years (P > .091). The intensive scheduling implemented in 2019 received more satisfaction from nurses than the traditional scheduling applied in 2018 (P < .01). CONCLUSIONS: The scheduling of anesthesia nurses affects PACU efficiency. The intensive scheduling mode implemented in 2019 resulted in a comparable number of admitted patients, a better quality of care, and higher nurse satisfaction than those under the traditional scheduling mode.

15.
Front Psychiatry ; 15: 1392811, 2024.
Article in English | MEDLINE | ID: mdl-38751419

ABSTRACT

Introduction: Attaining a favorable work-life balance is a complex and ongoing challenge in the nursing profession. According to a person-context interactionist perspective and the two-factor theory, this study investigated the underlying mechanism by which organizational support impacts work-family enrichment via protective factors (i.e., decent work) and depleting factors (i.e., burnout) among Chinese nurses. Methods: A descriptive cross-sectional research design was utilized in this study, employing an online questionnaire as the primary method for data collection. The study included 355 nurses who completed a self-reported questionnaire designed to measure variables such as organizational support, decent work, burnout, work-family enrichment, and demographic information. The collected data were analyzed using a chain mediation model in PROCESS macro (Model 6). Results: The findings of the analysis revealed that nurses reporting higher levels of organizational support also exhibited a greater sense of work-family enrichment. Moreover, the study identified indirect effects of organizational support on work-family enrichment, mediated by decent work and burnout. Discussion: These findings suggest that targeted interventions aimed at promoting organizational support can contribute to the overall well-being and work-life balance of nurses.

16.
Int J Orthop Trauma Nurs ; 54: 101104, 2024 May 09.
Article in English | MEDLINE | ID: mdl-38754341

ABSTRACT

BACKGROUND: The physical, psychological, and social effects of the earthquake affect a person's functionality directly. It challenges individuals because it is often traumatizing, intense fear is experienced, and it is unpredictable, uncontrollable, and destructive. Nurses are one of the professional groups that have important duties in social disasters, and they are constantly exposed to the details of the traumatic situation, sometimes physically and sometimes by listening. To understand the severity of the trauma caused by this exposure, it is important to understand the emotions and thoughts that nurses feel while caring for earthquake victims. AIMS: This study was planned to reveal the perceptions of nurses, who were themselves earthquake victims, regarding caring for earthquake victims through metaphors. METHODS: This study was conducted as a phenomenological study with a qualitative research approach, in a province affected by the earthquake, with 85 surgical clinic nurses who were also earthquake victims and cared for earthquake victims. RESULTS: The metaphors produced were examined together with their reasons and grouped under 3 categories (positive, negative, both positive and negative). CONCLUSIONS: As a result, when the metaphors used by earthquake victims are evaluated, the effects of nurses being earthquake victims themselves can be seen in the metaphors. It is revealed through metaphors that nurses' earthquake-related traumas are triggered while caring for earthquake victims.

17.
Public Health Nurs ; 2024 May 17.
Article in English | MEDLINE | ID: mdl-38757647

ABSTRACT

OBJECTIVES: Women's attendance to cervical cancer screening (CCS) is a major concern for healthcare providers in community. This study aims to use the various algorithms that can accurately predict the most barriers of women for nonattendance to CS. DESIGN: The real-time data were collected from women presented at OPD of primary health centers (PHCs). About 1046 women's data regarding attendance and nonattendance to CCS were included. In this study, we have used three models, classification, ensemble, and deep learning models, to compare the specific accuracy and AU-ROC for predicting non-attenders for CC. RESULTS: The current model employs 22 predictors, with soft voting in ensemble models showing slightly higher specificity (96%) and sensitivity (93%) than weighted averaging. Bagging excels with the highest accuracy (98.49%), specificity (97.3%), and ideal sensitivity (100%) with an AUC of 0.99. Classification models reveal Naive Bayes with higher specificity (97%) but lower sensitivity (91%) than Logistic Regression. Random Forest and Neural Network achieve the highest accuracy (98.49%), with an AUC of 0.98. In deep learning, LSTM has an accuracy of 95.68%, higher specificity (97.60%), and lower sensitivity (93.42%) compared to other models. MLP and NN showed the highest AUC values of 0.99. CONCLUSION: Employing ensemble and deep learning models proved most effective in predicting barriers to nonattendance in cervical screening.

18.
Clin Nurs Res ; : 10547738241253654, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38757758

ABSTRACT

Lack of access to primary care contributes to health inequities. Treatment settings that utilize the full experience and training of nurses, both registered nurses (RNs) and advanced practice registered nurses (APRNs), can expand in primary care and successfully address health inequities. This small study describes the implementation of a model of primary care called intensive primary care (IPC), which has eight elements that support the full utilization of a nurse's experience and training. This is a mixed method qualitative study, which reports the observations of the implementation and pre- and post-intervention measures. The IPC model was implemented at a free clinic, which targeted underserved population between 2020 and 2023. Participants were selected as a convenience sample. Participants were to have two or more chronic health problems The participants received primary care using the IPC model, which included setting self-management goals, and meeting with RN or APRN on a monthly basis (face to face, via phone or zoom) to monitor progress toward goals. Twenty-two people were approached, and 19 completed the intervention. Pre- and Post-intervention measures (Patient Assessment of Chronic Illness Care [PACIC]-20); Functional, Communicative, Critical Thinking Health Literacy; Perceived Stress; Patient Activation; Perceived Self Efficacy for Chronic Disease; EuroQo- 5 Dimension (EQ-5D); Trust in Provider; Emotional Support-Patient Reported Outcome Measure Information System (PROMIS); and Patient Health Questionnaire-9) were obtained and analyzed with paired T test (α < .05). Nurses involved meet weekly to share observations recorded in free form notes. These observations were summarized by two of the authors (MD and KF) at the end of the study. All patients had improved physical health outcomes, but more importantly, there were significant improvements in measures known to impact health and health outcomes, specifically, patient activation, self-efficacy for chronic illness, PACIC, and trust in provider. Time spent with patients, both duration and frequency of contact, was observed to have significant impacts.

19.
Omega (Westport) ; : 302228241252866, 2024 May 17.
Article in English | MEDLINE | ID: mdl-38758172

ABSTRACT

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

20.
Womens Health (Lond) ; 20: 17455057241247793, 2024.
Article in English | MEDLINE | ID: mdl-38733209

ABSTRACT

OBJECTIVE: The purpose of this study is to understand how school nurses, often the first line of defense for menstruating adolescents, use communication to assist adolescents in destigmatizing menstruation. DESIGN: I conducted semi-structured narrative interviews with nine nurses employed in a large school district in Northeast Indiana. METHODS: Interviews were coded, categorized, and used a phronetic iterative approach. RESULTS: Analysis determines that nurses assist menstruating students using steps toward accepting menstruation and suggesting ways to avoid menstrual stigmatization. CONCLUSION: This study suggests that school nurses use positive language to assist students in handling their menstruation problems, develop allyships with parents and other teachers, and stress menstrual education. This study highlights the need for more funding for menstrual products and additional school nurses.


Subject(s)
Menstruation , School Nursing , Social Stigma , Humans , Female , Adolescent , Menstruation/psychology , Indiana , Communication , Qualitative Research , Adult , Interviews as Topic , Students/psychology , Students/statistics & numerical data
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