Impact of On-the-Job Training on Nurses' Performance in Creating a Healing Environment and Clustered Nursing Care for Premature.

Introduction: Premature infants require specialized care, and nurses need to have specific skills and knowledge to provide this care effectively. Objective: To evaluate the impact of an on-the-job training program on the improvement of nurses' knowledge and practice related to creation of a healing environment and clustering nursing procedures. Methods: From January to April 2022, a study utilizing a one-group pre- and post-test design was conducted at NICUs in governmental hospitals. The study participants involved 80 nurses working in these NICUs. Researchers used predesigned questionnaire and checklist practice to collect the data pre and post the intervention. Results: 37.5% of the participants were aged between 25 and less than 30 years, with a mean age of 28.99 ± 7.43 years. Additionally, 73.7% of the nurses were female, with a mean experience of 9.45 ± 3.87 years. Prior to the intervention, the study found that a majority of the nurses (62.4%) demonstrated poor knowledge. However, after the intervention, a significant improvement was observed, with 60.0% of the nurses demonstrated good knowledge. Likewise, prior to the intervention, the study revealed that the majority of the nurses (83.8%) exhibited incompetent practice. However, post-intervention, a substantial improvement was observed, with 81.3% of the nurses demonstrated competent practice. Conclusion: On-the-job training had significant improvements in nurses' knowledge and practices regarding applying healing environments and clustering nursing care. On-the-job training is suggested as an adaptable, effective and low-cost technique to train nurses. To maintain the improvement achieved, ongoing instruction, feedback, assessment/reassessment, and monitoring are encouraged.

Are pediatric nurses prepared to respond to monkeypox outbreak?

BACKGROUND: Emphasizing the crucial significance of maintaining a national nursing workforce well-prepared with the necessary knowledge, skills, and abilities to respond effectively is the growing frequency of natural and environmental disasters, coupled with public health emergencies such as the COVID-19 pandemic. So, the study aimed to explore pediatric nurses' preparedness to monkeypox outbreak, and their stress during this outbreak in Egypt. METHODS: A cross-sectional study was conducted on a 416 nurses direct care for children at selected governmental hospitals in Egypt. Demographic form, Questionnaire for Infectious Disease Outbreak Readiness & Preparedness, factors affecting nurses' preparedness, and the generalized anxiety disorders scale-7 were the tools of the study. RESULTS: (81.5%) of studied nurses had unsatisfactory level of preparedness to monkeypox outbreak. (96.4%) and (95.4%) of them were affected their preparedness by high workload and inconsistent income with the of risk of infection factors. Also, (57.2%) of them had high stress level. CONCLUSIONS: The study revealed the importance of ensuring adequate supplies of PPE are available and provided, and protocols must be implemented to ensure availability in case of an outbreak. Moreover, nurse staffing levels and workload distribution should be regularly reviewed to create reasonable nurse-patient ratios.

The Stress Levels of Premature Infants' Parents and Related Factors in NICU.

Introduction: Parental stress related to their infants' hospitalization is a significant concern that affects both parents and their infants. Fathers' experiences tend to be understudied compared to mothers. Further research on fathers' stress levels is necessary. While parental stress has been correlated with infant health severity, the specific causes and risk factors contributing to heightened stress levels in parents of neonatal intensive care unit (NICU) infants are not yet fully understood and require further investigation. Objective: This study aimed to examine the stress levels experienced by parents of premature infants in the NICU and to explore the factors associated with parental stress in this specific context. Methods: A cross-sectional observational design was used to accomplish this study, which was carried out on 743 parents from nine different NICUs located in governmental hospitals across various locations in Egypt. We used characteristics of parents and premature infants, and Parent Stress Scale was used for data collection. Results: A majority of parents reported experiencing high stress in the following domains: sight and sound (80.3%), infants' appearance (69%), and the parent-infant relationship (81.4%). Additionally, about three-quarters (73.6%) of parents experienced high stress overall, with a mean score of 167.56 (21.3). Conclusion: About three-quarters of the parents experienced high overall stress levels. Also, factors that were found to affect parents' stress levels included premature infants connected to mechanical ventilators, previous neonatal death, parents living far from hospitals, infants delivered through cesarean section, insufficient income, and prolonged hospitalization beyond 5 days.

Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis.

Introduction: Nursing care plays a pivotal role in promoting patient well-being and optimizing health outcomes. The nursing profession is characterized by its commitment to delivering high-quality care to patients. Objective: The purpose of the study was to explore the role of nursing professional commitment as a mediator between the work environment and missed nursing care. Methods: A cross-sectional analysis study "STROBE guideline" used an online structured questionnaire to collect data. It was conducted on a sample of 813 nurses who worked at seven governmental hospitals in Egypt, in the hospital wards, operating rooms, intensive care unit (ICU) or outpatient clinics, during a 4-month period from April to August 2022. Researchers used Characteristics of nurses, Nursing Work Index-Revised, Nursing Professional Commitment Scale, and MISSCARE Questionnaire to collect the data. Structural equation modeling by AMOS was used for testing nursing professional commitment as a mediator between the work environment and missed nursing care. Nurses' professional commitment was used as a mediator between work environment and missing nursing care. Results: The working environment has a direct impact of -0.175, an indirect impact of -0.139, and a total impact of -0.314. Furthermore, professional commitment has a direct impact of -0.421. Additionally, when the working environment increases by 1, professional commitment increases by 0.33. Similarly, when the working environment increases by 1, missed care decreases by 0.175. Moreover, when professional commitment, as a mediating factor, increases by 1, missed care decreases by 0.421. Conclusion: In conclusion, the findings of this study highlight the significant role of professional commitment as an intermediary factor between the working environment and missed nursing care. According to these results, it is necessary to formulate and implement intervention strategies to improve nurses' professional commitment and working environment, which is the key to reducing their missed nursing care.

The Beneficial Effects of Emotional Intelligence Training for Critical Care Nurses on Job Burnout: A Quasi-Experimental Study.

Background: Critical care nurses are at especially high risk of burnout. Burnout is a maladaptive response to work-related stress that is associated with negative consequences for patients. Emotional intelligence enables nurses to make better decisions and manage their patients more effectively. It impacts positively on the quality of care. This study aimed to assess the effect of emotional intelligence training on job burnout for nurses at the critical care units. Materials and Methods: A quasi-experimental study was conducted at two critical care units: the Cardiac Surgery Academy and El Demerdash Hospital, both of which are affiliated to Ain Shams University. The subjects were 200 critical care nurses. Each group of nurses trained for five sessions, each lasting about two hours, in the form of seminars. Researchers collected data through self-administered questionnaires containing three parts (demographic data of nurses, Wong and Law's Emotional Intelligence Scale and Maslach burnout inventory). Results: For emotional intelligence, the mean (SD) score of studied nurses pre-intervention was 19.95 (6.30), while post intervention it was 36.4 (9.57), a significant difference (t = 14.01 p = <0.01). Regarding burnout, the mean score of studied nurses pre-intervention was 59.61 (19.58), while post intervention it was 89.90 (19.60), (t = 16.05 p = <0.01). The regression model explains 67% of the variation in total emotional intelligence detected through R2 value 0.67 (F = 12.980 p = <0.001). Conclusions: The present study revealed that emotional intelligence training had positive effects on nurses' experience of burnout at work. Providing educational training programs about emotional intelligence for newly hired nurses is recommended.

Effect of Training Program on Knowledge and Practice of Breast feeding Women During COVID-19.

Aim: Evaluate the effect of the training program on knowledge and practice of breastfeeding women during coronavirus disease 2019 (COVID-19). Methods: One-group pretest/post-test quasiexperimental research design was utilized to accomplish the aim of this study. The study was carried out at the primary health care units Ad Dar Al Baida 1, Ad Dar Al Baida 2, Al Aziziyah at Riyadh Province of Saudi Arabia. The study included a convenience sample of 100 breastfeeding women. Tool: A structured interviewing questionnaire sheet was used for data collection that included three parts knowledge, reported practice, and demographic characteristics. Results: More than one-quarter (30%) and (28%) of studied women had satisfactory knowledge-related causes, risk factor and signs, symptoms of COVID-19 at preintervention, while the majority 85% and 86% of them had satisfactory knowledge postintervention at p-value <.01**. In addition, less than one-fifth (17%) and (16%) of studied women had satisfactory knowledge about Breastfeeding guidelines during COVID-19 and care of breastfeeding women during COVID-19, compared with most of them (89%) and (92%) postintervention at p-value <.01**. Conclusion: Based on our current study, it was concluded that the educational program effectively improves breastfeeding women's knowledge and practices. There was a highly statistically significant positive linear correlation between the breastfeeding women's knowledge and reported practices regarding COVID-19 infection before and after the implementation of the educational program at p < .0.

Self-Assessed Capabilities, Attitudes, and Stress among Pediatric Nurses in Relation to Cardiopulmonary Resuscitation.

Background: In emergency medicine, cardiopulmonary resuscitation (CPR) is one of the most stressful scenarios for nurses who conduct both basic and advanced resuscitation methods. Aim: This study aimed to assess nurses' self-assessed capabilities, attitudes, and stress related to CPR. Methods: This cross-sectional, observational study was carried out on 748 pediatric nurses at six governmental hospitals. A self-assessed ability questionnaire and a structured stress and attitude questionnaire was used for data collection. Results: For self-assessed abilities, 45.5% of the nurses had moderate scores. Concerning stress, 48.3% had moderate scores and 63.1% negative attitudes. Also, attitude and self-assessed abilities had a high-frequency negative effect on stress scores (P<0.05). Conclusion: Attitude scores increased and stress scores decreased significantly with postgraduate educational level, attendance at training courses on pediatric basic life support and automated external defibrillator use, being exposed to >10 cardiac arrest cases in the previous year, and having an advanced life-support license (P<0.05). Positive attitudes and improving self-assessed abilities decreased the nurses' stress levels related to CPR.

Implementation of enhanced recovery in cardiac surgery: An experimental study with the control group.

INTRODUCTION: The Enhanced Recovery After Cardiac Surgery protocol is the most recent addition to cardiac treatment. In this paper, we aimed to test the safety and viability of this protocol in our hospital to improve our standard of care. METHODS: This study was conducted as an experimental study with a historical control at the Maritime Heart Center, Halifax, Nova Scotia, Canada. In order to quantify the success of this protocol, we measured the postoperative Length of Hospital Stay and three intensive care unit variables: time to extubation, time to ambulation, and opioid consumption. In the study, 100 patients were in the Enhanced Recovery After Cardiac Surgery group, and 103 patients were used as historic controls-selected by strenuous chart review and selection criteria. RESULTS: The primary outcome (Length of Hospital Stay) was reduced from a mean of 8.88 ± 3.50 days in the control group to a mean of 5.13 ± 1.34 days in the Enhanced Recovery After Cardiac Surgery group (p < 0.001). Likewise, we observed a significant reduction in intensive care unit variables: time to extubation was reduced from 10.54 ± 7.83 h in the control group to 6.69 ± 1.63 in the Enhanced Recovery After Cardiac Surgery group (p < 0.01), and time to ambulation was reduced from 36.27 ± 35.21 h in the control group to 9.78 ± 2.03 in the Enhanced Recovery After Cardiac Surgery group (p < 0.01) and opioid consumption was reduced from 50.58 ± 11.93 milligram morphine equivalent in the control group to 11.58 ± 4.43 milligram morphine equivalent in the Enhanced Recovery After Cardiac Surgery group (p < 0.01). CONCLUSION: Enhanced Recovery After Cardiac Surgery protocols were seamlessly integrated into selected cardiac surgical patients, contingent on a high level of interprofessional communication and collaboration.

Effect of educational intervention on nurses' perception and practice of antimicrobial stewardship programs.

BACKGROUND: Nurse involvement in antimicrobial stewardship programs is insufficient, which limits the programs' effectiveness. To evaluate the effect of the training programs on nurses' perception and practice of antimicrobial stewardship to embed it in practice. METHODS: A quasi-experimental study without a control group was conducted on 115 nurses. A specifically validated and designed instrument was utilized to evaluate perception and practice before, after, and 2 months follow-up the training sessions. RESULTS: The difference between the pre, post, and 2 months follow-up tests was highly significant for the dimensions of knowledge, perception, and practice (P < .01). Also, nurses reported a lack of knowledge, lack of training, high workload as barriers of AMS. Nurses suggested ways to overcome barriers such as physician and manager support, in-service training every 6 months, and saving time for training and education. CONCLUSIONS: An educational intervention improved perception and practice among nurses related to antimicrobial stewardship and easily embedded it in practice.

The outcomes of a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping.

Our study aimed to assess the effects of creating a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping. The study had an experimental research design for the control and study group, each with 53 premature infants. We collected the data through the Vital Signs Sheet, Premature Infant Pain Profile, and Neonatal behavioral state. We used T-tests and chi-square tests to assess the differences between groups. There was a highly statistically significant difference between the study and control groups concerning respiration (p-value<0.01) and heart rate, systolic blood pressure, and O2 saturation (p-value<0.05). 90.6% of participants in the study group had a mild total premature infant pain profile, while 37.7% of the control group had a moderate total premature infant pain profile score. Applying a healing environment and clustering nursing care significantly improved respiration, heart rate, oxygen saturation, and systolic blood pressure. Furthermore, it increased sleep time and decreased wake state and pain score.

Effect of Clustering Nursing Care on Spreading COVID-19 Infection Among Nurses: A Retrospective Study.

Background: The nurse's first and most important responsibility is to protect themselves from contracting or spreading COVID-19. Purpose: Investigate the effect of applying clustering nursing care on spreading COVID-19 infection and fatigue level among nurses who provide nursing care for COVID-19 patients. Methods: Retrospective case-control study, where cases had a COVID-19 infection in the previous six months and controls were free. Internet-based survey sent to nurses at eight hospitals. Findings: A total of 100 cases and 250 controls. About 36.8% of nurses who did not apply clustering care suffered from COVID-19 infection. Meanwhile, 83.3% and 93.3% of those who clustered three and four procedures, were free of COVID-19 infection. Discussion: Applying clustering for nurses' care decreases spreading of infection among nurses and decreases fatigue level related to work. Female nurses, increased fatigue, and a lack of training are all factors that may contribute to the spread of CVID-19 infection among nurses.

Mattering perception, work engagement and its relation to burnout amongst nurses during coronavirus outbreak.

AIM: To assess the mattering perception, feelings of burnout and work engagement amongst nurses during coronavirus outbreak. DESIGN: Cross-sectional research design. METHODS: It conducted at Zagazig fever hospital and chest hospital on 280 nurses. A self-administered questionnaire containing four parts; characteristics, mattering at Work Scale, Burnout scale and Engagement scale. RESULTS: The present study reported that more than half of studied nurses had moderate mattering level and more than one-quarter of them had low mattering. More than two-fifth of studied nurses had moderate level and slight less than one-third of them had low engagement. More than two-fifth of studied nurses had moderate level of burnout, whilst slight less than one-third of them had high burnout, and one-quarter of them had low burnout.

Outcome of abdominal massage before gavage feeding on tolerated feeding for low birth weight infants.

AIM: To assess the effect of abdominal massage pre-gavage feeding on tolerated feeding for low birth weight (LBW) infants. METHODS: An experimental research design at a government hospital at Egypt. Purposive sample composed of LBW infants was randomly divided into study and control groups each with 60 LBW infants. RESULTS: A total of 55% of the participants in the study group grew sleepy, whereas only 15% of the studied participants in the control group grew sleepy. The abdominal circumference after feeding in the study group was 23.18 ± 2.99 cm, whereas that in the control group was 24.79 ± 2.99 cm. The gastric residual volume in the study group was 0.8 ± 0.10 ml, whereas that in the control group was 3.86 ± 1.03 ml. CONCLUSION: Finally, abdominal massage had a positive impact on the postfeeding state of alertness and feeding tolerance.

Impact of structured simulation-based and on-job training program on nurses' competency in pediatric peripheral intravenous cannulation: Children's hospital experience.

BACKGROUND: Peripheral intravenous cannulation (PIVC) is a frequent invasive, painful procedure in children. Nursing education and competency are of great importance to decrease complications. OBJECTIVES: to evaluate the impact of structured simulation-based PIVC training and on-job assessment program on nurses' knowledge, attitudes, and performance. DESIGN: Settings/participants: A prospective, structured, competency improvement training, assessment, feedback, and reassessment conducted on 150 pediatric nurses. They provided nursing care for in-patients at the newly open Children's hospital, Ain Shams University. METHODS: PIVC insertion skills and care knowledge, structured simulation-based mannequin training arm venipuncture model and on-job assessment were conducted. In the preparatory phase, 15 nurses were interviewed to develop the assessment tools. Knowledge and attitudes were assessed quantitatively using a validated self-administered questionnaire. Structured simulation-based training, and on-job skill assessment were performed using validated observer checklist. Assessment performed at enrollment (baseline), immediate post training, and reassessment 2-months after the training, using same tools. RESULTS: Knowledge, performance, and attitudes were significantly improved for the 150 trained nurses. There was improvement in immediate post training assessment than the reassessment after 2-months, compared to baseline for total knowledge score; peripheral cannula insertion score; hand washing before aseptic procedure; skin antisepsis at puncture site; no puncture site palpation after disinfection; apply sterile dressing to puncture site, p = 0.00, respectively. There was improvement in the reassessment after 2-months than post training assessment, compared to baseline for the total attitude score, p = 0.02; peripheral cannula care, p = 0.00; aseptic technique, p = 0.00; wearing protective gloves, p = 0.01; total practice score, p = 0.00. Years of experience, last 6-months training course, practice level, educational level, age, and attitude influence overall performance. CONCLUSIONS: Structured simulation-based training and on-job skill assessment are effective for improvement of PIVC insertion and care. Continuous education, feedback, assessment/reassessment, and monitoring should be recommended to retain the gained improvement in attitudes, knowledge, and skills. Changing workplace structure and improve work environment should be studied as factors that might affect learning.

Predictive factors affecting stress among nurses providing care at COVID-19 isolation hospitals at Egypt.

AIMS: To examine predictive factors affecting stress among nurses providing care at COVID-19 Isolation Hospitals at Egypt. METHODS: A cross-sectional study conducted in five Isolation governmental hospitals for COVID-19. 374 nurses included at the study. Characteristic forms, factors affecting nurses' stress and Nursing Stress Scale (NSS) were used to collect data. RESULTS: (52.1%) of studied nurses had moderate level of total nursing stress scale. Also, (26.2%) of them had severe level, while (13.4% & 8.3%) of them had mild and normal level, respectively. Mean SD score of studied nurses regarding to total nursing stress scale was 99.47 ± 10.671. CONCLUSIONS: Training for COVID-19, availability of PPE, educational level and attention of hospital administration were negative predictor factors for nurses' stress, while having children, people showed that COVID-19 is stigma, fears of infection, workplace, fear of transmission infection for family and nurse to patient ratio were positive predictors.