Barriers and motivating factors for licensed practical nurses to pursue a bachelor's degree in nursing.

BACKGROUND: Connecticut License Practical Nurses (LPNs) face unique challenges in pursuing higher education. Understanding these challenges is essential for addressing the current nursing shortage and enhancing the nursing workforce's educational level. PURPOSE: This project aimed to identify the barriers preventing Connecticut LPNs from pursuing higher education and the factors motivating them to obtain a Bachelor of Science degree in Nursing (BSN) and Registered Nurse (RN) licensure. METHOD: A survey was administered to 13,684 LPNs in Connecticut after Institutional Review Board (IRB) approval. Of these, 1791 LPNs consented to participate, with 1424 completing at least one survey question. The survey was designed to identify the top three motivators and barriers influencing LPNs' decisions to pursue further education. RESULTS: The primary motivators identified were the desire for college credits for completed LPN coursework (96.7 %), a simplified BSN enrollment procedure (93.8 %), and potential salary increases (93.7 %). Conversely, the top barriers were current financial position (76.4 %), personal responsibilities (71.1 %), and the requirement to repeat previously taken courses (65.9 %). An unexpected finding was that 63 participants expressed readiness to immediately pursue a BSN degree, indicating a strong latent demand for advanced nursing education. CONCLUSION: The study highlights the eagerness of LPNs to advance their education, contingent on receiving credit for previous coursework, financial aid, tuition reimbursement, and flexible schooling options. These findings suggest the need for tailored educational programs and support systems to facilitate LPNs' transition to higher educational levels, addressing both the motivators and barriers identified.

Facilitators and Inhibitors of LPN-to-RN Student Transition: A Cross-Sectional National Survey.

AIM: The aim of the study was to describe the transition conditions (facilitators and inhibitors) encountered by licensed practical nurses in registered nurse educational programs (LPN-to-RN students). BACKGROUND: LPN-to-RN students are important because they may increase diversity and numbers of RNs. However, no prior study has examined transition experiences of LPN-to-RN students across the United States. METHOD: A cross-sectional survey of LPN-to-RN students was conducted using Meleis et al.'s transition theory. RESULTS: Students (n = 873) from 131 nursing programs responded. The most common facilitators were personal motivation and believing the content taught was valuable; the most common inhibitors were juggling multiple responsibilities and personal stress levels. Several significant relationships between transition conditions and program/student characteristics were identified. CONCLUSION: Faculty in LPN-to-RN programs can increase support for students by refining their own actions and addressing potential challenges when LPN and non-LPN nursing students share classes.

Costs and Effects of School-Based Licensed Practical Nurses on Elementary Student Attendance and Chronic Absenteeism.

Despite increasing reliance on licensed practical nurses (LPNs) to provide health services in schools, we do not know whether this is a cost-effective prevention strategy against student absenteeism. Therefore, we evaluated the costs and effectiveness of an LPN-based school nursing program for improving attendance and chronic absenteeism at a large, urban school district in the southeastern USA. We first identified a matched set of 46 elementary schools (23 nurse, 23 no-nurse) by using an optimal multilevel matching algorithm based on student- and school-level characteristics. We then conducted a cost-effectiveness analysis on the matched set, using the ingredients method to estimate societal costs and multilevel regression to estimate effects. The results indicated that despite substantial incremental costs of $68,228 per school, the presence of a full-time LPN was associated with at best negligible improvements, and at worst slight disimprovements, in attendance and chronic absenteeism. We recommend a careful review of the theory of change for LPN-based school nursing programs to clarify the specific inputs and activities that are expected to lead to improved student outcomes. Education agencies should develop explicit assignment, training, monitoring, and auditing plans to ensure LPNs are equitably distributed and that their activities are aligned with the theory of change. Education agencies should also explore whether expanded Medicaid billing can reduce their share of the nursing cost burden.

Nursing Home Patient Safety Culture Perceptions Among Licensed Practical Nurses.

BACKGROUND: Licensed practical nurses (LPNs) working in nursing homes are the primary licensed nurses providing care and ensuring patient safety in New Jersey. As such, it is important to understand LPNs' perception of patient safety culture (PSC) and job satisfaction, which may impact resident safety. PURPOSE: To describe the relationship between LPNs' perception of PSC in nursing homes and job satisfaction. METHODS: A cross-sectional study design was used to survey LPNs in New Jersey. RESULTS: LPNs working in nursing homes were less satisfied than LPNs working in other settings, and their perception of PSC was lower than that in 2019 national data report. CONCLUSION: LPNs in nursing homes indicated that PSC needs improvement. Now is an opportune time to implement initiatives to foster a culture of safety in nursing homes.

Atuação de técnicos de enfermagem na prevenção de pneumonia associada à ventilação mecânica: estudo qualitativo / Actuación de técnicos de enfermería en prevención de neumonía asociada a la ventilación mecánica: estudio cualitativo / Role of nursing technicians in the prevention of pneumonia associated with mechanical ventilation: qualitative study

Objetivo: descrever a percepção do técnico de enfermagem e a sua atuação no bundle de prevenção de pneumonia, associada à ventilação mecânica em Unidade de Terapia Intensiva. Método: estudo descritivo e qualitativo, realizado com técnicos de enfermagem de uma Unidade de Terapia Intensiva Adulto de Porto Alegre. Coleta dos dados realizada por meio de entrevistas gravadas, seguindo roteiro semiestruturado. Dados analisados sob a ótica da análise temática de Minayo. Resultados: participaram 40 técnicos de enfermagem, em queemergiram quatro categorias: a) atuação do Técnico de Enfermagem no bundle de prevenção de Pneumonia Associada à Ventilação Mecânica (PAVM); b) itens que compõem o bundle de prevenção de PAVM; c) fragilidades na implantação do bundle de prevenção de PAVM; d) educação continuada sobre PAVM. Considerações finais: participantes conhecem as medidas de prevenção, reconhecem sua importância e as executam direta e indiretamente. A equipe utiliza um mnemônico próprio para memorização dos itens do bundle.

Objetivo: describir la percepción del técnico de enfermería en cuanto a su actuación en el Bundle de prevención de neumonía asociada a la ventilación mecánica en Unidad de Terapia Intensiva. Método: estudio descriptivo, cualitativo, realizado con técnicos de enfermería de una Unidad de Terapia Intensiva Adulto de Porto Alegre. Recolección de datos realizada por medio de entrevistas grabadas, siguiendo guion semiestructurado. Datos analizados bajo la óptica del análisis temático de Minayo. Resultados: participaron 40 técnicos de enfermería. Surgieron cuatro categorías: a) actuación del Técnico de Enfermería en el bundle de prevención de neumonía asociada a la ventilación mecánica (NAVM); b) ítems que componen el bundle de prevención de NAVM; c) fragilidades en la implantación del bundle de prevención de NAVM; y d) educación continuada sobre NAVM. Consideraciones finales los participantes conocen las medidas de prevención, reconocen su importancia y las ejecutan directa e indirectamente. El equipo utiliza un mnemotécnico propio para memorizar los elementos de bundle.

Objective: to describe the perception of the nursing technician regarding their performance in the bundle of prevention of pneumonia associated with mechanical ventilation in an Intensive Care Unit. Method: a descriptive, qualitative study conducted with nursing technicians from an Adult Intensive Care Unit in Porto Alegre. Data collection performed through recorded interviews, following a semi-structured script. Data analyzed from the perspective of thematic analysis of Minayo. Results: the participants were 40 nursing technicians. Four categories emerged: a) the role of the Nursing Technician in the bundle for the prevention of ventilator-associated pneumonia (VAP); b) items that make up the bundle for the prevention of VAP; c) weaknesses in the implementation of the bundle for the prevention of VAP; and d) continuing education on VAP. Final considerations: participants know the prevention measures, recognize their importance and execute them directly and indirectly. The team uses its own mnemonic to memorize the bundle items.

Análise do conhecimento de profissionais de enfermagem sobre prevenção de lesão por pressão: estudo transversal / Análisis del conocimiento de profesionales de enfermería sobre prevención de úlcera por presión: estudio transversal / Analysis of nursing professionals' knowledge about pressure ulcer prevention: a cross-sectional study

RESUMO Objetivos analisar e comparar o nível de conhecimento sobre prevenção de lesão por pressão entre enfermeiros e técnicos de enfermagem que atuam em Unidades de Terapia Intensiva e graduandos em enfermagem no último ano do curso. Método estudo transversal, de caráter descritivo-exploratório e de abordagem quantitativa, utilizando o Pieper's Pressure Ulcer Knowledge Test. Os dados foram analisados através do Statistical Package for Social Science, mediante estatística descritiva e inferencial (ANOVA-One Way, teste de normalidade de Shapiro-Wilk e pressuposto de homogeneidade através do teste de Levene). Resultados a amostra da pesquisa abarcou 70 participantes, sendo 22 enfermeiros, 14 técnicos de enfermagem e 34 graduandos em enfermagem. Foi visto que apenas 22,7% dos enfermeiros, 7,1% dos técnicos e 0,0% dos graduandos em enfermagem atingiram o percentual de acertos ≥ 90% recomendado pelo teste de conhecimento. Conclusão e implicações para a prática os resultados encontrados neste estudo permitiram identificar um nível insuficiente de conhecimento e uma percepção de aptidão equivocada, relacionados à prevenção de lesão por pressão, entre os participantes do estudo, com ênfase para os técnicos e para os graduandos em enfermagem. Logo, esta pesquisa aponta para a necessidade de ações educativas que visem a capacitação do público supramencionado.

RESUMEN Objetivos analizar y comparar el nivel de conocimiento sobre prevención de úlceras por presión entre enfermeros y técnicos de enfermería que actúan en Unidades de Cuidados Intensivos y estudiantes de enfermería en el último año del curso. Método estudio transversal, descriptivo-exploratorio y de abordaje cuantitativo, utilizando el Pieper's Pressure Ulcer Knowledge Test. Los datos fueron analizados mediante el Statistical Package for Social Science, utilizando estadística descriptiva e inferencial (ANOVA-One Way, prueba de normalidad de Shapiro-Wilk y suposición de homogeneidad mediante la prueba de Levene). Resultados la muestra contó con 70 participantes, siendo 22 enfermeros, 14 técnicos de enfermería y 34 estudiantes de graduación en enfermería. Se observó que sólo el 22,7% de los enfermeros, el 7,1% de los técnicos y el 0,0% de los estudiantes alcanzaron el porcentaje de aciertos ≥ 90% recomendado por la prueba de conocimiento. Conclusión e implicaciones para la práctica los resultados encontrados permitieron identificar un nivel de conocimiento insuficiente y una percepción de aptitud errónea, relacionada con la prevención de úlceras por presión, entre los participantes del estudio, con énfasis en los técnicos y estudiantes de enfermería. Por lo tanto, esta investigación apunta la necesidad de acciones educativas dirigidas a la formación de dicho público.

ABSTRACT Objectives to analyze and compare the level of knowledge about pressure ulcer prevention among nurses and nursing technicians who work in Intensive Care Units and nursing students in the last year of the course. Method a cross-sectional, descriptive-exploratory study with a quantitative approach, using the Pieper's Pressure Ulcer Knowledge Test. Data were analyzed using the Statistical Package for Social Science, using descriptive and inferential statistics (ANOVA-One Way, Shapiro-Wilk normality test and assumption of homogeneity using Levene's test). Results the research sample included 70 participants, being 22 nurses, 14 nursing technicians and 34 undergraduate nursing students. It was observed that only 22.7% of nurses, 7.1% of technicians and 0.0% of students reached the percentage of correct answers ≥ 90% recommended by the knowledge test. Conclusion and implications for practice the results found in this study made it possible to identify an insufficient level of knowledge and a mistaken perception of aptitude, related to the pressure ulcer prevention, among the study participants, with emphasis on technicians and undergraduates in nursing. Therefore, this research points to the need for educational actions aimed at training the aforementioned public.

Assédio moral: ocorrências nas relações de trabalho da enfermagem / Moral harassment: occurrences in nursing work relationships / Acoso moral: incidencias en las relaciones laborales de enfermería

Objetivo: Identificar a ocorrência de assédio moral vivenciado por profissionais de nível médio em Enfermagem, que estão em fase de graduação em Enfermagem. Métodos: Trata-se de estudo transversal, descritivo com abordagem quantitativa realizado com 40 estudantes universitários do curso de enfermagem em instituição no interior paulista, por meio da aplicação de questionário semiestruturado e Questionário sobre Assédio Moral. Os dados foram analisados com análise estatística descritiva. Resultados: Dos 40 (100,0%) participantes, 14 (35,0%) eram Auxiliares e/ou Técnicos de Enfermagem, 11 (79,0%) entrevistados foram agredidos de forma repetitiva. As situações de agressão mais vivenciadas foram "critica você em público" (10,8%), "critica seu trabalho de forma injusta ou exagerada" (7,2%) e "dá instruções confusas e imprecisas" (7,2%). O agressor foi caracterizado como "é aquele que sempre tem razão" (10; 83,3%), "sempre está pronto para receber elogios, contudo, se é criticado coloca a culpa nos subordinados" (7; 58,3%). Dentre as consequências do assédio moral, as mais citadas foram o "estresse" (10; 11,9%), a irritabilidade (9; 10,7%), a ansiedade (7; 8,0%) e a dificuldade de concentração - 7 (8,0%). Conclusão: Dos profissionais alvos desta pesquisa, (14; 86,0%) não só tinham conhecimento acerca de assédio moral, como também afirmaram já terem sido vítima dessa violência. (AU)

Objective: To identify the occurrence of moral harassment experienced by mid-level nursing professionals, who are in the Nursing undergraduate phase. Methods: This is a cross-sectional, descriptive study with a quantitative approach carried out with 40 university students of the nursing course at an institution in the interior of São Paulo, through the application of a semi-structured questionnaire and a questionnaire on moral harassment. The data were analyzed with descriptive statistical analysis. Results: Of the 40 (100.0%) participants, 14 (35,0%) were Nursing Assistants and Technicians, 11 (79.0%) interviewees were repeatedly assaulted. The most experienced situations of aggression were "criticizing you in public" (10.8%), "criticizing your work in an unfair or exaggerated way" (7.2%) and "giving confused and inaccurate instructions" (7.2%). The aggressor was characterized as "he is the one who is always right" (10; 83.3%), "he is always ready to receive praise, however, if he is criticized, he places the blame on subordinates" (7; 58.3%). Among the consequences of bullying, the most cited were "stress" (10; 11.9%), irritability (9; 10.7%), anxiety (7; 8.0%) and difficulty concentrating - 7 (8.0%). Conclusion: Of the professionals targeted by this research, (14; 86.0%) not only had knowledge about bullying, but also stated that they had already been a victim of this violence. (AU)

Objetivo: Identificar la ocurrencia de acoso moral experimentado por profesionales de enfermería de nivel medio, que se encuentran en la etapa de licenciatura en Enfermería. Métodos: Se trata de un estudio descriptivo transversal con abordaje cuantitativo realizado con 40 estudiantes universitarios del curso de enfermería de una institución del interior de São Paulo, mediante la aplicación de un cuestionario semiestructurado y Cuestionario de Acoso Moral. Los datos fueron analizados con análisis estadístico descriptivo. Resultados: De los 40 (100,0%) participantes, 14 (35,0%) eran Auxiliares y Técnicos de Enfermería, 11 (79,0%) entrevistados fueron agredidos reiteradamente. Las situaciones de agresión más vividas fueron "criticarte en público" (10,8%), "criticar tu trabajo de forma injusta o exagerada" (7,2%) y "dar instrucciones confusas e inexactas" (7,2%). El agresor se caracterizó por "él es el que siempre tiene la razón" (10; 83,3%), "siempre está dispuesto a recibir elogios, sin embargo, si es criticado culpa a los subordinados" (7; 58,3%). Entre las consecuencias del bullying, las más citadas fueron "estrés" (10; 11,9%), irritabilidad (9; 10,7%), ansiedad (7; 8,0%) y dificultad para concentrarse - 7 (8,0%). Conclusion: De los profesionales objeto de esta investigación, (14; 86,0%) no solo tenían conocimientos sobre el bullying, sino que también manifestaron que ya habían sido víctimas de esta violencia. (AU)

Use of Curriculum Mapping to Promote Licensed Practical Nurses' Attainment of a Baccalaureate Nursing Degree.

BACKGROUND: To increase the number of baccalaureate-prepared nurses, efforts have focused on degree completion for RNs. Less attention has been given to foster baccalaureate nursing (BSN) degree pathways for licensed practical nurses (LPNs). To facilitate the development of an LPN-to-BSN degree pathway, faculty at one BSN program used curriculum mapping as a form of inquiry. METHOD: A six-step curriculum mapping process was used to examine content congruency and alignment between North Carolina LPN concept-based curriculum and foundational courses in the BSN program. RESULTS: Analysis of the data revealed an alignment between LPN courses and three foundational BSN courses. CONCLUSION: Findings were used to inform faculty members of the decision-making process for a revised LPN-to-BSN pathway. Curriculum mapping can be used as a tool to facilitate the development of the LPN-to-BSN pathway. LPN-centered curriculum options may be key to increasing the number of BSN nurses. [J Nurs Educ. 2022;61(11):646-649.].

Does empowerment enhance nurses' organizational commitment?

AIM: We examined whether psychological empowerment was significantly associated with the organizational commitment of licensed practical nurses. BACKGROUND: Healthcare organizations face unprecedented staffing challenges. This study provides insight into potential ways to ameliorate these issues. METHODS: In early 2010, we distributed a 45-item questionnaire, based on established measures of psychological empowerment and organizational commitment, to the entire population of active, full-time licensed practical nurses throughout a Midwestern US state. Our sample consisted of 1165 respondents. RESULTS: The results of our data analysis suggest that even after controlling for a range of potentially confounding variables, three subscales (meaning, self-determination and impact) were positively and associated with organizational commitment. However, one subscale (competence) was negatively related to the outcome. CONCLUSIONS: The psychological empowerment dimensions of impact, meaning and self-determination are associated with increased organizational commitment among licensed practical nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Considering the profound staffing challenges facing the nursing profession-exacerbated by the current global pandemic and retirements-our findings provide nurse administrators with critical information to use in stemming the wave of nurses leaving the profession.

Conhecimentos da equipe de enfermagem na mensuração da pressão arterial na triagem / Conocimiento del equipo de enfermería en la medición de la presión arterial en el cribado / Knowledge of the nursing team in the measurement of blood pressure in the screening

Objetivo: avaliar o conhecimento da equipe de enfermagem sobre a técnica correta de mensuração da Pressão Arterial. Método: Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa, aprovado pelo Comitê de Ética em Pesquisa sob protocolo CAAE no 42130720.2.0000.5587, realizado em instituições públicas de saúde do norte de Mato Grosso, avaliando 34 profissionais de enfermagem; utilizando um questionário validado para analisar o conhecimento dos profissionais. Resultados: o conhecimento dos enfermeiros e técnicos de enfermagem foram semelhantes, os maiores erros foram sobre a definição de pressão arterial, identificação dos sons de korotkoff, preparo dos materiais, largura do manguito, método palpatório, auscultatório e sobre os fatores que podem superestimar a pressão. Os maiores acertos foram sobre preparo do paciente e os fatores que podem contribuir nos erros de leitura. Conclusão: os profissionais de enfermagem têm déficit de conhecimento prático e teórico sobre a verificação da pressão arterial, sugerindo programas de capacitação.(AU)

Objective: to evaluate the nursing staff knowledge about the correct technique for measuring blood pressure. Method: This is a descriptive, exploratory study, with quantitative approach, approved by the Research Ethics Committee under protocol CAAE no 42130720.2.0000.5587, conducted in public health institutions in northern Mato Grosso, assessing 34 nursing professionals; using a validated questionnaire to analyze the professionals' knowledge. Results: the knowledge of nurses and nursing technicians was similar, the biggest errors were about the definition of blood pressure, identification of korotkoff sounds, preparation of materials, cuff width, palpatory and auscultatory method and about the factors that can overestimate the pressure. The greatest hits were about patient preparation and the factors that may contribute to reading errors. Conclusion: nursing professionals have a deficit of practical and theoretical knowledge about blood pressure checking, suggesting training programs.(AU)

Objetivo: evaluar los conocimientos del personal de enfermería sobre la técnica correcta de medición de la presión arterial. Método: Se trata de un estudio descriptivo, exploratorio, con enfoque cuantitativo, aprobado por el Comité de Ética de la Investigación bajo el protocolo CAAE no 42130720.2.0000.5587, realizado en instituciones de salud pública del norte de Mato Grosso, evaluando a 34 profesionales de enfermería; utilizando un cuestionario validado para analizar los conocimientos de los profesionales. Resultados: los conocimientos de las enfermeras y de los técnicos de enfermería fueron similares, los mayores errores fueron sobre la definición de la presión arterial, la identificación de los ruidos de korotkoff, la preparación de los materiales, la anchura del manguito, el método palpatorio y auscultatorio y sobre los factores que pueden sobrestimar la presión. Los mayores aciertos fueron sobre la preparación del paciente y los factores que pueden contribuir a los errores de lectura. Conclusión: los profesionales de la enfermería tienen un déficit de conocimientos prácticos y teóricos sobre la verificación de la presión arterial, lo que sugiere programas de capacitación.(AU)

Leadership Implications Related to Bullying and Intent to Leave Among Licensed Practical Nurses.

OBJECTIVE: This study examines the relationship between bullying and intent to leave among a sample of LPNs as mediated by exhaustion, job satisfaction, and organizational commitment. BACKGROUND: Bullying incidents may negatively impact the well-being, commitment, and retention for LPNs. METHODS: A cross-sectional survey design was used. A total of 168 questionnaires (19.65% response rate) were analyzed, performing Pearson correlation, mediation, and hierarchical regression tests. RESULTS: LPNs reported a relatively high score on exhaustion and were somewhat committed to their organization. They were fairly satisfied with the job and unlikely to leave it. The model explained 72% of the variance in intent to leave, with commitment, exhaustion, and bullying being the strongest correlates. CONCLUSIONS: Nursing leadership needs to implement antibullying language in policies, institute communication and self-leadership trainings, model authentic leadership, and foster ethical climates to support the retention of LPNs.

Transição de carreira: percepção de enfermeiros que atuaram como técnicos de enfermagem / Transición de carrera: percepción de enfermeros que actuaron como técnicos de enfermería / Career transition: perception of nurses who worked as nursing technicians

Objetivo: conhecer a percepção de enfermeiros que atuaram como té cnicos de enfermagem sobre a transição de carreira após a conclusão do curso superior. Método: pesquisa qualitativa, descritiva e exploratória, realizada com nove enfermeiros que já atuaram como técnicos. Os dados foram coletados por meio de entrevistas se miestruturadas e analisados por meio de Análise Temática. Resultados: a transição de carreira na instituição em estudo depende da disponibilidade de vagas e caracteriza - se como um momento de ansiedade e expectativa. Os participantes relatam desafios ligados às atr ibuições do enfermeiro e à sua aceitação nas equipes de enfermagem. Apontam que suas habilidades técnicas e vivências contribuem para articular gerência e assistência. Conclusões: é importante os empregadores pensarem estratégias para absorção e adaptação destes profissionais , bem c omo há a necessidade de reflexões dos docentes sobre as especificidades desse grupo na graduação.(AU)

Objective: to know the perception of nurses who worked as nursing technicians about the career transition after the conclusion of higher education. Method: qualitative, descriptive and exploratory research, carried out with nine nurses who have already worked as technicians. Data were collected through semi - structured interviews and analyzed by Thematic Analysis. Results: the career transition in the institution under study depends on the availability of vacancies and is characterized as a moment of anxiety and expectation. Participants report challenges, linked to the nurse's attributions and their acceptance in the nursing teams. They point out that their technical skills and exper iences contribute to articulating management and assistance. Conclusions: it is important for employers to think about strategies for absorbing and adapting these professionals as well as the need for professors to reflect on the specificities of this group at gr aduation.(AU)

Objetivo: conocer la percepción de los enfermeros que actuaban como técnicos de enfermería sobre la transición de carrera después de la conclusión de la educació n superior. Método: investigación cualitativa, descriptiva y exploratoria, realizada con nueve enfermeros que ya actuaron como técnicos. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados por Análisis Temático. Resultados: la transición de carrera en la institución en estudio depende de la disponibilidad de vacantes y se caracteriza por ser un momento de ansiedad y expectativa. Los participantes relatan desafíos vinculados a las atribuciones del enfermero y su aceptación en los equipos de enfermería. Señalan que sus habilidades técnicas y experiencias contribuyen a articular la gestión y la asistencia. Conclusiones: es importante que los empleadores reflexionen sobre estrategias de absorción y adaptación de estos profesional es bien como la necesidad de que los profesores reflexionen sobre las especificidades de este grupo en la graduación.(AU)

The impact of the work environment on the health-related quality of life of Licensed Practical Nurses: a cross-sectional survey in four work environments.

BACKGROUND: Nurses are known to have negative health outcomes related to their work. While it is acknowledged that nursing work is associated with things like back injuries and burnout, there is limited evidence as to what factors in the work environment contribute to these issues. PURPOSE: The aims of this study were to assess how Licensed Practical Nurses (LPNs) report their Health-related quality of life (HRQoL), and how nurses' health is impacted by their work environment. METHODS: These data used for analysis comes from a cross-sectional survey administered online to all LPNs in Alberta (2018). The survey collected data on the following variables: participant's demographics, the SF-36 HRQoL, Practice Environment Scale of the Nursing Work Index (PES-NW) and the CD-RISC measure of resilience. The beta distribution was used to model HRQoL outcomes. In instances where optimal health (score of '1') was observed then an extended version of beta distribution (called one-inflated beta) was applied. RESULTS: 4,425 LPNs responded to the survey. LPNs (mean age: 40) report lower scores on each SF-36 subscale than the general Canadian population aged 35-44. LPNs who work 'causal' had better physical health, (OR 1.21, CI 1.11-1.32, p = 0.000), and mental health (OR 1.22, CI 1.12-1.30, p = 0.000) than LPNs who work full time, even after controlling for resilience. LPNs' views on the adequacy of staffing and resources in their workplaces have an influence across all dimensions of health. CONCLUSION: This study suggests that improvements in the work environment could positively impact health outcomes and that adequate resourcing could support the nursing workforce.

Exploration of the occupational and personal dimensions impacted by the COVID-19 pandemic for nurses: A qualitative analysis of survey responses.

AIM: To explore the occupational and personal life dimensions that have been impacted by the COVID-19 pandemic for registered nurses (RN) and licensed practical nurses (LPN). DESIGN: Qualitative interpretive description approach. METHODS: Between July and September 2020, a web-based cross-sectional study was conducted among RNs and LPNs in Quebec, Canada. Included in this survey was an open-ended question allowing nurses to describe the occupational and personal life dimensions that were impacted by the COVID-19 pandemic. Thematic analysis was used to interpret the qualitative data from this open-ended question. Reporting followed the Standards For Reporting Qualitative Research (SRQR). RESULTS: Of the 1860 survey respondents, 774 RNs and 43 LPNs responded to the open-ended question (total n = 819). For the occupational dimension, six themes were identified: impacts of infection control on work, change in daily work tasks, offloading and reorganization of care, deterioration of working conditions, increased stress at work and issues related to the profession. For the personal dimension, four themes were found: impacts on the family, dealing with changes about leisure and personal life, impacts on physical and psychological health. CONCLUSION: Knowing the dimensions affected by the COVID-19 pandemic could help to identifying appropriate interventions to support RNs and LPNs. IMPACT: The COVID-19 pandemic has significantly impacted the occupational and personal lives RNs and LPNs working in the Quebec healthcare system. More specifically, Quebec's nurses experienced a major reorganization of care generated by important government decisions. Knowing how the pandemic affected different life dimensions will help in the development of support adapted to nurses' realities. Even in a pandemic context, improvements in the work environment or appropriate support could lead to an improved psychological health for nurses.

Assessment of staffing needs for registered nurses and licensed practical nurses at primary care units in Brazil using Workload Indicators of Staffing Need (WISN) method.

BACKGROUND: The balance between supply and demand for primary health care (PHC) services is one of the main challenges to the health system in Brazil. In this context, the application of planning methods could benefit the decision-making process for human resources organizations. Hence, the objective of this study was to assess the staffing needs for registered nurses (RNs) and licensed practical nurses (LPNs) at PHC services using the WISN method. METHODS: The Workload Indicators of Staffing Need (WISN) methodology was applied at 13 Primary Care Units (PCU) located in the city of São Paulo, Brazil. It included 87 RNs and 174 LPNs, and used data from 2017 to 2019. RESULTS: The WISN results found that RNs were under high workload pressure at 10 PCUs (77%) in 2017 and 2018, with a decrease to 8 PCUs (61%) in 2019. For LPNs, high workload pressure increased from 2 PCUs (15%) in 2017 to 13 PCUs (100%) in 2018, with a decrease to 11 (85%) in 2019. CONCLUSION: The assessment of staffing needs for RNs and LPNs at the PCUs included in the study identified a consistent deficit in the number of professionals, and high workload pressure in most services throughout the study period.

The Role of Schedule Volatility in Home Health Nursing Turnover.

Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Between 2016 and 2019, the average annual separation rate of home health nurses was over 30%, with most separations occurring voluntarily. Schedule volatility and turnover were positively associated for full-time nurses, but not for part-time nurses. These results suggest that reducing schedule volatility for full-time nurses could mitigate nursing turnover in home health care.

Percepção de cuidados desproporcionais entre médicos seniores, médicos residentes, enfermeiros e técnicos de enfermagem em um centro de terapia intensiva / Perception of disproportionate care among staff physicians, training physicians, nurses, and practical nurses in an intensive care unit

Introdução: O aumento progressivo de medidas avançadas para manutenção da vida em pacientes com pouca expectativa de sobrevida gera percepção de cuidado desproporcional. Objetivamos averiguar a prevalência de cuidado desproporcional em equipe médica e enfermagem que atuam na Unidade de Terapia Intensiva (UTI) em um hospital público do Brasil.Métodos: Estudo transversal envolvendo equipe médica e enfermagem em uma UTI multidisciplinar de 34 leitos de um hospital terciário no sul do Brasil de janeiro a julho de 2019. Ao total 151 profissionais responderam a um questionário eletrônico anônimo.Resultados: A taxa de resposta foi de 49,5%. Cento e dezoito (78,1%) profissionais identificaram cuidado desproporcional no ambiente de trabalho. Enfermeiros e técnicos de enfermagem receberam menos treinamento formal em comunicação de fim de vida do que médicos (10,6% versus 57,6%, p < 0,001). Vinte e nove (28,1%) enfermeiros e técnicos de enfermagem e 4 (0,08%) médicos responderam que não havia discussão sobre terminalidade na UTI (p = 0,006). Quarenta e três (89,5%) médicos afirmaram que havia colaboração entre equipe médica e equipe de enfermagem, ao passo que 58 (56,3%) enfermeiros e técnicos de enfermagem discordaram da assertiva (p < 0,001).Conclusão: Este é o primeiro estudo sobre percepção de cuidado desproporcional conduzido na América Latina, envolvendo residentes e técnicos de enfermagem e um centro de alta complexidade do sistema público de saúde. A vasta maioria dos profissionais percebe a existência de cuidado desproporcional em sua prática diária, independentemente da classe profissional.

Introduction: The increased use of life-sustaining measures in patients with poor long- and middle-term expected survival concerns health care providers regarding disproportionate care. The objective of this study was to report the prevalence of perceived inappropriate care among intensive care unit (ICU) staff physicians, training physicians, nurses, and practical nurses in a Brazilian public hospital.Methods: We conducted a cross-sectional study with the medical and nursing team of a 34-bed multidisciplinary ICU of a tertiary teaching hospital in Southern Brazil from January to July 2019. A total of 151 professionals completed an anonymous electronic survey. Results: The response rate was 49.5%. One hundred and eighteen (78.1%) respondents reported disproportionate care in the work environment. Nurses and practical nurses were less likely to receive formal training on end-of-life communication compared to physicians (10.6% vs. 57.6%, p < 0.001). Twenty-nine (28.1%) nurses and practical nurses vs. 4 (0.08%) physicians claimed that there were no palliative care deliberations in the ICU (p = 0.006). Of 48 senior and junior physicians, 43 (89.5%) believed that collaboration between physicians and nurses was good, whereas 58 out of 103 (56.3%) nurses and practical nurses disagreed (p < 0.001).Conclusion: This is the first survey on the perception of inappropriate care conducted in Latin America. The study included junior physicians and practical nurses working in a high-complexity medical center associated with the Brazilian public health system. Most health care providers perceived disproportionate care in their daily practice, regardless of their professional class.

A influência do retorno ao trabalho no aleitamento materno de trabalhadoras da enfermagem / La influencia de la reincorporación al trabajo sobre la lactancia materna en trabajadoras de enfermería / The influence of returning to work on maternal breastfeeding in nursing workers

Resumo Objetivo analisar a influência do retorno ao trabalho de mães trabalhadoras da enfermagem no aleitamento materno. Método pesquisa qualitativa, desenvolvida por meio de formulário semiestruturado, via Google Forms, junto a 49 trabalhadoras de enfermagem do estado do Rio de Janeiro. Os dados foram submetidos à análise lexicográfica, com auxílio do software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ), pelo método de Nuvem de Palavras e Classificação Hierárquica Descendente. Resultados o aproveitamento do corpus textual foi de 88,24%, gerando quatro classes de segmentos de texto. As principais influências do retorno ao trabalho na amamentação relatadas pelas participantes foram: a falta de apoio dos chefes e colegas de trabalho, a necessidade de local e tempo adequados para ordenha do leite materno, a diminuição na produção de leite por fatores inerentes ao trabalho e sobrecarga e ambientes insalubres de trabalho na enfermagem. Conclusão e implicações para a prática a identificação desses fatores possibilita a compreensão das demandas das nutrizes participantes e aponta para a necessidade de estratégias inovadoras, que garantam o direito das trabalhadoras, assim como adequações de infraestrutura em seus ambientes laborais.

Resumen Objetivo analizar la influencia de la reincorporación al trabajo sobre la lactancia materna de madres lactantes trabajadoras de enfermería. Método investigación cualitativa, desarrollada a través de un formulario semiestructurado, con utilización de Google Forms, con 49 trabajadoras de enfermería en el estado de Río de Janeiro. Los datos fueron sometidos a análisis lexicográfico, con el auxilio del software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ), por los métodos de Nube de Palabras y Clasificación Jerárquica Descendente. Resultados el aprovechamiento del corpus textual fue del 88,24%, y se generaron cuatro clases de segmentos textuales. Las principales influencias de la reincorporación al trabajo sobre la lactancia materna señaladas por las participantes fueron: falta de apoyo de jefes y compañeros, necesidad de disponer de lugar y tiempo adecuados para el ordeñe de la leche materna, disminución de la producción de leche por factores inherentes al trabajo y sobrecarga e insalubridad de los ambientes de trabajo en enfermería. Conclusión e implicaciones para la práctica la identificación de estos factores permite comprender las demandas de las madres lactantes participantes y señala la necesidad de adoptar estrategias innovadoras, que garanticen los derechos de las trabajadoras, además de adaptaciones de infraestructura en sus ambientes de trabajo.

Abstract Objective to analyze the influences of returning to work on maternal breastfeeding in mothers who are Nursing workers. Method a qualitative research developed through a semi-structured form, using Google Forms, with 49 female Nursing workers in the state of Rio de Janeiro. The data were submitted to lexicographic analysis, with the aid of the Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires (IRAMUTEQ) software, by the Word Cloud and Descending Hierarchical Classification methods. Results leverage of the text corpus was 88.24%, generating four classes of text segments. The main influences of returning to work on breastfeeding reported by the participants were as follows: lack of support from the management and coworkers, need for an adequate place and time for milking breast milk and decrease in milk production due to factors inherent to the work, in addition to overload and unhealthy working environments in Nursing. Conclusion and implications for the practice the identification of these factors enables understanding the demands of the participating nursing mothers and points to the need for innovative strategies, which guarantee the workers' rights, as well as infrastructure adaptations in their work environments.