Staff Perceptions of Implementing a Person-Centered Communication Tool in the Nursing Home Setting: PAL Cards.

PURPOSE: To understand direct care workers' perceptions of the impact of implementing a person-centered communication tool, Preference for Activity and Leisure (PAL) Cards, into care. METHOD: PAL Cards provide at-a-glance information about a nursing home (NH) resident's background and important preferences for activities and leisure. As a quality improvement project, 11 NHs implemented use of PAL Cards in their communities and provided feedback (N = 91 feedback forms received) on their perceptions of impact of PAL Cards on care communication and delivery. RESULTS: A variety of NH staff members, across disciplines, were a part of PAL Card implementation. The majority of staff (84%) perceived that PAL Cards helped them start a conversation with a resident and 64% indicated that PAL Cards helped them provide care for a resident. CONCLUSION: PAL Cards are an effective tool for communicating information about NH residents' preferences to staff. [Journal of Gerontological Nursing, 50(8), 5-10.].

The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care - a cross-sectional study.

BACKGROUND: Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance). METHODS: A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression. RESULTS: Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy. CONCLUSIONS: Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses. PATIENT OR PUBLIC CONTRIBUTION: Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.

Development and validation of a questionnaire to evaluate attitudes and beliefs of discrimination by nursing staff.

OBJECTIVE: Aim: The purpose of this study is to report on the development and initial psychometric testing of a questionnaire to investigate nurses' discrimination attitudes and beliefs towards people of dif f erent ethnic origins. PATIENTS AND METHODS: Materials and Methods: The initial stage involved the selection of the questions of the tool after a comprehensive evaluation of the relevant international literature and the tools used in previous related studies. The reliability (forward-backward translation) of the questions was assessed, along with the content, face, and structure. To conduct the study, which was carried out from 07/2021 to 01/2022 a sample consisting of 30 and 2,034 nurses and their assistants was used for the pilot and the fi nal research, respectively. RESULTS: Results: Given that the Kaiser-Meyer-Olkin (KMO) threshold value of 0.89 was achieved, the sample was considered sufficient and appropriate for factor analysis. A statistically signif i cant result (p<0.001) from Bartlett's test indicated a substantial connection between the questions and conf i rmed that the data were suitable for factor analysis. Twenty statements altogether, with seven possible answers ranging from "totally disagree" to "completely agree," were included in the questionnaire. For the questions, three distinct factors - communication, difficulties, and discrimination - were shown to account for 47.1% of the variability. Reliability analyzes showed satisfactory Cronbach alpha coefficient scores for all factors, ranging from 0.78 to 0.82. CONCLUSION: Conclusions: The current study demonstrates that the questionnaire we developed is a legitimate and trustworthy instrument for evaluating professional nurses' discriminatory attitudes and beliefs toward individuals from various ethnic backgrounds. The questionnaire can be used to help design interventions to end discrimination, guarantee equitable access to healthcare services, and provide high-quality care for individuals from diverse backgrounds. It can also be used to identify the factors that inf l uence nurses' attitudes and perceptions toward these patient populations.

Sleep duration and quality of Brazilian nursing staff who work in shifts.

OBJECTIVE: to analyze sleep duration and sleep quality in nursing professionals who work in shifts. METHOD: this is a cross-sectional, analytical research, carried out between September 2017 and April 2018, at a public hospital in southern Brazil, with the nursing team. A socio-occupational and health symptoms questionnaire, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index were used. Data are presented as descriptive and inferential statistics, bivariate analysis, and binary logistic regression. RESULTS: participants were 308 nursing professionals with a predominance of long-term sleep, absence of drowsiness, and poor sleep quality. Short-term sleep (<6h) was associated with day shift and poor sleep quality. Sleep quality was associated with presence excessive daytime sleepiness and work day shift. CONCLUSION: work shift, insomnia and headache were the main factors related short-term sleep for nursing professionals. The results may justify the development of intervention research for workers' health.

Effects of interventions to promote resilience in nurses: A systematic review.

BACKGROUND: Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects. OBJECTIVE: The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience. DESIGN: This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. METHODS: Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected. RESULTS: A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups. CONCLUSIONS: The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement. TWEETABLE ABSTRACT: It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.

A Comparative Study of Organizational Grief Support and Burnout Among Nursing Home Staff.

BACKGROUND AND OBJECTIVES: The purpose of this study was to examine the relationship between dimensions of grief support (recognition of the relationship, acknowledgement of the loss, and inclusion of the griever) and aspects of burnout (emotional exhaustion, depersonalization, and personal accomplishment) among nursing home staff. RESEARCH DESIGN AND METHODS: Data were collected from 553 nursing home workers from 37 nursing home facilities in 5 states during fall of 2022. Responses to the Maslach Burnout Inventory and Grief Support Health Care Scale were analyzed for this study. RESULTS: The study found that recognizing the relationship with deceased patients led to a decrease in exhaustion and depersonalization among workers while simultaneously enhancing their sense of personal accomplishment. Including the griever in the support process lowered all burnout subscales for nursing home staff. Acknowledging the loss was associated with higher levels of personal accomplishment. Registered nurses, nurse practitioners, and physicians experienced higher levels of exhaustion and depersonalization compared to other nursing home staff. Behavioral health workers had the highest personal accomplishment, whereas direct support workers reported the lowest. DISCUSSION AND IMPLICATIONS: These findings have important implications for improving the well-being of nursing home staff, emphasizing the importance of organizational grief support, and tailored interventions to address burnout among different healthcare provider roles in nursing homes.

Workforce thresholds and the non-linear association between registered nurse staffing and care quality in long-term residential care: A retrospective longitudinal study of English care homes with nursing.

BACKGROUND: Care needs amongst 425,000 dependent older residents in English care homes are becoming more complex. The quality of care in these homes is influenced by staffing levels, especially the presence of registered nurses (RNs). Existing research on this topic, often US-focused and relying on linear assumptions, has limitations. This study aims to investigate the non-linear relationship between RN staffing and care quality in English care homes using machine learning and administrative data from two major care home providers. METHODS: A retrospective observational study was conducted using data from two English care home providers. Each was analysed separately due to variations in data reporting and care processes. Various care quality indicators and staffing metrics were collected for a 3.5-year period. Regression analysis and machine learning (random forest) were employed to identify non-linear relationships. Ethical approval was obtained for the study. RESULTS: Using linear methods, higher skill mix - more care provided by RNs - was associated with lower incidence of adverse outcomes, such as urinary tract infections and hospitalisations. However, non-linear skill mix-outcome relationship modelling revealed both low and high skill mix levels were linked to higher risks. The effects of agency RN usage varied between providers, increasing risks in one but not the other. DISCUSSION: The study highlights the cost implications of increasing RN staffing establishments to improve care quality, suggesting a non-linear relationship and an optimal staffing threshold of around one-quarter of care provided by nurses. Alternative roles, such as care practitioners, merit exploration for meeting care demands whilst maintaining quality. This research underscores the need for a workforce plan for social care in England. It advocates for the incorporation of machine learning models alongside traditional regression-based methods. Our results may have limited generalisability to smaller providers and experimental research to redesign care processes effectively may be needed. CONCLUSION: RNs are crucial for quality in care homes. Contrary to the assumption that higher nurse staffing necessarily leads to better care quality, this study reveals a nuanced, non-linear relationship between RN staffing and care quality in English care homes. It suggests that identifying an optimal staffing threshold, beyond which increasing nursing inputs may not significantly enhance care quality may necessitate reconsidering care system design and (human) resource allocation. Further experimental research is required to elucidate resource-specific thresholds and further strengthen evidence for care home staffing. TWEETABLE ABSTRACT: How much nursing care is needed to assure quality in care homes? Evidence from 2 English care home providers shows that nurse sensitive outcomes (an indicator of quality) are better when ~25 % of care is provided by nurses. Nurse shortages increase risks for residents.

The Relationship between Nursing Home Staffing and Health Outcomes Revisited.

OBJECTIVE: Nursing homes make staffing decisions in conjunction with choosing quality goals, potentially leading to endogeneity bias between staffing and quality. We use instrumental variables (IVs) to explore it. DESIGN: Retrospective statistical analysis of 2017-2019 Payroll-Based Journal, Minimum Data Set, Nursing Home Care Compare, and Long-Term Care Focus. SETTINGS AND PARTICIPANTS: A total of 11,261 nursing homes nationally. METHODS: We estimated separate models for each of 6 quality measures as dependent variables, and registered nurses (RNs), certified nurse assistants (CNAs), and licensed practical nurses (LPNs) as independent variables, including other control variables associated with quality. The models were estimated using both ordinary least squares (OLS) and 2-stage least squares (2SLS) methods, the latter accounting for endogeneity. The IVs were defined as the average staffing of competing nursing homes in the same market as the index facility. RESULTS: Estimated coefficients for the quality measures in the 2SLS models were up to 5 times larger than in the OLS models. The 2SLS estimates for antipsychotic medications use increased with higher RN staffing [0.279 (0.004 to 0.553)] and decreased with higher CNAs [-0.125 (-0.198 to -0.052)]. Hospitalizations decreased with more RNs [-1.328 (-1.673 to -0.983)] and LPN staffing [-0.483 (-0.755 to -0.211])] and increased with CNA [0.201 (0.109 to 0.293)] staffing. Emergency room visits decreased with higher RNs [-1.098 (-1.500 to -0.696)] and increased with CNAs [0.191 (0.084 to 0.298)]. Long-stay activities of daily living [-0.313 (-0.416 to -0.209)] and short-stay functioning [-0.481 (-0.598 to -0.364)] improved only with higher CNA staffing and pressure sores improved only with increased RN staffing [-0.436 (-0.836 to -0.035)]. CONCLUSIONS AND IMPLICATIONS: Our findings demonstrate the importance of accounting for endogeneity in studies of staffing and quality. Endogeneity changes conclusions about significance, direction, and magnitude of the relationship between staffing and specific quality measures. These findings highlight the need to further study and understand the nuanced relationship between different staffing types and different health outcomes such as the difference between the relationship of RN and CNA hours per resident day to antipsychotic quality measures.

Challenges in recognizing and discussing changes in a resident's condition in the palliative phase: focus group discussions with nursing staff working in nursing homes about their experiences.

BACKGROUND: Most nursing home residents have complex care needs, require palliative care and eventually die in these facilities. Timely recognition of changes in a resident's condition is crucial for providing appropriate care. Observations by nursing staff play a significant role in identifying and interpreting these changes. METHODS: Focus group discussions were conducted with nursing staff from ten nursing homes in the Netherlands to explore their experiences and challenges in recognizing and discussing changes in a resident's condition. These discussions were analysed following the principles of thematic analysis. RESULTS: The analysis of the challenges nursing staff face in identifying and interpreting changes in a resident's condition, resulted in three themes. First, that recognizing changes is considered complex, because it requires specialized knowledge and skills that is generally not part of their education and must partly be learned in practice. This also depends on how familiar the nursing staff is with the resident. Furthermore, different people observe residents through different lenses, depending on their relation and experiences with residents. This could lead to disagreements about the resident's condition. Lastly, organizational structures such as the resources available to document and discuss a resident's condition and the hierarchy between nursing home professionals often hindered discussions and sharing observations. CONCLUSION: Nursing staff's experiences highlight the complexity of recognizing and discussing changes in nursing home residents' conditions. While supporting the observational skills of nursing staff is important, it is not enough to improve the quality of care for nursing home residents with palliative care needs. As nursing staff experiences challenges at different, interrelated levels, improving the process of recognizing and discussing changes in nursing home residents requires an integrated approach in which the organization strengthens the position of nursing staff. It is important that their observations become a valued and integrated and part of nursing home care.

Correlations between empathy fatigue, occupational identity, and sleep quality in nursing staff: a cross-sectional study.

Objective: To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between empathic fatigue, professional identity and sleep quality of nursing staff. Methods: This is a cross-sectional study. The method of convenient sampling was used to select 224 nursing workers from the older adult's institutions in the Panjin area as the investigation objects. The nurses' general data questionnaire, the Chinese version of the compassion fatigue short scale, the nurses' professional identity Scale, and the Pittsburgh Sleep Quality Index were used as evaluation tools. SPSS26.0 statistical software was used to sort out and analyze the data. Results: There was a positive correlation between empathic fatigue and sleep quality; there was a negative correlation between empathy fatigue and professional identity. Occupational identity and sleep quality were negatively correlated. Conclusion: There is a correlation between empathic fatigue, professional identity, and sleep quality of nursing workers. Empathy fatigue is positively correlated with sleep quality. Empathy fatigue was negatively correlated with professional identity. Occupational identity was negatively correlated with sleep quality. To provide a theoretical basis for the management of older adult's nursing staff and the formulation of corresponding management systems and policies, promote the mental health of older adult's nursing staff, improve sleep quality, and provide a theoretical basis and reference for future intervention research.

Changes in Nursing Staff Levels and Injury-Related Emergency Department Visits among Assisted Living Residents with Alzheimers Disease and Related Dementias.

OBJECTIVES: To examine the relationship between changes in nursing staff-hours per resident-day and injury-related emergency department (ED) visits among assisted living (AL) residents with Alzheimer disease and related dementias (ADRD). DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: We leveraged a data set of AL community characteristics in Ohio linked to Medicare claims data from 2007 to 2015. METHODS: We estimated Poisson models examining the relationships of personal care aide, registered nurse (RN), licensed practical nurse (LPN), and total nursing hours with injury-related ED visits. Models were adjusted for resident characteristics (ie, age, race, sex, dual eligibility, presence and number of chronic conditions), AL community characteristics (percentage of residents on Medicaid, average resident acuity), year fixed effects, and assisted living fixed effects. We examined all injury-related ED visits and injury-related ED visits resulting in hospital admission as separate outcomes. RESULTS: The sample included 122,700 person-months, representing 12,144 fee-for-service Medicare beneficiaries with ADRD within 455 different AL communities in Ohio between 2007 and 2015. Median total nursing hours increased from 1.34 in 2007 to 1.69 in 2015. In the fully adjusted model, an increase in 1 RN-hour per resident-day was associated with a decrease in the risk of any injury-related ED visit (incidence rate ratio 0.59, 95% CI 0.36-0.96), representing a 53% decrease. Changes in RN-hours were not associated with injury-related inpatient hospitalizations. Changes in total nursing, LPN, and personal care aide hours were not associated with changes in the risk of injury-related ED visits or inpatient hospitalizations. CONCLUSIONS AND IMPLICATIONS: Increases in RN staffing hours were associated with reduced injury-related ED use among AL residents with ADRD. RNs provide surveillance and care oversight that may help mitigate injury risk, and they are able to physically assess residents at the time of a fall and/or injury, which can preempt unnecessary ED transfers.

Huella psicosocial del COVID-19 en enfermeras de 4 países de Latinoamérica, año 2021-2022: aprendizajes y desafíos / Psychosocial footprint of COVID-19 in nurses from 4 South American countries, year 2021-2022: learning and challenges / Pegada psicossocial da COVID-19 em enfermeiros de 4 países da América do Sul, ano 2021-2022: aprendizado e desafios

Objetivo: determinar la huella psicosocial de la pandemia por COVID-19 en enfermeras de 4 países de Sudamérica, año 2021-2022. Métodos: estudio de corte transversal, en una muestra de 279 enfermeras: colombianas (86), paraguayas (68), mexicanas (54) y chilenas (71), que cumplieron los criterios de inclusión.Se aplicaron las escalas de Duke-UNC para evaluar apoyo social recibido y confidencial; El cuestionario Medical Outcomes Study-Social Support Survey (MOS) para evaluar apoyo social y el cuestionario de variables de interacción psicosocial (VIP) Resultados: tanto el buen apoyo confidencial como afectivo, se asoció con las variables de vivir con dos o más personas, ser perteneciente a una religión, y trabajar en una unidad con pacientes. El consumo de medicamentos fue significativamente menor en el grupo con buen apoyo confidencial y afectivo, (p=0.012) Conclusiones:la ejecución del rol profesional de la enfermera es conocido como de alta calidad, y con una destacada responsabilidad, especialmente en pandemia por SAR COVID 19. Sin embargo, se aprecian huellas residuales físicas y emocionales en los profesionales de enfermería.

Objective: to determine the psychosocial footprint of the COVID-19 pandemic in nurses from 4 South American countries, 2021-2022. Methods: cross-sectional study, in a sample of 279 nurses: Colombian (86), Paraguayan (68), Mexican (54) and Chilean (71), who met the inclusion criteria. Duke-UNC scales were applied to assess received and confidential social support; The Medical Outcomes Study-Social Support Survey (MOS) questionnaire to assess social support and the psychosocial interaction variables (VIP) questionnaire. Results: both good confidential and affective support were associated with the variables of living with two or more people, belonging to a religion, and working in a unit with patients. Medication consumption was significantly lower in the group with good confidential and affective support, (p=0.012). Conclusions: the execution of the professional role of the nurse is known to be of high quality, and with outstanding responsibility, especially in the SAR pandemic. COVID 19. However, residual physical and emotional traces can be seen in nursing professionals.

Objetivo determinar a pegada psicossocial da pandemia de COVID-19 em enfermeiros de 4 países da América do Sul, 2021-2022. Métodos: estudo transversal, em uma amostra de 279 enfermeiras: colombianas (86), paraguaias (68), mexicanas (54) e chilenas (71), que atenderam aos critérios de inclusão. As escalas de Duke-UNC foram aplicadas para avaliar o suporte social recebido e confidencial; o questionário Medical Outcomes Study-Social Support Survey (MOS) para avaliar o apoio social e o questionário de variáveis de interação psicossocial (VIP). Resultados: tanto o bom apoio confidencial quanto o afetivo estiveram associados às variáveis morar com duas ou mais pessoas, pertencer a uma religião e trabalhar em unidade com pacientes. O consumo de medicamentos foi significativamente menor no grupo com bom apoio confidencial e afetivo, (p=0,012). Conclusões: sabe-se que o desempenho da função profissional do enfermeiro é de alta qualidade, e com destacada responsabilidade, principalmente na pandemia SAR COVID 19. No entanto, traços residuais físicos e emocionais podem ser observados nos profissionais de enfermagem.

How do nurses advocate for the remaining time of nursing home residents? A critical discourse analysis.

INTRODUCTION: Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the remaining time of residents with dementia holds significance, for them and their families, as they seek respect and the ability to make meaningful end-of-life decisions. OBJECTIVE: To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia. DESIGN: A qualitative research design. SETTING(S): Four nursing homes in Korea from January 2023 to February 2023. PARTICIPANTS: Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited. METHODS: This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context. FINDINGS: Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identified: (1) Bridging perspectives: I am a negotiator between medical treatment and residents' families with differing views; (2) Embracing a shared humanity: Residents are no different from me; they just need professional help; (3) Affirming belongingness: Residents still belong to their families, even when care has been delegated; and (4) Empowering voices for change: We are struggling to provide better care in a challenging reality. CONCLUSIONS: This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for greater societal and political recognition of the efforts nurses make to preserve the personhood and well-being of these older adults.

The effectiveness of mindfulness for the management of anxiety in the nursing staff: Systematic review and meta-analysis.

A systematic review with meta-analysis following Joanna Briggs Institute recommendations. It aimed to determine the effectiveness of mindfulness for the management of anxiety symptoms in the nursing staff and stress as a secondary outcome. The databases searched were MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Psycinfo. Search was conducted in October 2022. Independent reviewers used standardized methods to research, track, and code the included studies. Data meta-analysis was performed using random effects models. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used as an approach to assess the quality and certainty of evidence in research studies. The review examined the effectiveness of mindfulness on nursing staff in 13 studies. The meta-analysis revealed a statistically significant decrease in anxiety and stress after treatment, with an average reduction of 0.36 in anxiety and 0.48 in stress. The results emphasizes the possibility of mindfulness being an effective intervention to the management of anxiety and stress in nursing staff. However, the studies analyzed presented limitations in the design and sampling in the development of the intervention, which impact the conclusive statements about the effectiveness of mindfulness and the generalization of the results. The implications to the nursing field involve adopting evidence-based research and practices to improve the well-being and quality of life of nursing professionals, as well as strengthening the evidence base surrounding mindfulness interventions in nursing practice. This may lead to changes in healthcare policies, care practices, and recognition of the importance of nurses' well-being for effective healthcare delivery.

Health communication and shared decision-making between nurses and older adults in community setting: An integrative review.

AIM: To explore the role of health communication in Shared Decision-Making (SDM) between nursing staff and older people in the community setting. BACKGROUND: Society and healthcare services are marked by an exponentially ageing population, leading to a significant proportion of patients being older adults with highly demanding care needs. Scientific literature supports shared decision-making as a process that engages patients in their care. However, the increasing use of technology and the consequences of the COVID-19 pandemic have influenced how nurses communicate with older patients. Therefore, it is crucial to understand how to develop health communication to reach effective, shared decision-making processes. METHODS: Whittemore and Knafl's integrative review method, the literature search comprised five databases: PubMed, CINALH, Web of Science, Scopus and PsycINFO. RESULTS: The 12 included studies were synthesised into three study patterns: (1) nurse-older patient health communication relationship, (2) older patients' perspectives and (3) nontherapeutic communication in end-of-life care. CONCLUSION: This review underscored the crucial role of effective health communication in shaping SDM dynamics between nursing staff and older people in the community setting. Key elements included transparent information exchange, establishing trust and maintaining communication channels with informal caregiving networks. SDM actions were aligned with preserving older people's autonomy, but communication challenges persisted, particularly in end-of-life situations. Advanced care planning was recommended to address these shortcomings and improve communication among older people, healthcare professionals and families. IMPLICATIONS: Implementing educational measures based on verbal and nonverbal health communication in nursing training could be beneficial. Nursing research could continue to develop and refine specific communication strategies adapted to the social determinants of health for diverse clinical situations regarding older adults in the community setting. REPORTING METHOD: The authors have adhered to relevant EQUATOR guidelines through the PRISMA 2020 checklist. No Patient or Public Contribution.

Knowledge of nursing staff before and after training on incontinence-associated dermatitis.

OBJECTIVE: To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. METHOD: A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. RESULTS: 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. CONCLUSION: The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.

Nurses' Perceptions of Telemonitoring Devices to Reduce Falls Among Hospitalized Patients: A Literature Review.

PURPOSE: Technological advances have led to the adoption of telemonitoring devices for fall prevention. Multiple previous studies looked at the effectiveness of these devices. However, few studies looked at nursing staff perceptions of the technology. The current integrated literature review examined factors that influence nurses' and nursing staff's acceptance of telemonitoring technology for fall prevention. METHOD: Three databases (CINAHL, Embase, and PubMed) were searched from January 2010 through September 2023. Study themes were analyzed, and study quality was appraised. Thirteen articles were identified and analyzed. RESULTS: Nurses' perceptions included positive, negative, and mixed views of tele-monitoring technology. Key factors influencing staff perceptions of telemonitoring technology include the effectiveness of the technology at improving patient safety, its ease of use, and the degree to which staff felt supported by nursing leadership and hospital administration. CONCLUSION: Findings demonstrate the importance of involving nurses in decisions regarding implementation of new technology. [Journal of Gerontological Nursing, 50(4), 6-10.].

Prevalence and associated factors of insomnia symptoms after ending China's dynamic zero-COVID policy: a cross-sectional survey of frontline nursing staff in Chinese hospitals.

Background: After the Chinese government announced the end of the dynamic zero-COVID policy on January 8, 2023, the COVID-19 pandemic peaked. Frontline nursing staff are at high risk of infection transmission due to their frequent contact with COVID-19 patients. In addition, due to the ending of China's dynamic zero-COVID policy, frontline nursing staff have grappled with increased workload, fatigue, and more. This study aimed to explore the prevalence of insomnia symptoms in frontline nursing staff and its influencing factors following the end of the policy. Methods: Between January and February 2023, this study was conducted by the Wenjuanxing platform to survey frontline nursing staff in a hospital in Wuhu City, Anhui Province. All the nursing staff included in this study had a COVID-19 infection. The questionnaires included the Athens Insomnia Scale (AIS), PC-PTSD-5 Chinese Version Scale, the Fear of COVID-19 Scale, The 2-item Connor-Davidson Resilience Scale (CD-RISC-2) Scale, and the burden of COVID-19 Scale. Binary logistic regression methods were used to identify variables associated with insomnia symptoms. Results: Among the 694 frontline nursing staff, 74.5% (517/694) exhibited insomnia symptoms. Fear of COVID-19 (p < 0.001), the burden of COVID-19 (p < 0.05), PTSD (p < 0.001), and higher technical titles (p < 0.008) were highly correlated with insomnia symptoms in frontline nursing staff. Psychological resilience (p < 0.001) was a protective factor for insomnia symptoms among frontline nursing staff. Conclusion: After ending China's dynamic zero-COVID policy, the prevalence of insomnia symptoms among frontline nursing staff is generally higher. This study highlights the association between insomnia symptoms and PTSD, fear of COVID-19, COVID-19 burden, and resilience. Psychological assistance is needed for frontline nursing staff to prevent insomnia symptoms and protect the mental health of frontline nursing staff after the end of China's dynamic zero-COVID policy.

A Different Mindset for a Different Culture: Sustaining the Next-Generation Workforce.

The author is a nurse executive who shares insights into why company leaders must change their mindset in how they build the next-generation nursing workforce culture. Despite the national nursing shortage crisis, nurses continue to be the most trusted profession for the 22nd consecutive year in a row. Technology advancements, generational paradigm shifts, global and domestic business transformations, diversity, equity, inclusion, and employee well-being are trends that have directly impacted the need for these changes. We know that it is not just about recruiting but also about creating a culture where the ambitions, aspirations, and perspectives of the nursing workforce are honored. There are key company strategies that matter to creating a next-generation workforce culture and are transferable to health care. Leaders must think differently about the culture they have to build in order to attract and retain the next-generational nursing and clinical workforce.