Deconstructing nursing's paradoxical relationship with the concept of complexity.

Although nursing seems to understand itself and its practice as complex, the literature is less clear about what this actually means. While complexity is discussed as an attribute of nursing, it is also suggested that complexity in nursing remains misunderstood and poorly articulated, is devalued, is not considered as a measure of health outcomes and remains invisible. Despite the overarching lack of a definition, some nurse scholars have conceptualized complexity as a complex intervention. For these authors, complexity becomes a complex intervention defined as that which is composed of component parts interacting in a variety of ways that influence the delivery of and outcomes of health-related interventions for populations. Conceptualizing complexity as a complex intervention forces nursing to embrace and adopt a received interpretation of complexity as expressed through complexity theory and complexity science. While complexity theory may afford us some tools for thinking about complexity, when we deconstruct nursing complexity to explicitly determinate and quantifiable tasks, this artificially narrowed orientation to complexity reveals an oversimplified explanation of the complexities associated with nursing and serves to blind us to its real qualities. Through a consideration of complexity from a Western philosophical tradition, I demonstrate that when nursing adopts the received interpretation of complexity as a complex intervention, this perspective on complexity contains nursing epistemologically and ontologically. I offer an extended conceptualization of complexity framed upon the consideration that nurses assume complexity and do not reduce it; that nurses have the capacity to not be paralysed by complexity and have developed logics to mobilize it in productive ways. Mobilizing complexity through navigating paradox and contradiction shapes an orientation to complexity that embraces an extended epistemology. This extended epistemology is characterized by a 'yes/and' mindset that expresses the dynamic and generative relationship between forms of knowledge which reflects complexity that characterizes nursing.

The public's perception of the nursing profession: Validity and reliability of the Chinese version of the nursing image scale in Taiwan.

The public's perception of the nursing image deeply influences nurses' work and professional development. However, the Taiwanese public's perception of nursing remains unclear. This study aimed to determine the validity and reliability of a Chinese version of the Nursing Image Scale (NIS) in Taiwan. This was a psychometric study using a cross-sectional survey. Participants were recruited via the snowball sampling method through the online community software LINE from August 1 to 13, 2019. After data collection, the construction and validation of the NIS to measure public opinion were assessed, including content validity, corrected item-total correlation, exploratory factor analysis (EFA), and reliability. A total of 1331 valid responses were included in the analysis. After EFA analysis, the 20 scale items were divided across the four domains of prudence and care, innovation and cooperation, efficiency and division, and professionalism and respect. The NIS (Chinese version) was valid and reliable for measuring public opinion and may be used to examine changes in public perceptions of nursing.

Nursing workload: use of artificial intelligence to develop a classifier model.

OBJECTIVE: to describe the development of a predictive nursing workload classifier model, using artificial intelligence. METHOD: retrospective observational study, using secondary sources of electronic patient records, using machine learning. The convenience sample consisted of 43,871 assessments carried out by clinical nurses using the Perroca Patient Classification System, which served as the gold standard, and clinical data from the electronic medical records of 11,774 patients, which constituted the variables. In order to organize the data and carry out the analysis, the Dataiku® data science platform was used. Data analysis occurred in an exploratory, descriptive and predictive manner. The study was approved by the Ethics and Research Committee of the institution where the study was carried out. RESULTS: the use of artificial intelligence enabled the development of the nursing workload assessment classifier model, identifying the variables that most contributed to its prediction. The algorithm correctly classified 72% of the variables and the area under the Receiver Operating Characteristic curve was 82%. CONCLUSION: a predictive model was developed, demonstrating that it is possible to train algorithms with data from the patient's electronic medical record to predict the nursing workload and that artificial intelligence tools can be effective in automating this activity.

School counselor perceptions and practices of advising male high school students regarding a career in nursing.

BACKGROUND: The literature describes how male high school students with an interest in a career in nursing have struggled to obtain guidance, support, and accurate information. PURPOSE: The purpose of this mixed-methods study was to understand the perceptions and practices of school counselors when advising male high school students about a nursing career. METHOD: Sixty-one school counselors completed an online survey, and nine participated in online interviews between June 2022 and February 2023. RESULTS: Unlike previously published studies, school counselors have an overall positive view of men in nursing and were supportive of male high school students becoming nurses. CONCLUSIONS: School counselors need more accurate and consistent resources.

Interventions that support novice nurses' transition into practice: A realist review.

BACKGROUND: Many transition-to-practice programs have been developed to support novice nurses during their first years into practice. These programs report improvements in retention, wellbeing and clinical competence, but the driving mechanisms of these interventions remain largely unclear. OBJECTIVE: To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully. METHODS: A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023. RESULTS: A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture. CONCLUSIONS: Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level. REGISTRATION: PROSPERO ID CRD42021268080, August 15, 2021. TWEETABLE ABSTRACT: Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiontopractice @nurseworkforce.

This Could Be a Game Changer.

Creating a potential solution to the nursing workforce issue.

[Nursing science put to the epistemological test]. / La science infirmière à l'épreuve de l'épistémologie.

Today, we are witnessing the emergence of a nursing discipline that is clearly seeking to base its legitimacy primarily on science. However, only an epistemological approach can assure us of the relevance of such an approach. While the nursing discipline must unquestionably be based on a rational, scientific approach, can we not nevertheless assume that an irreducible element of mystery will forever remain at the heart of care?

The digital transformation in nursing education and practice

Digital health refers to “the cost-effective and secure use of information and communications technologies in support of health and health-related fields, including healthcare services, health surveillance, health literature, and health education, knowledge and research.” The adoption of digital health solutions has been accelerated by the COVID-19 pandemic, proving they are key for the delivery of care at all levels of the public health system: the patient, the community, the care team, the healthcare institution, and the political and economic environment. Digital health is an integral part of health priorities and can be beneficial when used in an ethical, equitable, and sustainable way. The comprehensive benefits of digital health include facilitating the assessment, diagnosis, and management of health problems in a safe and effective manner, thereby fostering greater equity in access to timely medical care; addressing unmet health needs; and strengthening the capacity of the whole sector to access the information needed to understand complex scenarios and make decisions, among others. This publication presents the possibilities of incorporating and using technologies in the education and practices of nurses in their various contexts of activity and proposes a digital transformation of nursing as part of the increased technological advance in health care. It also contemplates regulatory and normative aspects in digital health. This digital transformation depends on a range of aspects, such as investment, infrastructure, professional recognition, cultural change, educational update, new skills, and competencies. It positions the nurse as a health agent capable of transforming nursing processes for a future setting where patients will be more digitally empowered and more knowledgeable on their own health status.

Estudo retrospectivo do perfil dos casos de violência contra a mulher / Restrospective study of the profile of cases of violence against women / Estudio restrospectivo del perfil de los casos de violencia contra la mujer

Objetivo:caracterizar os casos de violência contra a mulher, notificados em um município do sudoeste do Paraná. Método:trata-se de um estudo retrospectivo, descritivo e de abordagem quantitativa.A coleta de dados ocorreu no portal do Departamento de Informática do Sistema Único de Saúde, pesquisando variáveis como: faixa etária, escolaridade, raça/cor, tipos de violência e responsável pela agressão. Resultados:foram encontrados 1.762 casos notificados entre 2017 e 2021. Conclusões: as mulheres mais acometidas foram: jovens de 15 a 19 anos (27,70%); ensino médio completo (28,04%); e brancas (68,44%). Referente ao tipo de violência e responsável pela agressão, 20,56% das ocorrências foram de forma física e 33,47% tendo o cônjuge como principal executor

Objective:to characterize the cases of violence against women reported in a municipality in the southwest of Paraná, Brazil. Method:this is a retrospective, descriptive study with a quantitative approach. Data collection took place on the website of the Information Technology Department of the Unified Health System, searching for variables such as: age group, schooling, race/color, types of violence, and the person responsible for the aggression. Results:1,762 cases were reported between 2017 and 2021. Conclusions: the most affected women were:young people aged 15 to 19 (27.70%); complete high school (28.04%); and white (68.44%). Regarding the type of violence and the person responsible for the aggression, 20.56% of the incidents were physical and 33.47% had the spouse as the main perpetrator.

Objetivo:caracterizar los casos de violencia contra la mujer notificados a un municipio del suroestedel Paraná. Método:se trata de un estudio retrospectivo, descriptivo y de enfoque cuantitativo. La recopilación de datos ocurrió en el portal del Departamento de Informática del Sistema Único de Salud investigandovariables como: grupo de edad, educación, raza/color, tipos de violencia y, responsable por la agresión. Resultados:se encontraron1.762 casos reportados entre 2017 y 2021. Conclusiones:las mujeres más afectadas fueron jóvenes de 15 a19 años (27,70%), con enseñanza secundaria completa (28,04%) y blancas (68,44%). En cuanto al tipo de violencia y responsable por la agresión, el 20,56% de las ocurrencias fueron de forma física y el 33,47% tuvieron al cónyuge como principal ejecutor.

Instrumento de avaliação do processamento de produtos para saúde em centros de esterilização: estudo metodológico / Assessment instrument for the processing of healthcare products in sterilization centers: a methodological study / Instrumento de evaluación del procesamiento de productos sanitarios en centros de esterilización: estudio metodológico

Objetivo:construir e validar um instrumento de avaliação do processamento de produtos para saúde em centro de materiais e esterilização. Método:estudo metodológico realizado com 22 profissionais de saúde, sendo oito juízes especialistas e 14 enfermeiros responsáveis pelo setor de apoio. Foram realizadas quatro rodadas da técnica Delphi e posteriormente, as propriedades psicométricas foram analisadas por meio do Índice de Validade de Conteúdo e do teste Alfa de Cronbach. Resultados: o tempo de experiência dos juízes especialistas variou de 2 a 18 anos, com média de 7,7 (±6,1). A validação de conteúdo obteve média global de 0,95 (±0,05) e mediana de 0,97. O teste Alfa de Cronbach apresentou boa consistência interna após aplicação do pré-teste. Ao final, a versão do instrumento foi consolidada em 43 questões, divididas em três eixos de avaliação. Conclusão: este instrumento poderá ser utilizado em nível nacional, visto que suas propriedades psicométricas apresentaram valores satisfatórios.

Objective: to develop and validate an assessment instrument for the processing of healthcare products in a central materials and sterilization centers. Method:a methodological study was conducted with 22 healthcare professionals, comprising eight expert judges and 14 nurses responsible for the support sector. Four rounds of the Delphi technique were carried out, and subsequently, the psychometric properties were analyzed using the Content Validity Index and Cronbach's Alpha test.Results: the experience of the expert judges ranged from 2 to 18 years, with an average of 7.7 (±6.1). Content validation yielded a mean score of 0.95 (±0.05) and a median of 0.97. The Cronbach's Alpha test showed good internal consistency. Atthe end, the instrument version was consolidated into 43 questions.Conclusion: this instrument can be used nationally, asits psychometric properties showed satisfactory values.

Objetivo: construir y validar un instrumento para evaluar el procesamiento de productos sanitarios en centrosde materiales y esterilización.Método: estudio metodológico realizado con 22 profesionales de la salud, ocho de los cuales fueron jueces expertos y 14 enfermeros responsables del sector de apoyo. Se realizaron cuatro rondas de la técnica Delphi y posteriormente se analizaron las propiedades psicométricas mediante el Índice de Validez de Contenido y la prueba Alfa de Cronbach. Resultados:la experiencia de los jueces expertos osciló entre 2 y 18 años, con una media de 7,7 (±6,1). La validación de contenido obtuvo una media global de 0,95 (±0,05) y una mediana de 0,97. La prueba Alfa de Cronbach mostró buena consistencia interna luego de aplicar el pretest.Conclusión: este instrumento puede ser utilizado a nivel nacional, ya que sus propiedades psicométricas presentaron valores satisfactorios.

Comunicação na transferência de cuidados para realização de exames de imagem na ótica da enfermagem / Communication in the transfer of care for imaging exams from a nursing perspective / Comunicación en la transferencia de cuidados para exámenes por imágenes desde la perspectiva de enfermería

Objetivo:analisar a percepção de profissionais de enfermagem sobre a comunicação entre equipes na transferência de cuidados de pacientes para a realização de exames de imagem. Método:pesquisa exploratório-descritiva, qualitativa, realizada com 43 profissionais de enfermagem de um complexo hospitalar de Porto Alegre, entre junho e agosto de 2021. Os dados foram coletados por entrevista semiestruturada e utilizou-se Análise de Conteúdo de Minayo. Resultados:emergiram três temas: como ocorre o processo de comunicação para a transferência do paciente internado ao setor de exames; as potencialidades e fragilidades deste processo e ferramentas para qualificar a comunicação. O enfermeiro atua como articulador da comunicação, que ora ocorre utilizando ferramentase com etapas verbais/telefônicas. O sistema de notas de transferência, a dupla checagem e o readbackpossuem falhas, por não serem oficializados nem específicos. Conclusões:os profissionais consideram a comunicação verbal como a maior fragilidade e sugerem ferramentas formais para torná-la efetiva.

Objective:to analyze the perception of nursing professionals regarding communication between teams in the transfer of patient care for imaging examinations. Method:exploratory-descriptive research, qualitative, conducted with 43 nursing professionals from a hospital complex in Porto Alegre, between June and August 2021. Data were collected through semi-structured interviews and analyzed using Minayo's Content Analysis. Results: three themes emerged: how the communication process occurs for the transfer of the hospitalized patient to the examination department; the strengths and weaknesses of this process; and tools to enhance communication. The nurse acts as a communication facilitator, sometimes using tools and verbal/phone methods. The transfer note system, double-checking, and read-back have flaws because they are not formalized nor specific. Conclusions: professionals consider verbal communication the major weakness and suggest formal tools to make it more effective

Objetivo: analizar la percepción de profesionales de enfermería sobre la comunicación entre equipos al momento de transferir la atención al paciente para la realización de exámenes de imagen.Método: investigación realizada con 43 profesionales de enfermería de un complejo hospitalario de Porto Alegre, entre junio y agosto de 2021. Entrevistas semiestructuradas ocurrieron y se utilizó el análisis de contenido. Resultados: surgieron tres temas: cómo ocurre el proceso de comunicación para la transferencia delpaciente hospitalizado al departamento de exámenes; las potencialidades y debilidades de este proceso y las herramientas para cualificar la comunicación. El enfermero actúa como articulador de la comunicación, que en ocasiones ocurre mediante herramientasy pasos verbales/telefónicos. El sistema de notas de transferencia, la doble verificación y la relectura tienen fallas, pues no son oficiales ni específicos. Conclusiones: los profesionales consideran la comunicación verbal como la mayor debilidad y sugieren herramientas formales para hacerla efectiva.

[New Technology, Warm Care: Social Robots in Nursing Practice and Research].

Recent, rapid advancements in technology have enabled the introduction and integration of robots into everyday life. Different from the traditional image of robots as cold and mechanical, social robots are designed to emulate human interaction patterns, improving the user experience and facilitating social interactivity. Thus, social robots represent a promising new care intervention. In this article, after defining social robots and explaining the factors influencing "human-robot interaction", the authors discuss the effectiveness of social robots in the context of providing care to patients with dementia and autism as well as to pediatric patients. Finally, current cases in which PARO, a social robot, has been used in nursing are described, and key challenges and suggestions for future social robot applications are given. Current evidence indicates social robots must be developed and designed to adhere to a people-centered approach to achieve better robot-assisted care outcomes, be better accepted by patients, and better enable patients to open up emotionally and maintain good physical, mental, and social well-being.

An integrative review of racism in nursing to inform anti-racist nursing praxis in Aotearoa New Zealand.

AIM: To synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti-racist praxis to inform nursing in Aotearoa New Zealand. DESIGN: An integrative literature review was undertaken, integrating Indigenous Kaupapa Maori methodologies to ensure a cultural and philosophical lens. METHODS: Peer-reviewed literature published, between January 2011 and July 2023 were sourced. Of 1296 articles, 16 met the inclusion criteria and 4 were identified via citation chaining. In total, 20 articles were included. The Johns Hopkins Research Evidence Tool was applied, findings extracted, and thematic analysis completed utilising Indigenous Kaupapa Maori principles. DATA SOURCES: Databases, including CINAHL, Scopus, PubMed and Aus/NZ Reference Centre, were searched in July 2023. RESULTS: Two key themes were identified: (1) colonial active resistance to change; and (2) transformational, visionary, and proactive nursing. CONCLUSION: Nurses are well-positioned to confront the structures that maintain racism in health and education systems but are often actors in maintaining status quo. Anti-racist praxis can be a mechanism for nurses to reimagine, redefine and transform nursing care, leadership, and nursing education to begin to eradicate racism. REPORTING METHOD: This integrative review adhered to the 2020 Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPLICATIONS FOR THE PROFESSION: Racism remains prevalent in nursing and the healthcare system. It is necessary to implement anti-racist praxis and policies that resist, deconstruct, and dismantle power and racism while validating Indigenous values, beliefs and practices. This is vital to deliver equitable health care. IMPACT: This integrative review presents lived realities and knowledge of Indigenous and racially minoritised nurses and scholars, alongside nursing allies to inform anti-racist praxis. This evidence signifies that it is time to walk the walk to challenge the colonising systems and processes that hold racism in place.