Nurses' practices in stroke-related dysphagia in low- and middle-income countries.

BACKGROUND:  Nurses are often required to perform dysphagia screening prior to oral intake by people following stroke. Previous studies report limited knowledge of nurses in identifying symptoms of post-stroke dysphagia. OBJECTIVE:  To explore existing literature regarding nurses' practices and knowledge in the identification and management of post-stroke oropharyngeal dysphagia (OPD) in low- and middle income countries (LMICs). METHOD:  A scoping review was conducted according to the PRISMA-ScR guidelines. Studies were retrieved from PubMed, Scopus, EBSCOhost (CINAHL and Health source: Nursing and Academic edition), Web of Science Core collection, and Cochrane libraries. No time frame was applied, and all included studies were screened according to predefined eligibility criteria. RESULTS:  Eight studies were included from 1 792 initial hits. Studies described nursing practices in acute care pertaining to identification and management of stroke-related dysphagia in LMICs. Increased knowledge was reported in nurses who had greater clinical experience in managing patients with dysphagia. Needs for training relating to dysphagia management and opportunities for interprofessional collaboration with speech-language therapists (SLTs) were identified. Contextual barriers specific to LMICs impacting on optimal nursing management of dysphagia included heavy workloads, staff-shortages and time constraints.Conclusion and contribution: Eight studies described nurses' practices and identified needs for the improvement of nurses' dysphagia care in LMICs. This scoping review highlighted the urgency for further research in dysphagia management that provides creative, contextually relevant solutions for improved protocols and training of health care professionals. Findings may be valuable for the multidisciplinary team involved in post-stroke dysphagia care.

Nursing practices to optimise rheumatic fever prevention in a high-risk country: An integrative review.

BACKGROUND: New Zealand is one of the last high-income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this. AIM: To explore nursing practices that optimise rheumatic fever prevention. DESIGN: An integrative review. METHODS: Four electronic databases (CINAHL, SCOPUS, Medline via, and Ovid) were searched for peer-reviewed empirical articles published from 2013 to 2023. Grey literature (guidelines/reports) was also sourced. Critical appraisal was applied using the Mixed-Methods Appraisal Tools and the Joanna Briggs Critical Appraisal checklist. Qualitative Research in Psychology, 3(2), 77-101, thematic analysis method was used to generate themes. RESULTS: Seven research articles and three national reports were included. Four themes-in-depth nursing knowledge and improving prophylaxis adherence, cultural competency, and therapeutic nurse-patient relationships-were found. CONCLUSION: While nursing knowledge and ways to improve injection adherence are essential, being culturally receptive and developing therapeutic relationships are equally important. Without strong and trusting relationships, it is difficult to deliver care required for prevention success. IMPLICATIONS TO CARE: When working with vulnerable populations it is important to be culturally receptive in all interactions with patients and their families. IMPACT: New Zealand has high rates of rheumatic fever, especially among vulnerable populations such as Pacific Islanders and Maori. Nurses are often frontline primary care providers who, when skilled with the right tools, can help reduce the prevalence of this disease. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow chart. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution was required for this research.

Empowering nurses: exploring self-managed organizations in Indian healthcare.

BACKGROUND: Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. METHOD: This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. RESULTS: The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. CONCLUSION: In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.

The Ethical, Care, and Client-Caregiver Relationship Impacts Resulting From Introduction of Digital Communication and Surveillance Technologies in the Home Setting: Qualitative Inductive Study.

BACKGROUND: Embedding communication and surveillance technology into the home health care setting has demonstrated the capacity for increased data efficiency, assumptions of convenience, and smart solutions to pressing problems such as caregiver shortages amid a rise in the aging population. The race to develop and implement these technologies within home care and public health nursing often leaves several ethical questions needing to be answered. OBJECTIVE: The aim of this study was to understand the ethical and care implications of implementing digital communication and surveillance technologies in the home setting as perceived by health caregivers practicing in the region of Halland in Sweden with clients receiving home care services. METHODS: A questionnaire was completed by 1260 home health caregivers and the written responses were evaluated by qualitative inductive content analysis. The researchers reviewed data independently and consensus was used to determine themes. RESULTS: This study identified three main themes that illustrate ethical issues and unintended effects as perceived by caregivers of introducing digital communication and surveillance technologies in the home: (1) digital dependence vulnerability, (2) moral distress, and (3) interruptions to caregiving. This study highlights the consequences of technology developers and health systems leaders unintentionally ignoring the perspectives of caregivers who practice the intuitive artistry of providing care to other humans. CONCLUSIONS: Beyond the obtrusiveness of devices and impersonal data collection designed to emphasize health care system priorities, this study discovered a multifaceted shadow side of unintended consequences that arise from misalignment between system priorities and caregiver expertise, resulting in ethical issues. To develop communication and surveillance technologies that meet the needs of all stakeholders, it is important to involve caregivers who work with clients in the development process of new health care technology to improve both the quality of life of clients and the services offered by caregivers.

Relationship between Structural Empowerment and Nurse and Patient-Reported Outcomes: The Mediating Role of Control over Nursing Practices.

Practices that strengthen nurse work environments and enable them to have control over nursing practices have gained importance in recent years as they increase nurses' retention and patient care quality. This study aimed to examine the relationships between structural empowerment and nurse and patient-reported outcomes and the mediating role of control over nursing practices in these relationships. This correlational and cross-sectional study was carried out from September 2018 to May 2019 at two public hospitals in Turkey. We recruited staff nurses (n = 319) working in the inpatient units of these hospitals and their patients (n = 319). Data were collected using self-report measures from staff nurses and patients. It was determined that structural empowerment and control over nursing practices had a positive relationship with job satisfaction and nursing care quality, as well as a negative relationship with intention to turnover; however, there was no relationship with patient-reported outcomes. Control over nursing practices partially mediated the relationship between structural empowerment and outcomes of job satisfaction and nursing care quality. This study indicates that promoting the structural empowerment of nurses and ensuring that they have control over practice will increase job satisfaction and quality of care. Nurse managers can increase nurses' job satisfaction and quality of care by creating supportive work environments and ensuring they have control over nursing practices.

Mapping research findings on change implementation in nursing practice: A scoping literature review.

AIMS: The aim of this study was to map the diverse factors impacting change implementation in nursing practices and investigate different implementation strategies. DESIGN: Scoping literature review following PRISMA-ScR extension. METHODS: Data were collected from PubMed, Ebsco, Scopus and ScienceDirect databases from 1990 onwards. Only English peer-reviewed studies reporting an implementation of change in nursing practice were included. Of 9,954 studies, 425 abstracts were scanned and 98 full-text articles were screened. Finally, 28 studies were selected. RESULTS: A multifaceted approach, with a tailored intervention, was the most effective implementation strategy. Most identified factors were considered systematic, for example resource availability, leadership and knowledge. However, others related to local social and material context were identified in fewer number of studies. These seem to be operational elements for implementation processes. Both types of factors are essential and must be considered for successful implementation. CONCLUSION: We advocate the development of framework including systematic factors and which capture the local context flexibility.

Clinical nurses' knowledge and practices on routine care related to the prevention of complications of peripheral intravenous therapy: A cross-sectional study.

AIM: The aim of this descriptive and cross-sectional study was to determine the knowledge and practices of nurses related to the prevention of peripheral intravenous therapy (PIT) complications, and to identify the influencing factors. METHODS: The study adopted a cross-sectional and descriptive design and was conducted between April and August of 2018 with a total of 214 clinical nurses. The data collection tools employed were a 12-item sociodemographic questionnaire and a 16-item questionnaire on knowledge and practices related to the prevention of peripheral intravenous therapy complications. RESULTS: The mean knowledge scores of the nurses were found to be 81.54 ± 12.06 (min: 50, max: 100). No statistically significant difference was found to exist between the scores, and the variables of the nurses' gender, length of employment in the health profession, type of work, training received related to PIT complications, and self-competence level in PIT complications. CONCLUSION: The nurses were found to have high knowledge levels; however, their practices for preventing PIT complications differed. Standardized practice procedures and workplace training are needed in order to transform nurses' knowledge into practice with regard to the prevention of PIT complications.

A Phenomenological Analysis of Experiences and Practices of Nurses Providing Palliative and End of Life Care.

The aim of this study was to describe the experiences and practices of nurses providing palliative and end of life care. The study was conducted in the palliative care unit of a territory hospital in Turkey. The sample consisted of 11 nurses who had been working as palliative care nurses for at least one year. The face to face interview method was used to collect data, with a semi-structured in-depth individual interview. 5 main themes and 24 sub-themes were emerged in relation to the experiences and practices of the nurses. The majority of participant nurses pointed that inadequacy in the number of nurses, secondary nursing care activities, refusal of treatment, cultural and ethical problems were barriers in the provision of nursing care. They frequently experienced ethical issues when caring for end of life patients, and for this reason they felt the need for ethics counselling which they could consult.

Factors Affecting Patient Safety Culture from Nurses' Perspectives for Sustainable Nursing Practice.

Individual and group beliefs, attitudes, perceptions, competences, and behavioral patterns all contribute to the safety culture of a healthcare company. The study's goal is to assess nurses' perceptions of elements that influence patient safety culture in order to promote long-term nursing practice. A descriptive cross-sectional study design was done among a sample of 146 nurses who were recruited from one hospital in Egypt. They completed a self-administered, printed questionnaire. The questionnaire assessed participants' socio-demographic data and their perception regarding patient safety culture for sustainable nursing practices. The findings revealed that nursing staff had a high perception regarding patient safety culture a with mean score (159.94 ± 7.864). Also, the highest percentage (74.66%) of had no safety events reported yearly. Creating a unit-specific patient safety culture suited to the competences of the unit's RNs in patient safety practice would be crucial to increasing and sustaining high levels of patient safety attitudes, skills, and knowledge among the unit's RNs, influencing patient safety. When implementing interventions to promote patient safety and reporting culture in hospitals, policymakers, hospital administrators, and nurse executives should take the current findings into account. A multidimensional network intervention addressing many elements of patient safety culture and integrating different organizational levels should be implemented to enhance patient safety and a no-blame culture.

Scandinavian Nurses' Use of Social Media during the COVID-19 Pandemic-A Berger and Luckman Inspired Analysis of a Qualitative Interview Study.

There is a knowledge gap about nurses' use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann's theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 'reality' and 'knowledge' amongst nurses, with the pandemic bringing to the fore the issue of e-professionalism among nurses relating to their clinical practice. However, social media and virtual education were not commonly used in patient contacts. Further, nurses attempted a re-socialisation of the public to proper COVID-19 behaviour through social media. Moreover, blurred boundaries between acting as a private individual and a professional nurse were identified, where ethics of the nursing profession extended to nurses' private lives.

Assessing the Integrative Framework for the Implementation of Change in Nursing Practice: Comparative Case Studies in French Hospitals.

The implementation of healthcare policies in healthcare organizations is a pivotal issue for managers. They generally require a change in professional practices. In previous work, we developed the Integrative Framework for Implementation of change in Nursing Practices (IFINP) to support implementation initiatives for such change in nursing practices. We aimed to assess the generalizability of IFINP in other organizational settings and explore links between strategic and socio-material factors during implementation. We used a comparative qualitative case study at three French hospitals to assess the implementation of certification procedures. Data were collected from 33 semi-structured interviews with managers and nurses. Narratives reflecting actions and interactions were extracted and deductively analyzed using IFINP components. The results showed that the framework was flexible and captured the different aspects of implementation actions and interactions at the three hospitals. Strong interferences were identified between mobilization mechanisms and strategic elements. Interferences were observed mostly between 'reflexive monitoring and work articulation', and 'reflexive monitoring and sense-making' mechanisms. Leadership was integrated into the different mechanisms, especially the 'translation' mechanism. The IFINP facilitated a greater understanding of strategic elements and associated relationships with social and material factors during implementation. It helps to provide a clear definition of the managers' role when implementing new nurse practices.

The role of stroke nurses in thrombolysis administration in Australia and the United Kingdom: A cross-sectional survey of current practice.

BACKGROUND: The role of stroke nurses in patient selection and administration of recombinant tissue plasminogen activator (rt-PA) for acute ischaemic stroke is evolving. OBJECTIVES: To compare differences in stroke nurses' practices related to rt-PA administration in Australia and the United Kingdom (UK) and to examine whether these differences influence rt-PA treatment rates. METHODS: A cross-sectional, self-administered questionnaire administered to a lead stroke clinician from hospitals known to provide rt-PA for acute ischaemic stroke. Chi-square tests were used to analyse between-country differences in ten pre-specified rt-PA practices. Non-parametric equality of medians test was used to assess within-country differences for likelihood of undertaking practices and association with rt-PA treatment rates. Reporting followed STROBE checklist. RESULTS: Response rate 68%; (Australia: 74% [n = 63/85]; UK: 65% [n = 93/144]). There were significant differences between countries for 7/10 practices. UK nurses were more likely to: request CT scan; screen patient for rt-PA suitability; gain informed consent; use telemedicine to assess, diagnose or treat; assist in the decision for rt-PA with Emergency Department physician or neurologist; and undergo training in rt-PA administration. Reported median hospital rt-PA treatment rates were 12% in the UK and 7.8% in Australia: (7.8%). In Australia, there was an association between higher treatment rates and nurses involvement in 5/10 practices; read and interpret CT scans; screen patient for rt-PA suitability; gain informed consent; assess suitability for rt-PA with neurologist/stroke physician; undergo training in rt-PA administration. There was no relationship between UK treatment rates and likelihood of a stroke nurse to undertake any of the ten rt-PA practices. CONCLUSION: Stroke nurses' active role in rt-PA administration can improve rt-PA treatment rates. Models of care that broaden stroke nurses' scope of practice to maximise rt-PA treatment rates for ischaemic stroke patients are needed. RELEVANCE TO CLINICAL PRACTICE: This study demonstrates that UK and Australian nurses play an important role in thrombolysis practices; however, they are underused. Formalising and extending the role of stroke nurses in rt-PA administration could potentially increase thrombolysis rates with clinical benefits for patients.

Research progress on risk factors and nursing practice of fragile fracture / 中国实用护理杂志

Fragile fracture has become a major health concern in our society and an important cause of death in elderly patients. Effective identification of risk factors and optimization of clinical nursing practice are helpful to improve the effect of treatment and nursing and reduce the medical burden of disease. This article reviews the literature on the risk factors and clinical practice of fragile fractures at home and abroad, determines the important risk factors of fragile fractures, provides the latest situation of fragile fracture nursing practice, and puts forward relevant suggestions for domestic brittle fracture nursing management research, which provides reference for optimizing the clinical practice of patients with fragile fractures.

Exploration and development of fragility fracture nursing practice / 中国实用护理杂志

With the intensification of population aging, the world is facing the challenges of medical care brought by fragility fractures. From the current situation of fragility fractures, this paper summarizes the current nursing practice hotspots of fragility fractures, expounds the prevention strategies for secondary fractures, and propose promoting the effective management of fragility fractures through a multidisciplinary cooperative nursing model, and provide reference for improving the nursing quality of patients with fragility fractures

Perceptions About Nursing Practice Based on the Internet of Things: A Survey of Nursing Managers.

The purpose of this study was to investigate the perceptions of nursing managers about adopting nursing practices based on the Internet of Things and to examine related ethical issues. Questionnaires were sent to 538 nursing managers in Japan, with 131 responses. Of these, 87% and 33% agreed that a system using radio frequency identifiers would be useful for locating patients and nurses, respectively, 58%-81% recognized the value for patient safety of various camera systems for nursing observation, such as cameras linked to biometric alarms, 73% agreed the usefulness of automatically prioritizing alarms, but only around 39% were in favor of using facial recognition to help nursing observation. Many nursing managers expressed concerns about privacy. Data storage for at least 6 months was supported by 53% for location data and 41% for ceiling camera videos. Thus, nursing practice based on the Internet of Things is widely accepted in Japan.

Complexidade das Práticas da Enfermagem na Atenção Primária à Saúde / Complexity of nursing practices in primary health care / Complejidad de las prácticas de enfermería en la atención primaria de salud

Objetivo: Refletir sobre a complexidade das práticas de Enfermagem no âmbito da Atenção Primária à Saúde no Brasil, tendo na Estratégia Saúde da Família a base estruturante de um novo modelo de atenção. Método: Trata-se de um ensaio teórico-reflexivo, desenvolvido entre junho e julho de 2021, a paritr do conhecimento e das experiências, acadêmicas e profissionais dos autores; os quais analisam, refletem e contextualizam, sobre a contribuição da Enfermagem brasileira na extensão e profundidade dos atributos essenciais e derivados da APS, enraizados nos valores, princípios e diretrizes de promoção, prevenção, tratamento, reabilitação e cura nos processos de saúde-doença-cuidado. Resultados: Aponta os desafios contemporâneos à superação dos elementos constituintes do modelo médico-hospitalar, caracterizado pela ineficiência, baixa efetividade e insatisfação da população, em territórios de profundas desigualdades sociais, econômicas, políticas e sanitárias. Conclusão: Em síntese, indica que se faz necessário seguir imprimido movimentos ativos que ampliem as decisões políticas de assegurar a saúde como direito de cidadania plena, portanto como um bem fundamental do ser humano. (AU)

Objective: To reflect on the complexity of Nursing practices in the context of Primary Health Care in Brazil, having the Family Health Strategy as the structuring basis for a new model of care. Methods: This is a theoretical-reflective rehearsal, developed between June and July 2021, based on the authors' knowledge and experiences, both academic and professional; which analyze, reflect and contextualize the contribution of Brazilian Nursing in the extension and depth of essential attributes and derivatives of PHC, rooted in the values, principles and guidelines of promotion, prevention, treatment, rehabilitation and cure in health-disease processes. Caution. Results: It points out the contemporary challenges to overcoming the constituent elements of the medical-hospital model, characterized by inefficiency, low effectiveness and population dissatisfaction, in territories with deep social, economic, political and health inequalities. Conclusion: In summary, it indicates that it is necessary to follow printed active movements that expand political decisions to ensure health as a right of full citizenship, therefore as a fundamental good of human beings. (AU)

Objetivo: Reflexionar sobre la complejidad de las prácticas de Enfermería en el contexto de la Atención Primaria de Salud en Brasil, teniendo la Estrategia Salud de la Familia como base estructurante de un nuevo modelo de atención. Métodos: Se trata de un ensayo teórico reflexivo, desarrollado entre junio y julio de 2021, basado en los conocimientos y experiencias de los autores, tanto académicos como profesionales; que analizan, reflejan y contextualizan el aporte de la Enfermería brasileña en la extensión y profundidad de atributos esenciales y derivados de la APS, arraigados en los valores, principios y lineamientos de promoción, prevención, tratamiento, rehabilitación y curación en los procesos salud-enfermedad. Resultados: Señala los desafíos contemporáneos para la superación de los elementos constitutivos del modelo médico-hospitalario, caracterizado por la ineficiencia, baja efectividad e insatisfacción poblacional, en territorios con profundas desigualdades sociales, económicas, políticas y de salud. Conclusión: En resumen, indica que es necesario seguir movimientos activos impresos que amplíen las decisiones políticas para asegurar la salud como un derecho de la ciudadanía plena, por ende como un bien fundamental del ser humano. (AU)

A educação emocional pode influenciar na qualidade das competências e habilidades da Enfermagem? / Can emotional education influence the quality of nursing skills and abilities? / ¿Puede la educación emocional influir en la calidad de las habilidades y habilidades de enfermería?

Objetivo: Discutir as contribuições das competências e habilidades emocionais, identificadas no trabalho de enfermeiras e enfermeiros, em atuação em serviços da Rede de Atenção à Saúde, no município de João Pessoa - PB, para a qualificação do cuidado integral, afetuoso e humanizado ao indivíduo, família e comunidade. Método: Pesquisa de abordagem quantitativa e qualitativa, desenvolvida em serviços da Rede de Atenção à Saúde do município de João Pessoa ­ PB. Os dados foram coletados com base no Inventário de Educação Emocional Gonsalves (IEEG). Para o processamento dos dados utilizou-se o Epidemiological Information (EpiInfo), versão 3.5.2. Resultados: A partir da análise das respostas dos enfermeiros e enfermeiras pesquisados foram evidenciadas duas expressões de emoções: "empatia e o altruísmo". Conclusões: Dentre os núcleos de competências requeridas no trabalho de enfermagem, observa-se que para o núcleo "Cuidado de Enfermagem na Atenção à Saúde Humana", existem distintas assertivas que se sobressaem caracterizando a empatia e o altruísmo, a quais são potencializadoras das ações das enfermeiras e enfermeiros no exercício da prática profissional, sendo determinantes para a produção do cuidado integral, afetuoso e humanizado em saúde. (AU)

Objective: To discuss the contributions of emotional skills and abilities, identified in the work of nurses and nurses, working in services of the Health Care Network, in the city of João Pessoa - PB, for the qualification of comprehensive, affectionate and humanized care to the individual , family and community. Methods: Research with a quantitative and qualitative approach, developed in services of the Health Care Network in the city of João Pessoa - PB. Data were collected based on the Gonsalves Emotional Education Inventory (IEEG). For data processing, Epidemiological Information (EpiInfo), version 3.5.2 was used. Results: From the analysis of the responses of the nurses and nurses surveyed, two expressions of emotions were evidenced: "empathy and altruism". Conclusion: Among the core competencies required in nursing work, it is observed that for the core "Nursing Care in Human Health Care", there are different assertions that stand out characterizing empathy and altruism, which enhance actions nurses and nurses in the exercise of professional practice, being determinant for the production of comprehensive, affectionate and humanized health care. (AU)

Objetivo: Discutir las contribuciones de las habilidades y habilidades emocionales, identificadas en el trabajo de enfermeras y enfermeras, que trabajan en los servicios de la Red de Atención de Salud, en la ciudad de João Pessoa - PB, para la calificación de la atención integral, afectiva y humanizada para el individuo, la familia y la comunidad. Métodos: Investigación con enfoque cuantitativo y cualitativo, desarrollada en los servicios de la Red de Atención de la Salud de la ciudad de João Pessoa - PB. Los datos se recolectaron con base en el Inventario de Educación Emocional de Gonsalves (IEEG). Para el procesamiento de datos se utilizó Información Epidemiológica (EpiInfo), versión 3.5.2. Resultados: A partir del análisis de las respuestas de los enfermeros y enfermeros encuestados, se evidenciaron dos expresiones de emociones: "empatía y altruismo". Conclusion: Entre las competencias centrales requeridas en el trabajo de enfermería, se observa que para el núcleo "Atención de Enfermería en la Atención de la Salud Humana", se destacan diferentes aseveraciones que caracterizan la empatía y el altruismo, que potencian las acciones de enfermeras y enfermeras en el ejercicio de la profesión. práctica, siendo determinante para la producción de una atención de salud integral, afectuosa y humanizada. (AU)

Advanced practice nurses' and general practitioners' first experiences with introducing the advanced practice nurse role to Swiss primary care: a qualitative study.

BACKGROUND: Primary care is facing a multimorbid, ageing population and a lack of general practitioners (GPs), especially in rural areas. In many countries, advanced practice nurses (APNs) may be a potential solution for these challenges. Switzerland, however, is in the early stages of APN role development with a handful of pilot projects that are unresearched. Our aim was to explore the experiences of APNs and GPs involved in introducing the APN role to Swiss primary care. METHODS: We organised two focus group discussions with APNs (n = 9) engaged in primary care across German-speaking Switzerland and individual interviews with APNs (n = 2) and GPs (n = 4) from two pilot projects in remote areas. Data analysis followed an exploratory hybrid approach of thematic analysis and was guided by the PEPPA Plus framework. RESULTS: The analysis resulted in five main themes: The participants considered themselves pioneers developing a new model in primary care, seeking to shape and improve future health care ((1) pioneering spirit). Both nurses and doctors agreed on the additional value of the APN role, a role seen as having more time for and a different approach to patient care, bringing higher quality of care and flexibility to the practice ((2) added value from the APN role). Participants also emphasized the importance of asking for advice when unsure about diagnostic steps or appropriate treatment ((3) awareness of limited knowledge and skills). The main barriers identified included the impression that Swiss doctors have little knowledge about nurses in advanced roles ((4) GP's lack of knowledge regarding the APN role), and that further regulations will be important to foster role clarity and accountability ((5) political and legal obstacles in introducing the APN role). CONCLUSIONS: The early phase of introducing APNs to Swiss primary care is characterised by heterogeneous, small-scale projects of pioneering GPs and APNs recognising the added value and limits of APNs despite a lack of governance and knowledge regarding the APN role among GPs. Experiences gained from ongoing projects provide elements of good practice for political discussions and regulations.

The technology implications of master's level education in the professionalization of nursing: A narrative inquiry.

AIMS: (a) To explore the meanings of master's education in the professionalization of nursing; and (b) to describe the core attributes that nurses gained through master's study. DESIGN: Narrative inquiry. METHODS: From June 2017 to June 2018, unstructured interviews were conducted with 12 master-prepared nurses at advanced nursing position with minimum 5 years of postregistration experience. Collaborative thematic narrative analysis was conducted on verbatim transcripts. Members checking, peer validation and audience validation assured verisimilitude and utility. RESULTS: There was a need to fit one's own assertion for professional growth in nursing career structure. Master's study equipped nurses with specialty skills and knowledge with enhanced reflexivity, which nurtured morality, problem-solving ability and capacity to collaborate inter-professionally. Master-prepared nurses demonstrated effective clinical leadership through acting as change agents. CONCLUSIONS: Master's level education and master-prepared nurses are instrumental to the professionalization of nursing by expanding the roles of nurses. Nursing career mentoring will maximize nurses' agency in healthcare system. Developing innovative inter-professional pedagogy will nurture the reflexivity of master-prepared nurses.

Effects of an Intervention Program for Promoting Ethical Practices Among Pediatric Nurses.

The Japanese nursing education system only requires a general nursing qualification. After graduation, many Japanese nurses work within pediatric departments where they receive specialized training in pediatric care. An intervention program for promoting ethical nursing practices among patients and their families was implemented for pediatric nurses with 0-5 years pediatric nursing experience. The objective of this study was to clarify changes in nurses' recognition and behaviors, as well as the intervention's post-initiation durability. The pediatric nursing care model (PNCM), defining 24 nursing approaches, was developed to show simple examples of ethical nursing practices for pediatric patients and their families. An intervention program included an initial session that consisted of a 30-minute mini-lecture. Nurses also described details of approaches previously performed and conducted a peer-review. Concerning the PNCM, the frequency of implementing each approach was examined using a 4-point Likert scale both before and at 2-month post-intervention initiation. Recognition of intervention feasibility was evaluated using a 4-point Likert scale at the end of the first session. Furthermore, during the second month, reflection and outcome content was evaluated by examining approaches the nurses performed and described. During the third month, the nurses were asked to describe changes in their behavior in terms of ethical nursing practices, along with those observed by patient and family responses, and any recognition of future challenges. Regarding the care model items, feasible practices were recognized immediately post-intervention, and 18 of 24 items (75.0%) revealed significant improvement. Implementation frequency for 10 out of 18 items (55.6%) was higher than before the intervention, and there was a significant difference among four items. The intervention program led to improvements in highly feasible and basic ethical nursing practices, including an increase in greetings and self-introductions, verbal explanations for children, quantitative and qualitative alterations in order to improve children's coping behaviors, changes in nurses' active attitudes for reducing children's fear and attitudes for feasible future implementation. Changes in practices at 3-month post-initiation corresponded to the four components of "child assent" or the final three goals of our conceptual framework.