Uso de teléfonos inteligentes en Enfermería / Smartphone use in nursing

Objetivo: Analizar la evidencia en la literatura científica sobre el uso de los teléfonos inteligentes en Enfermería. Método: Revisión integradora de literatura científica publicada en los últi mos 7 años, disponible en diferentes ba ses de datos; con los criterios de inclu sión, teléfonos inteligentes, estudiantes y profesionales de enfermería. La muestra de 16 artículos originales que cumplieron criterios de calidad, se procesó según análisis temático. Resultados: Solo hay publicacio nes en inglés y escasez de investigacio nes en el Continente Sudamericano. Pro fesionales y estudiantes de enfermería lo usan en horas laborales, y existe poca evidencia de la forma en la que se utili zan y su efecto. Conclusión: Usarlo para comuni carse fue la actividad primordial de los profesionales de enfermería y la bús queda de información, para los estudian tes, pero, existen profesionales y estu diantes que exceden su uso en redes sociales poniendo en riesgo la seguridad del paciente. Se recomienda establecer políticas realistas y capacitaciones (AU)

Objective: To analyze the eviden ce in the scientific literature on the use of smartphones in Nursing. Method: Integrative review of scientific literature published in the last 7 years, available in different databases; with the inclusion criteria, smartphones, students and nursing professionals. The sample of 16 original articles that met quality criteria was processed according to thematic analysis. Results: There are only publica tions in English and a lack of research in the South American Continent. Nursing professionals and students use it during working hours, and there is little evidence of the way in which they are used and their effect. Conclusion: Using it to communi cate was the primary activity of nursing professionals and the search for informa tion for students, but there are professio nals and students who exceed their use of social networks, putting patient safety at risk. It is recommended to establish realistic policies and training (AU)

The Current State of Nursing.

Workforce issues, challenges, and opportunities.

Strategies associated with COVID-19 vaccine coverage among nursing home staff.

BACKGROUND: After the first of three COVID-19 vaccination clinics in U.S. nursing homes (NHs), the median vaccination coverage of staff was 37.5%, indicating the need to identify strategies to increase staff coverage. We aimed at comparing the facility-level activities, policies, incentives, and communication methods associated with higher staff COVID-19 vaccination coverage. METHODS: Design. Case-control analysis. SETTING: Nationally stratified random sample of 1338 U.S. NHs participating in the Pharmacy Partnership for Long-Term Care Program. PARTICIPANTS: Nursing home leadership. MEASUREMENT: During February 4-March 2, 2021, we surveyed NHs with low (<35%), medium (40%-60%), and high (>75%) staff vaccination coverage, to collect information on facility strategies used to encourage staff vaccination. Cases were respondents with medium and high vaccination coverage, whereas controls were respondents with low coverage. We used logistic regression modeling, adjusted for county and NH characteristics, to identify strategies associated with facility-level vaccination coverage. RESULTS: We obtained responses from 413 of 1338 NHs (30.9%). Compared with facilities with lower staff vaccination coverage, facilities with medium or high coverage were more likely to have designated frontline staff champions (medium: adjusted odds ratio [aOR] 3.6, 95% CI 1.3-10.3; high: aOR 2.9, 95% CI 1.1-7.7) and set vaccination goals (medium: aOR 2.4, 95% 1.0-5.5; high: aOR 3.7, 95% CI 1.6-8.3). NHs with high vaccination coverage were more likely to have given vaccinated staff rewards such as T-shirts compared with NHs with low coverage (aOR 3.8, 95% CI 1.3-11.0). Use of multiple strategies was associated with greater likelihood of facilities having medium or high vaccination coverage: For example, facilities that used ≥9 strategies were three times more likely to have high staff vaccination coverage than facilities using <6 strategies (aOR 3.3, 95% CI 1.2-8.9). CONCLUSIONS: Use of designated champions, setting targets, and use of non-monetary awards were associated with high NH staff COVID-19 vaccination coverage.

Using War Language in a Pandemic: Rhetoric or Responsibility?

Frontline workers deserve protection and follow-up support.

Efficacy of a Nasogastric Tube Educational Intervention for Nursing Staff.

AIM: We performed a single-center teaching intervention with nursing providers on nasogastric tube (NG tube) clinical practice. The initial purpose of this study was the validation of whether the training was sufficient enough to be retained at a later time point. METHODS: We performed a prospective pre-post study examining participants' knowledge before, immediately after, and 4 weeks after training in NG tube management. Training was delivered in face-to-face classroom sessions. Knowledge was assessed using a multiple-choice test (pretest, posttest #1and #2). RESULTS: A total of 137 nursing providers participated in the training intervention. Immediately after training (posttest #1) and again 4 weeks later (posttest #2), participants overwhelmingly recalled and retained the knowledge of NG tube management as compared to pretest results. Paired t-tests showed each participant increased their test score from pretest to posttest #1, t (134) = 12.64, P = .0001. Similarly, participants who took posttest #2 significantly improved their scores from the pretest to posttest #2, t (71) = 10.629, P < .0001. Secondary analysis showed that the NG tube management comfort level and age of provider were not significant in predicting test results. However, years of professional experience and frequency of NG tube care were significant predictors for higher test scores. CONCLUSION: To minimize the risk of NG tubes for patients, it is critical to follow clinical guidelines. This study shows that teaching interventions for providers to increase knowledge on NG tubes are beneficial. In addition, the knowledge is retained at later time points.

State and national data on the Georgia nursing workforce.

BACKGROUND: The enduring absence of robust nursing workforce data creates gaps to support evidence-based workforce planning and policy development. PURPOSE: The purpose of this study was to examine Georgia nursing workforce data available through state and national agencies to determine if significance differences exist among data sources. METHODS: A cross-sectional, descriptive analysis of 2017 Georgia nursing workforce data was used to examine and compare workforce characteristics available from five data sources. The advantages and limitations of each data source were reviewed. FINDINGS: Significant differences were noted in the quality and quantity of data collected on the Georgia nursing workforce as reported by state and national agencies. None of the datasets include in our analysis had comprehensive and timely data on the Georgia nursing workforce. DISCUSSION: Nursing workforce stakeholders must work collaboratively to require and implement a comprehensive re-licensure survey. It is only though a standardized national minimum dataset that we can ensure an adequate nursing workforce.

The economic impact of rostering junior doctors to triage to assist nursing staff in the early part of the patient journey through the emergency department.

OBJECTIVE: This study aims to determine whether redeploying junior doctors to assist at triage represents good value for money and a good use of finite staffing resources. METHODS: We undertook a cost-minimisation analysis to produce new evidence, from an economic perspective, about the costs associated with reallocating junior doctors in the emergency department. We built a decision-analytic model, using a mix of prospectively collected data, routinely collected administrative databases and hospital costings to furnish the model. To measure the impact of uncertainty on the model's inputs and outputs, probabilistic sensitivity analysis was undertaken, using Monte Carlo simulation. RESULTS: The mean costs for usual care were $27,035 (95% CI $27,016 to $27,054), while the mean costs for the new model of care were $25,474, (95% CI $25,453 to $25,494). As a result, the mean difference was -$1,561 (95% CI -$1,533 to -$1,588), with the new model of care being a less costly approach to managing staffing allocations, in comparison to the usual approach. CONCLUSION: Our study shows that redeploying a junior doctor from the fast-track area of the department to assist at triage provides a modest reduction in cost. Our findings give decision-makers who seek to maximise benefit from their finite budget, support to reallocate personnel within the ED.

Original Research: Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working Population.

PURPOSE: Although previous studies have revealed professional consequences of burnout among nurses, less is known about the potential personal consequences. This study investigated the prevalence of suicidal ideation and attitudes toward help seeking among U.S. nurses relative to other workers, and the extent to which personal and professional factors, including burnout, were related to suicidal ideation. METHODS: In November 2017, a cross-sectional survey was sent to 86,858 nurses who were members of the American Nurses Association and to a probability-based sample of 5,198 U.S. workers. The survey included questions regarding suicidal ideation, burnout, symptoms of depression, individual and professional characteristics, and willingness to seek professional help if a serious emotional problem arose. Multivariable logistic regression analyses were conducted to identify factors associated with suicidal ideation after controlling for other factors. RESULTS: Among the 7,378 nurse respondents, 403 (5.5%) reported having suicidal ideation within the past year. Most nurses (84.2%) indicated willingness to seek professional help for a serious emotional problem. Yet nurses with suicidal ideation were less likely to report that they'd seek such help (72.6%) than nurses without suicidal ideation (85%). In a multivariable analysis of nurses' data, after controlling for other personal and professional characteristics, we found that burnout was strongly associated with suicidal ideation. Adjusted combined multivariable analyses showed that nurses were more likely than other workers to have suicidal ideation. Both nurses and other workers who reported suicidal ideation were less likely to seek help than were those who did not report such ideation. CONCLUSIONS: Compared with other U.S. workers, nurses are at higher risk for suicidal ideation, and nurses with such ideation are more reluctant to seek help than those without it. Burnout contributes to the risk of suicidal ideation. These issues warrant greater attention. Systems- and practice-level interventions must be identified and implemented, both to address the higher prevalences of burnout and suicidal ideation in nurses and to mitigate the stigma about mental health problems and other barriers to seeking help.

Diversifying the health workforce: a mixed methods analysis of an employment integration strategy.

BACKGROUND: Historically, immigration has been a significant population driver in Canada. In October 2020, immigration targets were raised to an unprecedented level to support economic recovery in response to COVID-19. In addition to the economic impact on Canada, the pandemic has created extraordinary challenges for the health sector and heightened the demand for healthcare professionals. It is therefore imperative to accelerate commensurate employment of internationally educated nurses (IENs) to strengthen and sustain the health workforce and provide care for an increasingly diverse population. This study aimed to determine the effectiveness of a project to help job-ready IENs in Ontario, Canada, overcome the hurdle of employment by matching them with healthcare employers that had available nursing positions. METHODS: A mixed methods design was used. Interviews were held with IENs seeking employment in the health sector. Secondary analysis was conducted of a job bank database between September 1 and November 30, 2019 to identify healthcare employers with the highest number of postings. Data obtained from the 2016 Canadian Census were used to create demographic profiles mapping the number and proportion of immigrants living in the communities served by these employers. The project team met with senior executives responsible for hiring and managing nurses for these employers. The executives were given the appropriate community immigrant demographic profile, a manual of strategic practices for hiring and integrating IENs, and the résumés and bios of IENs whose skills and experience matched the jobs posted. RESULTS: In total, 112 IENs were assessed for eligibility and 95 met the inclusion criteria. Twenty-one healthcare employers were identified, and the project team met with 54 senior executives representing these employers. Ninety-five IENs were subsequently matched with an employer. CONCLUSIONS: The project was successful in matching job-ready IENs with healthcare employers and increasing employer awareness of IENs' abilities and competencies, changing demographics, and the benefits of workforce diversity. The targeted activities implemented to support the project goal are applicable to sectors beyond healthcare. Future research should explore the long-term impact of accelerated employment integration of internationally educated professionals and approaches used by other countries.

Nursing home performance in a trial to reduce hospitalizations: Implications for future trials.

BACKGROUND: Experience in trials of implementing quality improvement (QI) programs in nursing homes (NHs) has been variable. Understanding the characteristics of NHs that demonstrate improvements during these trials is critical to improving NH care. DESIGN: Secondary analysis of a randomized controlled trial of implementation of a QI program to reduce hospital transfers. PARTICIPANTS: Seventy-one NHs that completed the 12-month trial INTERVENTION: Implementation included distance-learning strategies, involvement of a champion, regular submission of data on hospitalizations and root cause analyses of transfers, and training, feedback and support. MEASUREMENTS: Primary outcomes included all-cause and potentially avoidable hospitalizations and emergency department (ED) visits per 1000 NH resident days, and the percentage of residents readmitted in 30-days. We compared multiple other variables that could influence effective program implementation in NHs in the highest versus lowest quartile of changes in the primary outcomes. RESULTS: The 18 high-performing NHs had significant reductions in hospitalization and ED visits, whereas the 18 NHs in the low-performing group had increases. The difference in changes in each outcome varied between a reduction of 0.75 and 2.30 events relative to a NH with a census of 100; the absolute difference in 30-day readmissions was 19%. None of the variables we examined reached significance after adjustment for multiple comparisons between the groups. There was no consistent pattern of differences in nonprofit status, nursing staffing, and quality ratings. CONCLUSION: Our experience and reviews of other NH trials suggest that key factors contributing to successful implementation QI programs in NHs remain unclear. To improve NH care, implementation trials should account for intervention fidelity and factors that have not been examined in detail, such as degree and nature of leadership support, financial and regulatory incentives, quality measures, resident and family perspectives, and the availability of onsite high-quality medical care and support of the medical director.

Development of the Perception of Opioid Use Survey Instrument.

BACKGROUND AND PURPOSE: A new instrument was designed specifically to evaluate nurses' knowledge, attitude, and practice toward patients who use opioids. This study team developed and tested the psychometric properties of the Perception of Opioid Use Survey (POUS) instrument. METHODS: The instrument was tested among 306 nurses at a 183 bed acute care community hospital, with psychometric evaluation for validity, reliability, and exploratory factor analysis. RESULTS: Internal consistency results were Cronbach's alpha = .550 for the overall scale and each subscale: Self-Efficacy = .796, Attitudes = .744, Community Impact = .806, and Causative Factors = .763. CONCLUSIONS: Psychometric testing results support that the POUS is valid, reliable, and significantly correlated with theoretically selected variables.

Enfrentamiento de la violencia en el trabajo de enfermería en el contexto hospitalario y en la Atención Primaria de Salud / Facing violence in nursing work hospital context and primary health care / Enfrentamento da violência no trabalho da enfermagem no contexto hospitalar e na Atenção Primária à saúde

INTRODUCCIÓN: La violencia en el trabajo se define como una acción, incidente o comportamiento con una actitud voluntaria del agresor, como resultado de lo cual un profesional es agredido, amenazado o sufre algún daño durante el desempeño de su trabajo. El equipo de enfermería está expuesto diariamente a situaciones de violencia en el trabajo. OBJETIVO: Comprender y analizar los mecanismos de afrontamiento de la violencia utilizados por los profesionales de enfermería en el contexto hospitalario y en la Atención Primaria de Salud. MATERIALES Y MÉTODO: Estudio explicativo secuencial mixto, con 198 trabajadores de enfermería de un hospital y 169 de atención primaria de salud, en un municipio del sur de Brasil. Los datos fueron recolectados mediante una encuesta en la etapa cuantitativa y entrevistas en la cualitativa, analizados a través del paquete estadístico de software para las Ciencias Sociales y por el análisis temático. RESULTADOS: Se identificó que el 51% de los participantes fueron víctimas de violencia, y los mecanismos de afrontamiento utilizados por los trabajadores son individuales y colectivos, con predominio del primero, lo que demuestra que el problema a menudo se dirige a la víctima. El trabajo colectivo fue un factor contribuyente en la lucha contra la violencia, con énfasis en el diálogo y el apoyo entre el equipo. Sin embargo, no hubo apoyo institucional en la búsqueda de conducta frente a episodios de violencia y consecuencias para los perpetradores. CONCLUSIÓN: La prevalencia de violencia fue alta en ambos escenarios, con diferentes características en cuanto al perfil de víctimas y perpetradores. Se refuerza la importancia del enfrentamiento colectivo, como la forma más efectiva de combatir la violencia en el lugar de trabajo

INTRODUCTION: Violence at work is defined as an action, incident, or behavior with a voluntary attitude of the aggressor, as a result of which a professional is assaulted, threatened, or suffers some damage during the performance of their work. The nursing team is exposed daily to situations of violence at work. OBJECTIVE: To understand and analyze the mechanisms of coping with violence used by nursing professionals in the hospital context and Primary Health Care.MATERIALS AND METHOD: A mixed sequential explanatory study, with 198 nursing workers from a hospital and 169 from Primary Health Care, in a municipality in southern Brazil. The data were collected using a survey in the quantitative stage and interviews in the qualitative one analyzed through the software Statistical Package for the Social Sciences and by the thematic analysis.RESULTS: It was identified that 51% of the participants were victims of violence, and the coping mechanisms used by the workers are individual and collective, with a predominance of the first, showing that the problem is often directed at the victim. Collective work was a contributing factor in tackling violence, with emphasis on dialogue and support among the team. However, there was no institutional support in the search for conduct in the face of episodes of violence and consequences for perpetrators. CONCLUSION: The prevalence of violence was high in both scenarios, with different characteristics regarding the profile of victims and perpetrators. The importance of collective coping is reinforced, as the most effective way to combat violence in the workplace

INTRODUÇÃO: A violência no trabalho é definida como ação, incidente ou comportamento com atitude voluntária do agressor, em decorrência da qual um profissional é agredido, ameaçado, ou sofre algum dano durante a realização do seu trabalho. A equipe de enfermagem, está exposta cotidianamente a situações de violência no trabalho. OBJETIVO: Analisar os mecanismos de enfrentamento da violência utilizados pelos profissionais de enfermagem no contexto hospitalar e na Atenção Primária à Saúde. Materiais e MÉTODO: Estudo misto explanatório sequencial, com 198 trabalhadores de enfermagem de um hospital e 169 da Atenção Primária à Saúde, em um município do Sul do Brasil. Os dados foram coletados utilizando-se uma survey na etapa quantitativa e entrevistas na qualitativa, analisados com auxílio do software Statistical Package for the Social Sciences e pela análise temática. RESULTADOS: Identificou-se que 51% dos participantes foram vítimas de violência, sendo os mecanismos de enfrentamento utilizados pelos trabalhadores são de cunho individual e coletivo, com predomínio do primeiro, evidenciando-se que o problema frequentemente, é direcionado à vítima. O trabalho coletivo foi um fator contribuinte para o enfrentamento da violência, com destaque ao diálogo e apoio entre a equipe. No entanto, não se observou suportes institucionais na busca por condutas frente aos episódios de violência e consequência aos perpretadores. CONCLUSÃO: A prevalência da violência mostrou-se elevada nos dois cenários, com características diferentes quanto ao perfil das vítimas e perpretadores. Reforça-se a importância do enfrentamento coletivo, como a forma mais eficaz para o combate da violência no local de trabalho

Understanding the general practice nursing workforce in New Zealand: an overview of characteristics 2015-19.

Limited knowledge about the nursing workforce in New Zealand general practice inhibits the optimal use of nurses in this increasingly complex setting. Using workforce survey data published biennially by the Nursing Council of New Zealand, this study describes the characteristics of nurses in general practice and contrasts them with the greater nursing workforce, including consideration of changes in the profiles between 2015 and 2019. The findings suggest the general practice nursing workforce is older, less diverse, more predominately New Zealand trained and very much more likely to work part-time than other nurses. There is evidence that nurses in general practice are increasingly primary health care focused, as they take on expanded roles and responsibilities. However, ambiguity about terminology and the inability to track individuals in the data are limitations of this study. Therefore, it was not possible to identify and describe cohorts of nurses in general practice by important characteristics, such as prescribing authority, regionality and rurality. A greater national focus on defining and tracking this pivotal workforce is called for to overcome role confusion and better facilitate the use of nursing scopes of practice.

Prayer Moderating Job Stress Among Muslim Nursing Staff at the University of Malaya Medical Centre (UMMC).

This study examines how Salat (prayer) in Islam moderates the relationship between job stress and life satisfaction among Muslim nursing staff. The researchers sampled 335 nursing staff employed at the University of Malaya Medical Centre in Kuala Lumpur, Malaysia. Their ages ranged from 21 to 60 years. The findings indicate the job stress was associated negatively with life satisfaction; there is a strong positive and significant correlation, respectively, between Salat and life satisfaction and that Salat reduces stress and increases the life satisfaction of Muslim nurses. Thus, Salat has a moderating effect on job stress and life satisfaction of Muslim nurses.

Prevalence of COVID-19 in Ohio Nursing Homes: What's Quality Got to Do with It?

With nursing homes being hit hard by the COVID-19 pandemic, it is important to know whether facilities that have any cases, or those with particularly high caseloads, are different from nursing homes that do not have any reported cases. Our analysis found that through mid-June, just under one-third of nursing homes in Ohio had at least one resident with COVID-19, with over 82% of all cases in the state coming from 37% of nursing homes. Overall findings on the association between facility quality and the prevalence of COVID-19 showed that having any resident case of the virus or even having a high caseload of residents with the virus is not more likely in nursing homes with lower quality ratings.

Evaluation of the Minnesota Safe Patient Handling Act: trends in workers' compensation indemnity claims in nursing home workers before and after enactment of the law.

OBJECTIVES: The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention. METHODS: Workers' compensation indemnity claims for years 2005-2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention. RESULTS: The patient handling indemnity claim rate declined by 25% in years 4-6 and 38% in years 7-9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7-9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate. CONCLUSIONS: Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.