Nurse experiences and perspectives with missed nursing care during COVID-19: A qualitative study.

AIM: This study aimed to determine clinical nurse and nurse manager perspectives on missed nursing care (MNC) during the COVID-19 pandemic. DESIGN: This study utilized a qualitative exploratory descriptive design. METHODS: Data were obtained through focus groups and virtual interviews. Purposive sampling was used to select nurse and nurse manager participants in COVID-19 units and the Emergency Department in one large healthcare organization in the northeastern United States of America. RESULTS: A total of 15 nurses and nurse managers participated in the study. Results revealed five categories: medication delivery, turning patients, double checks, communication and rapport, and patient surveillance. CONCLUSIONS: A variety of factors contributed to the perceptions and experiences of MNC of COVID-19 patients during the early stage of the pandemic. The COVID-19 crisis put additional and unparalleled pressure on a strained nursing workforce. Hospital leaders are responsible for ensuring their frontline nurses have the resources they need to feel supported in their roles regardless of the presenting circumstances. IMPLICATIONS FOR THE PROFESSION: Nurse leaders should employ evidence-based strategies such as promoting and championing teamwork to support staff and reduce incidences of MNC during crises. Our current work may serve as a basis for informing future revisions of pre-pandemic measurement tools when applied in a pandemic-specific context. REPORTING METHODS: This manuscript adheres to the standards for reporting qualitative research (SRQR); a synthesis of recommendations. PUBLIC CONTRIBUTION: There was not patient or public contribution for this study.

The lived experiences of providing nursing care in coastal areas: A qualitative study.

OBJECTIVE: To explore nurses' experiences in providing care in coastal areas. METHODS: The phenomenological study was conducted from July to September 2020 in two coastal areas located in the Riau province of Indonesia, and comprised nurses working in public health centers, hospitals and district health offices. Data was collected using in-depth interviews. Data was subjected to thematic analysis. RESULTS: Of the 13 nurses, 10(77%) were females and 3(23%) were males. The overall age range was 24-44 years. Four themes that emerged were health problems in coastal areas, obstacles in nursing care delivery, irrelevant duty, and procedures in delivering nursing care. There were a total of 10 sub-themes as well. CONCLUSIONS: Despite the challenged faced by the nurses, communities in coastal areas deserve to get due healthcare services.

Analysis of care and gender stereotypes in nursing scientific research: a scoping review.

OBJECTIVE: To map evidence about care and gender stereotypes in nursing scientific research. METHOD: A scoping review developed under the JBI framework with analysis of gender perspective in care approaches. The searches were carried out on January 31, 2023 in SciELO, Scopus, CINAHL, PubMed, BDENF. RESULTS: Of the 3,743 studies located, 25 were included. Evidence was grouped into categories: essentially female care (n = 9; 36%); calling and service of love (n = 3; 12%); erasure of gender inequalities (n = 2; 8%); "inadequate and harmful" care (n = 5; 20%); neutralization of gender and bodies (n = 3; 12%); and reporting oppression in care work (n = 3; 12%). CONCLUSION: Most scientific research on care reproduces gender stereotypes that reinforce the oppression of women in nursing. In contrast, resistance denounces naturalization of care as "inadequate and harmful", for perpetuating gender oppression in care work.

Electronic nursing documentation for patient safety, quality of nursing care, and documentation: a systematic review .

Objective: To evaluate the impact of electronic nursing documentation on patient safety, quality of nursing care and documentation. METHODS: The systematic review was conducted in December 2022, and comprised a comprehensive search on Scopus, ScienceDirect, ProQuest, PubMed, Cumulative Index to Nursing and Allied Health Literature, Sage Journals and Google Scholar databases for English-language human studies published between 2018 and 2022. The key words used in the search included "Nursing", "care", "documentation", "record", "electronic", "process" and "health services". The risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology tool. RESULTS: Of the 469 items initially identified, 15(3.2%) were analysed in detail, indicating a positive influence of electronic nursing documentation on patient safety, care quality, and documentation. However, shortcomings were observed in the development of electronic nursing documentation for optimal effectiveness. Conclusion: Electronic nursing documentation significantly enhanced patient safety, care quality and documentation. To facilitate its integration into clinical settings, a standardised and logically structured electronic nursing documentation system is essential.

Meticulous nursing care for coronary CT angiography: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: This study aimed to investigate the effects of meticulous nursing care (MNC) for patients with coronary heart disease undergoing coronary CT angiography (CCTA). METHODS: We conducted a comprehensive search of the Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, and Wangfang databases from inception to January 1, 2024. Randomized clinical trials (RCTs) evaluating the effects of MNC for CCTA were included. Outcomes assessed included self-rating anxiety scale (SAS), self-rating depression scale (SDS), overall satisfaction of nursing care (OSNC), examination time (ET, min), radiation dose received (RDR, mSv), breathing control time (BCT), and heart rate control time (HRCT).The methodological quality of all included RCTs was evaluated using the Cochrane risk-of-bias tool, while statistical analysis was conducted using RevMan 5.4 software. RESULTS: Six eligible trials involving 1064 patients were included. The results of the meta-analysis showed significant differences in SAS (MD = -2.84, 95% CI [-3.31, -2.37], I2 = 0%, P < .001), SDS (MD = -2.55, 95% CI [-3.51, -1.58], I2 = 0%, P < .001), OSNC (OR = 3.13, 95% CI [1.59, 6.17], I2 = 23%, P = .001), BCT (MD = -23.43, 95% CI [-25.07, -21.80], I2 = 45%, P < .001), HRCT (MD = -20.08, 95% CI [-21.70, -18.46], I2 = 29%, P < .001), ET (MD = -2.31, 95% CI [-2.56, -2.06], I2 = 5%, P < .001), and RDR (MD = -2.11, 95% CI [-2.45, -1.77], I2 = 0%, P < .001). CONCLUSION: MNC may benefit for patients with coronary heart disease undergoing CCTA. Future studies are still needed to warrant the current findings.

Effectiveness of homogenized nursing care intervention in postoperative bladder irrigation of urological system in primary hospitals-Taking the incidence of postoperative complications as an example: A retrospective study.

To explore the effect of homogenized nursing interventions for bladder irrigation after urological surgery in primary hospitals, and to further analyze the incidence of postoperative complications according to the different nursing methods. The experiment selected 110 patients with urological disorders who underwent bladder irrigation, and the subjects were admitted to the hospital from January 2020 to October 2023. The subjects were chronologically divided into a control group and an experimental group, with the admission time of the control group being between between January 2020 and October 2022. The experimental group was admitted between October 2022 and October 2023. Conventional nursing care and homogenized nursing care were used respectively, and the intervention effect of homogenized nursing care was assessed by comparing the patients' psychological state indexes, vital characteristic indexes, and the incidence of various postoperative complications under the 2 interventions. None of the indicators were statistically significant before the nursing intervention. In the comparison of nursing satisfaction and clinical comfort, the experimental group's nursing satisfaction was 94.5% and clinical comfort was 90.9%, which was significantly higher than that of the control group. In the comparison of the incidence of postoperative complications, the incidence of urinary retention in the experimental group was 1.82%, which was significantly lower than that of the control group. In addition, the total incidence of complications in the experimental group was 1.82%, which proved that the homogenized nursing intervention was effective in reducing the complications after urinary bladder irrigation. In multifactorial logistic regression analysis, after homogenized nursing intervention. The relative risks of the 4 complications were 1.836, 1.445, 1.993, and 2.138, respectively, which were significantly lower than those of conventional nursing intervention. In the ROC analysis, the AUC values of the 4 complications were 0.832, 0.731, 0.746, and 0.723, respectively. proving the superiority of homogenized care in preventing postoperative complications. Homogenized nursing intervention can effectively reduce the incidence of postoperative complications in patients with urological postoperative bladder irrigation, improve patients' symptoms and prognosis, and improve the quality of care and patients' quality of life.

Covenantal Care: Nursing with God's Love and Justice.

ABSTRACT: With resources stretched thin and the growing risk of compassion fatigue, faith beliefs can offer enriching perspectives for nurses. Covenantal care is a nursing approach rooted in theological insights about humanity's inherent purpose to engage in relationship with God and actively participate in acts of love and justice. Based upon interpretations of Judeo-Christian teachings of imago Dei and God's covenant with humankind, this approach provides guidance for the nurse to care for self, patients, and the wider community. This exploration of theology-in-practice provides an orientating ethos for nurses that reflects the loving, restorative, and dignified care that is at the heart of the Christian faith.

[Frequency and reasons for missed nursing care: a cross-sectional study in Veneto Region hospital]. / Frequenza e cause delle cure infermieristiche compromesse: studio trasversale nelle aziende sanitarie della Regione Veneto.

. Frequency and reasons for missed nursing care: a cross-sectional study in Veneto Region hospitals. INTRODUCTION: Missed nursing care (MNC) encompasses clinical, relational, and emotional aspects of care that are neglected, delayed, or incomplete as performed by nurses. AIMS: 1. To describe the frequency of MNC across various clinical settings within hospitals in the Veneto Region; 2. to identify the underlying motivations for MNC; 3. to analyze the relationship between the characteristics of nurses, organizational factors, and the perceived frequency of MNC. METHODS: This cross-sectional exploratory study involved 12 healthcare organizations in the Veneto region. A total of 2,179 nurses and 159 coordinators participated, completing the Unfinished Nursing Care Survey questionnaire. Data was collected on the individual characteristics of the nurses and the organizations involved. RESULTS: The least missed care activities included patient monitoring and surveillance, while the most missed were active/passive mobilization, supervision of support staff, and oral care. The primary reasons for MNC were related to insufficient human resources, unpredictability of workflow, and communication difficulties. Senior nurses were more likely to report MNC (OR 1.026; 95% CI 0.567-0.963), whereas those more satisfied with their role in the unit (OR 0.691; 95% CI 0.585-0.817) and those working in spoke hospitals (OR 0.739; 95% CI 0.567-0.963) were less likely to perceive missed nursing care. CONCLUSIONS: The study emphasizes that, generally, nurses perceive that they infrequently miss, omit, or delay care activities, particularly those related to patient monitoring and surveillance.

The role of mental health in the relationship between nursing care satisfaction with nurse-patient relational care in Chinese emergency department nursing.

BACKGROUND: The relationship between a nurse and a patient is a key part of nursing that can impact how happy the patient is with the care they receive. It appears that the nurse's mental health can also affect this connection. However, there is little research on this topic. So, the aim of the present study was to determine the correlation of nurse's mental health with nurse-patient relational care and nursing care satisfaction. METHODS: A total of 532 nurses and 532 patients from 13 Level-III hospitals of Hubei province (China) completed a China Mental Health Survey, general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale. RESULTS: Age, nurse working years, and night shift last month were correlated with mental health score (r = -0.142, r = -0.150, r = 0.164, p < 0.05). Nurse's mental health was correlated with relational care score and nursing care satisfaction score (r = -0.177, r = -0.325, p < 0.05). Also, relational care score, patients age and gender were correlated with nursing care satisfaction score (r = 0.584 and r = 0.143, x2 = 11.636, p < 0.05). Descriptive information of nurses had a direct impact on nurses' mental health (direct effect = 0.612, 0.419-0.713). Nurses' mental health had a direct effect on relational care score (direct effect = 0.493, 0.298-0.428) and an indirect effect on nursing care satisfaction score (indirect effect = 0.051, 0.032-0.074). Relational care score and patient's descriptive information had also a direct effect on nursing care satisfaction score (direct effect = 0.232, 0.057-0.172 and 0.057, 0.347-0.493). CONCLUSION: This study showed that the better the mental health of nurses, the more patients feel satisfied with nursing services.

Nursing Care of Patients Managed With a Defunctioning Tube Ileostomy: An Exploratory Study.

PURPOSE: The purpose of this study was to describe nurses' experiences of caring for patients with colorectal cancer who underwent surgery to create a spontaneously closed defunctioning tube ileostomy after low anterior resection. DESIGN: Exploratory, descriptive study. SUBJECTS AND SETTINGS: Data were collected from 6 registered nurses specialized in Wound, Ostomy and Continence Care (WOC nurses). The patient cohort comprised 247 hospitalized patients with histologically confirmed colorectal cancer who underwent low anterior resection of the rectum and creation of a closed defunctioning tube ileostomy. The study setting was the First Affiliated Hospital, Zhejiang University School of Medicine. METHODS: Semi-structured interviews and content analysis were used to collect and analyze data. The Wound, Ostomy and Continence Care nurses visited patient participants 1 week after hospital discharge and 1 to 2 times per week until the cannula was removed and the ostomy wound closed. Data were collected over a 6-month span after the surgery from January 2016 to December 2018. RESULTS: Content analysis identified 7 management strategies unique to caring for patients with a closed defunctioning tube ileostomy. They are: (1) cannula fixation (securement); (2) maintaining inflation of the cannular balloon to prevent fecal flow into the distal bowel, (3) cannular patency, (4) dietary advice for prevention of cannular blockage, (5) selecting an ostomy pouching system, (6) patient education, and (7) care during and following cannula removal (extubation). CONCLUSIONS: We identified 7 areas of nursing care unique to the closed defunctioning tube ileostomy that provide a basis for creating clinical guidelines for patients undergoing this procedure.

Principais intervenções de enfermagem na prevenção da pneumonia associada à ventilação mecânica: revisão integrativa / Main nursing interventions in the prevention of ventilador-associated pneumonia: integrative review / Principales intervenciones de enfermería en la prevención de la neumonía asociada a ventilación mecánica: revisión integrativa

Introdução: a Pneumonia Associada à Ventilação Mecânica é a mais importante e comum infecção que acomete os pacientes em ventilação mecânica. Além disso, é considerada um grave problema de saúde hospitalar, com preocupantestaxas de morbimortalidade.Objetivo: investigar na literatura quais as principais ações de enfermagem para a prevenção da Pneumonia Associada à Ventilação Mecânica. Metodologia:trata-se de um estudo do tipo revisão integrativa da literatura. Após utilizar a estratégia PICO, definiu-se a seguinte pergunta norteadora: "Quais as principais intervenções de enfermagem para a prevenção da Pneumonia Associada à Ventilação Mecânica?". Com a leitura e aplicação dos critérios de seleção, foram utilizados nove artigos. Resultados:as principais intervenções de enfermagem descritas foram elevação da cabeceira entre 30-45 graus, manter pressão do cuff entre 20 e 30 cmH2O, higienização oral com clorexidina 0,12%, higienização das mãos, aspiração de secreções e interrupção diária da sedação. Com relação à adesão dos profissionais, a maioria das intervenções atingiram de 50% a 70% de adesão.Conclusão:as principais medidas preventivas constantes na literatura são utilizadas na prática clínica pelos enfermeiros, e estes demonstram boa adesão sobre os cuidados imprescindíveis para a prevenção da Pneumonia Associada à Ventilação Mecânica (AU).

Introduction:Ventilator-AssociatedPneumoniais the most important and common infection that affects patients on mechanical ventilation. Furthermore, it is considered a serious hospital health problem,with worrying morbidity and mortality rates.Objective:to investigate in the literature which are the main nursing actions for the prevention of Ventilator-Associated Pneumonia. Methodology:this is an integrative literature review study. After using the PICO strategy, the following guiding questionwas defined: "What are the main nursing interventions for preventingVentilator-Associated Pneumonia?". After reading and applying the selection criteria, nine articles were used. Results:the main nursing interventions described were elevation of the headboardbetween 30-45 degrees, maintaining cuff pressure between 20 and 30 cmH2O, oral hygiene with 0.12%chlorhexidine, hand hygiene, suctionof secretions and daily interruption of sedation. Regarding professional adherence, most interventions reached 50% to 70% adherence. Conclusion:the main preventive measures listed in the literature are used in clinical practice by nurses,and they demonstrate good adherence to essential care for the prevention of Ventilator-Associated Pneumonia (AU).

Introducción:la Neumonía Asociada a Ventilación Mecánica es la infección más importante y común que afecta a los pacientes que recibenventilación mecánica. Asimismo, se considera un grave problema de salud hospitalaria,con preocupantes tasas de morbimortalidad.Objetivo: investigar en la literatura cuáles son las principales acciones de enfermería para la prevención de la Neumonía Asociada a Ventilación Mecánica. Metodología:se trata de un estudio de revisión integrativade la literatura. Después de utilizar la estrategia PICO, se definió la siguiente pregunta orientadora: "¿Cuáles son las principales intervenciones de enfermería para la prevención de la Neumonía Asociada a Ventilación Mecánica?".Luegode la lectura y aplicación de los criterios de selección, se utilizaron nueve artículos. Resultados:las principales intervenciones de enfermería descritas fueron elevarla cabeceraentre 30-45 grados, mantenerla presión del manguito entre 20 y 30 cmH2O, higiene bucal conclorhexidina al 0,12%, higiene de manos, aspiración de secreciones e interrupción diaria de la sedación.En cuanto a la adherencia profesional, la mayoría de las intervenciones alcanzaron entre un 50% y un70% de adherencia. Conclusión:las principales medidas preventivas contenidas en la literatura son utilizadas en la práctica clínica por los enfermeros,y muestran una buena adherencia a los cuidados esenciales para la prevención de la Neumonía Asociada a Ventilación Mecánica (AU).

The Relationship Between Work Environment and Missed Nursing Care in Nurses: The Moderator Role of Profession Self-Efficacy.

AIMS: This study aimed to examine the relationship between work environment and missed nursing care (MNC) in nurses and determine whether profession self-efficacy has a moderator role in this relationship. DESIGN: A quantitative, cross-sectional, correlational study design was used to test the study model. METHODS: The study was conducted with 433 nurses in 2 city hospitals in Istanbul, Turkey. Data were collected between November 2022 and February 2023 using the "MISSCARE Survey-Turkish," the "Work Environment Scale," and the "Nursing Profession Self-Efficacy Scale." RESULTS: The participants had a mean Nursing Profession Self-Efficacy Scale score of 66.67 ± 14.37, a mean Work Environment Scale score of 84.96 ± 13.62, a mean elements of MNC score of 1.30 ± 0.73, and a mean reason for MNC score of 3.18 ± 0.78. Nursing profession self-efficacy was determined to be positively related to the work environment of the participants and their reasons for MNC (respectively, r = 0.276 and r = 0.114) and negatively related to elements of MNC ( r = -0.216) ( P < 0.05). There was also a negative relationship between the work environment and elements of MNC ( r = -0.249; P < 0.05). Profession self-efficacy had a significant moderator role in the relationship between the work environment and elements of MNC. Having low or moderate levels of profession self-efficacy moderated the negative effects of the work environment on elements of MNC. CONCLUSIONS: There is a need for interventions to reduce elements of missed nursing care in nurses. Especially nurses and/or nurse managers may have difficulties in improving their work environment, considering its multifaceted structure. In such cases, administrators can reduce missed nursing care by increasing the profession self-efficacy of nurses. Therefore, profession self-efficacy should be considered in addition to interventions for the work environment to improve care.

The Integration of Information Technology in the Management and Organization of Nursing Care in a Hospital Environment: A Scoping Review.

The adoption of health technologies is occurring on an unprecedented scale, with enormous potential to improve the health of populations. In this context, information technology (IT) in nursing has emerged with a focus on quality and safety of care for the benefit of the patient. There is insufficient reliable evidence demonstrating how the integration of IT in nursing care influences methodologies for managing and organizing care in terms of structure and care practice, justifying a scoping review that synthesizes the knowledge produced so far. Online databases were used to identify papers published in 2012-2023, from which we selected nine publications that used information technology in the nursing care processes. The participants were hospital nurses and nurse managers. The results show that the integration of IT in healthcare organizations impacts the management and organization of nursing care, and changes in structure, process reorganization, management, training, and the development of nurses' skills. To minimize this impact, the organizational structure must be prepared for a cultural change, with well-defined and communicated policies and procedures, and strong leadership. Within the teams, the importance of process reorganization, continuous training, and skill development emerges, thus enhancing the integration of IT into practice environments in conjunction with care.

Visualizing Nursing Narratives: An Evaluation of Latent Dirichlet Allocation Topic Modeling for Care Reports.

The increasing volume of unstructured textual data in healthcare, particularly in nursing care reports, presents both challenges and opportunities for enhancing patient care and operational efficiency. This study explores the application of Latent Dirichlet Allocation (LDA) topic modeling to analyze free-text nursing narratives from inpatient stays in three different clinics, aiming to uncover the latent thematic structures within. Utilizing the R programming environment and the visualization tool LDAvis, we identified three main themes: "Patient Well-being," "Patient Mobility and Care Activities," and "Treatment and Pain Management," the latter combining two closely related but initially distinct topics due to their overlapping content. Our findings demonstrate the potential of LDA topic modeling in extracting meaningful insights from nursing narratives, which could inform patient care strategies and healthcare practices. However, the study also highlights significant challenges associated with the method, including the sensitivity to parameter settings, the lack of updates for key software packages, and concerns about reproducibility. These issues highlight the need for meticulous parameter validation and the exploration of alternative text analysis methodologies for future research. By addressing these methodological challenges and emphasizing the importance of comparative method analysis, this study contributes to the advancement of text analytics in healthcare. It opens avenues for further research aimed at developing more robust, efficient, and accessible tools for analyzing free-text data, thereby enhancing the ability of healthcare professionals to use unstructured data to improve decision making and patient outcomes.

Unveiling missed nursing care: a comprehensive examination of neglected responsibilities and practice environment challenges.

BACKGROUND: The global variable of missed nursing care and practice environment are widely recognized as two crucial contextual factors that significantly impact the quality of nursing care. This study assessed the current status of missed nursing care and the characteristics of the nursing practice environment in Iran. Additionally, this study aimed to explore the relationship between these two variables. METHODS: We conducted an across-sectional study from May 2021 to January 2022 in which we investigated 255 nurses. We utilized the Missed Nursing Care Survey, the Nursing Work Index-Practice Environment Scale, and a demographic questionnaire to gather the necessary information. We used the Shapiro‒Wilk test, Pearson correlation coefficient test, and multiple linear regression test in SPSS version 20 for the data analyses. RESULTS: According to the present study, 41% of nurses regularly or often overlooked certain aspects of care, resulting in an average score of 32.34 ± 7.43 for missed nursing care. It is worth noting that attending patient care conferences, providing patient bathing and skin care, and assisting with toileting needs were all significant factors contributing to the score. The overall practice environment was unfavorable, with a mean score of 2.25 ± 0.51. Interestingly, 'nursing foundations for quality of care' was identified as the sole predictor of missed nursing care, with a ß value of -0.22 and a p-value of 0.036. CONCLUSIONS: This study identified attending patient care interdisciplinary team meetings and delivering basic care promptly as the most prevalent instances of missed nursing care. Unfortunately, the surveyed hospitals exhibited an undesirable practice environment, which correlated with a higher incidence of missed nursing care. These findings highlight the crucial impact of nurses' practice environment on care delivery. Addressing the challenges in the practice environment is essential for reducing instances of missed care, improving patient outcomes, and enhancing overall healthcare quality.