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1.
Cancer Control ; 29: 10732748221115469, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35921175

RESUMO

BACKGROUND: The global pandemic has caused breast cancer (BC) patients who are receiving chemotherapy to face more challenges in taking care of themselves than usual. A novel nurse-led mHealth program (mChemotherapy) is designed to foster self-management for this population. The aim of the pilot study is to determine the feasibility, usability, and acceptability of an mChemotherapy program for breast cancer patients undergoing chemotherapy. The objective also is to evaluate the preliminary effects of this program on adherence to app usage, self-efficacy, quality of life, symptom burden, and healthcare utilization among this group of patients. METHODS: This is a single-blinded randomized controlled pilot study that includes one intervention group (mChemotherapy group) and one control group (routine care group). Ninety-four breast cancer patients who commence chemotherapy in a university-affiliated hospital will be recruited. Based on the Individual and Family Self-management Theory, this 6-week mChemotherapy program, which includes a combination of self-regulation activities and nurse-led support, will be provided. Data collection will be conducted at baseline, week 3 (T1), and week 6 (T2). A general linear model will be utilized for identifying the between-group, within-group, and interaction effects. Qualitative content analysis will be adopted to analyze, extract, and categorize the interview transcripts. DISCUSSIONS: Breast cancer patients receiving chemotherapy are a population that often experiences a heavy symptom burden. During the pandemic, they have had difficulties in self-managing the side effects of chemotherapy due to the lack of face-to-face professional support. An mChemotherapy program will be adopted through a self-regulation process and with the provision of nurse-led real-time professional support for these patients. If proven effective, BC patients who engage in this program will be more likely to take an active role in managing their symptoms, take responsibility for their own health, and subsequently improve their self-efficacy and adherence to the use of the app.


Assuntos
Neoplasias da Mama , Autogestão , Telemedicina , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Papel do Profissional de Enfermagem , Projetos Piloto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Clin J Oncol Nurs ; 26(4): 374-382, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35939721

RESUMO

BACKGROUND: Clinical oncology care is complex, and new technologies can improve efficiency, contribute to safe treatment delivery, and enhance care for the patient. The COVID-19 pandemic prompted a shift to the use of digital health technologies to provide care. Oncology care providers can ensure that technology is integrated with the patient's plan of care. OBJECTIVES: The aims of this review were to provide a survey of digital health technologies in oncology care and changes in practice resulting from the pandemic, as well as to highlight oncology nurses' and nursing leaders' roles in promoting digital health technology in clinical practice. METHODS: Current and emerging literature, frameworks, and real-world experiences were reviewed to provide an overview of digital health technology in oncology care. FINDINGS: Digital health technology has become an integral tool for the oncology care team and provides opportunities to improve the lives of patients. The pandemic accelerated the adoption of technology to provide safe and effective care. Oncology nurses play a role in identifying patients' needs and developing and implementing care strategies.


Assuntos
COVID-19 , Telemedicina , Humanos , Oncologia , Papel do Profissional de Enfermagem , Pandemias
4.
BMC Health Serv Res ; 22(1): 1000, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35932078

RESUMO

BACKGROUND: In hospitals, catheter acquired urinary tract infection causes significant resource waste and discomfort among admitted patients. An intervention for reducing indwelling catheterisations - No-CAUTI - was trialled across four hospitals in New South Wales, Australia. No-CAUTI includes: train-the-trainer workshops, site champions, compliance audits, and point prevalence surveys. The trial showed reductions on usual care catheterisation rates at 4- and 9-month post-intervention. This result was statistically non-significant; and post-intervention catheterisation rates rebounded between 4 and 9 months. However, No-CAUTI showed statistically significant catheterisation decreases for medical wards, female patients and for short-term catheterisations. This study presents a budget impact analysis of a projected five year No-CAUTI roll out across New South Wales public hospitals, from the cost perspective of the New South Wales Ministry of Health. METHODS: Budget forecasts were made for five year roll outs of: i) No-CAUTI; and ii) usual care, among all public hospitals in New South Wales hosting overnight stays (n=180). The roll out design maintains intervention effectiveness with ongoing workshops, quality audits, and hospital surveys. Forecasts of catheterisations, procedures and treatments were modelled on No-CAUTI trial observations. Costs were sourced from trial records, the Medical Benefits Scheme, the Pharmaceutical Benefits Scheme and public wage awards. Cost and parameter uncertainties were considered with sensitivity scenarios. RESULTS: The estimated five-year No-CAUTI roll-out cost was $1.5 million. It had an overall budget saving of $640,000 due to reductions of 100,100 catheterisations, 33,300 urine tests and 6,700 antibiotics administrations. Non-Metropolitan hospitals had a net saving of $1.2 million, while Metropolitan hospitals had a net cost of $0.54 million. CONCLUSIONS: Compared to usual care, NO-CAUTI is expected to realise overall budget savings and decreases in catheterisations over five years. These findings allow a consideration of the affordability of a wide implementation. TRIAL REGISTRATION: Registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12617000090314 ). First registered 17 January 2017, retrospectively. First enrolment, 15/11/2016.


Assuntos
Infecções Relacionadas a Cateter , Infecção Hospitalar , Austrália , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Cateteres de Demora/efeitos adversos , Infecção Hospitalar/epidemiologia , Feminino , Hospitais , Humanos , New South Wales , Papel do Profissional de Enfermagem , Estudos Retrospectivos , Cateterismo Urinário , Cateteres Urinários/efeitos adversos
5.
Soins ; 67(864): 41-43, 2022 Apr.
Artigo em Francês | MEDLINE | ID: mdl-35914880

RESUMO

Therapeutic patient education (TPE) is part of the nurse's role, but a minimum of 40hours of training is required to practice in a national or regional program. Offering TPE requires a good command of the pathologies concerned, finding the time to proceed in a way that is comfortable for everyone, identifying the health professionals who intervene in the home. But also showing adaptability to accompany the patient towards autonomy.


Assuntos
Papel do Profissional de Enfermagem , Educação de Pacientes como Assunto , Humanos
6.
Br J Community Nurs ; 27(8): 374-376, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35924905

RESUMO

Diabetes care-particularly in a community setting as a form of prevention and management, is a growing requirement across England and Ireland. Self-management skills are an essential part of diabetes management and nurses in the community setting are one of the first points of care to ensure this. It is therefore imperative that nurses working within these primary and community care settings have the knowledge and skills necessary to support those in the community setting to effectively manage their condition, improve their health outcomes and their quality of life. Primary care has been tasked with providing both routine and more complex diabetes care and highlights a risk of adverse outcomes if people with diabetes are transferred to general practices without adequate support. Developing an approach for effective and efficient joint collaboration for primary care and specialists to manage the population of people with diabetes under their care is vital in its prevention and management. So how can this be achieved and what resources are required? This article will discuss current research into clinical practice and pilots which can contribute to supporting a more holistic multi-disciplinary approach to diabetes management and prevention, and hence, a provision of community based services aimed at health prevention.


Assuntos
Diabetes Mellitus , Papel do Profissional de Enfermagem , Diabetes Mellitus/prevenção & controle , Inglaterra , Humanos , Irlanda , Qualidade de Vida
7.
Enferm Clin ; 32: S50-S53, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35935730

RESUMO

Objective: The objective was to describe Nurse's experience in giving nursing care to covid-19 patients. Method: Phenomenology design was used in this study. Participants in this study were nurses who provided nursing care for COVID-19 patients. Participant data were obtained from the nursing office and contacted via cell phone to become participants. After data saturation the researcher found six nurses as participants. In-depth interviews were conducted from July to August 2020 to explore the experiences of nurses giving nursing care to Covid-19 patients. Data was analyzed using the Colaizzi method. Result: We found five themes of nurses giving nursing care to Covid-19 patients. The themes include the Motivation of nurses to provide nursing care during the COVID-19 pandemic, the nurse emotional response, the patient emotional response, the problems faced by COVID-19 nurses, and the expectations of the nurses. Conclusion: Nurses need support while giving nursing care to Covid-19 patients to break Covid-19 transmission.


Assuntos
COVID-19 , Cuidados de Enfermagem , Humanos , Papel do Profissional de Enfermagem/psicologia , Pandemias
8.
Leadersh Health Serv (Bradf Engl) ; ahead-of-print(ahead-of-print)2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35916375

RESUMO

PURPOSE: The purpose of this study is to emphasise nurses' experiences of nurse leaders' changing roles over 25 years. DESIGN/METHODOLOGY/APPROACH: A qualitative study was performed with individual interviews of eight nurse managers. From Norway and Finland, all nurse managers with more than 25 years of experience and working in specialist health care and primary health care were included in the study. FINDINGS: These nurse managers have a lot of knowledge and resolved conflicts using improved methods and have experienced continuous change. The role of nurse manager ranges from bedside to exclusive administrative work. The organisations have become more extensive, and the staff has grown. These changes have led to many challenges and more complex organisations. RESEARCH LIMITATIONS/IMPLICATIONS: Nurse managers who have worked for over a 25-year period had useful experience and could handle many new challenges. They can change themselves and their organisation tasks over time and follow the development of society. ORIGINALITY/VALUE: Based on their experiences as novices at the beginning of their career, the informants demonstrate their development to the level of expert manager.


Assuntos
Liderança , Enfermeiras Administradoras , Humanos , Noruega , Papel do Profissional de Enfermagem , Pesquisa Qualitativa
10.
BMJ Open ; 12(7): e056408, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35798525

RESUMO

OBJECTIVE: The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction. DESIGN, SETTING AND PARTICIPANTS: We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient's clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations. RESULTS: Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient's treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07). CONCLUSION: This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician's burden.


Assuntos
COVID-19 , Doenças Cardiovasculares , Consulta Remota , Telemedicina , Doenças Cardiovasculares/terapia , Estudos de Viabilidade , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Pandemias , Consulta Remota/métodos , Telemedicina/métodos
11.
Br J Community Nurs ; 27(7): 328-335, 2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35776556

RESUMO

In the UK, Parkinson's disease (PD) is estimated to affect an annual incidence of 15-20 per 100 000 of the population over the age of 60. Service users living with advanced-stage PD require the use of apomorphine, which is generally used to control symptoms. The district nursing service plays a key role in monitoring and in the administration of apomorphine therapy. Although apomorphine is effective, skin problems such as nodules are commonly reported adverse events that can complicate efficiency of treatment. A sublingual delivery route to apomorphine has been known for years as a feasible alternative to subcutaneous route. Collaboration between the multidisciplinary team is essential to meet the complex needs of service users with advanced PD. However, due to the increase in demands of the district nurse service, this time crucial intervention can be unpredictable to meet. An alternative route can enable district nurses to become less task-orientated. However, an increased risk of oral cavity related adverse events should be taken into consideration with the sublingual administration of apomorphine.


Assuntos
Apomorfina , Doença de Parkinson , Administração Sublingual , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/uso terapêutico , Apomorfina/efeitos adversos , Apomorfina/uso terapêutico , Humanos , Bombas de Infusão , Papel do Profissional de Enfermagem , Doença de Parkinson/tratamento farmacológico
12.
Br J Community Nurs ; 27(7): 350-356, 2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35776559

RESUMO

This article will investigate the district nurse's role in managing urinary catheter blockages, looking at why people require long-term catheterisation and the causes of blockages and then reviewing treatment methods. Current practice will be critically analysed and compared to the most up to date research and literature to inform district nurses of best evidence-based practice in the hopes of improving service user outcomes and quality of life and reducing the impact this problem has upon district nursing services with regards to time and resources.


Assuntos
Qualidade de Vida , Cateteres Urinários , Cateterismo , Esperança , Humanos , Papel do Profissional de Enfermagem
13.
Home Healthc Now ; 40(4): 214-222, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35777943

RESUMO

The early months of the COVID-19 pandemic caused suspension of physician home visits at our NYC home-based primary care practice as well as disruptions in community-based services homebound patients rely on. This produced gaps in care for a vulnerable patient population that is considered underserved and medically and socially complex. Telephone triage nurses at Mount Sinai Visiting Doctors Program responded to these gaps in care with targeted enhancements to telephonic patient assessment: creating an encrypted email address to receive photographs, the use of two Epic dot phrases to screen and educate regarding COVID-19, assessment of patients' ability to complete a video visit, the reassessment of goals of care, and the assessment of changes in home care services. We surveyed 15 attending physicians in our practice to evaluate primary care providers' opinions regarding changes in nurse telephone triage and how helpful they were in managing patients at home during the early pandemic. We found enhancements to nurse telephone triage were viewed by physicians as beneficial, valuable, and improved patient care. Physicians found changes improved timeliness of care, could improve self-management, helped avoid transfer to emergency department, and helped manage patient care at home. As the pandemic continues and telehealth becomes more widely used, nurse telephone triage may be adaptable to help care for a variety of patient populations during future public health emergencies.


Assuntos
COVID-19 , Médicos , Telemedicina , COVID-19/epidemiologia , Humanos , Papel do Profissional de Enfermagem , Pandemias
14.
J Wound Ostomy Continence Nurs ; 49(4): 314-321, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35809007

RESUMO

PURPOSE: The purpose of this study was to identify barriers and facilitators for nurses in a pressure injury prevention (PIP) link nurse role. DESIGN: Mixed-methods study that used nominal group technique with focus groups, followed by online surveys. SAMPLE AND SETTING: The PIP link nurse project recruited 52 RNs; 32 completed the PIP educational program and participated in data collection. The sample was drawn from PIP link nurses, who were invited to participate in focus groups at the end of the project to identify perceived facilitators and barriers to their role. Focus groups were specific to work areas: aged care and community visiting, and hospital. Two were in an urban setting and one in a rural environment. Twenty-two PIP link nurses participated across 3 groups. To ensure comprehensive data from all involved in the project, online surveys were created using focus group priorities as the basis for questions to send to all PIP link nurses, their managers, and workplace colleagues. METHODS: Participants were invited to participate in focus groups to identify perceived facilitators and barriers to their role. These focus groups were organized around care settings: aged care, community visiting, and hospital. Using a nominal group technique focus group process, participants were asked to identify barriers and facilitators to their role. These were shared with the group until all answers were declared and understood. Voting on order of priority then took place, with majority voting leading to a prioritized list of facilitators and barriers for each group. Considering the similarities and differences across group priorities, researchers developed online surveys representing the main facilitators and barriers from the focus groups. Surveys were then distributed to all PIP link nurses, their managers, and colleagues. Survey data were collected and analyzed in REDCap and reported as percentages of agreement to the questions for each group of respondents. RESULTS: Focus group data indicated facilitating priorities included PIP link nurses' commitment to the role, the support they received from their managers and colleagues, and time release to complete the role. Barriers included lack of time-when other work pressures took priority, and PIP link nurses felt the focus on applying quality improvement theory was more challenging than they had anticipated. Surveys from all groups reiterated the importance of the support of the workplace team in facilitating the role, and the time pressures for the PIP link nurse were a barrier to the role. CONCLUSION: While the funding of such projects is advantageous, it should be carefully and generously considered how much time is required if the project is to succeed so that lack of time to complete the role does not become a barrier to successful completion.


Assuntos
Papel do Profissional de Enfermagem , Local de Trabalho , Idoso , Grupos Focais , Humanos , Nova Zelândia , Inquéritos e Questionários
15.
J Korean Acad Nurs ; 52(3): 245-260, 2022 Jun.
Artigo em Coreano | MEDLINE | ID: mdl-35818875

RESUMO

PURPOSE: This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors. METHODS: This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA. RESULTS: There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores. CONCLUSION: Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors.


Assuntos
Sobreviventes de Câncer , Neoplasias Colorretais , Ansiedade , Sobreviventes de Câncer/psicologia , Neoplasias Colorretais/psicologia , Depressão , Humanos , Papel do Profissional de Enfermagem , Qualidade de Vida/psicologia , Sobreviventes/psicologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-35897469

RESUMO

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.32 million deaths in 2019. COPD management has increasingly become a major component of general and hospital practice and has led to a different model of care. Nurse-led interventions have shown beneficial effects on COPD patient satisfaction and clinical outcomes. This systematic review was conducted to identify and assess nurse-led interventions in COPD patients in terms of mental, physical, and clinical status. The review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The relevance of each manuscript was assessed according to the inclusion criteria, and we retrieved full texts, as required, to reach our conclusions. Data extraction was performed independently by two reviewers, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Forty-eight articles were included in the analysis, which focused on the management of COPD patients by hospital, respiratory and primary nursing care. Nursing management was shown to be highly effective in improving quality of life, emotional state, and pulmonary and physical capacity in COPD patients. In comparison, hospital and respiratory nurses carried out interventions with higher levels of effectiveness than community nurses.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Humanos , Papel do Profissional de Enfermagem , Satisfação do Paciente , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , Autocuidado
17.
Int Emerg Nurs ; 63: 101191, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35810679

RESUMO

AIMS: This process evaluation aims at identifying the facilitators and inhibitors that influenced the successful uptake of a nurse-led triage system streaming low-risk patients from an emergency department (ED) to the general practitioner (GP). DESIGN & METHODS: Semi-structured interviews with ED nurses (n = 12), ED doctors (n = 6) from the ED of a Belgian general hospital and GPs (n = 5) affiliated with the adjacent GP cooperative (GPC). The process evaluation ran in parallel with the TRIAGE trial that started in March 2019 and ended 31st of December 2019. The first set of interviews was conducted in June 2019 and the second set in January 2020. Data were analysed based on grounded theory. RESULTS: Through a deductive framework, facilitators and inhibitors could be identified on three levels: the organisational, group and individual level. Main inhibitors are the degree of risk aversion of individual nurses, possible language barriers during delivery of the triage advice and the non-adapted ED infrastructure. Training on both the use of the triage protocol and effective delivery of the triage advice, in combination with periodical feedback from the GPC were the most important facilitators. CONCLUSION: Based on the process evaluation we can conclude that a consensus exists among stakeholders that the ED Nurses are considered ideally positioned to perform the triage of walk-in patients, although a certain degree of experience is necessary. Although the extended triage protocol and GPC referral increases the complexity and duration of triage and entails a higher workload for the triage nurses, ED nurses found it did lead to a lower (perceived) workload for the ED in general.


Assuntos
Enfermeiras e Enfermeiros , Triagem , Serviço Hospitalar de Emergência , Humanos , Corpo Clínico , Papel do Profissional de Enfermagem , Triagem/métodos
19.
Rev Esc Enferm USP ; 56: e20220026, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35876463

RESUMO

OBJECTIVE: To report a nurse's work experience with the street medical consultation teams in the city of São Paulo/SP Brazil. METHOD: Descriptive, experience report study, which describes the care for homeless people, from a nurse's perspective and experience. RESULTS: Among the attributions of the nurses working with the street medical consultation teams, there are the accurate knowledge of the territory, the ability to build bonds, the performance of diagnoses of health and epidemiological conditions, the planning of the team's actions, the establishment of integration flows with the Health Care Network, the knowledge and understanding about the people ending up on the streets, the supervision of the actions of nursing assistants and community health agents. CONCLUSION: Acting as a nurse on the street medical consultation team is a new and challenging experience that requires dynamic, strategic, creative, and empathic actions. The presence of nurses in the Street Medical Consultation teams contributes to ensuring access to health services and comprehensive care, expanding the possibilities of early detection, treatment, monitoring, and healing of chronic and infectious diseases.


Assuntos
Atenção à Saúde , Papel do Profissional de Enfermagem , Brasil , Humanos
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