Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana.

Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.

Evaluation of Clinical Competence and Job Satisfaction and Their Related Factors Among Emergency Nurses in Palestinian Hospitals.

Introduction: Nurses are responsible for providing primary care to millions of patients, and emergency nurses serve on the frontline in providing care for mildly to severely critically ill patients. Objectives: This study aims to assess and evaluate the clinical competence and its related factors among emergency nurses in Palestinian hospitals. Methods: A cross-sectional study was conducted among 170 nurses working in the emergency units of hospitals in the West Bank, Palestine. Data collection utilized the Nurse Competence Scale, and the Job Satisfaction Scale. Results: The results showed that only 33(19.4%) of the participants exhibited a good level of clinical competence, with none reaching the very good level. Among them, the highest proportion of good level 60 (35.3%) was in the helping role, while the lowest 38 (22.4%) was in ensuring quality. About 35% of nurses reported very low or low job satisfaction, while 58% had high or very high job satisfaction. Additionally, the results revealed a statistically significant relationship between clinical competence and job satisfaction (P < 0.05). Both clinical competence and job satisfaction were positively correlated with age and experience. Conclusion: The study found a significant relationship between demographic characteristics (e.g., education, experience, and marital status) and clinical competency among emergency nurses. Notably, less than half of the participants demonstrated good clinical competency, with none reaching a very good level. The highest scores were observed in the helping role domain, while the lowest were in the ensuring quality domain. Furthermore, clinical competence was found to be significantly associated with job satisfaction. Consequently, enhancing nurses' clinical competency will lead to an improvement in the quality of patient care.

The business of Doctor of Nursing Practice (DNP) education: Practical application strategies to apply business concepts in DNP education.

PURPOSE: The purpose of this article is to 1) review updated business competencies in The Essentials: Core Competencies for Professional Nursing Education for Advanced-Level Nursing Education (2021) and 2) suggest strategies on how to integrate business and finance concepts encompassing quality, safety, and systems-based practice into DNP educational curricula. BACKGROUND: The Institute of Medicine recognizes strong nursing leadership on all system levels from "bedside to boardroom" as critical to redesigning healthcare that is affordable and accessible. The business of healthcare requires the DNP-prepared nurse to be equipped to understand and navigate business principles necessary for sustainable change to improve patient outcomes. The updated 2021 AACN Essentials include enhanced business concepts and competencies as curricular elements to prepare practice-ready DNP prepared leaders. FINDINGS: Current healthcare translation of research to practice has historically been slow, and only recently has the average time for research to translate to practice decreased from 17 years to 15 years. DNP-prepared nurses, as evidence-based practice and quality improvement experts, are positioned perfectly to reduce this research translation time gap to improve patient outcomes by implementing evidence-based change. Employers outside the academic setting, and arguably even within the academic setting, often fail to understand this unique skill set of a DNP-prepared nurse. A lack of business expertise disadvantages s the DNP-prepared nurses 'ability to effectively communicate and demonstrate the ROI and value added to an organization or interprofessional team. Achieving competency with business concepts during DNP education such as marketing, budgeting, return on investment, healthcare finance and interprofessional collaboration are critical components for a practice-ready DNP graduate as noted within the revised AACN Essentials (2021). DISCUSSION: The didactic content of business education that meets the 2021 AACN Essentials can be integrated in established DNP core courses or through creating new courses in the curriculum. Students through innovative assignments, immersion experiences, and the DNP final scholarly project can demonstrate application and competence of learned business principles. Strategically integrating business concepts into DNP curriculum provides multiple benefits to the DNP graduate, organizations, and ultimately, patients.

Challenges in Nursing Care of Children With Substance Withdrawal Syndrome in the PICU.

Introduction: Substance withdrawal is one of the most common advert events in the Pediatric Intensive Care Unit (PICU), as the administration of potent opiates and sedative drugs is frequently performed several times each day. Objectives: The present study explored the challenges in nursing care of children with substance withdrawal syndrome in the PICU. Method: The study has an explorative and descriptive semi-structured qualitative interview design, with a strategic selection of informants. It was conducted at one out of three pediatric intensive care units in Sweden. Results: Three different main themes were identified describing the different challenges regarding withdrawal symptoms: monitor the child's interest, work with structured support, and understand the observation. Conclusions: There is a discrepancy between the medical perspective and the nursing care perspective regarding children in PICU suffering from withdrawal syndrome. The lack of joint guidelines, language, and nursing diagnoses may lead to subjective evaluations and increase suffering for these children.

Patients' Perceptions of Quality of Care: A Teamwork Intervention Study in a Surgical Ward.

INTRODUCTION: Improving teamwork competencies among health care professionals is important for patient safety. Few previous studies have investigated whether a teamwork intervention has an impact on patients' perceptions of quality of care. OBJECTIVE: To investigate patients' perceptions of quality of care before and after the implementation of a team training program in a surgical ward. METHODS: A quasi-experimental pre- and posttest design was used. The TeamSTEPPS® team training program was implemented in a surgical ward. Three groups of consecutively sampled patients responded to the Quality from the Patient's Perspective (QPP) questionnaire including four dimensions with 25 items. In addition to the QPP, six items were developed for this study. In total, 223 patients responded to the questionnaire. The mean age was 59.6 years, and there were 128 males and 94 females. RESULTS: The physical-technical condition dimension and four items showed significantly higher scores after six months of intervention. The majority of the patients scored quality of care in the four dimensions as very high at all three time points. Younger patients reported the lowest care quality. CONCLUSION: The results in this study indicate that the teamwork intervention had a minimal impact on the patients' perceptions of quality of care, with only significant differences between baseline and six months of intervention in one dimension and three items. At each data collection time point, the numbers of patients who perceived quality of care as modest decreased slightly. Younger patients were more likely to perceive care quality as modest.

Treatment of Depression in Integrated Care: Implementation of the Nurse Care Manager.

The collaborative care model is an effective model for improving depression symptoms in patients in a primary care (PC) setting. An essential role in this model is the care manager (CM), and nurses have been effective in this role. However, there remains a question of how to best design, train, and implement this nurse CM role in PC. The purpose of this review is to provide readers with a critical description of what processes for training and implementation of a collaborative nurse CM role have been be successful in the literature, specifically as it pertains to supporting patients with depression and chronic medical illnesses in an integrated PC setting. A literature review of PubMed, CINAHL, PsychINFO, Scopus, and the Cochrane Collaborative was conducted in October 2018. Successful nurse CM interventions have included regular patient follow-up, symptom check-in, treatment monitoring, goal setting, and education. Psychological support techniques such as Problem-Solving Therapy, behavioral activation, and motivational interviewing have been useful in supporting patient care-plan engagement and goal achievement. Nurse CM training should support the successful implementation of the designed role. Nurse CMs have an opportunity to significantly impact depressive outcomes of patients with depression and long-term health conditions. Further research is needed to explore the potential that this nursing role has as well as how to best operationalize this role.

A Sustainability Oriented and Mentored Approach to Implementing a Fall Prevention Guideline in Acute Care Over 2 Years.

The purpose of this study was to assess the impact of a mentored guideline implementation (Registered Nurses' Association of Ontario Prevention of Falls and Falls Injuries in the Older Adult Best Practice Guideline) focused on enhancing sustainability in reducing fall rates and number of serious falls and the experience of staff in three acute care hospitals. The National Health Service (NHS) Sustainability Model was used to guide the study. Interviews and focus groups were held with 82 point-of-care professional staff, support staff, volunteers, project leaders, clinical leaders, and senior leaders. Study results supported the importance of the factors in the NHS model for sustainability of the guideline in these practice settings. There were no statistically significant decreases in the overall fall rate and number of serious falls. The results supported strategies of participating hospitals to become senior friendly organizations and provided opportunities to enhance staff collaboration with patients and families.