Nursing Activities Research Articles

Burnout and Physical Activity as Predictors of Job Satisfaction Among Peruvian Nurses: The Job Demands-Resources Theory.

The Job Demands-Resources (JD-R) theory suggests that an imbalance between job demands and available resources can lead to burnout, negatively affecting job satisfaction. Physical activity is recognized for its positive effects on psychological well-being and could play a crucial role in mitigating burnout and improving job satisfaction, especially in high-demand professions such as nursing. This study investigates the relationship between burnout, physical activity, and job satisfaction in Peruvian nurses, using the JD-R theory as a theoretical framework. A cross-sectional and explanatory analysis was conducted on a sample of 420 Peruvian nurses, using a Structural Equation Modeling (SEM) design to analyze the relationships between burnout, physical activity, and job satisfaction. The instruments included the Ultra-Short Burnout Measure (IUB), the General Job Satisfaction Scale NTP 394, and the International Physical Activity Questionnaire (IPAQ). The findings showed a significant negative correlation between burnout and physical activity (β = -.40, P < .001) and between burnout and job satisfaction (β = -.46, P < .001). Physical activity exhibited a significant positive correlation with job satisfaction (β = .22, P < .001). Moreover, mediation analysis confirmed that physical activity mediates the relationship between burnout and job satisfaction (β = -.106, P < .001). The findings emphasize the importance of physical activity as a mediator in the relationship between burnout and job satisfaction among Peruvian nurses, highlighting the need to promote physical activity as a strategy to improve workplace well-being. It is suggested that enhancing access to and promotion of physical activity could mitigate the effects of burnout and improve job satisfaction, which is essential for the quality of care and the well-being of nursing staff. These findings underscore the need for organizational and public health strategies that promote a healthy work environment and balance between the demands and resources available.

A imagem de enfermeiras(os) no Chile por meio de desenhos infantis: um estudo iconográfico

Abstract Objective To reveal the image of nursing professionals in Chile through the analysis of children’s drawings. Method This is an exploratory qualitative study, involving the collection of information through nine drawings made by children aged between 7 and 10 years, using free technique, and then were analyzed with the Iconographic Method proposed by Erwin Panofsky. Results Most drawings depict clinical activities of nurses, focusing predominantly on the technical dimension of the profession. Although nursing is commonly associated with a mostly female occupation, permeated by gender stereotypes, some participants were able to identify the presence and importance of the male role in this professional field. No iconographic elements were identified that would reinforce stigmas associated with nursing professionals, such as the view that they are supporters, aides, or mere medical assistants. Conclusions and implications for practice Children’s drawings serve as a reflection of the collective imagination of society. By studying them in relation to nursing, we can identify the advances of the profession and glimpse its near future. This research contributes to understanding the current image of the profession in society, and allows an analysis that goes further, helping to establish future directions and the evolution of this collective perception.

Reflections on theoretical framework use in nursing research.

to reflect on theoretical framework use in nursing research. a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science. we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers' work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science. based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers' thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.

Implementation of Sepsis Prevention Guidelines for Nurses into a Clinical Practice

Background: Sepsis is one of the most serious complications in intensive care patients, which is associated with high mortality and morbidity of critically ill patients. Measures based on the effective prevention are one of the main strategies of treating patients. Aseptic procedures, barrier nursing techniques, selection of equipment used for the treatment as well as the replacement frequency of protective barriers are preferred nursing interventions of sepsis with regard to the prevention. The objective of this retrospective study was to assess the importance of nursing interventions and aspects of the incidence of sepsis and infectious complications in ICU patients, including analysis of erroneous nursing procedures that could affect the formation of sepsis. Methods: A retrospective study was conducted by data collection from medical records and observation of patients hospitalized at the Clinic of Anesthesiology and Intensive-care during the period from January 2019 to December 2022. The overall sample consisted of 736 patients who were diagnosed with sepsis by a doctor according to confirmed infectious etiology. Data were processed by descriptive statistics, frequency tables and x2 (chi-square) test were used for evaluating and the Fisher's exact test was used for small frequency (n &lt;5). Statistical tests were assessed at the significance level of 5. There were identified 231 patients with sepsis, 106 patients with confirmed infectious etiology, 31 patients with confirmed non- infectious causes (SIRS) and 7 cases of other infectious cause was confirmed during hospitalization. Another category of patients was represented by cases, in which the positive sputum was found in injection site infection, in positive punctate in wound, in purulent secretion from the wound or bacterial findings in urine without general symptoms of infection. Nursing interventions were analyzed with regard to the prevention of sepsis patients in intensive care. Results: The largest number of sepsis was proved in 2019 (26.23%) and in 2020 (20.01%), while in 2021 (11.67%) and 202022 (14.02%) there was recognized a decrease in sepsis. According to the etiology there was significant share of VAP and catheter sepsis compared to uremic and early infection Out of the nursing procedures that have proven to be important for the prevention of VAP there were identified a closed suction method, the selection of the endotracheal tube, the use of semi recumbent position. Selection of the catheter, puncturesite selection, use of infusion filters or disinfection options were found as important examples in the prevention of catheter sepsis. Using a closed circuit system has proved to be the most effective in urinary tract infections. The results clearly show the effect of educational activities of working group on compliance with the rules of asepsis, compliance with barrier nursing activities and practices that are entirely in the hands of the nursing staff. Conclusions: All preventive measures are in accordance with the recommendations of CDC (The Centers for Disease Control and Prevention) and SHEA (The Society for Healthcare Epidemiology of America) that recommend the education and training of the staff. The objective is to increase awareness of the necessity of preventive measures which help to reduce the incidence of infection with subsequent sepsis in patients in intensive care. Regular education and practical training can not only improve the quality of care, but we can also implement new procedures into the practice with regard to the nursing staff awareness of the importance of sepsis prevention at intensive care units.

Development and Evaluation of Psychometric Properties of a Chinese Version Questionnaire for Measuring Emergency Nursing Interruptions

Nursing interruptions occur frequently and often have adverse outcomes, threatening patient safety. Emergency departments have a high incidence of nursing interruptions owing to the concentration of critically ill patients and frequent emergencies. Current research mainly focuses on large hospitals and uses observation and interview methods. Therefore, there is a need to develop tools for measuring emergency nursing interruptions. This study develops a survey questionnaire on emergency nursing interruptions. It tests its validity and reliability by building on the conceptual framework of emergency nursing interruption proposed in the literature. Specifically, we develop a test version of the emergency nursing interruption survey questionnaire using a Delphi expert inquiry and preinvestigation. We selected 1047 emergency nurses in 22 provinces and autonomous regions of China to participate in the survey by completing the questionnaire between June and July 2023 to evaluate the validity and reliability of the questionnaire. The final questionnaire comprised 26 items across 5 dimensions—sources, types, interrupted nursing activities, consequences of interrupted nursing activities, and management of nursing interruptions. The content validity indexes were 0.948 at scale level and 0.842–1.000 at item level. We used exploratory factor analysis (EFA) to extract five common factors with a cumulative variance contribution rate of 66.550%. The results of the confirmatory factor analysis (CFA) demonstrated a good model fit. Cronbach’s α coefficient of the questionnaire was 0.912, split‐half reliability was 0.846, and the retest reliability calculated using the intraclass correlation coefficient was 0.915. To ensure the structural validity of the scales, EFA and CFA were conducted using two different datasets. Thus, the questionnaire showed good validity and reliability and can be used to evaluate how nurses understand emergency nursing interruptions.

Perceptions of Stress and Engagement in High-Intensity Caregiving: A Cross-Sectional Study in Lithuania.

The aging population and overstretched healthcare systems are increasing demand for home nursing by informal caregivers, significantly affecting their mental health. This study aimed to examine the level of population's engagement in caregiving and the association between high-intensity caregiving and perceived caregiving stress in the general population of Lithuania. A nationally representative sample (N = 1000) of Lithuanian residents aged 18 years and older (mean age 53.1 ± 17.9 years) was interviewed in their households. The results showed that 17.4% (95% CI: 15.1, 19.8) of respondents were involved in home nursing activities to some extent, with 42% of these being high-intensity caregivers (providing 11 or more hours of home care per week). Caregivers were statistically significantly more likely to be female and have higher education levels. Perceived stress was significantly associated with higher education levels (OR = 2.66, 95% CI: 1.41, 5.02), high-intensity caregiving (OR = 2.14, 95% CI: 1.15, 3.97), regular involvement in home nursing (OR = 1.86, 95% CI: 1.01, 3.43), and caring for recipients with dementia or individuals entirely dependent on assistance (OR = 2.52, 95% CI: 1.22, 5.23). Caregivers perceived stress is associated with their level of education, the intensity and regularity of home nursing, as well as the level of dependency of the care recipient, especially in cases of dementia. Comprehensive long-term care policies should be developed to ensure the larger availability of formal care resources, increased societal participation in home nursing, and tailored interventions for high intensity caregivers.

Doing Social Space as a Chacterestic of Clinical Leadership Based on Advanced Nursing Practice - A Qualitative Ethnographic Study

Aim: The study aims to present and analyze the daily practices of Advanced Practice Nurses in hospitals and to reconstruct the constitutive spaces of action, especially in the context of clinical leadership. In doing so, a detailed picture of the prevailing social practices will be described. Research Question: How can Clinical Leadership be interpreted in dynamic work processes and their interaction in the hospital? Methods: An ethnographic research design including participant observation of nine Advanced Practice Nurses in two hospitals was conducted during the period 5/2020 to 8/2020. Data analysis included sequence analysis of participant observations. The study was classified as ethically unobjectionable. Results: This study shows how Advanced Practice Nurses connect people in the hospital through spacing processes and how they influence clinical care processes. The findings paint a detailed picture of the recurring everyday social practices of advanced practice nurses that are interwoven in a bundle and help to constitute and occupy social space. The results are presented in the Doing social space model. Conclusion: This process of reflection helps nurses and other health professionals to critically examine the conventions and rules that underlie their actions in clinical care and to explain the reasons for their actions. The findings should be of great interest as the actions of nurses can be explained and understood from both practice-based theoretical approaches and a spatial sociological perspective.

The Effect of Shared Leadership, Self-efficacy and Perceived Patient Safety Culture on the Patient Safety Management Activities of Nurses in Small and Medium-sized General Hospitals

The Effect of Shared Leadership, Self-efficacy and Perceived Patient Safety Culture on the Patient Safety Management Activities of Nurses in Small and Medium-sized General Hospitals

Militarized environment in narratives and practices of Russian medical personnel of the First World War

Based on the analysis of individual narratives and expert materials created by Russian doctors and nurses of mercy during the occupation of Galicia in the First World War, the article intends to reconstruct the models of perception of the hostile environment and the practice of its mastering by medical personnel. The appeal to ego-documents allows revealing little-studied aspects of the interaction between man and nature in the conditions of the first industrial war. On the one hand, natural conditions were the most important factor in the activities of doctors and nurses of mercy: the peculiarities of climate, soil and water determined the activities on medical support of the front, occupied regions and frontline territory. On the other hand, epidemiological practices based on the construction of negative images of alien nature had a direct impact on the state of the environment: disinfection of water, soil and air sources, and the spread of sanitary and hygienic infrastructure. In this regard, the perception of belligerent landscapes and their construction, the use of environmental images in the communication of medical professionals fit into a wide range of motifs and forms: nature as a victim of industrial warfare and an object of compassion, nature and the living beings inhabiting it as a space of epidemiological danger, nature as an object of potential control by means of disinfection.

Hand and wrist complaints in dialysis nurses in Germany: a survey of prevalence, severity, and occupational associations.

Occupations involving repetitive movements of the wrists, activities that require a lot of force, and hand-arm swinging are particularly likely to contribute to the development of hand and wrist complaints. The daily setup and dismantling of dialysis machines as part of the dialysis treatment process can strain the wrists and fingers of nurses. However, evidence regarding the relationship between the work activities of dialysis nurses and the incidence of hand and wrist complaints is limited. This study aimed to investigate the prevalence and severity of hand and wrist complaints among dialysis nurses in Germany and to relate these to their work activities. An online survey was created and sent to 836 dialysis centres in Germany. The Nordic Musculoskeletal Questionnaire was used in an online survey to assess the prevalence of musculoskeletal complaints in the hands and wrists. The Boston Carpal Tunnel Questionnaire (BCTQ) was used to assess symptom severity. Dialysis nurses rated the effort required to set up dialysis machines using the BORG-CR10 scale. The analysis was descriptive. A total of 122 dialysis nurses (18 male, 104 female; mean age 45 ± 12 years) participated in the survey, and 59% of them reported developing hands or wrist complaints in the last 12 months. According to BCTQ, the average severity of these complaints is 2.0 ± 0.8 (N = 72). The severity of symptoms increased significantly with the number of setups performed by a dialysis nurse per day (rs = 0.35, P = 0.003, N = 72). The nurses rated the effort required to set up the dialysis machines as 2.8 ± 1.8 on the BORG-CR10 scale (N = 101). The results of the online survey showed that dialysis nurses were more likely than the general population to experience hand and wrist complaints. The repetitive activities of the hands and wrists while setting up a dialysis machine are thought to be the cause. Preventive measures are needed to reduce hand and wrist strain in dialysis nurses.

A pilot resiliency course for Doctor of Nursing Practice (DNP) students: Lessons learned

Graduate nursing students can face varied and significant stressors during their programs of study. The need for interventions to promote nursing student resiliency has been reported in the literature, by accrediting bodies, and in previous research conducted with students at the same university. Thus, the purpose of this project was to pilot a resilience course for Doctor of Nursing Practice (DNP) students. The theoretical frameworks guiding the design and implementation of the resiliency pilot program were andragogy (the science of adult learning) and rapid cycle quality improvement. The course included eleven monthly modules addressing resiliency content with written material, original videos, and online discussions and meetings. The first module overviewed the resiliency skills (Belief, Persistence, Trust, Strength, and Adaptability), five modules were dedicated to a specific resiliency skill, two modules addressed recent and anticipated challenges, two modules concentrated on the application (clinical and academic) of the resiliency skills, and the last module focused on reflection. Results of this pilot program indicate that DNP students can benefit from receiving resiliency content during their studies, especially from faculty involvement and increased peer support; however, future resiliency content may be more accepted and effective if embedded into nursing program curriculum and activities.

FROM MISFIT TO FIT: THE IMPACT OF NURSING PRACTICE ON COMPLEX NURSING INTERVENTION DEVELOPMENT

Abstract Nurses have a key role in providing nutritional care to older adults to prevent and treat malnutrition, and stimulate health and well-being. However, evidence for nursing activities regarding nutritional care is often lacking. Therefore, intervention development is necessary. From earlier studies, an evidence-based nutritional intervention carried out by nurses appeared the best solution. The aim of this study was to outline the steps taken to develop a complex nursing intervention to prevent and treat malnutrition in older adults and the challenges faced during this stage. Following the phase of intervention development of the Medical Research Council (MRC) Framework, a systematic review, a questionnaire survey, semi-structured interviews, focus groups and participant observation were carried out. The purpose was to gather information about current nursing practice and context, the needs of future users and providers, and gain insight into the problem. The studies showed that nurses had moderate knowledge of (mal)nutrition. They gave nutritional care low prioritization during daily nursing activities. These results provided insight that the intended nursing nutritional intervention would most likely lead to a misfit with the context. To fit the intervention properly into nursing practice, it was decided to develop an educational intervention targeting nurses instead of a nutritional intervention carried out by nurses. Building proofs in context leads to challenges but is essential to prevent a misfit between complex nursing interventions and nursing practice. As an element of rigorous intervention development following systematic steps, it increases the chance of successful implementation.

Assessment, diagnosis and planning of the ECP of AEDs in children from two to five years of age at the Fundación Hombro a Hombro, Santo Domingo, 2022

The research addresses the assessment, diagnosis and planning of the Nursing Care Process (PAE) in children from two to five years of age with acute diarrheal diseases (ADD) at the Fundación Hombro a Hombro, Santo Domingo, Ecuador. A qualitative and descriptive approach was used, analyzing data from 70 patients and their mothers. The findings reveal that male children have a higher prevalence of ADE (65.7%), influenced by sociodemographic factors such as the mothers' youth (18-27 years) and the need to work, resulting in inadequate care by other family members (71.4%). The main causes identified were poor hygiene practices, poverty and inadequate sanitation. NANDA, NIC and NOC taxonomies were used to identify diagnoses such as diarrhea (72.9%) and nutritional imbalance (15.7%). Although 84.3% of the mothers had knowledge of EDA, its application was deficient. Applied studies on preventive practices, health fairs, and educational sessions were recommended to improve the prevention and management of EDA. In addition, a nursing action plan based on Virginia Henderson's theory was developed to address these needs.

К вопросу о формировании инновационной lean-компетентности сестрин- ского персонала, оказывающего помощь населению в системе ПСМП.

Introduction. The article proposes and proves the effectiveness of a model for the formation of innovative lean competencies among nursing staff operating in an optimized healthcare environment. Goal: to determine the effectiveness of the implementation within the framework of postgraduate training of an educational module on the formation of innovative lean competence in the professional activities of practicing nursing specialists. Methods. The study was conducted according to a specially developed questionnaire in two stages: the first – in 2019 (before the implementation of the educational module); the second – in 2022 (evaluation of the implementation results). The analysis of the results provided for the calculation of relative values (P) and their errors (± m). The same indicators were compared in dynamics, the Student’s coefficient (t) was used to assess the reliability of the differences. The differences were considered statistically significant at p&lt;0,05. Microsoft Office Excel and Statistica 5,0 programs were used to create an electronic database and calculate indicators. Results. At the first stage, a high readiness of the majority of nurses for innovation was revealed, but a number of limitations for innovation were recorded: low level of computer skills, lack of necessary competencies for implementing innovations, lack of leadership qualities, search for personal gain. A strong inverse correlation was found between age and the desire to introduce innovations. The results of the second stage showed a 1,4-fold increase in the share of nursing staff who want to introduce innovations in their workplace; a 1,8-fold decrease in the proportion of people who are wary of changes in their professional activities; reducing the time spent on processing medical documentation and increasing the amount of time allocated to working with patients. The proportion of nursing specialists using an electronic document management system in their professional activities has also increased – from 1,6% to 41,6%. Conclusion. The effectiveness of the proposed educational module for the formation of innovative lean competence in the professional activities of nurses providing assistance to the population in the primary health care system is confirmed by the achieved positive results of its testing in healthcare institutions.

Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study

BackgroundIn today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. MethodsThis cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. ResultsThe mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. ConclusionOur findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.

Real requirements of nursing activities and patient-related factors related to nursing overload in an internal medicine department.

Adequate nursing care can be decisive for the outcome of a patient admitted to an internal medicine ward. Individual prediction of nursing activity at the time of a patient's admission could improve the work process. This study aimed to assess the objectively assessed nursing requirements of patients admitted to a medical setting and to identify clinical factors that correlate with high demands. This is a prospective and pragmatic observational study that enrolled patients admitted to the Internal Medicine ward at the Altovicentino Civil Hospital (Italy) between September 1 and December 31, 2022. Nursing activities were recorded for the first 3days of hospitalization and standardized as performance/5min/patient. Patients requiring more than the 75th percentile of performance/5min/patient were considered nursing over-activities. Multivariable models were used to assess patient-related risk factors associated with nursing over-activity. This study enrolled 333 patients (mean age: 74.2; 55.6% male). Their mean Charlson Comorbidity Index (CCI), Clinical Frailty Scale (CFS), Chronic Barthel Index, and Sistema Informtativo della Performance Infermieristica (SIPI) scores were 5.3, 4.2, 62.4, and 53.7, respectively. Mean National Early Warning System (NEWS) on admission was 3.9 (standard deviation: 2.8). A median of 73 (interquartile range [IQR]: 54-109) nursing care activities/5min/patient were performed. NEWS score (odds ratio [OR]: 1.372, 95% confidence interval [95%CI]: 1.216-1.547, p < 0.001) and Acute Barthel Index (OR: 0.983, 95%CI: 0.967-0.999, p = 0.041) were independent risk factors for nursing over-activities. NEWS and the Acute Barthel Index could help reorganize nursing resources within internal medicine wards, allowing for an equal distribution between patients who require more resources and those who require less.

Nurses’ occupational physical activity and workload in a perioperative intensive care unit in Slovenia

The field of nursing includes heavy occupational physical demands, including walking and standing for longer periods of time, in addition to moving and lifting. As such, in the context of a typical work shift, many nurses generally achieve the World Health Organization's recommended 10,000 steps per day. This study aimed at estimating the daily physical activity and workload of nurses in a perioperative intensive care unit. The data sources for this study included data from the hospital information system on various procedures and interventions, and the Silva Ex3 Plus pedometers for measuring steps, kilometers, calories, and activity time across various shifts in a perioperative intensive care unit. Twenty nurses from Slovenia volunteered to participate in this observational study. Over 13 weeks, a nurse working an 8-hour shift walked an average of 5,938 steps (4.4 km). However, nurses who worked a 12-hour weekend day shift came very close to the World Health Organization’s recommendation with an average of 9,003 steps (6.5 km). A total of 227 patients were admitted and an average of 80 nursing interventions were performed per day and there was a positive relationship between physical activity, workload, and patient admissions in the perioperative intensive care unit (p = 0.001). Results of this study could help managers better understand nurses' physical activity and workload during various shifts in the perioperative intensive care unit.

Mental Disorders with A Risk for Violent Behavior Who Have Risky Behaviors and Tend to Smoke: a Case Study

Smoking behavior in patients with mental disorders is known as a risk factor and can affect one aspect of treatment and change in behavior. In addition, smoking will also stimulate psychiatric symptoms and more severe symptoms of recurrence. The objective is to determine the extent of the impact or influence of smoking behavior on mental disorder patients with a risk of violent behavior who have risky behavior tending to smoke in Bantur Health Center. The method used in this research is a case study approach using qualitative and quantitative descriptive research types. This study involved 3 respondents. Data collection is based on interviews, observation, and documentation according to the format of mental nursing care. The results of the study showed that respondents were able to perform nursing actions in generalist nurse therapy sessions 1-5. In the final stage of the study, the results showed that the three patients experienced changes in behavior by being able to practice and mention interventions in each session, but had not been able to reduce smoking behavior because the three patients had been active smokers since they were teenagers. The conclusion from this study is that smoking behavior is a risk factor for pople with mental disorders, especially in behavior. Generalist ners therapy sessions 1-5 for respondents with the risk of violent behavior resolved well, but not for smoking behavior because it takes longer and requires several processes and a stronger desire. It is hoped that future researchers can increase research time in the care process to approach the family in carrying out nursing care not only for the patient but also for the patient's family.

Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses’ wellbeing

ObjectivesUnfinished care refers to the situation in which nurses are forced to delay or omit necessary nursing care. The objectives was: 1) to measure the prevalence of unfinished nursing care in intensive care units during the COVID-19 pandemic; 2) to examine whether unfinished nursing care has a mediating role in the relationship between nurse working environment and nurse-perceived quality of care and risk of burnout among nurses. DesignA national cross-sectional survey. SettingSeventy-five intensive care units in Belgium (December 2021 to February 2022). Main outcome measuresThe Practice Environment Scale of the Nursing Work Index was used to measure the work environment. The perception of quality and safety of care was evaluated via a Likert-type scale. The risk of burnout was assessed using the Maslach Burnout Inventory scale. ResultsA total of 2,183 nurse responses were included (response rate of 47.8%). Seventy-six percent of nurses reported at least one unfinished nursing care activity during their last shift. The staffing and resource adequacy subdimension of the Practice Environment Scale of the Nursing Work Index had the strongest correlation with unfinished nursing care. An increase in unfinished nursing care led to significantly lower perceived quality and safety of care and an increase in high risk of burnout. Unfinished nursing care appears to be a mediating factor for the association between staffing and resource adequacy and the quality and safety of care perceived by nurses and risk of burnout. ConclusionsUnfinished nursing care, which is highly related to staffing and resource adequacy, is associated with increased odds of nurses being at risk of burnout and reporting a lower level of perceived quality of care. Implications for clinical practiceThe monitoring of unfinished nursing care in the intensive care unit is an important early indicator of problems related to adequate staffing levels, the well-being of nurses, and the perceived quality of care.

P20: Effects of Transitional Care Program on Reducing Nursing Home Placement in People with Dementia

Objective:People with dementia are more prone to premature nursing home placement after hospitalization due to physical and mental deconditioning which makes care-at- home more difficult. This study aimed to evaluate the effect of a post hospital discharge transitional care program on reduction of nursing home placement in people with dementia.Methods:A matched case-control study was conducted between 2018 and 2021. A transitional care program using case management approach was developed. Participants enrolled the program by self-enrolment or referral from hospitals or NGOs. Community-dwelling people with dementia discharged from hospitals received a four- week residential care at a dementia care centre with intensive nursing care, physiotherapy and group activities promoting social engagement, followed by eight- week day care rehabilitation activities to improve their mobility and cognitive functioning. They were matched on a 1:5 ratio by age and sex to people with dementia discharged from a convalescent hospital who did not participate in this program for comparison. The study outcome was nursing home admission, measured three months (i.e. post-intervention), six months, and nine months after hospital discharge. Multinomial logistic regression was conducted to investigate factors associated with nursing home placement at each measurement time-point.Results:361 hospital admission episodes (n=67 interevntion, n=294 control) were examined. The regression results showed that participants in the intervention group were significantly less likely to be admitted to nursing home three months (OR = 0.023, 95% CI: 0.003-0.201, p = .001) and six months (OR = 0.094, 95% CI: 0.025-0.353, p = .001) than the controls after hospital discharge, but the intervention effect did not sustain nine months after hospital discharge. Longer hospital length of stay, and hospital admission due to dementia, mental disturbances such as delirium, or mental disorders IPA_Abstract_PDP_20230119_clean 2 such as schizophrenia significantly predicted nursing home admission three months and six months after hospital discharge.Conclusion:The transitional care program could help reduce nursing home placement in people with dementia after hospital discharge. To sustain the intervention effect, more continual support after the intervention as well as family caregiver training would be required.