Competent Nursing Care Research Articles

Barriers and outcomes of therapeutic communication between nurses and patients in Africa: a scoping review

BackgroundTherapeutic communication (TC) promotes effective patient care, emotional wellbeing, and improves patient outcomes. The purpose of this review was to synthesise evidence on barriers and outcomes of TC between nurses and patients in Africa and to inform future studies and systematic reviews.MethodsSearch for the records was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Results and findings from published studies and grey literature were included. A total of 16 articles met the eligibility criteria and were included in the review. This scoping review followed the guidelines by Askey and O’Malley.ResultsBarriers associated with TC were grouped under five main themes: sociodemographic factors, patient-related factors, nurse-related factors, environmental and health service-related. Age, and religious beliefs were the main sociodemographic factors that hindered TC while stress and inadequate knowledge and skills were identified among the nurse-related barriers to TC. Extreme weather conditions and mosquito infestation were environmental factors while lack of access to TC educational programmes on TC was a health service-related factor that interfered with TC. Both positive and negative outcomes of TC were also identified.ConclusionContinuous professional development on TC is necessary to improve nurses’ attitudes and update their skills to enable them to render culturally competent nursing care to patients.

Nursing core competencies for postresuscitation care in Iran: a qualitative study

ObjectiveThis study explored nurses’ perceptions of the core competencies required for providing postresuscitation care in both in-hospital and out-of-hospital cardiac arrest.DesignQualitative conventional content analysis.Participants17 nurses selected with purposeful sampling method.SettingThree...

Translation, Adaptation, and Validation of the Cultural Competence Assessment in Portuguese Nurses.

Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care.

Implications of understanding the undergraduate nursing students' learning styles: A discussion paper

The article aims to present and critique the literature exploring nursing students' learning styles and to discuss the implications of understanding nursing students' learning styles for nurse educators, nursing students, and nursing academic programs. Learning style refers to the way an individual prefers to learn. Learning styles are shaped by several factors and change with different contexts. The learning styles vary among students in nursing programs and other health professions, with no one dominant style. Despite inconsistent evidence, educators believe that matching their teaching methods with students' learning styles can promote academic performance. The authors share a teaching experience that incorporates offering several teaching methods for the same content to meet the different learning styles of nursing students. The teaching experience resulted in students' satisfaction and improvement in their performance. The paper proposes assisting nursing students to develop their learning styles to enable them to master the skillset required by nursing as a profession. These nursing students are future nurses who would have developed the necessary learning style and skills to provide safe and competent nursing care.

A phenomenological exploration of the gender transition experience: findings to improve culturally competent nursing care and decrease health disparities

Background Most recently, it has been reported that 1.4 million adults in the United States identify as transgender. This number is double what was reported just five years earlier. What little research has been completed on this vulnerable population indicates that people who identify as transgender experience higher rates of depression, suicide, and social stigmatization than the cisgender population. Stigmatization of transgender people and lack of access to quality care is often the root for these disparities. Very few studies have examined the experience of transition. Objective The purpose of this phenomenological study was to explore the experience of transitioning from one gender to another. Methods Non-structured, in-depth interviews were conducted via an online platform with 11 male-to-female transgender adults who gave their informed consent to participate. Results Through a process of group data analysis, four major themes emerged: (a) Everybody Saw the Mask; (b) A Turning Point; (c) Shedding My Skin; and (d) Navigating the Way. Conclusions These findings can heighten healthcare personnel’s sensitivity to this vulnerable population, as well as guide students and providers to provide culturally appropriate care, which can lead to a decrease in health disparities.

Enhancing cultural competence in caring for lesbian, gay, bisexual, and transgender patients: An online training program for Taiwanese student nurses and nurses

BackgroundHealth disparities exist among lesbian, gay, bisexual, and transgender (LGBT) populations worldwide. However, student nurses and nurse staff have limited knowledge and skills in providing culturally competent nursing care for LGBT patients in Taiwan. ObjectivesThis paper describes the development, implementation, and evaluation of an online training program for the cultural competence of student nurses and nurses in Taiwan. DesignA one-group pre-/post-test study design. SettingsThe study was conducted in five nursing schools, 10 nursing associations, and 37 long-term care facilities. Two prominent online bulletin boards (PTT Nurse and Dcard Nurse) and one Taiwanese nursing group on Facebook were used to recruit participants. ParticipantsIn total, 301 student nurses and nurses participated in the study and responded to pre- and post-test questionnaires. MethodsAn online training program for culturally competent nursing care was developed and implemented. The pre- and post-test questionnaires contained three sections: (1) demographics, (2) knowledge of LGBT health, and (3) the Sexual Orientation Counselor Competency Scale. Three open-ended questions were included in the post-test questionnaire to evaluate the online training program. ResultsThe online training program significantly improved the participants' knowledge and cultural competence skills. However, their attitudes towards cultural competence did not change after the program was implemented. Regarding qualitative feedback of the online training program, feedback on the strengths and limitations of the program was summarized under three themes: program content, website design, and online modules. ConclusionsThe results suggest the importance of an online training program which may contribute to reducing health disparities among the LGBT population.

Utilizing Handoff Reporting Tools to Improve the Novice Nurse's Workflow.

The novice nurse is task oriented and requires guidance to recognize connections in clinical practice. Novice nurses must learn to prioritize, organize, and differentiate between information that is "nice-to-know" versus "need-to-know" to deliver competent nursing care. Nursing literature makes evident that utilizing communication frameworks increases the delivery of clear communication and improves patient outcomes. Novice nurses require a comprehensive handoff-reporting tool to prompt the novice to engage in critical thinking and facilitate communication within their practice.

Faculty collaboration in transitioning to NGN test item writing

This article describes the process faculty used to implement National Council of State Boards of Nursing (NCSBN) Next Generation NCLEX-RN (NGN) test item writing at an urban southeast U.S. ADN program. Attendance at several NGN workshops included learning the clinical reasoning and test question composition process and incorporating NGN test items for use in the formative evaluation process which determines student proficiency in content in the ADN program. These methods integrated by faculty should help the nursing student attain the knowledge, skills, abilities, and reflection to improve critical thinking and ensure competent clinical judgment at the entry level in their careers as registered nurses. Additionally, incorporating NGN using the Clinical Judgment Measurement Model (CJMM) will preclude the potential failure by new graduates to recognize patient complications coupled with the inability to act to rescue patients. The goal for nursing programs implementing NGN is for new graduates delivering competent nursing care, intervening early, and reducing the incidence of patient harm.

Stressors and Coping Strategies among Menopausal Women during COVID-19 Pandemic Lockdown

Menopause is one of the women’s lifespan conditions that increases the potentiality of developing multiple physical and psychological diseases. Thus, it exposes the women to many fears and pressures, mainly during the COVID-19 pandemic. This study aims to assess stressors and coping strategies among Egyptian menopausal women during the COVID-19 pandemic. Methods: A descriptive cross-sectional design was used to identify the associated menopause complaints stressors and the types of coping strategies among 126 university working women ages 40 to 60. Three tools were used: the demographic-characteristic, menopause rating scale, and coping with menopause symptoms questionnaires. Results: The most prevalent complaints were psychological stressors with a mean of 88.8 (70.5%), where fear of infection and death by COVID-19 was the most common problem (87.3%). Further, the most coping technique used by participants was protective measures with a mean of 82.2 (65.2%). There is a highly significant difference (p=0.001) with all coping strategies based on the women’s menopausal status. Conclusion and recommendations: The COVID-19 pandemic with menopause represents a significant burden on women at a critical time of their lives. Based on the results, it is essential to address the effectiveness of highly competent nursing care and support that includes effective coping strategies. Establishing and adopting nursing care guidelines that deal with stress and caring during this pandemic is highly recommended.

Transgender people in the nursing discourse: An integrative review.

To integrate and analyse the literature produced by nurses in terms of care, education and understanding of the reality of transgender (trans) people. An integrative review methodology guided by the framework proposed by Whittemore and Knafl. The search strategy was applied in the following databases: Medline, Embase, Scopus, Web of Science and CINAHL, as well as in Biblioteca Virtual de Saúde, during February and March 2021, with no time frame. The references found were assessed according to the eligibility criteria established. The information of the articles included was extracted, and a thematic analysis was performed to synthesize the review findings. The searches in the databases yielded 2859 articles; 985 after removing duplicates, and 33 articles were included in this review. Three major themes were identified: (1) Understanding the trans universe through the trans perspective; (2) Understanding health and nursing care for trans people; and (3) Trans women as the focus of health and nursing care. The themes evidenced in the lens of nurses and clients the importance of nursing training at all levels to prepare professionals on how to provide culturally competent nursing care for this population and reduce healthcare inequities. Nurses must work to provide a space for convergence and enhancement of the rights of trans people and cease to be a verticalized care model. To such end, it is necessary to devise places and possibilities to teach and learn, to construct and reconstruct a culturally competent nursing care. This review highlighted the current knowledge and identified gaps in the understanding of nurses, health professionals and students about the experience lived by trans people, resulting from the lack of training and continuing education of these professionals.

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions.

This study aims to explore the disciplinary processes for nurses, from organizational supervision to final decisions by the Finnish regulatory authority. Regulatory authorities are responsible for protecting the public, by ensuring that they receive safe, competent and ethical nursing care, but little is known about the disciplinary processes for nurses. This is a retrospective document analysis of 296 disciplinary decisions by the Finnish regulatory authority from 2007 to 2016. The data were analysed using a quantitative design with descriptive statistics. We studied 204 disciplined nurses (81.4% female) with a mean age of 43.5years. The disciplinary process comprised organizational supervision, complaints, investigations and decisions. Nurses with substance abuse issues were more likely to face criminal investigations and receive temporary decisions. The process lasted from under 1 month to years and could have profound effects on nurses, colleagues and nurse managers and compromise patient safety. This study identified key factors that could inform the disciplinary processes for nurses. More knowledge is needed about how organisations ensure patient safety when unprofessional conduct is suspected. Retaining nursing professionals is vital due to global shortages, and more attention should be paid to organizational supervision and support for nurses during disciplinary processes.

New Parkinson’s Disease Pocket Guide: A Helpful Assistant for Busy Practitioners

Despite Medicare data showing that about 25% of people with Parkinson’s disease (PD) reside in nursing homes, many practitioners may not have a lot of experience with diagnosing and managing this condition. As Nora Reznickova, MD, a geriatrician at Colorado Permanente Medical Group in Boulder, said, “Starting with the differential diagnosis, practitioners aren’t necessarily comfortable managing PD patients. They may not feel like they have the necessary skills and experience, and they worry that they’ll miss more atypical Parkinsonian disorders.” Dr. Reznickova and others in AMDA – The Society for Post-Acute and Long-Term Care Medicine worked on a new PD pocket guide to help boost practitioners’ confidence in addressing this condition. Essential to effective PD treatment are: understanding all the manifestations of the disease; recognizing the importance of basic, competent primary nursing and medical care; understanding the roles of various disciplines, therapies, and specialties; and adopting the concept of realistic goal setting for each patient. “The pocket guide includes some tools to help with difficult issues related to PD, such as assessing not only motor symptoms but nonmotor ones which are frequently overlooked,” said Dr. Reznickova. The pocket guide also gives some tips about how to address PD during routine visits, Dr. Reznickova noted. This is significant partly because PD patients have tremendous palliative care needs, she stressed. “In the guide, we mention a study in which the authors looked at the palliative care needs of PD patients and found that they were similar to or higher than people with advanced cancer.” Having these palliative care conversations is important, and the guide helps make them easier, less stressful, and more productive. At the same time, Dr. Reznickova indicated, conversations about PD in general can be painful. “There is no cure, and that is difficult for people to hear. However, there are treatments that can significantly improve quality of life, and we can talk about those. For instance, I always encourage people to start exercising as intensively as they are capable.” Communication with staff is another challenge the guide addresses. As David Smith, MD, CMD, president of Geriatric Consultants in Brownwood, TX, observed, “One of the greatest challenges for physicians (and advanced practice providers), from my own experience, is that nursing and CNA [certified nursing assistant] staff may not recognize condition changes caused by PD’s progression. Without this information, prescribers are often unable to make those earlier interventions.” To address this, the pocket guide includes an integral history that nursing and CNA staff can collaborate on before the prescriber comes to the facility. There is an information overload right now, Dr. Smith observed; although COVID-19 demands top priority, that doesn’t mean everything else went on vacation. “We need to be increasingly efficient and find new ways to identify problems and fix them. That is a tall order, but we can’t put this off until after the pandemic,” he said. PD is one area that needs attention, and the new pocket guide can help. He said, “Parkinson’s can progress over time. There are issues that are urgent and will come to the forefront, such as PD-related psychosis, and these will need prompt action and attention.” However, it’s important to be able to identify subtle changes as well. “The pocket guide will give people the resources they need to identity and address those subtle changes, as well as the more obvious signs and symptoms,” Dr. Smith noted. He added, “The guide is like an auxiliary brain” for practitioners and their teams. The pocket guide is available in a package with the Society’s clinical practice guideline (CPG) on Parkinson’s disease. For more information or to order, go to https://paltc.org/product-store/parkinsons-disease-cpg-parkinsons-disease-psychosis-pocket-guide. The CPG and pocket guide are available in both paper and digital versions. Senior contributing writer Joanne Kaldy is a freelance writer in New Orleans, LA. and a communications consultant for the Society and other organizations.

Nursing students' perspectives and care giving experiences with refugees: A qualitative analysis

BackgroundIt is crucial to determine the intercultural sensitivity of nursing students who will provide care to refugees in the future and to examine their perspectives, experiences, and views on providing care to refugees. ObjectivesThe aim of this study was to describe nursing students' perspectives and caregiving experiences with refugees in Turkey. DesignThis study was conducted with a phenomenological approach in a qualitative design. Settings, participants, methodsThe sample of the study consisted of 10 intern nursing students with purposive sampling method in their last year of education at the bachelor level for nursing who had experience of caring for refugees and voluntary participation in this study. The data was collected through in-depth interviews conducted with a semi-structured interview form. MAXQDA program was used to code qualitative data. Results74 codes gathered under four themes with related subthemes as follows: a) Perspective on refugees with three subthemes: Health, social and economic perspective, b) Barriers in cultural care and two subthemes: Barriers on language and communication and problem-solving technique, c) Feelings and barriers in nursing care, d) Recommendations and five subthemes: society, refugees government, health services, and nursing education. Students expressed that language and communication were the most significant problems when they gave care to patients. They felt helpless, insufficient, and afraid of making mistakes in providing care due to communication barriers. Nursing students suggested that education is an essential factor to increasing awareness and break prejudice towards refugees. ConclusionsLanguage and communication were the greatest problems when students gave care to refugees patients. Language problems could be managed by using interpreters in hospitals to decrease cultural conflicts and provide equal healthcare. In order to increase students' cultural sensitivity and awareness, organizing training and integrating the concept of intercultural in nursing education into the curriculum could be suggested, and students should receive training to ensure they can provide culturally competent nursing care.

Exploring cultural competence of nurses and associated barriers in Ethiopian tertiary hospitals: A qualitative study

BackgroundsCultural diversities in both patients and health professionals possess difficulties in cultural care. Such cultural diversities can lead to culturally inappropriate care and health disparities. Delivering culturally competent nursing care is a powerful tool to provide care equally for all patients and eliminate health disparities among culturally diverse people. The present study aimed to explore the cultural competence of nurses and associated barriers in Ethiopian tertiary hospitals. MethodsThe study was conducted on eight purposively selected key informants from March 1 to April 30, 2018. Data was collected using semi-structured questions through face to face in-depth interview. The collected data analyzed using thematic analysis and presented in the form of text and table. ResultsEight (n = 3 females and n = 5 males) participants were involved in the study. After extensive analysis, four themes emerged: cultural competence, linguistic competence, cultural competence education and training, and barriers to cultural competence. Another six subthemes of barriers encountered by participants identified and consisted of the language barrier, trained interpreter and translator limitation, lack of knowledge of the patient's culture, lack of multicultural nursing workforce, and shortage of nursing staff, cultural and linguistic stereotypes. ConclusionsNurses less focused on cultural aspects of patients, and they focused more on biological factors and patients' disease. Interestingly, they expressed respect for the cultural and religious practice of patients and showed an interest to learn about cultural care nursing. Cultural competence of participants was hindered by several barriers that need nurses to overcome it.

Mucormycosis an avoidable complication of COVID-19: a case report

Mucormycosis is caused by the fungi belonging to the order Mucorales. There has been an increasing trend of rising fungal infection during the second wave of COVID in India, seen among patients recovering from COVID-19. A 37-years-old middle-aged adult, with the diagnosis of left paranasal sinus mucormycosis, left side pneumothorax (intercostal drainage tube in-situ) with COVID pneumonia reported to the emergency department (ED) during the COVID-19 pandemic in our hospital in India. The patient presented in the ED on oxygen support via a non-rebreathing mask at rate of 10 l/min with a history of progressive left eye redness, pain, and tenderness, periorbital swelling, sudden onset, and mild shortness of breath from 8 days. The patient had a history of taking steroids during the management of COVID-19, also had left intercostal drainage tube (ICD) in-situ, and underwent post endoscopic sinus surgery in the private hospital. The patient was clinically examined by multispeciality experts and subjected to laboratory investigations. The patient was diagnosed with left PNS mucormycosis and planned for debridement. The patient developed renal failure secondary to antifungal therapy had sudden deterioration and could not be saved. The mortality rate of mucormycosis is very high due to delayed presentation, toxicity associated with the antifungal therapy, etc. There is a need to identify risk factors, perform specific laboratory tests, and initiation of prompt treatment. Monitoring and competent nursing care are required during antifungal therapy and prolonged hospital stay.

Engaging students in a QI/QM presentation to enhance QSEN concept learning

The Quality and Safety Education for Nurses (QSEN) Initiative addresses goals to better prepare future nurses by proposing and defining 6 competencies addressing knowledge, skills, and attitudes (KSA) needed for undergraduate, pre-licensure nursing students to be successful, competent, and qualified registered nurses. Educators maintain the responsibility to bridge education and clinical preparation to enable nursing students to practice at a level that projects quality and safety. This article introduces and explains a guided Quality Indicator/Quality Measure (QI/QM) teaching-learning strategy aimed at the promotion of learning about QSEN competencies, in which students identify a clinical QI/QM issue, gather data, collaborate, apply research techniques, create a presentation, and report their findings. Specific QSEN competency sub-scores from an NCLEX test preparation strategy were used to measure students’ learning, and improvements on these sub-scores were observed. Introducing QSEN concepts sets the stage for competent nursing care in the future and this valuable teaching-learning strategy suggests how to infuse QSEN competencies into an undergraduate nursing curriculum.

Effect of a mobile app-based cultural competence training program for nurses: A pre- and posttest design

BackgroundImportance of providing culturally competent nursing care and cultural competence training for nurses has increased due to diversification of the cultural backgrounds of patients in South Korea. Currently there is little cultural competence training provided to nurses in South Korea. ObjectivesThis study aimed to develop and evaluate a mobile app-based cultural competence training program for nurses working at a tertiary teaching hospital in South Korea. DesignA one group pre- and posttest intervention design. SettingsA tertiary teaching hospital in South Korea. ParticipantsA total of 49 nurses participated in the study. MethodsA mobile app-based cultural competence training program for nurses was developed using the five stages of the ADDIE instructional model. Cultural competence scores were compared between pre- and posttest using the paired t-test. The differences in cultural competence scores between pre- and posttests were also compared by participant characteristics using analysis of variance, the Kruskal-Wallis test, and the Mann-Whitney-Wilcoxon test. ResultsThe mean total score of the nurses increased significantly after participating in the program, from 63.00 to 81.06 (p < 0.001). Comparisons of differences in cultural competence scores between pre- and posttests by participant characteristics revealed that the improvement in cultural competence was greater in those with no experience abroad for longer than 1 month compared to those who had experience abroad for longer than 1 month (p < 0.001) and in those who had never cared for a foreign patient compared to those who had cared for more than three foreign patients per week (p < 0.05). ConclusionsThe mobile app-based cultural competence training program developed in this study was demonstrated to be effective in improving the cultural competence of nurses in South Korea. Our novel training program can be applied as on-the-job training to improve the cultural competence of nurses.

The influence of international mobility programmes on nursing students' personal and professional development

Introduction: Student mobility programmes have become a valuable instrument in student education as they enable the acquisition of essential knowledge, skills and attitudes, and equip the individual more effectively to work in the globalised world. The aim of the study was to examine the impact of international exchange programmes on the personal and professional development of undergraduate nursing students.Methods: A quantitative secondary analysis was conducted. The primary data were collected in 2016 as part of the study entitled International Nursing Student Exchange – Comparison Between Slovene and Foreign Students. The sample in the secondary analysis consisted of 73 nursing students from Slovenia and other European countries. The questionnaire included 20 statements which were rated on a 5-point Likert scale (1-strongly disagree to 5-strongly agree). The data were described on the basis of calculated mean values and the Mann-Whitney U test.Results: On the personal level, students stressed that mobility can improve their self-confidence (Z = –2.088, p = 0.037) and acceptance of other cultures (Z = –3.116, p = 0.002). On the professional level, they highlighted the need to upgrade students' professional competencies (Z = –3.116, p = 0.002), particularly in the field of culturally competent nursing care (Z = –2.391, p = 0.017).Discussion and conclusion: The benefits reported by nursing students seem to show that it is sensible to continue to support and promote international student mobility programmes.

Self-Reported Cultural Competence of Nurses Providing Nursing Care in Slovakia.

The goals of this study were to determine and evaluate the perception of cultural competence of nurses in the Slovak healthcare system, identify factors that influence their perception, and ascertain opportunities to improve nurses' cultural competence. Cross-sectional nonexperimental study. Nurses from Slovakia were surveyed in this cross-sectional study using the standardized Cultural Competency Assessment (CCA) questionnaire. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA). In total, 267 nurses responded. Only 28% perceived themselves as very culturally competent to care for people from other cultures. Over 68% received no diversity training. Age (p < .011) and prior diversity training (p < .006) were significantly associated with culturally competent behavior (CCB). A significant relationship (r = 0.17; p < .015) was also confirmed between the self-reported CCA andCCB. Culturally competent care is a professional imperative. The ability to deliver high-quality, culturally congruent care may be enhanced by cultural diversity education and training. Further research is needed to identify other influences on cultural competency and the impact on patient care and outcomes. There is a need for nurses to enhance their knowledge and skills related to cultural competency, awareness, sensitivity, and behaviors. Education and training contribute to nurses' ability to provide high-quality, culturally competent nursing care to patients from different cultures, and may possibly contribute to decreased health disparities.

Safe and competent nursing care: An argument for a minimum standard?

There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. Thus, both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries.