Implications For Nurses Research Articles

Preventing Depression Among Older Adults With Severe Illness: The Mediating Role of Life Satisfaction and the Moderating Role of Gender.

The occurrence of severe illness, the risk for which increases as people age, often results in depression. The current study aimed to explore how and when severe illness leads to depression among older adults. Data collected from a sample of 756 older adults were analyzed using moderated mediation analysis to examine the underlying mechanism between severe illness and depression. Results, as verified by a robustness check, demonstrated that life satisfaction mediated the association between severe illness and depression among older men and women, and that gender moderated the direct relationship between severe illness and depression. The formation path of depression from severe illness among older adults varies according to gender. For men, severe illness did not directly trigger depression, but indirectly triggered depression through decreased life satisfaction; for women, severe illness not only triggered depression directly, but also indirectly triggered depression through decreased life satisfaction. Results yield theoretical and practical implications for gerontological nursing. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Caring for Patients With Injection Drug Use-Associated Infective Endocarditis at the End of Life: A Modified Photo-Elicitation Phenomenological Study.

Admissions for patients with injection drug use-associated infective endocarditis are increasing. Injection drug use-associated infective endocarditis is a serious and often fatal cardiac infection. Nurses are often frustrated when caring for these patients because these care assignments are physically and emotionally demanding. Nurses feel helpless, as they disposition young patients to a funeral homes, morgue, or hospice, or send them home to die, and yet a dearth of information regarding end-of-life care for injection drug use-associated infective endocarditis patients remains. This study explored the lived experiential impact these experiences have on nurses. The method was interpretive and participatory, a modified photo-elicitation phenomenological design. Twenty-nine nurses recruited by purposive sampling took photographs and wrote reflections, with 5 participating in an optional unstructured interview conducted by the author. Three themes emerged from the data that elucidated these experiences as (1) a "heartbreaking" experience to witness, (2) an "exhausting" experience to endure, and (3) a practice-altering experience that transforms. Data analysis reveals that nurses experience intense pain, exhaustion, and, yet, transformation, both negative and positive. Implications for nurses include the need for end-of-life education, formal debriefing process to mitigate turnover, and future research into nature-based therapies to help nurses process trauma, as a form of self-care.

Teamwork, psychological detachment from work during nonwork time, and burnout experienced by hospital-based nurses.

To assess the relationships in nursing teamwork, psychological detachment from work during nonwork time, and burnout, and the mediating effect of psychological detachment on the relationship between nursing teamwork and burnout. Nurse burnout has serious implications for nurses' health and performance and the overall functioning of their organizations. Evidence on the relationships between nursing teamwork, psychological detachment, and nurse burnout is limited. This study adds to the international body of knowledge by examining the interplay between nursing teamwork, psychological detachment, and burnout in nurses, a topic of global relevance. This cross-sectional study used survey data collected in May 2021 from 1115 Korean hospital nurses. The measurements included the Nursing Teamwork Survey, a subscale of the Recovery Experience Questionnaire, and the Copenhagen Burnout Inventory. We performed mediation analysis using PROCESS Macro based on 5000 bootstrapped samples to estimate the indirect effect of nursing teamwork. Nurses in units with stronger teamwork were more likely to report being psychologically detached from work during nonwork time. Nurses who distanced themselves from work-related thoughts during nonwork time reported lower personal, work-related, and patient-related burnout. Nursing teamwork had significant indirect effects on each burnout outcome through psychological detachment. By providing empirical evidence on the associations between nursing teamwork, psychological detachment, and burnout, this study enriches the international discourse on nurse burnout and the benefits of psychological detachment. Enhanced nursing teamwork can facilitate nurses' mental distance from work during nonwork time, thereby reducing burnout. Organizational efforts to manage nurse burnout can include increasing nursing teamwork among nurses and improving nurses' psychological detachment during nonwork hours. Interventions should include improving nursing teamwork and developing a supportive and collaborative unit culture.

A Scoping Review of Observational Research on Cannabis Use for Symptom Management in HIV and Cancer: Implications for Cannabis Nursing.

People with HIV have a higher risk of developing non-AIDS-defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations. To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full-text review and 51 were retained for data extraction. There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross-sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet. This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing. No patient or public contribution.

Racism and Redlining in the History of Psychiatric Policy and Practice in Atlanta: Implications for Nursing.

Recently, the Georgia state House of Representatives passed House Bill 1013, also called The Mental Health Parity Act. The bill sought to address access to and insurance coverage for mental health services, first identified in a report in 2020. The budget for mental health services was reduced by $8 m in 2020, despite an all-time high demand due to the beginning of the Covid-19 pandemic. There is an increasing inability to secure mental health care in the state. Georgia is ranked 37th in the country for access to quality mental health care (Reinert, Fritze, and Nguyen, 2022) and half the counties in the state have no psychiatrist; the projected mental health workforce will be able to meet only 12% of consumer demand by 2025. Problems with mental health care in Georgia have a long history which intersects with the history of racism, geographical segregation, and policing. HB1013 does not consider any of this history in its recommendations, which barely include nursing. At the same time, policy and practice in Georgia continues to entangle nurses and other professionals with a carceral and punitive system which not only threatens the safety of patients, but also nurses themselves. Nurses need to understand this history if they hope to develop policy that will intervene in the mental health care crisis.

Lord Darzi's NHS review: gastrointestinal nursing implications

Penny Harrison discusses the findings of the Darzi report and explores its recommendations for future development of the NHS.

Screening for Psychosocial Distress: A Brief Review with Implications for Oncology Nursing.

Psychosocial care is an integral component of caring for individuals living with cancer. The identification of psychosocial distress has been acknowledged as a hallmark of quality cancer care, and screening for distress standards has been established in several countries. The purpose of this brief review is to highlight recent developments in screening for distress in oncology populations; to provide insight into significant trends in research and implementation; and to explore implications for oncology nursing practice. This paper reports a brief review of the literature from March 2021 to July 2024 on the topic of screening for distress in oncology. The literature was accessed through PubMed and reviewed by two authors. Trends in the topics presented were identified independently and then discussed to achieve consensus. The search within the designated period produced 47 publications by authors in North America, Australasia, and Europe. Topic trends included the design and adaptation of tools for special populations, the use of technology, descriptions of programs, identification of benefits, challenges, and overcoming barriers to screening for distress. Screening for distress is endorsed as part of the provision of quality oncology care. Nurses have an important role in screening individuals at risk for developing psychosocial problems and acting to reduce the associated morbidity. By continuing to be informed and educated about the emerging developments in screening for distress, nurses can understand and overcome barriers to implementation.

Presenteeism among nurses: An integrative review

BackgroundPresenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves. ObjectiveWe aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences. DesignWe performed an integrative review. MethodsWe searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews. ResultsThe results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32 % and 94 %. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes. ConclusionThis review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.

Nurses as UN champions: Increasing nursing presence and influence at the United Nations.

Representing half of the global health workforce, nurses are critical to health promotion, disease prevention, and the economic and social needs of populations. However, nursing expertise is underutilized in the UN System, and nurses are underprepared for roles in policy to influence global health and sustainable development. Innovative education strategies are necessary to address the sidelining of nursing expertise in these spaces and build nursing literacy in shaping global policy. This quality improvement project aimed to develop and evaluate a model to build a USA-based school of nursing's literacy and engagement with the United Nations (UN) System. A Doctor of Nursing Practice (DNP) student developed an innovative educational model, the United Nations Essentials for Global Nursing Leadership, in partnership with a school of nursing (SON), to build faculty knowledge and skills on initiating and sustaining bidirectional engagement with the UN. In 2023, SON faculty piloted the model, and pre-/post-intervention survey data were utilized for improvement. Participants reported increased knowledge, awareness, and confidence related to the UN System and their ability to engage as policy influencers, health diplomats, and global citizens. In total, 100% of participants volunteered to hold the role of UN champion for the SON. This innovative model advances nursing knowledge and coherence in the UN System and key areas of policy, diplomacy, and global governance for meaningful UN engagement. CONCLUSION AND IMPLICATIONS FOR NURSING, HEALTH, AND SOCIAL POLICY: Models that invest in closing the global nursing leadership preparation gap can raise the profession's visible UN presence and strategic policy influence at a critical time for people and theplanet.

Nursing student insights: How clinical experiences shape perceptions and career decisions.

This survey, which was distributed to nursing schools across the US, explores nursing students' perceptions of interactions with nurses during clinical experiences. This article discusses the findings, which support the importance of fostering more positive relationships among clinical nurses and nursing students, provide important implications for nurses and nurse leaders, and guide future research.

Using single-dose liposomal amphotericin B for cryptococcal meningitis induction therapy: nurse pearls and practical perspectives

Background In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with cryptococcal meningitis in research settings. However, liposomal amphotericin B (AmBisome) is now available via the efforts of UNITAID. We sought to describe our nursing experience using AmBisome within a clinical trial for cryptococcal meningitis. Methods We describe the experience of using single-dose 10mg/kg liposomal amphotericin B from the perspective of a research nurse in Uganda. Second, we described the process of preparing and administering amphotericin. Third, we assessed the nursing time required for the administration of daily amphotericin B versus single-dose liposomal amphotericin. Fourth, we discuss the major challenges faced while using liposomal amphotericin B. Results We provide estimates for the nursing time required for reconstituting, filtering, diluting and administering liposomal amphotericin B and a visual aid for nursing tasks. Based on five trained nurses, the process of reconstitution and filtration lasts an average of 52 minutes (Range: 40 to 60 minutes), to reconstitute a mean of 11 (range: 8 to 15) 50mg vials (median weight 55kg). Overall, less nursing time was required for single-dose administration than for daily amphotericin B dosing. From a nursing perspective, liposomal amphotericin B was preferable to amphotericin B deoxycholate due to its reduced infusion reactions and other toxicities. Conclusions Single-dose liposomal amphotericin B is a better alternative to daily amphotericin B. In addition to less toxicity, nosocomial infections, reduced hospital stay, and the potential for lower hospitalisation costs, the nursing implications should not be discounted. Quality nursing care is a finite resource in low- and middle-income countries, and single-dose amphotericin B reduced the nursing time required for the care of patients with cryptococcal meningitis.

Critical Care Nursing and Mass Casualty Response During Operation Allies Refuge.

Operation Allies Refuge started in July 2021 with implications for critical care nurses, both military and civilian, serving at the US Army's Landstuhl Regional Medical Center in Landstuhl, Germany. Cultural and logistical concerns and complications were at the forefront of care provided to Afghan evacuees during the operation and were exacerbated by a mass casualty event on August 26, 2021, when a suicide bomber attacked the Abbey Gate of Hamid Karzai International Airport in Kabul, Afghanistan. This article discusses the issues that affected care, including language barriers, supply shortages, cultural differences, mass evacuation during a pandemic, and management of the mass casualty event by the critical care team. The information is compiled into a summary of lessons learned to assist in future management of emergency evacuee care within our military and civilian health care systems.

An Exploration of Registered Nurses' Experiences Caring for Patients Taking Medicinal Cannabis.

This study aimed to describe nurses' experiences caring for patients who use medicinal cannabis. For the purpose of this study, the term 'medicinal cannabis' is used to describe cannabis-based products that are sourced legally or illegally. Qualitative study using thematic analysis. Eleven registered nurses explored their experiences caring for patients using medicinal cannabis in the Australian healthcare sector. Semistructured interviews were via telephone, Zoom or face to face. Transcribed interview data were analysed using the six phases of thematic analysis. The nurses' experiences of caring for patients who use medicinal cannabis were described in three themes; 'Searching for predictable processes of regulation, access and use of medicinal cannabis', 'One conundrum after another' and 'There is a lot to learn'. Overall, nurses described feeling underprepared to care for patients who use or want to use medicinal cannabis in the Australian healthcare sector. The results indicate that nurses want to have meaningful discussions with patients about the use of medicinal cannabis, yet do not always have the confidence to do so. Nurses sought their own education on how to better support patients. All participants echoed the need for education. The nurse's role in caring for and supporting patients using medicinal cannabis could improve the patient experience. Nurses play an essential role in improving the patient's experience and advocating for those using or wanting to discuss medicinal cannabis as a part of holistic care. Defining the nurse's role in effectively caring for patients can begin by providing evidence-based education to nurses. Including nurses in policy development and beginning to understand the legal and regulatory implications for nurses are important. This is the first study presenting current issues for nurses who care for patients using medicinal cannabis in Australian healthcare systems. COREQ guidelines were adhered to for this study. For this research project on the experiences of registered nurses caring for patients using medicinal cannabis, we did not engage members of the patient population or the general public.

What factors influence clinical nurses' self-efficacy after wound care training? A scoping review

The inadequate management of wounds carries significant implications for patients and challenges clinical nurses. Consequently, there is a need for wound care training to enhance self-efficacy. However, despite participation in such training, nurses often need more practical experience and educational background to exhibit higher confidence levels. This results in a deficiency in self-efficacy when performing wound care. This study aims to amalgamate literature discussing the determinants influencing self-efficacy and present strategies for clinical nurses to enhance it after wound care training.The article search utilized the PRISMA method, with searches conducted in Google Scholar, Proquest, Science Direct, and Pubmed databases. Sixteen articles met the specified inclusion criteria, which required English-language articles published within the last five years (2018-2023) discussing factors affecting clinical nurse self-efficacy after wound training.Various factors, including competence, social support, and self-motivation, influence wound nurses' self-efficacy. Competence factors encompass structured training and education, while social support involves sharing experiences and engaging in case reflection. Additionally, motivational factors play a significant role, such as reinforcing values and attitudes when facing obstacles and maintaining the belief that nurses can effectively adhere to wound care standards. Enhancing self-efficacy includes improving competencies through standardized wound training, increasing educational opportunities, self-experience, social persuasion support, sharing experiences, high self-motivation, and managing emotions when assessing one's ability to achieve goals successfully.Professional development programs designed to provide structured training for nurses have enhanced their competencies, social support, and motivation, strengthened holistic wound care clinical skills and improved self-efficacy. Therefore, exploring additional factors that may further contribute to this positive outcome is advisable.

Internationally qualified nurses' perspectives on transitioning specialty skills within Australia: A content analysis.

To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia. The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022. A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis. Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition. Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses. This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective. Sixty-three internationally qualified nurses shared their experiences and opinions.

Impact of nursing policy on securing intensive care unit nurse staffing and in-hospital mortality

ObjectiveThis study aimed to evaluate changes in intensive care unit nurse staffing after the introduction of the government’s nursing policy, and the relationship between ICU nurse staffing levels and in-hospital mortality. DesignA retrospective cohort study. SettingThis study used data from the Health Insurance Review and Assessment Service and included all patients admitted to adult ICUs at general and tertiary hospitals in Korea from 2016 to 2020. MethodsThe primary variables of interest in this study were the level and overall trend change in the outcome variables after introducing the nursing policy; the nurse-to-bed ratio in the ICUs was evaluated. The secondary variable of interest was the relationship between nurse staffing levels and in-hospital mortality. Interrupted time-series analysis and generalized estimating equation models were used to evaluate the primary and secondary variables of interest. ResultsAfter the nursing policy was introduced, the nursing grades in the ICUs increased, especially in tertiary hospitals. The change at the time of the introduction of each policy was not statistically significant; however, after the introduction, the number of hospital beds per nurse decreased. In-hospital deaths of patients in ICUs increased as the number of beds per nurse increased (odds ratio [OR]: 1.17, 95 % confidence interval [CI]: 1.12–1.21) and decreased as the number of experienced nurses increased (OR: 0.97, 95 % CI: 0.96–0.98). ConclusionsThe introduction of a nursing policy centered on financial support for medical institutions led to an increase in nurse hiring, leading to improved nursing grades. However, the results of introducing these policies differed by medical institution and region, and disparities between medical institutions appear to have widened further. Implications for Clinical PracticeExperienced nurses are important for better outcomes for patients admitted to ICUs, and continuous policy efforts are needed to secure and maintain sufficient nurses.

Neuroleadership: A Concept Analysis and Implications for Nursing.

BACKGROUND: Neuroleadership in nursing is a specialized leadership approach that integrates insights from social neuroscience with nursing leadership practices, aiming to proficiently lead healthcare teams to enhance patient care, staff productivity, and organizational outcomes. Yet, the exploration of neuroleadership in nursing remains limited. AIM: The aim of this study was to provide an analysis of the concept of neuroleadership and its implications in the nursing context. METHODS: Walker and Avant's 8-step methodology was used for this concept analysis, including identifying the concept, clarifying the purpose of the analysis, exploring the uses of the concept, and defining its attributes, model and contrary cases, antecedents and consequences, and its empirical referents. A comprehensive search included PubMed, CINAHL, and ERIC, between 2000 and 2023. RESULTS: This concept analysis significantly contributes to the literature by providing a comprehensive overview of neuroleadership as a distinct form of nursing leadership. It covers key aspects such as definition, attributes, uses, cases, antecedents, consequences, and empirical evidence, and highlights the importance of specialized education, practical experience, and leadership attributes in this domain. The findings could serve as determinants for establishing a neuroleadership framework and developing a structured questionnaire to measure neuroleadership among nurses and nurse leaders, thereby addressing existing empirical reference gaps. CONCLUSION: Nurse leaders adopting a neuroleadership approach can gain insights into how cognitive processes shape nurses' behaviors and motivation, which directly impact patient outcomes and care quality. Further research is needed to assess the practical impact of neuroleadership and validate its factors and model case in clinical nursing practice.

Emotional Exhaustion: Concept Analysis for Nursing

Over the past two decades, emotional exhaustion has become one of the most prevalent issues affecting helping professions. In nursing, studies have shown that emotional exhaustion may affect not only the physical and mental health of nurses but also patient outcomes. This possibility highlights the need to explore emotional exhaustion to comprehensively understand this condition. Walker and Avant’s concept analysis method was used to analyze the concept of emotional exhaustion and identify its meanings, attributes, antecedents, consequences, empirical uses, and implications for nursing. Addressing emotional exhaustion among nurses is crucial to maintain patient safety, enhance the quality of nursing care, and improve healthcare organizations’ outcomes.

Key insights from the European Society of Cardiology guidelines for the management of cardiomyopathies

Bethan Cowley and colleagues outline the European Society of Cardiology's guidelines for the management of cardiomyopathies, highlighting the key implications for nurses.

The impact of cognitive fusion on stress among nurses: Exploring gender as a moderator controlling for depressive symptoms.

To investigate the influence of cognitive fusion on stress among nurses, with a focus on exploring gender as a moderator among Jordanian nurses controlling for depressive symptoms. Stress is a significant concern among healthcare workers, particularly nurses, given the escalating work demands and organizational constraints. Data were collected from 206 nurses using a cross-sectional design. Participants completed surveys that included measures for cognitive fusion, stress, and depressive symptoms. Statistical analysis included bivariate correlations, independent sample t-tests, and moderation analysis using Hayes PROCESS. The results were reported using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The findings revealed a moderate correlation among stress, cognitive fusion, and depressive symptoms. The regression model explained 42% of the variance in stress, with significant contributions from cognitive fusion, gender, depressive symptoms, and the interaction between cognitive fusion and gender. Gender moderated the relationship between cognitive fusion and stress, indicating differential effects for males and females. This study underscores the importance of cognitive fusion in understanding and managing stress among nurses. The moderating effect of gender highlights the need for tailored interventions. Reducing stress among nurses may benefit their mental health and potentially enhance patient care and treatment outcomes. IMPLICATIONS FORNURSING PRACTICE AND POLICY: The study highlights crucial implications for nursing policy. Addressing cognitive fusion is vital to reducing nurse stress, directly impacting patient care quality and healthcare outcomes. Policymakers should prioritize gender-aware strategies within nursing policies, fostering a less stressful and more supportive work environment. By doing so, healthcare institutions can enhance the well-being of nurses and ultimately improve patient care, aligning with broader healthcare policy objectives of patient safety and quality improvement.