Largest Group Of Health Care Providers Research Articles

Experiences of operating room nurses in disaster preparedness of a great disaster in Iran: a qualitative study

BackgroundIn recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses’ roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran.MethodsThe present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln’s criteria were employed.ResultsThe study conducted data analysis to identify the main theme as “insufficient disaster preparedness due to a faded preparedness”, along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations.ConclusionThe findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations’ disaster response teams.

Through the lens of the American Association of Colleges of Nursing's (AACN) new Essentials: Integration of human trafficking education and simulation within baccalaureate nursing curricula.

With an increase in human trafficking in the United States, there is a need for nursing curricula to provide education and engagement in recognizing and appropriately caring for victims. The purpose of this article is to describe an undergraduate nursing simulation involving a human trafficking victim with a discussion of how the American Association of Colleges of Nursing's (AACN) Essentials were addressed by the simulation. The results of the course evaluation indicated that providing an opportunity for baccalaureate nursing students to engage in a simulation involving a victim of human trafficking allowed them to solidify classroom theory and education. Students reported increased confidence in recognizing victims after participating in the education and simulation. In addition, the simulation met many of the American Association of Colleges of Nursing's new Essentials further highlighting the importance of this clinical activity within the nursing curriculum. Nursing education is obligated to empower students to identify social determinants of health and advocate for social justice related to vulnerable populations. Because nurses are the largest group of healthcare providers, they are likely to encounter human trafficking victims and should be educated to identify victims in practice.

Assessing the Spiritual Care Competence of Nurses in the Special Care Units for COVID-19 in Teaching Hospitals in Arak, Iran

Background & Aims Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran Materials & Methods This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16. Results The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience. Conclusion The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care.

An uncertain time: Clinical nurses' first impressions during the COVID-19 pandemic.

The COVID‐19 pandemic overwhelmed the US healthcare system and healthcare providers. Nurses, who comprise one of the most affected groups because they are the largest group of healthcare providers, were in a unique position to speak about their perspectives. As a result of the COVID‐19 pandemic, nurses have experienced ongoing physical and psychological challenges while displaying strength and perseverance during uncertain times. In this study, we explored the perceptions and experiences of nurses in clinical practice caring for patients diagnosed with COVID‐19 during the pandemic. Researchers conducted a qualitative descriptive study with 20 clinical nurses most of whom were enrolled in a graduate program while working in healthcare settings. Semi‐structured interviews conducted through Zoom occurred between August 2020 and December 2020. Thematic analysis was used to analyze the transcripts. Five themes emerged: navigating uncertainty, managing death and loss, acknowledging emotional responses, learning opportunities, and facing community undercurrents. Lack of clinical practice guidelines, and inconsistent access to personal protective equipment when providing care to patients with COVID‐19 caused emotional strain for nurses and highlighted future learning opportunities. Providing support to dying patients was devastating to nurses. Concern about community misunderstandings of the pandemic created challenges. Evolving teamwork provided invaluable support to study participants. Nurses shared essential information for revising and creating clinical practice guidelines. Nursing interventions and strategies were used to produce humane and positive patient outcomes and provide a foundation for nurse‐driven care in possible future pandemics.

The effect of evidence-based nursing education on nurses' clinical decision making: A randomized controlled trial.

IntroductionNurses are the largest group of health‐care providers and their clinical decisions have an essential role in patients' clinical condition. Evidence‐based nursing has been proposed as a health‐care method based on the latest findings and evidence. Therefore, we aimed to determine the effect of evidence‐based nursing education on dialysis nurses' clinical decision‐making.Material and MethodsThis single‐blind experimental study conducted in 2021 at dialysis wards of teaching hospitals affiliated to Urmia University of Medical Sciences. In this study, a total of 60 dialysis nurses were recruited using convenience sampling and allocated to two groups of intervention (n = 30) and control (n = 30). Data were collected at three time points of before, 1 week after, and 1 month after the intervention using a demographic questionnaire and the Lauri and Salantera Clinical Decision‐Making Questionnaire (LSCD‐MQ). Nurses in the intervention group received 12 sessions of evidence‐based nursing education, while nurses in the control group received no intervention.ResultsThe results showed the mean score of clinical decision‐making had a significant decreasing trend over time (p < 0.001) so that it decreased significantly 1 week after the intervention (72.83 ± 4.90) compared with before the intervention (69.5 ± 67.34) in the intervention group. Moreover, participants' decision‐making moved toward analytical decision‐making. The results also indicated there was a significant difference between the baseline mean score of clinical decision‐making and the postintervention mean scores obtained 1 week (p = 0.025) and 1 month (p = 0.001) after the intervention. However, this difference was not found to be significant in the control group (p = 1.000).ConclusionsThe study results indicate the positive effect of evidence‐based education on nurses' clinical decision‐making. Therefore, nurses are recommended to apply evidence‐based education methods to improve their level of clinical decision‐making. Health officials are also recommended to hold in‐service evidence‐based workshops to update nurses' knowledge.

Assessment of nurses’ preparedness for disasters

Nurses are the largest group of healthcare providers, constituting one of the most vital human resources for society to cope with disasters. For this reason, it is necessary to determine whether the nurses are ready for a disaster or not as well as the factors that affect their preparedness. This study is a descriptive study designed to evaluate nurses' preparedness for disaster and the influencing factors. The sample of the study consisted of 266 nurses who agreed to participate in the study. A questionnaire prepared by the researchers was used as a data collection form. In the study, statistical significance was found between the marital status of the participants, their status of having disaster preparedness education, and their preparedness for disaster situations at home and their preparedness for disasters (p < 0.05). Among the participants, disaster preparedness of those who received disaster preparedness training was found to be 3571 times higher than those who did not (95% CI 1.701–7.498). It was determined that those who were prepared for disasters at home basic disaster supplies kit were more prepared than those who were not. In this study, it was observed that preparedness of nurses, who play a key role in health care, for special situations such as disasters were affected by marital status, being prepared for disasters at home, and education. Therefore, it was concluded that it would be beneficial to include disaster trainings in the nursing curriculum and to repeat in-service trainings in hospitals regularly.

Reflecting on the challenges encountered by nurses at the great Kermanshah earthquake: a qualitative study

BackgroundIran has experienced an increasing number of earthquake in the past three decades. Nurses are the largest group of healthcare providers that play an important role in responding to disasters. Based on previous studies, they experienced challenges providing care in the previous disasters. Therefore, this study aimed to explore the nursing challenges to provide care to the injured in the Kermanshah earthquake, Iran.MethodsThis is a qualitative study with conventional content analysis using Granheim and Landman approach. In this study, 16 nurses involved in providing care to the injured in the Kermanshah earthquake were selected by purposeful sampling method. Data were collected using in-depth semi-structured interviews. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.ResultsData analysis led to the emergence of 453 primary codes, 14 subcategories, and 5 categories. The five categories were as follows: (a) organizational and managerial challenges; (b) human resources; (c) infrastructure; (d) educational preparations; (e) and ethical.ConclusionsThe results of this study showed that nurses faced several challenges in providing care to earthquake victims. Based on these findings, better educational management and planning, infrastructure reform, and establishment of a crisis nursing national team seem necessary.

Iranian Nurses' Experiences of their Roles in Care Provision to the Victims of Child Violence: A Qualitative Study

Background: As the largest group of healthcare providers, nurses have many different responsibilities in care provision to child violence victims (CVVs). Yet, their roles in care provision to these victims are poorly known. Objectives: The aim of this study was to explore nurses' experiences of their roles in care provision to CVVs. Methods: This qualitative study was conducted in 2018–2019. Fourteen nurses were purposively recruited from two pediatric specialty hospitals in Tehran and Ardabil, Iran. In-depth semi-structured interviews were held for data collection. Data were analyzed through conventional content analysis. Results: Data analysis revealed that nurses' roles in care provision to CVVs included the four main categories of protective, diagnostic, reporting, and educational roles. Conclusions: Nurses play significant roles in care provision to CVVs through diagnosing violence, reporting it, protecting CVVs, and providing education to CVVs and their families. Nonetheless, they receive limited education, if any, in this area.

Hospital service quality based on HEALTHQUAL model and trusting nurses at Iranian university and non-university hospitals: a comparative study

BackgroundEstablishment and improvement of patients’ trust in healthcare organizations like hospitals necessitate delivery of high-quality services by nurses, as the largest group of healthcare providers. The present study aimed to compare hospital service quality based on the HEALTHQUAL model and trusting nurses at university and non-university hospitals in Iran.MethodsThis comparative cross-sectional study was conducted on 990 patients admitted to university and non-university hospitals located in Bushehr Province, southern Iran, who were selected using the stratified random sampling method. The data were collected through the HEALTHQUAL questionnaire and the Trust in Nurses Scale, and then analyzed via the SPSS Statistics software (version 22) as well as the General Linear Model (GLM) univariate procedure and the Chi-square test with a significance level of 0.05.ResultsThe study findings revealed that the mean values of real quality (perceptions) and ideal quality (expectations) were 3.89 ± 0.69 and 4.55 ± 0.47, respectively. The gap between the real and ideal quality (− 0.64) was also larger at non-university hospitals from the patients’ viewpoints. Comparing various dimensions of service quality, the largest gap at university and non-university hospitals was associated with “environment” (− 0.13) and “empathy” (− 0.18), respectively. Additionally, the mean scores of the patient trust in nurses at university and non-university hospitals were 10.34 ± 5.81 and 8.71 ± 4.05, respectively, being a statistically significant difference (p < 0.001).ConclusionThe study results demonstrated that hospital service quality and trusting in nurses were at higher levels at the university hospital than the non-university one; however, hospital service quality was at a lower level than what the patients had expected. Accordingly, hospital managers and policy-makers were suggested to focus on patients to reduce gaps in service quality, to promote service quality, and to provide better healthcare services to patients.

Different Dimensions of Iranian Nurses’ Competency: A Scoping Review

Background: Nurses are the largest group of healthcare providers. What is most important in acquiring nursing competency is knowing the competency levels and the factors, barriers, and strategies to increase nurses’ competency. This study aimed to investigate the different dimensions of Iranian nurses’ competency. Methods: The present study is a scoping review. The related Persian articles were searched for in SID, Magiran, ISI, Scopus, PubMed, and other databases, from 1988 to 2019. The searched keywords included skill, competency, and nurse. After identifying the relevant studies, the data were selected, screened, and charted. Finally, the results were collated, summarized, and reported. Also, data extracted from the studies included the study design, sample size, research population, sampling method, key results, the concept of competency, and other information (such as the level of competency, data gathering tools, the language of study, etc.). Results: Totally, 210 studies were fully reviewed and the data from 160 studies were extracted and analyzed. The results of this study were summarized in five themes: nurses’ competency levels, nursing competency dimensions, effective factors in clinical competency, effective strategies for the promotion of clinical competency, and the relationship between nursing competency and other variables (such as job satisfaction, quality of work-life, emotional intelligence, and patient satisfaction). Conclusion: The studies did not reach a collective consensus regarding the relationship between some variables and nursing competency. Besides, the use of different questionnaires made the comparison difficult. Therefore, further research is recommended in this area.

Nurse workarounds in the electronic health record: An integrative review.

The study sought to synthesize published literature on direct care nurses' use of workarounds related to the electronic health record. We conducted an integrative review of qualitative and quantitative peer-reviewed research through a structured search of Academic Search Complete, EBSCO Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Engineering Village, Ovid Medline, Scopus, and Web of Science. We systematically applied exclusion rules at the title, abstract, and full article stages and extracted and synthesized their research methods, workaround classifications, and probable causes from articles meeting inclusion criteria. Our search yielded 5221 results. After removing duplicates and applying rules, 33 results met inclusion criteria. A total of 22 articles used qualitative approaches, 10 used mixed methods, and 1 used quantitative methods. While researchers may classify workarounds differently, they generally fit 1 of 3 broad categories: omission of process steps, steps performed out of sequence, and unauthorized process steps. Each study identified probable causes, which included technology, task, organizational, patient, environmental, and usability factors. Extensive study of nurse workarounds in acute settings highlights the gap in ambulatory care research. Despite decades of electronic health record development, poor usability remains a key concern for nurses and other members of care team. The widespread use of workarounds by the largest group of healthcare providers subverts quality health care at every level of the healthcare system. Research is needed to explore the gaps in our understanding of and identify strategies to reduce workaround behaviors.

Relationships between disaster nursing competence, anticipatory disaster stress and motivation for disaster engagement

Nurses are the largest group of healthcare providers and are often the first line responders to a disaster event. Nurses' disaster competence, motivation for disaster engagement, and factors that impact their motivation to respond to disaster events need to be understood. The purposes of the study were to determine the predictive relationships between Taiwanese nurses' disaster competence, anticipatory disaster stress, and motivation for disaster engagement. A cross-sectional design was used to analyze data collected between August 2017 and December 2017 from eight hospitals in southern Taiwan. Ninety participants who met the recruitment criteria completed and returned questionnaires with an 88.24% response rate. Data collection involved administering the Disaster Nursing Competence Questionnaire, Anticipatory Disaster Stress Questionnaire, and the Motivation of Disaster Engagement Questionnaire. The results indicated that anticipatory disaster stress was positively correlated with disaster competence and motivation for disaster engagement. Disaster competence and willingness to join a hospital disaster rescue predicts an individuals' motivation for disaster engagement. The results of the study add to the understanding of factors that correlate with nurses' motivation to participate in disaster events. By understanding these factors, the government and healthcare administrators can design disaster education plans and other strategies to improve Taiwanese nurses’ motivation to engage in disaster events.

Transforming Nursing Education and Practice: a Review on the Innovation Strategy towards Sustainable Primary Healthcare Workforce

Nurses embody largest group of healthcare providers and the initial access of patient contact in many settings. They convey primary care in small and large hospital practices in clinics, schools and workplace. They function independent and collaborative practices often taking lead clinical, management, accountability roles in innovative means in rural areas, where modern technology-assisted care delivery is little. The researcher-utilized reviews using content analysis to address aim of identifying barriers and innovation strategies that nurses have helped implement in health services to transform primary healthcare. Search strategy is based on combining terms including, health innovation, practice, innovation strategy, and primary healthcare policy, yielded 84 results. Due to diverse potential findings, the review utilized degrees of criteria selection. Multi-staging strategy was developed to identify relevant review literatures. ProQuest and Ebscohost serve as databases during retrieval. Results revealed barriers to transforming PHC practice include frequent staff turnover, scope-of-practice limitation, fragmentation of care and lack of support from key stakeholders. Literatures unveiled that these be resolved by allowing nurses practice fully their training, expanding opportunities for nurses to lead collaborative efforts and implementing nurse residency program. Additionally, transition programs should typically include periods of orientation, preceptorship from key stakeholders to promote innovative culture in workplace.

Nursing and Stereotypes

Nurses comprise the largest group of healthcare providers (Auerbach, Staiger, Muench, & Buerhaus, 2013), and a strong and resilient nursing workforce is crucial to effective healthcare delivery (Pr...

The Role of Nurses in Primary Care Reform: “The Wheel and Hub of Health Care System”

The current focus in Canadian healthcare system is on improving efficiencies and quality of care. Therefore, primary healthcare is receiving further attention. It is the right moment to highlight the value that registered nurses can bring to collaborative practice in primary care settings. Since nurses are the largest group of healthcare providers in Canada being present throughout the system, thy are ideally positioned to effect change at the national level. The purpose of this paper is to highlight the value that nurses bring to primary healthcare system to discuss how integrating registered nurses into family practice will optimize primary healthcare.

All Hands on Deck: Nurses and Cancer Care Delivery in Women's Health.

Access to expert gynecologic oncology care is hampered by geographic (1), racial (2), and socioeconomic disparities (3). As cancer care grows in complexity and expense (4) with an aging and increasingly diverse population, the Institute of Medicine and others have called for improvements in cancer care delivery and research (5, 6). The growing workforce gap in supply of gynecologic oncologists – where demand is increasing, but number of providers remains stagnant (2) – highlights the need for fully utilizing the skills of all clinicians working across the cancer control continuum (prevention, screening, treatment, survivorship, and end of life). To that end, nurses can have an enormous impact on improving and expanding access to oncology care as clinicians, designers, and leaders of initiatives to improve care. Nurses comprise the largest group of health-care providers in the U.S. (7). In its 2010 report on the future of nursing, the Institute of Medicine called for all nurses to practice to the full extent of their nursing “education, training, and competencies” (5). We argue that promoting and expanding nurses’ roles within innovative, multidisciplinary models of care in women’s health is essential in order to improve growing gaps in cancer care.

Determining the Relationship between Nurses’ Professional Ethics and Observance of Nursing Care Standards

Background and Objectives: As the largest group of healthcare providers and as professional individuals, nurses need to learn how to show ethical behavior in educational environment, which leads to an increase in wellbeing indices and patient satisfaction. Therefore, the present study was aimed at determining the relationship between the nurses’ professional ethics and observance of standards of nursing care in Bu Ali Sina Hospital, Sari in 2013-2014. Materials and Methods: The statistical population of the present descriptive-analytical study consisted of all 144 nurses working in Bu Ali Sina Hospital, Sari, Iran. They were selected as the study sample based on Krejcie and Morgan Table. A researcher-designed instrument was employed in order to collect the required data. Descriptive statistics (mean and standard deviation) and inferential statistics (one-sample t-test) were employed to analyze the data. Results: The results of the study indicated that there was a significant relationship between professional ethical learning and standards of nursing care. Statistically, the collected data rejected the null hypothesis (H0) at a confidence level of 95% (α = 0.05) and proved the study hypothesis. In other words, it can be claimed that there was a significant difference between the sample and the theoretical means. Conclusion: Since there is no appropriate relationship between ethical learning and standards of nursing care, it is necessary to evaluate the standards of nursing care and teach ethical principles constantly.

The social context of career choice among millennial nurses: implications for interprofessional practice

Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne’s theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.

Determinants of regulated nurses' intention to stay in long-term care homes

To examine determinants of intent to stay among regulated nurses employed in long-term care facilities. Elderly persons living in long-term care have increasingly complex care needs, putting greater demands on health-care providers. Indeed, regulated nursing staff employed in long-term care facilities represent the largest group of health-care providers who intend to leave their current jobs. Survey responses from 155 nurses from 12 long-term care facilities were analyzed to test the impact of six predictors on intent to stay. Intention to stay was positively associated with lower burnout, higher job satisfaction, older nurses and resident relationships. Work relationships were negatively associated with intention to stay. Leadership support was not a significant predictor. Most predictors were correlated with intention to stay as hypothesized. Further research is warranted to investigate the influence of management practices and work relationships on regulated nursing staff's intent to stay in long-term care. To retain qualified nursing staff and ensure quality of care, long-term care administrators should focus on creating a work environment that reduces burnout, increases job satisfaction, and enables nurses to foster relationships with residents. Recommendations for long-term care administrators include: (1) provide opportunities for self-scheduling, full-time work and benefits; (2) develop models of care that enhance resident relationships; (3) examine existing regulated nursing staff responsibilities and adjust to minimize burnout.

The impact of advanced practice nursing in healthcare: recipe for developing countries.

The increasing demand for healthcare services on all levels is placing great strain on healthcare systems throughout the world. Escalating demands combined with a shortage of General Practitioners (GPs) have forced politicians in many countries to reevaluate the distribution of work tasks and areas of responsibility between different healthcare personnel.1,2 Registered nurses’ (RN) roles and scope of practice have been expanded in many countries and the quality and cost-effectiveness of healthcare systems have improved.2,3 For example, a private nurse practitioner-run clinic opened in Brisbane, Australia4 in September 2011 with the aim to shorten patient waiting times for basic healthcare needs; in most parts of the world RNs now comprise the largest group of healthcare providers.