Medical-Surgical Nursing Research Articles

Nurses' perceptions of caring behaviors at referral hospitals in Ethiopia: A mixed-methods approach.

Caring plays a vital role in nursing and serves as an indicator of quality. Nurse caring behaviors are directed towards patients' safety and wellbeing. Nurses' perceptions of caring behaviors are affected by different factors. Understanding the factors linked to how nurses perceive caring behaviors is crucial for enhancing the quality of care. The aim of this study was to examine the factors associated with nurses' perceptions of caring behaviors and gain a more comprehensive understanding. A multicenter sequential explanatory mixed-methods study was conducted among medical-surgical nurses at three referral hospitals in the Amhara region, Ethiopia. Quantitative data were collected using a pretested self-administered survey package including the Amharic version of the Caring Behaviors Inventory-16. Qualitative interviews using semi-structured, open-ended questions were conducted after the survey to complement and clarify the quantitative results, facilitating integrate through a connecting approach. A multiple linear regression model was used to examine the relationship between nurses' perceptions of caring behaviors and associated factors. The qualitative data was examined to find meaningful patterns using codebook thematic analysis. This method was deductive and followed the guidelines by Braun and Clarke, building on the findings from the quantitative results. The overall mean of nurses' perceptions of caring behaviors was 4.75. The multiple linear regression analysis showed that female sex (b = 0.300, P = 0.004), age (b = 0.028, P = 0.001), nurse staffing (b=-0.115, P = 0.001), work-related stress (b = 0.298, P = 0.003), and job satisfaction (b=-0.254, P = 0.016) were associated with nurses' perceptions of caring behaviors. The codebook thematic analysis generated three themes, caring is universal and fundamental in nursing, impediments to provision of comprehensive care, and perception of the work conditions. The findings of the qualitative data complemented the results of the quantitative data. Discrepancies between nurses' expectations and the actual working environment may create uncertainty in care provision and impact quality-of-care. Strategies to harmonize the nurses' working environment should consider work-related factors.

Emotional Intelligence, Sense of Gratitude, and Compassion Fatigue of Medical-surgical Nurses in Government Hospitals in China

Emotional Intelligence, Sense of Gratitude, and Compassion Fatigue of Medical-surgical Nurses in Government Hospitals in China

Level of emotional intelligence in medical-surgical nursing specialist nurses

Level of emotional intelligence in medical-surgical nursing specialist nurses

Low levels of psychological safety in inpatient medical-surgical nurses on the tail end the COVID-19 pandemic

Background: The COVID-19 pandemic required an increased reliance on and utilization of the inpatient nursing workforce. We aim to examine the psychological safety of U.S. inpatient acute care nurses in the two years following the onset of COVID-19. Method: Participants were recruited for participation across two major metropolitan medical centers in the tristate area, six units per site (12 total). Anonymous Qualtrics survey invitations were distributed through work listservs in the first halves of 2022 and 2023. The invitation was open to registered nurses who provided at least 16 hours/week of direct patient care for at least six months at the hospital. The survey was open for 4-6 weeks, with reminders sent every other week. Nurses were offered a $25 gift card the firs year and $35 the second. Nurses were asked to rate how frequently they experience seven conditions indicative of psychological safety in their work environment from 1 = “Never” to 5 = “Always”. Two items were reverse coded in analysis as the prompts were negatively phrased. Blank and ineligible responses were excluded from the analytic sample. As response distributions were skewed, Wilcoxon rank-sum tests were used to analyze differences between years (alpha = 0.5). Blank and ineligible responses were excluded from the final analytic sample. Result: We achieved an overall response rate of 52% for each survey year (n=258 Year 1, n=221 Year 2). Psychological safety was found to be low overall for both years, but lowest for Year 1 (3.5 vs. 3.7, p=0.0132). The highest rated condition in both years was “When a medical error occurs at this hospital, health care workers are encouraged to discuss mistakes in order to learn how to prevent similar future errors” (4.0 Year 1 vs. 4.2 Year 2, p=0.0054). The lowest rated condition changed across years. For Year 1, “At this hospital, people are too busy to invest time in improvement” (reverse coded) received the lowest rating at 3.1 (vs. 3.3 in Year 2, p=0.0685). For Year 2, “If you make a mistake at this hospital, it is often held against you” became the lowest rating at 2.9 (vs. 3.4 year 1, <.0001). A summary of the psychological safety conditions is presented in Figure 1. Conclusion: Nurses in our study reported low psychological safety during the end of the COVID-19 pandemic. This has implications for overall patient safety and for nursing staff retention in acute care units.

Relationship of Demographic Profile to Satisfaction in Interprofessional Collaboration among Medical-Surgical Ward Nurses in Selected Hospitals of Shandong, China: A Cross-Sectional Study

With the spread of the concept of team medicine, active nurse-doctor collaboration is closely related to nursing quality. Nursing standards recognize that collaborative practice is a necessary condition for high-quality patient care, but many nurses are often reluctant to participate in interprofessional teams, indicating that challenges in nurse-doctor collaboration still exist. This study aimed to investigate the relationship between demographic data and nurse interprofessional satisfaction of medical and surgical nurses in tertiary hospitals in Shandong Province, and to provide a reference direction for improving teamwork. Methods: The research method was a cross-sectional study. Medical and surgical nurses in three tertiary hospitals in Shandong Province were surveyed. Medical and surgical nurses who were officially registered in the hospital and had been engaged in internal medicine or surgery for at least one year were selected. They were aged 18 to 45 years. The researchers used SPSS software to analyze the data, and descriptive statistics (frequency percentage distribution, mean score, and standard deviation) were used to present the satisfaction scores. If the data did not follow a normal distribution, nonparametric tests were used. Results: The average scores of the interprofessional collaboration satisfaction scale for the participating nurses were: "overall expectation" 2.67; "perception dimension of professional collaboration" 3.78; "The overall relationship satisfaction of professional cooperation" 3.83; "Communication and tolerance of interprofessional collaboration" 3.80; "Equality of interprofessional collaboration" 3.81; "Satisfaction with interprofessional collaboration" 2.98. The results of non-parametric tests showed that there was a significant difference between marriage and nurses' satisfaction with interprofessional collaboration (P<0.05). Conclusion: The overall satisfaction of nurses with interprofessional collaboration in three tertiary hospitals in Shandong Province was generally average. The three hospitals should improve the management model and care about the mental health of nurses according to factors such as the marital status of nurses. Nurses should make a good distinction and plan between work and life to promote interprofessional collaboration.

Responding to In-hospital Cardiac Arrests During Times of System-wide Strain: A Code Refresher Training.

Pandemic conditions of system-wide strain are associated with increased rates of in-hospital cardiac arrest (IHCA). During normal times, medical-surgical nurses may forget cardiopulmonary resuscitation (CPR) skills as soon as 3 months after training, leaving them unprepared and anxious about managing cardiac arrests. During pandemic surges, heightened anxiety can also impact concentration and confidence. Clinicians offered a 45-minute mock code training refresher for medical-surgical nurses to improve confidence performing CPR while adhering to pandemic-related safety procedures. In this pre-post clinical education project, nurses' confidence was measured with the Nursing Anxiety and Self-Confidence with Clinical Decision Making© Scale. Although the results were not statistically significant, participants verbally reported increased confidence to initiate resuscitation, collaborate with team members, and use personal protective equipment during the posttraining debrief. A high percentage of RNs do not have adequate confidence and/or competence in performing CPR, particularly during times of system-wide strain, and this brief, inexpensive refresher training warrants further study. [J Contin Educ Nurs. 2024;55(9):442-448.].

Original Research: Addressing Nurse Burnout: The Relationship Between Burnout and Physical Activity.

During the COVID-19 pandemic, nurses have faced innumerable challenges, which have contributed to staggering increases in burnout rates. In the health care arena, burnout has been associated with the onset or exacerbation of physical illness, neglect of self-care, fatigue, decreased patient satisfaction, higher medication error rates, lack of nurse engagement, and increased nurse turnover. This cross-sectional study sought to determine whether a correlation exists between self-reported physical activity and nurses' perception of burnout in a sample of hospital RNs. The secondary aim was to determine whether a correlation exists between the level of perceived burnout and the number of medication errors or near misses. Participants were asked to provide demographic information, complete the Copenhagen Burnout Inventory (CBI) and the Godin Leisure-Time Exercise Questionnaire (GLTEQ), and self-report the number of medication errors or near misses they were involved in during the previous 12 months. Data were analyzed using Stata version 17 software. A total of 216 participants returned usable surveys. Regarding the relationship between burnout and physical activity levels, data analysis was performed for the 210 participants who completed both the CBI and the GLTEQ. Compared with the least physically active nurses, the most active nurses had significantly lower CBI scores, with 68.5% of those reporting low or no burnout also scoring 24 or more on the GLTEQ. The least physically active nurses had significantly higher CBI scores, with 47.6% of those reporting high burnout also scoring 13 or less on the GLTEQ. Moreover, 90% of the nurses with high burnout levels had directly cared for COVID-19 patients at some point between 2020 and 2022. Medical-surgical nurses experienced significantly higher levels of burnout compared with nurses working in other service areas. No significant relationship was found between the number of medication errors or near misses and burnout levels. This study found that the most physically active nurses reported lower levels of burnout, while the highest levels of burnout were found in the least active nurses. Although COVID-19 infection rates have eased, many nurses, particularly those who have cared for COVID-19 patients and those who work in medical-surgical environments, continue to experience burnout. Targeted programs to reduce work-related burnout, as well as organizational sponsorship of and unit-level support for such programs, are urgently needed. This study's findings suggest that promotion of physical activity may be an essential component to alleviating burnout.

The Certified Medical Surgical Nurse Peer Study Group: A Journey to Certification Through Knowledge, Engagement, and Collaboration

The Certified Medical Surgical Nurse Peer Study Group: A Journey to Certification Through Knowledge, Engagement, and Collaboration

Correlates of Work Engagement among Medical-Surgical Nurses in Selected Hospitals in Shandong, China: Basis for Theoretical Development

Because of nurse-researchers bringing theories of organizational behavior to the field of nursing, they have become more increasingly involved in research. As frontline healthcare workers, nurses are critical to the development of the entire healthcare industry. Nurses' work engagement and related influencing factors are conducive to improving the quality of care and promoting the development of nurses' physical and mental health. This study was conducted to determine the current status of medical-surgical nurses' work engagement and to explore the influence of psychological capital, and organizational justice on their work engagement. It provided a theoretical basis for the management and education of medical-surgical nurses.

Effects of nurse managers' inclusive leadership on nurses' psychological safety and innovative work behavior: The moderating role of collectivism.

In the rapidly evolving healthcare landscape, the capacity to foster innovative work behavior among nurses is increasingly important. This study examined the dynamics between inclusive leadership, psychological safety, collectivism, and innovative work behavior among nurses. The study used a cross-sectional, correlational design. This study utilized data from 730 medical-surgical nurses who provided direct care to patients. Standardized instruments were used to assess key study variables. Statistical analyses, including moderated mediation regressions, were employed to investigate the complex interplay among these variables. We found a positive association between inclusive leadership and innovative work behavior, and psychological safety mediated this relationship. Collectivism moderated inclusive leadership's direct relationship with psychological safety and its indirect relationship with innovative work behavior. The results revealed that nurses with lower levels of collectivism were more responsive to their managers' inclusive behaviors, strengthening the relation between inclusive leadership, psychological safety, and innovative work behavior. Our findings suggest that promoting inclusive leadership behaviors among nurse managers to create a psychologically safe environment can motivate nurses to engage in innovative work behavior. However, it is also important to understand that the effectiveness of leadership may differ depending on the collectivist values of individual nurses. Nurse managers should adopt inclusive leadership behaviors, such as valuing trust, open communication, and diversity, in order to foster psychological safety and innovative work behavior among nurses.

Undergraduate Nursing Students’ Experiences on how Learning Style Impact Their Medical-Surgical Nursing Cognitive Performance in North-West Nigeria

Background: Learning style can have an impact on the cognitive performance of students in medical-surgical nursing. The medical-surgical nursing course is an important module in the undergraduate nursing program. It is, therefore, appropriate to investigate students’ learning style and their impact on their performance in medical-surgical nursing. Aim: This study was aimed to explore the Undergraduate Nursing Students’ Experiences on How Learning Style impacts their Medical-surgical Nursing Cognitive Performance in North-west Nigeria. Methodology: A qualitative research design was employed. A total of 13 students were interviewed in the study. A purposive sampling technique was used in the recruitment of the study participants Two (2) instruments were used for data collection. The data was transcribed and analyzed manually. Emerging themes relating to the codes were interpreted and presented thematically. Results: The result of the study indicated that the students mostly used the VARK learning styles in various combinations. More than 3/5 of the students perceived their cognitive performance in medical-surgical as very good. Three-quarters of the students also perceived a positive impact of learning style on cognitive performance in medical-surgical nursing. Conclusion: The study concluded that the learning style of undergraduate nursing students is positively related to their cognitive performance in medical-surgical nursing. Recommendations: An interventional study should be carried out to verify the findings of this study further, more lecturers who specialize in medical-surgical nursing should be provided.

Understanding Leadership Style and the Impact on Medical-Surgical Nurses and Patient Outcomes

Understanding Leadership Style and the Impact on Medical-Surgical Nurses and Patient Outcomes

Identifying Predictors of Nurses' Attitudes and Emotions Toward Caring for Adults with Intellectual Disabilities: An Online Nationwide Survey of Medical-Surgical Nurses

Identifying Predictors of Nurses' Attitudes and Emotions Toward Caring for Adults with Intellectual Disabilities: An Online Nationwide Survey of Medical-Surgical Nurses

Kebumen Cares through Free Circumcision at Taman Winangun Kebumen Islamic Boarding School

Circumcision is an obligation for Muslims. declared an obligation because it has been exemplified in the sunnah of the Prophet. It is stated in Siroh Nabawiyah that Rasulullah SAW performed circumcision when he was 7 days old. However, socialisation of the sunnah of Rasulullah Muhammad SAW in Indonesian society is mostly carried out when children are 5 years old or older. Currently, circumcision, or what is more commonly referred to ascircumcision," can be done in various ways. The choice of a variety of ways and the effects that arise are also very influential on the costs incurred. The obstacle in general is that the cost of circumcision under the care of a doctor is not affordable for the poor, who are being squeezed by economic problems. Based on this, we intend to organise a mass circumcision social service for poor children. As a medical tertiary institution engaged in the world of medical surgical nursing, the Community Service Team for the Undergraduate Nursing Study Program, Muhammadiyah University of Gombong, is motivated to participate in creating a healthy young generation. This small step is very important for us, especially if the circumcision process brings social values towards a better social life. This mass circumcision programme was carried out at the Tathmainnul Qulub Islamic Boarding School, Taman Winangun, Kebumen, and was attended by 22 participants. With the mass circumcision program, we are sure that we can fully obtain these positive values. Therefore, we are ready and able to be part of this noble step and invite benefactors to participate in it.

Stroke Admission Simulation: Engaging Novice and Expert Nurses.

In today's changing health care climate, clinical nurse educators are being challenged to educate nurses with a wide range of experience. This article describes the development and facilitation of a low-fidelity simulation used to educate nurses about identified gaps in standardized care during stroke admissions on a medical-surgical stroke unit at Legacy Emanuel Medical Center. The simulation was developed for use by novice and expert medical-surgical stroke nurses simultaneously. With the use of Bloom's Revised Taxonomy (Anderson et al., 2001), roles within the simulation were tailored to encourage the learning of nurses with varying levels of expertise. Overall, learners appeared to benefit from the class, which included the stroke admission simulation. Mean test scores increased from 55% pretest to 80% posttest. Additionally, 98% of learners found the simulation and lecture moderately helpful or extremely helpful. [J Contin Educ Nurs. 2024;55(3):113-119.].

Developing a Mobile Learning Virtual Nursing Diagnosis (VND) Media for Medical Surgical Nursing Course

Link of Video Abstract: https://youtu.be/4zHCrIC1IGE Background: The development of innovative and technology-aligned learning media is a necessary solution for nursing students. Students require access to interactive, practical, and easily accessible learning resources. An application that can facilitate students' learning in nursing diagnosis for surgical nursing, such as Virtual Nursing Diagnosis (VND), is needed. This study focuses on the development of the VND application specifically designed for the Surgical Nursing Care course. Patients and methods: The research is a Research and Development (R&D) study involving 253 nursing students from Aceh Health Polytechnic. A needs analysis was conducted to identify the difficulties faced by students in applying nursing diagnoses to topics related to surgical nursing, particularly the cardiovascular system. Based on the findings of the needs analysis, it was discovered that students face difficulties in determining nursing problems. Therefore, the VND application was developed with features such as assessment forms, assessment tools, disease pathology, and nursing diagnoses. Additionally, the application is equipped with competency tests on interesting nursing cases that are user-friendly for students. Results: The research results indicate that the VND application has received positive feedback from 253 students who have used it in real classroom environments. The application is user-friendly, efficient in performing nursing diagnoses, and provides available nursing case questions. VND application provides an interactive, innovative, and effective learning tool for understanding nursing diagnoses while enhancing accessibility and flexibility through mobile-based learning. The application equips students with the necessary skills to apply nursing diagnoses in real-world surgical medical practice. Conclusion: the VND application significantly contributes to the development of nursing education. It not only improves understanding of nursing diagnoses but also provides an engaging and interactive learning experience. It is hoped that the use of the VND application in surgical nursing education can be an effective and innovative solution to enhance competency in applying nursing diagnoses in clinical practice.

Attitudes and Beliefs of Nurses and Nurse Assistants toward Patients with Sickle Cell Disease: A Mixed Methods Study

BackgroundPain experienced among individuals with sickle cell disease (SCD) is the primary requirement for hospitalization. PurposeThis study examined the relationship of age, race, and years of experience among medical-surgical nurses and nursing assistants to their attitudes in caring for SCD patients and identified barriers that influence pain management care. Design, Setting, ParticipantsAn explanatory sequential mixed-methods study design was used. Online survey data were collected among 56 participants and online interviews were conducted among three participants. MethodsThe General Perceptions of Sickle Cell Patients (GPSCP) Scale-17, composed of four subscales, assessed providers attitudes toward patients with SCD. Two subscales assessed providers' attitudes behaviors related to acute and chronic pain management. ResultsThere was no relationship between age and years of experience to scores on four subscales. White/Caucasian study participants scored higher on the Red Flag Behaviors subscale, indicating that White/Caucasian participants had stronger beliefs concerning drug-seeking behaviors among SCD patients as compared to other ethnicities/races. Themes generated from the qualitative interview data analysis were: 1) reflections on one's own practice compared to others' practice; 2) communication as a barrier/facilitator to providing care; 3) lack of national guidelines; and 4) adjunct staff are critical to facilitating holistic care. ConclusionsRacial and ethnic differences exist among medical-surgical nurses and nursing assistants' attitudes. Poor communication and lack of national standards of care are barriers to providing high quality care. Clinical ImplicationsCulturally sensitive care, based on current practice guidelines, is needed for improved pain management care for patients with SCD.

The Relationship Between Learning Style and Cognitive Performance of Undergraduate Nursing Students of Medical-Surgical Nursing in North-west, Nigeria

Background: Medical-surgical nursing course is a critical component of the undergraduatenursing programme which provides foundations for clinical practice. Cognitive performance isthe foundation for nursing skills. Learning styles can affect the cognitive performances ofstudents in medical-surgical nursing. Aim: This study aimed to assess the relationship betweenlearning style and undergraduate nursing students' cognitive performances in medical surgicalnursing courses in North-west Nigeria. 4 objectives were achieved in the study. Methodology:Survey design was used in this study. The study population comprised 812 undergraduatenursing students from the Departments of Nursing Science of Bayero University, Kano andUsman Danfodio University, Sokoto. A sample size of 233 students was recruited via amultistage sampling technique. A total of 233 students' learning style questionnaires weredistributed to the students. Only 176 questionnaires were retrieved and analysed (75.5%response rate). Two (2) instruments were used for data collection. Data was analysed by usingStatistical Package for the Social Sciences (SPSS) version 23 using descriptive and inferentialstatistics. Results: The result revealed that 57.4% of the students were females with a mean ageof 24.95 years. Visual learning style was mostly used by the students (29.5%). The cognitiveperformance of the students in medical-surgical nursing was very good with a mean score of60.36. There is a significant negative correlation between learning style and students' cognitiveperformances in medical-surgical nursing (p-value < 0.05). There is a significant mediationeffect of students' mode of entry on students' cognitive performance in medical-surgical nursing(p-value < 0.05). Conclusion: The study concluded that learning style is significantly related tocognitive performance. Students’ mode of entry is a significant mediator between learning styleand cognitive performance

Attitudes and barriers to evidence-based practice: point of view of Portuguese nurses specialized in medical-surgical nursing

Attitudes and barriers to evidence-based practice: point of view of Portuguese nurses specialized in medical-surgical nursing

Identifying Usability Challenges in Electronic Medication Administration Record Design Through Scenario-Based Evaluations: A Pilot Study

Hospitals have more incentives than ever to make nurse-facing technologies usable. However, the complexities of the nursing workflow are not supported by health information technology. This investigation aimed to identify usability challenges in a hospital system’s electronic medication administration record (eMAR). The research team developed scenarios that nurses completed using a simulated electronic health record. Data was qualitatively analyzed using the reflexive thematic analysis method. Three female medical-surgical nurses participated in the study. Qualitative analysis identified five themes in the data including: 1) essential information exists outside of the eMAR, 2) unable to view future medications, 3) information lost with unit transfer, 4) unable to document home medications, 5) certain medications delay sequential orders. Future usability evaluations of the eMAR should continue to look for poor usability, identify solutions, and consider the process for how individual hospitals can apply these usability evaluations to their own eMARs.