Medical-Surgical Nursing Research Articles

A Study of Medical Surgical Nurses Leaders' Evidence-Based Practice Attributes: Critical Implications for Practice.

The purpose of this study was to determine medical-surgical nurse leaders' evidence-based practice (EBP) attributes, perceived barriers to EBP, and whether there were differences in leaders' EBP competencies and EBP implementation by demographic and organizational factors. Leaders are crucial to the development of cultures that support EBP implementation, but little is known about medical-surgical nurse leaders' capacity to perform this aspect of their role. A cross-sectional design using survey methodology was used. The survey contained demographic/work setting questions and 3 instruments to measure EBP beliefs, implementation, and competencies. Senior leaders self-reported higher EBP attributes compared with nurses in other roles; nurses with an MSN or higher reported greater frequency of EBP implementation. A regression revealed that EBP competencies, EBP beliefs, having a DNP degree, and working in an Academy of Medical-Surgical Nurses Premier Recognition In the Specialty of Med-surg unit or a Pathway to Excellence® organization had significant, positive effects on EBP implementation scores (R2 = 0.37). Findings demonstrate there is a range of EBP beliefs and competencies, and barriers to EBP among medical-surgical nurse leaders. Because medical-surgical nursing is the largest acute care practice specialty in the United States and many other countries, leaders fully integrating EBP into their practice would be a substantial contribution to advancing EBP in healthcare.

Medical-surgical emergency nurses’ burnout after the COVID-19 pandemic

Medical-surgical emergency nurses’ burnout after the COVID-19 pandemic

Reflections from the frontline of nursing on acute patient deterioration.

To describe medical-surgical nurses' reflections on their experiences with patient deterioration. An extensive body of knowledge exists regarding optimal responses to acute patient deterioration within a hospital environment. Much less attention has focused on the profound psychological and emotional impact these experiences of unexpected deterioration can have on nurses who provided the supportive or rescue care. A triggering event, such as patient deterioration, or direct questioning about these experiences, can lead nurses to reflect further on the situation. Engaging in reflection is believed to enhance learning and improve clinical judgement when future complex situations arise. Findings related to nurses' reflective practice when recalling previous situations with deteriorating patients are limited. This gap in the literature provided the basis for the current project. A qualitative descriptive design. Twenty medical-surgical nurses were interviewed in 2018. The nurses were recruited through purposive sampling. Semi-structured telephone interviews explored nurses' experiences of a patient deterioration. Conventional content analysis with iterative coding and categorising and theme development was used for data analysis. Three themes emerged as participants reflected on their experiences. The themes were, Enduring frustration and regret, Feeling deeply responsible for and to the patient and Making sense of what happened. Medical-surgical nurses who care for acutely deteriorating patients can experience lasting emotional, psychological and physical concerns that often go unrecognised and untreated. Furthermore, nurses with this background commonly reported their perceived increased risk for workplace distress. Findings from this study are important for nurses, healthcare administrators and leaders, and patients. Participating in a rescue attempt often has a negative impact on nurses' perception of workplace stress and on persistent concerns about nurses' mental and physical health. The findings can be useful in informing additional studies about the phenomenon. Findings also can inform the exploration of workplace design. Organisations should assess for factors influencing workplace stress, develop strategies to mitigate the presence of workplace stress and foster nurses' well-being so they can respond to future scenarios of patient deterioration, while maintaining their physical and mental health. This study did not include any patient or public input.

Medical-surgical nurses: Changing lives one patient at a time.

Medical-surgical nurses: Changing lives one patient at a time.

Committing Students to God.

Lyla L. Taft, MSN, RN, CMSRN, CNE, is a nursing instructor at Darton College of Health Professions at Albany State University in Albany, GA. She has been a nurse for 13 years, specializing in medical-surgical nursing and nursing education. The author declares no conflict of interest.

Burnout and secondary traumatic stress in medical-surgical nursing

Day to day care of patients throughout the continuum of life puts nurses at risk for burnout and secondary traumatic stress (STS). This mixed-methods study explores Medical-Surgical (MS) nursing burnout, STS, and support from professional nursing organization leadership and membership perspectives. Seventy-two nurses were recruited from a nursing organization website and surveyed to provide demographic and Professional Quality of Life Scale Version 5 (ProQOLv5) data. After quantitative data collection, nurse respondents were asked if they would like to participate in a Zoom interview. Qualitative data was derived from in-depth interviews of six medical-surgical nurses and free-text responses from three other participants. The nurses interviewed provided detailed personal definitions of burnout, which led to the identification of themes of “awareness” and “triggers: fueling the fire of burnout,” and also exposed the fluctuating nature of burnout. Participants defined STS as “invasiveness into one’s life” and reflected on the impact that it can have both personally and professionally. Despite the fluctuating nature of burnout and the invasiveness of STS, the nurses interviewed revealed a passion for nursing that served as a driving force for the day-to-day struggle, affirming, “I am a med-surg nurse.” Overcoming burnout and STS lead nurses to “lessons learned: I did not know what I did not know,” which focused on personal and professional growth and development. An overarching theme of “dream vs. reality” captures these stabilizing and destabilizing forces at play in bedside MS nursing.

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

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

Critical and Medical-Surgical Nurses' Adherence to Professional Nursing Code of Ethics and Quality of Nursing Care Satisfaction

Critical and Medical-Surgical Nurses' Adherence to Professional Nursing Code of Ethics and Quality of Nursing Care Satisfaction

Medical–Surgical Nursing

This specialty provides fertile ground for professional development.

Frontline Nurses' clinical judgment in recognizing, understanding, and responding to patient deterioration: A qualitative study

BackgroundEarly warning systems and rapid response teams have been widely implemented in hospitals worldwide to facilitate early recognition and response to patient deterioration. Unfortunately, evidence suggests that these interventions have made little impact on unexpected cardiac or respiratory arrest, hospital mortality, unplanned admission to intensive care units, or hospital length of stay. These programs depend on nurses recognizing at risk patients and initiating a timely response. Although physiologic abnormalities commonly precede serious adverse events, nurses often fail to recognize or respond effectively. Clinical judgment is a critical component in the effective response to deterioration, yet little is known about factors that influence nurses' clinical judgment in these situations. Noticing, interpreting, and responding are aspects of clinical judgment and are essential to preventing further patient deterioration and serious adverse events. ObjectiveTo describe medical-surgical nurses' perceptions of factors that influenced their clinical judgment in situations of patient deterioration. DesignA qualitative descriptive design using individual, semi-structured interviews. Tanner's Clinical Judgment Model served as the framework for interview questions and data analysis. ParticipantsA purposive sample of 20 medical-surgical registered nurses were recruited from 10 adult medical-surgical units at an academic medical center hospital in the United States. MethodsTelephone interviews occurred between March and July 2018. A directed approach to content analysis was used to code the transcribed data and identify themes. ResultsEight themes related to each aspect of clinical judgment emerged from the analysis: Knowing the patient, Experience matters, Lots of small points where the system can fail, Making sense of the data, Something doesn't go together, Caught in the middle, Culture of teamwork, and Increased nursing workload. An overarching theme was Nurses' keen sense of responsibility. Findings revealed that factors within the nurse, the patient, and the work environment influence each component of noticing, interpreting, and initiating an effective response to deteriorating patients. ConclusionsFindings have implications for health care systems regarding interventions to support timely recognition and response to deterioration. Nurses' clinical judgment and factors that influence each aspect (noticing, interpreting, and responding) should be a key consideration in organizational efforts to improve the overall response to patient deterioration. Research is needed to enhance understanding of the contextual factors that impact nurses' clinical judgment to inform interventions to support timely recognition and response.

An Experimental Study to Determine the Effectiveness of Strategic Teaching Module on Knowledge Regarding Prevention of Cervical Cancer Among Women of Reproductive Age Residing in Selected Urban Area of Maharashtra State

This study has been undertaken to investigate the effectiveness of a Strategic Teaching Module on knowledge regarding prevention of Cervical Cancer among women of reproductive age residing in selected urban area of Maharashtra. The abnormal growth of cells with the capacity to invade or spread to other parts of the body is what causes cervical cancer. A quantitative research approach was adopted for this particular study. A one group pre-test and post-test experimental design was used to determine the effect of Strategic Teaching Module on knowledge of women of reproductive age regarding prevention of Cervical cancer. The study comprised of 50 women of reproductive age who fulfilled inclusive criteria and were drawn by Purposive Sampling method. A self-administered questionnaire (SAQ) was used for collecting data from the study participants. The content Validity of the tool was established in consultation with 10 experts from the field of Obstetrics and Gynecological Nursing, Medical Surgical Nursing, an educationist and a statistician. Further, the Reliability coefficient of knowledge questionnaire was calculated using the Karl Pearson correlation coefficient method. However, a formal permission was obtained from authorities concerned for data collection. Later, the Collected data were tabulated and analyzed using descriptive and inferential statistics. The study revealed that the mean score among women of reproductive age was 12 during pre-test rose up to 19 in the post-test evaluation. Result interpreted that there was a significant increase in knowledge level of women of reproductive age after the intervention and the calculated ‘t’ value was greater than the table value of ‘t’ at 0.05 level. This indicates that Strategic Teaching Module was effective in improving the knowledge of the women of reproductive age. Keywords: Effectiveness, Strategic Teaching Module, Cervical Cancer, Knowledge, Women of reproductive age

Improving Recognition and Response of Clinical Deterioration Among Medical-Surgical Nurses

Improving Recognition and Response of Clinical Deterioration Among Medical-Surgical Nurses

Comparative Study Between Associate Degree Nursing and Bachelor of Science Students for Adopting Case-Based Learning in Medical-Surgical Nursing.

Despite the important gains of using case studies to engage and enhance student learning, research documenting student satisfaction of using online case studies is limited, especially a comparison between Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) programs. Comparisons in perception of enhanced learning using online case-based studies were explored between students enrolled in ADN and BSN programs during medical-surgical courses as case-based learning can be used to support clinical decision making when clinical placements are lacking. A survey was administered during medical-surgical classes for 110 BSN students and 79 ADN students. Questions were asked about enhanced learning, individual case satisfaction, and overall satisfaction using online case studies. Using descriptive statistics and t-test analyses, results showed that ADN student's perceptions of the exercises were more positive, useful, and more applicable to education. However, no difference in enhanced learning was observed between the ADN and BSN groups. Regardless of BSN or ADN student status, all nursing students expect their education to relate to both theory and practice in the clinical setting. Online case studies enhance and emphasize critical thinking to adapt to constantly changing, complex situations congruent with the American Association of Colleges of Nursing (AACN) Essentials Domain 1: knowledge for nursing practice and Domain 2: person-centered care.

Preventing Non-Ventilator Hospital-Acquired Pneumonia: A Survey of Medical-Surgical Nurses

Preventing Non-Ventilator Hospital-Acquired Pneumonia: A Survey of Medical-Surgical Nurses

Impacting Social Determinants of Health and Asthma: The Role of the Medical-Surgical Nurse

Impacting Social Determinants of Health and Asthma: The Role of the Medical-Surgical Nurse

Increasing Self-Efficacy and Knowledge of Cardiac Arrhythmias for Medical-Surgical Nurses

Increasing Self-Efficacy and Knowledge of Cardiac Arrhythmias for Medical-Surgical Nurses

Leadership Competencies of the Medical-Surgical Nursing Specialist Nurse.

To identify the leadership competencies of Medical-Surgical Nursing Specialist Nurses. A quantitative, descriptive study using the Leadership Competencies Questionnaire. 311 Portuguese Medical-Surgical Nursing Specialist Nurses participated. Data analysis involved descriptive and inferential statistical analysis using the Statistical Package for Social Sciences (SPSS), version 22.0. Study participants had an above-average self-perception on the scale (mean = 3.5) in all leadership roles, recognizing their leadership competencies. The leadership competencies of Medical-Surgical Nursing Specialist Nurses are balanced across all roles: Mentor (5.80 ± 1.02); Coordinator (5.53 ± 0.86); Facilitator (5.38 ± 1.04); Innovator (5.34 ± 0.88); Director (5.31 ± 1.10); Producer (5.30 ± 0.98); Monitor (5.15 ± 1.00); Corrector (4.79 ± 1.29). Specialized nursing practice enhances nurses' self-perceived leadership competencies. Nurses see themselves as leaders focused on internal support and facilitation of collective effort and opportunities for skill development.

PICC Line Occlusions: Implications and Opportunities for Medical-Surgical Nurses

PICC Line Occlusions: Implications and Opportunities for Medical-Surgical Nurses

Association between nurses’ perceived self-confidence in performing family witnessed resuscitation and implementation of the practice at Siaya County Referral Hospital in Kenya

ObjectivesThis study aimed to identify the relationship between nurses’ perceived self-confidence in performing family-witnessed resuscitation and the implementation of the practice among nurses and to describe nurses’ preferences regarding family-witnessed resuscitation practice. MethodsThis study was a cross-sectional survey. A stratified random sampling design was used to obtain study participants from various units within the medical-surgical departments of the hospital. Data was collected using the Family Presence Self-confidence Scale designed by Twibel et al. Chi-square test and binary logistic regression were used to analyze the association between levels of perceived self-confidence and the implementation of family-witnessed resuscitation practice. ResultsThere was a significant association between nurses’ perceived self-confidence (χ2 = 8.06, P = 0.01) and the implementation of family-witnessed resuscitation practice. The nurses who were quite/very confident were 4.9 times more likely to perform witnessed resuscitation than those who were somewhat confident (OR = 4.94, 95% CI 1.07–22.71) ConclusionThe perceived self-confidence in performing family-witnessed resuscitation varied widely among nurses. To achieve successful implementation of family-witnessed resuscitation practice, medical-surgical nurses should get higher levels of perceived self-confidence in the presence of patients’ families through advanced specialized training and practice on resuscitation.

Use of the Modified Early Warning Score by Medical-Surgical Nurses to Initiate the Rapid Response Team: Impact on Patient Outcomes.

Cardiac arrests are often preceded by several hours of physiological deterioration that may go undetected. Cardiac arrests frequently occurred on medical-surgical units without prior rapid response team intervention. A pre/postintervention design was used to evaluate a protocol to guide the use of the Modified Early Warning Score (MEWS) by medical-surgical nurses to escalate the care of deteriorating adult patients. Following staff education, the MEWS protocol was implemented across 8 medical-surgical units. There was a significant increase in patients experiencing a rapid response prior to a cardiac arrest after implementing the MEWS protocol ( P < .0001). Implementing a consistent review of MEWS values allows medical-surgical nurses to initiate assistance from a rapid response team that may prevent an inpatient cardiac arrest.