Nurses In Critical Units Research Articles

The Relationship between Nursing Job Satisfaction and Missed Nursing Care in Critical Care Units

Background: Missed nursing care is a common occurrence that has a negative impact on the standard of patient care. Missed care is indicative of nurses' affected work satisfaction in times of workflow. The purpose of this study was to determine the prevalence of missed nursing care (MNC), and the reasons for its occurrence among Jordanian nurses. The study sought to assess the level of job satisfaction and missed nursing care among Jordanian nurses and their association with demographic variables. Methods: A descriptive, cross-sectional design was used in this study. A convenience sample of 181 registered nurses working in different critical care units in one teaching hospital and two government hospitals was recruited. Three tools were used to collect the data: a sociodemographic data form, a survey of missed nursing care (MISSCARE Survey) consisting of two parts (part A was designed to measure missed nursing care (MNC), and part B addressed the reasons for MNC), and the nursing-workplace satisfaction questionnaire (NWSQ). Results: The results of the study revealed Jordanian nurses in critical care units to have a moderate level of job satisfaction (45.50±9.09). In addition, the total mean score of the MNC was found to be 2.18±0.40 out of 5, which is a low level of missed nursing care. The most commonly occurring missed nursing care aspects were turning patients every 2 hours (2.53 ±1.43), mouth care (2.37 ±1.36), and teaching patients about illness, tests, and diagnostic studies (2.36 ±1.47). Moreover, among the reasons for missed nursing care with respect to teamwork, the caregiver being off the unit or unavailable was the most significant one (24.3%, n=44); with respect to the material resources, the unavailability of medications, when needed, was the most significant factor (21.5%, n=39) for missed nursing care, and regarding the labor resources, an unexpected rise in patient volume and acuity on the unit was the most significant factor influencing missed nursing care (23.8%, n=43). Finally, a statistically significant weak negative correlation was found between nurses’ job satisfaction and missed nursing care score (R=-0.177, P=0.012). Conclusion: The study concluded that nurses in critical units have a low level of missed nursing care and a moderate level of job satisfaction.

Relationship between Work Related Nurses Stress and Socioeconomic Status of Critical Care Units at Medical City in Baghdad city

Work related stress is recognized worldwide as a major challenge for the health of workers especially nurses. Nursing has been identified as one of the most stressful jobs. Work-related stress in nurses affects both individual and organizational functioning as well as health care. A descriptive study was conducted among the nurses of the critical care units in the medical city to assess the work-related stress and determine Socioeconomic Status for nurses at Critical Care Unit. A non- probability (purposive) sample of (200) nurses who were working at Critical Care was chosen. The questionnaire was developed by the researcher; It consists of three parts; the first one (nurse demographic data) consists of (7) items; the second part (Socioeconomic Status scale) consists of (13) items, and Perceive stress scale which consists of (10) items. The data was collected by using a questionnaire and analysed through Statistical Package for the Social Sciences (version24.0) using a descriptive statistical approach (frequency, percentage, mean of score, standard deviation) and inferential statistical approach (chi_sequre test). The result reveals that, all staff nurses who are working in Critical Care Unit suffer from stress; that nurses working in critical care units are experiencing severe stress (71%). Motivational and specification programs for workers in critical care units are exposed to work pressure, and encourage nurses for working in critical units by giving awards and increase of encouragement, Working providing a sufficient number of nurses in critical units to avoid nursing shortage in critical care unit, and increase level of income

Caring behavior: a qualitative exploration of nurses' perception in a caring patient with acute myocardial infarction

Introduction: Acute Myocardial Infarction (AMI) and the care environment affect the patient's physical, psychological, and social condition. Caring applications in the nursing process can increase positive change and build trust and satisfaction in patients and families. This study aims to get an overview of the application of caring in AMI patients in the Intensive Care Unit (ICU) from perceptive nurses.Methods: The descriptive qualitative design was selected to obtain in-depth information with face-to-face interviews with twelve nurses. Participatory involvement in the research was selected using purposive. Data analysis is manually done with Collaizi's Content Analysis. Triangulation, member checking, and peer debriefing have increased data crawling. Before and during the data retrieval process, the ethics of the researchers are appliedResults: Data analysis produces three themes that can answer research objectives. The themes formed can describe the caring behavior of nurses in critical units caring for AMI patients.Conclusion: Nurse care is an interpersonal process with professional knowledge and skills that can result in protection, emotional support, and fulfillment of the bio-psycho-social needs of patients. This study's perception and application of nursing care for AMI patients are with the spirit of caring and implementing instrumental caring. Unfortunately, there are still obstacles in applying nurse care to AMI patients.

Effectiveness of an Interventional Program on Nurses' Knowledge and Practices About Clinical Monitoring Devices Alarms at Intensive Care Unit at Al-Imam Al-Hussein Medical City in Holy Karbala Governorate

Background: In recent years, the number of devices with alarms has multiplied exponentially in the vast majority of hospital units. Where monitors, ventilators, infusion pumps, and many other devices beep endlessly, demanding the care provider’s attention always (1).
 Aims of the study: The aims of the present study is to find out the effectiveness of instruction program on nurses knowledge concerning causes of releasing clinical devices alarm and to find out the relationship between the effectiveness of program and nurses level of education, year of experiences in nursing, and year of experiences in intensive care units. 
 Methodology: a quasi-experimental study was carried out on 80 nurses which is divided to two groups (Experimental group who exposed on program, and control group to compare with experimental group) of nurses working in Al-Imam Al-Hussein Medical City, in holy Kerbala 'a City, Iraq. The study started in 3rd of May, 2020 to 25th of May, 2021. The instrument consist of two part; part one deals the characteristics of the sample which of age, gender, level of education, year of experiences in nursing, year of experiences in intensive care units, and specific training courses. Part two deals with the nurses' knowledge concerning causes of releasing clinical devices alarm which of 23 items. The validity of instrument and program was obtained from 12 experts in specialty, the reliability was =1.81, the data analysis was done by uses SPSS program version 23, the statistical methods which used in present study is descriptive and inferential statistics. 
 Results: the findings of present study revealed that the nurses’ responses for experimental, and control groups about the causes of releasing alarm for monitor, ventilator, and syringe pump infuser alarm, which of 54.31% of experimental group knowledge about the causes of monitor device alarm at pretest, while their knowledge was improved to 100.0% at posttest, the control group knowledge related to causes of monitor device alarm was still at same level in pre and posttest which of 54.32%, the experimental group knowledge related to causes of ventilator machine alarm was 53.16% at pretest, and changes to 93.66% at posttest, while the control group knowledge related to causes of ventilator alarm was 22.26% in pre and posttest, and the nurse responses for causes of syringe pump infuser alarm was 63.38% at pretest and their responses improved at posttest which of 100.0% for experimental group, and the control group knowledge about causes of alarm for syringe pup infuser was 26.66% at pre and posttest. 
 Conclusion: the study concluded that the instruction program on nurses’ knowledge was effective on experimental group through improving their knowledge. 
 Recommendations: The researcher recommends that the current program should be applied to all nurses in critical units because of its utmost importance in monitoring and patient safety

Effectiveness of Instruction Program on Nurses' Knowledgeabout Clinical Devices Alarm in Intensive Care Unit

The clinical alarms are used to enhance safety by alerting care provider to any deviations from normal status. The alarms alert care provider when there is deterioration in patient’s condition and there is a need for intervention, or when a device is not working as it should (1). Objectives:The aims of present study is to find out the effectiveness of instruction program on nurses knowledge about the clinical devices alarm, and to find out the relationship between the effectiveness of program and nurses level of education, year of experiences in nursing, and year of experiences in intensive care units. Methodology: a quasi-experimental study wascarried out on 80 nurses is divided to two groups (Experimental group who exposed on program, and control group to compare with experimental group) two group of nurse is workingin Al-Imam Al-Hussein Medical City, in holy Kerbala’a City, Iraq. The study started at 3rd of May, 2020 to 25th of May, 2021.The instrument consist of two part; part one deals the characteristics of the sample which of age, gender, level of education, year of experiences in nursing, year of experiences in intensive care units, and specific training course. Part two deals the nurses knowledge related to clinical devices alarm which of 30 items, the validity of instrument and program was obtained from 12 expert in specialty, the reliability was =1.81, the data analysis was done by uses SPSS program version 23, the statistical methods which used in present study is descriptive and inferential statistics. Results: the findings of present study revealed that the correct answer for experimental group at pretest was 42.44% then at post test was 99.87%, and correct answer for control group was 31.71 at pretest and 35.69% at post test., and there were statistical differences between experimental and control group at post test at P≤0.05 Conclusions:the study concluded that the instruction program on nurses knowledge was effective on experimental group through improving their knowledge Recommendations:The researchers recommend that the current program should be applied to all nurses in critical units because of its utmost importance in monitoring and patient safety. Keywords:Effectiveness, InstructionsProgram,Nurses, Knowledge, Clinical, Monitoring, Devices, Alarms, Intensive Care Unit

COVID-19 and difficult conversations in critical units: A practical guide for nurses.

The editorial published in this journal in April 2020, entitled “Has COVID-19 forced us to implement better practices?,”1 brought up a relevant and emerging theme. Nurses are the largest group of health care professionals on the front line providing care in the COVID-19 pandemic, working in multidisciplinary teams and participating in the planning of coping strategies in health institutions. Working in a health emergency of such magnitude tends to generate physical and psychological stress that cannot be underestimated.2 Nursing critical care patients of any age group can cause emotional tension and physical exhaustion, and this experience is accentuated when caring for patients infected with COVID-19 at the end of their lives.3 In this context, fear, incapacity, and anxiety regarding breaking bad news can be high because many professionals (especially those who have been relocated to critical units because of the pandemic) are working outside their original units and may possess limited experience to serve families of patients at the end of their lives.2, 4, 5 The term “communicating bad news” or “communicating difficult news” is a communication process that occurs before, during, and after the communication of some bad news and is considered health information that alters a person's perception of the present and future in a negative way.6 Usually, it is the medical team who disclose difficult news to patients and their families. However, nurses who work at the bedside are fully involved in this activity because they spend more time with the patient and often know the details of the needs of both the patients and the families.7 Nurses help families in many instances during the process of communicating bad news; for example, following up conversations to clarify technical terms and jargon, ensuring understanding of difficult information or clarifying the implications of the diagnosis or potential treatments. In addition, families may have a preference for conversations with nurses because of their proximity in the nurse-family-patient relationship and the fragility of the relationship with other professionals from the team.7-9 The task of communicating bad news is a complex skill that requires empathy, appropriate body language, and a welcoming voice tone, among other measures that are impaired in the context of the COVID-19 pandemic.10 Physical distancing prevents touching or hugging, impedes face-to-face conversations regarding the side effects or symptom evolution, and often makes family farewells unfeasible when the patient dies. In turn, the use of personal protective equipment leaves the facial non-verbal language subsumed, weakening both communication and interaction,10, 11 especially in critical care units. We call on all nurses to reflect on the communication of bad news in critical units in the context of the COVID-19 pandemic. In a quick review of the scientific literature on communicating bad news, we observed that there are several protocols in the area of oncology and palliative care, which are widely used in the context of critical care. In the COVID-19 pandemic, such protocols are being rapidly reformulated to a telehealth strategy, which has been useful for several professionals who make up the health team.8, 10-13 However, when it comes to clinical situations that involve nurses in critical units, for example, the communication of death of a patient with COVID-19 diagnostic, mostly young people, there is little evidence about the application of bad news protocols. Our objective was to systematize a practical guide for communicating bad news based on the SPIKES protocol,14 to provide clinical guidance for nurses when caring for family members of patients with COVID-19 in critical care units (Table 1). Communicating difficult news is a highly complex activity and nurses need to feel confident that their participation in the communication process is effective. Although nurses face many challenges participating in this process, this practical guide can facilitate family-centred care centred for patients in critical care units.