Nurses In Health Care Settings Research Articles

PERSPECTIVE ON OBJECTIVE STRUCTURED CLINICAL EXAMINATION AMONG UNDERGRADUATE NURSING STUDENTS

An important trend in nursing education has been the move to an OUTCOME or COMPETENCY-BASED model, where the learning outcomes are defined and decisions about the curriculum are based on these. The aim of the study was to explore the perspectives of the students regarding OSCE (Objective structured clinical examination). A descriptive survey using 19 item three-point Likerts scale questionnaire was conducted. The study sample consisted of 190 B.Sc., (N) students. 76.31% students were agreed that OSCE is well structured and sequenced, 76.31% students agreed that OSCE represented an objective evaluation method of psychomotor skills and 76.42% students perceived their OSCE experience positively than traditional examination. In conclusion, the OSCE appears to be single gold-standard assessment tool for clinical competency. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experience gave new nursing graduates confidence to work as registered nurses in health care settings.

Factors Contributing to Increased Workplace Violence Against Nurses During COVID-19 in the Healthcare Settings of a Lower Middle-income Country: A Qualitative Study

PurposeTo provide the perceptions of nurses, nursing supervisors, and nursing administrators about factors contributing to increased workplace violence against nurses within the healthcare settings in Pakistan during the first wave of COVID-19 pandemic. MethodsThis study employed a Descriptive Qualitative design, with a purposive sampling technique. From September to December 2021, In-depth Interviews (IDIs) of 45 to 60 minutes, using a semi-structured interview guide, we collected data from a private and a public healthcare setting in Pakistan. Given the travel restrictions during COVID-19, these interviews were conducted online, using Zoom audio features. Bedside nurses, nursing supervisors, and nursing administrators with at least six months of work experience participated in this study. ResultsThe qualitative data analysis steps suggested by Braun and Clarke (2013) were used for thematic analysis. The overarching theme emerging from the data was "Factors perceived by nurses that contributed to increased workplace violence in their work settings during the first wave of COVID-19, in a lower middle-income country" The sub-themes from the participants’ narrations were (a) Highly stressed patients, attendants, and healthcare workers; (b) the financial burden on patients and their families; (c) lack of resources and shortage of staff; (d) restricted visiting policy and a weak security system; (e) lack of awareness about the seriousness of COVID-19; (f) misconceptions about COVID-19 vaccines and nurses’ role in disseminating awareness. ConclusionThe current pandemic increased the intensity of WPV against nurses in healthcare settings in Pakistan. Despite any supposed reasons for WPV, exposure to violence should never be an acceptable part of nursing. The healthcare system in Pakistan needs to pay equal attention to funding, resource provision, and ensuring a safe working environment for healthcare workers.

Barriers in Clinical Decision-Making among Staff Nurses at Tertiary Care Hospital

Clinical decision-making is a continuous and changing process in which information is collected, clarified, and assessed. Barriers that affect decision-making ability of nurses in health care setting include occupational, environmental, organizational and lack of professional skills. Objective: To identify barriers in clinical decision-making among staff nurses. Methods: The descriptive quantitative study was carried out at Mayo hospital to assess barriers in clinical decision-making among staff nurses. The study consisted of 109 staff nurses selected conveniently. Data were collected by using self-modified questionnaire consisted of 15 items. This study was conducted in Mayo Hospital, Lahore. Results: 46% staff nurses have more professional experience when make challenging decision. 55%nurses agreed on emotional intelligence. 50% nurses agreed on supportive behavior.44% staff nurses agree that time management affect their decision-making and 37% staff nurses agreed that their decision-making is a deliberative logical process. Conclusions: Majority of staff nurses agreed about the barriers like professional experience, emotional intelligence, time management, organizational support and professional skills affecting their decision making.

Moral distress in nurses in developing economies: an integrative literature review.

Moral distress has been extensively studied in developed economies; however, not much in terms of studies has been carried out in developing economies. To review the literature reporting the experience of moral distress in nurses in health care settings in developing economies. An integrative literataure review was used. Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online Cochrane and Psych INFO were searched to retrieve titles and abstracts of papers on the experience of moral distress in nurses in developing economies. Sixteen articles reporting the experience of moral distress in nurses in developing economies published between 1984 and March 2019 were used for the review. Analysis of the findings revealed seven themes, nurses' experience of moral distress, inadequate material and human resources, end-of-life challenges, cultural and religious beliefs as a source of moral distress, perceived inactions of medical and nursing staff, impact of moral distress on nurses in developing economies and coping strategies. There is paucity of empirical studies on moral distress in nurses in developing economies. More qualitative studies are needed in various cultural settings to enhance its understanding in nurses working in developing economies.

Talent management of international nurses in healthcare settings: A systematic review.

To identify and systematically review current scholarship on talent management of international nurses in healthcare organizations. As nurse shortages persistently pose challenges for healthcare organizations globally, one of the primary strategies employed to address these shortages is employment of international nurses. To date little has been done to systematically review and collate contemporary research on talent management of this strategically important cohort. Talent management is a holistic construct that can support healthcare organizations to attract, develop, motivate, and retain talented employees to drive organizational performance. This systematic review isolates, appraises and collates available evidence on talent management practices for international nurses. Systematic literature review. Searches of PubMed, EBSCO and Scopus were made covering literature from 2012-2022. This study followed Cochrane protocol for Systematic Reviews and key search terms were developed in consultation with University of Limerick library. As a key aim of the review was to provide evidence for the development of effective talent management practices, only peer-reviewed academic papers and empirical studies were included. Initial articles screening was conducted by two reviewers and full articles review was conducted by the entire research team. Findings were combined in a data extraction template for further analysis. This review includes 62 articles thematically analysed under the headings recruitment and selection, retention and turnover, career progression, professional development, discrimination and racism, culture and communication. No articles were found that directly address talent management for international nurses. Although there are studies that address aspects of talent management independently, more research is required on talent management as a holistic process for international nurses to inform evidence-based practice. This research emphasizes the importance of talent management for retention of international nurses in healthcare settings. It provides a knowledge base for healthcare organisations to enhance employee retention and ensure quality care for patients, as well as setting the foundation for future studies in this area.

Awareness, Attitude, Facilitators, and Barriers of Continuing Professional Development among Nurses Working in Tertiary Care Hospitals of Chitwan

Introduction: Continuing professional development is one of the vital aspects of maintaining up-to-dateknowledge and skills among nurses in health care settings to provide standard patient care. This study's aim was to find out the awareness, attitude, facilitators, and barriers of continuing professional development among nurses.Methods: A descriptive, cross-sectional study was conducted among 287 nurses working in three differenthospitals in Bhartpur, Chitwan. Structured, self-administered questionnaires were used to gather data within the three-month period. The data were analyzed using descriptive statistics.Results:More than fifty percent of the respondents had high level of knowledge and attitude toward continuing professional development, and 77% had participated in CPD activity. CPD enhances professional development (76.9%), knowledge improves skills at work (76.9%), and sponsorship by the organization (55.2%) were considered the key facilitators, while understanding the entire program (73.8%), a shortage of staff (69.7%), not being available for all staff (68.3%), a lack of organizational support (63.3%), and a lack of commitment (63.3%) were the major barriers to CPD participation.Conclusions: This study found that less than half of the nurses were unaware and low level of attitude towardsCPD. One-third of nurses were not involved in CPD activity. So it is important that the all nurses should participate in the CPD program, which will help to update nurses’ knowledge and skills.

Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge—rooted in the philosophy of care—is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.

An evidenced-based approach to understanding and informing talent management practices for internationally trained nurses in healthcare: A systematic review protocol.

This paper details a protocol for a systematic review that will be used to identify, critically appraise, and synthesize current academic evidence relating talent management practices for internationally trained nurses in healthcare organizations. Databases used in the search will include CINAHL with full text (EBSCOhost), PubMED, PsycINFO, Embase, Business Source Complete, Academic Source Complete, Web of Science, and Medline. Searches are limited to studies in English. Based on receiving funding approval in May this review will systematically search all materials in databases up until 2022, with predetermined search terms. All studies will be screened based on specific criteria and predetermined search terms using the Boolean terminology. Risk of any bias will be considered and assessed using the checklist provided by the National Institute of Health and Clinical excellence. Two assessors will review the findings using convergence and any disagreement will be settled by a third-party reviewer. The systematic review will produce a synthesis of the data related to talent management practices for internationally trained nurses in healthcare settings, as well as outlining areas for further research. The study will be the first of its type to systematically review and synthesize talent management practices for internationally trained nurses. In particular, the findings will provide the latest, validated evidence to narrate the development talent management practices specifically in relation to the strategically important cohort of internationally trained nurses in healthcare organizations. It will also help create a pipeline of suitably qualified candidates for future roles, as well as helping internationally trained nurses identify career trajectories. By systematically gathering and analyzing the relevant research, a stakeholder informed evidence-based approach to talent management for this cohort can be informed as a way of improving the quality and safety of care to the patient.

Nurse leadership in promoting and supporting civility in health care settings: A scoping review.

This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward.

Hemşirelik Öğrencilerinin Eleştirel Düşünme Becerilerinin Geliştirilmesinde Kullanılan Öğretim Yöntemleri

Eleştirel düşünme, bir problem hakkında karar vermeden önce, problemin iyi yorumlanması için var olan bilgilerin gözden geçirilip değerlendirilmesi sürecini içeren bir düşünme biçimidir. Hemşireler, sağlık bakım ortamlarında sıklıkla eleştirel düşünmelerini gerektiren karmaşık durumlarla karşı karşıya kalmaktadır. Bu nedenle hemşirelikte eleştirel düşünme hemşirelik eğitim, araştırma ve uygulamalarının temel parçası olarak kabul edilmektedir. Eleştirel düşünme becerisi eğitim yolu ile kazandırılabilir ve geliştirilebilir. Ancak eleştirel düşünme becerisinin karmaşık yapısı, bu becerinin tek bir öğretim yöntemi aracılığıyla kazandırılmasını zorlaştırmakta, farklı ve yeni yaklaşımların da kullanımını zorunlu kılmaktadır. Hemşirelik eğitiminde öğrencilere eleştirel düşünme becerilerini kazandırmak ve bu beceriyi geliştirmek amacıyla çeşitli öğretim yöntemleri denenmektedir.

Development and psychometric testing of the Perceived Organizational Climate Scale for nurses.

Retaining nurses on the job is vital, and their successful retention is related to the organizational climates (OC) of healthcare settings. The purpose was to develop and test the psychometric properties of the Perceived Organizational Climate Scale (POCS). The methodologic research design was used by following the scale development strategies by DeVellis (2017). The conceptual framework for this study was based on the broader theoretical framework of the Competing Value Framework (CVF) of Quinn et al. (2015), the concept analysis and extensive literature review (1939-2018), and combined with the inductive qualitative data. A two-phase study of scale construction and psychometric testing was conducted for content validation, construct validation and internal consistency reliabilities of the instrument. An expert panel validated the 4-point scale, followed by exploratory factor analysis, the known-group approach and split groups. Data were collected from (1161) registered nurses in eight general hospitals across Myanmar from August 2019 to September 2020. The 35 items with four essential dimensions: transformational climate, bureaucratic climate, team climate and strategic climate, explained almost 50% of the variation with all factor loading greater than .40. The internal consistency reliabilities of the instrument showed the Cronbach's alpha coefficient of .93, and the dimensions were from .82 to .85. As hypothesized, the known-group approach demonstrated that experienced nurses had higher mean scores than novices. The internal consistency reliabilities of the scale and dimensions across the splitting groups illustrated the stability. This evidence supports this instrument as having satisfactory initial psychometric properties with a comprehensive picture of OC by its essential components contributing to an inclusive understanding of this climate globally. This instrument can be used as an objective tool for evaluating OC as perceived by nurses in healthcare settings to inform improvements in working environments.

Violation of Professional Behavior Towards Nurses in Pakistan: An Ethical Violation in Healthcare Settings

Professional behavior violation is a ravaging issue worldwide. Incidents of violation of professionalism toward nurses are common in every healthcare setting either in public or in private sectors. Nurses are more vulnerable to workspace violence due to the nature of the job and tasks performed by them in healthcare settings. Lack of respect towards the nursing profession in Pakistani society is a significant contributing factor in violation of professional behavior in the workplace toward nurses. 
 An ethical violation is a conduct that is against the code of ethics and policy of the institute. There are many categories of ethical violation in workplace but the nurses are facing mostly sexual harassment, safety violation, discrimination, professional boundaries violation, abusive and threathening behviour on daily basis. There are many reported cases in which nurses experience rape, unwanted sexual deeds, workplace bullying, and physical violence from patients, their family members and other paramedical staff which leads to the psychologically and physically detrimental effects on the health as well as on the career of the nurses. Yet nothing specific has been done to control the ethical violation at the healthcare settings in Pakistan. In Pakistan on the basis of the job description and direct contact of the nurses with patients and their family members, many incidents are yet disclosed because of the lack of security and threatening behavior toward the nurses in Pakistani society. There should be a strict penalty for those who are incriminated in any type of delinquency to help out the nurses to get through from the ethical violation efficiently and in a decent way. A protective and respectful work environment will give life to the nursing profession and improve the image of the nurses in healthcare settings.

Occupational stress in clinical and non-clinical staff in Child and Adolescent Mental Health Services (CAMHS): a cross-sectional study.

Previous literature has highlighted high rates of burnout among doctors and nurses in healthcare settings. Non-clinical and support staff such as administrative, housekeeping and managerial staff are also exposed to the stressors of a health care setting, but fewer studies report on their experiences. Therefore, the aim of this research is to examine occupational stress in all staff working in Child and Adolescent Mental Health Services (CAMHS) in Ireland and identify risk and protective factors. Fifty-nine clinical and non-clinical staff (44% response rate) were surveyed. Participants completed the Copenhagen Burnout Inventory (CBI) and the Effort Reward Imbalance scale, as well as survey-specific questions. Both clinical and non-clinical staff were found to experience moderate or high rates of work-related, personal and patient-related burnout (57.6%, 52.2% and 50.8%, respectively). Univariate general linear modelling showed an association between total CBI scores and effort reward index (B = 64 306, t = 3.430, p = 0.001); overcommitment (B = 1.963, t = 3.061, p = 0.003); and an unwillingness to work in CAMHS (B = 28.429, t = 3.247, p = 0.002). Pre-pandemic levels of stress were high among clinical and non-clinical staff surveyed. Given the anticipated increased demand on CAMHS post COVID-19, urgent action is needed to protect all staff from intolerable levels of occupational stress and burnout.

The Influence of Face Masks on Verbal Communication in Persian in the Presence of Background Noise in Healthcare Staff.

Wearing face masks has resulted in verbal communication being more challenging during the COVID-19 pandemic. This study aimed to investigate the effect of face masks on the speech comprehensibility of Persian nurses in healthcare settings. Twenty female nurses from the governmental hospitals randomly participated in an experiment on seven typical commercial face masks at two background noise levels. Nurses' speech intelligibility from a human talker when wearing each face mask was determined based on the speech discrimination score. The vocal effort of nurses wearing each face mask was determined based on the Borg CR10 scale. Based on the linear mixed model, the speech intelligibility of nurses from a human speaker wearing surgical masks, N95 masks, and a shield with face masks were approximately 10%, 20%, and 40–50% lower, respectively, than no-mask conditions (p < 0.01). The background noise decreased the speech intelligibility of nurses by approximately 22% (p < 0.01). The use of a face shield further decreased speech intelligibility up to 30% compared to using a face mask alone (p < 0.01). The vocal efforts of nurses when wearing surgical masks were not significant compared with the baseline vocal efforts (p > 0.05); however, vocal efforts of nurses when wearing N95 and N99 respirators were at an unacceptable level. The face masks had no considerable effect on the speech spectrum below 2.5 kHz; however, they reduced high frequencies by different values. Wearing face masks has a considerable impact on the verbal communication of nurses in Persian. The level of background noise in the healthcare setting can aggravate the effect sizes of face masks on speech comprehensibility.

Knowledge of Nurses Regarding Respiratory Physical Assessment in Tertiary Hospital Lahore, Pakistan

In health care setting nursing practices depends on knowledge. Knowledgeable nurses express their expertise in critical care units. Specialty in critical care units required respiratory knowledge regarding physical assessment. Furthermore nursing profession has been viewed central point for client care. The rapid changes in healthcare setting that increased demand of trained, experienced nurses in health care setting. The knowledge about anatomy and physiology regarding respiratory assessment necessary in the field of auscultating expertise like respiratory system that gives the chance of early diagnosis, assess the clients need and client health problem to implement the nursing process. Study Design: Descriptive Cross Sectional Study design was applied. Settings: Data was collected through convenient sampling method from ICU department of tertiary Hospital Lahore. Study Participants: 36 female nurses within the age range 24 to 39 years were included in this research. Results: The knowledge of ICU Nurses regarding anatomy of respiratory above 50% but knowledge regarding physical assessment less than 50%. Furthermore less knowledge among nurses about respiratory physical assessment in clinical practices. Keywords: Physical Assessment, Nurses application, Respiratory Knowledge, Practices

Psychiatric Nurses’ Lived Experiences of Workplace Violence in Acute Care Psychiatric Units in Western Canada

Workplace violence directed at nurses in healthcare settings is a common occurrence across the globe resulting in negative nurse and organizational implications that may impact the quality of care provided. Psychiatric nurses working on acute care psychiatric units are at an increased risk and are frequently subjected to patients’ violent and aggressive behaviors. These implications pose significant threats to the nurses’ emotional, physical, and psychological health. Efforts to reduce workplace violence on acute care psychiatric units requires an examination of psychiatric nurses’ lived experiences. A qualitative descriptive phenomenological inquiry was conducted using semi-structured interviews with 10 registered psychiatric nurses within a Western Canada health region to explore their lived experiences of patient-to-nurse workplace violence. The findings of this study highlight the implications of workplace violence and substantiates the urgent need to improve the safety on acute care psychiatric units.

A Systematic Review: Effectiveness of Interventions to De-escalate Workplace Violence against Nurses in Healthcare Settings.

Workplace violence (WPV) is an increasing cause of concern around the globe, and healthcare organizations are no exception. Nurses may be subject to all kinds of workplace violence due to their frontline position in healthcare settings. The purpose of this systematic review is to identify and consider different interventions that aim to decrease the magnitude/prevalence of workplace violence against nurses. The standard method by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2009) has been used to collect data and assess methodological quality. Altogether, twenty-six studies are included in the review. The intervention procedures they report on can be grouped into three categories: stand-alone trainings designed to educate nurses; more structured education programs, which are broader in scope and often include opportunities to practice skills learned during the program; multicomponent interventions, which often include organizational changes, such as the introduction of workplace violence reporting systems, in addition to workplace violence training for nurses. By comparing the findings, a clear picture emerges; while standalone training and structured education programs can have a positive impact, the impact is unfortunately limited. In order to effectively combat workplace violence against nurses, healthcare organizations must implement multicomponent interventions, ideally involving all stakeholders.

Fundus Photography as the Base of Three-Tier Diabetic Retinopathy Care System to Its Wider Roles: Learning from a Case Experience.

A case experience of initiating the ocular fundus photography (OFP) service in a diabetes outpatient clinic of a tertiary-care institution is presented. In the community and within the hospitals, the OFP helps to develop the three-tier diabetic retinopathy (DR) care system comprising: OFP-based DR screening and monitoring, an experienced ophthalmologist in laser therapy, and vitreo-retina specialist services. After three to six months of training, non-ophthalmic allied health professionals could also grade the DR. We also learned that such training program, however, requires broadening to encompass diabetes and major non-communicable diseases comprehensively to fulfill the need of the primary care nurses in health care settings and the full-time job and professional career for them. Medical students and residents now need to be 'directly' trained in the interpretation of OFP. The stakeholders involved in public health and medical education may recommend to the public hospitals and medical colleges for the provision of OFP service.

Evaluation of the Situation, Background, Assessment, and Recommendation Handover Tool in Improving Communication and Satisfaction Among Jordanian Nurses Working in Intensive Care Units.

The SBAR (situation, background, assessment, and recommendation) is a standardized handover tool that has been utilized in health care settings. It has positive impacts on staff communication and patient quality of care. In Jordan, few reports are available about handover tools' impacts. To evaluate the implementation of the SBAR among nurses in intensive care units (ICUs) in Jordan. A pretest-posttest quasi-experimental design was used. A convenience sample of 71 ICU nurses participated. The 43-item ICU physician-nurse questionnaire was used to measure SBAR effectiveness as measured by the following subscales: general relationship and communication, teamwork and leadership, and job satisfaction. There was a significant improvement in posttest knowledge scores and in "general relationships and communication" and "satisfaction" scores. There was a significant improvement in both "general relationships and communication" and "satisfaction" posttest scores compared with their pretest scores (t = 16.709, 2.656; P < .001, P < .01) consecutively. This study revealed a strong indicator to encourage the SBAR utilization among nurses in health care settings. The SBAR has a positive impact on enhancing communication between nurses and increasing their job satisfaction. Thus, the utilization of such a standardized tool that maintains and assures good communication relationships shall increase level of satisfaction. Future studies are recommended to provide further evidence on its feasibility and efficacy as compared with traditional handover tools and among different health care contexts.

Attitude of Nurses towards Care of Elderly People in Teaching Hospitals of Kathmandu Valley

Introduction: Globally, the numbers of elderly population are increasing which is one of the challenges for nurses in health care setting. Nurses' attitude towards elderly people is associated to quality of care they provide. &#x0D; Objective To identify attitude of nurses towards care of elderly people in teaching hospitals of Kathmandu valley. &#x0D; Methodology A cross sectional research design was used to identify attitude of nurses towards care of elderly people. Proportionate stratified random sampling technique was used to select 450 nurses. Ethical approval was taken from Institutional Review Board of Nepal Health Research Council. Data collection was done from 17 April 2017 to 16 April 2018 by using self-administrative questionnaire on socio-demographic characteristics and Multi-factorial Attitude Questionnaires (MAQ) to measure attitude. Data analysis was done using descriptive and inferential statistics. &#x0D; Results The study revealed that 55.3% of respondents had negative attitude and 44.7% had positive attitude towards care of elderly people. There was significant association between age, marital status, studied geriatric nursing and work experiences in nursing with attitudes of nurses. However, there is no association found of ethnicity, religion, type of family, living with elderly, education and currently working with elderly with attitudes of nurses. &#x0D; Conclusion From these findings, it is concluded that about more than half of the nurses had negative attitude towards care of elderly. Gerontological nursing course plays significant role in the attitude of nurses. Therefore, it should be given continuity in all level of nursing education for providing quality care of elderly people.