Surgical Ward Nurses Research Articles

Mediating effect of coping style between empathy and burnout among Chinese nurses working in medical and surgical wards.

AimThis study aimed to investigate burnout, coping style and empathy among Chinese nurses working in medical and surgical wards and to examine the mediating effect of coping style between empathy and burnout among this group of nurses.DesignA cross‐sectional questionnaire survey.MethodThe study recruited a convenience sample of 363 nurses from three university‐affiliated tertiary hospitals in Shiyan City, Hubei, China. A set of self‐administered questionnaires was used to measure the variables of burnout, coping style and empathy. Structural equation modelling was performed using AMOS 20.0.ResultsNurse burnout was prevalent among Chinese nurses in medical and surgical wards, and coping style and empathy were significantly associated with burnout. Positive coping strategies and high levels of empathy could reduce burnout in nurses. Coping strategies were found to play a partial mediating role between empathy and burnout among this group of nurses.

Influenza Vaccination Rate and Factors Associated With Compliance Among Health Care Employees in Large and Medium Acute Care Hospitals.

Annual influenza epidemics are associated with high morbidity and mortality worldwide, with vaccinations being the main preventive intervention; however, the compliance rate of health care employees remains low. Study aims were to examine vaccination rates among physicians and nurses in surgical and medicine wards, compare between medium and large tertiary hospitals, and identify factors associated with increased vaccination rates. Structured questionnaires were distributed. A total of 238/339 (70.2%) were vaccinated. In multivariate analysis, respiratory illness during precedent winter (odds ratio [OR] 3.146, P = .007), working in a medium hospital (OR 2.4, P = .003), and an attending resident with an infectious diseases subspecialty (OR 20.473, P = .007) were associated with a higher vaccination rate. Institutional email or portal messages were associated with decreased vaccination rates (OR = 0.259, P = .007). The leading reason for vaccination was "to stay healthy" (73.5%). Recruiting experts in the field, providing up-to-date information, and increasing management's involvement could encourage vaccination among health care employees.

Effects of Standardized Patient-Based Training on Surgical Nurses' Competencies for Managing Hand Injuries.

The competence of nurses who care for patients with finger replantation is critical for positive patient outcomes. This study sought to identify the effects of standardized patient (SP)-based training on surgical ward nurses' knowledge, clinical performance, and self-efficacy regarding finger replantation. A wait-list control group with a crossover design was used for this study. Nurses were randomly assigned to group A (n = 10) or to the wait-list control group B (n = 10). Training consisted of a lecture, task training, and SP-based training. Knowledge, clinical performance, and self-efficacy data were collected at baseline, after the first intervention, and after 1 month at group crossover and second intervention. Data were analyzed using repeated measures ANOVA. Nurses demonstrated greater knowledge, better clinical performance, and higher self-efficacy scores after the SP-based training. Following crossover, knowledge, clinical performance, and self-efficacy scores were retained 1 month after the training in group A. SP-based training produced improvement and retention in knowledge, clinical performance, and self-efficacy. [J Contin Educ Nurs. 2020;51(4):189-196.].

Turkish surgical nurses' attitudes related to patient safety: A questionnaire study.

Surgical nurses work in demanding environments and play a vital role in maintaining and promoting patient safety due to the nature of their work. Hence it is important to know their attitudes toward patient safety. This research aimed to evaluate the patient safety attitudes of Turkish surgical nurses. This was a descriptive cross-sectional and questionnaire research. Data were collected from August 2015-January 2016 using the staff information form and the safety attitudes questionnaire (SAQ). The study population included 231 nurses who work in operating rooms, surgical intensive care, and surgical wards of four hospitals in western Turkey. Data were analyzed with frequency, percentage, mean, standard deviation, the Mann Whitney U test, and Kruskal Wallis tests using the SPSS 18. The teamwork and safety climate scores of operating room nurses were higher than the scores of surgical intensive care and ward nurses. The stress recognition scores of surgical ward nurses were the highest, followed by the scores of the operating room and surgical intensive care nurses. The perception of management scores of operating room nurses was higher than those of surgical ward nurses, and nurses ages 18-30 were higher than those of nurses ages 31-40. None of the six domains of safety culture, including job satisfaction, teamwork, safety climate, the perception of management, stress recognition, and working conditions achieved a positive mean score over 75. This research paper provides an evaluation of the safety attitudes of surgical nurses. Findings can provide information for healthcare leaders to improve the safety culture.

Qualitative research of working experience in the management mode of distributed daytime surgery nurse

Objective To briefly describe the work experience of nurses under the decentralized day Operation management mode, and explore Improvement Strategies, so as to provide reference for the better construction of day surgical nursing team. Methods Using phenomenological qualitative research method, Semi-structured interviews were conducted with 15 nurses, and the interview data were analyzed by using Colaizzi′s 7-Step analysis method. Results After analysis, the theme: the development of decentralized day surgery management mode has certain necessity, there are various kinds of diseases, complicated medical advice, strong fluidity, the characteristics of emotional agitation, nurses are faced with the lack of professional knowledge, poor health education, medical care and doctor-patient communication errors, gap between nurses′ performance expectation and actual existence, and bed vacancy increases the psychological burden of nurses. Conclusions Optimize the process and management system for patients in day surgical wards, ensure smooth communication between doctors, patients and nurses, pay attention to the mental health of nurses and patients, improve the nurse pay management system, and improve nurse training and education system. These can effectively help decentralized day surgical ward nurses to carry out their work better. Key words: Nurses; Dispersion type; Day surgery management; Work experience; Qualitative research

Patient-Nurse Ratio is Related to Nurses' Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction.

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Review nurses' skills in handover using SBAR tool in general ward

Patient's clinical handoff which is a critical organizational and clinical process is considered one of the fundamental responsibilities of nurses. In this regard, lack of tools and resources to be applied for this purpose threatens the life of patients. The present study aimed to investigate the nursing handoff skill among nurses using situation-background-assessment-recommendationquestionnaire. This observational research was carried out on 64 nurses in internal and surgical wards in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2018. The research population included the content of reports related to nursing handoff of nurses working in the hospitals. The reliability and validity of the questionnaire were confirmed, and descriptive statistics were applied to evaluate the data. It is worthy to note that the majority of participants were female (68.8%). After the evaluation, patient information was reported in areas of current situation (90.0%), clinical background (10.0%), assessment of systems’ status (57.5%), and recommendations (92.5%). Based on the results of the study, less attention was paid to mentioning clinical background and assessing patients’ systems during nursing handoff, which necessitates the training courses on accurate reporting for nurses to ensure patient safety.

Adherence to evidence-based recommendations for surgical site infection prevention: Results among Italian surgical ward nurses.

BackgroundThe aims of the study were to assess the level of knowledge, the attitudes and the adherence to evidence-based recommendations for surgical site infection (SSI) prevention and to describe any influences that may motivate nurses to adopt evidence-based practices for SSI prevention.MethodsThe present study was a national cross-sectional survey conducted from June to November 2017. For each hospital that agreed to participate, 30 nurses were randomly selected. The questionnaire was aimed at exploring socio-demographic and practice characteristics, knowledge of, attitudes toward, and reported practices regarding evidence-based procedures for SSI prevention.ResultsOut of 55 hospitals that were contacted, 36 agreed to participate (a response rate of 65%). Of the original sample of 1313 nurses, a total of 1305 returned the questionnaire, a response rate of 99.4%. Regarding knowledge, only 53.8% knew that preoperative hair removal, if necessary, should take place shortly before surgery, and 28.9% of the sample did not know the right definition of “bundle”. Over three quarters of participants stated that they always perform hand antisepsis before and after biological sample collection while 9.7% considered that wearing gloves during this practice is sufficient to prevent SSI. Furthermore, 91% of nurses reported that they always performed hand antisepsis before and after invasive procedures.ConclusionThe study findings highlight the areas that were most lacking in nurses’ training and for which targeted activities are needed. These data could support healthcare managers to implement interventions focused at enabling adherence to effective prevention practices to reduce risk to all patients.

Relationship Supervision and Motivation with Nurse Performance in Meeting Patient's Personal Hygiene Needs

Abstract
 Background: personal hygiene is one of the role of nurse in educating health service. It intends to keep patient’s hygiene during treatment. It is supported by supervision and motivation as stated in nurses’ job description. In fact, personal hygiene has not been run properly according standard operating procedure. The purpose of this study was to know the correlation between supervision and motivation with nurses’ performance in giving health service of personal hygiene in inpatient room.
 
 Method: This study was a quantitative using cross sectional method. The samples consisted of nurses in surgical inpatient ward. Total sampling was employed; that is, there were 38 nurses taking part in this research. Data were collected through administering questionnaire. Then, univariate and bivariate analysis were used by using statistic chi-square test.
 
 Result: univariate statistic test revealed that 22 (57,9%) of respondents had good performance, 26 (68.4%) of respondents confirmed that supervision run well, 24 (63.2%) of respondents stated that they had high motivation in instructing personal hygiene. Bivariate analysis showed that there was a significant correlation between supervision and nurses’ performance (p-value 0.002<0.05) and there was a significant correlation between motivation and nurses’ performance (p-value 0,002 < 0,05).
 Conclusion: there was a significant correlation between supervision and motivation with nurses’ performance in instructing personal hygiene to patients at surgical inpatient ward of Raden Matther hospital.
 

Nursing Practice on Post-Operative Wound Care in Surgical Wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania

Background: Postoperative wound healing has been a problem which causes high mortality in the developing world; postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was applied by (90%), arrangement and setting up of dressing forceps and other items that may be needed in order of their application using forceps (20%), usage of forceps to dip gauze into antiseptic solution (35%) and cleaning of the wound cleaning from least contaminated to most contaminated area was only adhered to by (34%). Post-operative counseling and giving to the patient not to temper with the wound was done by a representation of only 15% of nurses. All the nurses did not do the documentation of the changes observed on the wound nor did they report on the patients comfort and the date and time after the procedure wound changes, reported patient comfort, and recorded date or time after the procedure. Conclusion: Majority of the nurses in surgical wards do not follow the postoperative wound care checklist provided by MNH although they know its importance. Assessment of the wound and documentation continues to be a problem in the nursing profession in Tanzania. Nurses are reasonably knowledgeable about the principal of wound dressing; however, lack of knowledge on some of the key principles of wound dressing is worth noting. Almost half of the nurses do not wash hands before and after the procedures, they don’t use single gauze in one direction only, not cleaning from least contaminated to most contaminated area, which can lead to wound contamination.

Surgical ward nurses’ responses to worry: An observational descriptive study

BackgroundRapid response systems aim to improve early recognition and treatment of deteriorating general ward patients. Sole reliance on deviating vital signs to escalate care in rapid response systems disregards nurses’ judgments about a patient’s condition based on worry and other indicators of deterioration. To make worry explicit, the Dutch-Early-Nurse-Worry-Indicator-Score was developed, summarising non-quantifiable signs of deterioration in the nine indicators: breathing, circulation, temperature, mentation, agitation, pain, unexpected trajectory, patient indicates not feeling well and nurses’ subjective observations. Nurses’ worry can be present even when vital signs are largely unchanged, enabling treatment to commence at an early stage. On the other hand, reliance on nurses’ worry might lead to unnecessary calls for medical assistance or an overuse of rapid response teams. ObjectivesExplore the occurrence of nurses’ worry in real time, determine whether acting on worry leads to unnecessary action and determine the indicators present at different levels of deterioration. DesignA prospective cohort study. Setting: Three surgical wards in a tertiary, university affiliated teaching hospital. ParticipantsAll nurses participated and adult, surgical, native speaking patients were included in the study. MethodsA descriptive analysis is performed on one year of data on surgical ward nurses’ experience of worry and its underlying indicators in addition to routinely measured vital signs. ResultsOut of a total of 46,571 measurements, vital signs were normal 18,727 times, with worry expressed 605 times (3%), resulting in 62 calls (10.2%) to the attending physician. More than half of these calls resulted in necessary interventions. Calls for assistance and subsequent intervention after worry was expressed increase in parallel with early warning scores. The breathing indicator showed the highest increase in frequency with increasing deviation in vital signs. ConclusionThis study suggests that worry has potential as an early indicator of deterioration, alerting nurses and encouraging them to start timely interventions. Overuse of medical assistance could not be determined, The Dutch-Early-Nurse-Worry-Indicator-Score objectifies worry when vital signs do not support its presence and systematic assessment of these indicators is recommended.

MP01-13 VARIATIONS IN PROVIDER MANAGEMENT OF GROSS HEMATURIA DURING CONTINUOUS BLADDER IRRIGATION: AN INITIAL ASSESSMENT

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment I1 Apr 2018MP01-13 VARIATIONS IN PROVIDER MANAGEMENT OF GROSS HEMATURIA DURING CONTINUOUS BLADDER IRRIGATION: AN INITIAL ASSESSMENT Tony Chen, Claudia Covelli, Akshay Randad, Eleftherios Kampianakis, Allegra Branch, Jialu Sun, John Gore, and Robert Sweet Tony ChenTony Chen More articles by this author , Claudia CovelliClaudia Covelli More articles by this author , Akshay RandadAkshay Randad More articles by this author , Eleftherios KampianakisEleftherios Kampianakis More articles by this author , Allegra BranchAllegra Branch More articles by this author , Jialu SunJialu Sun More articles by this author , John GoreJohn Gore More articles by this author , and Robert SweetRobert Sweet More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.119AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Decisions regarding continuous bladder irrigation (CBI) management such as irrigation rate titration and irrigation cessation rely on the subjective observations of multiple healthcare providers including resident trainees, nurses, and attending physicians. We surveyed healthcare providers at our institution to understand the ranges of tolerable hematuria between different provider groups during active CBI management. METHODS Simubleed 100 (Spectra Group Limited, Inc) is a high-fidelity blood simulant that was titrated with saline to different concentrations to create a range of increasingly severe gross hematuria specimens numbered 1 to 25. Actively practicing surgical ward nurses, urology residents and urology faculty were presented with the samples and surveyed on which degrees of hematuria would mandate increased or decreased rates of irrigation. Attendings and residents were additionally surveyed on which degrees of hematuria would mandate a clamp trial. Each participant indicated their experience level and completed an Ishihara color blindness test. Responses between participant groups were compared with ANOVA and independent samples t-tests. RESULTS Of 54 participants surveyed, 13 were urology residents, 27 were ward nurses, and 14 were attending urologists. 5 attendings who had not interacted with a CBI patient within the previous 12 months were excluded. No participants demonstrated color vision deficiency. Attendings reported more years of experience (p=0.001, p=.002) than nurses and residents, and more confidence in managing CBI (p=0.01) than nurses. There was no significant difference between groups in the upper and lower bounds of hematuria severity for titrating CBI irrigation rates. We observed a trend that residents would initiate CBI clamp trials at darker hematuria values than would attending physicians(p=0.08). CONCLUSIONS At a single-institution, we observed excellent congruency, irrespective of provider experience, in the titration parameters of CBI. This congruency is notable in the context of the inherent subjectivity and variability in evaluating hematuria severity and despite the absence of a formal CBI curriculum. This study informs future work to formalize standard ranges for the titration of CBI among hematuria patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e7 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Tony Chen More articles by this author Claudia Covelli More articles by this author Akshay Randad More articles by this author Eleftherios Kampianakis More articles by this author Allegra Branch More articles by this author Jialu Sun More articles by this author John Gore More articles by this author Robert Sweet More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Identifying the nontechnical skills required of nurses in general surgical wards.

To identify the nontechnical skills (NTS) required of nurses in general surgical wards for safe and effective care. As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms; however, these skills have not been identified for nurses in general surgical wards. A nonparticipant observational descriptive design was used. A purposive sample of 15 registered nurses was recruited from four surgical wards and observed for a full shift on a morning, afternoon or night shift. Nonparticipant observations were conducted using field notes to collect data. A coding frame was developed, and an inductive process was used to analyse the data. A taxonomy comprising seven NTS required of nurses in their roles in surgical ward teams emerged from the data analysis. They are communication, leadership and management, planning, decision-making, situation awareness, teamwork and patient advocacy. Patient care provided by general surgical nurses involved the seven identified key NTS. These particular NTS are an important component of safe nursing practice as they underpin the provision of safe and effective care for general surgical patients. Nurses block the trajectory of error by using NTS to address the vulnerabilities in the system that can lead to adverse patient events. Identifying general surgical nurses' NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety.

Investigating the Relationship between Nurses’ Moral Sensitivity and Patients’ Satisfaction with the Quality of Nursing Care

Patient satisfaction is considered as an important indicator of the quality and effectiveness of health system. Moral sensitivity plays an important role in how professional responsibilities and moral decisions are made by nurses. This study aims to investigate the relationship between nurses' moral sensitivity and patients' satisfaction with quality of nursing care. This study is descriptive and analytic. First, nurses in internal, surgical and special wards were selected through census method. Then, patients were selected using quota sampling to the ratio of nurses from each section. Data were collected through Demographic Questionnaires, Patient Satisfaction Instrument and Moral Sensitive Questions. Data were analyzed using SPSS 23. There was a significant positive correlation between nurses' moral sensitivity and patients' satisfaction with quality of nursing care (P < 0.05). The majority of patients (70.5) had moderate level of satisfaction with quality of nursing care. 93.5 of nurses had high moral sensitivity. There was no statistically significant relationship between nurses' moral sensitivity and variables of sex, location of work, marital status, type of responsibility and work shift. Relationship between patient satisfaction and type of admission ward was significant (P = 0.03). Increased moral sensitivity in nurses is effective on improving patients' satisfaction with the quality of nursing care. It is suggested to conduct further research with larger sample size and investigate other factors affecting patient satisfaction in order to ensure the generalizability of research results.

Cerrahi Servisler ve Yoğun Bakımda Çalışan Hemşirelerde İş Doyumu ve Etkileyen Faktörler

Cerrahi Servisler ve Yoğun Bakımda Çalışan Hemşirelerde İş Doyumu ve Etkileyen Faktörler

Hubungan Shift Kerja dengan Stres Kerja dan Circadian Rhythm Perawat

Introduction: Shift work, primarily night shift may worsen some health disturbances because it changes especially circadian rhythm. Therefore, it may lead to sleep disturbance, increased vital signs (heart rate, respiration rate and blood pressure), bowel disturbance, reaction times, conscious stage and increased work stress. The objective of this study was to analyze the correlation between shift work and Nurse’s circadian rhythm. Method: These study was cross sectional with nurses in Flamboyant Intermediate Surgical Ward Dr. Soetomo Hospital Surabaya as subjects. Samples were recruited by using total sampling and there were 15 samples as on inclusion criteria. Data were analyzed using Paired t-Test, Krusskall-Wallis, Wilcoxon, Mann-Whitney, Anova and Chi-Square with significance level α≤0.05. Result: The result showed that shift work had no correlation with nurses’ work stress (p=0.221). Nurses stress stage had no differences in three of shift (p=0.757). While shift work had correlation with nurse’s circadian rhythm disturbance (p=0.038) and night shift had differences circadian rhythm disturbance (p=0.038). Discussion: It can be concluded that there was correlation between shift work and circadian rhythm disturbance, however there is no correlation between shift work and work stress. Further studies are recommended to identify the dominant factor which cause work stress for nurses.

English

Surgical operations are vital procedures in the health care delivery system. Advancement in surgery has played a pivotal role in managing and treating complex health challenges requiring the process. However, the process and procedure involved in surgical operations could significantly endanger the life of the patient. Healthcare associated infections (HAI) pose grave danger to patients and health workers alike. Empirically establishing the level of knowledge, attitude and actual practices of surgical site Infections (SSIs) infection prevention among nurses is therefore an issue for research if the alarming rate of SSIs in developing countries is to be checked. The study adopted cross-sectional survey and the population comprised surgical ward nurses in University of Ilorin Teaching Hospital, Ilorin. Data were generated using self-developed questionnaire with a reliability estimate of 0.88 on the Cronbach alpha scale. These data were analyzed using descriptive statistics of frequency counts and percentages and inferential statistics of Pearson Product Moment Correlation Coefficient at 0.01 alpha. Findings showed that respondents demonstrated relatively high level of knowledge on SSIs prevention, relatively poor attitude towards SSIs prevention and unsatisfactory level of SSIs prevention. When associations among the variables were examined, findings showed that there is positive association between all the variables studies. Findings showed that there is positive and moderate correlation between knowledge and attitude towards SSIs prevention (r = 0.695, p = 0.000<0.01) as well as between knowledge and practice (r = 0.570, p = 0.000<0.01). High correlation was however found for attitude and practice of SSIs prevention (r = 0.763, p = 0.000<0.01). Nurses’ level of knowledge does not translate to desired attitude and practices on SSIs prevention. Improving attitude and practice of SSIs through close supervision, patients’ rights education, in-service training and provision of supplies and consumables were recommended. Key words: Surgical site infections, knowledge, attitude, practices, prevention, nurses.

Registered nurses' perception of self-efficacy and competence in smoking cessation after participating in a web-based learning activity.

To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery. Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way. A convergent mixed-method design with data collection was done using questionnaires (n=47) and semistructured interviews (n=11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis. After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts. The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation. Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities.

Hospital text paging communication as a surgical quality improvement initiative

BackgroundStudies on medicine wards have shown that numeric pages can be disruptive of workflow and patient care. We created a quality improvement program among surgical ward nurses and residents and hypothesized that a text-based, urgency-stratified initiative would improve communication at no detriment to patient care. MethodsSurgery residents recorded preintervention data for 1 mo including number of total pages, text pages, and numeric pages received from surgical floors. Nurses and residents completed surveys to assess preintervention satisfaction with communication, responsiveness, and workflow. Nurses were then instructed to use text paging for nonurgent issues. Paging data were again recorded for 1 mo, surveys repeated, and patient safety and satisfaction data collected. Primary endpoints evaluated included patient safety and satisfaction data. Secondary endpoints included communication satisfaction of nurses and residents. ResultsAfter text paging implementation, 40.1% of nonurgent pages sent from nurses to resident physicians were alphanumeric texts versus only 17.9% before implementation (P < 0.0001). There was a 19.5% reduction in the number of nonurgent numeric pages sent (P < 0.0001). Overall, 70% of nurses responded postintervention that text paging was the preferred method of contacting a physician and that the text paging initiative improved efficiency. After implementation, 62% of nurses thought that overall communication with clinicians improved. In addition, there was no change in patient safety issues or patient satisfaction. ConclusionsOur text paging initiative for all nonurgent pages from nurses to residents improved physician–nurse workflow and communication on the surgical ward with no decrease in patient satisfaction or safety.

SELF-CONFIDENCE OF NURSES TO TREAT SUDDEN DETERIORATION PATIENTS IN MEDICAL WARDS

Background: Sudden deterioration defined as a condition in which a progression over a complex illness. Progression of pain to the patient causing displacement status characterized by the vital signs of patients who experienced abnormality. Nurses in medical and surgical ward almost everytime facing with patients with acute deterioration conditions. Nurses should have confidence when giving proper treatmen for acute patents deterioration. Methods: This study utilize quantitative descriptive research conducted in the hospital ward illness Islam Sultan Agung Semarang. The number of respondents that used in this study were 98 nurses, utilized consecutive sampling technique. Results: The results showed that the average level of confidence gained nurses treating patients in the ward conditions of acute deterioration in the disease is expressed 3.03. It is mean that respondents have moderate level of confidence. Conclusions: The level of confidence of nurses in treating patients with acute exacerbation of conditions needs to be improved to provide excellent service qualityKeywords: nurse, self-confidence, sudden deterioration