Intensive Care Unit Nurses Research Articles

Delirium Care by Intensive Care Unit Nurses: Focus Group Studies in a Medical Center of Southern Taiwan.

Studies have identified many nursing interventions that can prevent delirium and fall accidents in clinical patients, detect and treat delirium early to prevent functional decline in the patient, shorten hospitalization duration, and lower the death rate. This study aimed to explore delirium care by intensive care unit (ICU) nurses in a medical center of southern Taiwan. This study conducted 3 semistructured focus group interviews, each for a single medical ICU, involving groups of 6 to 8 nurses each. The nurses were recruited through purposive sampling. This research was approved by an institutional review board in the medical center of southern Taiwan from March 31, 2020, to January 30, 2021. The co-principal investigator described the purpose and process of this study to the participants before they provided their written informed consents. The interviews were conducted in the meeting room and were audiotape recorded. The recordings were transcribed and subject to content analysis to identify the themes of delirium care. For nursing interventions of delirium, satisfying the patient's physical needs: comfort care, massages, and early rehabilitation; and psychological care: being presence, communication, and ensuring familial support were included. In terms of environmental interventions for delirium, providing reorientation, music, light, belongings with sentimental value, and audiovisual equipment were included. However, according to the recruited medical ICU nurses, these nonpharmacological interventions, although effective, do not have long-lasting effects. Finally, nurses reported themselves as having been attacked by patients with delirium. Thus, they all agreed that restraining patients with delirium may be necessary, but restraining is a double-edged sword for ICU delirium patients. Research team suggests for future studies to extend their evidence-based findings of physical, psychological, and environmental care for ICU delirium patients toward integrating the efforts of various health care professionals.

Prevalence of voice handicap among nurses in intensive care units due to occupational noise during pandemic.

Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses. A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications. Results indicate that the most frequently reported voice symptoms were 'voice tiredness' and 'voiceless'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic. More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.

Nurses' Burden of Elimination Care: Sequential Explanatory Mixed-Methods Design.

Inpatients commonly experience problems with elimination due to incontinence, urinary retentions, and complications with indwelling catheters. Although elimination care (EC) is an important nursing area, few studies explore the burden of EC on nurses. To identify the burden on EC by analyzing nurses' opinions using sequential explanatory mixed method. This research was conducted using a sequential explanatory mixed-methods design. A total of 59 nurses at a tertiary hospital in South Korea participated in the study from January 1 to March 31, 2022. For quantitative analysis, information about number of delays of work due to EC, required time for serving bedpan or diaper changes, percentage of EC per shift, and percentage of patients who need EC was collected through a survey. For qualitative analysis, focus group interviews were conducted to identify factors that put a burden on EC. Important themes were derived by analyzing nurses' opinions on EC. For nurses in intensive care units, general wards, and integrated nursing care wards, the number of work delays due to EC was 3.6 ± 1.5, 2.3 ± 1.2, and 4.8 ± 2.4 (p<0.01), respectively. The mean percentage of EC work out of total nursing tasks per shift was 36.2 ± 19.0, 29.3 ± 14.4, and 43.8 ± 14.1 (p=0.02), respectively. The mean percentage of patients requiring EC out of patients a nurse cares was 85.4 ± 16.6, 41.3 ± 26.1, and 58.8 ± 21.9 (p<0.01), respectively. Following qualitative analysis, four themes related to nurses' EC burden were derived: physical burden, frequent care needs, delay of other jobs due to EC, and complications. Among them, frequent care needs were found to be the primary factor requiring consideration to reduce nurses' burden. This research found that EC is one of the most burdensome tasks that nurses want to avoid. To alleviate their burden, effective EC protocol or smart medical devices assisting with EC should be developed.

Prevalence of foot posture deformities using foot posture index in various intensive care unit nurses

Background: This study aims to determine the prevalence of foot posture deformities among various intensive care unit nurses using the Foot Posture Index. Nurses working in ICUs often face long hours of standing and walking, which can contribute to the development of foot-related problems. Understanding the extent of these deformities can contribute to the development of preventive measures, such as ergonomic interventions and targeted exercises, to mitigate the risk of foot-related issues. Methods: A study was conducted among 159 nurses from various Intensive Care Units. The Foot Posture Index, a validated tool for assessing foot posture was used to assess foot deviations in nurses. Results: In total159 participants were evaluated, with 6 (4%) being males and 153 (96%) being females. The mean age of the participants was (Mean=40.67) and standard deviation (SD=9.6). Prevalence percentage of foot posture deviations were found to be bilateral as demonstrated by Foot Posture Index. Out of 159 participants 43% participants had pronated foot, 14% participants had highly pronated foot, 16% participants had supinated foot, 7% had normal highly supinated foot posture and 20% participants had normal foot. Conclusions: To conclude the present study, pronated foot posture was the most common foot deviation. Moreover, when BMI was compared with the pronated foot deviation, there was a positive association between pronated foot and the nurses who were overweight.

Therapeutic Communication Skills Training: An Effective Tool to Improve the Caring Behaviors of ICU Nurses

Caring behaviors are crucial in intensive care units (ICU) because patients in these wards require high levels of care. Effective communication with patients is one of the most important factors in the caring behaviors of nurses working in ICUs. This study aimed to evaluate the effect of therapeutic communication skills training on the caring behaviors of ICU nurses. This experimental pre-test/post-test study was carried out on 105 nurses working in ICUs of hospitals affiliated with Yazd University of Medical Sciences in Iran in 2019. Nurses were randomly assigned into control (52 nurses) and intervention (53 nurses) groups. A two-day therapeutic communication training workshop was conducted for the participants. Data were collected using a demographic information questionnaire and caring behaviors questionnaire before and one month after the intervention. The findings showed no significant difference between the control and intervention groups regarding the nurses' caring behaviors in the pretest (P=0.148). However, after the implementation of the training program, a significant difference was observed in the mean scores of caring behaviors between the two groups. In the control group, the mean scores of caring behaviors decreased significantly after the intervention (P=0.001); whereas, the mean scores of the intervention group increased significantly after the intervention (P=0.001). According to the results, ICU nurses' training in therapeutic communication skills had a positive effect on their caring behaviors. Therefore, we suggest the authorities prepare and implement educational packages of therapeutic communication skills as a coherent program for other nurses. As a result, the caring behaviors and the quality of care can be improved for patients.

A qualitative study of ICU nurses assisting in Wuhan who suffered from workplace violence during the COVID-19 outbreak.

To explore the psychological experience and coping methods of nurses exposed to workplace violence and to propose measures to prevent and control workplace violence and provide psychological assistance for health workers. We adopted a phenomenological qualitative design. Twelve nurses in intensive care units assisting in Wuhan who experienced workplace violence during the COVID-19 outbreak were selected using purposeful sampling. Data were collected through semi-structured individual telephone interviews and analysed using Colaizzi's 7-step method. Analysis revealed three main categories including "Full of negative emotions", "Facing challenges and danger" and "Coping methods". The subjects experienced stress, fear, anger, helplessness, disappointment, sympathy and job burnout after suffering from workplace violence. The coping methods for workplace violence mainly included seeking support and help, escaping, making explanations, exercising tolerance and confronting the issue. No patient or public contribution since nurses' experiences were explored.

Knowledge of pulse oximetry among emergency and critical care nurses.

The pulse oximeter is a simple, cost-effective and reliable device for estimating arterial blood oxygen saturation. Nurses are required to be knowledgeable in pulse oximeter use. Little is known about nurses' knowledge of pulse oximetry in the Middle East region. To assess nurses' knowledge of pulse oximetry among emergency and critical care nurses and to explore predictors of nurses' knowledge of pulse oximetry. This is the second part of data analysis that was first presented in the 'proficiency in ECG' study conducted in Jordan. The original data used for both parts of analysis included a questionnaire with two tests; a knowledge of pulse oximeter test and an ECG proficiency test. Participants were asked to take, alone without receiving assistance, both tests. In this study, the second part of analysis, the focus is on the pulse oximeter test. The test consisted of 21 items that emphasize knowledge of basic physiological principles as well as device limitations; whether technical or interpretation. The test administration procedure also included asking participants to provide socio-demographic variables. In the original data collected in both parts of analysis, nurses working in the emergency department, cardiac care units or intensive care units from nine different hospitals (1 governmental, 6 private and 2 educational) and holding a bachelor degree or higher were asked to participate. The total number of participating nurses was 210; out of 247 approached (response rate, 85%). The mean score in the nurses' knowledge of pulse oximetry test was 12.33 out of 21, corresponding to 58.7%. The clinical area currently working in predicted the knowledge of pulse oximetry test score after controlling for all other variables. Emergency department and intensive care unit nurses scored higher than cardiac care unit nurses by 1.86 and 1.63 points respectively (58.2% and 60% respectively). Nurses consistently report inadequate education and training concerning pulse oximeter use and interpretation. A revision to hospital in-service education seminars and undergraduate nurses' curriculum to assure adequate preparation is needed. Knowledge of pulse oximetry among emergency and critical care nurses is modest. This is a challenge worldwide. Predictors of nurses' knowledge of pulse oximetery are the clinical area currently working in (ICU and ED nurses are more knowledgeable than CCU nurses), proficiency in electrocardiography and taking an advanced cardiac life support course.

Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations.

Health professionals can be 'second victims' of adverse patient events. Second victimhood involves a series of physical and psychological signs and symptoms of varying severity and is most prevalent among nurses and women and in intensive care units (ICUs). Previous research has described personal and organizational coping strategies. The objective of this research is to determine the prevalence of second victimhood, focusing on psychological distress, among Chilean adult intensive care nurses and its relationship with the support provided by their organizations. A descriptive, correlational and cross-sectional study was conducted in seven intensive care units of Chilean hospitals. Of a sample of 326 nurses, 90.18% reported having been involved in an adverse event and 67% reported psychological distress resulting from the adverse event. Embarrassment was the most prevalent psychological symptom (69%). Only 2.8% reported that their organization had an action plan for professionals in the event of a serious adverse event. Participants who had spent longer working in an ICU reported more support from their organization around adverse events. Two-thirds of Chilean adult intensive care unit nurses report psychological stress following an adverse event. These results should be assessed internationally because second victims have major implications for the well-being of health professionals and, therefore, for retention and the quality of care. Critical care leaders must actively promote a safe environment for learning from adverse events, and hospitals must establish a culture of quality that includes support programmes for second victims.

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel.

Intensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the '5 rights'). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety. To identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel). A dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56-bedded adult intensive care unit and a 6-bedded neonatal intensive care unit in Sydney, Australia. Incident monitoring data were examined. Direct semi-covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel. No medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the '5 rights' and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling. This study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses. This novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling.

In-service education in trauma care for intensive care unit nurses: An exploratory multiple case study

AimThis study explores the perceptions of intensive care units (ICUs) nurses with different educational backgrounds regarding their abilities in trauma care and the in-service education they receive to support it. BackgroundThe advanced care of patients with traumatic injuries in ICU environments requires skilled and knowledgeable nurses, who need continuing and in-service education to provide the best care. Therefore, it is essential to understand the competencies and educational support these nurses may need in the ICUs to ensure safe and effective care delivery. DesignAn exploratory multiple case study design was used, comprising three hospitals located in two different regions of Saudi Arabia. MethodsThe study was conducted between October 2021 and March 2022. A total of forty ICU clinical staff, twelve managers, nine leaders and seven clinical educators participated in semi-structured interviews, which were complemented by a review of available documents on the trauma care in-service education syllabi, competencies and protocols. Interview data were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis. FindingsThe data analysis revealed two interrelated categories relevant to trauma care: (i) care practice and (ii) education practice. The trauma care practice category highlighted the limited competencies and education in trauma care, as well as the perceived challenges and educational needs of nurses. The education practice category described the staff learning behaviours, supervision practices and in-service education systems in the participants’ settings. ConclusionsThe study concludes that there is a lack of trauma care education at the examined sites. It suggests the need for further research to develop a theoretical foundation for trauma care education that can meet ICU nurses’ educational needs while this being feasible to implement in the specific ICU context and practice.

Knowledge, attitude and practice regarding hypoactive delirium among ICU nurses: A nationwide cross-sectional study

Aims and objectivesThis study aimed to assess the knowledge, attitude and practice (KAP) of intensive care unit (ICU) nurses in patients with hypoactive delirium in China. BackgroundThe presentation of hypoactive delirium is not obvious and tends to be ignored. However, it has a high incidence and can cause critical impairment. Although nurses are the primary caregivers of patients, the evidence of the current status of KAP of hypoactive delirium among ICU nurses is insufficient in China. DesignThe study participants were 2835 ICU nurses from 201 hospitals in 69 cities from 31 provinces in China. MethodsThe current status of KAP of hypoactive delirium among ICU nurses was determined using a self-reported structured questionnaire, including 52 questions covering general personal information; three dimensions of KAP; and relevant issues. Descriptive analyses of the sample distribution were reported as percentages and medians. The factors were detected using univariate and multivariate analyses. To guide the reporting of the research, a STROBE checklist of cross-sectional studies was used. ResultsOf the 3101 returned questionnaires, 2835 were analyzed. Approximately 64. 94 % and 53. 30 % of them were identified with a positive attitude and appropriate practice, respectively, whereas only 1. 48 % showed a good level of knowledge. The regression analysis showed that age, years of working in the ICU, educational background, professional title, caring for patients with delirium, attending training on hypoactive delirium and hospital grading were significantly associated with their KAP status(P＜005). ConclusionsHypoactive delirium is an ignored entity by nursing professionals, with no definite nursing procedure. This study shows that receiving relevant training is a factor affecting KAP status, indicating that training should be strengthened. Additionally, appropriate screening and nursing procedures should be developed to standardize the behavior of ICU nurses and improve the quality of care. Relevance to clinical practiceICU nurses have poor knowledge of hypoactive delirium and related training should be strengthened, especially for middle-aged nurses. Screening and nursing procedures should be set up, which is critical to promote nursing practice. No patient or public contributionNone.

Use of Sequential Organ Failure Assessment Among Intensive Care Unit Patients with Septic Shock

Purpose: Sepsis is a significant cause of mortality in modern intensive care units (ICUs). At Sharp Grossmont Hospital (SGH), sepsis cases increased the patient mortality rate in comparison to other Sharp facilities. Currently, no tools are utilized to identify septic patients at SGH. The study aimed to find out the impact of early consultation of advanced illness management (AIM) and goals of care conversations (GOCC) on reducing the length of stay (LOS) among septic shock patients.&#x0D; Methodology: Descriptive data were attained based on Electronic Medical Records (EMR) of 39 septic shock patients form which ICU nurses utilize to calculate Sequential Organ Failure Assessment (SOFA) on admission and daily for 2 days. &#x0D; Findings: The education increased the ICU staff’s awareness of the high occurrence of septic shock among ICU patients. After the deployment of SOFA scores among 39 patients of septic shock, the average LOS was 3 days, compared to more than 5 days before implementing SOFA scores. Post-implementation, 33 % of patients received early AIM or GOCC intervention, with 84% of them receiving intervention from the first day of admission. These percentages are compared to pre-implementation, when early AIM or GOCC intervention was provided to 36.4 % of patients, with 41.3 % of them receiving AIM or GOCC from the first day of admission.&#x0D; Recommendations: In this study, the leader of change must be aware of standardized Arterial Blood Gas (ABG) orders for SOFA scores and measure the compliance of ICU nurses in documenting SOFA scores. Moreover, raise awareness among healthcare professionals about the high occurrence of septic shock mortality among ICU patients.

Exploring patients’ and relatives’ needs and perceptions regarding family participation in essential care in the intensive care unit: A qualitative study

ObjectivesTo examine the needs, perceptions and influencing factors according to former adult intensive care unit patients and relatives with regard to family participation in essential care in the unit. Research designA qualitative interpretive descriptive study using inductive thematic analysis. SettingTwelve pairs of former Dutch patients and their relatives were interviewed within two months after the patient’s discharge from the unit between December 2017 and April 2018. FindingsFour themes emerged: the family’s history, the patient’s condition, supporting the patient and supporting the relative. The family’s history, in particular the relationship with the patient and former experience with care, determined the level of participation in essential care. The level of participation was also influenced by the patient’s condition, more specifically level of consciousness, stability of the patient’s situation and length of the patient’s stay. The third theme, supporting the patient, related to presence/being able to ‘be there’ for the patient and a mostly positive attitude towards family participation. The last theme was supporting the relative, with three subthemes associated with relatives’ needs and perceptions: (dis)comfort with participation in essential care, need for invitation and support, and concern about the possible strain experienced by relatives. ConclusionSupporting the patient and supporting the relative are reflecting the needs and perceptions of patients and relatives regarding family participation in essential care. Both the family’s history and the patient’s condition influence the relative’s level of participation. Intensive care unit nurses and other healthcare providers could take these themes into account when encouraging family participation in essential care. Implications for clinical practicePatients’ and relatives’ needs and perceptions of family participation in essential care in the intensive care unit vary. Family participation in essential care is influenced by the family’s history and the patient’s condition. Healthcare providers could take these findings into account when implementing family participation in essential care.

Level of Satisfaction of ISBARE Technique among Staff nurses in Intensive Care Unit: Descriptive Study

ISBARE is one of a number of frameworks for discussing patient issues among healthcare professionals. The ISBARE tool is utilized in nurse-to-nurse handoff processes as well as communication between nurses, doctors, and other healthcare professionals. Identify, Situation, Background, Assessment, and Recommendation is a communication framework that was implemented by the public health service in the 2000s.A descriptive study was conducted to assess the level of satisfaction of ISBARE technique on handover among staff nurses in Intensive Care Unit. A total of 60 samples who met the inclusion criteria were selected by purposive sampling technique. Assessment was done by using the 20 satisfaction questionnaire. Data were analyzed by using descriptive and inferential statistics. The study finding revealed that 34(56.7%) had satisfied and 26(43.3%) strongly satisfied in following ISBARE technique during handing over the patient and none of them had dissatisfied. Chi-square test showed statistically significant association between the level of satisfaction with selected demographic variables of information ISBARE handover time, age in years and type of ICU workingat p&lt;0.05. The study finding concluded that nurses working in intensive care unit were satisfied with ISBARE technique during handing over the patient as it helps to report the comprehensive information about the patient thereby to provide good quality care.

Intensive care as a specialty of choice for registered nurses: A descriptive phenomenological study.

Shortage and retention of experienced nurses are crucial matters and internationally acknowledged, particularly in specialty areas such as Critical Care. To explore the experiences of registered nurses in their first and fourth years of practice in an adult intensive care unit. This descriptive phenomenological study was conducted over 4 years. Eligible participants were interviewed at two different points in their career. Ten registered nurses were interviewed after three to 6 months of employment in an adult intensive care unit (Phase One). Five of the same participants were interviewed in their fourth year of practice (Phase Two). Findings related to factors influencing the participants' choice of specialty and their retention are reported in this paper. Two themes emerged from Phase One: a unique environment, positive and negative emotions, unclear expectations, and the journey of a registered nurse. Two themes generated from data collected in Phase Two included a unique environment and being a proficient nurse. In both phases, nurses considered the Intensive Care Unit a stimulating learning environment. This paper highlights that the registered nurse's perception of the Intensive Care Unit and Intensive Care Nursing influenced their choice of specialty, and learning opportunities influenced their decision to remain in the Intensive Care Unit. The findings of this study inform action areas for healthcare organizations and nursing managers. Challenges, learning opportunities and the nature of critical care nursing should be considered target areas for organizations to promote and develop as part of critical care nurses' retention strategies. Education not only for new graduate nurses but also for all registered nurses should be ongoing.

Practices of the ABCDEF care bundle in intensive care units as reported by nurses: A cross-sectional study from Turkey.

Recent critical care guidelines recommended the evidence-based ABCDEF care bundle for intensive care unit (ICU) patients. However, limited information is available on the implementation of the bundle in Turkish ICUs. To assess the current practices of the ABCDEF care bundle as reported by ICU nurses. A cross-sectional study using a web-based survey was conducted. Researchers invited nurses with at least 1 year of ICU experience to participate by sending the link to the research questionnaires they created in Google Forms to the one ICU nurse association and one communication group of which they are members. A total of 342 ICU nurses completed the survey. Although 92% of the participants performed pain assessments in their ICUs, 52.7% reported not using protocols. Based on the responses of the nurses, spontaneous awakening and breathing trials are performed in 88.8% and 92.4%, respectively, of ICUs. Fewer than half of the participants reported following a sedation protocol in their ICUs. Only 54.7% of ICU nurses surveyed reported routinely monitoring patients for delirium. It was reported that early mobilization was practised in 68.7% of ICUs, but non-ventilated patients were mobilized more frequently (70.2%), and 9.7% of ICUs had mobilization teams. Family members were actively involved in 95% of ICUs; however, 9.7% used dedicated staff to support families and 3.5% reported that their unit was open 24 h/day for visits. While the implementation of most pain and sedation evaluations in ICUs were reported by nurses, many of them did not use structured delirium assessments. There is a need to encourage early mobilization programs and family participation. Health institutions can improve patient care and outcomes by establishing and standardizing a protocol for each component of the ABCDEF care bundle in ICUs.

The issue of advanced training quotas for intensive care unit nurses

The issue of advanced training quotas for intensive care unit nurses

Factors related to intensive care unit Nurses' work engagement: A web-based survey.

A questionnaire survey on the personal and work factors related to work engagement among intensive care unit nurses concerning their recovery experiences and the nursing practice environment was conducted using a web-based tool. Two individual factors (demographics and experience on recovery from job stress) and four work factors (work employment type, nursing method, COVID-19 nursing experience, and nursing practice environment) were surveyed. Data from 244 participants were obtained, and survey items were analyzed using a multiple regression analysis with work engagement as the dependent variable. The results show that 3-5 years of nursing experience is significantly associated with lower work engagement. Conversely, certifications for higher-level and specialized nursing, mastery experience such as learning new things, 1-9 days/month of COVID-19 nursing experience, and suitable nursing practice environment were significantly associated with higher work engagement. These factors are considered important for improving the work engagement of intensive care unit nurses.

Effectiveness of an Instructional Program on Nurses’ Practices toward Change Position Effect of Preterm Babies with Respiratory Disorders

Background: Positioning is a crucial aspect of developmental care because it keeps the infant flexible, aligned, confined, and comfortable. It is a simple therapeutic procedure that is effective and safe for preterm infants. Objectives: To determine the effectiveness of an instructional program on nurses' practices toward change position, and to find out the relationships between the effectiveness of instruction program and demographic characteristics of nurses. Methodology: A quasi-experimental study design was initiated from 20 December 2022 to 22 May 2023 at Maysan hospital for child and birth, in Al-Amarah city. A non-probability “convenience” sample was selected and consisting of 50 Nurses. The data was obtained by observation utilizing a constructive practices checklist. Descriptive and inferential statistics were used to analyze the data by using SPSS (version 26.0) Results: Findings reveal that nurses in the study group are showing fair level of practices during the pre-test time (76%) while they are showing good level of practices during the post-test 1 (88%) and post-test 2 (84%) that indicate the significant changes in level of practices among nurses after applying the program. Conclusion: The Instructional program had a positive effect on the practices of neonatal intensive care unit nurses. There were significant differences in the study group's practices scores between the pre-test and post-test. There was association between nurses’ practices and their age. Recommendations: Providing Neonatal intensive care unit nurses with posters, leaflets, and books so they can learn enough about the right and safe position for preterm babies. Standardized checklists should be made available in NICU.

Assessment of psychological and physical stressors among nurses in different functional areas before and during the COVID-19 pandemic: a cross-sectional study

BackgroundThe COVID-19 (coronavirus disease) pandemic placed a great burden on all health-care resources, especially nurses. The prevalence and underlying risk factors of affective symptoms related to the COVID-19 pandemic have been studied primarily among nurses in intensive care units (ICU) and emergency departments. The aim of this study was to identify at-risk nursing areas by examining the psychological and physical stress values of nurses in different functional areas.MethodsA questionnaire with standardized items was developed to assess psychological and physical stress values. At least 50 nurses with a minimum work experience of 3 years were recruited from the ward, outpatient clinic (OC), intermediate care (IMC) unit, and operating room (OR) of the University Hospital RWTH Aachen. The participants answered the questionnaire by referring to their perceptions before and during the COVID-19 pandemic. Absolute differences and relative trends in psychological and physical stress values were compared within and across functional areas.ResultsThe ward and OR nurses experienced significant increases in workload (p < 0.001 and p = 0.004, respectively) and time stressors (p < 0.001 and p = 0.043, respectively) during the COVID-19 pandemic. Regardless of functional area, the nurses showed strong tendencies toward increases in subclinical affective symptoms. After adjustments for age, sex, working in a shift system, the treatment of patients with COVID-19, and the impact of the COVID-19 pandemic on personal life, the values for working with pleasure decreased significantly among the ward (p = 0.001) and OR nurses (p = 0.009) compared with the OC nurses. In addition, the ward (p < 0.001) and OR nurses (p = 0.024) were significantly more likely to express intent to leave their profession than OC nurses.ConclusionsThe IMC nurses showed good adaptation to the exacerbated situation caused by the COVID-19 pandemic. The ward nurses, followed by the OR nurses, were the most vulnerable to mental and physical exhaustion, which threatened the nurses’ resilience and retention in the wake of the COVID-19 pandemic. Therefore, intervention programs must specifically address the professional and emotional needs of ward and OR nurses to prepare the health-care system for future crises.