Practice Nurses Research Articles

Ethical decision-making: exploring the four main principles in nursing.

Nurses are regularly confronted with moral questions and ethical dilemmas in their practice, for example where a patient's decisions about their treatment conflict with the nurse's own views. While the standards contained in the Nursing and Midwifery Council The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates provide nurses with an overarching framework to guide practice, it is important that nurses understand the four main principles that underpin ethical care - autonomy, beneficence, non-maleficence and justice. This article examines these four principles and how they relate to nurses' ethical decision-making. The author also explores how nurses' ethics were tested by the coronavirus disease 2019 (COVID-19) pandemic. Having an awareness of ethical decision-making can enhance nurses' practice by providing them with a theoretical framework for treating patients with dignity and respect.

Inspirational Professional Practice Model Redesign Using Shared Decision-Making.

An integrated health system including 12 hospitals, an expansive network of ambulatory settings, and health insurance plans began a systematic review of the existing nursing professional practice model (PPM) created in 2007 to assess current relevancy. The goal was to determine PPM concepts and imagery that represent present-day nursing workforce. This article shares how a formal review of literature, utilization of focus groups, and system-wide shared decision-making influenced creation and evaluation of a revised PPM.

The effect of the “Femininity Identity Improvement Program” based on cognitive behavioral and expressive techniques applied to gynecological cancer patients on prolonged grief reactions: Study protocol for randomized controlled trial

The research was designed to determine the impact of the Femininity Identity Improvement Program based on cognitive-behavioral and expressive techniques applied to gynecological cancer patients on their prolonged grief responses. The research is the study protocol created for a randomized controlled experimental study. The research protocol prepared in accordance with SPIRIT 2013 was registered in the Clinical Trials system (XXXX). The research was conducted with 80 patients (40 patients in the intervention group and 40 patients in the control group) who underwent surgery in the gynecology and obstetrics clinic of a university hospital within the last year. Among these patients, those who had a surgery at least three months ago were included in the study. The intervention group participated in the Femininity Identity Improvement Program for 10 weeks, with sessions once a week, each lasting 90-120 minutes. The control group received no intervention. Measurements were taken before the program (pretest), at the end of the program (posttest at the 10th week), and three months after the program (follow-up measurement) to determine the effect of the program. Data were collected using the Prolonged Grief Disorder Scale-Patient Form. The Analysis of Covariance (ANCOVA) was used to analyze the data obtained at different times. The study integrates two psychotherapeutic interventions (cognitive-behavioral theory and art therapy) in an innovative way to structure the Femininity Identity Improvement Program for psychiatric nursing practice. Psychiatric nurses in oncology and other relevant clinical settings are recommended to apply this program to provide comprehensive care using current approaches.

Features and evaluations of organizational support provided by occupational health nurses in private practice for the implementation of sustainable health and productivity management in medium-sized enterprises

This study aimed to clarify the features and evaluations of the organizational support provided by occupational health nurses (OHNs) in private practice to promote sustainable health and productivity management (HPM) in medium-sized enterprises. Corporate managers and employees of four enterprises with fewer than 300 employees received support from an experienced OHN in private practice through five support sessions per company, primarily targeting company managers. The OHNs documented their support steps and evaluations. After completing the support process, we conducted semi-structured interviews with company managers and OHNs to evaluate the support provided by the OHNs. The support processes were organized for each company according to an analytical framework based on the consolidated framework for implementation research; the support features of OHNs were extracted. The evaluations of the support provided by OHNs from the perspective of company personnel were categorized using content analysis. Six features of support by OHNs for the promotion of HPM were extracted, including clarifying corporate needs while focusing on relationships of trust with company representatives, providing appropriate health information, and introducing external resources to facilitate independent and continuous efforts in the company to promote sustainable HPM. The managers' evaluations of the support provided by the OHNs included the following six categories: 1) identified and recognized current internal health issues; 2) received specific assistance tailored to the company; 3) gained an opportunity to work on health promotion measures; 4) considered the development and continuation of future health promotion measures; 5) learned about the existence of OHNs as easy to consult with; and 6) identified aspects of support from OHNs that were different from what they expected. This study clarified the features and evaluations of the support provided by OHNs in private practice in medium-sized enterprises for the promotion of HPM. Our findings suggest that the involvement of OHNs in private practice may increase the number of medium-sized enterprises that can autonomously commit themselves to HPM in a sustainable manner.

Process evaluation of the implementation of the assessment of burden of chronic conditions tool in Dutch primary care – lessons from a qualitative implementation study

BackgroundThe Assessment of Burden of Chronic Conditions (ABCC-)tool is developed to facilitate a personalized approach to care in the patient-healthcare provider (HCP) conversation based on shared decision-making and individualized care plans. An effectiveness study highlighted its effect on the perceived quality of care and patient activation. Successful implementation of novel interventions necessitates an understanding of the user’s actual application, user experiences and an evaluation of implementation outcomes. This study aims to evaluate the implementation of the ABCC-tool by HCPs in Dutch primary care.MethodsThis study is the process evaluation of a larger type 1 effectiveness-implementation hybrid trial. Semi-structured interviews with HCPs, who were interventionists in the hybrid trial, were held at three and twelve months after they started using the ABCC-tool. The Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework was used to evaluate implementation outcomes. The Implementation domain was further strengthened with an evaluation of implementation fidelity using Carroll’s framework. Inductive coding and thematic analysis were applied to identify relevant participant experiences and implementation outcomes within the RE-AIM framework.ResultsSeventeen HCPs (1 general practitioner, 16 practice nurses) participated in the study, representing 39% of potentially eligible participants. Most HCPs applied the tool after finishing their own routines instead of how it is intended to be used, namely from the beginning of the consultation. HCPs reached 2–6 patients. The ABCC-tool was initially adopted, but twelve HCPs stopped using the tool due to COVID-19 related cancellation of consultations. High fidelity was found for applying the questionnaire and visualization. Low fidelity was present for applying shared decision-making, formulating care goals and monitoring progress. HCPs indicated that maintaning the ABCC-tool depended on accompanying training and implementation support.ConclusionsHCPs applied the ABCC-tool critically different from intended, potentially diminishing its benefits and ease of use. This evaluation stresses the need for a tailored implementation plan that includes more detailed training and guidance on how and when to use the ABCC-tool.

Correctional nurses’ practices and perceptions of family engagement

BackgroundIn healthcare, family engagement has been recognized as critical to improved nursing care and outcomes. However, the practice of family engagement in corrections is unknown, despite the large amount of nursing care delivered there. PurposeThe study’s aim was to describe correctional nurses’ perceptions of family engagement and the extent to which it is practiced. MethodA qualitative descriptive study design was used, composed of semistructured interviews. Thematic analysis was conducted, including line-by-line coding. DiscussionThe main themes of the study were: (a) Family engagement is rare, and (b) Systems friction which describe the lack of family engagement in correctional nursing practice, and the need to balance advocating for patients while maintaining a collegial relationship with correction staff. ConclusionDespite the lack of family engagement in correctional nurses’ practice, most participants felt that family engagement would be beneficial for incarcerated patients but would require changes to institutional policies.

Practical Strategies for Nurse Leaders to De-Implement Low-Value Nursing Practices.

Practical Strategies for Nurse Leaders to De-Implement Low-Value Nursing Practices.

Development of advanced practice nursing core competencies in Saudi Arabia: A modified Delphi study

BackgroundAdvanced practice nursing requires a diverse set of competencies that define what advanced practice nurses need to know and be able to do to deliver safe, effective, and high-quality healthcare. Given the lack of evidence regarding core competencies and the evolution of advanced practice nursing roles in Saudi Arabia, it is becoming increasingly important to develop core competencies to standardize educational and clinical training programs. ObjectiveTo define the core competencies of advanced practice nursing in Saudi Arabia. DesignUtilizing a modified Delphi design and snowball sampling technique, data were collected between April and July 2023 using an online questionnaire consisting of 28 core competencies that was developed based on an in-depth literature review and a critical analysis of advanced practice nursing core competencies published by leading professional organizations. Two rounds of Delphi surveys were conducted. SettingsThe study was set in clinical and academic settings in Saudi Arabia. ParticipantsNursing experts with graduate degrees as advanced practice nurses. ResultsIn Round 1, 34 advanced practice nursing experts reached full consensus on 24 of the 28 core competencies, and four core competencies reached partial consensus. Based on suggestions and feedback from the experts, the investigators revised ten core competencies to reflect the improvement suggestions and created three new core competencies. A total of 26 core competencies were used in Round 2, which achieved a full consensus among the 34 advanced practice nursing experts, under the following six core competency domains: knowledge of advanced practice nursing, person-centered care, professional improvement, professionalism, communication and interprofessional partnership, and leadership and system-based practice. ConclusionsGiven the need for a standardized competency framework, the 26 core competencies proposed in our study have the potential to guide education and training in academic programs and facilitate the implementation of advanced practice nursing in clinical settings.

New graduate nurses’ readiness for practice, transition and integration into the workplace: A longitudinal study with mixed methods research

AimTo examine the readiness of new graduate nurses for practice and evaluate factors influencing their transition into the workplace. BackgroundThis is new research in Bahrain. Understanding readiness for practice is important during a time when there is a national initiative to promote nursing as a career among the indigenous Bahraini population. The worldwide nursing shortages and aging workforce require new and innovative recruitment and retention measures. There is change, increased demand and complexity, in nursing and healthcare needs with accompanying healthcare specialization. In such a health care environment, the transitioning and readiness of newly qualified nurses is an increasing challenge. DesignA longitudinal design, with a triangulated, mixed methods, research approach was used. MethodsThe study population consisted of 50 newly graduated nurses. Data were collected over one year through self-administered questionnaires, reflective diaries and focus groups. Quantitative data were analysed using SPSS and qualitative data using thematic analysis with adherence to GRAMMS reporting guidelines. ResultsIn Bahrain, there are actions to recruit young Arabic students to nursing including schools and community presentations by trained nurse ambassadors, social media activities and career exhibitions, however there is a lack of objective information on the perspective of cohorts of nurses who have successfully completed graduate nursing registration programmes and transitioned into practice. International literature suggests that the transition of newly graduated nurses can be stressful and challenging. On entry to practice, the respondents positively perceived their characteristics and attributes; however, their confidence was affected by challenges in the workplace. The transitioning of the new graduate nurses was affected by the availability of support and leadership, induction programmes and the new complex work environment. ConclusionUnderstanding work readiness and the emotional needs of new graduate nurses, accompanied by improved support, will enhance the transition of newly qualified nurses into the workplace and reduce attrition. Study RegistrationKHUH/Research/No.279/2019

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review.

As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution. In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels. This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded. A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice. There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement. RR2-10.11124/JBIES-22-00266.

A Study of Factors Contributing to Emotional Exhaustion in Online Nursing Students.

Emotional exhaustion in online nursing students leads to attrition in educational and professional settings. Few studies have been performed on practicing nurses enrolled in online programs. The purpose of this study was to explore factors contributing to emotional exhaustion in nursing students. Survey methodology targeted licensed practical nurses, registered nurses, and advanced practice registered nurses enrolled in online programs. Data collected from 116 students included demographics and answers to closed- and open-ended questions regarding emotional exhaustion. Participants reported high levels of emotional exhaustion related to multiple factors. Findings from this study will be used to identify at-risk students and interventions to decrease attrition and increase student success.

Efficient Biomedical Waste Management- Need of the Time: A Lesson Learnt From COVID-19 Pandemic

Background: Medical waste management (MWM) is of concern to the medical and general com-munity. Adequate knowledge regarding the management of healthcare waste is an important precursor to the synthesis of appropriate attitudes and practices of proper handling and disposal of medical waste by healthcare workers (HCWs). This study aimed to investigate the knowledge, attitudes, and practices of doctors, nurses, laboratory technicians, and housekeeping staff, regarding BMW management at a tertiary hospital in Telangana.Subjects and Method: This was a cross‑sectional study carried out at a tertiary health care center in Mahbubnagar district, Telangana, India. A stratified sampling technique was used to select the different cadre of healthcare providers from the hospital. A self‑administered questionnaire assessing the knowledge, attitude, and practices of 300 study participants was prepared. Data were analyzed using SPSS software version 26. Descriptive statistics were used to summarize the data.Results: The majority of respondents were nursing staff 43% (143/300) followed by doctors, interns, sanitation workers, and lab technicians. About 3/4th of the HCWs had experience of more than 3 years. Only 65% of the doctors have correct knowledge of the colour coding of bags. About only 20% of the nursing staff practiced segregation of the waste on-site. The practice of hand washing was significantly higher among female HCWs (p = 0.010).Conclusion: This study showed that there is a clear lack of BMW management among the HCW especially class IV staff who handle a large. Thus ongoing training should be provided to HCWs on MWM, with more attention to knowledge of regulatory requirements, and involvement of HCWs in the development of MWM policies to enhance compliance.

Profiles and Characteristics of Mental Health Nurses in Community-Based Health Care for People with Mental Illness - Integrative Review and Thematic Framework Analysis

To examine the specific scope of practice of community mental health nurses (CMHNs) across CMHN roles and care contexts. Systematic literature searches in CINAHL, PubMed/Medline, Google and Google Scholar, supplemented by a search of various publishers' databases. Data were analyzed and synthesized using the framework analysis method. This paper identifies two role profiles in CMHN practice that describe distinct functions in the outpatient care of people with mental illness: (A) Primary Care CMHN and (B) Specialized Care CMHN. For each role profile, contextual factors and specific role content are described and analyzed for similarities and differences. The described role profiles can serve as a template for the development of curricula in the field of CMHN. It is important to consider the national context as well as the current and future need for psychosocial care.

Perceived Competencies and Training Needs of Public Health Nurses in the Philippines: Basis for the Development of NurseLEAD: A Leadership Course on Advanced Practice Nursing in Public Health.

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs. A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data. A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken. Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

Exploring emotional intelligence-implications for professional nursing practice

Exploring emotional intelligence-implications for professional nursing practice

Supporting graduate students’ skills with simulated experiences in a professional foundation course

The population’s health depends on a well-educated nursing workforce that includes graduate-prepared nurses. However, the nation’s demand for graduate nurses in advanced practice, teaching, and research roles surpasses the supply. Graduate nursing educators can support student success by creating positive learning experiences for students at the beginning of their study programs. Initially, we created a pilot writing orientation, which was implemented for new students. Although the results of the pilot study showed significance with paired t-tests (p < .000; Cohen’s d = 1.21), the writing skills were not applied in long-term coursework. Therefore, a seven-week course was created to provide students with small-scale assignments, preparing them for complex future graduate coursework. The study aimed to evaluate the effectiveness of the skills learned in the course using student (n = 15) and faculty (n = 9) focus groups. A qualitative design using thematic analysis showed the following student themes: tools to improve scholarly writing, magnitude and feasibility of the project, graduate-level writing and professional presentations, clear expectations of achieving program requirements, and professional development using a digital e-portfolio. Faculty focus groups compared the skills of students who had completed the course and those who had not. Faculty themes included stronger writing skills despite the variation, resource availability, tool use, APA format skills, and writing synthesis skills development. Overall, the participants’ perspectives shared positive feedback with insightful suggestions for future course improvement.

Factors influencing general practice nurse's implementation of culturally responsive care, using normalization process theory: A cross-sectional study.

To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory. A self-administered online cross-sectional survey. A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients. This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices. Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services. The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.

Clinical effect of nursing methods integrating health belief models on self-care of maintenance hemodialysis patients: A retrospective study.

This study aimed to explore the clinical effectiveness of nursing methods that incorporate health belief models on the self-care practices of maintenance hemodialysis patients. The objective was to enhance patients' health beliefs, strengthen their healthy behaviors and habits, improve their unhealthy daily behaviors, and provide robust theoretical and practical foundations for future nursing practices in this area. A retrospective analysis was conducted on 150 hemodialysis patients from our hospital, from January 2019 to February 2023. The participants were divided into 2 groups: a control group (N = 75) using routine nursing methods, and an experimental group (N = 75) using methods integrated with health belief models. Both groups were comparable in terms of demographic and baseline clinical characteristics such as gender, marital status, age, education level, total scores of self-care ability, and dialysis duration, with no significant differences observed (P > .05). Data collection tools included a general information questionnaire and a self-care ability scale, and clinical effectiveness was measured through specific indicators such as parathyroid hormone, blood phosphorus, urea, potassium, calcium, and IWGR%. Post-intervention, the experimental group demonstrated significant improvements in self-care capabilities across various dimensions and most clinical indicators compared to the control group, with the exception of parathyroid hormone and blood urea levels. The study concludes that integrating health belief models into nursing practices significantly enhances the self-care abilities of maintenance hemodialysis patients, improves several clinical parameters, and holds promise for fostering better patient outcomes and guiding future clinical nursing practices.

Nurses' Perceptions of Spirituality and Spiritual Care and Influencing Factors in Türkiye, Italy, and Albania: A Multicultural Study.

The present study aimed to explore the perceptions of spirituality and spiritual care among nurses who work in three different countries with different cultures as well as the factors influencing their perception. This is a cross-sectional multicultural study conducted with a total of 1090 nurses from Türkiye, Albania, and Italy. Data were collected through the "Individual Information Form" and the "Spirituality and Spiritual Care Rating Scale". Nurses' mean score on the Spirituality and Spiritual Care Rating Scale was above average. It was also found that country, marital status, religious belief, Islamic religion, training for spiritual care, and using spiritual practices to cope with difficulties or illnesses influenced nurses' perception of spirituality and spiritual care. It was concluded that nurses from the three countries associated spirituality and spiritual care with religion and that some personal characteristics influenced their perceptions of spiritual care. The results highlight the need for training in spiritual care to improve nurses' perceptions and practices of spiritual care.

Consultation infirmière en médecine légale : étude de faisabilité dans un hôpital d’Île-de-France

Difficulties encountered in care giving to assault survivors originate from the specific vulnerability of the persons themselves, their reluctance to disclose the assaults and the necessary coordination of caregivers, police and law enforcement authorities. We intended to increase nurses' involvement in care giving to assault survivors, so that quality of care would increase. The aim of the present study was to describe the characteristics of assaulted patients who were received by a nurse, and the follow-up to the consultations. Inclusion criteria were an age over 16 and a presentation in the department of forensic medicine following a sexual assault or Intimate partner violence without prior appointment. The consultation with the nurse allowed the characteristics of the situation of violence, traumatic injuries, the psychologic condition, needs of and requests by the patients to be recorded. A total of 134 persons (132 women) were included in an observational study (17/09/2016-17/03/2020). The nursing consultations dedicated to survivors of intimate partner violence or sexual assaults participate in increasing the quality of care. It might be part of advanced nursing practice in the future.