Nursing Care Plan Research Articles

The Relationship between Intensive Care Unit’s Nurses’ Informatics Competency and Quality of Patients’ Electronic Health Record’s Documentation

Background: Nursing informatics and the development and growth of health information technology are becoming a necessary part of all aspects of the nursing practice, especially in critical care settings. In addition, researchers agree on using standardized and electronic documentation to support the nursing process and promote nursing documentation quality. Purpose: To examine the relationship between Intensive Care Unit Nurses' Informatics Competency and Quality of Patients' Electronic Health Record Documentation. Methods: A descriptive, correlational, retrospective, cross-sectional design was used. Three hospitals that implemented the Electronic Health Records (EHRs) system were included in this study, using non-probability convenience sampling technique to recruit a total of 176 nurses. The nursing informatics competency was measured by the Self-assessment of Nursing Informatics Competencies Scale (SANICS). The Quality of Electronic Health Record Documentation was assessed by the audit instrument for nursing care plans in the patient record (Cat-ch-Ing). Descriptive and inferential statistics were utilized to answer research questions. Results: The overall mean informatics competency score among nurses was 2.49 (SD = 0.73), with most of the nurses (81.79%) reporting a low competency score of less than three. The highest percentage of participants 29.4% (n = 52) have moderate quality of EHR documentation. Also, related personal and clinical characteristics account for 93.7% of the variance in quality of patients’ electronic health record documentation (R2 = 0.937, F = 8.707, p = 0.004). Once nursing informatics competency was entered into the model, R2 is still the same, making a total explained variance of 93.7% (R2 = 0.937, F = 6.907, p = 0.013). Conclusion: The present study revealed low levels of nursing informatics competency among nurses, and the highest percentage of participants have moderate quality of EHR documentation. In addition, personal and clinical related characteristics account for 93.7% of the variance in the quality of patients’ electronic health record documentation. Implications for Nursing: This study provides evidence to guide nursing leaders, supervisors and policymakers in their planned actions and policies to support nursing capacity, nursing education, and nursing practice in the area of nursing informatics and electronic nursing documentation.

Standardizing nursing data extracted from electronic health records for integration into a statewide clinical data research network

BackgroundCare plans documented by nurses in electronic health records (EHR) are a rich source of data to generate knowledge and measure the impact of nursing care. Unfortunately, there is a lack of integration of these data in clinical data research networks (CDRN) data trusts, due in large part to nursing care being documented with local vocabulary, resulting in non-standardized data. The absence of high-quality nursing care plan data in data trusts limits the investigation of interdisciplinary care aimed at improving patient outcomes. ObjectiveTo map local nursing care plan terms for patients’ problems and goals in the EHR of one large health system to the standardized nursing terminologies (SNTs), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC). MethodsWe extracted local problems and goals used by nurses to document care plans from two hospitals. After removing duplicates, the terms were independently mapped to NANDA-I and NOC by five mappers. Four nurses who regularly use the local vocabulary validated the mapping. Results83% of local problem terms were mapped to NANDA-I labels and 93% of local goal terms were mapped to NOC labels. The nurses agreed with 95% of the mapping. Local terms not mapped to labels were mapped to the domains or classes of the respective terminologies. ConclusionMapping local vocabularies used by nurses in EHRs to SNTs is a foundational step to making interoperable nursing data available for research and other secondary purposes in large data trusts. This study is the first phase of a larger project building, for the first time, a pipeline to standardize, harmonize, and integrate nursing care plan data from multiple Florida hospitals into the statewide CDRN OneFlorida+ Clinical Research Network data trust.

Factors Affecting the Implementation of Nursing Care Plans in Patient Care

Abstract: Background: Nursing Care Plan (NCP) is used in practice as a systematic and scientific problem-solving method to determining the care needs of individuals. There is lack of research on factors affecting regarding utilization of nursing care plan in patient care. Objective: The objective of this study were to evaluate the implementation of the nursing process and to determine the factors that may influence the implementation of the nursing process. Materials and Methods: A cross-sectional survey was conducted at a private hospital during February to June, 2023. The study protocol was reviewed and approved. Permission from institutional heads was sought. Informed consent was obtained before data collection. Simple random sampling method was employed. The data were collected with structured questionnaires whose responses were rated on Likert scale. Data were coded and analyzed using SPSS v25.0. Result: A total 108 nurses participated in the study. Study findings revealed 89% of the nurses were female nurses and 82% possessed diploma in nursing. The knowledge 50.5%, confidence 50.9% and willingness 54.2%, were at borderline good level. Whereas, assessment and diagnosis, planning, implementation, evaluation, and nurses’ views about nursing care planning implementation were at < 50% as poor. There was a moderate positive correlation between knowledge and implementation R-Value 0.312 and confidence and evaluation R-Value 0.246. Barrier to implement nursing process included uncooperative patients, lack of awareness about nursing process, lack of preparedness, low satisfaction level, lack of in-service training, lack of time, and high patient flow. Conclusion: Study’s findings revealed knowledge, confidence and willingness of the nurses determine the use of nursing process in their nursing practice.

The impact of spiritual care delivered by nurses on patients' comfort: A propensity score matched cohort utilizing electronic health record data

BackgroundSpiritual care has been associated with better health outcomes. Despite increasing evidence of the benefits of spiritual care for older patients coping with illness and aggressive treatment, the role of spirituality is not well understood and implemented. Nurses, as frontline holistic healthcare providers, are in a position to address patients' spiritual needs and support them in finding meaning in life. This study aimed to identify spiritual care by analyzing nursing data and to compare the psychological and physical comfort between older chronically ill patients who received spiritual care versus those who did not receive spiritual care. Material and methodsA propensity score matched cohort utilizing nursing care plan data was used to construct balanced groups based on patient characteristics at admission. 45 older patients (≥65 years) with chronic illnesses received spiritual care with measured psychological or physical comfort and 90 matched controls. To ensure the robustness of our results, two sensitivity analyses were performed. Group comparisons were performed to assess the average treatment effect of spiritual care on psychological and physical comfort outcomes. ResultsThe mean psychological comfort was 4.3 (SD = 0.5) for spiritual care receivers and 3.9 (SD = 0.9) for non-receivers. Regression analysis showed that spiritual care was associated with better psychological comfort (estimate = 0.479, std. error = 0.225, p = 0.041). While its effect on physical comfort was not statistically significant (estimate = -0.265, std. error = 0.234, p = 0.261). This study provides suggestive evidence of the positive impact of nurses' spiritual care in improving psychological comfort for older patients with chronic illnesses. ConclusionUsing interoperable nursing data, our findings suggest that spiritual care improves psychological comfort in older patients facing illness. This finding suggests that nurses may integrate spiritual care into their usual care to support patients experiencing distress.

"Eat Enough"-A nurse-led intervention to enhance hospitalized older adults' protein and energy nutrition.

To develop an intervention enhancing hospitalized older adults' nutrition. For the first time, a mixed-methods design with data triangulation was applied according to the six-step model of Corry etal. to elaborate on a complex nursing intervention in the form of a logic model. Patients who were aged ≥80 years and hospitalized for at least 5 days were included. Sample size for quantitative practice analysis was 135 older adults, whereas 22 older inpatients participated in interviews and observations for needs analysis and generated data for key principles. The intervention "Eat Enough" encompasses nursing team culture and comprises six actionable targets to deliver needs-based support and reach required protein and energy intake for hospitalized older adults by sensitizing nurses and the interprofessional team. Facilitating nutritional intake would be supported by an advanced practice nurse who considers the medical and nursing care plan and therapy. The intervention "Eat Enough" demonstrates that nurses play a key role in interprofessional teams to enhance older adults' nutrition in hospital. The pipeline model displays how the actionable targets can be achieved, and how awareness raising can influence the context-leading to raised calories and protein requirement coverages and shorter length of stay. By identifying risk factors of malnutrition and strengthening nurses' responsibilities, the intervention "Eat Enough" could significantly enhance nutrition among hospitalized older adults. However, the logic model should be tested and implemented in future research.

Nursing Care Plan Documentation Status and give Suggestions to Improve the Same

Nursing Care Plan Documentation Status and give Suggestions to Improve the Same

Making Nurses and Nursing Care Visible in Nigeria. A Review of Standardized Nursing Care Plan from the Nurse Len

Making Nurses and Nursing Care Visible in Nigeria. A Review of Standardized Nursing Care Plan from the Nurse Len

Patient-centered health care planning in acute inpatient mental health settings: a best practice implementation project.

The current project aimed to improve the quality of health care by promoting evidence-based practice (EBP) regarding mental health care planning (MHCP) for adult inpatients. The implementation of the best evidence in the process of developing and documenting nursing care plans is currently an important legal requirement that contributes to increasing the quality of care. This implementation project was based on the JBI evidence implementation approach and included a baseline audit of seven criteria, implementation of strategies, and a follow-up audit. The project was conducted in an acute psychiatric setting at a university hospital in Bucharest, Romania. The sample included 17 nurses and 30 ward patients. The baseline audit revealed low compliance (33%-37%) for criterion 3 (a comprehensive care plan) and criterion 4 (patient involvement); moderate compliance (55%) for criterion 1 (care plan for all patients); and increased compliance (97%-100%) for criterion 2 (assessment of patient's needs), criterion 5 (education of patients/caregivers), criterion 6 (providing a copy at discharge), and criterion 7 (education of professionals). As a result of implementing the most appropriate strategies, the maximum improvement (100%) was observed across all five audit criteria that were found to be deficient in the baseline audit. The development and implementation of strategies adapted to specific care need to play a key role in the implementation of EBP. In this case, educating nurses, facilitating nurses' access to EBP for care planning, and improving procedures proved effective in achieving maximum compliance with all the audit criteria.

Nursing care plan on gas exchange impairment due to SARS-CoV-2: case report

INTRODUCTION: Over the years, mankind has been in contact with several viruses, which have threatened human existence by becoming pandemics such as influenza in 1918. However, in January 2020, the Chinese Centre for Disease Control and Prevention identified SARS-CoV-2 as the etiological agent of the 2019 coronavirus. So far it is known that 5% of patients with severe COVID-19 will require attention in intensive care units. To this end, critical care nursing staff use the nursing care process to prioritize the care of the critically ill patient. OBJECTIVE: To develop a nursing care plan by analyzing a clinical case of an adult patient with a diagnosis of COVID-19. METHODOLOGY: The case of a patient with a diagnosis of COVID-19 was analyzed to develop a nursing care process using the taxonomies of the North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification. Documentary research was carried out through a literature search in databases such as: Scielo, Medicgraphic, Google Scholar and PubMed. RESULTS: Three real nursing diagnoses and seven risk diagnoses were identified. The priority nursing diagnostic label based on Maslow's pyramid of needs was deterioration of related gas exchange. CONCLUSIONS: The critical care nurse takes a leading role in the care of patients with a diagnosis of COVID-19, the development of the nursing care process contributes to providing quality care focused on the well-being of the user.

Effectiveness of Standardized Nursing Care Plan on Nurses’ Usability Regarding Quality Nursing Care in Private Tertiary Care Hospital Lahore

Nursing care entails both an art and a science, involving the provision of tailored patient care based on individual healthcare requirements. The nursing care plan is instrumental, serving as a precise guide for nurses in delivering patient-centered, high-quality care. It functions as a roadmap, enabling nurses to monitor the patient's response to treatment and make necessary adjustments to meet medical needs. Challenges such as excessive workload, absence of policies, inadequate resources, understaffing, and unavailability of assessment forms hinder the effective utilization of nursing care plans Objective: To evaluate the effect of standardized nursing care plan on nurses` usability of nursing process during patient care. Methods: A quasi-experimental study was conducted at a Tertiary Care hospital Lahore Pakistan. A stratified Random sample of n=47 participants intervention group was recruited. A validated questionnaire of Nurses’ usability of standardized nursing care plan consisted of 23 items. Data were analyzed through SPSS version 21. Results: Majority of the participants 44.7% (n=21) were between 26-30 years of age, 46.8% of the participants (n=22) had working experience between 1-4 years, 70.2% (n=33) of them having nursing diploma, 23.4% (n=11) were attained Post RN BSN. A significant difference was found between Nurses` usability scores before and after intervention as evident by p=0.000 with mean and SD of 2.8085+0.79778 and 3.7872+0.41369, respectively. Conclusions: It is evident from results that standardized nursing care plan has a significant effect on nurse’s usability that improve the quality of nursing care in Hospital.

Application Development and Content Validation of "SinoBed" for Pressure Ulcer Prevention and Monitoring

Aims: This study aimed to describe the application development and validation of the "SinoBed" application for pressure ulcer prevention and monitoring. Methods: The Delphi technique was used in this study to validate the researchers' content. Twelve specialists willing to help with this research validate the content of the SinoBed application. The experts were invited through email to participate in the study, and they were then issued an electronic form to fill out and return for evaluation. The data collecting tool was created using the Google Forms® platform and included a sociodemographic survey of the participants and an evaluative survey with seventeen closed-ended questions. We used the CVI (Content Validity Index) to check the information and modified kappa. Results: The study involved twenty experts, but only twelve participated. The I-CVI ranged from 0.92 to 1.00. The summary received mostly positive expert assessments throughout the study. The SinoBed app has a collection of five unique algorithms. The topics to be discussed in this paper include: 1) Identification creation, 2) Roles as a patient or nurse, 3) Monitoring position and mobilization, 4) Nursing care plan, and 5) Education. Conclusion: The content supplied in SinoBed® was validated using an expert consensus. The experts determined that the mobile application is suitable for preventing pressure ulcers.

Nursing Approach and Nursing Care Plan in Breastfeeding Mother

Breastfeeding is a natural phenomenon which is showing a global decline in the last few years. Young, new generation mothers are more inclined towards the use of artificial milk for their newborn rather than breastfeeding. Exclusive breastfeeding is not practiced in the Indian sub continent. In this study, we will report 3 incidents of failure of breastfeeding and the role of healthcare providers, especially nurses, in imparting knowledge and education to the young mothers.

Nursing Intervention for the Timing of Catheterization in a Patient with Frequent Abnormal Autonomic Reflexes from Cervical Medullary Injury: A Case Report

Introduction: Cervical medullary injury is a severe type of spinal cord injury that can lead to neurogenic bladder and neurogenic rectum, which increases the risk of autonomic dysreflexia (AD) in patients. Autonomic dysreflexia is a common group of clinical syndromes characterized by autonomic dysfunction after spinal cord injury in the T6 or higher level. If left untreated, AD can lead to severe complications such as hypertensive crisis, paroxysms, intracranial hemorrhage, and even death. Nursing interventions are crucial in selecting the timing of catheterization for a patient with frequent AD during intermittent catheterization for cervical medullary injury, enhancing the overall quality of care for patients with cervical medullary injury. Case Presentation: This study focused on a tetraplegic patient with a cervical medullary injury who developed AD during intermittent catheterization. The factors influencing AD during intermittent catheterization were explored through a literature review, urodynamics, and a bladder scanner. The nursing interventions implemented included active control of AD, personalized assessment of the risk of abnormal autonomic dysreflexia, prevention, early identification, acute episode management, precise bladder management, and implementation of a personalized care plan. After 31 days of treatment, the number of AD episodes was significantly reduced, leakage was decreased, and urine volume was controlled in the normal range with good results. The key points of care included timely control of urine output, selection of the best catheterization timing, and other health education methods. The nursing interventions played an active and effective role in maintaining normal bladder function, and the patient resumed regular intermittent catheterization. Conclusions: Nursing interventions are vital in managing patients with cervical medullary injuries who require intermittent catheterization. A comprehensive nursing care plan that includes personalized assessment and management of AD can significantly improve outcomes for these patients and prevent the occurrence of AD, ultimately leading to a better quality of life.

219: Nursing Care Plan for ECMO Patient Management: Early Experience from a Single Center Program in Ecuador

219: Nursing Care Plan for ECMO Patient Management: Early Experience from a Single Center Program in Ecuador

Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis

Background One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. Objectives To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. Methods A qualitative interview based on Heidegger’s interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. Results The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over pain-related fear were the key factors explaining not being afraid of experiencing pain. Conclusions This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their pain-related fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients’ concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear.

Assessment of Reliability and Validity of a Nursing Tool Used to Examine Knowledge, Attitude, and Practices of Professional Nurses in Writing Nursing Care Plans at a Teaching Hospital in Gauteng Province, South Africa

Background: A nursing care plan is a guideline developed for a patient's needs. A well-documented care plan provides holistic patient-centred care and includes assessing, evaluating, and administering a variety of interventions as well as teaching patients and families. There are existing tools to measure nurses' knowledge, attitude, and practices in writing nursing care plans in many countries. However, cultural differences and most of the tools do not cover region-specific aspects of diseases, making it challenging to be used between countries. Objective: Thisstudy aimed to develop and validate a tool for determining the knowledge, attitudes, and practices of nurses in writing nursing care plans at a teaching hospital in Gauteng province, South Africa. Methods: A cross-sectional study was conducted among 218 registered nurses in selected hospital wards. Reliability was examined using Cronbach alpha and item-total correlation, while validity was assessed using Exploratory Factor Analysis (EFA EFA) and convergent validity. SPSS for Windows (version 10.0; SPSS, Inc., Chicago, IL, USA) was used to analyze data. Results Cronbach's alpha was 0.75 for knowledge, 0.74 for attitude, and 0.77 for practices. The item-total correlation values ranged from -0.203 to 0.742. Kaiser-Meyer-Olkin was 0.877, 0.793, and 0.797 for the three dimensions, respectively and the Bartlett test was significant (p< 0.0001). The EFA showed that all the items had loadings ≥0.5 except for item A1. Knowledge and practice had a good convergent validity. Implications for Nursing Efforts to develop, validate and implement a new instrument to assess nursing knowledge, attitudes, and practice in writing nursing care plans improve communication between nursing staff, and involve patients more in their care, resulting in fewer medical errors and improving the quality of patient care. Conclusion: This study indicates that the tool has satisfactory reliability, and the use of EFA for the investigation of validity is adequate, but one item in the attitude dimension has a lower threshold value. Further confirmatory factor analysis studies with a larger sample size are needed to support construct validity.

Could artificial intelligence write mental health nursing care plans?

WHAT IS KNOWN ON THE SUBJECT?: Artificial intelligence (AI) is freely available, responds to very basic text input (such as a question) and can now create a wide range of outputs, communicating in many languages or art forms. AI platforms like OpenAI's ChatGPT can now create passages of text that could be used to create plans of care for people with mental health needs. As such, AI output can be difficult to distinguish from human-output, and there is a risk that its use could go unnoticed. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Whilst it is known that AI can produce text or pass pre-registration health-profession exams, it is not known if AI can produce meaningful results for care delivery. We asked ChatGPT basic questions about a fictitious person who presents with self-harm and then evaluated the quality of the output. We found that the output could look reasonable to laypersons but there were significant errors and ethical issues. There are potential harms to people in care if AI is used without an expert correcting or removing these errors. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We suggest that there is a risk that AI use could cause harm if it was used in direct care delivery. There is a lack of policy and research to safeguard people receiving care - and this needs to be in place before AI should be used in this way. Key aspects of the role of a mental health nurse are relational and AI use may diminish mental health nurses' ability to provide safe care in its current form. Many aspects of mental health recovery are linked to relationships and social engagement, however AI is not able to provide this and may push the people who are in most need of help further away from services that assist recovery. ABSTRACT: Background Artificial intelligence (AI) is being increasingly used and discussed in care contexts. ChatGPT has gained significant attention in popular and scientific literature although how ChatGPT can be used in care-delivery is not yet known. Aims To use artificial intelligence (ChatGPT) to create a mental health nursing care plan and evaluate the quality of the output against the authors' clinical experience and existing guidance. Materials & Methods Basic text commands were input into ChatGPT about a fictitious person called 'Emily' who presents with self-injurious behaviour. The output from ChatGPT was then evaluated against the authors' clinical experience and current (national) care guidance. Results ChatGPT was able to provide a care plan that incorporated some principles of dialectical behaviour therapy, but the output had significant errors and limitations and thus there is a reasonable likelihood of harm if used in this way. Discussion AI use is increasing in direct-care contexts through the use of chatbots or other means. However, AI can inhibit clinician to care-recipient engagement, 'recycle' existing stigma, and introduce error, which may thus diminish the ability for care to uphold personhood and therefore lead to significant avoidable harms. Conclusion Use of AI in this context should be avoided until a point where policy and guidance can safeguard the wellbeing of care recipients and the sophistication of AI output has increased. Given ChatGPT's ability to provide superficially reasonable outputs there is a risk that errors may go unnoticed and thus increase the likelihood of patient harms. Further research evaluating AI output is needed to consider how AI may be used safely in care delivery.

Nursing Care Plan for Patients with Tay-Sachs-A Rare Paediatric Disease.

Tay-Sachs disease is classified as a rare paediatric disease of metabolic origin. It is an autosomal recessive inherited disease. The gene responsible for the disease is known as HEXA, and it is located on chromosome 15(15q23). There is currently no effective treatment for Tay-Sachs disease; hence, it is an incurable disease in which patients do not live for more than five years, meaning that nursing care takes on greater importance to maintain quality of life. The main objective of this work is to develop a specific standard nursing care plan by applying an inductive research method supported by nursing methodology using the NANDA-NIC-NOC taxonomy and validated by the Delphi method. This care plan will improve the knowledge of health professionals on this topic and support future studies on the disease. Following its implementation, the care plan proposed in this study aims to increase the quality of life of patients diagnosed with this disease.

Changing Mindsets to Create a New Mental Health Nursing Care Landscape

Perception of change is a real and profound out come of the recently ended COVID-19 pandemic. The course of this pandemic was unpredictable and subject to change with no clear end in sight. Thus, "uncertainty" became the only certainty in daily life. The realities of the pandemic necessitated that changes and adjustments be made in our physical, psychological, and emotional states as well as life and work styles, which tested everyone's resilience. Change interpreted through Buddha Siddhartha's "Theory of Dependent Origination" is normal and to be expected. The Buddha believed all "conditioned dharmas" in the world (things that can be seen with form) were not created from nothing and could not exist alone. Instead, they must have been formed through a combination of various causal conditions and, once these conditions disappear, must return again to nothingness. Thus, "All dharmas arise due to conditions, and all dharmas cease due to conditions (Sina Buddhism, 2017)". Because of this, the Buddha believed all things and all phenomena to be impermanent and changing (Master Sheng Yen, 2002). According to the Buddha, change is normal and impermanence is permanent. As such, the practice of mental healthcare has not been passively changed by the epidemic, but has always been changing continuously and proactively. The process of treating and restoring to health in patients with mental illness is actually a long and arduous journey, and mental health nurses play a very important role throughout this long process of recovery. We abandon the traditional treatment and care model that only focuses on mental disorders and symptoms, and instead adopt the concept of holistic healthcare (Mandal et al., 2020), which focuses on patient physical, psychological, social and spiritual aspects, helping them achieve whole person wellness (Swanson et al., 2019). Each patient should be regarded as a unique individual not only in terms of their disease diagnosis, symptoms, physical and mental states, understanding, and communications but also in terms of their socioeconomic status, family support, and social resources. Because of this, nursing care plans should not be institutionalized or mechanistic, but rather allow flexibility to address each patient's current condition. Through comprehensive and integrated care and consultation and interdisciplinary teamwork, the psychiatric and mental health nurses work hard to ensure every patient and family member who receives care is satisfied in terms of their physical, psychological, social, and spiritual needs. Another aspect of change is the adoption by mental health nurses of a more active, more professional, larger pattern, and broader vision of their professional services. After all, mental patients may not necessarily fully understand their needs. As mental health professionals, we can develop our professional sensitivity. Moreover, while devoting ourselves to helping patients move towards holistic health and providing holistic care for patients, we should also try our best to detect and pay attention to whether current mental-health-related policies, medical system norms, or usual modes of operation may be ignoring patient needs or increasing the obstacles encountered in the rehabilitation process. In addition, we should try to seek strategies to change the situation, advocate for the health and well-being of patients, and improve the quality and effectiveness of overall mental healthcare. In this issue, four professors respectively discuss issues related to mental health policy, clinical practice, community rehabilitation and employment support, and the expansion of the professional role and service field of mental health nursing. These authors share how the field and functions of mental healthcare can change and evolve along a positive path forward. They not only provide direction and light but also show the results of their efforts.

Family Needs and Their Satisfaction in The Intensive Care Unit Hospital University Sains Malaysia (HUSM) Kubang Kerian Kelantan, Malaysia

A holistic approach to critical care nursing requires that the family be included in the plan of care. Once the patient has been admitted to the critical care unit, an assessment of the family provides valuable information for the preparation of the nursing care plan. Therefore, this study intends to gain information about the level of the family need and their satisfaction in the Intensive Care Unit Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian Kelantan, Malaysia. A cross-sectional study design with 111 respondents was selected using convenience sampling. The inclusion criteria: The patient’s family came to accompany them in the ICU ward; volunteer participate in this study. The questionnaire is divided into two sections: Part A: Demographic data and part B: Critical Care Family Needs Inventory (CCFNI) questionnaire was administered to all consenting relatives of ICU patients to determine the family needs. The frequency, mode, mean, standard deviation, and Pearson's correlation coefficient were measured. The correlation analysis revealed a significant positive correlation between family satisfaction and family needs. There was a significant correlation between family satisfaction and family need the p-value is .001. In an intensive care unit, family members' top five needs are support, proximity, comfort, information, and assurance. Support is presently in first place on the ranking. Family needs and satisfaction is commonly taken care of at ICU HUSM. The information gathered can be used to improve ICU services. Therefore, nurses must have trusting relationships with family members and be proactive to contribute to satisfaction.