Nursing Patients Research Articles

Feasibility of Administering Anti-CD45 Iodine (131I) Apamistamab [Iomab-B] for Re-Induction and Targeted Conditioning in Older Patients with Active, Relapsed or Refractory AML without Lead-Lined Rooms: Sierra Trial Experience at MSKCC

Background: Patients ≥55 years of age with active, relapsed or refractory acute myeloid leukemia (R/R AML) who have failed standard induction and salvage therapies do not routinely undergo allogeneic hematopoietic cell transplantation (HCT) due to their inability to receive myeloablative conditioning and lack of efficacy. The SIERRA trial is a prospective, randomized, phase 3, open-label, multicenter trial designed to address this significant unmet need. Preliminary results have shown the re-induction and targeted conditioning therapy with Iomab-B can lead to successful engraftment. Because of the administered activity of 131I (300-1030 mCi, mean ~600 mCi), patients are isolated for several days after the drug administration before being discharged. Radiation safety procedures with rolling lead shields and blankets were implemented to ensure compliance with local regulations for therapeutic radioisotopes and the safe administration of Iomab-B. Methods: A corner room with private bathroom was selected as the patient room for drug administration and patient isolation. The room was prepared to prevent radioactive contamination. Rolling lead shields were utilized depending on the room configuration: 2 shields against the patient emitting radiation and closer to the door, or 3 shields total with 1 additional shield by the nurses' work station in the room. Lead blankets were placed under the patient bed. Extensive radiation safety training was provided to nursing staff who interacted with Iomab-B patients. The administration was performed in the room using an automatic pump system with Iomab-B drug vial placed in a lead pig during infusion (4-5 hours). Radiation dose rates at several locations were measured at the completion of administration. Radiation doses to nurses who provided care to patients were monitored with personal dosimeters throughout the course of treatment, while the patients remained in radiation isolation. Results: 10 Iomab-B patients were treated with 788 ± 192 (range: 543-1069 mCi). Exposure survey results were taken within 2 hours after therapeutic infusion outside the patient door (mean 0.64, range 0.06-1.95 mrem/hr) the hallway (0.01 mrem/hr, background levels) adjacent rooms (mean 0.747, range 0.2-1.82 mrem/hr) as well as above (mean 0.986, range 0.5-1.6 mrem/hr) and below (mean 1.398, range 0.81-1.88 mrem/hr) the room. All the exposure survey results were below the regulated public area limit, 2 mrem/hr. The dose to inpatient nurses caring for the patient was 9.42 ± 6.6 (range: 1-27 mrem), which is minimal comparing to annual occupational dose limit of 5,000 mrem. The rooms were surveyed for contamination after the patient was cleared from radiation isolation and removable surface contamination was below 200 dpm/100cm2, lower than the limit of 24,00 dpm/100cm2 Conclusion: The use of rolling lead shields and implementation of specific radiation safety procedures allows for the safe administration of Iomab-B and enable treatment of patients without the need for lead-lined rooms. Table Disclosures Pandit-Taskar: Y Mabs: Consultancy, Honoraria; Fusion Pharmaceuticals: Consultancy, Honoraria; Progenics: Consultancy, Honoraria; Medimmune: Consultancy, Honoraria; Actinium Pharmaceuticals, Inc: Consultancy, Honoraria. Gyurkocza:Actinium Pharmaceuticals: Research Funding. Liang:Actinium Pharmaceuticals: Employment. Reddy:Actinium Pharmaceuticals: Employment. Berger:Actinium Pharmaceuticals, Inc: Employment, Equity Ownership. Dauer:Actinium Pharmaceuticals, Inc: Other: MSKCC - NIH/NCI Cancer Center Support Grant P30 CA008748, Research Funding.

"You're kind of at war with yourself as a nurse": Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder.

In the midst of an opioid epidemic, health care workers are encountering an increasing number of patients who have opioid use disorder in addition to complex social, behavioral and medical issues. Of all the clinicians in the hospital, nurses spend the most time with hospitalized patients who have opioid use disorder, yet there has been little research exploring their experiences in caring for this population. The objective of this study was to assess the attitudes, perceptions, and training needs of nurses in the inpatient setting when caring for patients who have opioid use disorder. One-on-one in-depth interviews were conducted with nurses working at a large academic medical center in Boston, MA, using a semi-structured interview guide. Nurses were recruited via email notifications and subsequent snowball sampling. Interviews were recorded, transcribed and analyzed using a grounded theory approach. Data from in-depth interviews with 22 nurses were grouped into six themes: (1) stigma, (2) assessing & treating pain, (3) feelings of burn out, (4) communication between providers, (5) safety & security, and (6) opportunities for change. These themes were organized within four ecological levels of the Socio-Ecological Model: I) societal context, II) hospital environment, III) interpersonal interactions, and IV) individual factors. Nurses were cognizant of the struggles that patients who have opioid use disorder confront during hospitalization such as pain, withdrawal and stigma, and elaborated on how these challenges translate to professional and emotional strain among nurses. Nurses offered recommendations by which the hospital could streamline care for this population, including expanded role support for nurses and more structured policies regarding care for patients who present with a comorbid opioid use disorder. Our results highlight the need for the development of programs targeting both organizational culture and the inpatient nurse quality of life to ultimately enhance quality of care for patients who present with opioid use disorder.

2038. Antimicrobial Stewardship (AS) Recognition, Confidence, and Organizational Factors: Multi-center Survey of Bedside Nurses

BackgroundThere is no literature on practices nurses associated with AS processes and how patient safety culture influences nursing AS understanding and confidence.MethodsThis cross-sectional study used an investigator-developed survey with optional comments to describe how bedside nurses recognize and perceive their confidence performing nursing activities that support AS processes and the potential role of organization culture as an AS engagement factor. 9 hospitals ranging in size from 42 to 562 beds participated. Composite scores for practice, confidence, and safety were calculated and correlated. ANOVA with Tukey HSD post-hoc tests and non-parametric (Kruskal–Wallis) tests with Bonferroni adjusted P-values for multiple comparisons were used to evaluate differences by clinical unit and years of clinical experience.ResultsA total of 558 inpatient nurses participated (response rate 13%). A significant positive association was identified between nurses’ beliefs about nursing practices that contribute to the antibiotic stewardship process and their perceived confidence to perform rs = 0.454, P < 0.001. Nurses ≤5 years of experience were significantly less confident than those with >15 years of experience in: (a) assessing for a history of an adverse drug reaction (P = 0.049, P = 0.023), (b) reviewing preliminary microbiology results and comparing susceptibilities (P = 0.011, P < 0.001), and (c) notifying a provider of a wrong antibiotic dose (P = 0.011, P = 0.017). Medical/surgical nurses (P = 0.003 recognized that taking an allergy history contributes to the stewardship process significantly more than ICU respondents and were more confident, in assuring that cultures are obtained prior to antibiotic administration (P = 0.038). Free text comments indicated: organizational factors (n = 50), knowledge gap (n = 35) and poor communication (n = 11) impeded AS engagement.ConclusionThis is the largest multi-site study on nursing stewardship practice that includes organizational culture as a factor influencing behavior to steward. The results identify interprofessional collaboration is needed to improve organizational factors so nurses can serve as powerful AS collaborators in this important patient safety effort.Disclosures All authors: No reported disclosures.

Compassion Fatigue and Satisfaction: Influence on Turnover Among Oncology Nurses at an Urban Cancer Center.

Oncology nurses are exposed to stressors that may contribute to compassion fatigue (CF), leading to high rates of turnover, potential financial implications for organizations, and concerns for patient safety and employee well-being. The purpose of this study was to explore the relationship among CF, compassion satisfaction (CS), and turnover intention in a sample of 93 inpatient oncology nurses at a 90-bed urban cancer center. Data were collected using paper surveys. CS, secondary traumatic stress, and burnout were measured using the Professional Quality of Life-Version 5 scale, and turnover intention was determined using the Turnover Intention Scale-6. Burnout and CS were found to be significantly predictive of turnover intention. Strategies to reduce CF individually and organizationally may improve patient and employee well-being.

Understanding the nature of mental health nursing within CAMHS PICU: 2. Staff experience and support needs

In the UK and other western countries, child and adolescent care is increasingly understood as a distinct speciality. Internationally, inpatient units are the most widely used element of acute adolescent mental health services. Child and adolescent mental health inpatient nursing has been identified as unique, and yet there is a dearth of research investigating the role of nursing in adolescent mental health inpatient units and its impact. This is the second of a two papers presenting findings from a first of its kind, qualitative study investigating into the nature of mental health nursing within a child and adolescent mental health service psychiatric intensive care unit (CAMHS PICU). A qualitative conceptual analysis design was used. Findings relating to understanding of staff experience of their work and their support needs are presented. Results indicate there is significant emotional labour generated from the detailed and intense relationally-focused work with young people; responsible for both a sense of value and job satisfaction, and corrosion of staff capacity to sustain these interventions over the longer term. The central role of projective identification and the specific support requirements that emerge from these intrapersonal dynamics are explored. A conceptual model of CAMHS PICU nursing is proposed, synthesised from findings in the two parts of this series.

National Diabetes Audits inform best practice for diabetes foot care and hospital inpatients

National Diabetes Audits inform best practice for diabetes foot care and hospital inpatients

Inpatient Nurses’ Perception on The Implementation of Acute Care Nursing in The Hasanuddin University Hospital

Introduction: Acute care is a type of time-sensitive care, this is due to an acute condition requiring rapid intervention. Acute conditions that exist in the inpatient unit would require special care in handling. This acute condition can affect many things, one of which is the patient satisfaction. With proper treatment for acute cases, the course will improve patient satisfaction itself. However, to date, acute care has been poorly defined and inadequately supported in most developing health systems. Aims of Study: This research aims to determine nurses’ perception on the implementation of inpatient acute nursing care in the Hasanuddin University Hospital. Method: This research was a qualitative method, data collection using individual interviews against ten participants (inpatient nurses) and validity checks of the data that utilizes something beyond the data. Data analyze used thematic analysis. Result: The results of the research yield four themes. Those four themes are perception of acute conditions, supporting factors in the management of patients with acute conditions, inhibiting factors in the management of patients with acute conditions, and nurses’ hope for acute care. Conclusion: From this research it is known that the incidence of acute conditions in the inpatient unit of Hasanuddin University Hospital less than chronic conditions. To handle acute cases, nurse in the inpatient unit take action early by monitoring vital signs, then immediately gave emergency action if necessary, while collaborating with the doctor. Supporting factors for nurses is the availability of emergency trolly, as well as cooperation among nurses who are good. Whereas the inhibiting factor is the number of nurses who are still lacking and the absence of code blue team. Advice from researchers, to health institutions is expected to be able to form a rapid response team (code blue), so that patients with serious/acute condition can be handled more quickly and efficiently, so that the implementation of nursing, especially nursing acute to run well and the nurse also will not experience in serving patients overwhelmed.

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

In recent times, policies stemming from the American Recovery and Reinvestment Act of 2009 have served as a stimulus for healthcare organizations to adopt an electronic medical record. As a result, nurses are now more knowledgeable of and experienced with an electronic medical record. In August 2016, our facility converted from instructor-led training to electronic learning for inpatient nurse electronic medical record training, hoping to capitalize on previous experience with the clinical information system. However, a complete program evaluation of this transition had yet to be conducted. The purpose of this study was to evaluate electronic learning usability and the return on investment of an electronic medical record training conversion. Evaluations of electronic medical record electronic learning training were collected from 75 newly hired, inpatient nurses from November and December 2017, and compared to our instructor-led program. Results showed that users found it effective and were satisfied with this training method. The electronic learning had superior efficiency, reducing training time by ~50% compared to instructor-led training, while proving to yield effectiveness and satisfaction. The return on investment was $18 540, with a gain of 593.25 hours in nursing time during the study period of two months. These results support the organizational decision to convert to electronic learning, further supporting the conversion for other clinical roles.

A Comparison of Attitudes and Practice between Pediatric Nurses and Respiratory Therapists in Addressing Tobacco Smoke Exposure during an Inpatient Pediatric Hospital Stay

Background Second and third hand smoke exposure is a major issue in pediatrics. Growing evidence supports smoking cessation interventions in pediatric hospitals. Little is known about the role of inpatient pediatric nurses (RN’s) and respiratory therapists (RT’s) in smoking cessation interventions for parents and caregivers of hospitalized children. Purpose We seek to improve our understanding of nurse and respiratory therapists attitudes and activities around smoking cessation during a child’s hospitalization. Aim 1: Identify and compare current …

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

Interventions delivered by nurses in adult outpatient psychiatric care: An integrative review.

WHAT IS KNOWN ON THE SUBJECT?: In many countries, the majority of psychiatric care is being delivered in an outpatient setting and the proportion of outpatients is increasing on a global level. Nurses are the largest workforce in psychiatric care, but their role has been said to be difficult to define. According to our knowledge, there are no previous reviews focusing on nurse-delivered interventions in the adult psychiatric outpatient setting. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This review summarizes nurse-delivered interventions identified in the research literature and describes these systematically. Analysing all the identified interventions using the Nursing Interventions Classification, we conclude that the emphasis of nurse-delivered interventions in psychiatric outpatient care is on interventions aiming at improving the functioning of both patients and their family members by building on their own strengths. These findings differ from those presented in a review on inpatient psychiatric nursing. There are several clinical trials describing nurse-delivered evidence-based treatments, such as psychoeducation for patients and their family members in the case of patients diagnosed with schizophrenia and bipolar disorder. The quality of randomized controlled trials was higher than in earlier reviews describing psychiatric nursing interventions in general or in connection with a specific patient group. Further clinical trials are needed to describe the role of nurses in the care of patients diagnosed with depression and in the use of web-based interventions. Additionally, it would be important to study what supports, and on the other hand hinders, the role of nurses in delivering evidence-based treatments at the clinical level. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can play a central role in responding to the growing demand for evidence-based practices in adult outpatient psychiatry, by delivering treatments for patients and family members. It is important that both nursing education and clinical practices recognize and support this role. Abstract Introduction According to our knowledge, there are no previous reviews on nurse-delivered interventions in the adult psychiatric outpatient setting. Aim To identify and systematically describe and analyse nurse-delivered interventions based on research literature. Method An integrative review. Results This review included 60 studies, of which 46 were intervention studies, including 40 clinical trials. The most common patient groups were patients diagnosed with schizophrenia and bipolar disorder. The nursing interventions described in the studies resembled a total of 68 interventions from the Nursing Interventions Classification. The treatment delivery methods varied and treatments often lacked a clear theoretical background. Implications for practice The core of nurse-delivered interventions identified in research literature in psychiatric outpatient care is on interventions aiming at improving the functioning of both patients and their family members by building on their own strengths. These findings differ from the interventions identified in a review describing nursing in the inpatient setting. There are high-quality clinical trials describing nurse-delivered treatments for patients diagnosed with schizophrenia and bipolar disorder. These include evidence-based treatments such as psychoeducation. Understanding of how these treatments are transferred in clinical practice is missing. Clinical trials describing nurse-delivered web-based interventions and interventions for patients diagnosed with depression are needed.

Hospital-to-Homecare Videoconference Handoff: Improved Communication, Coordination of Care, and Patient/Family Engagement.

Transitions of care between settings and clinicians are a time of vulnerability for patients, and can result in fragmented care, medication errors, avoidable readmissions, and patient/nurse dissatisfaction. Through the use of technology and a structured face-to-face handoff, the patient and family can be engaged in the transition across settings. The purpose of this project was to determine the feasibility and effectiveness of videoconference handoffs between inpatient, case management, and home care nurses, and the patients/families during transitions of care from hospital to home care. Videoconferences were conducted for 2 months with patients transitioning from two pediatric inpatient units to the hospital-based home care agency. The nurses and patient/family connected through a secure cloud-based videoconferencing platform. Participants discussed the patient's status, safety concerns, ongoing plan of care, what the patient/family could expect at home, and the coordination of equipment/supply needs and postdischarge visits. Videoconference handoffs (n = 10) were found to be feasible and address gaps in communication, coordination of care, and patient/family engagement during transitions from hospital to home care. Postpilot, nurses agreed the videoconference handoffs should continue with minimal modifications.

Fatigue and nurses’ work patterns: An online questionnaire survey

BackgroundFatigue resulting from shift work and extended hours can compromise patient care and the safety and health of nurses, as well as increasing nursing turnover and health care costs. ObjectivesThis research aimed to identify aspects of nurses’ work patterns associated with increased risk of reporting fatigue-related outcomes. DesignA national survey of work patterns and fatigue-related outcomes in 6 practice areas expected to have high fatigue risk (child health including neonatology, cardiac care/intensive care, emergency and trauma, in-patient mental health, medical, and surgical nursing). MethodsThe 5-page online questionnaire included questions addressing: demographics, usual work patterns, work in the previous two weeks, choice about shifts, and four fatigue-related outcomes – having a sleep problem for at least 6 months, sleepiness (Epworth Sleepiness Scale), recalling a fatigue-related error in clinical practice in the last 6 months, and feeling close to falling asleep at the wheel in the last 12 months. The target population was all registered and enrolled nurses employed to work in public hospitals at least 30 h/week in one of the 6 practice areas. Participation was voluntary and anonymous. ResultsRespondents (n = 3133) were 89.8% women and 8% Māori (indigenous New Zealanders), median age 40 years, range 21–71 years (response rate 42.6%). Nurses were more likely than New Zealand adults in general to report chronic sleep problems (37.73% vs 25.09%, p < 0.0001) and excessive sleepiness (33.75% vs 14.9%, p < 0.0001). Fatigue-related error(s) in the last 6 months were recalled by 30.80% and 64.50% reported having felt sleepy at the wheel in the last 12 months.Logistic regression analyses indicated that fatigue-related outcomes were most consistently associated with shift timing and sleep. Risk increased with more night shifts and decreased with more nights with sleep between 11 p.m. and 7 a.m. and on which nurses had enough sleep to feel fully rested. Risk also increased with roster changes and more shift extensions greater than 30 min and decreased with more choice about shifts. Comparisons between intensive care/cardiac care and in-patient mental health nursing highlight that fatigue has different causes and consequences in different practice areas. ConclusionsFindings confirm the need for a more comprehensive and adaptable approach to managing fatigue. We advocate an approach that integrates safety management and scientific principles with nursing and management expertise. It should be data-driven, risk-focused, adaptable, and resilient in the face of changes in the services required, the resources available, and the overall goals of the healthcare system.

PENGARUH ROLE CONFLICT TERHADAP KEPUASAN KERJA PADA PERAWAT RUMAH SAKIT TINGKAT III dr. REKSODIWIRYO PADANG DENGAN WORK FAMILY CONFLICT SEBAGAI VARIABEL MEDIASI

This study aims to determine the effect of Role Conflict on nurse job satisfaction with work family conflict as a mediating variable. The variables of this study include role conflict, job satisfaction and work family conflict. This research is a quantitative explanatory study. This study reaches out to inpatient nurses who are married RS Level III Dr. Reksodiwiryo Padang with a total sample of 70 nurses. The sample was obtained by the total sampling method. Data was obtained directly through respondents using a questionnaire. Data analysis includes descriptive analysis and inductive analysis which is used using SPSS.16. this study showed role conflict had a positive and significant effect on work family conflict, work family conflict had a negative and significant effect on job satisfaction and role conflict had a significant negative effect on nurse job satisfaction through work family conflict as a madiation variable. Role conflict cannot directly influence work satisfaction but must work through conflict family.Keywords: Conflict Role, Job Satisfaction, Work Family Conflict

Nurse Vigilance: A Three-Part Simulation Course to Decrease Cardiopulmonary Arrests Outside Intensive Care Units.

Early recognition of and prompt intervention for the deteriorating pediatric patient remains paramount in preventing cardiac arrests from occurring outside intensive care units. To decrease these events, we developed a three-part simulation-based blended learning course consisting of a computer-based training module, a simulation scenario, and follow-up in situ scenarios for inpatient nurses. After initiation of the course, our facility has seen a decrease in the number of codes outside critical care areas.

A Prenatal Clinic Collaborates With Drug Treatment Programs to Improve Mother–Child Outcomes

As a result of the current opioid crisis, hospitals and clinics are experiencing increased numbers of prenatal women enrolled in methadone or buprenorphine programs or using illicit drugs. Many hospitals are changing their practice in caring for these women and their families by encouraging rooming-in, breastfeeding, shorter lengths of stay, and less medication for newborn withdrawal. As those changes were made at Yale New Haven Hospital, it was acknowledged that partnerships between the Women’s Center clinic and local drug treatment programs would be an important component of the new plan of care for the families, as they have frequent contact with these women. Before this program, there was very little interaction between the clinic and the program. The care coordinator in the Women’s Center began to reach out to the local clinics when a patient presented for prenatal care. She verified doses and compliance with the program. Over time, a relationship developed and a team from the hospital went to the drug treatment programs to provide in-services about changes in the care of the families. Three clinics decided to collaborate with the prenatal clinic and began biweekly case management meetings. Patients agreed to be discussed and were aware of the collaboration. Each current patient was discussed, and concerns were addressed immediately. Patients signed release-of-information documentation at both sites and named the program “the pregnancy team.” The drug treatment programs are identifying pregnancy earlier and facilitating entry to prenatal care. Seventy-five percent of the patients at these three sites have entered care in the first trimester. If patients miss prenatal appointments, the team works to re-engage in care by contacting the program. Patients are seeking out education in the clinic, and the no-show rate for prenatal care has decreased by 58%. Patients are receiving consistent messages across the continuum and have expressed positive comments. Patient satisfaction is not measured in this clinic. The model can easily be replicated at other prenatal practices. Inpatient nurses are very pleased that patients are well prepared for their hospitalization and understand the expectations. When patients enter care earlier, it allows for more preparation and education time.

PENGARUH LINGKUNGAN KERJA DAN BEBAN KERJA TERHADAP BURNOUT PADA PERAWAT RSUD KARDINAH KOTA TEGAL

This study aims to examine and analyze whether there is influence of the working environment and workload against exhaustion in nurses. Observed object are ministerial government agencies that district general hospitals. The sample in this study is a hospital nurses Kardinah Tegal City with a number of 201 nurses as respondents, which consisted of 140 nurses inpatient and 61 outpatient nurse. The sampling technique in this study is purposive sampling and analysis method used is multiple linear regressions. Results of analysis showed the environment variabel inpatient nurses working in a negative influence on weariness.While working environment variabel on an outpatient nurse has no effect on tension. Variable capacity of nurses inpatient and outpatient positive effect on burnout. Of this study obtained a value of 0,525 or 52,5%. It means that 52,5% of burnout variables can be explained by the independent variables are the working environment and workload. The residual 47,5% is explained by other variable outside variable examined.

001–Understanding Stress of Inpatient Nurses Caring for Pediatric Diabetes Patients

Background: With the opening of an outpatient Pediatric Diabetes Center, patients with diabetes were more often being admitted. In order to focus inpatient nurse education, we wanted to understand their level of comfort with diabetes management. Aims: This Quality Improvement (QI) project’s goal was to understand and reduce the stress levels of inpatient nurses caring for pediatric diabetes patients by assessing stress and providing educational in-services over 12 months. Methods: The diabetes team provided in-services for pediatric medical (PM) and intensive care unit (PICU) nurses. Pre-education, nurses reported stress related to each diabetes topic using a stress thermometer (stress assessing tool, 0=mild, 10=severe). Education included: pathophysiology, meters, injections, insulin pens, vial/syringe, hyperglycemia, ketones, hypoglycemia, carbohydrate counting, calculating insulin doses, technology, and overall management. Nurses were also administered a stress thermometer post-education. Results: Aspects of diabetes care most stressful were identified. For PM nurses, average stress scores decreased from pre to post education for the topics that had the highest stress: technology (4.7 vs. 3.9), pathophysiology (4.0 vs. 2.7), and carbohydrate counting (3.9 vs. 3.4). For PICU nurses, average stress scores decreased from pre to post education for: pathophysiology (5.5 vs. 2.7), meters (4.2 vs. 2.2), hyperglycemia (4.0 vs. 2.8), and hypoglycemia (4.0 vs.1.4). However, the average stress score increased for PICU nurses from pre to post education for the topic of carbohydrate counting (4.0 vs. 4.7). Conclusions: Post-education, nurses’ average stress mostly decreased however the most stressful topics differed between PM and PICU nurses. Also, the stress level increased for one of the topics for the PICU nurses. This may indicate many were not aware of the magnitude of knowledge needed or education provided was not suited for them. These findings furthermore suggest it is necessary to develop educational tools targeted to the type of care delivered on the unit. Clinical Implications: Diabetes management requires in-depth education. The stress thermometer is a useful tool to evaluate nurses’ stress levels and understand where to focus education.

Educating Multidisciplinary Care Teams, Patients, and Caregivers on CAR T-Cell Therapy.

Two anti-CD19 chimeric antigen receptor (CAR) T-cell therapies are approved for adults with relapsed or refractory large B-cell lymphoma after more than two lines of therapy. Although CAR T-cell therapy has demonstrated significant efficacy for some patients, the treatment process can be long and complex and each phase is associated with unique challenges. Care for patients receiving CAR T-cell therapy also involves many health-care players, including physicians, advanced practitioners, nurse coordinators, nurse educators, apheresis nurses, inpatient and outpatient nurses, cellular therapy technologists, case managers, social workers, and many more. Dedicated educational efforts for patients, caregivers, and clinical providers that make up the multidisciplinary care team are warranted for optimal treatment. Here we present an overview of key elements for education along the treatment journey with CAR T-cell therapy, including considerations for each stage of therapy and specific recommendations for care teams, patients, and caregivers. We also present examples of educational programs that have been implemented at our institution.

Analisis Faktor-Faktor yang Mempengaruhi Penerapan Berpikir Kritis Perawat dalam Melaksanakan Asuhan Keperawatan di Rumah Sakit

Critical thinking skills is a very essential ability in providing services to patients. Factors that can influence critical thinking skills include physical condition, motivation, anxiety, habits, intellectual development, consistency, feelings, and experience. These factors can provide positive support or can reduce critical thinking skills. The purpose of the study was to analyze the factors that influence the application of nurses' critical thinking skills in implementing nursing care to patients. Crossectional research design. The study population was inpatient nurses and a total population sample of 113 nurses. The results of this study (73%) were female, (78%) education was not Ners, (91%) were married, (57%) were civil servants, (53%) were more than 30 years old, (58%) were working long &lt; 6 years. There was a significant relationship between sex factors (p. 005), duration of work (p. 0,045), motivation (p. 0.015), anxiety (p. 0.008), intellectual development (p. 001), and experience (0.002) towards the application of critical thinking nurses in implementing nursing care. There was no significant relationship between factors of age, education, marital status, employment status, physical condition, feelings, habits, consistency in the application of nurse critical thinking in implementing nursing care (p value&gt; 0.005).The intellectual development of nurses can improve critical thinking which is the most dominant in implementing nursing care.&#x0D;