Nursing Support Research Articles

Abstract 4138578: NICE-Support program effectively improves symptom and psychological distress in patients with heart failure

Background: Patients with heart failure may suffer from symptom distress, affecting their overall quality of life and psychological well-being including depression. Limited researches focused on the effects of intervention on symptoms and psychological distress for patients with heart failure. Research Hypothesis: Nutritional education and exercise intervention can significantly improve symptoms and psychological distress in patients with heart failure. Aims: To investigate the effectiveness of the Nutrition Instruction Combined Exercise and Support program (NICE-Support) on symptom and psychological distress in patients with heart failure. Methods: This randomized controlled trial recruited 240 patients with heart failure from two medical centers in Taiwan by convenience sampling. Participants were divided into two subgroups based on participation in the "Post-Acute Care Integration Program (PAC)." Each group was randomly assigned to the experimental group and control group, including PAC, PAC+NICE, N-PAC, and N-PAC+NICE groups. The experimental group received a 12-week NICE-Support intervention, encompassing nursing instruction, nutritional counseling, exercise, and support. The control group followed routine hospital care. Data were collected through a structured questionnaire, including basic information, the Heart Failure Symptom Distress Scale, Hospital Anxiety and Depression Scale at baseline, 4, 12, and 24 weeks after enrollment. Data were analyzed using SPSS 24, including descriptive, t-tests, one-way ANOVA, Pearson correlation coefficients, chi-square tests, and generalized estimating equations. Results: The overall symptom distress score was 45.02 (SD = 13.50). Anxiety and depression were reported in 23.8% and 30.9% patients, with the mean anxiety and depression score of 5.01 (SD = 4.50) and 5.98 (SD = 4.16), respectively. Compared with the N-PAC control group, the PAC+NICE group and N-PAC+NICE group exhibited significant greater improvements in symptom distress at 4, 12, and 24 weeks post-intervention, while the N-PAC+NICE group showed statistically significant greater improvement in anxiety at 12 and 24 weeks. Conclusion: The NICE-Support program effectively improves symptom and psychological distress in patients with heart failure and could implement in patients with heart failure.

Future Nurses in a Changing Climate: Exploring the Relationship Between Environmental Literacy and Climate Anxiety.

Climate change significantly impacts public health, increasing the prevalence of respiratory, cardiovascular and mental health issues. Nurses, as frontline healthcare providers, need strong environmental literacy to manage these health challenges. This study explores how environmental literacy among nursing students relates to climate anxiety, aiming to improve educational strategies and mental health support for future nurses. Is to investigate how environmental literacy among nursing students affects their levels of climate anxiety. A cross-sectional survey was utilised on a representative sample of 620 nursing students from each academic year. Climate anxiety scale and the environmental literacy scale for adults were used to collect data. Environmental literacy and its components were positively linked to cognitive-emotional and functional impairments and climate anxiety. Gender differences were observed, with females experiencing higher climate anxiety. Increased environmental literacy generally reduced climate anxiety, particularly in females, emphasising gender differences in environmental literacy's impact on climate anxiety. Despite the model's low explanatory power (R2 = 0.026), the findings highlight the importance of gender differences in the relationship between environmental literacy and climate anxiety. Nursing students show promise in their environmental knowledge but face significant climate anxiety. Gender differences in anxiety levels warrant attention. Addressing these concerns is crucial for preparing nurses to effectively address climate change's health effects and ensuring a resilient healthcare system. The study underscores the importance of integrating environmental literacy into nursing education and promoting pro-environmental behaviours among nursing students and professionals. It highlights the crucial role of mental health support services, policy advocacy and ongoing research in addressing climate anxiety and preparing nurses to tackle the health impacts of climate change. No patient or public involvement.

Perceived Stress and Coping Strategies for Frontline Nurses Caring for COVID-19 Patients: A Path Analysis.

This cross-sectional study explored the relationships among perceived stress, social support, positive coping, and mental health in frontline nurses caring for patients with COVID-19 in China. A quantitative cross-sectional study. A convenience sample of 339 eligible frontline nurses was identified from a designated hospital for COVID-19 in Shanghai, China, between May 2022 and August 2022. Data from nurses were collected through an online survey that contained 4 measurement domains: perceived stress, social support, coping strategies, and mental health. Path analysis was used to analyze the data in SPSS 24.0 and AMOS 23.0. The model tested in the path analysis fit the data well. The results demonstrated relationships among perceived stress, social support, positive coping, and mental health among frontline nurses caring for patients with COVID-19. Social support had a positive effect on positive coping strategies and a negative effect on perceived stress and mental health. In addition, path analysis indicated that social support moderated the relationship between perceived stress and mental health in nurses. Nurses experienced work-related mental stress while providing COVID-19-related care. Based on study findings, social support is expected to play a key role in stress management in nurses. Expanding opportunities for social support is an essential step for nurses to improve their mental health and quality of life.

Mediating role of resilience on burnout to well-being for hospital nursing staff in Northeast China: a cross-sectional study

ObjectivesThe well-being of nursing staff is closely related to nursing performance and patient safety. It has attracted much attention from nursing managers and researchers. However, the most important influencing factors...

Mediating Effect of Job Burnout on the Relationship Between Organisational Support and Quiet Quitting in Nurses.

The main purpose of this study was to investigate the potential mediating role of job burnout in the relationship between organisational support and quiet quitting among nurses. Additionally, this study aimed to determine the associations between organisational support, job burnout and quiet quitting. This study was a descriptive, cross-sectional study. This descriptive and cross-sectional study included a total of 383 nurses. The convenience sampling method was used, and the study was conducted in Türkiye. Self-reported measures, which included organisational support, job burnout and the quiet quitting scale, were completed by using an online version of the scale. Statistically significant associations were found between organisational support, job burnout and quiet quitting. Organisational support had a significant negative effect on quiet quitting. Additionally, job burnout had a positive effect on quiet quitting behaviour. Moreover, job burnout partially mediated the relationship between organisational support and quiet quitting. The findings highlight the importance of considering job burnout as a critical factor in mitigating the positive effect of organisational support on quiet quitting. Prioritising the job burnout of healthcare workers plays a significant role in reducing quiet quitting behaviour through organisational support. This study focused on how organisational support and burnout interact with quiet quitting, which is a current issue among nurses, and explained the mediating role of job burnout in the relationship between organisational support and quiet quitting. The main findings of this research provide evidence that organisational support influences quiet quitting behaviour. Similarly, job burnout affects quiet quitting behaviour. Moreover, job burnout plays a mediating role in the relationship between organisational support and quiet quitting behaviour. It has been proven that job burnout is a significant barrier to the impact of organisational support in reducing quiet quitting behaviour. This research will have an impact on the management and strategic planning of healthcare organisations. STROBE reporting method has been followed. No patient or public contribution.

Experiences of Turkish nurses volunteering in the disaster zone following the 2023 Türkiye-Syria earthquake.

The study aimed to determine the experiences of Turkish nurses who volunteered in the disaster zone following the 2023 Türkiye-Syria earthquake. The earthquake devastated 11 cities in Türkiye, which required a comprehensive humanitarian response. Despite the crucial role of nurses in crisis management, limited research exists on their experiences in earthquake zones. Nurses experience difficulties in disaster areas, such as physical conditions, lack of disaster plans, and inadequate disaster training before being deployed to earthquake areas. This study used a qualitative research model and case study design. Data were collected through in-depth qualitative interviews. Nine participants who had worked in earthquake zones for at least 5 days were included in the study. The discussions were recorded, transcribed verbatim, and analyzed thematically. The purposive sampling method was used, and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed. As a result, 4 themes, namely physical conditions, psychosocial conditions, professional conditions, and organization, and their 14 subthemes were determined. This study revealed that nurses encountered difficulties related to physical conditions in earthquake zones. Moreover, the emotional burden expressed by the nurses highlighted the profound psychological impact of disaster response. This study determines that disaster preparedness and support for nurses should be enhanced to improve the arrangement of health services in future calamities. The results of this study can be used by nurse managers and healthcare policymakers to create nursing training programs that focus on disaster-related competencies.

Addressing burnout among nurses of color: Key priorities and calls for action

BackgroundNursing burnout remains a public health crisis. However, few stakeholders have considered the disproportionate toll of burnout among nurses of color, including nurses identifying as Black, Hispanic/Latino, or Native American. PurposeWe convened a one-day conference, titled Solutions to Health Inequities and Nurses’ Emotional Exhaustion (SHINE), to begin identifying contributing factors and solutions to burnout amongst nurses of color. MethodSHINE convened nearly 40 expert stakeholders. The convening included plenaries, small group discussions, and breakout sessions. We employed a deliberative dialogue (DD) methodology to identify key takeaways and implications for research, practice, and policy. DiscussionHigh-priority solutions included: improving the work environment and nurse staffing, reducing stigma against nurses seeking mental healthcare, addressing workplace racism as a root cause of nurse burnout, and increasing support for nurses experiencing racism at work. ConclusionKey priorities identified through SHINE offer a roadmap for nurse leaders to address burnout through an equity-centered lens.

The compensatory protective effects of organizational and supervisor support for nurses’ morale in sickness presenteeism: a three-way moderated mediation model

PurposeThe present study explored sickness presenteeism as a linchpin connecting prolonged working hours to elevated turnover intention among hospital nurses (mediation). In addition, we examined the joint moderating effects of organizational health care support and supervisor support on the second stage of the “long working hours-presenteeism-turnover” process (three-way moderated mediation).Design/methodology/approachWe conducted a two-wave survey to collect data over a four-month period from hospital nurses in Taiwan. The final sample for analysis had 294 nurses.FindingsWe found that presenteeism partially mediated the elevated turnover intention after working long hours four months later. We also found a significant three-way moderation effect of organizational health care support and supervisor support on the positive relationship between presenteeism and turnover intention. Specifically, nurses reported the lowest turnover intention with high levels of both organizational healthcare and supervisor support, the highest turnover intention with both support being low, and the intermediate level of turnover intention when any one of the support was high.Practical implicationsOrganizations should build a positive work environment through organizational health care support and supervisor support to retain talents.Originality/valueOur findings suggested that support resources of different origins (organization-level vs line supervisor) can compensate for one another to protect the employees in demanding work conditions. Our moderated mediation model exploring the psychosocial context of presenteeism has theoretical contributions pivoting on the interplay of resources at different levels in the organization as well as practical implications for presenteeism management.

National census of UK endoscopy services in 2023

BackgroundThe Joint Advisory Group on Gastrointestinal Endoscopy (JAG) conducts a biennial census of UK endoscopy services. The 2023 census aimed to assess the current status of endoscopy services and compare them with pre-pandemic census benchmark data.MethodsAn electronic survey was sent to all JAG participating services in April 2023. Key domains included activity, waiting times, workforce and safety. Whole census and service level paired comparison was made with 2019 census data.ResultsThere were 334 census responses representing 443 JAG-participating services (86.7% response rate). NHS services were operating at 110% of pre-pandemic activity levels. In the first 3 months of 2023, 53.6% of NHS services met urgent suspected cancer waiting time targets, 26.5% met routine waits and 26.2% met surveillance waits. The proportion of NHS services meeting all three targets decreased from 40.9% to 21.9% between 2019 and 2023. Compared with 2019, the proportion of independent sector activity has significantly increased. Insourcing activity has significantly increased and is being used by 57.9% of NHS services. Staff shortages were the most cited reasons for services not meeting waiting time targets or providing training. Absence through sickness rates for Band 2–6 nursing and healthcare support workers were significantly higher in 2023 compared with 2019 (p<0.001).ConclusionThe 2023 census presents a system under strain. While overall activity is above pre-pandemic levels, this is set against workforce concerns, increasing staff absences and reliance on insourcing for additional activity. This census re-emphasises the need to proactively plan for rising demand, while maximising all current available resources.

Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.

After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges. The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake. A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data. The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included "humanitarian duties," "non-adherence to ethical principles," "respect for the injured," and "medical errors." In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency. Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining the integrity of healthcare delivery, preserving public trust, and ensuring the well-being of both the injured and healthcare providers during times of crisis.

Nurses’ perceptions regarding the establishment of clinical education and training units in public hospitals in the North-West Province: a qualitative study

BackgroundA Clinical Education and Training Unit is defined as a unit in which the clinical orientation, teaching, learning, and assessment, mentoring and support of student nurses are coordinated to achieve the outcomes of their learning programmes in the health establishment. In South Africa, Clinical Education and Training Unit was developed to reconstruct and revitalise nursing education and training. The clinical education is crucial to enable nursing students to put what they learn in the classroom into practice as they direct patient care, practise therapeutic communication, hone technical skills, demonstrate caring behaviours, investigate ethical dilemmas, and take on the roles of nurses. The clinical teaching unit is one of the models that show potential in advancing clinical education. Since the proposed clinical education and teaching model concluded that Clinical Education and Training Units should be established in 2012, to the researcher’s knowledge, no research study has been conducted to explore and describe the nurses’ perceptions regarding the establishment of Clinical Education and Training Units, particularly in the North-West Province. This has resulted in the scarcity of literature on their perceptions. Thus, the researcher believed that it was essential to explore and describe the perceptions of professional nurses regarding the establishment of Clinical Education and Training Units in the North-West Province of South Africa, so that their perceptions may be known and understood.AimThe study aimed to explore and describe the perceptions of professional nurses regarding the establishment of Clinical Education and Training Units in public hospitals in the North-West Province.MethodsA qualitative-exploratory-descriptive and contextual research design was used. This method was used because it is known to unearth a wide range of views, opinions, thoughts, and feelings of the participants thus enabling a deeper understanding concerning perceptions of professional nurses regarding the establishment of Clinical Education and Training Units at the hospitals of interest. Participants were recruited using pamphlets and flyers. A non-probability convenience and purposive sampling techniques were used to select participants based on an inclusion criterion. From 09 September 2023 to 07 December 2023, the researcher used face-to-face group discussions to collect data and it was analysed using six steps of inductive thematic data analysis as outlined by Braun and Clarke.ResultsFour focus groups discussions were conducted with a total of 19 participants who were professional nurses. Responses were categorised into three domains: advantages of the Clinical Education and Training Unit, challenges of the Clinical Education and Training Unit, and recommendations for the Clinical Education and Training Unit. Subsequently, a total of three main themes with eight sub-themes were determined for advantages of the Clinical Education and Training Unit, two themes with six subthemes for challenges of the Clinical Education and Training Unit, and one theme with two sub-themes for recommendations for the Clinical Education and Training Unit respectively.ConclusionThe need to establish functional Clinical Education and Training Units is therefore very important not only to student nurses but also to health care professionals. Most of the participants emphasised that if Clinical Education and Training Units were fully established they would be beneficial in developing health care professionals, especially in terms of in-service training where nursing standards are emphasised as outlined by the South African Nursing Council. The research study results might contribute to the full establishment of CETUs in the hospitals of the North- West Province, South Africa.Trial registrationnot applicable to the study.

IMPACT organizational survey highlighting provision of services for patients with locally advanced and recurrent colorectal cancer across Great Britain and Ireland.

Locally advanced and recurrent colorectal cancer represents a complex clinical entity, which requires multidisciplinary decision-making and management. The aim of this work is to understand the provision of clinical services in this cohort of patients across Great Britain and Ireland (GB&I) as a key essential step to help facilitate future service development and improvement. A cross-sectional, organizational survey was sent to all colorectal cancer multidisciplinary teams (MDTs) across GB&I. It consisted of 12 key questions addressing the provision of specialist services and advanced surgical techniques. Results are reported in line with the CHERRIES guideline. One hundred and seventy-five MDTs across GB&I participated, with 142 English, 13 Welsh, 14 Scottish, 3 Northern Irish and 3 Irish MDTs. The overall response rate was 93.5% (175/187). Ninety (51.4%) hospital sites reported having a specialist dedicated or subsection MDT. Specialist advanced nursing support was available in 46 (26.2%) hospitals, with a dedicated advanced colorectal cancer outpatient clinic available in 31 (17.7%) hospitals. One hundred and thirteen MDTs (64.5%) offered surgery for advanced colonic cancer, 82 (46.8%) for recurrent colonic cancer, 58 (33.1%) for advanced rectal cancer and 39 (22.2%) for recurrent rectal cancer. A variable number of MDTs offered specialist surgical techniques, including distal sacrectomy [33 (18.9%)], high sacrectomy [16 (9.1%)], complex vascular resection ± reconstruction [33 (18.9%)] and extended lymphadenectomy (pelvic sidewall or para-aortic) [44 (25.1%)]. The IMPACT organizational survey highlights the current variation in the delivery and provision of clinical services for patients with advanced and recurrent colorectal cancer across Great Britain and Ireland.

Nurse Experiences of Caring for Medically Compromised Adolescents With Eating Disorders in General Hospital Environments: A Scoping Review.

Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non-mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five-step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed-methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non-mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a 'choice.' This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders.

Experiences and attitudes of nurses with the legislation on assisted suicide in Austria.

In 2022, assisted suicide (AS) was legalized in Austria. We aimed to investigate the experiences and attitudes of palliative care (PC) and hospice nurses toward AS in Austria after the first year of implementation of the new law. A cross-sectional survey was distributed online to nurses in every known specialized and general hospice and PC units in Austria (n = 255 units). The questionnaire included sociodemographic characteristics, the Assisted Suicide Attitude Scale, the Comfort Discussing Assisted Suicide Scale, and questions on recent experiences with AS requests. We used Spearman's correlation coefficient for determining associations between sociodemographic characteristics and attitudes toward AS, as well as comfort discussing AS. For comparison of frequencies, we applied ꭓ2 tests. We computed a linear regression model to examine predictors for attitudes toward AS. The total sample were N = 280 nurses. More than half (61.2%) indicated that they had cared for a patient who expressed a wish for AS within the first year of implementation. Though responses varied widely, more nurses expressed support for AS than those were opposed (50.36% and 31.75%, respectively). Factors that statistically contributed to more reluctance toward AS in the regression model were older age, religiousness, and experience of working with patients expressing a wish for AS. This work provides valuable insight into nurses' perceptions toward the legislation of AS in the first year since the new law was passed. The results can inform the future development of the AS system and support for nurses in end-of-life care, and critically contribute to international discussions on this controversial topic.

Small Ruminant Parturition Detection Based on Inertial Sensors—A Review

The birth process in animals, much like in humans, can encounter complications that pose significant risks to both offspring and mothers. Monitoring these events can provide essential nursing support, but human monitoring is expensive. Although there are commercial monitoring systems for large ruminants, there are no effective solutions for small ruminants, despite various attempts documented in the literature. Inertial sensors are very convenient given their low cost, low impact on animal life, and their flexibility for monitoring animal behavior. This study offers a systematic review of the literature on detecting parturition in small ruminants using inertial sensors. The review analyzed the specifics of published research, including data management and monitoring processes, behaviors indicative of parturition, processing techniques, detection algorithms, and the main results achieved in each study. The results indicated that some methods for detecting birth concentrate on classifying unique animal behaviors, employing diverse processing techniques, and developing detection algorithms. Furthermore, this study emphasized that employing techniques that include analyzing animal activity peaks, specifically recurrent lying down and getting up occurrences, could result in improved detection precision. Although none of the studies provided a completely valid detection algorithm, most results were promising, showing significant behavioral changes in the hours preceding delivery.

Assessing the frontline competency gap: Emergency care perceptions among nurses in Yemen's conflict zone.

Nursing competencies in armed conflict situations are critical for effective response and recovery. This study explores nurses' perceptions regarding their competencies in armed conflict zones to identify areas of proficiency and those requiring further emphasis in training. This cross-sectional descriptive study adhered to the STROBE reporting guidelines. It used a validated questionnaire examining 47 different competencies for nursing in armed conflict zones, which were subsequently ranked to identify those that were valued most and least. In total, 102 questionnaires were returned (85% response rate). The highest-ranked competencies focused on immediate life-saving interventions and personal safety. In contrast, competencies involving broader disaster management, such as understanding organizational disaster plans, post-death care, and risk identification, ranked lower. This observation may indicate a tendency to prioritize direct clinical care over strategic planning and long-term recovery in disaster nursing education. This study highlights the critical need to strengthen emergency care competencies among nurses working in armed conflict zones in Yemen. Its findings underscore the importance of targeted training programs, particularly in complex trauma management and psychological first aid, to address nurses' self-identified competency gaps. Policy implications include prioritizing resource allocation for emergency care infrastructure, implementing competency-based deployment strategies, and ensuring access to mental health support for nurses in working conflict zones. These actions are essential for building a resilient nursing workforce capable of providing quality care amidst the unique challenges of armed conflict.

Nurse Managers' Experiences in Managing Inpatient Wards During a Crisis: Lessons from the COVID-19 Pandemic

The COVID-19 pandemic has provided valuable lessons for all parties, including nursing services in hospitals. To date, literature has been lacking on the role of nurse managers in managing inpatient wards for COVID-19 patients, especially in Indonesia. This study aims to explore the experiences of, and the challenges encountered by nurse managers in managing inpatient wards during the crisis. This is a qualitative study with a phenomenology design. The study used a purposive sampling technique involving four nurse managers from several hospitals in South Sulawesi Province, Indonesia. Data were obtained through semi-structured interviews and were analyzed using thematic analysis. This study yielded three themes and nine sub-themes. Nurse managers experienced panic and fear but carried out inpatient management immediately. There was also a solid commitment to protect the fellow nurses from infection. Valuable lessons include the availability of human resources, strong commitment from all lines, management support, and teamwork. Meanwhile, nurse managers encountered challenges such as the lack of personal protective equipment, frequently changing service procedures and the psychological needs of nurses. Nurse managers obtained numerous lessons from the COVID-19 pandemic related to their capabilities in managing inpatient wards. The findings suggest the adaptability of nurse managers to similar challenging crisis encounters in the future by analysing the effects of frequent workflow changes on care quality and staff adaptation, examining the long-term psychological impact of pandemic work on nurses developing strategies to enhance organizational support for nurses including coping mechanisms and well-being related trainings and services, and to build dynamics of effective teamwork during crisis.

Managing End of Life Needs of Frail, Older Adults in the Community: The Role of a Hospital-Based Community Outreach Team

Abstract Background Our current healthcare systems are designed around periods of acute illness and are ill equipped to meet the needs of multimorbid and frail adults with worsening mobility, cognition and function. According to The Irish Longitudinal Study on Aging (TILDA), Ireland has a high proportion of hospital deaths, indicating inadequate community and home care supports. Recognizing patients who are likely to benefit from supportive and palliative approaches with a goal to die at home can be done using a combination of tools and based on advanced care planning discussions. Methods In 2021, our Department for Older Persons Services allocated a team consisting of a Registrar and Advanced Nurse Practitioner in Frailty to form an outreach service. Inpatients who appear nearing end of life who have expressed wishes to avoid further hospitalization and to die at home are identified during their admission. Home visits allow for a holistic assessment and family members are given the opportunity to ask questions. We provide education on end of life, trying to anticipate needs and often see patients and families through periods of deterioration until they stabilize again in a ‘new normal’ or begin the process of active dying. We communicate with Public Health Nurses, General Practitioners and the Community Palliative Care Team. Results Families and carers supporting loved ones who wish to avoid further hospitalization and die at home benefit from combined medical and nursing support & specialist expertise the team brings. Conclusion Addressing end of life for multimorbid patients living with severe frailty is a global challenge. Hospital admission is an ideal time to begin conversations regarding goals of care and initiate advanced care planning. The outreach team work together with hospital and community colleagues to the common goal of following patients’ wishes at end of life.

The psychometric properties of the Persian version of the innovation support inventory (ISI-12) in clinical nurses: a methodological cross-sectional study

BackgroundInnovation in nursing involves applying new knowledge to create novel ideas, methods, or technologies, resulting in higher-quality care and improved patient outcomes. Adequate support for innovation is crucial for progress in nursing. This study aimed to translate the Innovation Support Inventory (ISI-12) into Persian and assess its psychometric properties specifically among clinical nurses.MethodsA methodological cross-sectional study was conducted from September 2022 to July 2023 to evaluate the face, content, and construct validity of the ISI-12. Construct validity was assessed through confirmatory factor analysis (CFA) and convergent and discriminant validity evaluation using data obtained from 321 clinical nurses. The test–retest stability and internal consistency of the ISI-12 were also evaluated to assess its reliability.ResultsThe Persian version of the ISI-12 validation through confirmatory factor analysis has confirmed its fit with the proposed three-factor model. The ISI-12 demonstrated high reliability, as evidenced by a Cronbach's alpha coefficient (α = 0.969), McDonald's omega coefficient (ω = 0.922), coefficient H (H = 0.979), and mean inter-item correlation (ρ = 0.418). Additionally, the stability of the ISI-12 during two weeks among 40 clinical nurses was found to be excellent, with an ICC of 0.951.ConclusionThe Persian version of the ISI-12 is a valid inventory for evaluating the innovation Support of clinical nurses.

Facilitating home birth in perinatal palliative care: A case report.

Perinatal palliative care can offer compassionate support to families following diagnosis of a life-limiting illness, to enable them to make valued choices and the most of the time that they have with their newborn. However, home birth is usually only offered in low-risk pregnancies. A couple who received an antenatal diagnosis of hypoplastic left heart syndrome and who had made a plan to provide palliative care to their baby after birth requested the option of a home birth. Recommend birth at hospital or explore the possibility of a home birth with perinatal palliative care support. Multidisciplinary discussion and collaboration enabled a plan for home birth to be made which anticipated potential complications. The baby was born at home and died on day 5 of life receiving outreach nursing, paediatric and palliative care support and buccal and oral opioids for symptom management. We include reflections from the family on the importance of this experience. We provide a list of potential criteria for considering home birth in the setting of perinatal palliative care. Facilitating a home birth in the setting of perinatal palliative care is an option that can be hugely valued by families, but this service may be practically difficult to deliver in many contexts. Further research is needed to understand the preferences of women and families receiving perinatal palliative care.