Outpatient Nurses Research Articles

The roles and responsibilities of general practice nurses in China: a qualitative study

BackgroundGeneral hospitals in China have been establishing General Practice Departments (GPD). Although General Practice Nurses (GPNs) are an important part of this medical system, their training has not been synchronised. This study explored the working status of nurses in GPDs in general hospitals in Beijing to provide a theoretical basis for the training and development of GPNs in China.MethodsWe conducted in-depth, individual interviews with outpatient nurses at 19 hospitals in Beijing between March and April 2021. We employed a qualitative analysis to interpret participant narratives and used a codebook thematic analysis to analyse the interview data and extract themes.ResultsThe analysis revealed four themes: (i) a lack of full-time GPNs in GPDs of most tertiary hospitals, (ii) the inability of GPNs to fully express their potential and skills owing to their limited roles, (iii) insufficient standardised patient education provided by nurses in GPDs, and (iv) a lack of systematic and relevant training for nurses working in general practice settings.ConclusionsTo promote the development of GPNs, GPDs in general hospitals in China should hire full-time GPNs, define their job duties in alignment with their values, and provide standardised training to strengthen their core competencies.

Dry eye disease as an occupational risk factor in operating room nurses

ABSTRACT Clinical relevance Knowing occupational risks in a multifactorial disease such as dry eye disease is important for disease diagnosis and treatment. Background Dry eye disease (DED) is a multifactorial disease of the ocular surface characterised by tear film instability, adversely affecting visual function and quality of life. The operating room environment has many risk factors for DED such as air conditioning, constant humidity, constant room temperature, intense lighting, surgical smoke, anaesthetic gases and irritating chemicals, and prolonged mask use. This study investigates the ocular surface findings and blink patterns of operating room nurses at risk of DED. Methods A total of 68 nurses (operating room, n = 34; outpatient clinic, n = 34) were included in this study. The diagnosis of DED was assessed using a questionnaire, best-corrected visual acuity, tear break-up time, corneal fluorescein staining, meibomian gland assessment, Schirmer I test. All the tests were conducted in the same area. Results According to the ocular surface disease index, the rate of dry eye symptoms was significantly higher among operating room nurses than among outpatient nurses (70.5% vs 41.1%). Severe dry eye symptoms were more common in the operating room group. The meibomian gland score was higher in the operating room group (29.4% vs 5.9%). The numbers of blinks (30.91 ± 12.81 vs 21.05 ± 7.77) and incomplete blinks (8.76 ± 4.68 vs 5.76 ± 3.20) at rest were higher in operating room nurses. Conclusion The occupational risk for DED was high among operating room staff. National and international standards for the prevention and management of DED in personnel involved in health care services are needed.

Factors Associated With Job Fatigue In Outpatient Nurses In Hospital X

Work fatigue is a prevalent issue among public service workers, particularly nurses, impacting their performance and patient care. This study focuses on outpatient nurses at Hospital X in South Jakarta, aiming to identify factors associated with job fatigue. Using a quantitative cross-sectional design, data was collected from 100 outpatient nurses in 2023. Univariate and bivariate analyses, including the chi-square test, were conducted. Results revealed that 68.9% of nurses reported moderate fatigue, with significant associations found between high fatigue complaints and workload (p-value 0.000) and age (p-value 0.026). These findings underscore the need for Hospital X to address workload issues by considering additional personnel to mitigate fatigue among nurses. Such measures can enhance service quality and potentially improve nurse well-being, thereby benefiting patient care. Furthermore, implications suggest the importance of empathy training and holistic awareness of biopsychosocial components in addressing nurse fatigue and improving patient outcomes.

Provision and use of assistive products in patients after stroke and spinal cord injury in Germany: a qualitative interview study

Purpose Mobility impairments are a common consequence of stroke and spinal cord injury (SCI). Assistive products (APs) such as wheelchairs are often needed for activities and participation. The aim of the study was to explore the provision and use of APs in Germany and to identify associated factors underlying this practice. Materials and methods Semi-structured interviews were conducted with 19 professionals from outpatient neurorehabilitation services (three general practitioners, five physical therapists, five occupational therapists, one speech therapist, one neuropsychologist, two outpatient nurses, one rehab technician and one social worker), two patient advocates (long-term survivors, each stroke and SCI) and 20 patients (10 each after stroke and SCI with mobility impairment, and first-ever affected). Analysis was performed by qualitative content analysis. Results Reported experiences were mixed, varying from high satisfaction to unusable APs and unmet needs. Identified factors associated with these experiences were related to care pathways, care coordination, inter-professional collaboration, professionals’ knowledge and patient information, cost coverage, and approval procedures. Conclusion Overall, patients seem satisfied with the APs they receive, but patients with more severe mobility impairments in particular experience deficits in the provision and use of APs. Further research is needed to develop and test strategies for the provision and use of APs.

Factors of Increasing Intention to Use Information Systems

This research is based on information from the IT division regarding non-performance of implementation since the use of HIS at RSU Bhakti Asih began in 2005 until 2022, which has changed three times and none of the implementation achievements for the three HIS have ever reached 100 percent. The aim of this research is to empirically reveal the influence of training and utility on intention to use HIS with work motivation as a mediating variable. This type of research is quantitative with a causality design. The population used is health workers consisting of outpatient nurses, inpatient nurses, emergency room nurses, pharmacy departments, laboratory departments and radiology departments. The sampling technique used proportional sampling, with calculations using the Slovin formula with an error rate of 5 percent, so that the sample size was determined to be 175 respondents. Data collection analysis techniques use survey methods, and data analysis techniques use SEM with the help of the Lisrel program and three box method analysis. The results of the analysis prove that training and utility influence the intention to use HIS with work motivation as a mediator, training influences utility, training and utility influence work motivation and intention to use HIS, and work motivation influences intention to use HIS and is also able to provide positive intervention on the influence training and utility on intentions to use HIS, so that with work motivation, the effectiveness of training and utility will be higher in increasing intentions to use HIS.

COVID-19 pandemic: Emotional burnout in nurses (3 years later).

Introduction. During the COVID-19 pandemic, crises occurred in various spheres of life – health, politics, economics, education, etc. Medical staff turned out to be a more vulnerable category in terms of the risk of developing emotional burnout. The various problems that the doctors had to face contributed to a huge increase in workload, as well as increased susceptibility to burnout and stress. The aim of the study is to investigate the emotional burnout of COVID nurses in hospitals, polyclinics and hospitals 3 years after the COVID-19 pandemic. Material and methods. To achieve the purpose of the study, a survey and analysis were conducted among nurses who worked in the “red zone” of COVID hospitals (n=73); polyclinic nurses (n=78) and nurses of multidisciplinary hospitals (n=77), as well as the control group (n=79). To study the burnout syndrome, the Maslach Burnout questionnaire was used and a questionnaire was conducted, which allowed us to assess the attitude of nursing staff to the situation 3 years after the COVID-19 pandemic. The processing of the obtained data was carried out using the statistical package “Statistica”. Results. It was revealed that nurses who worked in the “red zone” in COVID hospitals, their colleagues from polyclinics and multidisciplinary hospitals, according to the results of the study, have increased indicators of emotional burnout. COVID hospital nurses have significantly higher characteristics of “occupational exhaustion” and “depersonalization” compared to hospital nurses (p≤0.001) and outpatient nurses (p≤0.001). It should be noted that the nurses of COVID hospitals have a significantly lower indicator of “reduction of personal achievements” compared to the nurses of multidisciplinary hospitals and outpatient clinics. Risk factors that affect the psychological health and emotional burnout of nurses during the COVID-19 pandemic have been identified: changes in the organization of work, the risk of infection and social isolation. Conclusions. The study revealed that all three groups have increased characteristics of professional burnout. Thus, COVID hospital nurses have significantly higher rates of “professional exhaustion”, “depersonalization” and low values of the indicator “reduction of personal achievements”, compared with colleagues in multidisciplinary hospitals and outpatient clinics, even after 3 years. The treatment of patients with COVID-19 exposes physicians to specific risk factors associated with the care of infected patients, with significant changes in the organization of work, as well as safety-related aspects that contribute to increased stress and emotional burnout.

PENGALAMAN PASIEN RAWAT JALAN DI RSIA MARDI WALOEJA RAMPAL, MALANG

Background: In recent years, there has been a trend away from global satisfaction measures to a more detailed measurement of the patient experience. While the measurement of service quality through patient experience is still rarely done in Indonesia. The number of hospitals in Malang city increase every year that creates fairly tough competition in hospital business. To answer that challenge, RSIA Mawar has measured the patient satisfaction index with an achievement of 82-89% with the lowest satisfaction score in outpatient services. Even so, hospital still received several negative comments written by patients in the 'suggestions and input' column on the patient satisfaction form. This indicates that the patient satisfaction survey has not described the real experience that patients receive.
 Objectives: To describe the outpatient experience and formulate recommendations for improving the outpatient experience at RSIA Mardi Waloeja Rampal, Malang.
 Methods: The design of this study is a retrospective case study. The research subjects were patients in outpatient services, doctors and nurses in outpatient services, and related hospital management. Quantitative data were collected by translated and modified outpatient experience questionnaire (OPEQ). Quantitative data will be processed and presented descriptively. Qualitative data were obtained by in-depth interviews with outpatients, doctors, and nurses as well as discussions with groups of hospital management. Qualitative data was analyzed thematically.
 Results: Quantitative studies show that the majority of respondents agree with the statements in the outpatient experience questionnaire. Qualitative studies dig deeper informations into quantitative results and also generate recommendations for improvement. In addition to the seven dimensions of outpatient experience, it was found that the number of human resources in the hospital was also considered to influence the patient experience.
 Conclusions: The dimension that has provided a good experience in outpatient services is the dimension of nurse-patient communication. The dimensions that still need improvement are the dimensions of health information and medical costs. There are several recommendations that have been formulated to improve the outpatient experience. RSIA Mawar is expected to be able to measure patient experiences and discuss it regularly.

Penggunaan Video Interaktif sebagai Upaya Optimalisasi Edukasi Persiapan Operasi oleh Perawat Setting Rawat Jalan

This study aims to provide an overview of the obstacles to education on preparation for surgery for outpatients and alternative solutions to increase the effectiveness of offering education on preparation for surgery. The method is a survey with interviews, questionnaires, fishbone analysis, problem prioritization, implementation, and evaluation. The results showed that 60.7% of outpatient nurses involved in the study conducted surgery preparation education without specific media and guidance based only on general educational SOPs. Data shows that 46% of nurses need more time to provide education, and its implementation will not be optimal during busy hours. 28% of cases of surgical failure are caused by ineffective education on preparation for surgery. In conclusion, interactive video educational media makes it easier for nurses to implement instruction quickly. This impacts patients' ability to understand educational material more efficiently so that the surgical failure rate can be reduced.
 
 Keywords: Operation Preparation Education. Fishbone. Educational Media. Interactive Videos

Streamlining urgent, same day oncology admissions from an ambulatory clinic and patient safety, patient experience, and team communication.

394 Background: The urgent, same-day, admission process for an ambulatory oncology patient is complex. Between January 1, 2021 and November 8, 2022, at least 35 safety reports were filed relating to urgent, same-day admissions yielding a rate of 1.72% of direct admissions resulting in a safety report. Issues included communication breakdowns (e.g. insufficient handoff, insufficient updates on patient condition, incorrect mode of communication which led to delays in care), admissions to incorrect teams, and admissions to locations ill-equipped to manage the patient’s acuity. Another challenge is the ambulatory facility, Dana-Farber Cancer Institute, and the admitting facility, Brigham and Women’s Hospital (BWH), are two different hospitals further complicating the admissions process. The goal was to streamline the urgent, same-day admission process, set expectations for the interdisciplinary teams involved, and determine a process to triage high acuity patients to the emergency department (ED) when warranted. Methods: The interdisciplinary workgroup identified gaps and pain points in the current state process. This collaborative effort led to new, streamlined workflows for key stakeholders in the process. New workflows were created for outpatient nurses, outpatient providers, and inpatient nurses. An important step in the new workflows revolves around establishing the rule that patients will be routed to the ED at 5pm if no bed will become available by clinic closing. This allows the patient to receive care quicker and triages the patient to the inpatient bed queue at an earlier point in the day. These workflows were posted in clinic and inpatient areas, distributed electronically, and presented in multiple team meetings. A new safety report event type, “Admissions from Clinic,” was created in the system to identify issues related to these processes. Results: From the date of implementation of the new workflows to the time of reporting (approximately 2.5 months), there have been 4 safety reports yielding a rate of 1.68% of direct admissions leading to safety reports. Most of these reports pertained to the bed tracking system not functioning properly leading to patients showing up to the inpatient floor before their bed was ready. Overall, the new workflows are functioning efficiently with no increase in the number of patients sent to the ED due to communication of bed availability at 5pm. Conclusions: Interdisciplinary collaboration involving key stakeholders in the direct admissions process from a cancer clinic to the inpatient setting, led to a reduction in safety reports generated regarding communication, patient safety and patient experience. There was no increase in patients being triaged to the ER at the end of the day.

Analysis of professional stress formation at outpatient polyclinic service nurses

The problem of professional stress in modern medical teams is the focus of attention of many domestic and foreign scientists, theorists and practitioners, representatives of various scientific schools and directions. In modern conditions, a clearly expressed need has formed in society for both fundamental and applied knowledge about the causes and nature of professional stress, and methods for managing it. Solving the problem under consideration can help overcome the difficulties that have emerged in connection with the need to manage stress in the organizational environment. Target. To analyze the severity of professional stress among nursing staff in outpatient clinics and, based on the results obtained, to develop recommendations for the prevention and management of stress. Results. Based on theoretical material, the concept of professional stress, its causes and nature, management methods, and developmental features among nursing personnel are revealed; the level of professional stress of clinic nurses, the nature of professional stress, the strength and frequency of stress were determined; typical and subjectively significant causes of stress in the professional activities of specialists have been identified; coping strategies for overcoming stress by nursing staf f have been identified. Conclusion. The study showed that the development of professional stress in nurses is influenced by everyday, routine professional activities, which often require specialists to have quite intensive, not necessarily conflict-ridden, but for various reasons emotionally intense communication.

Development and Validation of the Outpatient Nurses Communication Behavior Inventory

Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings. The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity. During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated. The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89. The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.

Current practice of outpatient rehabilitation services in patients with mobility-impaired paralysis due to stroke or spinal cord injury: a qualitative interview study in Germany

Purpose When mobility deficits persist after stroke or spinal cord injury (SCI), outpatient neurorehabilitation services are required. This study aimed to explore the current practice of German outpatient neurorehabilitation services and identify factors associated to this practice. Methods This was a qualitative observational study in which semi-structured interviews were conducted with professionals from outpatient neurorehabilitation services and mobility-impaired patients. A qualitative content analysis with a data-driven coding process was used. Results Three general practitioners, five physical, five occupational, and one speech therapist, one neuropsychologist, two outpatient nurses, one rehabilitation technician, one social worker, two patient advocates (long-term survivors, each stroke and SCI), and 20 patients (10 after stroke, 10 after SCI, all first-ever affected since approximately one year) participated. The reported experiences ranged from high satisfaction to perceived deficits in participation-oriented, evidence-based, and coordinated care. Identified associated factors were: (a) availability of specialised therapists and professional education, (b) outpatient service catalogue, (c) cost coverage, (d) setting rehabilitation goals, and (e) physician as care coordinator. Conclusion Areas of improvement identified focused on: setting rehabilitation goals towards participation, training therapists on evidence-based treatments and shared decision-making, updating the outpatient service catalogue, and implementing coordination actions. Implementation of these recommendations should be evaluated.

Pediatric outpatient experiences of senior nursing students: A qualitative study.

This study aimed to explore the experiences of senior nursing students working in a pediatric outpatient clinic. This study adopted a descriptive phenomenological approach, through semi-structured interviews. Purposive sampling was used to select 12 senior nursing students in the pediatric outpatient clinic of West China Second University Hospital, Sichuan University, China, from August 2020 to March 2021. The collected data were analyzed using the Colaizzi method. Four themes were identified in this study: knowledge and skills (triage, emergency care), communication (courage, communication skills), value re-evaluation (understand of outpatient nurses, judgment of outpatient nurses), and outpatient feelings (satisfaction, empathy, pressure). Pediatric outpatient internships have a positive impact on senior nursing students. Research has found that constructing a nursing clinical practice pathway in pediatric outpatient clinics helps teachers and students clarify the objectives and content of internships, and the "shadow teaching" model is conducive to nursing students' empathy and thinking. In addition, outpatient internship experience can help students gain communication courage.

Strategies Used by Outpatient Oncology Nurses to Introduce Early Palliative Care: A Qualitative Study.

Although early palliative care is linked to improved health-related quality of life, satisfaction with care, and symptom management, the clinical strategies that nurses use to actively initiate this care are unknown. The aims of this study were to conceptualize the clinical strategies that outpatient oncology nurses use to introduce early palliative care and to determine how these strategies align with the framework of practice. A constructivist-informed grounded theory study was conducted in a tertiary cancer care center in Toronto, Canada. Twenty nurses (6 staff nurses, 10 nurse practitioners, and 4 advanced practice nurses) from multiple outpatient oncology clinics (ie, breast, pancreatic, hematology) completed semistructured interviews. Analysis occurred concurrently with data collection and used constant comparison until theoretical saturation was reached. The overarching core category, pulling it all together , outlines the strategies used by oncology nurses to support timely palliative care referral, drawing on the coordinating, collaborating, relational, and advocacy dimensions of practice. The core category incorporated 3 subcategories: (1) catalyzing and facilitating synergy among disciplines and settings , (2) promoting and considering palliative care within patients' personal narratives , and (3) widening the focus from disease-focused treatment to living well with cancer . Outpatient oncology nurses enact unique clinical strategies, which are aligned with the nursing framework and reflected multiple dimensions of practice, to introduce early palliative care. Our findings have clinical, educational, and policy implications for fostering the conditions in which nurses are supported to maximize their full potential in the introduction of early palliative care.

Psychological adaptation and implemented coping strategies under stressful working conditions in medical workers

The purpose is to study the features of manifestation of coping strategies as a mechanism of psychological adaptation to stressful working conditions in medical workers. Material and methods. The survey and analysis were conducted in the following groups: group A — medical workers of COVID hospitals providing medical care to patients with COVID-19 (n=201). Group A included 3 subgroups: group 1 — general practitioners of COVID hospi tals (n=111); group 2 — surgical doctors of COVID hospitals (n=61); group 3 — nurses of COVID hospitals (n=29). Group B — medical workers of multidisciplinary hospitals providing medical care in their main profile (n=195). Group B also included 3 subgroups: group 4 — general practitioners of multidisciplinary hospitals (n=106); group 5 — surgical doctors of multidisciplinary hospitals (n=58); group 6 — nurses of multidisciplinary hospitals (n=31). Group C — medical workers of outpatient and polyclinic departments (n=186). Group C in cluded 3 subgroups as well: group 7 — general practitioners of the outpatient and polyclinic level (n=102); group 8 — surgical doctors of outpatient and polyclinic departments (n=55); group 9 — outpatient and polyclinic nurses (n=29). The control group included employees of professions that are not related to work in medical organizations (healthy). To study the mechanisms of coping strategies for overcoming psychological difficulties in medical work ers, a technique developed by R. Lazarus and S. Folkman was used. Results. Thus, as a result of the study, the features of the formation of psychological defens es of adaptive coping strategies of professional behavior in general practitioners, surgical doctors, and nurses of specialized COVID hospitals, multidisciplinary hospitals in the mode of normal operation, and outpatient and polyclinic departments are identified. Conclusions. It is shown that the prevailing coping strategies among surgical doctors of specialized COVID hospitals at a high level are such coping strategies as «distancing», «self-control», and «taking responsibility». Meanwhile, the coping strategy of «distancing» is at a high level among nurses of COVID hospitals.

Survey on the current situation and influencing factors of humanistic care ability of outpatient and emergency nurses in tertiary Grade A hospitals in Zhengzhou City

Objective: To investigate the humanistic care consciousness and ability of outpatient and emergency nurses in tertiary Grade A hospitals in Zhengzhou City. Methods: In June 2021, a total of 345 outpatient and emergency nurses from 6 tertiary Grade A hospitals in Zhengzhou City were selected as the survey objects by random number table method. The humanistic care ability of outpatient and emergency nurses was investigated. Multiple linear regression analysis was used to analyze the related factors influencing the humanistic care ability of outpatient and emergency nurses. Results: The total score of humanistic care ability of outpatient and emergency nurses in Zhengzhou tertiary Grade A hospital was (194.18±30.53). The scores of humanistic care ability of outpatient and emergency nurses with different gender, age, educational background, professional title, length of service, night shift frequency, marital status, children's status, employment patterns and average monthly household income were significantly different (P<0.05). Regression analysis showed that education background, length of service, professional title and night shift frequency were independent influencing factors for outpatient and emergency nurses' humanistic care ability (β=0.243, 0.139, 0.163, -0.126, P<0.05) . Conclusion: At present, the humanistic care ability of outpatient and emergency nurses in tertiary Grade A hospitals in Zhengzhou City is still low. Education, length of service, professional title and night shift frequency are independent influencing factors affecting the humanistic care ability of nurses.

External Service Providers (ESP) Reach-Out Project: How Can Nurses Assist With Improving Patients’ Social, Economic, and Physical Environments?

This project aimed to improve Capital, Coast and Hutt Valley’s cardiology outpatient “nurses” confidence in connecting patients to community support services (Exercise, Food and Nutrition, Medications, Healthy Homes including Power and Gas, Mobility, Social Isolation and Transport) from 46% to 80% by October 2022. The plan-do-study-act (PDSA) cycle is a methodology for rapidly testing change. A baseline of the “nurses” confidence and identification of the types of services needed by patients was established. Follow-up focus group sessions were held with nurses at two hospitals, covering four geographical locations, within the district. The development of a driver diagram translated the high-level improvement goal and identified various causes to help organise the Change Ideas. Not all ideas could be undertaken in the 3-month timeframe. However, Change Idea One—“Help Directory”—was researched and created by the project manager, which is currently a 37-page resource, with seven categories of services, formatted by region (four) that includes links to service providers, referral forms, and printable handouts for patients. The resource was shared with the “nurses” and an incentivised quiz developed to encourage its review. A second anonymous survey was constructed, allowing for a PDSA cycle, to compare confidence levels after having access to the resource. Cardiology outpatient nurses’ level of confidence (quite confident to extremely confident) connecting patients to community support services increased from 46% to 100%. Since completion, the ESP Reach-Out Resource has proven useful to select nurses and, in turn, their patients. The next steps are to escalate to executives within the hospital to seek budget for the development of the resource, including a more environmentally friendly and dynamic resource that is preferably electronic. Once established, it will be promoted within Capital, Coast and Hutt Valley for internal users.

The Role of Perceived Susceptibility, Perceived Severity, Perceived Barriers and Benefits in COVID-19 Vaccine Hesitancy and Uptake Among Outpatient Surgery Nurses in the United States: A Qualitative Study

Background and Objective: This qualitative study explores outpatient nurses’ perceptions of coronavirus disease 2019 (COVID-19) and the COVID-19 vaccine, aiming to inform future research and health education strategies for reducing vaccination hesitancy among healthcare workers, particularly nurses. The nurses recruited for this study were all registered nurses (RNs). Studies have shown that registered professional nurses consistently display higher vaccination hesitancy versus other healthcare groups, specifically doctors. Little is known about the vaccine acceptance disparities that exist among healthcare workers, or why nurses appear to consistently display higher rates of vaccine hesitancy, versus other healthcare groups, especially doctors. Methods: Semi-structured interviews guided by the health belief model were conducted with 8 outpatient nurses, and a focus group guided by the health belief model was conducted with 5 outpatient nurses, for a total of 13 nurses (N=13). The data were triangulated through interviews, a focus group, and a literature review. In addition, an independent external secondary analyst confirmed the findings. Results: Three key themes appeared: (1) sources of information (trusted sources of information), (2) experience (belief about personal risk and personal responsibility), and (3) logistics (COVID-19 testing requirements, booster frequency, and mandate versus choice). Conclusion and Implications for Translation: We advise public health professionals to adopt a grassroots approach to vaccine hesitancy interventions, engaging and training doctors and nurses. We also recommend consistency in prevention approaches, as that produces trust. We also recommend further research into the booster requirement, as requiring an unknown number of boosters appears to lower trust among nurses. Copyright © 2023 Matta et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study.

To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model. Descriptive, cross-sectional study. All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the 'Advanced Practice Nurse Role Definition Instrument (IDREPA)'were administered to assess the nurses' level of competence development. Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activityand 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of 'expert care planning' and 'comprehensive care'. Three (11.1%) nurses met all criteria for advanced nursing practice. The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses. Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.

HUBUNGAN SHIFT MALAM TERHADAP PENYAKIT REFLUKS GASTROESOFAGUS PADA PERAWAT DI RUMAH SAKIT UMUM PUSAT SANGLAH

Gastroesophageal reflux disease is one of the most frequently diagnosed gastrointestinal diseases in the world with a prevalence that continues to increase every year. There are several studies state that night shifts can increase the risk of GERD. One group of workers who often undergo night shift rotation are nurses who work in hospitals. This study aims to determine the correlation between night shift work and gastroesophageal reflux disease among nurses. This study is an analytical study with a cross-sectional design. The data collection technique was carried out by purposive sampling by distributing questionnaires to 161 nurses on duty at Single Hospital which were divided into 85 Inpatient Installation nurses who worked night shifts and 76 Outpatient Nurses who worked morning shifts. This study found a significant correlation between night shift work and gastroesophageal reflux disease (p value = 0.013; Prevalence Ratio = 3; 95% Confidential Interval 1.18-7.84) by the chi square test. Furthermore, by the logistic regression analysis of night shift and GERD, the AOR (Adjusted Odd Ratio) was 3.61 with 95% CI (1.05-12.52) and other variable like age, gender, BMI and fast food consumption habits on GERD did not shown any significant result. There is a significant correlation between night shift work and gastroesophageal reflux disease. Nurses who undergo night shifts have a 3.61 times higher risk of experiencing GERD.&#x0D; Keywords : Night Shift Work, Gastroesophageal Reflux Disease, Nurse