Readiness Of Nurses Research Articles

The Effect of the Implementation of the National Program for Hospital Preparedness on the Readiness of Nurses Under Simulated Conditions of Incidents and Disasters

The Effect of the Implementation of the National Program for Hospital Preparedness on the Readiness of Nurses Under Simulated Conditions of Incidents and Disasters

Greek Military Nurses Readiness to Provide Transcultural Care to Immigrants

Greek Military Nurses Readiness to Provide Transcultural Care to Immigrants

Readiness of hospital nurses for disaster responses in Taiwan: A cross-sectional study

BackgroundBecause patients in disaster areas require the most critical care, mobilising hospital nurses has become a pivotal strategy. Given the importance of disaster nursing training programmes, understanding how well prepared hospital nurses are to provide disaster care is vital. ObjectivesThis paper analyses the perceived readiness of hospital nurses for a disaster response and the factors influencing their report for work outside the hospital environment. DesignA cross-sectional research design was used. SettingsThis study was conducted at a military hospital in Taiwan. ParticipantsA sample of 311 registered nurses participated in this study. MethodsData were collected on readiness for disaster responses using a 40-item researcher-designed, self-administered questionnaire found to have satisfactory reliability and validity. The questionnaire has four domains: personal preparation (16 items), self-protection (11 items), emergency response (6 items), and clinical management (7 items). Data were analysed using descriptive statistics, independent t-tests and generalised linear models. ResultsThe majority of hospital nurses demonstrated poor readiness for disaster responses. Scores on the four domains were most associated with nurses' disaster-related training, experience in disaster response and emergency/intensive care experience. ConclusionsOur results indicate that disaster-related training should be included in undergraduate programmes and continuing education courses to help hospital nurses recognise and improve their own readiness for disaster responses outside the hospital environment. Future research is needed to improve hospital nurses' disaster-response readiness in Taiwan and other countries.

Faktor-faktor yang Mempengaruhi Kesiapan Perawat Anestesi Melakukan Tindakan General Anestesi di RSUP Mataram Nusa Tenggara Barat

Background : The provision of the type of anesthesia in patients undergoing surgery can be performed under general anesthesia, and with the anesthetic to a specific body part (regional anesthesia). The type of anesthesia used in surgery, either by using general anesthesia or regional anesthesia with each having its own complications. Readiness of each participant looks diverse, there is no action in the first prepare medications and tools so often happens unpreparedness in implementing the action. Readiness of nurses in providing anesthesia is influenced by various factors such as age, education, work experience, knowledge and gender.
 Methods : The aim of research to explore preparedness for nurse anesthetists in general anesthetic action. This study used a naturalistic qualitative research. Participants in this study is a nurse anesthetist who is still on active duty in the department of West Nusa Tenggara Province. Intake of total participants performed the sampling technique. Data collection was conducted in natural conditions, the primary data sources and data collection techniques through observation, in-depth interviews to the participants to explore the role of a nurse anesthetist does and documentation. Data obtained through the data collection process immediately processed and analyzed by the researchers.
 Results of the study : The study states that the age of anesthesia nurses between 21 to 59 years, that the longer the period of employment will be more and more experience and better prepared for the patient, not the readiness of gender and all have the same roles and functions.
 Suggestion : Readiness nurse anesthesia before and during work is crucial to achieve satisfactory results in implementing the anesthesia.

Nurses' Resuscitation Performance: Study on the Effectiveness of Training and Support at a Teaching Hospital in KSA

Introduction: This paper discussed nurses' resuscitation trainings and their performance in a teaching hospital based on AHA guideline recommendations. The study explored the current standard practices and investigates the nurses' views on the effectiveness of the training, quality of equipment, familiarity and readiness of nurses in performing resuscitation. Methodology: A cross-sectional descriptive study conducted at teaching hospitals which mandate all nurses must be certified with the BLS and attends two code blue drill sessions per year. A self-administered questionnaire examined the support and guidance provided, the availability of resuscitation equipment and their quality/familiarity, the quality of training received in performing the resuscitation actions and finally explored the opinion in improving resuscitation. Results: The study revealed that the organization has established system to prepare the nurses adequately. Based on the 192 nurses, the total mean 2.63 supported that nurses are adequately trained with resuscitation knowledge and skills, 95% (n=171) of nurses were confident in announcing the code blue procedure, 93.3% (n=169) received appropriate training and 90% (n=162) found training instructors utilized standard method of simulation training which 90% (n=161) shared a real-life clinical scenarios are used in the training whilst 90.5% (n=162) stated SBAR is utilized as mode of communication and 66.6% (n=120) practiced post-procedure resuscitation debriefing. However, concerns were raised in three areas: availability of AEDs, cable and pad accessibility and permission to perform defibrillation procedures. In conclusion, study established nurses were well-prepared, trained and supported for resuscitation care.

Perceptions of Pediatric Critical Care Nurses on the Initiation of a Nursing-Led Feeding Protocol

Critically ill children frequently receive inadequate nutritional support. Feeding protocols have been shown to facilitate optimal nutritional care.We aim to determine the perceptions of critical care nurses with regard to the implementation of a feeding protocol as well as to their preferred teaching methods before introducing this protocol in our pediatric intensive care unit (PICU). We hypothesize that nursing experience and educational level are factors that predict readiness to adopt this protocol.All PICU nurses were invited to participate in an online survey to investigate their perceptions on protocol implementation and on preferred teaching methods. Statistical analysis was performed using simple logistic regression and the Fisher exact test. Statistical significance was taken as p < .05.Seventy-four nurses completed the survey. Fifty-four (73%) had nursing degrees. Mean duration of PICU experience was 6.2 years (5th, 95th percentile: 1, 15). Three quarters of participants (74%, n = 55) felt that they did not have sufficient knowledge regarding feeding protocols, and 86% (n = 64) expressed that they were keen to implement a feeding protocol. There was no association between readiness to adopt the feeding protocol with years of ICU experience (OR = 0.99, 95% CI [0.84, 1.18]) and educational level (OR = 1.43, 95% CI [0.31, 6.68]). The preferred teaching methods were bedside teaching (61%), didactic lectures (51%), and the distribution of protocol manuals (50%). PICU nurses felt that the advantages of a feeding protocol included standardization of practice, optimization of patient's nutritional intake, earlier initiation of feeding, increased patient safety, and the extension of nursing roles. Perceived disadvantages included inapplicability of the feeding protocol to all patients, lack of flexibility in feeding management, increased confusion, and doctors placing little value on the feeding protocol.This study found that nursing experience and level of education do not significantly affect the readiness of nurses to adopt a feeding protocol. Medical and nursing teams should not shy away from introducing a new protocol although their nurses have little experience or prior knowledge of that protocol. Future studies to investigate the impact of tailoring of educational needs before introduction of a new protocol are necessary to study the overall effectiveness of this teaching before introducing a new protocol in the ICU.

Information seeking and retrieval skills of nurses: Nurses readiness for evidence based practice in hospitals of a medical university in Iran

BackgroundWith the explosion of medical information, and emergence of evidence-based practice (EBP) in healthcare system, searching, retrieving and selecting information for clinical decision-making are becoming required skills for nurses. AimsThe aims of this study were to examine the use of different medical information resources by nurses and their information searching and retrieving skills in the context of EBP. MethodA descriptive, cross-sectional study was conducted in four teaching hospitals in Iran. Data were collected from 182 nurses using a questionnaire in 2014. ResultsThe nurses indicated that they use more human and printed resources than electronic resources to seek information (mean=2.83, SD=1.5; mean=2.77, SD=1.07; and mean=2.13, SD=0.88, respectively). To search online resources, the nurses use quick/basic search features more frequently (mean=2.45, SD=1.15) than other search features such as advanced search, index browsing and MeSH term searching. (1.74≤mean≤2.30, SD=1.01). At least 80% of the nurses were not aware of the purpose or function of search operators such as Boolean and proximity operators. In response to the question measuring skills of the nurses in developing an effective search statement by using Boolean operators, only 20% of them selected the more appropriate statement, using some synonyms of the concepts in a given subject. ConclusionThe study showed that the information seeking and retrieval skills of the nurses were poor and there were clear deficits in the use of updated information resources. To compensate their EBP incompetency, nurses may resort to human resources. In order to use the latest up to date evidence independently, nurses need to improve their information literacy. To reach this goal, clinical librarians, health information specialists, nursing faculties, and clinical nurse educators and mentors can play key roles by providing educational programs. Providing access to online resources in clinical wards can also encourage nurses to learn and use these resources.

Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals.

To investigate the reliability, validity and feasibility of the RAFAELA workforce planning system (including the Oulu patient classification system - OPCq), before deciding on implementation in Dutch hospitals. The complexity of care, budgetary restraints and demand for high-quality patient care have ignited the need for transparent hospital workforce planning. Nurses from 12 wards of two university hospitals were trained to test the reliability of the OPCq by investigating the absolute agreement of nursing care intensity (NCI) measurements among nurses. Validity was tested by assessing whether optimal NCI/nurse ratio, as calculated by a regression analysis in RAFAELA, was realistic. System feasibility was investigated through a questionnaire among all nurses involved. Almost 67000 NCI measurements were performed between December 2013 and June 2014. Agreement using the OPCq varied between 38% and 91%. For only 1 in 12 wards was the optimal NCI area calculated judged as valid. Although the majority of respondents was positive about the applicability and user-friendliness, RAFAELA was not accepted as useful workforce planning system. Nurses' performance using the RAFAELA system did not warrant its implementation. Hospital managers should first focus on enlarging the readiness of nurses regarding the implementation of a workforce planning system.

Nurses readiness and electronic health records.

Background:The importance of the electronic health records in health care well known to everybody, as well as, the role of nurses to provide clinical care; they have a valuable role in successful implementation of electronic systems. The aim of this paper is to assess the nurses’ readiness for EHR implementation.Methods and Materials:This was a descriptive cross sectional study, conducted in 2013. Using cluster sampling, 310 nurses selected from teaching hospitals at Tehran University of Medical Sciences (TUMS). A self-structured questionnaire was used for gathering data. Data management and analysis was performed using SPSS for windows by using descriptive statistics.Results:85.9% of nurses, participated in the study. The Microsoft Word (58.8%) was the higher level of skill according to ICDL. The mean of computer skills, knowledge and attitude of nurses towards EHR was 43.4%, 51.2% and 65.2%, respectively. In overall, the mean of readiness of nurses was 57.2%. Establish proper communication among providers and prevent duplications was the most positive attitude and complexity of service delivery was the most negative attitude toward EHR.Conclusion:The most obvious finding to emerge from this study is that it should be considered in the education, training and participation of nurses, it should be ensured the level of knowledge and attitude toward EHR and finally, some related courses in Health Information Systems suggested including the curriculum of nursing.

Ready for practice: What child and family health nurses say about education

Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence. To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning. The study used an interpretive descriptive approach. This paper presents data from four questions from a larger survey of child and family health nurses across Australia. 1098 child and family health nurses responded to the survey. Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis. Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning. This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities.

Assessment of knowledge, attitude and practice and associated factors towards palliative care among nurses working in selected hospitals, Addis Ababa, Ethiopia

BackgroundTo provide quality care at the end of life or for chronically sick patients, nurses must have good knowledge, attitude and practice about palliative care (PC). In Ethiopia PC is new and very little is known about the type of services offered and the readiness of nurses to provide PC.MethodsA cross sectional quantitative study design was carried out using 341 nurses working in selected hospitals in Addis Ababa from January 2012 to May 2012. Systematic random sampling was the method employed to select two governmental and two non-governmental hospitals. The researchers used triangulation in their study method making use of: Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale, Palliative Care Quiz for Nursing (PCQN) and practice questions. This led to enhanced validity of the data. EPI-INFO and SPSS software statistical packages were applied for data entry and analysis.ResultOf the total 365 nurses selected, a response rate of 341 (94.2%) were registered. Out of the total study participants, 104 (30.5%) had good knowledge and 259 (76%) had favorable attitude towards PC. Medical and surgical wards as well as training on PC were positively associated with knowledge of nurses. Institution, individuals’ level of education, working in medical ward and the training they took part on PC were also significantly associated with the attitude the nurses had. Nurses working in Hayat Hospital (nongovernmental) had a 71.5% chance of having unfavorable attitude towards PC than those working in Black Lion Hospital (governmental). Regarding their knowledge aspect of practice, the majority of the respondents 260 (76.2%) had poor implementation, and nearly half of the respondents had reported that the diagnosis of patients was usually performed at the terminal stage. In line with this, spiritual and medical conditions were highly taken into consideration while dealing with terminally ill patients.ConclusionThe nurses had poor knowledge and knowledge aspect of practice, but their attitude towards PC was favorable. Recommendations are that due attention should be given towards PC by the national health policy and needs to be incorporated in the national curriculum of nurse education.

Pre-deployment preparation of military nurses of the South African National Defence Force for participation in peace support operations.

South Africa has dedicated itself to participate in peace support operations (PSOs). The concept of 'jointness', involving different arms of services, was adopted within the South African National Defence Force, thus involving nurses in PSOs. Combat-readiness being a prerequisite for those involved in PSOs raised questions as to the readiness of forces to participate in these missions. There is a need for specific nursing care during PSOs, but the role and functions of nurses during such operations were not clearly defined; thus their preparation for these missions had very little scientific grounding. These were to explore the pre-deployment preparation needs of military professional nurses during PSOs, and to describe the experience of these nurses whilst being deployed. A quantitative exploratory, descriptive and contextual approach was used. Questionnaires were distributed to 99 professional nurses who had deployment experience, and 72 participated (73% response rate). Relevant peace mission concepts are the environment, jointness, behaviour and mission readiness, which served as the conceptual bases for the study. Findings indicated that the nurses were not fully informed of their responsibilities during deployment or the circumstances under which they would have to work and live. Their preparation is not fully integrated with that of the other armed forces, and deficiencies in their training and development were identified which negatively impact on their mission readiness. Recommendations were made in terms of human resource requirements, psychological training, better integration of jointness training, and content of training and development to ensure mission readiness of nurses.

Screening physical health? Yes! But…: nurses’ views on physical health screening in mental health care

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken.

Work readiness of graduate nurses and the impact on job satisfaction, work engagement and intention to remain

Graduate work readiness is a relatively new construct that can predict graduate potential. Its impact on graduate work outcomes however, is unknown. The current study aimed to explore the relationships between work readiness and a number of work outcomes (job satisfaction, work engagement, and intention to remain). A survey design was used. A sample of 96 graduate nurses from two regional hospitals in Victoria, Australia participated in this study. Data were collected using quantitative surveys Three of the four work readiness dimensions (organisational acumen, clinical competence and social intelligence) were found to predict job satisfaction and work engagement. Moreover, both job satisfaction and work engagement were found to mediate the relationship between organisational acumen and intention to remain. The findings indicate that dimensions of work readiness uniquely predict work outcomes. Findings support prior research, which suggests that graduate work readiness is a multidimensional construct comprising skills and attributes beyond discipline-specific competence.

Cultivating nurses’ potential to incorporate assessment and minimisation of the consequences of the effects of illness into presence

Background: In 2006 a phenomenological study was completed which explored the experiences of 14 participants (supportive spouses) each of whom had a partner who was hospitalised in a non-local tertiary centre. Methods: Data were gathered through unstructured interviews with the supportive spouse. Individual stories were analysed, underpinned by Heideggerian philosophy of understanding, and interviews with new participants continued until patterns of the experiences emerged. Three overall themes emerged from the research, ‘being in suspense’, ‘living day by day amid the unknown’, and juggling the unknown when the couples were separated emotionally from those who surrounded them; mainly because it was the everyday for hospital personnel, but unknown for the couples. Although they did not clearly articulate this, the catalyst for managing their non-local hospital experiences was bound in the readiness, or lack of readiness of nurses to engage in therapeutic interactions. This paper is focussing on the third of the overall research findings; that is of the importance of a therapeutic relationship. Results: A catalyst for managing hospitalisation is bound in the readiness of nurses to engage in therapeutic interactions (presence). Patient groups recognise this phenomenon when they perceive the nurse can appreciate the patient’s world view. Despite theorists clearly identifying caring (and therefore presence) as the key concept of nursing practice, the concept of presence is no longer reflected in the everyday world of nursing. Increased technological demands on nurses have resulted in nursing losing sight of its unique characteristics. Nursing needs to move beyond being measured in terms of technical competency, and should ensure instead that nurses develop confidence in articulating what constitutes the holistic characteristics of care. On emphasising the need for greater emphasis of presence to practice, nurses need to be mindful of the value placed on care; a re-emphasis of presence in nursing education programmes; and, modelling of care in practice. Conclusions: Academic and clinical nurses need to argue that presence is the defining principle of nursing care, and, therefore, must be included in assessments. The inclusion of presence as a competency will substantiate the argument that nursing is more than the technical-based frameworks and will underscore that presence is the key underpinning principle of optimal care.

Readiness of nurses for practicing telehealth.

Nurses represent the largest group of healthcare professionals; and their role in healthcare is diverse. The lack of nurses in the workforce and the increasing demand of care continues to challenge health systems across the globe. Telehealth has been identified as a potential alternative method for delivering health services. Evidence is emerging that the use of telehealth by nurses results in efficiency gains and cost effective health care delivery. Regardless of growing evidence, the use of telehealth in nursing practice is still very limited. The lack of systematic education programs in telehealth and the lack of resilience in regards to organisational change remain significant barriers for the uptake of telehealth for nurses.

Improving the Quality of Rheumatoid Arthritis Patients' Education Using Written Information

The objective of this study was to evaluate whether the quality of patient education could be improved by using written education materials. Seventy-five inpatients with rheumatoid arthritis (RA) were provided with individual education sessions during their inpatient stay. The education sessions were supported with written educational materials. A patient education quality instrument was used to assess the sufficiency and implementation of the education and the readiness of nurses and doctors to deliver the education. A Mann-Whitney U-test and content analysis was used to analyse the data. There was a statistically significant difference in the sufficiency of education concerning the disease, medication and treatment after the revised material was introduced (p < 0.005). The quality of interaction improved significantly during the intervention (p = 0.004). The strengths of the education included individual treatment, two-way interaction, the opportunity to receive patient education and its sufficiency. Clear, readable and understandable written education material improved the quality of the education of RA patients in terms of implementation, sufficiency and the readiness of nurses and doctors to deliver the education.

Medical–Surgical Nursing at the 86th Combat Support Hospital (2007–2009) in Support of Operation Iraqi Freedom: Caring for Host Nation Patients

A descriptive study of the patients admitted to the host nation intermediate care ward (ICW) of the 86th Combat Support Hospital in Baghdad, Iraq was performed. A retrospective chart review was conducted of the patients admitted to the host nation ward between June 2 and September 5, 2008. One hundred and forty host nation patients were included in the study. Patient demographics, origin of admission, length of stay, and disposition of patient are reported. The types of illnesses and injuries most commonly seen as well as the most common surgical procedures are also reported. This study details the nursing care provided to host nation armed forces and civilians during a 3-month period of the deployment of the 86th CSH in Baghdad, Iraq. Information gained from this study is important for predeployment training and readiness of nurses preparing to deploy to Iraq.

Self-Assessed Emergency Readiness and Training Needs of Nurses in Rural Texas

Nurses, particularly public health nurses, play a key role in emergency preparedness and response in rural areas. To prepare rural jurisdictions for unforeseen disastrous events it is imperative to assess the public health emergency readiness and training needs of nurses. The objective of this study was to assess the self-reported terrorism preparedness and training needs of a nurse workforce. Cross-sectional prevalence of practicing nurses in regions of North Texas. 3,508 rural nurses practicing in North Texas participated in the study. Data were collected through a mailed survey; analyses included multinominal logistic regression and descriptive statistics. A total of 941 (27%) nurses completed the survey. The majority of respondents reported limited bioterrorism-related training. Fewer than 10% were confident in their ability to diagnose or treat bioterrorism-related conditions. Although only 30% expressed a willingness to collaborate with state and local authorities during a bioterrorism event, more than 69% indicated interest in future training opportunities. Preferred training modalities included small group workshops with instructor-led training, and Internet-based training. Licensing agencies, professional organizations, and community constituencies may need to play a stronger role in improving the bioterrorism-related emergency preparedness of rural nurses.

Improved Nurse Readiness Through Pediatric Mock Code Training

The proficiency of the nursing staff in pediatric resuscitation is limited when realistic and consistent practice is not provided. NADEL ET AL., 2000a, 2000b and Van Schaik, Von Kohorn, and O'Sullivan (2008) found that inpatient pediatric cardiopulmonary arrests are infrequent events (Nadel et al., 2000a, 2000b). However, this fortunate rarity places a significant burden on the staff responsible for the child to remain proficient in the skills needed. Staff and physician training, such as Pediatric Advanced Life Support (PALS) and mock codes, have been developed to address this problem. Gilfoyle, Gottesman, and Razack (2007); Smith and Crnkovic (1994); Toback, Fiedor, Kilpela, and Reis (2006); and Monachino (2005) have demonstrated that pediatric “mock code” training is a useful tool to improve the proficiency and confidence of physicians and staff in community hospitals and in the outpatient setting, as well as during residency training (Mikrogianakis et al., 2008). However, the proficiency of the nursing staff in pediatric resuscitation is limited when realistic and consistent practice is not provided. Limitations of mock code training include insufficient time and opportunity for training of staff and an insufficient number of qualified instructors. Gilfoyle et al. (2007) and van Schaik et al. (2008) demonstrated that during a mock code, chance dictates the opportunity to take part in simulated code scenario, and these scenarios are not availed by all participants. In a community hospital setting, pediatric or emergency physicians may not be immediately available. Therefore, the nursing staff needs to be thoroughly comfortable in initiating