Nursing Skills Research Articles

Enhancing the competencies of obstetrical nurses and midwives in high-risk pregnancy management through simulation-based training in Lao people's democratic republic: A pilot study

BackgroundSimulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited. AimTo examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives’ knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting. MethodDuring September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared. FindingsWorkshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills. ConclusionsThe simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.

Effectiveness of an Educational Program on Improving Nursing Care for Thalassemia Patients Undergoing Blood Transfusion

Background: Thalassemia is a genetic disorder that disrupts hemoglobin production, leading to severe anemia. Beta-thalassemia major patients often require lifelong blood transfusions. Nurses play a crucial role in managing these transfusions, but gaps in knowledge and practice can lead to complications. This study assessed the impact of an educational program on nurses' knowledge and skills regarding thalassemia and blood transfusion protocols. Methods: A quasi-experimental study was conducted at the Jin Pediatric Hematology-Oncology Center in Duhok City, Iraqi Kurdistan. The sample included 20 nurses. The program consisted of four sessions (two theoretical and two practical). Data collection instruments included a socio-demographic sheet, a knowledge questionnaire, and a skills checklist. Pre- and post-intervention knowledge and practice scores were analyzed using paired t-tests and chi-square tests. Results: The educational program significantly improved nurses' knowledge of thalassemia (P < 0.00) and transfusion protocols, with the mean knowledge score increasing from 5.2 ± 2.09 to 8.05 ± 1.82. Practice scores also showed statistically significant improvements (P < 0.002). Correlations between total knowledge and practice scores, as well as with nurses' experience and educational level, were statistically significant. Conclusion: The study demonstrated that an educational program can enhance nurses' knowledge and practices in managing thalassemia patients undergoing blood transfusions. Continued education and targeted interventions are essential to improving the quality of care for these patients.

Hospital–Skilled Nursing Facility Integration and Participation in a Bundled Payment Initiative

Reduced institutional postacute care has been associated with savings in alternative payment models. However, organizations may avoid voluntary participation if participation could threaten their own revenues. To characterize the association between hospital-skilled nursing facility (SNF) integration and participation in Medicare's Bundled Payments for Care Improvement Advanced (BPCI-A) program. This is a cross-sectional analysis of hospital participation in BPCI-A beginning with its launch in 2018. Each SNF-integrated hospital was matched with 2 nonintegrated hospitals for each of 4 episode-specific analyses. Fifteen hospital-level variables were used for matching: beds, case mix index, days, area SNF beds, metropolitan location, ownership, region, system membership, and teaching status. Hospitals were also matched on episode-specific volume, target price, and the interaction of target price and case mix. Episode-specific logistic models were estimated regressing hospital participation on integration and the previously listed variables. The marginal effect of integration on participation was then calculated. Analysis took place from August 2022 to May 2024. Hospital-SNF integration, as defined by common ownership and referral patterns and identified using cost reports, Medicare claims, and Provider Enrollment, Chain, and Ownership System records. Additional sources included records of target prices and participation, the Area Health Resources File, and the Compendium of US Health Systems. Participation in BPCI-A. In total, 1524 hospitals met criteria for inclusion in the hip and femur (HFP) analysis, 1825 were included in the major joint replacement of the lower extremity (MJRLE) analysis, 2018 were included in the sepsis analysis, and 1564, were included in the stroke-specific analysis. Across episodes, 191 HFP-eligible hospitals (12.5% of HFP-eligible hospitals), 302 MJRLE-eligible hospitals (16.5%), 327 sepsis-eligible hospitals (16.2%), and 185 sepsis-eligible hospitals (11.8%) were SNF integrated. In total, 79 hospitals (5.2%) participated in the HFP episode, 128 (7.0%) participated in the MJRLE episode, 204 (10.1%) participated in the sepsis episode, and 141 (9.0%) participated in the stroke episode. Integration was associated with a 4.7-percentage point decrease (95% CI, 2.4 to 6.9 percentage points) in participation in the MJRLE episode. There was no association between integration and participation for HFP (0.5-percentage point increase in participation moving from nonintegrated to integrated; 95% CI, -2.9 to 3.8 percentage points), sepsis (1.0-percentage point increase; 95% CI, -2.2 to 4.2 percentage points), and stroke (0.3-percentage point decrease; 95% CI, -3.1 to 3.8 percentage points). In this cross-sectional study, there was an uneven association between hospital-SNF integration and participation in Medicare's BPCI-A program. Other factors may be more consistent determinants of selection into voluntary payment reform.

Associations Between COVID-19 Symptoms & Amounts of PT & OT in COVID-19 Patients in a Skilled Nursing Facility

Abstract Date Presented 03/22/24 This study explored potential associations between COVID-19–related symptoms and rehabilitation intensities. COVID-19 patients with delirium may be less able to tolerate high rehabilitation amounts. Moderate rehabilitation amounts are recommended. Primary Author and Speaker: Benjamin Ezra Canter Additional Authors and Speakers: Anne Escher Contributing Authors: Lauren Raschen, Joann Reinhardt, Himali Weerahandi, Wingyun Mak, Orah Burack, Kenneth Boockvar

Application of Virtual Combined Simulation Model in Experimental Teaching of Intravenous Infusion in Pediatric Nursing in Higher Vocational Education

Objective: To explore the effect of virtual teaching combined with simulation models in the teaching of intravenous infusion skills in pediatric nursing in vocational colleges. Method: A total of 296 nursing college students from the 2021 cohort were enrolled in the teaching of intravenous infusion skills for children using virtual and simulation models called Simbaby. A questionnaire survey and operational assessment were conducted before and after the teaching. Result: Students were highly satisfied with the teaching of virtual combined simulation models, with an average score of 92.5 in the assessment of intravenous infusion operations. In the interview with the head nurse of clinical pediatrics, the evaluation of nursing students was good. Conclusion: The combination of virtual teaching and simulation models has a good effect on the teaching of intravenous infusion skills in pediatric nursing in vocational colleges and can be promoted.

Current situation of knowledge, practice skill of nurses on wound care and some related factors according to Vietnamese nursing competency standards: A study in a hospital in Hanoi

Background: The introduction of Vietnamese Nursing Competency Standards in 2012 has urged the needs for re-assessment of nursing skills, with the aim to improve the quality of the training on wound care in country. Purposes: The study aimed to describe knowledge and practice of nurses on wound care and identify some the related factors in order to make the recommendation for improvement of the nursing care competency. Methods: This a cross-sectional descriptive prospective study was conducted in Ha Dong General Hospital from July 2023 to October 2023. Results: 76 clinical nurses were enrolled with the mean age was 35.6±6.8 years, female nurses most commonly accounted for 89.5%. Notably, the lowest average score in terms of knowledge was observed in suture removal (9.74±3.21) and pressure ulcer wound care (6.93±1.63). In terms of practice, the lowest average score was recorded for pain assessment and bleeding control (7.91±1.33). Furthermore, the study revealed a statistically significant correlation between knowledge and working experience (p<0.05). Nurses with a good level of knowledge were found to have a 4.66 times higher likelihood of demonstrating good practice (OR=4.66). Conclusions and recommendations: The factors related to the competency of wound care of nurses were found in the study strongly suggest the need for improvement of quality of training in order to align with the established standards.

How to take a comprehensive patient history.

A significant proportion of diagnoses are made based on history taking, often alongside physical assessments and laboratory investigations. Taking a thorough patient history is fundamental for the accurate diagnosis and effective management of health conditions. This article outlines a step-by-step process for taking a comprehensive patient history and discusses the evidence for this procedure. • History taking is a structured but flexible process of gathering relevant information from patients to inform diagnosis and treatment. • Important communication skills for nurses when history taking include active listening, empathetic communication and cultural sensitivity. • By actively engaging the patient in a conversation about their health issues, the nurse facilitates their participation and autonomy. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when taking a patient history. • How you could use this information to educate nursing students or colleagues on taking a patient history.

Trends in Diverticular Disease Hospitalizations and Racial Disparities in Outcomes Across the United States.

Objective This study evaluated trends and racial disparities in hospitalization, clinical outcomes, and resource utilization for diverticular disease (DD) between 2017 and 2020. Methods We performed a retrospective analysis using the NISdatabase from 1 January 2017 to 31 December2020to study hospitalizations for DD (CCSRcode: DIG013). Our primary outcomes were hospitalization rates, all-cause mortality, total charges, and length of stay. Secondary outcomes included in-hospital complicationsand discharge status. Outcomes were stratified by race and ethnicity (White, Black, Hispanic, Asian or Pacific Islanders and Native Americans). Data were weighted and adjusted for clustering, stratification, and other relevant factors. The normality of the continuous data distribution was confirmed usingKolmogorov-Smirnov, and descriptive statistics were used to summarizevariables. Demographic characteristics were compared usingχ² and Student's t-test, with significance set at P<0.05. We usedstepwise multivariable logistic regressionto estimateadjusted odds ratios for studyoutcomes by race and ethnicity, controlling for demographic and clinical factorsand correcting for multicollinearity. Missing data were treated with multiple imputations, trend analyses were performed using Jonckheere-Terpstra tests, and costs were adjusted for inflation using the GDPprice index. Analyses were conducted with Stata 17MP. Results A total of 1,266,539 hospitalizations for DD were included for analysis. Approximately953,220 (75.3%) were White patients and 313,319 (24.7) did not belong to the White race. Atotal of 747,868 (59%) were women compared to 518,671 (41%) men. Compared to patients who were not of the White race, White patients were younger(63.5 vs. 66.8 years; p<0.001). Hospitalizations for DD increased by 1.2% from 323,764 to 327,770 hospitalizations (2017-2019) and decreased by 11.8% from 327,770 to 289,245 admissions in 2020. Mortality rates were higher among White patients than in those not of the White race (16,205 (1.7%) vs 5,013 (1.6%)).However, no significant difference was observed in mortality odds between both sets of patients (aOR, 0.953; 95% CI 0.881-1.032; P=0.237).Mortality rates showed an uptrend over the study period (4,850 (1.5%) in 2017 to 5,630 (1.9%) in 2020; Ptrend<0.001).DD accounted for 7,016,718 hospital days, 2,102,749 procedures, and US$ 6.8 billion in hospital costs. Mean hospital costs increased from US$54,705 to US$72,564 over the study period (P<0.000). Patients who were not of the White race incurred higher mean hospital charges than White patients ($67,635 ± $6,700 vs $59,103 ± $3,850; P<0.001). Black race correlated with lower odds of bowel perforation, routine home discharge, and bowel resection (P<0.001). Conclusion During the study period, hospitalization and mortality rates and resource utilization for DD increased. Patients from other racesincurred higher hospital costs than White patients. White Americans were more likely to be discharged to skilled nursing, intermediate care, and other facilities. Additionally, White patients were less likely to develop bowel abscesses compared to patients who were not White. Compared to White American patients, Black patients had fewer DD hospitalizations complicated by bowel perforations or requiring bowel resections. In contrast, DD admissions among Hispanic patients were more likely to require bowel resections than those among White American patients.

Can an Immersive Virtual Reality 360 Enhancing Students' Self-Directed Learning on Diabetes Knowledge and Self-Efficacy?

Nurses need to be competent in clinical nursing knowledge and skills via engagement in continuing education. The knowledge of nurses should be updated especially in caring for diabetes disease. The potential for immersive experience provision by 360-degree video. This study aims to design an immersive interactive learning experience based on 360° immersive videos and pilot testing on nursing students receiving diabetes education.

Data Preparation for Supervised Learning: Improving Nursing Situation Awareness to Reduce Healthcare-Acquired Urinary Tract Infection.

Situation awareness (SA) is an important non-technical skill for nurses. Nurses interact directly with patients and review their clinical signs. If we improve nurses' SA, they will likely detect clinical changes and prevent patient harm. A clinical endeavor that can benefit from improved nurses' SA is the prevention of Healthcare-Acquired Urinary Tract Infection (HAUTI). Electronic Health Records contain comprehensive nursing assessment data that researchers can use to analyze trends and provide a context-based understanding of the infection risk factors. We conducted a study that involved extracting nursing assessment data and preparing it for supervised learning algorithms and predicting HAUTI. In this paper, we share the methods we used to prepare the data for supervised learning algorithms and present the challenges related to data missingness.

Continuing Professional Development (CPD) Impact to Clinical and Nursing Practice: A systematic literature review

Introduction and aims: Professionalism is an obligation for nurses in carrying out nursing care in hospitals and this is obtained from continuing professional development (CPD). The aim of this research is to review the benefits of CPD in nursing practice. Material and methods: This paper is a literature review using several databases, namely Scopus, PubMed, Science Direct. Articles were searched with the keywords /MeSh “[Continuing Professional Development]” OR “[CPD] AND “[Nursing]”AND [Professional]. Result: Based on the search results, 9 articles were found with mixed methods n=2, qualitative n= 2 and quantitative n=5. Conclusion: CPD impacts nurses' knowledge, skills, job retention, patient safety and quality of care.

Challenges and support systems of nurses caring for women with advanced cervical cancer in Accra, Ghana

IntroductionCervical cancer is one of the causes of female deaths worldwide. Cervical cancer incidence is rising with almost three thousand (2797) women in Ghana being diagnosed with the condition each year, with almost two thousand (1,699) of them dying from its complications Nurses caring for cervical cancer patients are exposed to emotional and psychological distress due to late presentation, the burden of care, patients’ suffering and the alarming number of deaths associated with it. Improving positive patient outcomes require identifying the challenges and support systems available to nursing staff so as to harness these support systems for improving care outcomes.AimThis study explored the challenges and support systems of nurses caring for women with advanced cervical cancer in Accra, Ghana.MethodIn this study, we adopted an exploratory qualitative design. The study was conducted among eleven (11) nurses and nine (9) midwives engaged at the national referral hospital in Ghana who were providing care for patients with advanced cervical cancer for over a year who were purposively sampled. The data was collected using in-depth interviews with a pre-tested semi-structure interview guide from the twenty participants. We recorded the interviews using an audio-tape. The audio files were transcribed verbatim and thematic analysis was undertaken with the aid of Nvivo 10.0.ResultsThe challenges when rendering nursing care faced by participants of this study were exposure to frequent deaths, inadequate resources, and workload. Most participants lamented that they received absolutely no support from their workplace, hence their only form of support was from their family and friends. They also added that most of them were general nurses and midwives with no special training in oncology nursing or palliative nursing.ConclusionNurses and midwives experience resource, knowledge and skill challenges when caring for patients with advanced cervical cancer. However, the nurses and midwives had emotional attachment to their jobs and their patients and were not distracted by their bad experiences. We recommend improving resource allocation for cervical cancer care through the National Health Insurance Authority (NHIA), Ghana and increased training of nurses in oncology and palliative nursing by the Ministry of Health, Ghana to improve knowledge and skills of the nurses and midwives caring for women with advanced cervical cancer to improve their quality of care. Further, hospitals must make it a priority to have more nurses and midwives trained in oncology and end of life care to improve the knowledge and skills of nurses and midwives caring for advanced cervical cancer patients. Also, these findings should trigger policy-level discussions at the Ministry of Health, Ghana on the training of specialized nurses and midwives in cancer and end of life care to help Ghana meet the sustainable development goal targets related to health.

Effects of integrated management on surgical outcomes and mental health of patients following endoscopic submucosal dissection.

Endoscopic submucosal dissection (ESD) is a less invasive local treatment for diseases throughout the gastrointestinal tract. To develop an integrated management protocol and analyze its effects on surgical outcomes and mental health of patients after ESD. The study population consisted of patients undergoing ESD before implementation of integrated management and those undergoing ESD by the same pool of surgeons after implementation of integrated management. The management group exhibited shortened fasting time and length of hospital stay compared to the control group (P < 0.05). The management group exhibited a higher incidence rate of postoperative complications than the control group (3 cases vs 11 cases; P = 0.043). The management group exhibited a lower uncertainty score for disease knowledge compared to the control group 12 h after surgery (P < 0.05). The management group gave more scores on the domains of patient familiarity to the responsible nurses, professional skills of responsible nurses, and general evaluation compared to the control group. The management group had a higher total score of patient satisfaction towards the responsible nurses in term of health care than the control group (P < 0.01). The management group exhibited lower Self-Rating Anxiety Scale and Self-Rating Depression Scale scores compared to the control group 12 h after surgery (P < 0.01). The study demonstrates that integrated management could improve surgical outcomes and mental health of patients undergoing ESD.

Nursing student's experiences of Role-Play Scenario-Based Disaster Triage (START) training: A qualitative research

BackgroundDisasters can overwhelm healthcare systems, making effective triage a crucial skill for nurses. Role-Play Scenario-Based Disaster Triage Training offers a promising approach to prepare nursing students for these situations. Understanding students' experiences with this training method can inform its development and effectiveness in fostering disaster preparedness. However, little is known about this training experience of nursing students. In particular, by examining the challenges faced by students, the emotional distress they experience and their achievements, it will provide guidance for the development of education programs in a more comprehensive and student-oriented manner. AimThe aim of this study is to elucidate the experiences of nursing students regarding Role-Play Scenario-Based Disaster Triage Training. Design and methodsA qualitative approach was employed to comprehend participating students' experiences. Face-to-face and online semi-structured interviews were conducted with 17 students using an interview guide, and the interactions were recorded for subsequent analysis. Thematic analysis was employed to develop themes. ResultsThe study results emphasize the challenges experienced by students during triage training, their gains and the support they need to cope with the challenges they experience. Data were organized around four main themes: “Challenges of the triage process” with subthemes such as “Thinking of the actual earthquake moment” and “Ethical dilemmas”; “Emotional turmoil” with subthemes including “Anxiety” and “Fear and Helplessness”; “Achievements” with subthemes such as “Increase in knowledge and skills” and “The importance of the nurse”; and “Suggestions” with subthemes including “Continuous education” and “Mandatory course”. ConclusionsThe findings of the study provide new insights into the experiences of nursing students during the disaster triage process. The results may contribute to the improvement of future training programs by identifying the challenges and needs faced by nursing students after disaster triage education.

Education of postpartum hemorrhage management clinical skills among midwifery students in Malawi: A qualitative study

BackgroundUnskilled health professionals in healthcare systems are contributing to the high numbers of maternal mortality in Malawi. It is therefore essential that midwifery students acquire postpartum hemorrhage management clinical skills, especially in view of high maternal mortality, with postpartum hemorrhage being the leading cause. However, there is limited evidence on how the teaching is conducted with regard to students’ learning of postpartum hemorrhage management clinical skills. PurposeThis study aimed to describe the current teaching of postpartum hemorrhage management clinical skills in undergraduate nursing and midwifery program in Malawi. MethodsThe study applied a qualitative exploratory descriptive design. Data were collected through ten individual interviews with lecturers and three focus group discussions with twenty-four students in a midwifery education program in Malawi. The data were analyzed using thematic analysis. ResultsTwo themes emerged from the data analysis: (1) there are various teaching and learning approaches for postpartum hemorrhage management in use and (2) unpreparedness of midwifery students in postpartum hemorrhage management for patient care. ConclusionThe present study demonstrated that teaching of postpartum hemorrhage management clinical skills in an undergraduate nursing and midwifery programme in Malawi focuses on theoretical knowledge rather than practical skills, leaving midwifery students unprepared for postpartum hemorrhage management during clinical practice. The findings from the present study may provide knowledge guiding revision of the curriculum for the undergraduate nursing and midwifery programme in Malawi to consider global standards of midwifery education; enhance the lecturer to student ratio to provide the students with appropriate supervision; and to employ innovative teaching and learning strategies that promote peer education and skills practice among midwifery students. In addition, to conduct more research related to various teaching approaches in nursing and midwifery educational programs and among qualified midwives in Malawi. Statement of significancePostpartum hemorrhage management education in undergraduate nursing and midwifery programme in Malawi focuses more on theory than clinical skills. Improving midwifery students' acquisition of postpartum hemorrhage management clinical skills is needed to ultimately help lower Malawi's maternal mortality ratio.

Development of Promising Interventions to Improve Human Papillomavirus Vaccination in a School-Based Program in Quebec, Canada: Results From a Formative Evaluation Using a Mixed Methods Design.

Despite the availability of school-based human papillomavirus (HPV) vaccination programs, disparities in vaccine coverage persist. Barriers to HPV vaccine acceptance and uptake include parental attitudes, knowledge, beliefs, and system-level barriers. A total of 3 interventions were developed to address these barriers: an in-person presentation by school nurses, an email reminder with a web-based information and decision aid tool, and a telephone reminder using motivational interviewing (MI) techniques. Here we report on the development and formative evaluation of interventions to improve HPV vaccine acceptance and uptake among grade 4 students' parents in Quebec, Canada. In the summer of 2019, we conducted a formative evaluation of the interventions to assess the interventions' relevance, content, and format and to identify any unmet needs. We conducted 3 focus group discussions with parents of grade 3 students and nurses. Interviews were recorded, transcribed, and analyzed for thematic content using NVivo software (Lumivero). Nurses received training on MI techniques and we evaluated the effect on nurses' knowledge and skills using a pre-post questionnaire. Descriptive quantitative analyses were carried out on data from questionnaires relating to the training. Comparisons were made using the proportions of the results. Finally, we developed a patient decision aid using an iterative, user-centered design process. The iterative refinement process involved feedback from parents, nurses, and experts to ensure the tool's relevance and effectiveness. The evaluation protocol and data collection tools were approved by the CHU (Centre Hospitalier Universitaire) de Québec Research Ethics Committee (MP-20-2019-4655, May 16, 2019). The data collection was conducted from April 2019 to March 2021. Following feedback (n=28) from the 3 focus group discussions in June 2019, several changes were made to the in-person presentation intervention. Experts (n=27) and school nurses (n=29) recruited for the project appreciated the visual and simplified information on vaccination in it. The results of the MI training for school nurses conducted in August 2019 demonstrated an increase in the skills and knowledge of nurses (n=29). School nurses who took the web-based course (n=24) filled out a pretest and posttest questionnaire to evaluate their learning. The rating increased by 19% between the pretest and posttest questionnaires. Several changes were made between the first draft of the web-based decision-aid tool and the final version during the summer of 2019 after an expert consultation of experts (n=3), focus group participants (n=28), and parents in the iterative process (n=5). More information about HPV and vaccines was added, and users could click if more detail is desired. We developed and pilot-tested 3 interventions using an iterative process. The interventions were perceived as potentially effective to increase parents' knowledge and positive attitudes toward HPV vaccination, and ultimately, vaccine acceptance. Future research will assess the effectiveness of these interventions on a larger scale.

The effect of intestinal stoma care training on knowledge and skill levels of pediatric surgery nurses

Objectives: The study aimed to examine the effect of intestinal stoma care training on the knowledge and skill levels of pediatric surgery nurses in stoma care and to determine the factors affecting the knowledge and skill levels of pediatric surgery nurses in stoma care. Materials and methods: This quasi-experimental prospective study included 30 nurses (28 females, 2 males; mean age: 33.0±7.5 years; range, 23 to 46 years) working in pediatric surgery clinics who met the inclusion criteria between September 2023 and January 2024. A pediatric intestinal stoma care training was given to the nurses using a 20-min video prepared by the researchers. Data were collected by using a sociodemographic survey and a pediatric stoma care knowledge and skills survey developed by the researchers. The knowledge and skill levels of the nurses before and after the training and after three months were compared. Results: It was found that the pediatric intestinal stoma care training increased the knowledge and skill levels of the nurses. There was a difference between the mean number of practiced skills of nurses working only during the day and nurses working only at night before the training, and this difference was found to be statistically significant. Conclusion: Increasing the knowledge and skill levels of nurses about stoma care could decrease the risk of complications and the duration of hospitalization, ensure cost-effective care, and support the national economy in this direction.

Informing the clinical reasoning of advanced practice students with nursing theories

This article examines the integration of a Clinical Nurse Reasoning (CNR) model into advanced nursing practice training to develop the clinical reasoning skills of advanced practice nurses. The article explores the contribution of Callista Roy's conceptual model of adaptation and presents a global analysis of a complex care situation that justifies the introduction of an CNR model paired with nursing knowledge to ensure comprehensive, quality nursing care.

Nurses' experiences of hospital‐acquired pressure injury prevention in acute healthcare services in Victoria, Australia: A qualitative study using the Theoretical Domains Framework

AbstractWe investigated nurses' experiences of hospital‐acquired pressure injury (PI) prevention in acute care services to better understand how PI prevention may be optimised. We used the Theoretical Domains Framework to systematically identify barriers and enablers to evidence‐based preventive practices as required by the International Guideline. This study was one element of a complex capacity building project on PI surveillance and prevention within the acute health service partners of Monash Partners Academic Health Science Centre, an accredited academic health partnership located in Melbourne, Australia. We adopted a qualitative descriptive design. We interviewed 32 nurses that provided care in intensive care units, general wards and COVID wards of four acute care services. Nurses were recruited from four large acute care services (three public, one private) located in Melbourne. Most of them worked with patients who were at high risk of hospital‐acquired PI on a daily basis. Interview transcripts were coded and analysed using thematic analysis guided by the Theoretical Domains Framework. The domains referred to most frequently by all participants included: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, and Environmental Context and Resources. The key barriers discussed by nurses included gaps in nurses' knowledge and skills related to identification and staging of PI, heavy nursing workload and inadequate staffing levels, stigma and self‐blame related to PI identification, and exacerbating impacts of the COVID‐19 pandemic. Main facilitators discussed were training programmes, nursing audits and feedback, and teamwork. Participants suggested improvements including accessible and tailored training, visual reminders, and addressing heavy workloads and emotional barriers nurses face. Investing in tailored training initiatives to improve nurses' knowledge and organisational changes to address low level staffing and heavy workloads are urgently needed to support nurses in delivering optimal care and preventing hospital‐acquired PI.

Mastering the Art of Making Patients Satisfied: Introducing the Evaluation of Seven Nursing Care Dimensions Among Patients and Families Within the Directorate General of Khoula Hospital (Dgkh) - Cross Sectional Survey

Introduction and Background: The most important predictor of nursing care is patient’s perceptions and expectation toward that care. Nurses are involved in almost every aspect of patient’s care in hospital. For this, highlighting on the roles and responsibilities of bedside nurses on achievening the best level of PS is important. Problem Statement: A study to assess patient satisfaction level with quality of nursing care within DGKH. Methodology: Cross sectional descriptive study approach was used by means of distribution of barcode surveys in all in patients wards, ICU, NICU and ED. The questions of the surveys explain the following nursing dimensions: Admission Process, Patient’s Needs &amp; Comfort, Pain Management, Communication Aspects, Nurse Attitudes, Nurses Skills and Competency and Patient and Family involvement. Conduction and Sampling: A pilot study (phase one) of patient satisfaction valuation was started for one month- September 2021. Total of 279 participants were involved. During the pilot, a new rating scale is also examined. Phase two started with the effect from 02nd of March 2022 to 30th of May 2022, in which a total of 462 forms were collected. After that, 329 forms were collected with the effect from 1st of June to 30th of October 2022. The implementation continued in which a total of 2376 surveys were collected from the period of 01st January 2023 till 31st December 2023. Results: Out of 2376 surveys being collected, the majority of patients and their relatives have a high satisfaction rate with the provided nursing care with 93%. The highest complements raised in taff attittudes. Among 11308 respondents, 86% stated that nurses were excellent and treated them with respect and kindness. Majority of responds, 83%, rated the patient’s accurate identification as excellent. Maintaining of hand washing and other infection control measures, taking of consent before any procedure and maintaining of patient’s privacy, are also rated as excellent by the majority with 82% for each. Nursing monitoring to safety measures and implementing of pain management strategies, were rated as excellent with 81.9%. There was also a total of 1678 complements &amp; only 162 complains being raised. 256 statements raised about “the nurse treats me with respect and kindness” and 107 statements of “the nurse monitors my condition frequently”. On the other hand, majority of complains were about “The nurse not providing me with clean, warm &amp; quite environment” with 51 complain and about “The nurse not ensuring proper and good food” with 34 complains. Conclusion and Implications: The new updated tool was able to assess and monitor different outcomes in nursing care. Through this, nurses can understand their strength and weakness and other alternatives that effectively can change the level of care. This includes also increasing of nurses’ knowledge of patient feelings and expectations. Planning and conducting of education programs that enhance this knowledge is one of the proposed interventions. In addition, the role of nursing administration should be also prioterized to bring about any changes in nursing practice, like staffing needs and motivation strategies.