Specific Nursing Care Research Articles

Time, resourcing, and ethics: how the routinisation of organ donation after circulatory death in the NHS has created new ethical issues

ABSTRACT Controlled Organ Donation after Circulatory Death (DCD) was re-introduced in the UK in 2008, in efforts to increase rates of organs for transplant. Following reintroduction there were debates about the ethics of DCD, leading to production of legal and ethical guidelines. Today, DCD makes up 40% of deceased organ donors, leading to claims that the UK has ‘overcome’ its ethical challenges. However, there is little understanding of how DCD works in practice and the ethical implications of making DCD routine in the context of the NHS. This paper draws on data from an ethnographic study examining the practices of DCD in two acute NHS Trusts in England. Interviews with Intensive Care staff and Specialist Nurses in organ donation, observations of organ donation committee meetings and analysis of Trust documents were conducted. Findings reveal that the routinisation of DCD has created new ethical issues relating to interactions between organisational timeframes for DCD and (under)resourcing for, and de-prioritisation of, donation within an NHS subject to austerity. They include: the perceived burden on families and implications for consent when there are delays in the donation process, due to theatre space and retrieval team shortages; family and staff distress when death does not happen ‘on time’; and the problem of where to take patients who do not die in time to donate. I argue these temporal-ethical issues are likely to become heightened as potential donor rates increase with the new opt-out legislation, unless the resourcing required to deal with these problems are also addressed.

Surgical Treatment of Habitual Temporomandibular Joint Dislocation Caused by Aging

Temporomandibular joint dislocation occurs not only in the elderly but in all age groups. However, in recent years, the number of elderly people with various underlying diseases such as dementia, cerebral infarction, and Parkinson’s disease has increased, and the number of elderly people who suffer habitual dislocation of the temporomandibular joint has also increased. It is considered that there are potential patients in special nursing homes and health care facilities for the elderly, and thus a large-scale fact-finding survey is desired. There is a consensus that non-invasive therapy is the first choice for the treatment of habitual temporomandibular joint dislocation. Currently, non-invasive treatments as well as invasive treatments such as the mandibular condyle anterior motion inhibition method and the mandibular condyle reduction method are being performed at many facilities for treating habitual temporomandibular joint dislocation. It is our duty as surgeons to choose minimally invasive surgery as surgical therapy. Therefore, there is an urgent need to accumulate cases and determine trends through joint research with other institutions and to select minimally invasive surgery.

What factors contribute to the need for physical restraint in institutionalized residents in Taiwan?

In Taiwan, physical restraint is commonly used in institutions to protect residents from falling or injury. However, physical restraint should be used cautiously to avoid side effects, such as worse cognition, mobility, depression, and even death. To identify the rate of physical restraint and the associated risk factors in institutionalized residents in Taiwan. A community-based epidemiological survey was conducted from July 2019 to February 2020 across 266 residential institutions. Among the estimated 6,549 residents being surveyed, a total of 5,752 finished the study. The questionnaires were completed by residents, his/her family or social workers. The cognition tests were conducted by specialists and a multilevel analysis approach was used to identify cognition/disability/medical history/special nursing care/BPSD risk factors for physical restraints. Of the 5,752 included institutionalized residents, 30.2% (1,737) had been previously restrained. Older age, lower education level, lower cognitive function, higher dependence, residents with cerebrovascular disease, pulmonary disease, dementia, and intractable epilepsy, all contributed to a higher physical restraint rate, while orthopedic disease and spinal cord injury were associated with a lower physical restraint rate. Furthermore, residents with special nursing care had a higher restraint rate. Residents with most of the behavior and psychological symptoms were also associated with an increased restraint rate. We studied the rate of physical restraint and associated risk factors in institutionalized residents in Taiwan. The benefits and risks of physical restraint should be evaluated before application, and adjusted according to different clinical situations.

Occupational benefit perception of acute and critical care nurses: A qualitative meta-synthesis.

BackgroundWith the development of society, nurses have an increasingly more important role in the medical team. At the same time, due to various reasons, the number of active nurses is continuously decreasing, and the shortage of nursing personnel is becoming ever more serious. The COVID-19 pandemic made these clinical problems more serious. As the department with the greatest work pressure and the most intense pace, acute and critical care nurses are already facing serious problems related to job burnout and dismission. In the context of the COVID-19 pandemic, these problems should be solved urgently. Furthermore, with the rise of positive psychology, many scholars are turning their research direction to the positive professional experience of nurses so as to get inspiration to encourage nurses to face work with an optimistic attitude and guide nursing managers to better retain nursing talents.ObjectiveThe purpose of this paper is to summarize and evaluate the positive emotional experience and professional benefit of acute and critical care specialist nurses in the process of work. So as to better interpret their occupational benefit perception and guide nursing managers in adopting positive measures and promoting the development of high-quality nursing.MethodsCinahl plus, Embase, Medline and other twelve databases were searched for relevant literature. Meta-aggregation was used to synthesize the findings of the included studies.ResultsFrom a total of 12 articles included in this study, 55 main results were presented, 8 new categories were integrated, and three themes were formed: professional identity, social support, and personal growth. The professional identity included: being proud of professional ability and increasing professional value; social support included: friends and family support, organizational, environmental support, peer support, and support of patients and their families; personal growth included realizing self-worth and promoting self-development.ConclusionHospital managers should pay attention to the positive emotional experience of nurses in work and based on this, provide practical and beneficial protection for nurses from the aspects of salary, learning opportunities, working environment, social support and internal personality, stimulate work enthusiasm, guide nurses to correctly face negative emotions and occupational pressure, and improve the sense of professional benefit.

Are nurses at Swedish Departments of Infectious diseases prepared to care for patients with African viral haemorrhagic fever? - A survey study

Background: The African viral haemorrhagic fevers have in recent years been the cause of large outbreaks with high mortality rates and elevated risks of global spread. These outbreaks put the Departments of Infectious diseases, both national and international, on high demand when caring for this patient group, in a patient- and staff-safe manner. The aim of the study was to describe nurses’ perceived ability and knowledge about caring for patients with suspected or verified African viral haemorrhagic fever at Departments of Infectious diseases in Sweden.Methods: A web survey was conducted to collect data. The results are presented through a descriptive design. The participants were registered nurses working in infectious diseases clinics; 216 survey results were registered.Results: Registered Nurses in Swedish Departments of Infectious diseases witnessed having limited knowledge about the African haemorrhagic fevers. The respondents also perceived having limited or very limited knowledge about various practival procedures, such as drawing blood samples to confirm the infection. The majority of the participants had not been given theoretical education, nor had been given the opportunity to sufficiently practice using personal protective equipment at their place of work. The nurses perceived fear for their personal safety while caring for this group of patients.Conclusions: The participants perceived fear, both limited theoretical and practical knowledge and training about caring for patients with African haemorrhagic fever, even though they had worked with infectious diseases for several years. There is a need for implementation of measures to ensure the healthcare professionals' safety and to prevent them from being infected with potentially lethal infections. It also poses a risk for the patient in the absence of specific nursing care, which can lead to an increased critical disease state.

More support, knowledge and awareness are needed to prepare emergency department nurses to approach potential intimate partner violence victims.

Intimate partner violence is a global health issue. In the emergency department, patients seek help for health problems that may be related to exposure to physical, psychological or sexual violence, or controlling behaviour from a current or former partner. Of the many victims that seek care in an emergency department, few are identified, especially among those whose chief complaint is not clearly related to recent physical abuse. Not having all the facts about a patient can jeopardise patient safety and delay treatment. The aim of this study was to describe experiences of caring for adults, subjected to intimate partner violence, from an emergency nurse perspective. A qualitative semi-structured interview study of nine emergency care specialist nurses was conducted using content analysis. Two categories emerged: 'Subtle signs' and 'Not being enough'. The short encounters in emergency care do not allow for deep conversations. The informants highlighted the need for more knowledge about what and how to ask in that specific context. Some mentioned situations where the question had been avoided due to lack of time to handle the answer. The interviews revealed the importance of regular discussions to increase awareness of intimate partner violence and its prevalence among patients. The organisation plays an important role in putting the question about intimate partner violence on the daily agenda and giving time to emergency nurses and other professions for training and reflection.

Autogenerated Text Updates for Pediatric Surgical Patients

<h3>Background Information</h3> Waiting while a child has surgery is a stressful time for families. Providing timely updates helps families feel engaged and supported. With a focus on the patient-family experience within the healthcare setting, communication plays an integral part in patient/family perception and satisfaction. The Family Services Nursing role provides liaison services between Operating Room personnel and families to educate, support, and guide families through the perioperative experience. Parent tracker boards are also displayed in the waiting area. <h3>Objectives of Project</h3> Text messaging enables family members to confidently untether themselves from the physical waiting area, without fear of missing an update, and still feel engaged. To optimize communication with families and foster a partnership with the healthcare team, the Perioperative Information Systems (IS) committee at Children's Hospital of Philadelphia (CHOP) explored text messaging as a plausible adjunct to current communication systems. <h3>Process of Implementation</h3> The multidisciplinary members of CHOP's Perioperative IS Committee investigated ways to introduce a non-interactive text communication platform to engage families. Committing to fiscal responsibility, the committee assessed resources already available within the institution. Epic, the electronic medical record used at CHOP, provided the springboard for implementation. Case tracking events in Epic trigger autogenerated, prepopulated texts to families, updating throughout surgery. Messages are sent directly to a family member's mobile device without the need to download a separate application. Additionally, there is no interference with Operating Room nursing workflow. <h3>Statement of Successful Practice</h3> A seven-month retrospective analysis showed a consistent increase to over 75% family enrollment. Texting was further operationalized to include CHOP's bedside medication delivery program providing enrolled families with alerts regarding the status of their medications and time of delivery. Texting was subsequently expanded to include a link to patient family education with need-to-know information for the day of surgery. Family Care Specialist Nurses disseminate monthly Press-Ganey Ambulatory Surgery reports to the Peri-Anesthesia Care Unit staff and committees. Anecdotal feedback from families and Press Ganey comments confirm a positive response to the initiative. This validates that texting is a significant adjunct to improve the patient/family experience. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> The use of technology to provide autogenerated text updates promotes patient/family-centered care and patient satisfaction in a convenient and user-friendly way.

The differences between learned and practiced competences among nurses: An international pilot study

AimThe primary aim was to describe differences, if any, between learned and practiced competences among a convenience sample of Italian and Slovenian nursing staff; the secondary aim was to validate an instrument capable of measuring internationally such competences. BackgroundThe distance between competences learned and those practiced as a source of under- or over-education has not been investigated to date at the international level. DesignA explorative observational investigation was performed in 2019 by involving 426 Italian and Slovenian members of the nursing staff working in medical and surgical departments. The study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. MethodsMembers of the nursing staff (health care assistants, general nurses, specialist nurses and advanced nurses) were invited to complete the Nursing Competence Instrument based on the European Federation of Nursing Association’s four categories of the nursing care continuum, from health care assistants to advanced practice nurses. ResultsThe construct validity of the Nursing Competence Instrument indicated the presence of four identifiable dimensions (internal consistency ranging from 0.82 to 0.93). On average, the scores of the competences practiced were interestingly slightly higher than those learned among general care nurses. In contrast, health care assistants, specialist nurses and advanced practice nurses, reported to have learned importantly slightly lower as that practiced. ConclusionsAt the overall levels, nurses tend to apply what they had been thought; additionally, all profiles seem to rate at low ranges both the competences practiced and those learned, suggesting the need to maximise nursing competences, both in the classroom and in the daily practice. Mapping the degree of competences acquired in education, as applied in the clinical practice, might assist clinical nurses, nurse educators and health care managers to identify areas at need of improvement. Moreover, mapping differences (if any) across countries might have research, managerial and educational implications.

Caring for people living with dementia in their own homes: A qualitative study exploring the role and experiences of registered nurses within a district nursing service in the UK.

In the UK, district nursing services (DNS) deliver care to people intheir own homes and have regular contact with people with dementia. Research conducted with nurses working in similar roles outside the UK suggests their contribution to high quality dementia care is limited by compassion fatigue, lack of dementia training and low levels of confidence. However, there is a paucity of research exploring the role and learning and support needs of nurses within DNS. The aim was to gain insight into the role and experiences of nurses caring for people living with dementia at home. The study was informed by a descriptive phenomenological approach. Semi-structured interviews were conducted with a purposive sample of ten nurses working in DNS. Data were analysed thematically. Five main themes were identified: 'Home as a care setting' reflected how delivering home-based care shaped participants experiences of caring for people with dementia; 'Taking it in their stride' revealed how participants adapted and responded to the complexity of care needs for people with dementia; 'Complexity and unpredictability' related to the unpredictable nature of people with dementia's care needs and the impact this had on participants' workloads; 'Expertise and support within the wider team' detailed which networks nurses used for advice and support to manage the complex needs of people living with dementia at home; 'Specialist support' identified the need for structural changes and resources to enable the nurses to deliver the care needed. This study enables better understanding of the role of DNS in supporting people with dementia to live at home. This is important for defining how dementia care can become effectively integrated into primary care. Recommendations include improved models of care, which factor in specialist nurses, additional time for home visits and greater emphasis on education and training. Improved models of working that factor in additional time and staffing such as specialist nurses in dementia and palliative care would allow DNS to meet the needs of people with dementia more effectively.

Stressors experienced by nurses providing end-of-life care in intensive care unit (ICU): A Qualitative study

Background of Study: Palliative care is unique in that the service focuses on the needs of dying patients and their families as opposed to focusing on maintaining critical bodily functions, as in critical care nursing, or on improving functional capacity, as in rehabilitation nursing (Martens, 2009). The philosophy of palliative care nursing includes providing care to patients using medical science combined with compassion and caring. Patients may be cared for in hospital wards in acute care settings, in specialist hospice or palliative care units, in aged care homes, or in their own home. Palliative care specialist nurses primarily have generalist nursing skills with various levels of specialisation and post-registration education, including palliative care certification. (International Journal of Palliative Nursing 2012).Aims and Objectives: Purpose of the study is to gain a deeper understanding of the stressors experienced by ICU nurses providing End of Life Care and to describe stressors experienced by nurses working in ICU providing End of Life Care.Materials and Methods: Phenomenological research design was used.10 nurses working in ICU and giving End of life Care were selected using purposive sampling technique as per the pre-determined inclusion criteria. Semi-structured interview schedule was used for data collection. Voice recording of the conversation was done, the transcript was then thematically analysed using Open Code Software.Results: By the findings of the study themes emerged as Emotional Stressor, Personal Stressor, Professional Stressor, Anticipatory Stressor and Experiential Stressor.Conclusion: Limited research has been undertaken on the provision of End of Life care by nurses in the Intensive care setting and thus a need arises to conduct a study in this area. Identification and development of strategies to support nurses in the provision of End Of life care is required to ensure quality care and to minimise stress and eliminate burnout.

Person-centred care to prevent hospitalisations – a focus group study addressing the views of healthcare providers

BackgroundThe primary healthcare sector comprises various health services, including disease prevention at local level. Research shows that targeted primary healthcare services can prevent the development of acute complications and ultimately reduce the risk of hospitalisations. While interdisciplinary collaboration has been suggested as a means to improve the quality and responsiveness of personal care needs in preventive services, effective implementation remains a challenge. To improve the quality and responsiveness of primary healthcare and to develop initiatives to support the interdisciplinary collaboration in preventive services, there is a need to investigate the views of primary healthcare providers. The aim of this study was to investigate perceptions of preventive care among primary healthcare providers by examining their views on what constitutes a need for hospitalisation, and which strategies are found useful to prevent hospitalisation. Further, to explain how interdisciplinary collaboration can be supported with a view to providing person-centred care.MethodsFive focus group interviews were conducted with 27 healthcare providers, including general practitioners, social and healthcare assistants, occupational therapists, physiotherapists, home care nurses, specialist nurses and acute care nurses. Interviews were transcribed, and analysed with qualitative content analysis.ResultsThree categories emerged from the analysis: 1) Mental and social conditions influence physical functioning and hospitalisation need, 2) Well-established primary healthcare services are important to provide person-centred care through interdisciplinary collaboration and 3) Interdisciplinary collaboration in primary healthcare services is predominantly focussed on handling acute physical conditions. These describe that the healthcare providers are attentive towards the influence of mental, social and physical conditions on the risk of hospitalisation, entailing a focus on person-centred care. Nevertheless, in the preventive services, interdisciplinary collaboration focusses primarily on handling acute physical conditions, which constitutes a barrier for interdisciplinary collaboration.ConclusionsBy focusing on the whole person, it could be possible to provide more person-centred care through interdisciplinary collaboration and ultimately to prevent some hospitalisations. Stakeholders at all levels should be informed about the relevance of considering mental, social and physical conditions to improve the quality and responsiveness of primary healthcare services and to develop initiatives to support interdisciplinary collaboration.

Nursing Care Plan for Patients with Hajdu-Cheney Syndrome.

Hajdu–Cheney syndrome is a rare genetic disease. Its main features include phenotypic variability, age-dependent progression and the presence of acroosteolysis of the distal phalanges and generalized osteoporosis, which have significant disabling potential. Currently, there is no effective curative treatment, so nursing care is essential to ensure the maintenance of the quality of life of these patients. The main objective of this study was to establish a specific standardized nursing care plan using the NANDA–NIC–NOC taxonomy. The application of a care plan as such would improve the quality of life of patients affected by this rare disease, will contribute to increasing healthcare professionals’ knowledge on this matter and will support future studies on this disease.

Planning nursing care for a patient diagnosed with testicular cancer by using International Classification for Nursing Practice (ICNP®)

Testicular cancer is the most common malignancy in young men and its prevalence is increasing all over the world. The diagnosis of such a life-threatening disease at a relatively young age may have a considerable devastating impact on numerous spheres of everyday functioning. Although testicular cancer treatment is highly effective, in some cases only symptomatic treatment is possible, an integral part of which is specialist nursing care. This study aimed to present the possibility of using the terminology of the International Classification for Nursing Practice (ICNP®) in planning nursing care for a hospice patient suffering from advanced testicular cancer. An analysis of medical records allowed for developing a patient’s case and then formulating a plan of nursing care considering diagnoses concerning biopsychosocial functioning and nursing intervention. Moreover, the study highlights typical problems of patients in the period of dying as well as the role of a nurse in hospice care.

Trauma-informed mental health practice during COVID-19: Reflections from a Community of Practice initiative.

ABSTRACTThis article discusses insights arising from a Community of Practice (CoP) initiative within a mental health short stay inpatient unit adjacent to a major Emergency Department to explore how COVID‐19 has influenced engagement and support of people in mental distress. The present initiative was designed as a collaboration between the University of South Australia and SA Health. Community of Practice (CoP) is combined with a narrative review of current evidence to explain specific nursing care responses within an operating environment of pandemic‐induced fear and uncertainty. Meetings discussed the challenges associated with delivering mental health care for people experiencing mental health distress in the COVID‐19 context. Applying trauma‐informed principles to mental health care delivery was identified to be of relevance in the context of an ongoing pandemic. Humanizing nursing care and increasing people's sense of predictability and safety contributed to therapeutic engagement and support during COVID‐19. Factors discussed to mitigate the effects of safety measures include, for example, nuanced verbal and non‐verbal engagement of health workers with people in mental distress when wearing personal protective equipment (PPE). We highlight the need to ‘humanise’ nursing and openly communicating that both practitioners and people in distress are navigating special circumstances. The CoP participants additionally acknowledged that the experience of moral distress among frontline health workers needs to be addressed in future policy responses to COVID‐19. Person‐centred and trauma‐informed responses at the point of care might help to mitigate the pandemic short‐ and long‐term effects for both service users and frontline health workers.

OA43 Development of a national across specialty multi-disciplinary team for management of hyper-inflammatory conditions during the SARS-CoV-2 pandemic

Abstract Background/Aims Effective multi-specialty team working is extremely beneficial in management of children with hyper-inflammatory conditions. With the recognition of paediatric inflammatory multisystem syndrome (PIMS) it became apparent a standardised process for discussion of patients would be beneficial. This includes urgent discussion, with access to multiple specialties, and sharing knowledge and experience in a novel condition. Delivering equitable healthcare including access to expertise, specific treatments and research is challenging in Scotland due to its geography. This is facilitated by successful clinical networks (Scottish Paediatric &amp; Adolescent Rheumatology Network [SPARN] and Scottish Paediatric&amp; Adolescent Infection &amp; Immunology National Managed Clinical Network [SPAIIN]) and a well-established paediatric transport service (ScotSTAR). Our aim was to develop a multi-specialty multi-disciplinary team (MDT) for management of patients with hyper-inflammatory conditions. Methods Narrative account of MDT and service development Results We identified a core group of individuals with an interest in inflammatory disorders from different centres and specialties across Scotland including Rheumatology, Infectious Diseases, Cardiology, Intensive Care, Academic Paediatrics, Pharmacists and Clinical Nurse Specialists. Three priorities emerged from initial planning stages: urgent discussions around patient management, peer-to-peer learning and information sharing, and effective prioritisation of research. We designed a written framework and referral pathway, including criteria for acute cardiology involvement, ScotSTAR transfer and intensive care. An electronic proforma was designed to guide MDT discussion, medico-legal documentation and audit purposes. Table 1 describes characteristics of the first nine patients discussed. A particular strength was in diagnostics and consideration of differentials; among patients referred we identified those with haematological malignancy, systemic lupus erythematosus and non-accidental injury. Regular peer-review sessions were held, for reflection on cases and their management in both secondary and tertiary care settings. Clinicians throughout Scotland were encouraged to join via SPARN and SPAIIN networks. Conclusion This multi-specialty MDT has been and continues to be beneficial for management of hyper-inflammatory patients. We will review the process but hope the MDT will prove to continue to be beneficial for future patients. The authors would like to acknowledge all members of the MDT. Disclosure K. McLellan: None. L. Reilly: None. L. Pollock: None. O. Swann: None. C. Anderson: None. N. Martin: None. M. Brennan: None. R. Hague: None. J. Walsh: None.

The effect of action modules on resilience and psychological health of stroke patients: A pilot non-randomised control trial.

To determine whether interventions that use the Specific Thematic Nursing Care Action Modules (STNC-AM) platform improve patients' psychological health over a two-month period. Stroke survivors often are left with a disability after a stroke, which can have an impact on their physical and mental health. Therefore, it is necessary for stroke patients to have tailored programmes in the face of post-stroke mental health concerns and the need for care information. A non-randomised controlled pilot study was conducted. Participants included 44 post-stroke patients at a medical university hospital, between 1 August 2019-28 February 2021, of whom 24 were assigned to the control group and 20 were assigned to the intervention (STNC-AM). Data were analysed on an intention-to-treat basis. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist (case-control studies) for this study. There were no statistical differences between the two groups at baseline. At the end of two months, however, the scores for resilience, depression and positive factors illness representation were statistically different between the two groups (p<.05). The results of the generalised estimating equation model analysis indicated that resilience and anxiety remained more significant in decreasing depression in the intervention group than in the control group. This preliminary trial suggests that, although action modules may be associated with a decrease in depression post-stroke, part of this effect was likely associated with an increase in resilience and a decrease in anxiety of the patients. The STNC-AM platform provides a coaching platform that helps patients and caregivers to be effective and accessible.

Cardiogenic Shock and the Use of Percutaneous Mechanical Assist Devices.

Percutaneous mechanical assist devices are used in patients with cardiogenic shock. The purpose of this article is to familiarize critical care nurses with the various types of percutaneous mechanical assist devices, including the intra-aortic balloon pump, the Impella device, extracorporeal membrane oxygenation, and the TandemHeart device. Each type of device requires specific nursing care. In a patient with cardiogenic shock, the monitoring, care, and interventions provided by an experienced critical care nurse can make the difference between survival and death.

Stavovi sestara specijalista kliničke nege o istraživanjima u sestrinstvu

Introduction: Research in nursing today has a major impact on current and future nursing practice. The aim was to examine the attitudes of nurses towards research in nursing, after completing their specialization of clinical care. Methods: The study involved 86 nurses - specialists in clinical care. The instrument used in the research was a modified version of the Boot nurses' attitudes scale about the research, which consists of subscales: Interest and support of the workplace environment, Cost-effectiveness and benefits, and Obstacles (difficulties). Results: The highest average score was recorded in the statement "I would like to conduct research," while the lowest in the statement "I believe that my job provides the time required to conduct the research." (on the subscale Interest and support of the workplace environment). The highest average score was recorded in the statement "The research results are useful for better health care of patients and can be applied in my workplace environment," while the lowest in claims " Nurses receive praise from their associates and colleagues when they conduct research" (on the Cost-effectiveness and benefit subscale). On the subscale Obstacles, the highest average result was recorded in the statement "Obtaining consent from the patient for the implementation of research is very difficult," while the lowest in the statement "Research in nursing should be conducted by nurses with a completed doctorate degree." Conclusion: According to the statements of clinical care specialist nurses, there is certain interest in participating in research activities, but there is a lack of free time for research.

Effect of COVID-19 Specific Critical Care Nursing Program on Knowledge and Skills of Nursing Officers in an Apex Level Hospital of Uttarakhand - A Pre-Post Design

Introduction: COVID-19 was global pandemic during its outbreak and it brought challenges for healthcare workers at every level. The patients were admitted in ICU for critical care and COVID-19 specific nursing care was urge in need. Hence, to keep this background in mind there was specific need of training regarding COVID-19 critical care and the study was conducted on same. Methods: A quantitative research analysis was done on 100 nursing personal who worked in COVID-19 areas. The knowledge was assessed and then training was given followed by reassessment of knowledge and skills. The training included different 12 critical care procedures which were specific to COVID-19 care. Results: The study result showed the significant increase in knowledge from pre-test to post-test 1 and 2. The skill assessment was done for 12 procedures with the OSCE checklist. Nursing officers who performed better in posttest also performed better in OSCE skills assessment. COVID-19 specific critical care training program had a significant impact on knowledge and skills of nursing officers. Conclusion: Evidence based nursing practice on COVID-19 specific critical care training was significantly effective on knowledge and skills of nursing officers. The simulator based training on different critical care procedure helped our nurses for enhancing their knowledge, practice, and skills during patient care

Nursing Care During Lidocaine Infusion Therapy for Chronic Pain

Pain is a universal event, and perianesthesia nurses provide a pivotal role in the assessment, treatment, and management of the physical and emotional responses to pain. Chronic neuropathic pain is particularly resistant to treatment, and patients often present after many failed therapies with multiple co-morbidities and complex medication histories. With more and more perianesthesia nurses involved with chronic pain management, it is imperative they understand the special nursing care needs of patients receiving intravenous lidocaine infusion therapy.