Surgical Nursing Research Articles

Inductive process of moral distress development in viewpoints from surgical nurses: a mixed-method study

BackgroundMoral distress is a multifactorial and complex phenomenon influenced by various individual, cultural, and systemic factors. This study aimed to investigate the frequency and intensity of nurses’ moral distress, explore their experiences, and develop the conceptual model of risk factors of moral distress in surgical units and operating rooms.MethodThis is a sequential mixed-method study conducted at four teaching hospitals affiliated with the Qom University of Medical Sciences. In the first step, the moral distress of nurses in surgical units and operating rooms was investigated by a survey. The participants included nurses who worked in the operating room and surgical units. (n = 180). The data was collected by a Moral Distress Scale-Revised (MDS-R) questionnaire. In the second step, the experiences of nurses regarding risk factors of moral distress were explored using semi-structured interviews and analyzed using the conventional content analysis by Graneheim and Lundman’s approach.ResultsOne hundred eighty nurses participated in this study. The mean total moral distress scores ranged from 12 to 221, with a mean (SD) of 116.8 (42.73). The causes of moral distress cited with the highest frequency and intensity related to the ‘role of healthcare providers’. The experiences of the participants in the theme ‘Inductive process of moral distress development’ were categorized into three categories: ‘Melting into the faulty system’, ‘Power and the system as distress promotors’, and ‘Perceived unpleasant consequences’.ConclusionThe results indicated that the frequency of moral distress in operating rooms and surgical units was at a moderate level and the distress intensity of nurses was at a moderately high level. The results indicated that in the investigated system, the “inductive moral process of distress development” was continuously understood by the participants. This process was influenced by systemic and individual factors. Weak assertiveness, conservative compromise, and desensitization to unprofessionalism as individual factors were effective in causing distress. Risk factors at the systemic level led nurses to melt into the faulty system and created adverse outcomes at the individual level. The lack of systemic support and the stabilization of mobbing by powerful system members had a negative impact on the individual factors of distress development. Also, these factors directly cause negative consequences.

The Factors Affecting Surgical Room Nurse's Compliance in Performing Sterile Handwashing in the Central Surgery Installation of RSUD Banyumas

Background: Surgical site infection, as a part of Healthcare-Associated Infections (HAIs), can be prevented by proper handwashing among the surgical team members. Compliance with handwashing has been proven to reduce healthcare associated infections. Method: This was quantitative research with a descriptive correlation design using a cross sectional approach. A total sampling technique was used with a sample size of 35 surgical room nurses’s in the central surgery installation of RSUD Banyumas who met the inclusion and exclusion criteria. The research instrument was aquestionnare. Data analysis was conducted using the chi-square test. Results: The study result show that the majority of nurses have good knowledge (45,7%), high motivation (77,1%), perceive good supervision (74,3%) and are compliant in performing sterile handwashing (71,4%). There is a correlation between knowledge, motivation and supervision with the compliance of surgical room nurses in performing sterile handwashing in the central surgery installation of RSUD Banyumas. Conclusion: Factor such as nurses knowledge and motivation in the surgical room and supervision from the department head are related to the compliance of surgical room nurses in performing sterile handwashing.

Factors Related to the Completeness of Electronic Surgical Safety Checklist Documentation in Banyumas Public Hospital

Background: Patient safety in surgery is a program established by the WHO and is a standard for accreditation by KARS, implementing the electronic surgical safety checklist. This has been proven to reduce patient safety incidents in the surgical room. Method: This quantitative research used a descriptive correlation design with a cross-sectional approach. A total sampling technique was employed, involving 34 surgical nurses in the Central Surgical Installation of RSUD Banyumas, who met the inclusion and exclusion criteria. The research instrument utilized an observation sheet based on the surgical safety checklist Standard Operating Procedure (SPO) at RSUD Banyumas. Data analysis was conducted using the chi-square test. Results: The results of the study revealed that the majority of nurses were male (70.6%), aged between 31-40 years (41.2%), and above 40 years (41.2%), with a DIII level of education (70.6%), and work experience of 1-5 years (44.1%), and they completed the electronic surgical safety checklist documentation (67.6%). Age, education level, and work experience correlate with the completeness of electronic surgical safety checklist documentation at RSUD Banyumas (p-value ? ?). Conclusion: Age, education level, and work experience related to the completeness of electronic surgical safety checklist documentation at RSUD Banyumas.

Facilitating Evidence-Based Practice among Nurses in a Tertiary General Hospital: A Six-Year Practice of an Implementation Strategy Informed by the i-PARIHS Framework

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy’s effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients’ outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p<0.05. After four years, EBP members’ scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses’ academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects.

Personality characteristics of Dutch nurse anesthetists and surgical nurses when compared to the normative Dutch population, a quantitative survey study

BackgroundWorking in the perioperative context is complex and challenging. The continual evaluation in this environment underscores the need for adaptability to technological advancements, and requires substantial allocation of resources for training and education. This study aimed to explore personality characteristics of nurse anesthetists and surgical nurses that are instrumental for sustainable employability in technologically advanced environment. MethodsExploratory, cross-sectional survey study including nurse anesthetists and surgical nurses, both certified and in training, and a sample of the normative Dutch population. Personality characteristics were identified with the Big Five Inventory, which consisted of 60 items answered on a five-point Likert scale (strongly disagree to strongly agree). ResultsSpecific personality traits were found for nurse anesthetists and surgical nurses when compared to the normative Dutch population. Traits of both nurse anesthetists and surgical nurses differed significantly on all domains of the Big Five Inventory, with the largest differences found within the dimension negative emotionally. ConclusionsThis study highlights the role of specific personality traits in maintaining employability within the rapidly evolving and technologically advanced landscape of healthcare. It emphasizes the relationship between individual traits and professional excellence, being crucial educational strategies for overall improvement in healthcare.

Knowledge and associated factors with respect to prevention of post-traumatic compartment syndrome among surgical unit nurses; a multi-center cross-sectional study

BackgroundDelayed recognition of compartment syndrome can result in devastating consequences such as the need for amputation or even death. Nurses are at the frontline of patient care and they must have a high index of suspicion for compartment syndrome. Even though nurses’ knowledge about the prevention of compartment syndrome is important, there are no studies in Ethiopia. Therefore this study aims to assess the knowledge and associated factors of nurses towards the prevention of post-traumatic compartment syndrome.MethodAn institutional-based cross-sectional study was conducted among 410 nurses from 26 April to 25 May 2023 at five Comprehensive Specialized Hospital. A stratified sampling technique was employed to recruit the required participants for the study. The data were collected using a structured self-administered questionnaire. The descriptive statistics were presented in text and tables. Analytical analysis schemes including bivariable and multivariable logistic regression were computed considering P-value < 0.05 to identify statistically significant factors.ResultNearly three- fifths (61.6%; 95% CI: 56.7 to 66.3) of nurses had adequate knowledge and significantly associated with being male (AOR: 1.615, 95% CI: 1.050–2.485), nurse use of guidelines (AOR: 2.079, 95% CI: 1.307–3.307), nurses they have been trained (AOR = 1.650; 95 CI: 1.063–2.562), and nurses’ who had more than 15 years’ (AOR: 4.207, 95 CI: 1.762–10.045) experience had good knowledge with respect to prevention of compartment syndrome than the counterparts.ConclusionEven though nurses’ knowledge regarding the prevention of post-traumatic compartment syndrome was found to be good, Diligent nursing assessment and monitoring of clinical signs should be critically performed. So, it is better to strengthen training, equip wards with standardized guidelines, and create a safe working environment should be routine activities.

Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study.

To construct a nursing assessment framework for patients in anaesthesia recovery period. A three-round modified Delphi method was employed to capture the consensus of 22 panellists. The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini-clinical evaluation exercise (mini-CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post-anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework. This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History-taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern. The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts' opinions. The assessment framework constructed in this study could be used for the process evaluation of post-anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills. The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations. No patient or public contribution.

The influence of selected work characteristics on missed and unfinished nursing care in hospitals: Evidence from the Czech Republic

Missed and unfinished nursing care in hospitals depends on the quality of human resources. This paper aims to analyze the influence of selected work characteristics on missing and incomplete nursing care in inpatient wards of Czech hospitals. The relationship between the rate of missed and unfinished nursing care and selected work characteristics was studied using the Czech version of the standardized questionnaire, the MISSCARE Survey. The study was conducted from September 26, 2021, to October 15, 2021. Controlled interviews with 1,205 nurses working in ward blocks in Czech hospitals were used. The research results showed statistically significant connections between selected work characteristics and missed and unfinished nursing care. Nurses with the highest level of education (Master, Ph.D.), nurses with specialized education, nurses with the lowest number of working hours (less than 30 hours per week), and nurses with the highest number of years of work experience (21 years and over) show a significantly lower rate of missed nursing care. Nurses from surgical departments, specialist nurses, and nurses with the highest education (Master, Ph.D.) report statistically significantly lower unfinished care levels. In contrast, nurses from regional/district hospitals, practical nurses/nursing assistants, and nurses with the lowest education (secondary school of nursing) report significantly higher unfinished nursing care levels. The information obtained can be used to improve nursing processes in the identified weak parts, strategic planning of nursing care, and sufficient personnel. AcknowledgmentsI would like to express my gratitude to co-authors and other members of the research team – Hana Hajduchová, Chloubová Ivana, Hana Kubešová, Josef Malý, Martin Doseděl, Ondřej Tesař, and Kateřina Malá-Ládová, without whose support the article could not have been published.Supported by the Ministry of Health of the Czech Republic, grant no. NU20-09-00257. All rights reserved.

Enhancing Surgical Nursing Student Performance: Comparative Study of Simulation-Based Learning and Problem-Based Learning.

Surgical nursing is a high-risk, high-pressure, and complex field. Nurses need extensive knowledge, skills, and abilities. Problem-Based Learning (PBL) and Simulation-Based Learning (SBL) are effective student-centered methods. Which method is better for surgical nurse training? More research is needed to determine the best approach for undergraduate surgical nurse education. To compare the impact of PBL and SBL on undergraduate nursing students' performance and improve learning outcomes in surgical nursing education. We used a pretest/post-test design with 318 nursing undergraduates randomly assigned to two groups. Participants completed three progressive scenarios focused on surgical nursing cases. Experts blindly reviewed video recordings using the 70-item Korean Nurses' Core Competence Scale (KNCCS) to assess performance. The 13-item Satisfaction and Self-confidence in learning Scale (SSS) measured learning confidence and satisfaction. SBL participants also completed the 16-item Educational Practices in Simulation Scale (EPSS) and 20-item Simulation Design Scale (SDS). The study found significant positive effects on both groups, with noticeable improvements in post-test, retention, and follow-up test results (P < 0.001). The SBL group showed higher competency levels in nurses (P < 0.001). The Cohen's d and effect size (r) for various skills were as follows: clinical performance (0.84767 and 6.39023), critical thinking (0.31017 and 0.15325), professional attitude (0.85868 and 0.39452), and communication skills (1.55149 and 0.61294). The satisfaction and self-confidence of nurses were higher in the SBL group (4.53±0.596; 4.47±0.611) compared to the PBL group (4.32±0.689; 4.25±0.632) in all dimensions of SSS (all P < 0.05). The SBL group also scored high in simulation design and EPSS. However, improvements are needed in fidelity, objectives, information, and students' expectations. SBL and PBL improve nurses' core competence, satisfaction, and self-confidence. SBL is superior. This study promotes student-centered education, enhancing surgical nursing professionals' quality and ensuring future patient safety.

Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards.

To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Qualitative action research was used working with nurses as co-researchers. Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. This paper has adhered to the COREQ guidelines. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.

Application of Specialized Group Management in the Quality Control of Perioperative Nursing

Objective: To explore the role of specialized group management in the quality control of perioperative nursing. Methods: 45 surgical nurses from our hospital were selected as the research subjects. Traditional operating room management was adopted from July 2019 to June 2020, and specialized group management was adopted from July 2020 to June 2021. The surgeon’s satisfaction, surgical nurses’ core professional competence, and surgical patients’ satisfaction were obtained through surveys and the results were analyzed. Results: Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation (P &lt; 0.05). Besides, surgical nurses’ core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation (P &lt; 0.05). Lastly, surgical patients’ satisfaction before the implementation of specialized group management was significantly lower than after its implementation (P &lt; 0.05). Conclusion: Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.

Observation of the Effect of Rapid Recovery Surgical Nursing on Postoperative Ovarian Cancer Patients and Its Impact on Pain Levels

Objective: To observe the application effect of rapid recovery surgical nursing in patients with ovarian cancer and its impact on pain levels. Methods: Forty cases of ovarian cancer patients admitted from December 2019 to December 2022 were selected as the subjects of this study and divided into two groups using a double-blind method. The number of cases was the same; one group served as the control group, receiving routine care, while the other served as the observation group, receiving rapid recovery surgical care. Postoperative gastrointestinal function recovery indicators, postoperative pain, and postoperative complications between the two groups were compared. Results: The first postoperative exhaust, defecation, and out-of-bed activity times of the 20 patients with ovarian cancer in the observation group were shorter than those of the patients in the control group, and the motilin level 48 hours after surgery was higher than that of the patients in the control group (P &lt; 0.05). The pain score of the observation group 48 hours after surgery (1.33 ± 0.21 points) was lower than that of the control group (P &lt; 0.05). Additionally, the postoperative complication rate of the observation group was 5.00%, which was lower than that of the control group (P &lt; 0.05). Conclusion: Providing rapid recovery surgical care for patients with ovarian cancer can help restore postoperative gastrointestinal function, relieve pain, reduce complications, and promote early recovery.

Patient Safety Culture of Surgical Nurses and Affecting Factors

Objective: One of the most important components of patient safety is safe surgical practices. Presence of risky surgical patients and units, and the increased number of surgical interventions applied to patients globally increase the responsibility of surgical nurses in terms of patient safety culture. The aim of this study was to determine the perception of patient safety culture of surgical nurses and the factors affecting it. Methods: The data of this descriptive and cross-sectional study were collected with the voluntary participation of nurses who worked in the surgical units of two public hospitals and one university hospital. This study aligns with the STROBE (Strengthening the Reporting of Observational Studies) checklist. Results: Nurses who received training on patient safety and nurses who are satisfied with their working conditions had a more positive patient safety culture perception. It was determined that the nurses working in the surgical services attach more importance to cooperation and comply with the policies to ensure patient safety compared to the operating room nurses. Conclusions: The perception of the nurses regarding patient safety culture was found to be moderate. It is recommended to maintain training opportunities and good working conditions on patient safety and to provide management support.

Burnout and Its Related Risk Factors: A Comparison Study of Nurses Working in Two Different Wards

Background: Nursing is a physically and emotionally demanding job, making nurses highly susceptible to burnout. Burnout is associated with many deleterious consequences affecting health care outcomes. Objectives: We aimed to evaluate and compare burnout and its associated risk factors in nurses working in 2 different wards: Operating rooms and surgical wards. Methods: This cross-sectional analytical study was conducted on 100 operating room nurses and 100 surgical ward nurses at Vali-Asr Hospital, Tehran University of Medical Sciences. Data collection instruments included a demographic questionnaire and Maslach Burnout Inventory (MBI). Data were analyzed using SPSS version 22. Results: Overall, the burnout score in surgical ward nurses was 69.22, while it was 67.97 in nurses working in operating rooms (P = 0.449). Scores of emotional exhaustion, depersonalization, and personal accomplishment subscales in nurses of surgical wards were 54.66, 81.16, and 71.85, respectively. These rates for operating room nurses were 53.02, 80.44, and 70.47, respectively; however, these differences were not statistically significant. There was a significant correlation between working shifts and burnout (P = 0.002). Satisfaction with income was significantly associated with the working environment (P = 0.047). Conclusions: The levels of burnout were high in nurses in both operating rooms and surgical wards. Due to nurses' pivotal role in the health system, identifying burnout and eliminating its causes are highly crucial.

Nurses' knowledge and attitudes towards hand hygiene in Aceh, Indonesia: A correlational study among surgical nurses

This study aims to thoroughly examine nurses' knowledge and attitudes about hand hygiene and investigate how these factors are related. Conducted in a hospital environment, the research aims to gather detailed information to help develop better hand hygiene practices among nurses. Healthcare-associated infections (HAIs) pose a global issue, impacting numerous people each year. However, consistent hand hygiene can greatly reduce these infections. Nurses are vital in preventing HAIs, and this study looks at the hand hygiene behaviors of thirty-three surgical nurses. The research involved collecting data through three questionnaires and analyzing it with the Pearson correlation test. The results revealed that the average knowledge score of the nurses was 11.6, and their average attitude score was 16.33. There was a strong correlation (r=0.688) between the nurses' knowledge and their attitudes towards hand hygiene practices. Moreover, a significant positive correlation (ρ-value of 0.000) was observed, indicating a meaningful relationship between knowledge levels and attitudes towards hand hygiene. The findings suggest that enhancing knowledge about hand hygiene results in a more positive attitude towards its practices. The role of the hospital ward manager is crucial in maintaining proper hand hygiene among staff. As a role model, supervisor, and evaluator, the ward manager significantly influences awareness and adherence to good hand hygiene practices. Additionally, the hospital should provide adequate support and resources to enable staff to perform hand hygiene effectively.

The Effect of Surgical Nurses' Attitudes Towards Evidence-Based Practices on Patient Safety Culture: Descriptive and Relationship-Seeking Study

Aim: This study was aimed to evaluate the relationship and the effect of surgical nurses' attitudes to evidence-based nursing (EBN) practices on patient safety culture (PSC). &#x0D; Material and Method: The study was descriptive and correlational. The sample consisted of 364 nurses working in the surgical departments of a university hospital. Data were collected by using individual information form, attitude towards EBN scale and PSC scale.&#x0D; Results: The average total score of PSC of surgical nurses was 3.60±0.38 and the average total score of attitudes towards EBN practice was 60.07±6.01. There was a strong positive correlation between EBN practices and PSC (r=0.705, p=0.000). In the regression analysis, it was seen that the attitude towards EBN practices, which was the predictor variable, explained approximately 49.7% of the variance in the predicted variable of PSC (F=358.175; R2=0.497; p=0.000).&#x0D; Conclusion: It was determined that the attitudes of surgical nurses towards EBN practices and PSC were positive. It was found that surgical nurses with higher attitudes towards EBN practices had more positive attitudes towards PSC. Although PSC is important for nurses working in all clinics, it is more important for nurses working in surgical clinics. Therefore, it is recommended that working conditions should be improved and in-service trainings should be planned in line with the latest evidence findings.

Nurses' encounters with patients having end-of-life dreams and visions in an acute care setting - A cross-sectional survey study.

This study aimed to estimate the proportion of acute care nurses witnessing end-of-life dreams and visions or having these reported by a patient or relative, and to canvass their related attitudes and beliefs. A cross-sectional survey study was conducted from February 2023 to May 2023. Participants were medical and surgical nurses from a 200-bed acute care hospital in metropolitan Australia. Fifty-seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end-of-life dreams and visions. The nature of end-of-life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end-of-life dreams and visions but identified an unmet need for education and training on this aspect of end-of-life care. Our results suggest that nurses in acute care encounter end-of-life dreams and visions in a similar proportion to oncology and long-term care but lower than in palliative care settings. Education and training regarding end-of-life dreams and visions are needed to ensure the provision of comprehensive, patient-centred end-of-life care. No patient or public contribution. Research in sub-acute and long-term care settings suggests that end-of-life dreams and visions are a common accompaniment to the dying process. No research has yet focused on the acute care setting, despite this being the place of death for the majority of people in most high-income countries. This study demonstrates that acute care nurses encounter end-of-life dreams and visions in similar proportions to oncology and long-term care nurses but lower than palliative care nurses. Acute care nurses would benefit from education and training regarding end-of-life dreams and visions to enable the provision of holistic person-centred end-of-life care. This study was reported using the STROBE Checklist for cross-sectional studies.

Description Competencies of Medical Surgical Nursing Preceptors at Naval Center Hospital Dr. Ramelan Surabaya, Indonesia

This study evaluated the competence of preceptors in surgical medical nursing. The research method uses quantitative descriptive with a cross-sectional research design. The sample number was 100 respondents doing clinical practice in medical-surgical nursing at the Navy Central Hospital. Dr. Ramelan Surabaya. The sampling technique uses Simple Random Sampling. The questionnaire used is the Preceptor Competency Questionnaire, which is a self-assessment. The results showed that all preceptors had good competence in all indicators. These indicators include knowledge competence, clinical skills, teaching ability, communication skills, personal characteristics, leadership, professional behavior, and ethics. However, a small percentage of receptors need to improve the ease of consultation. This research provides new insights into the practice of clinical guidance in surgical medical nursing. It can be applied to enhance the quality of clinical learning in hospitals and nursing education institutions.

Practical effect of different teaching modes in teaching gastrointestinal surgery nursing.

With the continuous development and progress of medical technology, the position of surgical nursing in the field of clinical medicine is becoming increasingly prominent. As an important branch of the surgical field, the nursing requirements and difficulty of gastrointestinal surgery are also increasing. In order to improve the teaching quality of nursing care in gastrointestinal surgery, many educators and researchers are actively exploring new teaching methods. Among them, the teaching method case-based learning (CBL), scene-simulated learning (SSL), task-based learning (TBL), combining self-evaluation and training mode is considered as an effective method. This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability. To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery. Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected. According to different teaching modes, they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group (conventional teaching mode), of which 36 were in observation group and 35 were in control group. The results of operational skills, theoretical knowledge, nursing students' satisfaction, learning effectiveness questionnaire and teaching effect were compared between the two groups. Compared between the two groups, the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group, and the difference was statistically significant (P < 0.05). Compared between the two groups, the total satisfaction ratio of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05). Compared between the two groups, the observation group was lower than the control group in the questionnaire results of learning efficacy, and the difference was statistically significant (P < 0.05). Compared between the two groups, the proportion of thinking ability, subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group, the difference was statistically significant (P < 0.05). The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns, theoretical knowledge and satisfaction scores of nursing students, improve the results of learning efficiency questionnaire and teaching effect, which can be popularized in clinical teaching.

Effect of different positioning before, during and after surgery on pressure injury: a randomized controlled trial protocol

Background: Patients undergoing surgery are at risk of developing pressure injuries because they remain immobile and in a fixed position on the operating table for a long time under anesthesia. Prevention of surgery-induced pressure injuries is the best strategy and requires risk assessment and timely implementation of preventive interventions. This trial aims to evaluate the effect of positioning in a different position pre-operatively and post-operatively than the position adopted during surgery on pressure injuries. Methods: This trial was designed as a prospective randomized controlled study. Participants meeting the inclusion criteria will be assigned to the intervention or control groups using a random number generator. The participants in the intervention group will be placed in different positions than their surgical position during the night before surgery, and the first 36 h after surgery. The control group will receive only routine care. The groups will be evaluated in terms of pressure injury development for at least 72 h, until discharge. Conclusions: Surgery-induced pressure injuries have important effects on patients, healthcare professionals, and healthcare organizations. Current guidelines recommend that patients be positioned in a different position preoperatively and postoperatively than the surgical position to redistribute the pressure generated during surgery. There is a need for well-designed, comprehensive studies to investigate the effectiveness of this weak evidence-level recommendation. This trial will provide valuable evidence to inform clinical practice, guide surgical nurses, and allow evaluation of the effects of this intervention. Trial registration: Clinical trials registration number NCT05549830