Hasil untuk "Nursing"

J. Morse, P. Field

Nidia Gaona

R. Parish, C. Powell, E. Wilkes

N. Jamshidi, Z. Molazem, F. Sharif et al.

Background/Aim. Clinical learning is a main part of nursing education. Students' exposure to clinical learning environment is one of the most important factors affecting the teaching-learning process in clinical settings. Identifying challenges of nursing students in the clinical learning environment could improve training and enhance the quality of its planning and promotion of the students. We aimed to explore Iranian nursing students' challenges in the clinical learning environment. Materials and Methods. This is a qualitative study using the content analysis approach. The participants consisted of seventeen nursing students and three nursing instructors. The participants were selected through purposive sampling method and attended semistructured interviews and focus groups. Results. Three themes emerged after data analysis, including ineffective communications, inadequate readiness, and emotional reactions. Conclusion. Nursing students in Iran are faced with many challenges in the clinical learning environment. All challenges identified in this study affected the students' learning in clinical setting. Therefore, we recommend that the instructors prepare students with a specific focus on their communication and psychological needs.

Elizabeth Flott, L. Linden

Gabrielli Maria Ribeiro Corsini, Leticia Sepulveda da Silva, Rafaela Ferreira Machado et al.

Objetivo: evidenciar as práticas de estímulo cognitivo desenvolvidas pela enfermagem com pessoas idosas. Metodologia: revisão integrativa de literatura, desenvolvida em seis etapas sem recorte temporal. As buscas foram realizadas nas bases/bibliotecas de dados: BVS, MEDLINE, WOS, EMBASE e SCOPUS. Resultados: foram selecionados 22 artigos para compor a amostra final, após a aplicação dos critérios de elegibilidade. As práticas de estímulo cognitivo foram organizadas de maneira sistemática e classificadas em grandes classes de intervenção, sendo vinculadas aos principais domínios cognitivos estimulados. Observou-se a predominância das Instituições de Longa Permanência como local de realização das pesquisas, enquanto os hospitais apresentaram menor frequência. Conclusão: as práticas de estimulação são variadas e essenciais na enfermagem geriátrica, de fácil implementação e com resultados que reverberam na manutenção da autonomia e  funcionalidade das pessoas idosas.

N. Lee, Sun-Mi Chae, Haejin Kim et al.

Mobile devices are a regular part of daily life among the younger generations. Thus, now is the time to apply mobile device use to nursing education. The purpose of this study was to identify the effects of a mobile-based video clip on learning motivation, competence, and class satisfaction in nursing students using a randomized controlled trial with a pretest and posttest design. A total of 71 nursing students participated in this study: 36 in the intervention group and 35 in the control group. A video clip of how to perform a urinary catheterization was developed, and the intervention group was able to download it to their own mobile devices for unlimited viewing throughout 1 week. All of the students participated in a practice laboratory to learn urinary catheterization and were blindly tested for their performance skills after participation in the laboratory. The intervention group showed significantly higher levels of learning motivation and class satisfaction than did the control. Of the fundamental nursing competencies, the intervention group was more confident in practicing catheterization than their counterparts. Our findings suggest that video clips using mobile devices are useful tools that educate student nurses on relevant clinical skills and improve learning outcomes.

Bilu Gu, Yiming Lv, Jiyu Zhu et al.

BackgroundHumanistic care is a good glue for the doctor-patient relationship, and it is a general trend to improve the practice of humanistic care.MethodsA narrative research method was used to conduct semi-structured interviews with 18 master’s degree nursing students from China who were in the clinical rotation stage, and the data were content analyzed and explored from the perspective of the learners who were learning about humanistic caring practices using the social learning theory model.ResultsThere is a triple tension structure in the practice of humanistic care: At the cognitive level, there is a knowledge-activity rupture, with learners showing theoretical clarity but practical confusion. At the environmental level, it is divided into the dual role of facilitating and inhibiting environments. “rewarding” environments included positive psychological attitudes of patients, caring-friendly departmental environment, perceptually rewarding mindfulness environment, and loving family environment. In contrast, “punishing” environments included patients’ irresponsible attitudes toward themselves, poor care experiences, inflexible management mechanisms, missing incentives. At the behavioral level, there is a dialectical game between constructive and alienating practices. “forward” behaviors included personalized care in the details, respect for patient autonomy, proactive communication and empathy, systemic support and teamwork. Conversely, “backward” behaviors included mechanized procedures and emotional detachment, disregard for privacy and dignity, systemic issues that exacerbate apathy.ConclusionBased on the framework of social learning theory, this study constructs a learning trajectory model of humanistic care to explain the synergistic mechanism between cognitive dimension and environmental system and its two-way shaping of caring practice behavior. The study finds that there is a “black box” phenomenon in which the theory of humanistic care is clear but the practice of humanistic care is confusing in the cognitive dimension, and in the environmental dimension, there are systematic limitations in the traditional biomedical model. Based on the above two-dimensional analysis, this study proposes an optimization path combining cognitive explicit cultivation and environmental support system reconstruction, which points out the direction for breaking through the dilemma of humanistic care practice.

Adama Ouedraogo, Patrice Ngangue, David Jean Simon et al.

Objective This study estimated the proportion of children aged 12–23 months who were fully vaccinated in sub-Saharan Africa (SSA), explored geographical disparities across subregions and countries, and identified country-level factors associated with full vaccination (FV).Design Cross-sectional study.Setting SSA.Participants Children aged 12–23 months.Primary outcome FV.Methods Data for this study were extracted from the most recent Demographic and Health Survey (DHS) conducted in 34 SSA countries between 2012 and 2023. The study included a total weighted sample of 69 218 children. Univariate analyses were performed to describe the socio-demographic profile of the participants and estimate the proportion of FV and the proportion for each of the eight vaccines (BCG, DTP1, DTP2, DPT3, Polio1, Polio2, Polio3, Measles1) at regional level. Bivariate and spatial analyses were produced to examine existing disparities at regional, subregional and countries’ income levels. A multivariate logistic regression analysis was fitted for identifying country-level factors associated with FV.Results 54.1% (95% CI 53.7% to 54.5%) children aged 12–23 months in SSA were fully vaccinated. In addition, substantial inequalities emerged in FV coverage across countries ranging from 23.9% in Guinea to a high of 95.5% in Rwanda. The same pattern was observed for the eight vaccines. Findings also showed that children of birth order 3 and above, who were delivered at home, had received less than four antenatal visits, from poor households and households with more than 5 members, whose mothers were under 25, had primary education level and below, and had no income-generating activities were less likely to be fully vaccinated.Conclusion To achieve WHO’s global vaccination coverage target of 90% by 2030 in SSA, vaccination programmes must take account of regional, subregional and national inequities. Our findings also underline the need for interventions tailored to each SSA country’s socio-cultural context.Ethical consideration Ethical approval was not required as this is a secondary analysis of publicly available data.

Rong Hu, Yan-fei Ma, Chun-yan Wang et al.

Abstract Aim This study aimed to test the psychometric properties of the Attitudes Toward Artificial Intelligence in Nursing Scale (ASUAITIN) in Chinese culture. Methods A convenience sampling method was employed to recruit 499 clinical nurses from Sichuan Province, China. Following the Brislin model, the ASUAITIN scale underwent forward translation, synthesis, and back-translation. Cultural adaptation and revisions were conducted through expert consultation and pilot testing, resulting in the finalized ASUAITIN-C. The structural validity of the scale was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed through internal consistency and test-retest reliability. Results The ASUAITIN-C consists of 15 items and two factors, which account for 73.278% of the total variance. The overall Cronbach’s α coefficient of the ASUAITIN-C is 0.785, while the Cronbach’s α values for the two subdimensions are 0.920 and 0.948, respectively. The test-retest reliability over two months, measured by the intraclass correlation coefficient (ICC), is 0.91. Conclusion Studies have shown that this questionnaire is a valid and reliable tool for assessing nurses’ attitudes toward using artificial intelligence in the nursing field.

Piroozeh Taheri, Mohammad Taghi Beig Mohammadi, Mostafa Mohammadi et al.

Background: Exploring risk factors for the development of COVID-19 in vital organs of the body is necessary to improve patient survival and reduce disability and morbidity due to disease progression. By identifying these underlying risk factors and controlling them, it is possible to prevent extra-pulmonary involvement and even alleviate pulmonary involvement in patients, resulting in a significant reduction in mortality and morbidity rates. This study aimed to identify the underlying risk factors associated with pulmonary and extrapulmonary organ complications of COVID-19. Methods: This study was a cross-sectional descriptive-analytical study. Patients with a definitive diagnosis of COVID-19 who were admitted to the intensive care unit of Imam Khomeini Hospital in Tehran due to respiratory distress and poor clinical condition were included in the study population and were clinically followed up on. Patients' information was collected by reviewing patients' records and the hospital information system. Results: A total of 123 patients were included in the study (63.4% were male, mean age = 58.87 ± 12.37). Using ROC curve analysis, the calculated risk score is considered statistically significant for diagnostic accuracy (AUC = 0.862 [0.797–0.927], P value < value<0.001). A risk score cutoff greater than 1.5 (sensitivity 89.9%, specificity 38.9%) favors an increased likelihood of in-hospital mortality. According to multiple linear regression (F (9,93).369, P value=0.001), chronic obstructive pulmonary disease, asthma, diabetes, SOFA score on days 2 & 3, and ventilation support were predictors of ICU length of stay. Conclusion: A history of chronic heart failure with renal impairment, liver cirrhosis with liver complication, and any underlying disease are associated with pulmonary complications in COVID-19 patients.

Wei Liu, Tianchun Li, Mengshi Lu et al.

Problem definition: We study a workforce redeployment problem in hospital networks, where clinical staff, such as nurses, are temporarily reassigned from overstaffed to understaffed sites to address short-term imbalances. This practice of ``internal travel,'' which gained traction during the COVID-19 pandemic to tackle nurse shortages, presents new operational challenges that require tailored analytical support. Key requirements such as advance notice and short-term secondments must be incorporated. Moreover, in rapidly evolving environments, reliance on historical data leads to unreliable forecasts, limiting the effectiveness of traditional sample-based methods. Methodology: We formulate the problem as a stochastic dynamic program and incorporate demand uncertainty via a sample robust optimization (SRO) framework. Using linear decision rule approximation, we reformulate the problem as a tractable linear program. Results: We evaluate the impact of key network design components on system performance. Network connectivity has the largest effect in reducing the total cost, number of redeployments, and travel distance, but its benefits depend on aligning the secondment duration with the network structure. Full connectivity without proper secondments can be counterproductive. The SRO approach outperforms the traditional sample-average method in the presence of demand surges or under-forecasts by better anticipating emergency redeployments. Managerial implications: Internal travel programs offer a promising strategy to alleviate workforce shortages in healthcare systems. Our results highlight the importance of network design, aligning secondment durations with the network structure, and adopting planning methods that are robust to demand surges or inaccurate predictions.

Linkun Zhou, Jian Li, Yadong Mo et al.

Autonomous interaction is crucial for the effective use of elderly care robots. However, developing universal AI architectures is extremely challenging due to the diversity in robot configurations and a lack of dataset. We proposed a universal architecture for the AI-ization of elderly care robots, called AoECR. Specifically, based on a nursing bed, we developed a patient-nurse interaction dataset tailored for elderly care scenarios and fine-tuned a large language model to enable it to perform nursing manipulations. Additionally, the inference process included a self-check chain to ensure the security of control commands. An expert optimization process further enhanced the humanization and personalization of the interactive responses. The physical experiment demonstrated that the AoECR exhibited zero-shot generalization capabilities across diverse scenarios, understood patients' instructions, implemented secure control commands, and delivered humanized and personalized interactive responses. In general, our research provides a valuable dataset reference and AI-ization solutions for elderly care robots.

Shunlei Li, Jin Wang, Rui Dai et al.

In modern healthcare, the demand for autonomous robotic assistants has grown significantly, particularly in the operating room, where surgical tasks require precision and reliability. Robotic scrub nurses have emerged as a promising solution to improve efficiency and reduce human error during surgery. However, challenges remain in terms of accurately grasping and handing over surgical instruments, especially when dealing with complex or difficult objects in dynamic environments. In this work, we introduce a novel robotic scrub nurse system, RoboNurse-VLA, built on a Vision-Language-Action (VLA) model by integrating the Segment Anything Model 2 (SAM 2) and the Llama 2 language model. The proposed RoboNurse-VLA system enables highly precise grasping and handover of surgical instruments in real-time based on voice commands from the surgeon. Leveraging state-of-the-art vision and language models, the system can address key challenges for object detection, pose optimization, and the handling of complex and difficult-to-grasp instruments. Through extensive evaluations, RoboNurse-VLA demonstrates superior performance compared to existing models, achieving high success rates in surgical instrument handovers, even with unseen tools and challenging items. This work presents a significant step forward in autonomous surgical assistance, showcasing the potential of integrating VLA models for real-world medical applications. More details can be found at https://robonurse-vla.github.io.

Syed Hasib Akhter Faruqui, Adel Alaeddini, Yan Du et al.

Background: Type 2 diabetes (T2D) is a prevalent chronic disease with a significant risk of serious health complications and negative impacts on the quality of life. Given the impact of individual characteristics and lifestyle on the treatment plan and patient outcomes, it is crucial to develop precise and personalized management strategies. Artificial intelligence (AI) provides great promise in combining patterns from various data sources with nurses' expertise to achieve optimal care. Methods: This is a 6-month ancillary study among T2D patients (n = 20, age = 57 +- 10). Participants were randomly assigned to an intervention (AI, n=10) group to receive daily AI-generated individualized feedback or a control group without receiving the daily feedback (non-AI, n=10) in the last three months. The study developed an online nurse-in-the-loop predictive control (ONLC) model that utilizes a predictive digital twin (PDT). The PDT was developed using a transfer-learning-based Artificial Neural Network. The PDT was trained on participants self-monitoring data (weight, food logs, physical activity, glucose) from the first three months, and the online control algorithm applied particle swarm optimization to identify impactful behavioral changes for maintaining the patient's glucose and weight levels for the next three months. The ONLC provided the intervention group with individualized feedback and recommendations via text messages. The PDT was re-trained weekly to improve its performance. Findings: The trained ONLC model achieved >=80% prediction accuracy across all patients while the model was tuned online. Participants in the intervention group exhibited a trend of improved daily steps and stable or improved total caloric and total carb intake as recommended.

Mohamed Gharbi, Maria Di Mascolo, Christine Verdier

For decades, hospital services have been faced with the challenge of ensuring quality care for patients despite the pressures on staff due to workload overload. Nursing staff are particularly affected by this reality, with a patient/nursing staff ratio so imbalanced that it directly affects the quality of care and the well-being of nurses. This article examines in detail the workload of nursing staff, shedding light on the various factors influencing this workload, including the type of care provided, the characteristics of patients and nursing staff, as well as the organizational context. Furthermore, different methods of calculating and estimating workload are analyzed, ranging from workload calculation systems to advanced predictive models. Finally, reflection is made on future research avenues, particularly concerning the identification of factors influencing workload, data collection and processing, and model validation.

April Mackey, S. Bassendowski

Sabine Homeyer, W. Hoffmann, Peter Hingst et al.

BackgroundTo ensure high quality patient care an effective interprofessional collaboration between healthcare professionals is required. Interprofessional education (IPE) has a positive impact on team work in daily health care practice. Nevertheless, there are various challenges for sustainable implementation of IPE. To identify enablers and barriers of IPE for medical and nursing students as well as to specify impacts of IPE for both professions, the ‘Cooperative academical regional evidence-based Nursing Study in Mecklenburg-Western Pomerania’ (Care-N Study M-V) was conducted. The aim is to explore, how IPE has to be designed and implemented in medical and nursing training programs to optimize students’ impact for IPC.MethodsA qualitative study was conducted using the Delphi method and included 25 experts. Experts were selected by following inclusion criteria: (a) ability to answer every research question, one question particularly competent, (b) interdisciplinarity, (c) sustainability and (d) status. They were purposely sampled. Recruitment was based on existing collaborations and a web based search.ResultsThe experts find more enablers than barriers for IPE between medical and nursing students. Four primary arguments for IPE were mentioned: (1) development and promotion of interprofessional thinking and acting, (2) acquirement of shared knowledge, (3) promotion of beneficial information and knowledge exchange, and (4) promotion of mutual understanding. Major barriers of IPE are the coordination and harmonization of the curricula of the two professions. With respect to the effects of IPE for IPC, experts mentioned possible improvements on (a) patient level and (b) professional level. Experts expect an improved patient-centered care based on better mutual understanding and coordinated cooperation in interprofessional health care teams. To sustainably implement IPE for medical and nursing students, IPE needs endorsement by both, medical and nursing faculties.ConclusionIn conclusion, IPE promotes interprofessional cooperation between the medical and the nursing profession. Skills in interprofessional communication and roles understanding will be primary preconditions to improve collaborative patient-centered care. The impact of IPE for patients and caregivers as well as for both professions now needs to be more specifically analysed in prospective intervention studies.

Bruna Fonseca Vasconcelos, Douglas de Araújo Vilhena, Luísa Fonseca Vasconcelos et al.

ABSTRACT Objectives: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. Methods: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. Results: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges’ suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. Conclusions: the booklet presented satisfactory content validity sources of evidence.

Paulus Mukuve PGDip, Vistolina Nuuyoma PhD

Introduction Managing a patient on mechanical ventilation is a vital aspect of clinical scope in intensive and critical care units. In addition, it is a highly technical, intricate, dynamic task requiring extensive knowledge and skills. Little is known about critical care nurses’ experiences caring for patients on mechanical ventilation in contexts where resources are constrained, creating an empirical gap in the available body of knowledge. Objective This study explored critical care nurses’ experiences caring for patients on mechanical ventilators at an intermediate hospital in northeastern Namibia. Method The study followed qualitative descriptive and explorative designs. The purposive sample included 13 critical care nurses who had cared for patients on mechanical ventilation for more than 6 months. Data were collected via individual unstructured interviews and analyzed using a reflexive thematic analysis approach. Results Four themes and eight subthemes emerged. Varied personal feelings, such as feeling proud, competent, exhausted, traumatized, overwhelmed, and concerns for patients’ well-being were experienced by critical care nurses. Participants described learning from colleagues in the unit and expressed concerns about not having postbasic training in critical care nursing. Negative experiences included concerns about community members’ misconceptions about critical care units and mechanical ventilators, and challenges with resources, personnel, and admission procedures. Conclusion Critical care nurses in resource-constrained settings have positive and negative experiences caring for patients on mechanical ventilators. The findings have implications for the development of support systems for critical care nurses, including induction programs, competence enhancement, psychological support, the development of guiding documents for admission, patient preparation and sensitization of community members. There is a need for this study to be replicated in other resource-constrained contexts where specialized critical care nurses are available.