Hasil untuk "Nursing"

Zagalioti SC, Ziaka M, Exadaktylos A et al.

Sofia-Chrysovalantou Zagalioti,1 Mairi Ziaka,2 Aristomenis Exadaktylos,2 Barbara Fyntanidou1 1Department of Emergency Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Department of Emergency Medicine, Inselspital University Hospital, University of Bern, Bern, SwitzerlandCorrespondence: Sofia-Chrysovalantou Zagalioti, Email sofia_zag@yahoo.comBackground: Accurate decision-making in triage largely determines the amount of time required for a patient to be evaluated and treated while in the emergency department. Nursing staff worldwide have similar learning characteristics with similar working hours and common goals, despite the fact that different triage scales are used globally. The aim of this mini review is to present the different educational methods and identify the most effective for triage training of triage nurses.Materials and Methods: We screened studies concerning triage education for nurses in Emergency Department, in databases including PubMed, CENTRAL and CINAHL. From November 12, 2023 to February 15, 2024, databases were searched for relevant literature. “Triage education” OR “triage training” AND “emergency nurses” OR “triage nurses” were the MeSH terms.Results: There are various educational methods, including traditional, web-based, audiovisual, simulation-based, blended learning, and other specialized approaches. Almost all of the studies that are currently available demonstrate how effectively an educational intervention might improve nurses’ comprehension of triage. Except for one, every study concluded that the educational intervention significantly improved nurses’ triage knowledge. Comparing the included studies is challenging due to their heterogeneity, and applying the results in practice requires caution.Conclusion: The majority of studies reported that educational interventions effectively increased nurses’ triage knowledge. Blended learning in conjunction with refresher courses enhanced triage-related knowledge and decision-making; however, additional research is required to ascertain whether this approach is superior to the others and whether these improvements will last.Keywords: educational method, emergency department, triage education

Megha K. Shah, Alannah L. Couper, Stephanie Sandanasamy et al.

This systematic review aimed to investigate the extent of nursing students' knowledge regarding climate change and its impact on health. A comprehensive and systematic review was conducted across several international electronic databases, including Scopus, PubMed, and Web of Science. The search employed keywords based on Medical Subject Headings, including "knowledge", "climate change", "nursing students", and "health". The search period was extended from these databases’ inception until May 28, 2024. The quality of the studies included in this review was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS tool). The systematic review encompassed five cross-sectional studies, collectively involving 2,150 nursing students. Among these participants, females constituted 75.81%. The geographical distribution of the studies included in this systematic review spanned several countries: Egypt (n=3), Saudi Arabia, Iraq and Palestine (n=1), China (n=1), and the United States (n=1). Findings from three studies indicate that nursing students’ mean knowledge level regarding climate change’s impact on health is 63.70%. The knowledge level of nursing students regarding climate change’s impact on health was moderate. Factors including education level, practice, academic year, gender, and rural areas were related to nursing students’ knowledge about climate change and its effect on health. Policymakers and healthcare administrators must enhance the educational framework by prioritizing factors that influence the knowledge base of nursing students. These factors include academic level, geographic location (such as rural areas), gender, and clinical practice experience.

Fatemeh Tahmasbi, Khadijeh Yazdi, Navisa Sadat Seyedghasemi et al.

Background: The use of information technology improves the competency of nurses at the bedside. This study was conducted to determine the relationship between informatics competency and clinical competency in nurses working in intensive care units. Methods: In this cross-sectional study, 135 nurses employed in intensive care units affiliated with Golestan University of Medical Sciences, Iran, were included. The inclusion criteria were having at least a bachelor's degree in nursing, a minimum of six months of work experience in the ICU, and current employment in the ICU. The participants were enrolled in 2023 using a stratified sampling method with proportional allocation. Data were collected using demographic information forms, clinical competency questionnaires, and informatics competency questionnaires. Statistical inferential tests included Mann-Whitney, Kruskal-Wallis, multiple linear regression, and generalized multiple linear regression models. The significance level for all statistical tests was set at 0.05. Results: The mean scores of the nurses' clinical competency and informatics competency were 58.41±8.80 and 45.67±18.88, respectively. There was no statistically significant correlation between these two variables (r = -0.07, p-value = 0.42). When examining the simultaneous effect of explanatory variables, only work experience in the ICU had a significant association with clinical competency (β = 0.3, P = 0.02). Moreover, informatics competency was significantly associated with gender (β = -12.93, P = 0.001) and the duration of using health information systems (β = -6.22, P = 0.008). Conclusion: There is no significant relationship between informatics competency and clinical competency among ICU nurses. It is suggested that health system policymakers introduce the components of nurses' informatics competence and emphasize their importance in the clinical setting to improve the quality of care. In addition, nurses should be encouraged to enhance their professional skills and acquire competency in new approaches by gaining updated knowledge.

Julia R. Varshavsky, Swati D. G. Rayasam, Jennifer B. Sass et al.

Abstract A key element of risk assessment is accounting for the full range of variability in response to environmental exposures. Default dose-response methods typically assume a 10-fold difference in response to chemical exposures between average (healthy) and susceptible humans, despite evidence of wider variability. Experts and authoritative bodies support using advanced techniques to better account for human variability due to factors such as in utero or early life exposure and exposure to multiple environmental, social, and economic stressors. This review describes: 1) sources of human variability and susceptibility in dose-response assessment, 2) existing US frameworks for addressing response variability in risk assessment; 3) key scientific inadequacies necessitating updated methods; 4) improved approaches and opportunities for better use of science; and 5) specific and quantitative recommendations to address evidence and policy needs. Current default adjustment factors do not sufficiently capture human variability in dose-response and thus are inadequate to protect the entire population. Susceptible groups are not appropriately protected under current regulatory guidelines. Emerging tools and data sources that better account for human variability and susceptibility include probabilistic methods, genetically diverse in vivo and in vitro models, and the use of human data to capture underlying risk and/or assess combined effects from chemical and non-chemical stressors. We recommend using updated methods and data to improve consideration of human variability and susceptibility in risk assessment, including the use of increased default human variability factors and separate adjustment factors for capturing age/life stage of development and exposure to multiple chemical and non-chemical stressors. Updated methods would result in greater transparency and protection for susceptible groups, including children, infants, people who are pregnant or nursing, people with disabilities, and those burdened by additional environmental exposures and/or social factors such as poverty and racism.

Alexander W. Burke, Susan Welch, Tamara Power et al.

Abstract Objectives To explore how clinical yarning has been utilised as a health intervention for Aboriginal and/or Torres Strait Islander peoples and if there are any reported impacts yarning might have on health outcomes. Study design Systematic scoping review of published literature. Data sources A one-word search term “yarning” was applied in Scopus, EMBASE, CINAHL, MEDLINE, International Pharmaceutical Abstracts, Australian Public Affairs Information Service-Health, and the Aboriginal and/or Torres Strait Islander Health Bibliography databases. Databases were searched from inception to May 20, 2020. Study selection Studies were included where clinical yarning had been used as a health intervention. Inclusion and exclusion criteria were developed and applied according to PRISMA systematic and scoping review reporting methods. Data synthesis A total of 375 manuscripts were found from the initial data search. After removal of duplicates and removal of manuscripts based on abstract review, a total of 61 studies underwent full-text review. Of these, only five met the inclusion criteria of utilising yarning as a clinical intervention. Four of these studies described consumer self-reported health outcomes, with only one study looking at improvements in objective physiological health outcomes. Conclusions Whilst clinical yarning may be a culturally appropriate intervention in healthcare, there are limited studies that have measured the impact of this intervention. Further research may be needed to ascertain the true benefits of this intervention.

Qinghua Wang, Xiaohong Cao, Tianjiao Du

Abstract Background Research shows that the clinical learning environment can affect medical learners’ levels of empathy and formation of professional identity. However, few studies examined the impacts of early exposure to the clinical learning environment on first-year nursing students’ empathy levels and professional identity perceptions. Aim This study aimed to explore effects of initial contact with the clinical learning environment on first-year nursing students’ empathy levels and perceptions of professional identity. Methods This is a mixed-methods study conducted in a medical university and its affiliated hospital in Northeast China. For quantitative analysis, 220 first-year nursing students finished Interpersonal Reactivity Index (IRI) twice before and after their five-day clinical placement in the hospital in June, 2021. Paired samples t tests were used to explore the changes in first-year nursing students’ cognitive empathy, affective empathy and total empathy levels as measured by IRI before and after the clinical placement. For qualitative analysis, 15 first-year nursing students’ diary recording their clinical learning experiences were analyzed. An inductive thematic analysis approach was adopted to extract themes from the content on professional identity in nursing students’ diary. Results After the five-day clinical placement, first-year nursing students’ cognitive empathy, affective empathy and total empathy levels all increased. Five themes emerged regarding nursing students’ perceptions of professional identity: (1) Love for the nursing profession; (2) Multiple roles nurses play; (3) Personal characteristics a good nurse needs to have; (4) Deeper understanding of the nursing profession; (5) New understanding of the relationships between patients and nurses, between patients and doctors, and between doctors and nurses. Conclusions First-year nursing students’ initial contact with the clinical learning environment helped them enhance empathy levels and shape professional identity. Nursing educators may consider providing nursing students with opportunities of early exposure to the clinical learning setting to cultivate their empathy and develop their professional identity.

Chieh-Liang Huang, Chieh-Liang Huang, Yao-Chang Chiang et al.

Methadone maintenance treatment (MMT) remains the cornerstone for the management of opiate abuse. However, MMT can be associated with complex factors, including complications during the tolerance phase, the inability of some patients to maintain treatment effects during the tapering or abstinence phases, and the development of methadone dependence. Previous studies have revealed a sex disparity in MMT efficacy, showing that women undergoing MMT experiencing an increase in psychological symptoms compared with men and suggesting a link between disparate responses and the effects of estrogen signaling on methadone metabolism. More specifically, estradiol levels are positively associated with MMT dosing, and the expression of a single-nucleotide polymorphism (SNP) associated with estrogen receptor (ER) regulation is also associated with MMT dosing. In addition to performing mechanistic dissections of estrogen signaling in the presence of methadone, past studies have also proposed the targeting of estrogen signaling during MMT. The present report provides an overview of the relevant literature regarding sex effects, including differences in sex hormones and their potential impacts on MMT regimens. Moreover, this article provides a pharmacological perspective on the targeting of estrogen signals through the use of selective ER modulators (SERMs) during MMT. Preliminary preclinical experiments were also performed to evaluate the potential effects of targeting estrogen signaling with tamoxifen on methadone metabolism.

曾兆兰, 杨翔

Abstract

Aline Cristina Zerwes Ferreira, Tatiana Brusamarello, Fernanda Carolina Capistrano et al.

Objetivo: conocer como el portador de trastorno mental vivencia el uso de psicofármacos. Método: investigación cualitativa, exploratoria y descriptiva que utilizó como referencial teórico el pensamiento complejo de Edgar Morin. Datos fueron recolectados por entrevista semiestructurada aplicada a 26 portadores de trastorno mental con la prescripción de psicofármacos y fueron sometidos al análisis categorial temático. Resultados: emergió una categoría central: “La vivencia compleja del portador de trastorno mental en el uso de psicofármacos”, que muestra las interrelaciones entre las categorías temáticas: vivenciando los efectos de los psicofármacos; utilizando los psicofármacos de modo irregular; identificando facilidades y dificultades en el uso de psicofármacos; y desarrollando estrategias para mantenimiento del uso regular de psicofármacos. Conclusion: que la vivencia del portador de trastorno mental en el uso de psicofármacos es un proceso dinámico y complejo que engloba la multidimensionalidad que envuelve el ser humano y su tratamiento.

Elżbieta Stasiak, Karolina Stasiak, Łucja Stasiak et al.

The elderly person in the geriatric age, and thus very often with a disability, is too sparingly provided with holistic health care services in the home environment. One of the forms, which operates in the market of health care services and which is dedicated to the elderly and disabled is a long-term home-based nursing care. For over 17 years the market for health care services has been organized and led by nurses who are an independent professional group and whose actions have been based on the contracts with the National Health Fund. Despite the ever increasing demand for this type of care, the payer or the National Health Fund treats these benefits as limited. These benefits are for the payer the cheapest form of care addressed to the elderly and disabled. In view of the fact that Polish society is aging at a rapid rate and is thus faced with multiple morbidities, these health benefits should be guaranteed and unlimited. This change would bring huge savings in health care. Due to the insufficient number of places, the person who is eligible for long-term home-based nursing care is put on a waiting list.

Badr Ratnakaran

Xi Pan, Jiao-jiao Bai, Jiao Sun et al.

Objective: To explore the walking strategy by monitoring the characteristics of center of pressure (COP) of gait in the elderly with type2 diabetes. Methods: All of the elderly patients with type2 diabetes (n = 543) were enrolled from Huadong Hospital Affiliated to Fudan University. Dynamic barefoot plantar pressure was assessed by Footscan7 USB2 flat. Outcome measures included excursion, the x- and y-coordinates displacement of COP and falling frequency. Results: There were 64.5% of cases with abnormal COP trajectory. Among them, 45.2% were with abnormal fold-back, 14.0% with two or more abnormal fold-back, 20.5% with abnormal beginning point deviating from the heel to the arch and metatarsal region, 18.0% with abnormal terminal point deviating from the hallux to toe 2–5 and the x- and y-coordinates displacement of COP in both feet are asymmetry. Conclusions: It highlights to put forward the walking strategy according to the abnormal COP trajectory. Due to the elderly diabetics with high risks of falling, the rehabilitation nursing should be strengthened mainly including the training of enhancing proprioception to prevent the elderly patients with type2 diabetes from falling.

Dorota Religa, Seyed-Mohammad Fereshtehnejad, Pavla Cermakova et al.

<h4>Background</h4>The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden.<h4>Methods</h4>SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes.<h4>Results</h4>The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden.<h4>Conclusion</h4>SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.

M. Irwan Katili, Andrey Nino Kurniawan, Nanang Sulaksono

The purpose of this study is to test the X-ray equipment GE Type XR 6000 in in JTRR Laboratory of Health Polytechnic in Semarang the and analyze the test results. It is a quantitative measurement of some components including Collimator, X-ray tube and generator. The instruments used for the measurement were Piranha test tool, TOR ABC as well as the water passes. The measurement result for light is 281.67 lux, deviation for collimator ΔX + ΔY is 1.8% and a deviation of 1.5 degrees. For the measurement of tube leakage is still below the leak amounted to 1 mGy / h. The accuracy of all tubes is less than 5% (diff kVp). Tube current output is still appropriate with the setting. The linearity coefficient results in mAs linearity testing is less than 0.1. The CV value of reproducibility is ≤ 0.05. While the value of the measured HVL is already greater than 2.3 mmAl at 80 kVp. In conclusion, the results of the measurements of X-rays equipment Ge Type XR 6000 in JTRR Laboratory of Health Polytechnic of Semarang is still within the acceptance for use.

A. Silva-Costa, R.H. Griep, L. Rotenberg

Cardiovascular diseases (CVDs) are known to be associated with poor sleep quality in general populations, but they have not been consistently associated with specific work schedules. Studies of CVD generally do not simultaneously consider sleep and work schedules, but that approach could help to disentangle their effects. We investigated the association between insomnia and a self-reported physician diagnosis of CVD in day and night workers, considering all sleep episodes during nocturnal and diurnal sleep. A cross-sectional study was conducted in 1307 female nursing professionals from 3 public hospitals, using baseline data from the “Health and Work in Nursing - a Cohort Study.” Participants were divided into two groups: i) day workers with no previous experience in night shifts (n=281) and whose data on insomnia were related to nocturnal sleep and ii) those who worked exclusively at night (n=340) and had data on both nocturnal and diurnal sleep episodes, as they often sleep at daytime. Multiple logistic regression analysis was performed. Among day workers, insomnia complaints increased the odds of CVD 2.79-fold (95% CI=1.01-6.71) compared with workers who had no complaints. Among night workers, reports of insomnia during both nocturnal and diurnal sleep increased the odds of reported CVD 3.07-fold (95% CI=1.30-7.24). Workers with insomnia had similar probabilities of reporting CVD regardless of their work schedule, suggesting a relationship to insomnia and not to night work per se. The results also highlighted the importance of including evaluation of all sleep episodes (diurnal plus nocturnal sleep) for night workers.

Monique Pio Astolpho, Aline Cristiane Cavicchioli Okido, Regina Aparecida Garcia Lima

O estudo objetivou caracterizar as instituições de apoio às crianças com necessidades especiais de saúde e apreender como se conformam as interações entre essas instituições e os demais serviços que compõem a rede de cuidados. Estudo descritivo exploratório com abordagem qualitativa. Participaram dez responsáveis por instituições que atendem essa clientela. Utilizou-se, como instrumento de coleta de dados, a entrevista semiestruturada. As instituições atendem, aproximadamente, 3.310 clientes, sendo 432 crianças; oito atendem acima de suas capacidades e a demanda reprimida chega a 200 pacientes; duas possuem atendimento 24 horas; a maioria tem como característica ser não governamental e as fontes de recursos consistem de doações, recursos próprios e repasse governamental. Com relação à dinâmica do processo de trabalho, foram mencionadas integração e articulação deficientes. Faz-se necessário a reorganização dos serviços na busca por uma assistência qualificada e integradora, minimizando as dificuldades de comunicação e cooperação entre os serviços.

Jose Luis Gómez Urquiza

La enfermería basada en la evidencia aboga por la transferencia de los resultados de investigación a la práctica diaria para la mejora de los cuidados. Existen numerosos recursos donde las enfermeras pueden localizar evidencia científica. Este texto reflexiona sobre si es pertinente la existencia de un modelo de reconocimiento de implementación de evidencias en cuidados, paralelo a los ya reconocidos oficialmente por las Comunidades Autónomas, que centra su evaluación en el uso de un único recurso de evidencia y en el que la enfermería es relegada del reconocimiento de su labor en pro de la distinción del centro sanitario.

Tauna Gulley

Asset Based Community Development (ABCD), a guide for building healthier communities, was used to promote positive change in a rural southwest Virginia community. This paper illustrates how community assets were recognized and social capital increased as children painted a mural depicting the history of the community. A literature review of successful community building partnership models is provided and implications for nursing education are discussed, including suggestions for teaching collaboration skills for effective community partnering.

Cooper Simon, Beauchamp Alison, Bogossian Fiona et al.

<p>Abstract</p> <p>Aims</p> <p>To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients.</p> <p>Background</p> <p>There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders.</p> <p>Design/Methods</p> <p>A mixed methods triangulated convergent design.</p> <p>In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase.</p> <p>Conclusion</p> <p>This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.</p>

Celiane Camargo-Borges, Marisa Japur

Los nuevos discursos en el contexto del Sistema Unificado de Salud han exigido una mirada más crítica sobre el auto-cuidado. Este es un estudio de carácter cualitativo, basado teórica y metodológicamente en el construccionismo social. Su objetivo es describir los sentidos del autocuidado producidos en grupos comunitarios en el contexto de la Estrategia de la Salud de la Familia. Los datos fueron recolectados durante el año 2001, totalizando 28 participantes con 50 años de edad, aproximadamente. Las conversaciones fueron grabadas, transcritas y analizadas dando visibilidad a las versiones del auto-cuidado. El análisis, basado en una perspectiva construccionista, permitió ampliar los sentidos del auto-cuidado, favoreciendo una reflexión sobre su complejidad, señalando necesidades más amplias, diferentes de la adopción de un medicamento prescrito. Diálogo y foco en la relación son presentados como recursos transformadores de las prácticas de cuidado y auto-cuidado, los cuales posibilitan la construcción de acciones dentro de una perspectiva más integral y co-responsable.