Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility
Melissa M. Arons, Kelly M. Hatfield, Sujan C. Reddy
et al.
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can spread rapidly within skilled nursing facilities. After identification of a case of Covid-19 in a skilled nursing facility, we assessed transmission and evaluated the adequacy of symptom-based screening to identify infections in residents. Methods We conducted two serial point-prevalence surveys, 1 week apart, in which assenting residents of the facility underwent nasopharyngeal and oropharyngeal testing for SARS-CoV-2, including real-time reverse-transcriptase polymerase chain reaction (rRT-PCR), viral culture, and sequencing. Symptoms that had been present during the preceding 14 days were recorded. Asymptomatic residents who tested positive were reassessed 7 days later. Residents with SARS-CoV-2 infection were categorized as symptomatic with typical symptoms (fever, cough, or shortness of breath), symptomatic with only atypical symptoms, presymptomatic, or asymptomatic. Results Twenty-three days after the first positive test result in a resident at this skilled nursing facility, 57 of 89 residents (64%) tested positive for SARS-CoV-2. Among 76 residents who participated in point-prevalence surveys, 48 (63%) tested positive. Of these 48 residents, 27 (56%) were asymptomatic at the time of testing; 24 subsequently developed symptoms (median time to onset, 4 days). Samples from these 24 presymptomatic residents had a median rRT-PCR cycle threshold value of 23.1, and viable virus was recovered from 17 residents. As of April 3, of the 57 residents with SARS-CoV-2 infection, 11 had been hospitalized (3 in the intensive care unit) and 15 had died (mortality, 26%). Of the 34 residents whose specimens were sequenced, 27 (79%) had sequences that fit into two clusters with a difference of one nucleotide. Conclusions Rapid and widespread transmission of SARS-CoV-2 was demonstrated in this skilled nursing facility. More than half of residents with positive test results were asymptomatic at the time of testing and most likely contributed to transmission. Infection-control strategies focused solely on symptomatic residents were not sufficient to prevent transmission after SARS-CoV-2 introduction into this facility.
Nursing Research
Kimberly Horns LaBronte, Kim Friddle, Amy R. Koehn
Nursing Research covers key issues, including health promotion, human responses to illness, acute care nursing research, symptom management, cost-effectiveness, vulnerable populations, health services, and community-based nursing studies. Each issue highlights the latest research techniques, quantitative and qualitative studies, and new state-of-the-art methodological strategies, including information not yet found in textbooks. Expert commentaries and briefs are also included. In addition to 6 issues per year, Nursing Research from time to time publishes supplemental content not found anywhere else.
An overview of the qualitative descriptive design within nursing research
L. Doyle, C. Mccabe, B. Keogh
et al.
Background Qualitative descriptive designs are common in nursing and healthcare research due to their inherent simplicity, flexibility and utility in diverse healthcare contexts. However, the application of descriptive research is sometimes critiqued in terms of scientific rigor. Inconsistency in decision making within the research process coupled with a lack of transparency has created issues of credibility for this type of approach. It can be difficult to clearly differentiate what constitutes a descriptive research design from the range of other methodologies at the disposal of qualitative researchers. Aims This paper provides an overview of qualitative descriptive research, orientates to the underlying philosophical perspectives and key characteristics that define this approach and identifies the implications for healthcare practice and policy. Methods and results Using real-world examples from healthcare research, the paper provides insight to the practical application of descriptive research at all stages of the design process and identifies the critical elements that should be explicit when applying this approach. Conclusions By adding to the existing knowledge base, this paper enhances the information available to researchers who wish to use the qualitative descriptive approach, influencing the standard of how this approach is employed in healthcare research.
1482 sitasi
en
Medicine, Psychology
Burnout in nursing: a theoretical review
C. Dall'ora, J. Ball, Maria Reinius
et al.
Background Workforce studies often identify burnout as a nursing ‘outcome’. Yet, burnout itself—what constitutes it, what factors contribute to its development, and what the wider consequences are for individuals, organisations, or their patients—is rarely made explicit. We aimed to provide a comprehensive summary of research that examines theorised relationships between burnout and other variables, in order to determine what is known (and not known) about the causes and consequences of burnout in nursing, and how this relates to theories of burnout. Methods We searched MEDLINE, CINAHL, and PsycINFO. We included quantitative primary empirical studies (published in English) which examined associations between burnout and work-related factors in the nursing workforce. Results Ninety-one papers were identified. The majority ( n = 87) were cross-sectional studies; 39 studies used all three subscales of the Maslach Burnout Inventory (MBI) Scale to measure burnout. As hypothesised by Maslach, we identified high workload, value incongruence, low control over the job, low decision latitude, poor social climate/social support, and low rewards as predictors of burnout. Maslach suggested that turnover, sickness absence, and general health were effects of burnout; however, we identified relationships only with general health and sickness absence. Other factors that were classified as predictors of burnout in the nursing literature were low/inadequate nurse staffing levels, ≥ 12-h shifts, low schedule flexibility, time pressure, high job and psychological demands, low task variety, role conflict, low autonomy, negative nurse-physician relationship, poor supervisor/leader support, poor leadership, negative team relationship, and job insecurity. Among the outcomes of burnout, we found reduced job performance, poor quality of care, poor patient safety, adverse events, patient negative experience, medication errors, infections, patient falls, and intention to leave. Conclusions The patterns identified by these studies consistently show that adverse job characteristics—high workload, low staffing levels, long shifts, and low control—are associated with burnout in nursing. The potential consequences for staff and patients are severe. The literature on burnout in nursing partly supports Maslach’s theory, but some areas are insufficiently tested, in particular, the association between burnout and turnover, and relationships were found for some MBI dimensions only.
869 sitasi
en
Medicine, Psychology
Nursing Research: Generating and Assessing Evidence for Nursing Practice
D. Polit, Cheryl Tatano Beck
State of the world's nursing 2020: investing in education, jobs and leadership
C. McCarthy
807 sitasi
en
Political Science
Nursing Research Generating and Assessing Evidence for Nursing Practice
F. Timmins
The future of nursing. Leading change, advancing health.
Anxiety and coping strategies among nursing students during the covid-19 pandemic
B. Savitsky, Yifat Findling, Anat Ereli
et al.
Anxiety is highly prevalent among nursing students even in normal circumstances. In Israel during the covid-19 pandemic and mandatory lockdown, nursing students encountered a new reality of economic uncertainty, fear of infection, challenges of distance education, lack of personal protection equipment (PPE) at work etc. The objective of this study was to assess levels of anxiety and ways of coping among nursing students in the Ashkelon Academic College, Southern District, Israel. A cross-sectional study was conducted among all 244 students in the nursing department during the third week of a national lockdown. Anxiety level was assessed using the Generalized Anxiety Disorder 7-Item Scale with a cut-off point of 10 for moderate and of 15 for severe anxiety. Factor analysis was used to identify coping components. The prevalence of moderate and severe anxiety was 42.8% and 13.1% respectively. Gender, lack of PPE, and fear of infection were significantly associated with a higher anxiety score. Stronger resilience and usage of humor were associated with significantly lower anxiety levels, while mental disengagement with higher anxiety levels. The nursing department's staff may contribute in lowering student anxiety by maintaining a stable educational framework, providing high quality distant teaching and encouraging and supporting students through this challenging period.
649 sitasi
en
Psychology, Medicine
The Application of Content Analysis in Nursing Science Research
H. Kyngäs, K. Mikkonen, M. Kääriäinen
Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics
D. Pollock, E. Davies, M. Peters
et al.
Abstract Aim The aim of this study is to discuss the available methodological resources and best‐practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research. Design Discussion Paper. Data Sources Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Scoping Review extension (PRISMA‐ScR). Implications for nursing and midwifery Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency. Conclusion This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery. Impact With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.
Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.
U. H. Graneheim, B. Lundman
Essentials of Nursing Research: Appraising Evidence for Nursing Practice
D. Polit, Cheryl Tatano Beck
Strategies for theory construction in nursing
Lorraine O. Walker, K. Avant
2593 sitasi
en
Computer Science
The Practice of Nursing Research: Conduct, Critique, & Utilization
N. Burns, S. Grove
3335 sitasi
en
Psychology
Nursing Research—Principles and Methods
J. Sweeney
2782 sitasi
en
Psychology
Simulation in Clinical Nursing Education
K. Koukourikos, A. Tsaloglidou, L. Kourkouta
et al.
Background: Simulation constitutes a teaching method and a strategy for learning and understanding theoretical knowledge and skills in the nursing and medical field. Objective: To review and present modern data related to this issue. Methods: Literature review of data related to the issue derived from Medline, Cinhal, and Scopus databases, in English, using the following keywords: nursing, simulation, simulator, nursing laboratory. Results: The implementation of simulation enables students to practice their clinical and decision-making skills for some significant issues they may face in their daily work. The protected environment and the sense of security enhance students’ self-esteem and confidence, thus promoting learning. In this way, the gap between theory and practice is substantially reduced. Conclusion: The further development of simulation, along with other instructional techniques, can significantly help the efforts made by the students to become integrated and successful healthcare professionals.
Exploring the impact on faculty of the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education.
M. Pearson, Jennifer Shumway
BACKGROUND Current nursing instructional methods inadequately prepare students for complex healthcare settings, exacerbating challenges in new graduate competency and transition to practice. The introduction of standardized competencies marks a substantial shift in nursing education, posing a considerable challenge for faculty implementing these changes. PURPOSE This study examined the experiences of faculty implementing a competency-based education program utilizing The Essentials: Core Competencies for Professional Nursing Education (2021) in undergraduate Bachelor of Science in Nursing (BSN) education programs. METHODS A qualitative research design using phenomenology was chosen to explore the experiences of eight faculty and gain insight into perceived challenges experienced during the implementation of The Essentials recommendations through semi-structured interviews. Data was analyzed using a manual content analysis with a constant comparative technique. RESULTS The data analysis revealed three primary themes focused on the faculty's initial uncertainty, the challenges associated with change processes and faculty engagement, and the strategies employed to develop and implement a competency-based program. CONCLUSION The findings provide insight into the faculty experience during The Essentials implementation, proposing strategies for curriculum alignment and overcoming resistance to change. Faculty continue to seek validation for their work while also facing the challenge of balancing implementation demands and broader institutional responsibilities. Continued discussions on faculty role development and resource identification are essential for future competency-based education program advancements.
A systematic review study on the factors affecting shortage of nursing workforce in the hospitals
A. T. Tamata, M. Mohammadnezhad
This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses.
The Impact of Transformational Leadership in the Nursing Work Environment and Patients’ Outcomes: A Systematic Review
Line Miray Kazin Ystaas, Monica Nikitara, Savoula Ghobrial
et al.
Background: With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective leadership; particularly, transformational leadership (TFL) is shown to scientifically be the most successfully recognized leadership style in healthcare, focusing on relationship building while putting followers in power and emphasizing values and vision. Aim: To examine how transformational leadership affects nurses’ job environment and nursing care provided to the patients and patients’ outcomes. Design: A systematic literature review was conducted. From 71 reviewed, 23 studies were included (studies included questionnaire surveys and one interview, extracting barriers and facilitators, and analyzing using qualitative synthesis). Result: TFL indirectly and directly positively affects nurses’ work environment through mediators, including structural empowerment, organizational commitment, and job satisfaction. Nurses perceived that managers’ TFL behavior did not attain excellence in any of the included organizations, highlighting the necessity for additional leadership training to enhance the patient safety culture related to the non-reporting of errors and to mitigate the blame culture within the nursing environment. Conclusion: Bringing more focus to leadership education in nursing can make future nursing leaders more effective, which will cultivate efficient teamwork, a quality nursing work environment, and, ultimately, safe and efficient patient outcomes. This study was not registered.