International Journal of Nursing Studies Advances最新文献

{"title":"Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: A qualitative descriptive study","authors":"Hyunmin Yu ,&nbsp;April J. Ancheta ,&nbsp;Dalmacio Dennis Flores ,&nbsp;Stephen Bonett ,&nbsp;Steven Meanley ,&nbsp;Seul Ki Choi ,&nbsp;José A. Bauermeister","doi":"10.1016/j.ijnsa.2024.100262","DOIUrl":"10.1016/j.ijnsa.2024.100262","url":null,"abstract":"<div><h3>Background</h3><div>Discrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems.</div></div><div><h3>Methods</h3><div>Twenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation.</div></div><div><h3>Results</h3><div>Nurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices.</div></div><div><h3>Conclusion</h3><div>Implementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100262"},"PeriodicalIF":3.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presenteeism among nurses: An integrative review","authors":"Maisa Gerlach ,&nbsp;Sabine Hahn ,&nbsp;Celine Rossier ,&nbsp;Franziska Geese ,&nbsp;Jan Hamers ,&nbsp;Ramona Backhaus","doi":"10.1016/j.ijnsa.2024.100261","DOIUrl":"10.1016/j.ijnsa.2024.100261","url":null,"abstract":"<div><h3>Background</h3><div>Presenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves.</div></div><div><h3>Objective</h3><div>We aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences.</div></div><div><h3>Design</h3><div>We performed an integrative review.</div></div><div><h3>Methods</h3><div>We searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews.</div></div><div><h3>Results</h3><div>The results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32 % and 94 %. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes.</div></div><div><h3>Conclusion</h3><div>This review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100261"},"PeriodicalIF":3.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of multifaceted interventions including motivational interviewing and home-based rehabilitation program for improving mental and physical health in stroke patients: A randomized controlled trial","authors":"Thao Thi Phuong Nguyen ,&nbsp;Hai Bui Hoang ,&nbsp;Huyen Thi Thanh Vu","doi":"10.1016/j.ijnsa.2024.100259","DOIUrl":"10.1016/j.ijnsa.2024.100259","url":null,"abstract":"<div><h3>Background</h3><div>In Vietnam, early screening and intervention for post-stroke mental health are limited, with rising demand for home-based rehabilitation due to the scarcity of inpatient programs.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate the effectiveness of multifaceted interventions, including Motivational Interviewing and home-based rehabilitation, in improving the mental and physical health of stroke patients.</div></div><div><h3>Design</h3><div>A randomized controlled trial at the Vietnam National Geriatric Hospital assessed a multi-intervention approach for stroke survivors from 2021 to 2022. Ninety-two participants (aged over 45 with a stroke diagnosis) were randomly assigned to an intervention group (Motivational Interviewing and home-based rehabilitation) or a control group (standard care), with 46 participants in each group. Outcomes for mental health (Patient Health Questionnaire-9, Fatigue Severity Scale, Mini-Mental State Examination) and physical health (Barthel Index) were measured at baseline and after 1, 3, and 6 months. Statistical analyses used <em>t</em>-tests, Cohen's <em>d</em>, and repeated measures ANOVA.</div></div><div><h3>Results</h3><div>Over 6 months, 37 participants completed the intervention program. Baseline characteristics were similar except for age, lesion locations, and National Institutes of Health Stroke Scale scores. The intervention group showed significant improvements in mental health and physical function. Patient Health Questionnaire-9 scores decreased from 9.1 to 1.8, and Fatigue Severity Scale scores dropped from 28.5 to 17.8, while Barthel Index scores improved from 58.8 to 68.8 (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>We found that participants who underwent Motivational Interviewing therapy and home-based rehabilitation were more likely than those receiving standard care to experience substantial improvements in both mental and physical health metrics.</div></div><div><h3>Registration</h3><div>The research protocol was registered on ClinicalTrials.gov on August 1, 2021 (Identifier: NCT04941482, link: <span><span>https://clinicaltrials.gov/study/NCT04941482</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100259"},"PeriodicalIF":3.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of early warning scoring systems on adverse outcome in surgical patients: A systematic review","authors":"Annick Stolze ,&nbsp;Tara N.M. Woolley-Hendriks ,&nbsp;Yara Bassa ,&nbsp;Ralph de Vries ,&nbsp;Christa Boer ,&nbsp;Peter G. Noordzij","doi":"10.1016/j.ijnsa.2024.100256","DOIUrl":"10.1016/j.ijnsa.2024.100256","url":null,"abstract":"<div><h3>Background</h3><div>An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.</div></div><div><h3>Methods</h3><div>This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799. PubMed, Embase.com, CINAHL (Ebsco) and Wiley/Cochrane Library were searched from inception up to 20-06-2023 for randomized controlled trials and non-randomized studies of interventions. Studies were eligible for inclusion if the effect of an early warning scoring system using spot check monitoring was studied.</div></div><div><h3>Results</h3><div>Eight articles were included, of which two were randomised controlled trials. The overall risk of bias was high. A statistically significant decrease in mortality was seen in three studies. Two studies reported a decrease in cardiopulmonary arrests, and three studies found a decrease in ICU-admissions. There was heterogeneity among studies regarding the types of complications that were reported.</div></div><div><h3>Conclusions</h3><div>The evidence in favor of an early warning scoring system to reduce complications and mortality in surgical patients is low, mainly due to a limited number of studies and poor study design. Well-designed trials are needed to investigate whether an early warning scoring system improves outcome in surgical patients.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100256"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grit, academic resilience, and mindset of nursing students: A cross-sectional study","authors":"Boitumelo Setlogelo,&nbsp;Champion N Nyoni","doi":"10.1016/j.ijnsa.2024.100253","DOIUrl":"10.1016/j.ijnsa.2024.100253","url":null,"abstract":"<div><h3>Background</h3><div>Nursing students engage with the complex health system for competence development. These students are exposed to nerve-wrecking experience in addition to their everyday personal and social challenges. Non-cognitive attributes, namely grit, resilience and mindset can influence students’ ability to overcome complexities as they become nurses resulting in academic success and well-being. Insights into the state of non-cognitive attributes among undergraduate nursing students are essential in developing tailor-made educational programmes to enhance their grit, resilience, and mindset.</div></div><div><h3>Objectives</h3><div>To describe the undergraduate nursing students’ grit, academic resilience, and mindset at a university in South Africa</div></div><div><h3>Design</h3><div>A quantitative descriptive cross-sectional design.</div></div><div><h3>Setting</h3><div>A School of Nursing at a public multi-campus university in South Africa.</div></div><div><h3>Participants</h3><div>All students (N = 315) registered for the undergraduate nursing programme were invited to participate, and 70 % (N = 221) chose to participate.</div></div><div><h3>Methods</h3><div>Data were collected using self-administered questionnaires that included a 7-item demographic survey, the 30-item Academic Resilience Scale (ARS-30) that measures affective, cognitive, and behavioural responses in an educational context, the 16-item Dweck Mindset Scale (DMI) that measures a personal belief about whether intelligence and talent are fixed or amenable to change, and the 8-item Grit-S scale measuring passion for long term goals and perseverance. The collected quantitative data were analysed statistically through the Statistical Analysis Software Version 9.4 computer programme.</div></div><div><h3>Findings</h3><div>The findings revealed that the participants have normal grit and a growth mindset, but low academic resilience.</div></div><div><h3>Conclusions</h3><div>Tailor-made educational programmes that target non-cognitive attributes must integrate interventions that are focused on enhancing academic resilience for undergraduate nursing students.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100253"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing interventions in a newly established community health nursing system: A cross sectional survey","authors":"Raimund M. Kovacevic ,&nbsp;Doris A. Behrens ,&nbsp;Walter Hyll","doi":"10.1016/j.ijnsa.2024.100258","DOIUrl":"10.1016/j.ijnsa.2024.100258","url":null,"abstract":"<div><h3>Background</h3><div>Community health nursing was introduced in Austria in 2022. Information about nurses' activities, their alignment with established public health frameworks, and their relationship to existing care services is crucial for understanding the role's implementation and potential impact.</div></div><div><h3>Objective</h3><div>This study examines the activities of the first cohort of Austrian Community Health Nurses, focusing on their alignment with the Public Health Intervention Wheel and the Nursing Intervention Classification. An important aspect comes from the question, whether these new services complement or substitute existing direct care services. In this process, we also address heterogeneity across urbanization levels.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting(s)</h3><div>An online survey (April to June 2023) among Community Health Nurses captured their perception of activity frequencies based on the Public Health Intervention Wheel and Nursing Intervention Classification.</div></div><div><h3>Participants</h3><div>130 nurses (59 %, <em>N</em> = 220) answered &gt;6 (out of 33) questions, 98 nurses (45 %, <em>N</em> = 220) provided all required information.</div></div><div><h3>Methods</h3><div>The analysis used descriptive statistics, statistical tests, and hierarchical cluster analysis, employing Excel®, Stata® and R.</div></div><div><h3>Results</h3><div>Austrian Community Health Nurses implement many principles of the Public Health Intervention Wheel, with a focus on counselling, consultation, and health teaching. Direct care interventions (according the Nursing Intervention Classification) are rarely performed. Findings indicate that community health nurses complement rather than substitute existing direct care and home nursing services. However, unlike international practices, activities are primarily at the individual level, with limited engagement at community and systems levels.</div></div><div><h3>Conclusions</h3><div>Community health nursing in Austria demonstrates a public health focus and therefore complements existing care services. However, it focuses primarily at the individual level, which differs from international norms where activities span individual, community, and systems levels.</div></div><div><h3>Tweetable abstract</h3><div>First Austrian Community Health Nurses implement public health intervention principles mainly on individual level.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100258"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological safety in enhancing the competence of nurse educators among early career nursing faculty in Japan: A cross-sectional study","authors":"Miho Satoh ,&nbsp;Naoko Sato ,&nbsp;Noriko Tamura ,&nbsp;Akiko Fujimura","doi":"10.1016/j.ijnsa.2024.100254","DOIUrl":"10.1016/j.ijnsa.2024.100254","url":null,"abstract":"<div><h3>Background</h3><div>Given the diverse roles and responsibilities expected of academic nurse educators, it is essential that they acquire relevant nursing educator competencies. Early career nursing faculty often struggle to engage in their tasks. Therefore, systematic support is crucial in developing the necessary capacities for early career nursing faculty. In organizational sociology, the positive interaction between organizational and individual resources enhances the competence of nurse educators. Psychological safety enhances organizational members' ability to cope with challenges and perform effectively. It may also foster a high sense of coherence, linked to improved job performance and competence in nursing faculty. Both psychological safety and coherence promote work engagement, further boosting nurse educator competence.</div></div><div><h3>Aim</h3><div>This study explored the relationships between psychological safety, sense of coherence, work engagement, and competence of nurse educators among assistant professors and assistants in nursing education.</div></div><div><h3>Design</h3><div>A cross-sectional survey design was used. Data were collected from 164 early career nursing faculty using an anonymous self-administered web-based questionnaire. The study measured the psychological safety, sense of coherence, work engagement, and competence of academic nurse educators. The mediating effects of a sense of coherence and work engagement on the relationship between psychological safety and competency were assessed using the PROCESS macro model. Bootstrapping with 5,000 re-samples was used to determine the significance of the mediating effects.</div></div><div><h3>Setting</h3><div>The study was conducted from October 1 to December 31, 2022, at nursing universities in Japan.</div></div><div><h3>Results</h3><div>Positive correlations were identified among psychological safety, sense of coherence, work engagement, and the competence of nurse educator. The sense of coherence and work engagement indirectly mediated the relationship between psychological safety and the competence of nurse educator. A serial multiple mediation model demonstrated that psychological safety indirectly influenced the competence of nurse educator through a sense of coherence and work engagement.</div></div><div><h3>Conclusions</h3><div>Supportive organizational environments foster a sense of coherence, enabling effective resource utilization and the competence of nurse educator development. While structured intervention programs such as faculty development are vital, establishing supportive systems that nurture adaptable qualities and use various resources is also essential. A positive work environment can create a cycle of increasing competency through positive attitudes toward work.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100254"},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can family members of patients in the intensive care unit be supported? A systematic review of qualitative reviews, meta-synthesis, and novel recommendations for nursing care","authors":"Thora Gunnlaugsdóttir ,&nbsp;Rannveig J. Jónasdóttir ,&nbsp;Kristín Björnsdóttir ,&nbsp;Marianne Elisabeth Klinke","doi":"10.1016/j.ijnsa.2024.100251","DOIUrl":"10.1016/j.ijnsa.2024.100251","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Families are an important part of the intensive care unit (ICU) team. Being a family member in the ICU can be distressing due to interacting factors, such as the critical condition of the patient, the responsibility of acting as the patient's advocate, and partaking in decision-making related to treatment. Nurses need to be aware of the family's well-being throughout the patient's ICU stay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To synthesize reviews of family members' experiences and needs during patients' ICU admission and develop recommendations to support nurses in strengthening their relationships with families.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Systematic review of qualitative and mixed method reviews.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data sources&lt;/h3&gt;&lt;div&gt;Extensive searches without time limits identified systematic reviews published until June 27, 2024 in CINAHL, PubMed, Scopus, and Web of Science. Reviews were eligible if they provided knowledge required to inform high-quality on-site family care during the patient's ICU admission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Review methods&lt;/h3&gt;&lt;div&gt;Quality appraisal adhered to the Joanna Briggs Institute checklist for systematic reviews and research syntheses. Themes were generated by integrating review results and narratively summarizing the main contents. Finally, findings were translated into clinical practice recommendations by using the four-component GRADE-CERQual assessment (low to high recommendation grades). Recommendations were backtracked to primary research studies for validation. All recommendations were critically reflected upon with an expert panel of ICU nurses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The nine included reviews were built on 124 original studies published between 1995 and 2021. One central theme, “Emotional limbo and extreme moments”, mirrored the core of families' experiences characterized by waiting time, i.e., for the patient to get better or worse, and overwhelming emotions and confusion brought about by the patient's critical illness. Three sub-themes reflected actions to counterbalance emotional challenges: a) Responding to family members' existential needs, b) Establishing optimal grounds for reciprocal communication, and c) Enhancing a humanizing approach and atmosphere in the ICU. The meta-synthesis resulted in 11 aggregated recommendations. The findings highlighted that nurses should proactively address emotional issues to help preserve families' ability to keep going, allow families to be present and function as a part of the team, and inform families of the patient's situation and how they can practically help.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Nurses should use multiple adjustable approaches to alleviate family's burden during an ICU stay. Findings help nurses to prioritize care and make physical and emotional space for family caregivers. Results emphasize the need to facilitate the agency of family caregivers and reinforce their strengths throug","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100251"},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From ‘strong recommendation’ to practice: A pre-test post-test study examining adherence to stroke guidelines for fever, hyperglycaemia, and swallowing (FeSS) management post-stroke","authors":"Kelly Coughlan ,&nbsp;Tara Purvis ,&nbsp;Monique F. Kilkenny ,&nbsp;Dominique A. Cadilhac ,&nbsp;Oyebola Fasugba ,&nbsp;Simeon Dale ,&nbsp;Kelvin Hill ,&nbsp;Megan Reyneke ,&nbsp;Elizabeth McInnes ,&nbsp;Benjamin McElduff ,&nbsp;Jeremy M. Grimshaw ,&nbsp;N Wah Cheung ,&nbsp;Christopher Levi ,&nbsp;Catherine D'Este ,&nbsp;Sandy Middleton","doi":"10.1016/j.ijnsa.2024.100248","DOIUrl":"10.1016/j.ijnsa.2024.100248","url":null,"abstract":"<div><h3>Background</h3><div>The Quality in Acute Stroke Care (QASC) Trial demonstrated that assistance to implement protocols to manage Fever, hyperglycaemia (Sugar) and Swallowing (FeSS) post-stroke reduced death and disability. In 2017, a ‘Strong Recommendation’ for use of FeSS Protocols was included in the Australian Clinical Guidelines for Stroke Management. We aimed to: i) compare adherence to FeSS Protocols pre- and post-guideline inclusion; ii) determine if adherence varied with prior participation in a treatment arm of a FeSS Intervention study, or receiving treatment in a stroke unit; and compare findings with our previous studies.</div></div><div><h3>Methods</h3><div>Pre-test post-test study using Australian acute stroke service audit data comparing 2015/2017 (pre-guideline) versus 2019/2021 (post-guideline) adherence. Primary outcome was adherence to all six FeSS indicators (composite), with mixed-effects logistic regression adjusting for age, sex, stroke type and severity (ability to walk on admission), stroke unit care, hospital prior participation in a FeSS Intervention study, and correlation of outcomes within hospital. Additional analysis examined interaction effects.</div></div><div><h3>Results</h3><div>Overall, 112 hospitals contributed data to ≥1 one Audit cycle for both periods (pre=7011, post=7195 cases); 42 hospitals had participated in any treatment arm of a FeSS Intervention study. Adherence to FeSS Protocols post-guideline increased (pre: composite measure 35% vs post: composite measure 40 %, aOR:1.2 95 %CI: 1.2, 1.3). Prior participation in a FeSS Intervention study (aOR:1.6, 95 %CI: 1.2, 2.0) and stroke unit care (aOR 2.3, 95 %CI: 2.0, 2.5) were independently associated with greater adherence to FeSS Protocols. There was no change in adherence over time based on prior participation in a FeSS Intervention study (<em>p</em> = 0.93 interaction), or stroke unit care (<em>p</em> = 0.07 interaction).</div></div><div><h3>Conclusions</h3><div>There is evidence of improved adherence to FeSS Protocols following a ‘strong recommendation’ for their use in the Australian stroke guidelines. Change in adherence was similar independent of hospital prior participation in a FeSS Intervention study, or stroke unit care. However, maintenance of higher pre-guideline adherence for hospitals prior participation in a FeSS Intervention study suggests that research participation can facilitate greater guideline adherence; and confirms superior care received in stroke units. Nevertheless, less than half of Australian patients are being cared for according to the FeSS Protocols, providing impetus for additional strategies to increase uptake.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100248"},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of an algorithm for predicting exacerbations in telemonitoring: A multimethod study of patients’ and clinicians’ experiences","authors":"Sisse Heiden Laursen ,&nbsp;Lisa Korsbakke Emtekær Hæsum ,&nbsp;Julie Egmose ,&nbsp;Thomas Kronborg ,&nbsp;Flemming Witt Udsen ,&nbsp;Ole Kristian Hejlesen ,&nbsp;Stine Hangaard","doi":"10.1016/j.ijnsa.2024.100257","DOIUrl":"10.1016/j.ijnsa.2024.100257","url":null,"abstract":"<div><h3>Background</h3><div>Prediction algorithms may improve the ability of telehealth solutions to assess the risk of future exacerbations in patients with chronic obstructive pulmonary disease. Learning from patients’ and clinicians’ evaluations and experiences about the use of such algorithms is essential to evaluate its potential and examine factors that could potentially influence the implementation and sustained use.</div></div><div><h3>Objective</h3><div>To investigate the patients’ and clinicians’ perceptions and satisfaction with an algorithm for predicting exacerbations in patients with chronic obstructive pulmonary disease.</div></div><div><h3>Design</h3><div>Multimethod study.</div></div><div><h3>Setting</h3><div>Three community nursing sites in Aalborg Municipality, Denmark.</div></div><div><h3>Participants</h3><div>One hundred and eleven adults with chronic obstructive pulmonary disease and four clinicians (three nurses and one physiotherapist) specialized in telehealth monitoring of the disease.</div></div><div><h3>Methods</h3><div>The study was performed from November 2021 to November 2022 alongside a clinical trial in which a prediction algorithm was integrated into an existing telehealth system. The patients’ perspectives were investigated using a self-constructed questionnaire. The clinicians’ perspective was explored using semistructured individual interviews.</div></div><div><h3>Results</h3><div>Most patients (84.0 %–90.8 %) were satisfied with the algorithm and the additional measurements required by the algorithm. Approximately 71.7 %–75.9 % found that the algorithm could be a useful tool for disease assessment. Patients elaborated that they could see an exacerbation prevention potential in the algorithm. Patients trusted the algorithm and found an increased sense of security. The clinicians showed a positive response toward the algorithm and its user-friendliness. However, they were concerned that the additional measurements could be too demanding for some patients and questioned the accuracy of the measurements. Some felt that the algorithm could risk being time-consuming and harm the overall assessment of the individual patient. They expressed a need for continuous information about the algorithm to understand its functions and alarms.</div></div><div><h3>Conclusions</h3><div>Optimal use of the algorithm would require that patients perform additional pulse and oxygen saturation measurements. Furthermore, it will require in-depth insight among clinicians regarding the algorithm's functions and alarms.</div></div><div><h3>Registration</h3><div>The study was performed alongside a clinical trial, which was first registered September 9, 2021, at clinicaltrials.gov (registration number NCT05218525). Date of first recruitment was September 28, 2021.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100257"},"PeriodicalIF":3.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}