Quarterly published in print and online "Inventi Impact: Nursing Research" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal welcomes articles in all the nursing specialties including such areas as patient education, discharge planning, nursing diagnosis, nursing influence on length of hospital stay and nurse/physician collaboration.
Background: Worldwide, hypertension affects approximately 25% of the adult population and diabetes about 8.5%.\nLack of adherence to prescribed treatment regimen remains a problem among patients undergoing long-term\ntreatment, showing high non-adherence rates, at estimated range of between 36 and 93%. In our city, patients\nwith hypertension and diabetes in primary care are looked after mainly by doctors with little nursing support; also,\nthere is no published dataset among Colombian populations on the effect of nursing intervention to increase\nadherence to therapeutic regimen. The aim of this study was to evaluate the efficacy of nursing intervention\nâ??Teaching: Individualâ? compared with usual care, to increase adherence to therapeutic regimen in people with\nhypertension and/or type-2 diabetes, and to analyze the impact to glycosylated hemoglobin and systolic blood\npressure levels.\nMethods: A two-arm, single-blinded, randomized controlled trial, with participants allocated to either intervention\ngroup with â??Teaching: Individualâ? provided by two nurses, or control group receiving routine care only. Two Hundred\npatients attending cardiovascular risk programs of Bucaramanga, Colombia were included. Nursing intervention\nconsisted of six educational sessions about Coping Enhancement; Behavior Modification; Teaching: Disease Process,\nPrescribed Medication, Prescribed Diet and Prescribed Exercise. The outcomes were Treatment Behavior: Illness or\nInjury (adherence to treatment), levels of both glycosylated hemoglobin (HbA1c) and systolic blood pressure for 24 h,\nto be measured at baseline and two follow-up time points. Basic characteristics of the groups were compared through\nchi-square/Fisherâ??s exact or Students-T/Mann-Whitney U test. Outcomes were evaluated with repeated data methods\nand investigated changes in the outcomes over time and to compare these changes among treatment groups, and\nstatistical significance with p-value < 0.05 were considered.\nDiscussion: The nursing intervention â??Teaching: Individualâ? to increase adherence to therapeutic regimen in people\nwith hypertension and/or type-2 diabetes represents an innovative care approach intended for low-income population.\nThe study will advise district health system policy makers and managers as to the efficacy of implementing this\nintervention. Should this intervention turn out efficacious, it can potentially achieve wide application in cardiovascular\nrisk programs....
Background: Serious bacterial infections associated with substance use often result in long hospitalizations, premature
discharges, and high costs. Out-of-hospital treatment options in people with substance use disorder (SUD) are
Methods: We describe a novel multidisciplinary and interprofessional care conference, “OPTIONS-DC,” to identify
treatment options agreeable to both patients and providers using the frameworks of harm reduction and patientcentered
care. We retrospectively reviewed charts of patients who had an OPTIONS-DC between February 2018 and
July 2019 and used content analysis to understand the conferences’ effects on antibiotic treatment options.
Results: Fifty patients had an OPTIONS-DC during the study window. Forty-two (84%) had some intravenous (IV)
substance use and 44 (88%) had an active substance use disorder. Participants’ primary substances included opioids
(65%) or methamphetamines (28%). On average, conferences lasted 28 min. OPTIONS-DC providers recommended
out-of-hospital antibiotic treatment options for 34 (68%) of patients. OPTIONS-DC recommended first line therapy of
IV antibiotics for 35 (70%) patients, long-acting injectable antibiotics for 14 (28%), and oral therapy for 1 (2%). 35 (70%)
patients that had an OPTIONS-DC completed an antibiotic course and 6 (12%) left the hospital prematurely. OPTIONSDC
expanded treatment options by exposing and contextualizing SUD, psychosocial risk and protective factors;
incorporating patient preferences; and allowing providers to tailor antibiotic and SUD recommendations.
Conclusions: OPTIONS-DC is a feasible intervention that allows providers to integrate principles of harm reduction
and offer patient-centered choices among patients needing prolonged antibiotic treatment....
Background: Hospital noise can adversely impact nurses’ health, their cognitive function and emotion and in turn,
influence the quality of patient care and patient safety. Thus, the aim of this study was to predict the contributing
roles of exposure to hospital noise, staff noise-sensitivity and annoyance, on the quality of patient care.
Methods: This descriptive and cross-sectional study was carried out among nurses in an Iranian hospital. To determine
nurses’ noise exposure level, the noise was measured in 1510 locations across the hospital in accordance with
ISO 9612 standards using KIMO DB 300/2 sound level meter and analyzer. An online survey was used to collect nurses’
individual data. Study questionnaires included demographics, Weinstein noise sensitivity scale, noise annoyance scale,
and quality of patient care scale. Finally, to analyze the data, Bayesian Networks (BNs), as probabilistic and graphical
models, were used.
Results: For the high noise exposure state, high noise sensitivity, and high annoyance, with the probability of 100%,
the probability of delivering a desirable quality of patient care decreased by 21, 14, and 23%, respectively. Moreover,
at the concurrently high noise exposure and high noise sensitivity with the probability of 100%, the desirable quality
of patient care decreased by 26%. The Bayesian most influence value was related to the association of noise exposure
and annoyance (0.636). Moreover, annoyance had the highest association with the physical aspect of quality of care
(0.400) and sensitivity had the greatest association with the communication aspect (0.283).
Conclusion: Annoyance induced from environmental noise and personal sensitivity affected the quality of patient
care adversely. Moreover, noise and sensitivity had a separate direct adverse effect upon the quality of patient care,
and their co-occurrence reduced the potential for delivering quality patient care....
Background: Urinary retention is common in elderly patients undergoing acute hip fracture surgery. Avoiding overfilling
the urinary bladder is important to avoid detrusor muscle damage and associated motility problems. The aim of
this study was to analyse associations between the co-creation of a nurse-driven urinary catheterisation protocol and
the incidence of bladder distension in patients undergoing hip fracture surgery.
Methods: This is a single-centre implementation intervention with a retrospective longitudinal observation design,
using five measures points, spanning from June 2015 to March 2020. The intervention was theory driven and the
participants, together with the facilitators and researcher, co-created a nurse-driven urinary catheterisation protocol.
Data were retrieved from the hip fracture register. Uni- and multivariable logistic regressions were used for analyses of
changes in bladder distension and urinary volume of ≥500 ml over the years.
Results: A total of 3078 patients were included over a five-year period. The implementation intervention was
associated with a reduction in the proportion of patients with bladder distension of 31.5% (95% confidence interval
26.0–37.0), from year 1 to year 5. The multivariable analysis indicated a 39% yearly reduction in bladder distension,
OR 0.61 (95% confidence interval 0.57–0.64, p < 0001). There was a reduction in the proportion of patients with a
bladder volume of ≥500 ml of 42.8% (95% confidence interval 36.2–49.4), from year 1 to year 5. The multivariable
analysis found a 41% yearly reduction in patients with a bladder volume of ≥500 ml, OR 0.59 (95% confidence interval
0.55–0.64, p < 0.0001). The intervention was associated with improved documentation of both catheter indications
and removal plans.
Conclusion: The use of predefined catheter indications and a tighter bladder scanning schedule were associated
with a reduction in the incidence of both bladder distension and urine volume ≥ 500 ml in hip fracture patients. Registered
nurses can play an active role in the facilitation of timely and appropriate catheter treatment in patients with hip
Objective: To understand the appetite and nutritional status of hospitalized
patients in a tertiary A general hospital in Guangzhou, Guangdong Province.
Methods: A cross-sectional survey of appetite and nutritional status assessment
on inpatients in 44 wards of the hospital was conducted. Taking all
“conscious patients hospitalized for more than 48 hours” in the hospital on
November 25, 2020 as the survey subjects, the patients’ appetite, dietary intake,
nutrition and nutritional support in the past week were investigated.
Results: A total of 890 cases were investigated, among which 25 cases (2.81%)
with missing data were excluded, and thus 865 investigated cases were considered
effective. The incidence of nutritional risk was 28.67%, malnutrition
13.29%, external tube feeding nutrition 3.24%, parenteral nutrition 7.05%,
and oral nutritional supplement 10.40%. The average score of appetite assessment
was (6.99 ± 2.43) points. Among them, cases with appetite assessment
scores < 5 points accounted for 15.84%, and 52 patient cases utilized
appetite-improving drugs. Among the 137 patients with appetite scores < 5,
only 7 patients utilized appetite-improving drugs. The patients’ dietary selfevaluation
scores were averagely (4.08 ± 1.16) points, and the daily intake
compliance rate of patients was 85.78%. Appetite assessment score was correlated
with dietary intake score (r = 0.548) and daily intake compliance rate (r
= 0.263) (p < 0.01). The differences in body weight, BMI, grip strength, albumin,
and hemoglobin concentration of patients with different appetite states
were statistically different (p < 0.01). Appetite was an influencing factor of................
Background: This study is part of a larger project called ViSam and includes testing of a decision support system\ndeveloped and adapted for older people on the basis of M (R) ETTS (Rapid Emergency Triage and Treatment\nSystem). The system is designed to allow municipal nurses to determine the optimal level of care for older people\nwhose health has deteriorated. This new system will allow more structured assessment, the patient should receive\noptimal care and improved data transmission to the next caregiver.\nMethods: This study has an explanatory approach, commencing with quantitative data collection phase followed\nby qualitative data arising from focus group discussions over the RNs professional experience using the Decision\nSupport system. Focus group discussions were performed to complement the quantitative data to get a more\nholistic view of the decision support system.\nResults: Using elements of the decision support system (vital parameters for saturation, pain and affected general\nhealth) together with the nurses' decision showed that 94 % of the older persons referred to hospital were\nultimately hospitalized. Nurses felt that they worked more systematically, communicated more effectively with\nothers and felt more professional when using the decision support system.\nConclusions: The results of this study showed that, with the help of a decision support system, the correct patients\nare sent to the Emergency Department from municipal home care. Unnecessary referrals of older patients that\nmight lead to poorer health, decreased well-being and confusion can thus be avoided. Using the decision support\nsystem means that healthcare co-workers (nurses, ambulance/emergency department/district doctor/SOS alarm)\nbegin to communicate more optimally. There is increased understanding leading to the risk of misinterpretation\nbeing reduced and the relationship between healthcare co-workers is improved. However, the decision support\nsystem requires more extensive testing in order to enhance the evidence base relating to the vital parameters\namong older people and the use of the decision support system....
Background: Spinal fusion is the common form of corrective surgery for scoliosis, and it is often accompanied\nwith the occurrence of pressure ulcer development. New research and approaches are needed to address the\nincidence of peptic ulcer in surgical patients.\nObjectives: The study was designed to reduce/prevent the incidence of pressure sores and to improve the health\nof patients undergoing scoliosis surgery.\nMethods: 130 patients with scoliosis surgery were randomly assigned into two groups: 65 patients in the training\ngroup and control group, respectively. The patients in the training group received a pre-surgery visit with adaptive\ntraining on prone position prior to their surgery, while the control group received no such training. Surgery\npreparation time and total time in the surgical room were recorded for all patients. The incidence and size of red skin\nand pressure sores due to scoliosis surgery were also measured and recorded upon surgeries.\nResults: A comparative analysis showed that a pre-surgical visit to the surgical room has significantly reduced\nthe preparation time prior to surgery by up to 15 minutes for patients in test group, which led to an ostensible\nreduction of the total time for the day-of-surgery. The implementation of a pre-set optimal prone position helped test\npatients to reduce the incidence of pressure sores significantly from over 33.8% (control group) to less than 14%\n(test group, p<0.05). In particular, the optimal setting of the prone position with soft gel pats and cushion has\neffectively protected patients from serious facial damage as a result of a lengthy surgical process.\nConclusion: A simple arrangement of a pre-surgical visit with adaptive training for optimal prone position to\nscoliosis patients could have important impacts on reducing the incidence of pressure sore and improving patientsÃ¢â?¬â?¢\nhealth condition....
Nursing inhypertension care comprises counselling about lifestyle changes, blood pressuremeasurement, and being a translator for\nthe physician. For the patient, changing lifestyle means performing self-care. As notmuch in the form of research and guidelines\nfor nurses is available, a middle-range theory of nursing in hypertension care was developed to guide nurses in their practice,\nin order to improve the nursing of patients and design studies for investigating nursing in hypertension care. Concepts are\npresented related to the patient (attitude and beliefs regarding health and sickness, autonomy, personality and traits, level of\nperceived vulnerability, hardiness, sense of coherence, locus of control, self-efficacy, and access to social support and network)\nand the nursing (applying theories and models for behavioural change in the consultation and using counselling skills, patient\nadvocacy, empowerment, professional knowledge and health education, and supporting the patient). Then the concepts related\nto the consultation (communication, shared decision-making, concordance, coping, adherence, and self-care) are integrated with\nOremÃ¢â?¬â?¢s theory of nursing. Clinical and research implications of the theory are discussed....
Background: Patient falls, the most common safety events resulting in adverse patient outcomes, impose\nsignificant costs and have become a great burden to the healthcare community. Current patient fall reporting\nsystems remain in the early stage that is far away from reaching the ultimate goal toward a safer healthcare.\nAccording to the Kirkpatrick model, the key challenge in reaction, learning, behavior and results is the realization of\nlearning stage due to the lack of knowledge management, sharing and growing mechanism.\nMethods: Based on the key contributing factors defined by AHRQ Common Formats 2.0, a hierarchical list of\ncontributing factors for patient falls was established by expert review and discussion. Using the list as an\ninfrastructure, we designed and developed a novel reporting system, where a strategy to identify contributing\nfactors is intended to provide reporters knowledge support, in the form of similar cases and potential solutions. A\nsurvey containing two scenarios was conducted to evaluate the learning effect of our system.\nResults: In both scenarios, potential solutions recommended by the system were annotated with correct\ncontributing factors, and presented only when the corresponding factors were identified from the query report or\nselected by the user. The five experts show substantial consistency (Fleissâ?? kappa > 0.6) and high agreement\n(ranging between fully agree and mostly agree) in the assessment of the three perspectives of the system, which\nverifies the effectiveness of the proposed knowledge support toward sharing and learning through the novel\nreporting system.\nConclusions: This study proposed a profile of contributing factors that could measure the similarity of patient\nsafety events. Based on the profile, a knowledge-based reporting and learning system was developed to bridge the\ngap between surveillance, reporting, and retrospective analysis in the fall management circle. The system holds\npromise in improving event reporting toward better and safer healthcare....
Background: Therapeutic communication is essential in the provision of quality healthcare to patients. The purpose\nof this study was to explore the perceived barriers to effective therapeutic communication among patients and\nnurses at Komfo Anokye Teaching Hospital,Kumasi.\nMethods: An exploratory study design was employed using a qualitative approach. A purposive sampling technique\nwas used to select 13 nurses and patients who were interviewed using an unstructured interview guide.\nInterviews were audio-taped, transcribed verbatim and analyzed using thematic content analysis.\nResults: Patient-related characteristics that were identified as barriers to effective therapeutic communication included\nsocio-demographic characteristics, patient-nurse relationship, language, misconception, as well as pain. Nurse-related\ncharacteristics such as lack of knowledge, all-knowing attitude, work overload and dissatisfaction were also identified as\nbarriers to effective therapeutic and environmental-related issues such as noisy environment, new to the hospital\nenvironment as well as unconducive environment were identified as barriers to effective therapeutic communication\namong patients and nurses at Komfo Anokye Teaching Hospital,Kumasi.\nConclusion: Nurse-patient communication is an inseparable part of the patient's care in every health setting; it is one of\nthe factors that determine the quality of care. Several patient-related characteristics, nurse- related characteristics and\nenvironmental-related issues pose as barriers to effective therapeutic communication at Komfo Anokye Teaching\nHospital,Kumasi and have ultimately; resulted in reducing effective communication at the wards. Therefore, all the barriers\nmust be eradicated to promote effective therapeutic communication....
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