Quarterly published in print and online "Inventi Impact: Nursing Research" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals.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....
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....
Objective: Anemia is an important complication which affects quality of life and self-care agency in\nhemodialysis patients. The aim of this study was to determine the effects of anemia on quality of\nlife and self-care agency in adult patients who receive chronic hemodialysis treatment. Methods:\nIn this cross-sectional study, the Quality of Life Scale, the Self Care Agency Scale, and a data form\nwere administered to 136 hemodialysis patients who were receiving treatment three hospitalbased\ndialysis units in Istanbul. Results: The health perception of cases whose hemoglobin level\nwas 12 mg/dl and above was significantly better than those whose hemoglobin level was lower\nthan 12 mg/dl. Hemoglobin levels were significantly and positively correlated to physical role\nfunction, general health, and health from the previous year (p < 0.05). As the hemoglobin levels of\nthe cases increased, quality of life pertaining to the mentioned domains increased. Conclusion: It\nwas concluded that the quality of life in chronic dialysis patients was affected by anemia....
Background: Tuberculosis (TB) treatment loss to follow up (LTFU) plays an important contributory role to the\nstaggering TB epidemic in South Africa. Reasons for treatment interruption are poorly understood. Treatment\ninterruption appears to be the culmination of poor health literacy of patients and inadequate health education\nprovided by clinicians. We explored clinician and patient perspectives of the gaps in TB messaging that influence\nTB treatment LTFU.\nMethods: We conducted semi-structured in-depth interviews between January and May 2018 with a sample of 15\nclinicians managing TB and 7 patients identified as LTFU in public clinics in the Free State Province, South Africa.\nThematic analysis using a mixed deductive/inductive thematic approach was used.\nResults: Limited occupational opportunities, fear of disclosure and stigmatization all contributed to treatment LTFU.\nPatients felt that the TB messaging received was inadequate. Many of the clinicians interviewed felt that improving\npatientâ??s TB knowledge would reinforce adherence to treatment and thus focused on sharing information on\ntreatment completion, side effects and infection control. However, the inability of clinicians to establish rapport\nwith patients or to identify social support challenged TB treatment adherence by patients. Clinicians perceived this\nas patients not following their instructions despite what they considered lengthy TB education. Having said this,\nclinicians concurred that their medical management of TB lacked the psycho-social dimension to treat a social\ndisease of this magnitude.\nConclusions: Limited occupational opportunities, fear of disclosure and stigmatization all contributed to treatment\nLTFU. Clinicians concurred that poor patient understanding of TB and that biomedical management lacking a\npsycho-social dimension further exacerbated the poor treatment outcome. TB remains a social disease, the\nsuccessful management of which hinges on patient-centred care....
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