Frequency: Quarterly E- ISSN: Awaited P- ISSN: Awaited
Quarterly published in print and online "Inventi Impact: Clinical Nursing" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal focuses on development of clinical research, patient and family experiences of health and health care, clinical nursing leadership, clinical decision-making, dissemination of clinical knowledge and changing boundaries of clinical nursing.
Introduction. The prevalence of diabetes mellitus is rapidly rising in SSA. Interventions are needed to support the decentralization\nof services to improve and expand access to care. We describe a clinical mentorship and quality improvement program that\nconnected nurse mentors with nurse mentees to support the decentralization of type 2 diabetes care in rural Rwanda. Methods.\nThis is a descriptive study. Routinely collected data from patients with type 2 diabetes cared for at rural health center NCD\nclinics between January 1, 2013 and December 31, 2015, were extracted from EMR system. Data collected as part of the clinical\nmentorship program were extracted from an electronic database. Summary statistics are reported. Results. The patient\npopulation reflects the rural settings, with low rates of traditional NCD risk factors: 5.6% of patients were current smokers,\n11.0% were current consumers of alcohol, and 11.9% were obese. Of 263 observed nurse mentee-patient encounters, mentor and\nmentee agreed on diagnosis 94.4% of the time. Similarly, agreement levels were high for medication, laboratory exam, and\nfollow-up plans, at 86.3%, 87.1%, and 92.4%, respectively. Conclusion. Nurses that receive mentorship can adhere to a type 2\ndiabetes treatment protocol in rural Rwanda primary health care settings....
Background: In 2017, the elderly made up 27.3% of Japanâ??s population, accounting\nfor 57.2% of all ambulance trips. When an elderly person is in a\ncritical life situation, it is difficult to ascertain their decisions about treatment\nchoices, and for family members who become surrogate decision-makers, this\nis a grave responsibility. Aim: This study aimed to shed light on the constructs\nthat support decision-making by family members and medical staff in\ncritical situations, and to investigate decision-making by families of the elderly\nin critical situations. Method: We selected 29 papers published in Japan\nand elsewhere that focused on families involved in treatment decisions in\ncritical life situations and analyzed them using Rodgersâ?? concept analysis approach.\nResults: From 475 codes, we extracted six attributes, four antecedents,\nand four consequences. The unusual setting of the â??critical care unitâ?, lack of\ntime, and unstable psychological state are all considered by family members\nmaking treatment decisions, along with the patientâ??s prognosis, their relationship\nwith the patient, conjecture about the patientâ??s wishes, and taking\nother family memberâ??s views into account. Medical staff supports the family\nthroughout the process, through provision of treatment, preparing family\nmembers to face reality, empathizing with the difficulty of decision-making,\nbuilding relationships with family members, monitoring the decision-making\nprocess, and being attentive to family membersâ?? feelings until the end. Conclusion:\nOur results indicate the importance of advance confirmation of patientsâ??\nwishes, and the role played by cultural context and family relations in\ndecision-making by family members of the elderly....
Background. The prognosis is poor when acute pancreatitis (AP) progresses to sepsis; therefore, it is necessary to accurately predict the probability of sepsis and develop a personalized treatment plan to reduce the disease burden of AP patients. Methods. A total of 1295 patients with AP and 43 variables were extracted from the Medical Information Mart for Intensive Care (MIMIC) IV database. The included patients were randomly assigned to the training set and to the validation set at a ratio of 7 : 3. The chisquare test or Fisher’s exact test was used to test the distribution of categorical variables, and Student’s t-test was used for continuous variables. Multivariate logistic regression was used to establish a prognostic model for predicting the occurrence of sepsis in AP patients. The indicators to verify the overall performance of the model included the area under the receiver operating characteristic curve (AUC), calibration curves, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and a decision curve analysis (DCA). Results. The multifactor analysis results showed that temperature, phosphate, calcium, lactate, the mean blood pressure (MBP), urinary output, Glasgow Coma Scale (GCS), Charlson Comorbidity Index (CCI), sodium, platelet count, and albumin were independent risk factors. All of the indicators proved that the prediction performance and clinical profitability of the newly established nomogram were better than those of other common indicators (including SIRS, BISAP, SOFA, and qSOFA). Conclusions. Thenew risk-prediction system that was established in this research can accurately predict the probability of sepsis in patients with acute pancreatitis, and this helps clinicians formulate personalized treatment plans for patients. The new model can reduce the disease burden of patients and can contribute to the reasonable allocation of medical resources, which is significant for tertiary prevention....
Background: Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general\npopulation consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity\nfor practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting\npatients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline\ncore recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic,\nand secondly to describe the development, key learning objectives, content and impact of the training to support its\ndelivery.\nMethods: A training programme was developed and delivered to provide practice nurses with the knowledge and skill\nset needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA\nmanagement was evaluated using case report forms and pre and post training questionnaires.\nResults: The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they\nshould be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to\nfeel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical\nmanagement patients received in the nurse-led OA clinics.\nConclusions: A significant gap between what is recommended and what practice nurses feel they can currently provide\nin terms of OA management was evident. The development of a nurse training programme goes some way to develop\na system in primary care for delivering the core recommendations by NICE....
In Japan, almost one-quarter of young women in their 20s are lean, with a body mass index less than\n18.5 kg/m2, and the number of thin pregnant women has also increased. Although the effects of several\nnutrients and foods have been well examined, little is known regarding the current status of foods and\nnutrients intake during pregnancy. The purpose of our pilot study was to investigate the current status\namong nutrients and foods intake during pregnancy, and parity.\nStudy subjects who were recruited 3-4 days after delivery were admitted to three maternity hospitals\nin Miyagi Prefecture in 2009. We analyzed 113 postpartum women. The subjects were divided into\ntwo groups according to the parity: 52 nulliparas and 61 multiparas. The questionnaire contained the\nfollowing information: age, body mass index, gestational weight gain, parity, occupation, smoking habits,\ninfant status (gestational weeks and birth weight) and a semi-quantitative food frequency questionnaire\n(FFQ) inquiring about foods. We examined categorical data using the chi-square test, and compared\ncontinuous variables using Student�s t-test.\nAmong the major macronutrients(carbohydrate, protein and fat), the multiparas group showed\nsignificantly higher fat intake than the nulliparas group. The nulliparas group showed significantly higher\ncarbohydrate intake than the multiparas group.\nAmong food intakes, the multiparas group showed a higher intake of fish and a lower intake of fruits\ncompared with the nulliparas group. Among the proportion of frequency of fish intake in both group,\nless than the nulliparas group had frequency of fish intake than did the multiparas group.\nOur pilot study shows that the diet of Japanese pregnant women is insufficient and far below the\nrecommended levels. Although fish intake is also insufficient, the proportion of fish intake increases with\nincreasing parity. Pregnancy can be an opportune time to improve nutrition and presents an ideal time\nfor promotion of health activities....
Background and Aim. Reflection is known as a skill that is central to nursing students� professional development. Due to the\nimportance and the role of reflection in clinical areas of nursing, it is important to knowhowto achieve it.However, nursing trainers\nface the challenge of how to help their students to improve reflection in clinical settings. The aimof this study was to investigate the\nnursing students� experiences of facilitating reflection during clinical practice. This qualitative study was conducted by qualitative\ncontent analysis approach. Twenty nursing students during the second to eighth semester of their educational programwere selected\nfor participation using purposive sampling. Data were collected through in-depth semistructured interviews. The interview was\ntranscribed verbatim, and qualitative content analysis was used to analyze the data. From the data analysis, four main themes were\nextracted.Motivation to reflect, complex experiences, efficient trainer, and effective relations were four main themes obtained from\nstudy that, in interaction with each other, had facilitating roles in students� reflective process on experiences. The findings revealed\nthat the nursing students� reflection in clinical settings is effective in personal and professional level. Reflection of nursing students\ndepends on motivational and educational factors and these factors increase the quality of care in patients. Furthermore, nursing\neducators need to create nurturing climate as well as supporting reflective behaviors of nursing students....
Background: In order to manage the acute and long-term effects of living with a chronic disease such as diabetes,\nboth medical treatment and good psychosocial support are needed. In this study, we wish to examine whether a\npsychological group intervention targeting people with poorly controlled type 1 diabetes can be helpful in augmenting\nquality of life while also lowering participantsââ?¬â?¢ HbA1c level. The group intervention will consist of a brief treatment\ndeveloped from a branch of cognitive behavioural therapy called acceptance and commitment therapy, which is part\nof the so-called third wave of cognitive behavioural therapy. Common for these third-wave therapies, the focus is less\non the content and restructuring of thoughts and more on the function of behaviour. Here, we describe the protocol\nand plans for study enrolment.\nMethods/Design: This on-going study is designed as a randomised wait-list controlled trial. Eighty patients aged 26ââ?¬â??55\nyears and with an HbA1c level >70 mmol/mol at the time of enrolment will be included.\nDiscussion: In this study, we will assess the effect of starting acceptance and commitment therapy group treatment for\npatients with type 1 diabetes and its effect on glycaemic control and well-being....
Introduction: Clinical competency and knowledge of the effective factors are of critical importance\nin nursing. Competency, self-esteem, and self-knowledge are achievable through professional identity.\nEmployees� participation in and attachment to their professional role is contingent considerably\nupon their professional identity. In light of this, the present study is aimed at determining\ncorrelation between professional identity and clinical competence of the nurses working in psychiatric\nwards of the hospitals affiliated with Tehran-based medical sciences universities. Methodology:\nThis correlative study was conducted on 125 nurses working in psychiatric wards of Tehran-\nbased hospitals affiliated with medical sciences universities. Data gathering tool of the study\nwas a researcher-designed questionnaire to collect demographic, clinical competency, and professional\nidentity data of the participants. For data analyzing, Statistical Package for the Social\nSciences (SPSS) version 18 was used. Findings: The results showed 91.2% of the participants evaluated\ntheir professional identity at good (47.2%) and very good (44%) levels; and 78.2% evaluated\ntheir clinical competency at very good level. The results also indicated positive and significant\nrelationship between professional identity and clinical competency(r = 0.32, p = 0.001). In addition, none of the demographical variables were related to professional identity and clinical\ncompetency. Conclusion: There is positive relationship between clinical competency and professional\nidentity, which means that development of positive attitudes regarding the psychiatric\nnursing can lead to higher clinical competency of the participants. The findings of the study highlighted\nthe weight and role of positive attitude regarding the professional identity. It could result\nin increase of clinical competency and deserved attention of hospital�s managers....
The aim of this systematic review was to illuminate intuition in clinical nursing. Frequently described\nas a defining characteristic of professional expertise, intuition is gaining acceptance as a\nlegitimate form of knowledge in clinical nursing. A total of 352 abstracts were read and eight\nquantitative studies included. A thematic analysis was performed to one main theme, two themes,\nand four sub-themes emerged. The main theme was: Sensing an unconscious and conscious state\nof mind, and the two themes were: A sudden emotional awareness and reflection, and arousal of\nconscious thought processes. The first theme included two sub-themes: Sensing spiritual connections\nwith patients and experiencing physical sensations; worrying and reassuring feelings. The\nsecond theme comprised two sub-themes: Willingness to act on personal, interpersonal, and clinical\nexperiences; the influence of maturity and social support in clinical decision-making. An implication\nfor clinical nursing was the need to develop sensitivity as a key to understanding the patient�s\nillness. In conclusion, leadership and management could facilitate discussions about intuition\nas a legitimate method of processing information and making decisions about patient\ncare....
Background: Pregnant women should receive two vaccines during pregnancy due to\nmaternal-foetal complications and risks as well as the influenza and pertussis vaccinations. The goal\nwas to evaluate vaccination coverage against influenza and pertussis in pregnant women, following\nmidwife professional advice during the pregnancy follow-up; Methods: Prospective cohort study of\n1017 pregnancies during the vaccination campaign in 2015-2016. To estimate the degree of consistency\nbetween the coverage declared by mothers and that registered in the Nominal Vaccination Registry\n(NVR), we used the Cohenâ??s kappa index (k); Results: 95.4% were registered in the NVR. Vaccination\ncoverage recorded against influenza was 64.2% (95% CI: 61.2-67.2), and 89.8% (95% CI: 87.9-91.7)\nagainst pertussis. The coverage of the pregnant women interviewed was 61.7% (95% CI: 58.1-67.3))\nfor influenza and 92.3% (95% CI: 91.4-95.3) for pertussis. Subsequent interviews of 67.2% of the\nwomen produced a kappa agreement index between the data obtained from interviews and those\nrecorded in the NVR of 0.974 (IC95%: 98.0-99.6) for influenza, and 0.921 (IC95%: 98.1-99.7) for\npertussis. The women identified midwives as the main source of vaccination information and advice\n88.4% (IC95%: 85.8-90.9); Conclusions: The NVR is an effective platform for estimating immunisation\ncoverage in pregnant women. The degree of agreement between declared vaccinations and registered\nvaccinations was high for both vaccines....
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