Current Issue : October-December Volume : 2023 Issue Number : 4 Articles : 5 Articles
Background The COVID-19 pandemic created major challenges in long-term care (LTC) homes across Canada and globally. A nurse practitioner-led interdisciplinary huddle intervention was developed to support staff wellbeing in two LTC homes in Ontario, Canada. The objective of this study was to identify the constructs strongly influencing the process of implementation of huddles across both sites, capturing the overall barriers and facilitators and the intervention’s intrinsic properties. Methods Nineteen participants were interviewed about their experiences, pre-, post-, and during huddle implementation. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection and analysis. CFIR rating rules and a cross-comparison analysis was used to identify differentiating factors between sites. A novel extension to the CFIR analysis process was designed to assess commonly influential factors across both sites. Results Nineteen of twenty selected CFIR constructs were coded in interviews from both sites. Five constructs were determined to be strongly influential across both implementation sites and a detailed description is provided: evidence strength and quality; needs and resources of those served by the organization; leadership engagement; relative priority; and champions. A summary of ratings and an illustrative quote are provided for each construct. Conclusion Successful huddles require long-term care leaders to consider their involvement, the inclusion all team members to help build relationships and foster cohesion, and the integration of nurse practitioners as full-time staff members within LTC homes to support staff and facilitate initiatives for wellbeing. This research provides an example of a novel approach using the CFIR methodology, extending its use to identify significant factors for implementation when it is not possible to compare differences in success....
Background Mothers spend long hours at their preterm infant’s bedside in the Neonatal Intensive Care Unit (NICU), giving clinicians the opportunity to engage mothers in caring for their own health. Objective To develop a NICU based intervention to reduce the risk of a future premature birth by engaging and empowering mothers to improve their own health and identify barriers to implementing their improvement. Design Development based on a framework of narrative discourse refined by the Quality Improvement Plan Do Study Act Approach. Setting Level II Stepdown Neonatal Intensive Care Unit. Participants 14 mothers of preterm infants, ages 24–39 years. Methods A team of Maternal Fetal Medicine Physicians, obstetricians, neonatologists, neonatal nurses, and parents developed guidelines to elicit the mother’s birth story, review the story with a clinical expert to fill in knowledge gaps, identify strategies to improve health to reduce the risk of future preterm birth, and facilitate mother developing an action plan with specific six week goals. A phone interview was designed to assess success and identify barriers to implementing their health plan. The protocol was modified as needed after each intervention to improve the interventions. Results “Moms in the NICU” toolkit is effective to guide any clinical facilitator to engage, identify health improvement strategies, and co-develop an individualized health plan and its take home summary reached stability after the 5th mother. Mothers reported experiencing reassurance, understanding, and in some cases, relief. Participants were enthusiastic to inform future quality improvement activities by sharing the six week barriers faced implementing their health plan. Conclusion Engaging in the NICU provides an opportunity to improve mothers’ understanding of potential factors that may be linked to preterm birth, and promote personally selected actions to improve their health and reduce the risk of a future preterm birth....
Background: In sub-Saharan Africa, one in 13 children died before their fifth birthday. Objective: To study mortality among children hospitalized in the intensive care unit of the CHUPB. Methodology: This was a retrospective, descriptive study over a 12-month period. Included were children aged 1 month to 15 years hospitalized in the intensive care unit and who died during the period. The data were entered and analyzed through the Epi Info software. The statistical test used was Pearson’s chi2. Results: The overall mortality rate was 21.49%. The sex ratio was 1.14 and the mean age was 3.17 ± 2.21 years. Children < 5 years of age accounted for 78.49% (n = 197) of cases. Deaths were more frequent in January, April and December. The mean time to consultation was 6.91 ± 1.8 days. Fever 78.48% (n = 197), diarrhea/vomiting 35.45% (n = 89) and convulsions 26.29% (n = 66) were the main reasons for consultation. Prior to admission, treatment was administered in 73.38% (n = 184) of children. The main diagnoses of death were: septic shock 29.08% (n = 73), hypovolemic shock post AEG 17.13% (n = 43), severe malaria 10.76% (n = 27) and meningitis 6.38% (n = 16). Death was early in 66.53% (n = 167) of cases. It was influenced by male sex, origin of residence, rural residence, herbal medicine and the occurrence of deaths during the shifts after 16 hours. Conclusion: Mortality in pediatrics remains a concern in our practice. It is related to conditions that are mostly preventable by vaccination, information, education and communication....
Background Nurses’ effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context. Methods A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis. Results The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators. Conclusion and recommendations Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study’s findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses’ well-being to control or mitigate the effect of psychological precursors on the quality of nurses’ handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments....
Background The nursing profession’s uniqueness contributes to the development of knowledge, experience, age, education, economy, and position, as well as a unique gender role. Thus, the development and advancement of demographic characteristics of nurses while in this profession influences their caring behavior. Objective The purpose of this study was to determine the effect of work setting and demographic factors on nurses’ caring behaviour, as well as the differences in nurses’ caring behaviour based on demographic factors between nurses in public hospitals and nurses in public health services in Sabah, Malaysia. Methods This research is a cross-sectional study using the survey method. Data were collected from 3,532 nurses (88.3% response rate) in public hospitals and public health services within Sabah, Malaysia. Data were analysed using two-way ANOVA. Results The two-way ANOVA test revealed no significant impact of the work setting on CB, nor was there a notable interaction between the work setting and demographic factors influencing nurses’ CB. However, demographic factors such as gender, age, education, economic status, position, and experience had a significant effect on CB. Conclusion The present research has provided convergent evidence on the effect of demographic factors on nurses caring behavior and the differences in caring behavior based on demographic factors among nurses in public hospitals and public health services in Sabah, Malaysia....
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