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Healthcare
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Nursing Contributions to Improve Healthcare Outcomes
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Nursing Contributions to Improve Healthcare Outcomes

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 10869

Special Issue Editor

Prof. Dr. Manuel Lillo-Crespo

E-Mail Website
Guest Editor
1. Faculty of Health Sciences, University of Alicante, Carretera de San Vicente del Raspeig s/n, San Vicente del Raspeig, 03690 Alicante, Spain
2. HLA Vistahermosa Hospital, Av. de Denia 103, 03015 Alicante, Spain
Interests: healthcare improvement; person-centred care; health care outcomes; nursing leadership; implementation; patient’s experience; care excellence; efficiency; nursing education; nursing innovation; effective care; patient safety

Special Issue Information

Dear Colleagues,

Nurses are the key to providing safer, more effective care and to achieving better outcomes for patients. In this Special Issue, we plan to publish their contributions from the field of nursing that can improve the healthcare outcomes of the population and advance nursing knowledge, leadership and professional competences. Those contributions may come from implementation and pre-implementation interventions, applied research, educational interventions, innovation initiatives and management strategies and should be focused on providing person-centred care that respects the patient’s experience, culture, values, needs and preferences in the planning, coordination and delivery of care. These objectives should complement better use of resources, the lowering of costs, and improvements in efficiency, satisfaction and care excellence.

Prof. Dr. Manuel Lillo-Crespo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • healthcare improvement
  • person-centred care
  • health care outcomes
  • nursing leadership
  • implementation
  • patient’s experience
  • care excellence
  • efficiency
  • nursing education
  • nursing innovation
  • effective care
  • patient safety

Published Papers (7 papers)

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Research

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13 pages, 1771 KiB  
Article
A Simple Nomogram for Predicting Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke
by Youn-Jung Lee and Hee Jung Jang
Healthcare 2023, 11(23), 3015; https://doi.org/10.3390/healthcare11233015 - 22 Nov 2023
Cited by 1 | Viewed by 849
Abstract
The purpose of this study was to develop a prediction model for stroke-associated pneumonia (SAP) based on risk factors for SAP and to suggest nursing interventions to prevent SAP. In addition, a nomogram was developed to enhance its utility in nursing practice. The [...] Read more.
The purpose of this study was to develop a prediction model for stroke-associated pneumonia (SAP) based on risk factors for SAP and to suggest nursing interventions to prevent SAP. In addition, a nomogram was developed to enhance its utility in nursing practice. The retrospective cohort study included 551 patients hospitalized for acute ischemic stroke at a university hospital in South Korea. Data were collected through a structured questionnaire and a review of the electronic medical record (EMR). In the development of a predictive model for SAP, multivariate logistic regression analysis showed that independent risk factors for SAP were age ≥ 65 years, National Institute of Health Stroke Scale (NIHSS) score ≥ 7, nasogastric tube feeding, and C-reactive protein (CRP) ≥ 5.0 mg/dL. The logit model was used to construct the SAP prediction nomogram, and the area under the curve (AUC) of the nomogram was 0.94. Furthermore, the slope of the calibration plot was close to the 45-degree line, indicating that the developed nomogram may be useful for predicting SAP. It is necessary to monitor the age, NIHSS score, nasogastric tube feeding status, and CRP level of stroke patients and identify high-risk groups using the developed nomogram to provide active nursing interventions to prevent SAP. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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14 pages, 1093 KiB  
Article
Effects of Infection Control Education Program Using Flipped Learning Based on the ARCS Model for Nursing Students: A Mixed Method
by Dain Jeong, Chang Park and Young Eun
Healthcare 2023, 11(20), 2731; https://doi.org/10.3390/healthcare11202731 - 13 Oct 2023
Cited by 1 | Viewed by 1182
Abstract
This study was conducted to verify the effect of an infection control education program, using flipped learning based on the ARCS model, for nursing students. The study was a mixed-method study, composed of a nonequivalent control group, a pretest-posttest design, and focus group [...] Read more.
This study was conducted to verify the effect of an infection control education program, using flipped learning based on the ARCS model, for nursing students. The study was a mixed-method study, composed of a nonequivalent control group, a pretest-posttest design, and focus group interviews. The total number of participants was 37, with 18 in the experimental group and 19 in the control group. The mean age of the participants was 24.32 ± 5.60 years, consisting of three males (8.1%) and thirty-four females (91.9%). The collected data were analyzed using a linear mixed-effects method. The data regarding experiences of participation were analyzed using conventional content analysis. The experimental group had a higher degree of learning motivation, self-directed learning ability, and confidence in infection control practice than the control group. In the results of the focus group interviews, the themes were derived from ‘Engaging learning experience, although difficult, in new ways of learning’. It was confirmed that the infection control education program, using flipped learning based on the ARCS model, was an effective intervention for improving nursing students’ self-directed learning ability. Therefore, it is strongly recommended to use the educational program developed in this study for infection control education for nursing students and new nurses. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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12 pages, 627 KiB  
Article
Can High-Fidelity Patient Simulation Be Used for Skill Development in Junior Undergraduate Students: A Quasi-Experimental Study
by Florence M. F. Wong, Alice M. L. Chan, Natalie P. M. Lee and Kevin K. H. Luk
Healthcare 2023, 11(15), 2221; https://doi.org/10.3390/healthcare11152221 - 7 Aug 2023
Viewed by 1097
Abstract
High-fidelity patient simulation (HFPS) is widely used in professional training to enhance students’ competence in clinical management. A guideline for HFPS provides a systematic approach to direct students to learning during the simulation process. Problem-solving (PS) and clinical reasoning (CR) skills are essential [...] Read more.
High-fidelity patient simulation (HFPS) is widely used in professional training to enhance students’ competence in clinical management. A guideline for HFPS provides a systematic approach to direct students to learning during the simulation process. Problem-solving (PS) and clinical reasoning (CR) skills are essential to developing students’ professional competence in safe and effective care. These two skills should be initiated in the early training. A structured guideline was developed for HFPS. This study aimed to investigate the effects of the structured HFPS guideline on the development of PS and CR skills in junior nursing students. The students were required to go through four sessions, pre-briefing, simulation design, facilitation, and debriefing, for the HFPS; the study utilized the Problem-Solving Inventory (PSI) and the Nurses’ Clinical Reasoning Scale (NCRS) to measure PS and CR abilities before and after HFPS. Bivariate analysis, a one-sample t-test, and an independent t-test were performed to evaluate the performance of the PS and CR skills during the two study periods. A total of 189 students were recruited, with 92 in the intervention group and 97 in the control group. The research assistant was responsible for student recruitment through email invitations and allocating the students into the control group or the intervention group. A Wilcoxon analysis was performed and revealed significant differences in PS and CR between the two groups (p < 0.001). The analytic results showed that the PSI, particularly in domains of Problem-Solving Confidence (PSC) (p < 0.001) and overall PS (p < 0.001), and the CR (p < 0.001) had significant improvement after HFPS, particularly in the intervention group. The study concluded that the structured HFPS guideline significantly improved the students’ problem-solving and clinical reasoning abilities. Nurse educators play an important role in providing explicit learning instructions in a simulation guideline that directs and guides students to learn at each stage of HFPS. The students can be directed to be engaged in their learning through HFPS to enhance their competence in knowledge and skill development (PS and CR) for their personal and professional development. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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15 pages, 542 KiB  
Article
A Comparison of the Charlson and Elixhauser Methods for Predicting Nursing Indicators in Gastrectomy with Gastric Cancer Patients
by Chul-Gyu Kim and Kyun-Seop Bae
Healthcare 2023, 11(13), 1830; https://doi.org/10.3390/healthcare11131830 - 22 Jun 2023
Viewed by 1274
Abstract
Background: Comorbidity indices such as Charlson’s (CCI) and Elixhauser’s (ECI) are used to adjust the patient’s care, depending on the severity of their condition. However, no study has compared these indices’ ability to predict nursing-sensitive outcomes (NSOs). We compared the performance of CCI [...] Read more.
Background: Comorbidity indices such as Charlson’s (CCI) and Elixhauser’s (ECI) are used to adjust the patient’s care, depending on the severity of their condition. However, no study has compared these indices’ ability to predict nursing-sensitive outcomes (NSOs). We compared the performance of CCI and ECI in predicting NSOs in gastric cancer patients’ gastrectomy. Methods: Gastric cancer patients with gastrectomy, aged 19 years or older and admitted between 2015 and 2016, were selected from the Korea Insurance Review and Assessment Service database. We examined the relationships between NSOs and CCI or ECI while adjusting patient and hospital characteristics with logistic regression. Results: The ECI item model was the best in view of the C-statistic and Akaike Information Criterion for total NSO, physiologic/metabolic derangement, and deep vein thrombosis, while the Charlson item model was the best for upper gastrointestinal tract bleeding. For the C-statistic, the ECI item model was the best for in-hospital mortality, CNS complications, shock/cardiac arrest, urinary tract infection, pulmonary failure, and wound infection, while the CCI item model was the best for hospital-acquired pneumonia and pressure ulcers. Conclusions: In predicting 8 of 11 NSOs, the ECI item model outperformed the others. For other NSOs, the best model varies between the ECI item and CCI item model. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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16 pages, 456 KiB  
Article
Concept Analysis of Nursing Surveillance Using a Hybrid Model
by Se Young Kim and Mi-Kyoung Cho
Healthcare 2023, 11(11), 1613; https://doi.org/10.3390/healthcare11111613 - 31 May 2023
Viewed by 1471
Abstract
This study aims to analyze the concept of nursing surveillance among nurses caring for patients in acute care hospitals in Korea. The conceptual analysis was conducted using the hybrid model proposed by Schwartz-Barcott and Kim. In the theoretical phase, the attributes of nursing [...] Read more.
This study aims to analyze the concept of nursing surveillance among nurses caring for patients in acute care hospitals in Korea. The conceptual analysis was conducted using the hybrid model proposed by Schwartz-Barcott and Kim. In the theoretical phase, the attributes of nursing surveillance were explored through a literature review. In the fieldwork phase, the attributes of nursing surveillance were derived by analyzing interview materials. In the final analysis phase, nursing surveillance attributes and the related factors were integrated and confirmed. The attributes of nursing surveillance were systematic assessment, pattern recognition, the anticipation of problems, effective communication, decision-making, and performing nursing practice. Based on the theoretical basis of the nursing surveillance concept, this study identified the nursing surveillance concept as perceived by Korean nurses, and examined strategies to promote nursing surveillance. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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Review

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17 pages, 1334 KiB  
Review
The Influence of Nurse-Led Interventions on Diseases Management in Patients with Diabetes Mellitus: A Narrative Review
by Hamad Ghaleb Dailah
Healthcare 2024, 12(3), 352; https://doi.org/10.3390/healthcare12030352 - 30 Jan 2024
Viewed by 3282
Abstract
The global prevalence of people with diabetes mellitus (PWD) is rapidly increasing. Nurses can provide diabetes care for PWD in several areas. Interventions led by nurses can support PWD for effective management of diabetes, which can positively improve clinical outcomes. Nurse-led diabetes self-management [...] Read more.
The global prevalence of people with diabetes mellitus (PWD) is rapidly increasing. Nurses can provide diabetes care for PWD in several areas. Interventions led by nurses can support PWD for effective management of diabetes, which can positively improve clinical outcomes. Nurse-led diabetes self-management education (DSME) is an effective strategy to manage diabetes mellitus (DM) since it improves self-care practice and knowledge regarding diabetes. PWD often need to stay in hospitals longer, which involves poorer patient satisfaction and clinical outcomes. Nurse-led clinics for DM management are a new strategy to possibly ameliorate the disease management. Diabetes specialist nurses can play an important role in improving diabetes care in inpatient settings. Various studies have revealed that nurses can independently provide care to PWD in collaboration with various other healthcare providers. Studies also demonstrated that the nurse-led education-receiving group showed a significantly reduced level of average glycosylated haemoglobin A1c level. Moreover, nurse-led interventions often result in significant improvements in diabetes knowledge, psychological outcomes, self-management behaviours, and physiological outcomes. The purpose of this literature review was to identify the impact of nurse-led interventions on diabetes management. Moreover, in this review, a number of nursing interventions and the nurses’ roles as educators, motivators as well as caregivers in DM management have been extensively discussed. This article also summarises the outcomes that are measured to evaluate the impact of nursing interventions and the strategies to overcome the existing and emerging challenges for nurses in diabetes care. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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Other

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16 pages, 3553 KiB  
Protocol
Effectiveness and Health Outcomes of Collaborative Nurse Prescribing for Patients Anticoagulated with Antivitamin K in Primary Care: A Study Protocol
by Juan Carlos Palomo Lara, Joan Carles March-Cerdà, José Antonio Ponce-Blandón, Manuel Pabón-Carrasco and Nerea Jiménez-Picón
Healthcare 2024, 12(3), 347; https://doi.org/10.3390/healthcare12030347 - 30 Jan 2024
Viewed by 1072
Abstract
The development of collaborative nurse prescribing (NP) in Andalusia (Spain) in 2018 gives us the opportunity to measure the impact of this practice. Scientific evidence indicates that prescribing is not more costly when performed by nurses and, in fact, is more economical in [...] Read more.
The development of collaborative nurse prescribing (NP) in Andalusia (Spain) in 2018 gives us the opportunity to measure the impact of this practice. Scientific evidence indicates that prescribing is not more costly when performed by nurses and, in fact, is more economical in some cases. The aim of this study is to determine the effects of NP on the effectiveness, health outcomes and adverse events related to prescribing including in the follow-up of patients treated with antivitamin K oral anticoagulants in primary care (PC) by nurses. The design is a randomized clinical trial. The population comprises 1208 anticoagulated patients in 2019. The sample size calculation considers an alpha error of 0.05, a power of 99% and an effect size of 0.5, resulting in 127 users per group. Therefore, a total sample of 254 participants is needed. However, as the project intends to treat patients it will include the universal sample that meets the criteria in the two health centers participating in the study, with 575 participants in total. Data collection was carried out in the PC District of the Alamillo-San Jerónimo Clinical Management Unit of Sevilla for one year from January 2020. Data analysis is performed using the SPSS Statistics 25 package. We intend to study if nurse collaborative prescription in the follow-up and management of patients taking antivitamin K oral anticoagulants in PC is as effective as the traditional approach to follow-ups carried out by a family physician. Full article
(This article belongs to the Special Issue Nursing Contributions to Improve Healthcare Outcomes)
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