Search Results (47)

Background: The concept of evidence-based practice (EBP) is globally relevant in current healthcare climates. However, nursing students and teachers often struggle with integrating EBP effectively into a curriculum. This has implications for the way students learn to use evidence for their nursing practice. A new undergraduate EBP module was co-designed with current nursing students and university staff throughout 2023. Underpinning the module was a UDL (universal design for learning) pedagogy consisting of flexible approaches to learning for nursing students which included co-developed videos, co-developed audio podcasts, and co-developed serious games to complement traditional flipped classroom learning. The module commenced in September 2023, running in Year 1 one of a 3-year undergraduate nursing program, and was co-taught by staff and senior students. Methods: A pre/post-test design was used to collect data on student attitude, knowledge, and utilization of EBP. A total of 430 students completed two validated questionnaires, the EBP Beliefs Scale© and EBP Implementation Scale©, before and after the module. Following the post-test, six focus group interviews were also conducted with 58 students to explore how the module informed student nursing practice whilst attending clinical placement during Year 1. A convergent mixed-methods design was employed. Sample attrition occurred (~25%). Effect sizes and 95% confidence intervals were calculated for primary outcomes. Results: Quantitative data was analyzed using paired t-tests and this highlighted statistically significant improvements in attitude, knowledge and utilization of evidence-based practice after learning (p < 0.001). Qualitative data was transcribed verbatim, thematically analyzed, and highlighted three main findings; EBP is my business, EBP positively influenced the care of my patients and EBP has positively impacted my professional development. Conclusions: Partnership with current nursing students in the co-design and implementation of a module about EBP was associated with improvements in student knowledge, attitude and utilization of evidence in practice. These factors are likely to also improve professional competence and ultimately patient care. Full article

Background: Nurses play a fundamental role in identifying the early symptoms of sepsis and thereby contribute to early diagnosis and prevention, which decreases complications and mortality rates and lowers the cost of care. This study aimed to evaluate nurses’ knowledge of sepsis and to analyze its relationship with attitude, self-assessment, and sociodemographic variables. Methods: A correlational, cross-sectional study was conducted. A total of 293 nurses in Poland using a validated tool, the Nurses’ Attitudes and Knowledge about Sepsis Scale (NAKSeS), which assesses both knowledge and attitudes toward sepsis. The instrument included two knowledge subscales (Factor 1: knowledge of pathogenesis, treatment, and prevention; Factor 2: knowledge of nursing actions), an attitude subscale, and a self-assessment item. Sociodemographic data included age, seniority, voluntary postgraduate education, current workplace, and place of residence. Results: Nurses demonstrated moderate levels of general knowledge, Factor 1, Factor 2, attitude toward sepsis, and self-assessed knowledge. Higher scores across all domains were observed among nurses who had completed postgraduate education, cited professional experience or books as key sources of knowledge, and worked in high-acuity settings such as intensive care units, emergency departments, or pediatric wards. Nurses working in larger cities scored significantly higher in general knowledge and Factor 1 compared to those in smaller towns or rural areas. Additionally, greater age and longer work experience were positively associated with more favorable attitudes and higher self-assessed knowledge, although negatively correlated with some knowledge scores. Conclusions: Nurses’ knowledge and attitudes toward sepsis were influenced by the source of education and clinical exposure, with significantly better outcomes observed among those with postgraduate training and experience in high-acuity settings. These findings underscore the need to strengthen sepsis education across all levels of nursing curricula and promote accessible, continuous professional development supported by validated assessment tools. Full article

Natural and human-made disasters can severely impact communities and can result in high numbers of human injuries and deaths. Animals, both companion and livestock, are often injured as a result of these disasters and require veterinary care. Veterinarians are not only involved in providing care for these animals but also play important roles in planning and preparedness functions that occur before a disaster strikes. There are several examples of the use of multi-user virtual environments (MUVE) to provide human health care workers with valuable training centered on disaster response and disaster medicine. This communication provides a thorough review of a clinical rotation, as part of a professional veterinary curriculum, that uses a combination of classroom and experiential learning via an MUVE, Second Life^®. This rotation has provided more than 1800 senior veterinary students at a veterinary school in the United States with experiential learning opportunities focused on veterinary disaster preparedness, planning, and response training. The authors have prepared this communication to provide other institutions and educators with information on the practical implementation of Second Life^® in teaching and to offer recommendations based on our institutional experience. Full article

Electronic Medical Records (EMRs) have the potential to enhance decision-making in the healthcare sector. However, healthcare providers encounter various challenges when using computer-based systems such as EMRs in clinical decision-making. This study explores healthcare professionals’ experiences with EMR usage through a qualitative approach. A total of 78 interviews were conducted, leading to the identification of four key themes: (1) healthcare professionals’ engagement with EMR systems, (2) job performance, (3) collaboration among healthcare professionals, and (4) quality of care and patient satisfaction. The findings provide valuable insights for researchers and practitioners, including policymakers, senior management, and information technology professionals, to inform strategies for optimising EMR implementation and adoption. Full article

Objectives: To evaluate the influence of job demands and resources on burnout risk among Italian pediatric neuropsychiatrists. Methods: This cross-sectional study was conducted between December 2023 and February 2024 and involved Italian pediatric neuropsychiatrists. The study applied the Job Demands-Resources (JD-R) model to assess the impact of job demands (such as work–family conflict, time pressure, and job uncertainty) and job resources (like organizational support and perceived job meaning) on burnout. Burnout was measured through emotional exhaustion, depersonalization, and personal accomplishment subscales. Demographic data, including gender and career stage, were analyzed for their association with burnout. Results: High job demands were significantly associated with increased emotional exhaustion and depersonalization, while greater job resources correlated with lower burnout levels and higher personal accomplishment. Gender differences emerged, with female neuropsychiatrists reporting significantly higher emotional exhaustion and lower personal accomplishment than male neuropsychiatrists. Seniority was not a strong predictor, but early-career professionals, particularly residents, exhibited higher susceptibility to emotional exhaustion. Perceived job meaning and organizational support were protective factors across all burnout subscales, buffering the effects of job demands. Conclusions: Burnout risk in Italian pediatric neuropsychiatrists is shaped by both job demands and resources. Addressing work–family conflict, job uncertainty, and time pressure alongside enhancing organizational support and fostering job meaning is crucial to mitigate burnout. Special attention should be given to early-career professionals and female neuropsychiatrists to reduce their emotional exhaustion and improve their well-being. These findings provide valuable insights for developing targeted strategies to improve well-being in this field, ultimately enhancing patient care. Full article

Therapeutic hospital gardens (THGs) need to be purposefully designed for hospital users and well-integrated into the clinical hospital treatment plan to be effective. Healthcare decision-makers are critically important in establishing therapeutic gardens in hospitals and healthcare facilities because they have the ultimate decision-making power to include such gardens for the holistic care of their patients, staff, and visitors. This study aims to establish how THGs can be successfully created by investigating the professional experiences of 12 global healthcare decision-makers in hospital administration, executive government, and senior consultancy to government on the role of THGs in creating a healthy and sustainable hospital environment. This article shows how these decision-makers, who have already worked with healthcare designers and clinical practitioners to design and establish THGs, have been selected and interviewed. The qualitative analysis of these semi-structured interviews uncovered why and how these healthcare decision-makers made THGs a reality in their hospitals. This analysis informed the development of the THG Healthcare Decision-maker Guidelines, which were designed to guide all hospital CEOs, government executives, and senior consultants to the government to both design and then establish THGs successfully. These guidelines include five systematic steps: 1. design for hospital cohorts; 2. purposefully design and integrate THGs well; 3. facilitate inclusive and defined stakeholder engagement; 4. evaluate the garden visitor experience; and 5. understand the benefits and values of THGs. These five systematic steps can be used immediately by healthcare decision-makers to work with healthcare designers and clinical experts to implement such gardens in hospitals successfully. When the three sectors, healthcare governance, healthcare design, and clinical health, work together, more THGs can be established in hospitals for better patient care, visitor well-being, and a healthy and sustainable hospital environment. Full article

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective care for women with PMH needs. This study explores how the newly qualified midwives (NQMs) are prepared through pre-registration midwifery education and placements to have sufficient confidence in their knowledge, attitude, skills, and habits (KASH) for their post-registration PMH role. Methods: This explanatory sequential mixed methods study collected survey data from two independent groups: NQMs (n = 50), who qualified from 10 UK universities, and senior specialist midwives (SSMs) (n = 32). Descriptive and inferential responses were analysed using SPSS. Statistical differences between the ranged Likert scale responses of the NQMs and SSMs were analysed using the Mann-Whitney U test. The p-value of <0.05 was considered statistically significant. The semi-structured interview phase comprised of NQMs (n = 12) and SSMs (n = 8). The qualitative data were thematically analysed using NVivo. Results: The pre-registration midwifery programme significantly prepared the NQMs to have sufficient confidence in their knowledge of the related PMH role, multidisciplinary team (MDT) role, and available services (p < 0.05) and good attitude towards women with varying PMH conditions (p < 0.0005). The NQMs had sufficient confidence in their skills in using the validated tool for PMH assessment, to build rapport to facilitate disclosure, and recognise deteriorating PMH (p < 0.01). They had regular habits of discussing PMH well-being at booking and made prompt referrals (p < 0.05). The NQMs were not prepared to have sufficient knowledge of PMH medications, perinatal suicide prevention, and the impact of maternal mental health on partners (p < 0.01) including children (p < 0.05); skills in managing PMH emergencies (p < 0.05), and to regularly discuss suicidal thoughts (p < 0.01), issues of self-harm, and debrief women following pregnancy or neonatal losses and traumatic births (p < 0.05). Some aspects were either confirmed or contradicted at the interviews. Conclusions and recommendations: The pre-registration midwifery programme prepares the NQMs to some extent for their post-registration PMH role. Perceived areas for improvement suggest implications for the development of educational, practice, policy, and preceptorship to facilitate the NQMs’ sustainable confidence in their KASH. Full article

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. The aim of this study was to explore family medicine physicians’ perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using social exchange theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians (six focus groups) with clinical experience ranging from 3 to 20 years. The data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and Conclusions: This study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance. Full article

This study examines mental health service providers who provided care to evacuees during the Israel–Hamas conflict. Utilizing a phenomenological qualitative method, the research delves into the psychological impact on the participants’ lived experiences. The sample included 25 mental health providers (13 female, age range 28–63, mean 42.4, SD 7.3; 15 psychologists and 10 social worker, average seniority 10.8 years, SD 5.2, range 2–18 years). Data were collected through semi-structured interviews conducted between December 2023 and March 2024. The data analysis revealed a dual narrative: Participants paid a major personal price and experienced secondary traumatization manifesting in emotional detachment, physical symptoms, and heightened arousal. They also derived a profound sense of meaning and fulfillment from their work, contributing to personal and professional growth. These findings underscore the complexity of their experiences, which were marked by the challenges of secondary trauma and the resilience fostered through their work. This study emphasizes the importance of support systems, including social and familial networks and professional supervision, in navigating these challenges. This study has several limitations, including small sample size and the use of virtual interviews, suggesting the need for further research with a broader participant base and in different contexts. Full article

Background: Articulating a clear scope of practice for all nursing categories is essential for improving patient safety, quality of care, and nurse retention. However, this is not the case in many countries, including Saudi Arabia. This study aimed to analyze the actual scope of practice for nursing staff in Saudi Ministry of Health hospitals. Methods: The study used a cross-sectional exploratory design. The sampling method used in the study was the quota sampling technique. The scale utilized in this study was the Actual Scope of Practice (ASCOP) scale. Data were collected in March 2021 through an electronic form questionnaire completed by 286 nurses in two hospitals in Al-Hasa province in Saudi Arabia. Results: The overall mean score for ASCOP was 4.64 out of 6. When participants were grouped according to select characteristics (various nursing staff categories, educational levels, years of experience, nationality, gender, and type of work setting), the results revealed no statistically significant differences in overall ASCOP mean scores, except for gender and nationality. Conclusions: The overall mean scores of nursing activities performed in practice do not significantly differ across nurses with different professional categories (health assistant, nursing technician, nursing specialist, and senior nursing specialist), indicating no clear scope of practice for each nursing category, in turn leading to role overlap among them in practice. The current study’s findings can guide decision-makers to develop a clear scope of practice for nurses. The findings should also urge the decision-makers to reevaluate the usefulness of having multiple professional categories of nurses who are allowed to carry out almost the same job duties. Full article

Effective communication in nursing, particularly with older patients, is critical to providing high-quality care. The purpose of this research is to fill key gaps in the existing literature by emphasizing the importance of therapeutic communication in the setting of mental nursing care for elderly patients in Saudi Arabia. Building on the study’s foundation, which recognizes the various issues faced by cultural, religious, and linguistic diversity, this research adopted a rigorous research methodology incorporating a broad group of senior healthcare professionals as experts. We analyze various therapeutic communication approaches used by mental health nurses using extensive surveys and observations. This empirical study’s findings are likely to make a significant addition to the field by throwing light on the most efficient methods for improving nurse–elderly-patient communication. The study identifies Simulation-Based Training as the most viable technique, with potentially far-reaching implications for improving care for older patients in Saudi Arabia. This study paves the way for significant advances in healthcare practices, with a focus on mental health nursing, ultimately helping both nurses and elderly patients by developing trust, understanding, and increased communication. Full article

Background: This paper is based on results from the Survey of Health, Ageing and Retirement in Europe (SHARE), exploring many aspects (health, economic situation and welfare) of the European population aged 50+. Differently from many other international studies, SHARE includes persons living in nursing homes or residential care facilities as part of its sample. The aim of this paper is to provide a socio-demographic, functional and psychosocial snapshot of older residents in nursing homes in Europe. Methods: This paper uses data from SHARE Wave 8/2020, carried out in 27 European countries. A quantitative/descriptive approach explores the prevalence of older people aged 65+ living in residential facilities as mapped by the SHARE survey across Europe, with regard to associated dimensions, i.e., socio-demographic, family relationship, perceived health/main diseases, functional and psychological status. Results: These show that older residents live mainly in Central and Northern Europe, are aged 80+, female and widowed. A small social network (SN) size is often reported. Health is perceived, above all, as being fair–poor, and the presence of long-term illness is high, with several chronic health conditions and functional limitations. The reported quality of life (QoL) is low for most respondents, with moderate–low satisfaction with life. Conclusion: The analysis depicts a profile of seniors needing residential care in Europe, and provides useful insights for policymakers, to better sustain this frail population group, and to allow and improve access to high-quality long-term care (LTC) in Europe. Our findings could also be of help to train health professionals, and potentially drive the research towards the exploration of new housing solutions for seniors. This would in turn contribute to the effective implementation of European initiatives to strengthen LTC systems. Full article

Background: The oncology setting is characterized by various complexities, and healthcare professionals may experience stressful conditions associated with ethical decisions during daily clinical practice. Moral distress (MD) is a condition of distress that is generated when an individual would like to take action in line with their ethical beliefs but in conflict with the healthcare facility’s customs and/or organization. This study aims to describe the MD of oncology health professionals in different care settings. Methods: Descriptive quantitative study was conducted in the Operating Units of the Istituti Fisioterapici Ospitalieri in Rome between January and March 2022. The investigated sample consisted of the medical and nursing staff on duty at the facility, who were given a questionnaire through a web survey. Besides a brief sociodemographic form, the MD Scale-Revised questionnaire was used for data collection. Results: The sample consisted of nurses (51%) and physicians (49%), predominantly working in surgeries (48%), and having 20–30 years of service (30%). MD was higher among healthcare professionals, in medicine than that ing in corporate organizations, surgeries, or outpatient clinics (p = 0.007). It was not related to the profession (p = 0.163), gender (p = 0.103), or years of service (p = 0.610). Conclusions: This paper outlines the prevalence of MD in care settings and describes its relationship with profession, gender, and seniority. There is no patient care without the care of health professionals: knowing and fighting MD improves the safety of the treatments provided and the quality perceived by patients. Full article

Evidence highlights the need for professionals to be aware of their stigmatizing attitudes and discriminatory practices in order to minimize the negative impact on the people they take care of. However, nursing students’ perceptions of these issues have been poorly studied. This study explores the perspective of senior undergraduate nursing students on mental health and the stigma around it, by considering a simulated case vignette of a person with a mental health problem. A descriptive qualitative approach was chosen and involved three online focus group discussions. The findings show various manifestations of stigma, both at an individual and collective level, which indicates that it is an obstacle to the wellbeing of people with mental illness. Individual manifestations of stigma concern its effect on the person with mental illness, while at the collective level they concern the family or society in general. Stigma is a multifactorial, multidimensional, and complex concept, in terms of identifying and fighting it. Thus, the strategies identified involve multiple approaches at the individual level, aimed at the patient and family, namely through education/training, communication, and relationship strategies. At the collective level, to intervene with the general population and specific groups, such as groups of young people, strategies suggested include education/training, use of the media, and contact with people with mental disorders as ways to fight stigma. Full article

A wide range of healthcare professionals provide care for patients in the emergency department (ED). This study forms part of a wider exploration of the determinants of patient experience for older adults in the ED, to assist the development of a new patient-reported experience measure (PREM). Inter-professional focus groups aimed to build on findings from earlier interviews with patients conducted in the ED, by exploring professional perspectives on caring for older people in this setting. A total of thirty-seven clinicians, comprising nurses, physicians and support staff, participated in seven focus groups across three EDs in the United Kingdom (UK). The findings reinforced that meeting patients’ communication, care, waiting, physical, and environmental needs are all central to the delivery of an optimal experience. Meeting older patients’ basic needs, such as access to hydration and toileting, is a priority often shared by all ED team members, irrespective of their professional role or seniority. However, due to issues including ED crowding, a gap exists between the desirable and actual standards of care delivered to older adults. This may contrast with the experience of other vulnerable ED user groups such as children, where the provision of separate facilities and bespoke services is commonplace. Therefore, in addition to providing original insights into professional perspectives of delivering care to older adults in the ED, this study demonstrates that the delivery of suboptimal care to older adults may be a significant source of moral distress for ED staff. Findings from this study, earlier interviews, and the literature will be triangulated to formulate a comprehensive list of candidate items for inclusion in a newly developed PREM, for patients aged 65 years and older. Full article