Proactive rounding: Perspectives and experiences of nurses and midwives working in a large metropolitan hospital

OBJECTIVEIn this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).METHODSAfter operating on 2 patients with brainstem cavernoma at the Great Metropolitan Hospital Niguarda in Milan and noticing a similar pathological pattern postoperatively, the authors asked 10 different neurosurgery centers around the world to identify similar cases, and a total of 20 were gathered from among 1274 cases of brainstem cavernomas. They evaluated the tremor, cavernoma location, surgical approach, and SEZ for every case. For the 2 cases at their center, they also performed electromyographic and accelerometric recordings of the tremor and evaluated the postoperative tractographic representation of the neuronal pathways involved in the tremorigenesis. After gathering data on all 1274 brainstem cavernomas, they performed a statistical analysis to determine if the location of the cavernoma is a potential predicting factor for the onset of HT.RESULTSFrom the analysis of all 20 cases with HT, it emerged that this highly debilitating tremor can occur as a delayed complication in patients whose postoperative clinical course has been excellent and in whom surgical access has strictly adhered to the SEZs. Three of the patients were subsequently effectively treated with deep brain stimulation (DBS), which resulted in complete or almost complete tremor regression. From the statistical analysis of all 1274 brainstem cavernomas, it was determined that a cavernoma location in the midbrain was significantly associated with the onset of HT (p < 0.0005).CONCLUSIONSDespite strict adherence to SEZs, the use of intraoperative neurophysiological monitoring, and the immediate success of a resective surgery, HT, a severe neurological disorder, can occur as a delayed complication after resection of brainstem cavernomas. A cavernoma location in the midbrain is a significant predictive factor for the onset of HT. Further anatomical and neurophysiological studies will be necessary to find clues to prevent this complication.

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When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS)

BMJ Case Reports ◽

10.1136/bcr-2020-238006 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238006

Author(s):

Mitchell Cox ◽

Sophie Paviour ◽

Sophie Gregory ◽

Rusheng Chew

Keyword(s):

Drug Reaction ◽

Cytomegalovirus Reactivation ◽

First Case ◽

Metropolitan Hospital ◽

Orthopaedic Ward ◽

Systemic Hypersensitivity ◽

Systemic Symptoms ◽

Inflammatory Syndrome ◽

Intravenous Glucocorticoids

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.

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Night shift work characteristics and 6-sulfatoxymelatonin (MT6s) in rotating night shift nurses and midwives

Occupational and Environmental Medicine ◽

10.1136/oemed-2011-100273 ◽

2012 ◽

Vol 69 (5) ◽

pp. 339-346 ◽

Cited By ~ 27

Author(s):

Beata Peplonska ◽

Agnieszka Bukowska ◽

Jolanta Gromadzinska ◽

Wojciech Sobala ◽

Edyta Reszka ◽

...

Keyword(s):

Shift Work ◽

Night Shift ◽

Work Characteristics ◽

Night Shift Work ◽

Nurses And Midwives

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Australian nurses' and midwives' knowledge of computers and their attitudes to using them in their practice

Journal of Advanced Nursing ◽

10.1046/j.1365-2648.2003.02523.x ◽

2003 ◽

Vol 41 (2) ◽

pp. 140-146 ◽

Cited By ~ 26

Author(s):

Joan Webster ◽

James Davis ◽

Victoria Holt ◽

Glenys Stallan ◽

Karen New ◽

...

Keyword(s):

Nurses And Midwives

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Implementation of evidence-based practice and associated factors among nurses and midwives working in Amhara Region government hospitals: a cross-sectional study

Reproductive Health ◽

10.1186/s12978-021-01096-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Asrat Hailu Dagne ◽

Mekonnen Haile Beshah ◽

Bekalu Getnet Kassa ◽

Eyaya Habtie Dagnaw

Keyword(s):

Associated Factors ◽

Evidence Based Practice ◽

Cross Sectional Study ◽

P Value ◽

Evidence Based ◽

Sectional Study ◽

Cross Sectional ◽

Work Index ◽

Nurses And Midwives ◽

Practice Skills

Abstract Background Implementation of evidence-based practice is crucial to enhance quality health care, professional development, and cost-effective health service. However, many factors influence the implementation of evidence-based practice. Therefore, this study aimed to assess the implementation of evidence-based practice and associated factors among nurses and midwives. Methods Institutional-based cross-sectional study design was conducted to assess the implementation of evidence-based practice and associated factors from February 15 to March 15, 2019, among 790 nurses and midwives. Data were entered into EpiData version 3.1 then exported to SPSS version 20 for statistical analysis. Categorical variables were presented as frequency tables. Continuous variables were presented as descriptive measures, expressed as mean and standard deviation. Cronbach’s alpha was used to measure reliability, mean, standard deviation, and inter-items correlation of the factors. Independent variables with a probability value (P-value) of less than 0.2 in the Chi-square analysis were entered in the multivariable logistic regression model. Statistically significant associated factors were identified at probability value (P-value) less than 0.05 and adjusted odds ratio with a 95% confidence interval. Results The mean age of participants was 28.35 (SD ± 4.5) years. This study revealed that 34.7% (95% CI 31.5–38%) of participants implemented evidence-based practice moderately or desirably. Age of participants (AOR = 5.98, CI 1.34–26.7), barriers of implementation of evidence-based practice (AOR = 4.8, CI 2.2–10.6), the attitude of participants (AOR = 5.02, CI 1.2–21.5), nursing/midwifery work index (AOR = 3.9, CI 1.4–10.87), self-efficacy of implementation of evidence-based practice skills (AOR = 12.5, CI 5.7–27.5) and knowledge of participants (AOR = 3.06, CI 1.6–5.77) were statistically significant associated factors of implementation of evidence-based practice Concussion Implementation of evidence-based practice of nurses and midwives was poor. Age of participants, barriers of implementation of evidence-based practice, the attitude of participants, self-efficacy of implementation of evidence-based practice skills, nursing/midwifery work index, and knowledge of participants were found to be predictors of implementation of evidence-based practice. Insufficient time and difficulty in judging the quality of research papers and reports were the most common barriers to the implementation of evidence-based practice.

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Nurses’ and midwives’ knowledge, attitudes, and acceptance regarding human papillomavirus vaccination in Ghana: a cross-sectional study

BMC Nursing ◽

10.1186/s12912-020-00530-x ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Nancy Innocentia Ebu ◽

Gifty Esinam Abotsi-Foli ◽

Doreen Faakonam Gakpo

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Hpv Vaccination ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Cancer Risk Factors ◽

Cervical Cancer Risk ◽

Nurses And Midwives

Abstract Background Nurses and midwives play important roles in educating the public on cervical cancer prevention strategies. Aim This study sought to assess nurses’ and midwives’ knowledge of, attitudes towards, and acceptance of human papillomavirus (HPV) vaccination in relation to their background characteristics. Methods A descriptive cross-sectional study using questionnaires was conducted with a convenience sample of 318 female nurses and midwives, ages 20 to 59, at the Korle-Bu Teaching Hospital in Ghana. The data were summarised using frequencies, percentages, chi-square tests, and Fisher’s exact tests. Results The results indicated that 41.5% (n = 132) of the participants had high levels of knowledge about cervical cancer risk factors, and 17.6% (n = 56) of the respondents had received at least one dose of the HPV vaccine. Reasons for receiving the HPV vaccination included advice from a colleague (12.9%, n = 41) and perceived threat of cervical cancer (11.7%, n = 37). Of the 262 respondents who had not been vaccinated, 24.45% (n = 78) strongly agreed and 28.0% (n = 89) agreed with the statement that there was limited information on HPV vaccination. Also, there were statistically significant associations between age (X2 = 23.746, p = 0.001), marital status (X2 = 14.758, p = 0.005), completed level of education (X2 = 21.692, p = 0.001), and duration of working at the hospital (X2 = 8.424, p = 0.038) and acceptance of HPV vaccination. Conclusions This study demonstrated gaps in knowledge about cervical cancer risk factors and attitudes towards HPV vaccination, indicating the need for targeted measures to improve knowledge and attitudes. Also, measures to increase acceptance of HPV vaccination among nurses and midwives should consider their sociodemographic characteristics.

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An Examination of the Moral Habitability of Resource-constrained Obstetrical Settings

Nursing Ethics ◽

10.1177/0969733020988311 ◽

2021 ◽

pp. 096973302098831

Author(s):

Priscilla N Boakye ◽

Elizabeth Peter ◽

Anne Simmonds ◽

Solina Richter

Keyword(s):

Work Environment ◽

Workplace Violence ◽

Moral Agency ◽

Work Environments ◽

Professional Relationships ◽

Resource Constrained ◽

Ethical Considerations ◽

Scarcity Of Resources ◽

Childbearing Women ◽

Nurses And Midwives

Background: While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings. Research objective: The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker. Research design and participants: A critical moral ethnography was conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials. Ethical considerations: After receiving ethics approval, signed informed consent was obtained from participants before data collection. Results: Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage. Discussion: The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women. Conclusion: Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice.

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