Critical Care Nurses’ Knowledge of Confidentiality Legislation

Background Health care legislation can be difficult to understand and apply in critical situations where patients may not be physically capable of autonomous control of confidential health information. Nurses are often the first to encounter confidential information about patients. Objectives To explore critical care nurses’ knowledge of federal and North Carolina state legislation regarding confidentiality. Methods This descriptive, qualitative study included 12 critical care nurses who were asked to describe their knowledge of federal confidentiality legislation and specific knowledge of North Carolina’s confidentiality legislation. Results Critical care nurses were knowledgeable about federal confidentiality laws but demonstrated a need for further education about state-specific legislation. Conclusion Nurses’ application of confidentiality legislation demonstrates their knowledge of confidentiality legislation. To continue the trusting relationship that nurses have traditionally held with patients and patients’ families, it is imperative for nurses to remain current about confidentiality legislation. Through education both before and after licensure, correct application of legislation can be achieved. Further research can aid in exploring the intersection between health care legislation and ethics.

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Critical Care Nurses’ Physical and Mental Health, Worksite Wellness Support, and Medical Errors

American Journal of Critical Care ◽

10.4037/ajcc2021301 ◽

2021 ◽

Vol 30 (3) ◽

pp. 176-184

Author(s):

Bernadette Mazurek Melnyk ◽

Alai Tan ◽

Andreanna Pavan Hsieh ◽

Kate Gawlik ◽

Cynthia Arslanian-Engoren ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Critical Care ◽

Physical Health ◽

Medical Errors ◽

Odds Ratio ◽

Care Quality ◽

Critical Care Nurses ◽

Worksite Wellness ◽

Physical And Mental Health

Background Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses’ overall health affects the occurrence of medical errors. Objective To examine the associations among critical care nurses’ physical and mental health, perception of workplace wellness support, and self-reported medical errors. Methods This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors. Results A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%). Conclusion Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.

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The Effect Of Educational Program On Critical Care Nurses’ Knowledge, Practice And Clinical Outcome Regarding Delirium Among Critically Ill Patients

Menoufia Nursing Journal ◽

10.21608/menj.2016.120317 ◽

2016 ◽

Vol 1 (2) ◽

pp. 43-56

Author(s):

Gehan Younis ◽

Sabah Abo El-Fetoh

Keyword(s):

Critical Care ◽

Clinical Outcome ◽

Critically Ill ◽

Critically Ill Patients ◽

Educational Program ◽

Critical Care Nurses ◽

Knowledge Practice ◽

Nurses Knowledge

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A survey of pediatric critical care nurses' knowledge of pain management

American Journal of Critical Care ◽

10.4037/ajcc1997.6.4.289 ◽

1997 ◽

Vol 6 (4) ◽

pp. 289-295 ◽

Cited By ~ 23

Author(s):

C Pederson ◽

D Matthies ◽

S McDonald

Keyword(s):

Critical Care ◽

Pain Management ◽

Signs And Symptoms ◽

Educational Interventions ◽

Critical Care Nurses ◽

Toxic Metabolite ◽

Pediatric Critical Care ◽

Related Information ◽

Item Scale ◽

Nurses Knowledge

BACKGROUND: Although nurses are accountable for pain management, it cannot be assumed that they are well informed about pain. Nurses' knowledge base underlies their pain management; therefore, it is important to measure their knowledge. OBJECTIVE: To measure pediatric critical care nurses' knowledge of pain management. METHOD: A descriptive, exploratory study was done. After a pilot study, an investigator-developed Pain Management Knowledge Test was distributed to 50 pediatric ICU nurses. Test responses were collected anonymously and coded by number. Item analysis was done, and descriptive statistics were calculated. Modified content analysis was used on requests for pain-related information. RESULTS: The test return rate was 38%. The overall mean score was 63%. Mean scores within test subsections varied from 50% to 92%. Other mean scores were 85% on a nine-item scale of drug-action items and 92% on a two-item scale of intervention items. However, no nurse recognized that cognitive-behavioral techniques can inhibit transmission of pain impulses; only 32% indicated that meperidine converts to a toxic metabolite, only 47% recognized nalbuphine as a drug that may cause signs and symptoms of withdrawal if given to a patient who has been receiving an opioid; and only 63% indicated that when a child states that the child has pain, pain exists. Thirteen nurses requested pain-related information, and all requests focused on analgesic medications. CONCLUSIONS: Testing nurses' knowledge of pain indicated gaps that can be addressed through educational interventions. Research is needed in which the test developed for this study is used as both pretest and posttest in an intervention study with pediatric critical care nurses or is modified for use with nurses in other clinical areas.

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Impact of Workplace Climate on Burnout Among Critical Care Nurses in the Veterans Health Administration

American Journal of Critical Care ◽

10.4037/ajcc2020831 ◽

2020 ◽

Vol 29 (5) ◽

pp. 380-389 ◽

Cited By ~ 1

Author(s):

Lakshmana Swamy ◽

David Mohr ◽

Amanda Blok ◽

Ekaterina Anderson ◽

Martin Charns ◽

...

Keyword(s):

Health Care ◽

Critical Care ◽

Health Care System ◽

Critical Care Nurses ◽

Common Method ◽

Health Administration ◽

Workplace Climate ◽

Common Method Bias ◽

Method Bias ◽

Care System

Background Burnout is a maladaptive response to work-related stress that is associated with negative consequences for patients, clinicians, and the health care system. Critical care nurses are at especially high risk for burnout. Previous studies of burnout have used survey methods that simultaneously measure risk factors and outcomes of burnout, potentially introducing common method bias. Objectives To evaluate the frequency of burnout and individual and organizational characteristics associated with burnout among critical care nurses across a national integrated health care system using data from an annual survey and methods that avoid common method bias. Methods A 2017 survey of 2352 critical care nurses from 94 sites. Site-level workplace climate was assessed using 2016 survey data from 2191 critical care nurses. Results Overall, one-third of nurses reported burnout, which varied significantly across sites. In multilevel analysis, workplace climate was the strongest predictor of burnout (odds ratio [OR], 2.20; 95% CI, 1.50-3.22). Other significant variables were overall hospital quality (OR, 1.44; 95% CI, 1.05-1.99), urban location (OR, 1.93; 95% CI, 1.09-3.42), and nurse tenure (OR, 2.11; 95% CI, 1.44-3.10). In secondary multivariable analyses, workplace climate subthemes of perceptions of workload and staffing, supervisors and senior leadership, culture of teamwork, and patient experience were each significantly associated with burnout. Conclusions Drivers of burnout are varied, yet interventions frequently target only the individual. Results of this study suggest that in efforts to reduce burnout, emphasis should be placed on improving local workplace climate.

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Curriculum to Introduce Critical Care Nurses to Extracorporeal Membrane Oxygenation

American Journal of Critical Care ◽

10.4037/ajcc2020739 ◽

2020 ◽

Vol 29 (4) ◽

pp. 262-269

Author(s):

Whitney D. Gannon ◽

Lynne Craig ◽

Lindsey Netzel ◽

Carmen Mauldin ◽

Ashley Troutt ◽

...

Keyword(s):

Critical Care ◽

Extracorporeal Membrane Oxygenation ◽

Reference Group ◽

High Volume ◽

Critical Care Nurses ◽

Care Nurse ◽

Membrane Oxygenation ◽

Written Examination ◽

Advanced User ◽

Before And After

Background Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses. Objectives To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions. Methods An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Courses incorporated didactic and simulation components, written knowledge examinations, and electronic modules. Differences in examination scores before and after each course for the overall cohort and for participants from each ICU type were analyzed with t tests or nonparametric equality-of-medians tests. Differences in postcourse scores across ICU types were examined with multiple linear regression. Results Critical care nurses new to ECMO (n = 301) from various ICU types participated in the basic safety course; 107 nurses also participated in the advanced user course. Examination scores improved after completion of both courses for overall cohorts (P < .001 in all analyses). Median (interquartile range) individual score improvements were 23.1% (15.4%-38.5%) for the basic safety course and 8.4% (0%-16.7%) for the advanced user course. Postcourse written examination scores stratified by ICU type, compared with the medical ICU/cardiovascular ICU group (reference group), differed only in the neurovascular ICU group for the basic safety course (percent score difference, −3.0; 95% CI, −5.3 to −0.8; P = .01). Conclusions Implementation of an ECMO curriculum for a high volume of critical care nurses is feasible and effective.

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Nursing Leadership From the Bedside to the Boardroom

AACN Advanced Critical Care ◽

10.4037/nci.0b013e31828b47f4 ◽

2013 ◽

Vol 24 (2) ◽

pp. 186-193 ◽

Cited By ~ 1

Author(s):

Mary Frances D. Pate

Keyword(s):

Health Care ◽

Critical Care ◽

New Age ◽

Nursing Leadership ◽

High Impact ◽

Critical Care Nurses

Experienced acute and critical care nurses are poised to be high-impact leaders in the current, ever-changing health care landscape. These professionals need new skills to carry them to the next level, as they are called on to lead in a new age filled with increasing complexities. This article provides strategies for nurses to consider and reflect on throughout their leadership journey.

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