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Izabela Witczak ◽  
Łukasz Rypicz ◽  
Mária Šupínová ◽  
Elena Janiczeková ◽  
Piotr Pobrotyn ◽  

Pharmacotherapy, i.e., the use of medicines for combating a disease or its symptoms, is one of the crucial elements of patient care. Nursing workloads in the pharmacotherapy process prove that nurses spend 40% of their work on the management of medications. This study was aimed at the determination and comparison of safety levels at the nurse-managed stage of the pharmacotherapy process in Poland and Slovakia by identifying the key risk factors which directly affect patient safety. The study involved a group of 1774 nurses, of whom 1412 were from Poland and 362 were from Slovakia. The original Nursing Risk in Pharmacotherapy (acronym: NURIPH) tool was used. The survey questionnaire was made available online and distributed to nurses. The Cronbach’s alpha coefficient was 0.832. Nurses from Slovakia most often, i.e., for six out of nine factors (items: one, five, six, seven, eight, and nine), assessed the risk factors as “significant risk (3)”, and Polish nurses most often, i.e., for as many as eight out of nine risk factors (items: one, two, three, four, five, six, seven, and nine), assessed the risk factors as “very significant (5)”. It has been found that the safety of the pharmacotherapy process is assessed by Polish nurses to be much lower than by Slovak nurses.

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1265
Giana Carli Lorenzini

Home care nurses assist older people in their daily living and well-being, including medication management. Medication management can be challenging for older people with functional constraints and several chronic conditions. This paper presents how home care nurses manage medications and their packaging for older people at their homes. This study followed an explorative qualitative research design, in which semi-structured interviews were conducted with home care nurses in Sweden (n = 14). The study revealed that home care nurses need to coordinate a multitude of interrelated tasks, with documentation being paramount. Regarding medication management, automated systems were preferred, as they reduce medication errors and facilitate dispensing of medications for each patient when compared with analogue systems still in use (i.e., dosing boxes), commonly used by older people. Importantly, the lack of a common journal system for updates on prescribed medication among health care providers and analogue communication still in place creates space for outdated prescription of medications for patients. There are opportunities for further investigation on how technology can help home care nurses in coordinating medication management tasks with other health care providers, and on receiving updates about medication intake by older patients when the nurse is not at their homes.

2021 ◽  
Amelia Ganefianty ◽  
Praneed Songwathana ◽  
Kittikorn Nilmanat

Background: Effective nursing interventions for caring for patients with moderate to severe traumatic brain injury are still challenging during a transition from hospital to home. Since traumatic brain injury has deep-rooted sequelae, patients and their caregivers require better arrangement and information on the condition to achieve improved outcomes after discharge. Objective: This study aimed to assess transitional care programs to improve outcomes of patients with traumatic brain injury and their caregivers. Methods: A systematic review and meta-analysis were performed on studies retrieved from ProQuest, PubMed, Science Direct, CINAHL, and Google Scholar from January 2010 to July 2021. RevMan 5.4.1 software was used for meta-analysis. Results: Nine studies were systematically selected from 1,137 studies. The standard approaches of interventions used in patients with traumatic brain injury and their caregivers were education, mentored problem-solving, home-and community-based rehabilitation, counseling, skill-building, and psychological support. We observed that there was significant evidence indicating beneficial effects of intervention in increasing the physical functioning of patients with traumatic brain injury (SMD = -0.44, 95% CI -0.60 to -0.28, p <0.001), reducing the psychological symptoms among caregivers (SMD = -0.42, 95% CI -0.59 to -0.24, p <0.001), and increasing the satisfaction (SMD = -0.35, 95% CI -0.60 to -0.11, p = 0.005). Conclusion: Education, skill-building, and psychological support should be the main components in transitional care nursing programs for patients with traumatic brain injury and their caregivers.   Funding: Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand.

2021 ◽  
Vol 11 (10) ◽  
pp. 945
Marco Clari ◽  
Michela Luciani ◽  
Alessio Conti ◽  
Veronica Sciannameo ◽  
Paola Berchialla ◽  

The COVID-19 pandemic has had a severe impact on nursing care. This cross-sectional survey-based study compared aspects of nursing care and nurses’ satisfaction with care provided before and during the first wave of the COVID-19 pandemic. A total of 936 registered nurses (RNs) rated the frequency with which they performed fundamental care, nursing techniques, patient education, symptom management, and nurse–patient relationships before and during the pandemic. A recursive partitioning for ordered multivariate response in a conditional inference framework approach was applied. More frequent fundamental cares were associated with their frequency before the pandemic (p < 0.001), caring for COVID-19 patients (p < 0.001), and workplace reassignment (p = 0.004). Caring for COVID-19 patients (p < 0.001), workplace reassignment (p = 0.030), and caring for ≤7.4 COVID-19 patients (p = 0.014) increased nursing techniques. RNs in high-intensity COVID-19 units (p = 0.002) who educated patients before the pandemic, stopped this task. RNs caring for COVID-19 patients reported increased symptom management (p < 0.001), as did RNs caring for more non-COVID-19 patients (p = 0.037). Less frequent nurse–patient relationships before the pandemic and working in high-intensity COVID-19 units decreased nurse–patient relationships (p = 0.002). Despite enormous challenges, nurses continued to provide a high level of care. Ensuring the appropriate deployment and education of nurses is crucial to personalize care and to maintain nurses’ satisfaction with the care provided.

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1228
Nermine M. Elcokany ◽  
Amal Ismael Abdelhafez ◽  
Vivian Magdi Samuel Sharaby ◽  
Safia Belal

Computer-based learning has numerous advantages. It gives students the chance to accommodate and solve problems independently, it can increase motivation during the learning process, and it offers students direct feedback. Students will also receive an authentic learning experience, increasing their level of knowledge retention. It can assist nursing educators in improving learning outcomes. Aim: This study aimed to investigate and evaluate the impact of computer-based scenarios on undergraduate nursing students’ decision-making skills. Sample: There was a total sample of 112 nursing students who were enrolled in a critical care nursing course at the College of Applied Medical Sciences in Saudi Arabia. These students were divided into two groups. Methods: The two groups were taught the same topic for one week. Two case scenarios were given to each group during the clinical rotation. The study group used the computer-based case scenario, and the control group used the paper-based case scenario. The two groups were compared regarding their decision-making skills. The student’s feedback about the computer-based case scenarios was also investigated. Results: The study group scored significantly higher in their decision-making skills when compared to the control group. In addition, the study group reported that they highly agreed that their general learning and specific nursing abilities improved after using computer-based case scenarios.

Sara Guillen-Aguinaga ◽  
Antonio Brugos-Larumbe ◽  
Laura Guillen-Aguinaga ◽  
Felipe Ortuño ◽  
Francisco Guillen-Grima ◽  

(1) Background: Patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: The APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. 505889 people over 18 years were followed during 5 years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: Schizophrenic patients had an HR 1.414 (1.031-1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, Charlson Index, antecedents of cardiovascular disease, and smoking. (4) Conclusions: Patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should be implemented to monitor these patients and reduce cardiovascular risk factors.

J. van Ramshorst ◽  
M. Duffels ◽  
S. P. M de Boer ◽  
A. Bos-Schaap ◽  
O. Drexhage ◽  

Abstract Background Healthcare expenditure in the Netherlands is increasing at such a rate that currently 1 in 7 employees are working in healthcare/curative care. Future increases in healthcare spending will be restricted, given that 10% of the country’s gross domestic product is spent on healthcare and the fact that there is a workforce shortage. Dutch healthcare consists of a curative sector (mostly hospitals) and nursing care at home. The two entities have separate national budgets (€25 bn + €20 bn respectively) Aim In a proof of concept, we explored a new hospital-at-home model combining hospital cure and nursing home care budgets. This study tests the feasibility of (1) providing hospital care at home, (2) combining financial budgets, (3) increasing workforces by combining teams and (4) improving perspectives and increasing patient and staff satisfaction. Results We tested the feasibility of combining the budgets of a teaching hospital and home care group for cardiology. The budgets were sufficient to hire three nurse practitioners who were trained to work together with 12 home care cardiovascular nurses to provide care in a hospital-at-home setting, including intravenous treatment. Subsequently, the hospital-at-home programme for endocarditis and heart failure treatment was developed and a virtual ward was built within the e‑patient record. Conclusion The current model demonstrates a proof of concept for a hospital-at-home programme providing hospital-level curative care at home by merging hospital and home care nursing staff and budgets. From the clinical perspective, ambulatory intravenous antibiotic and diuretic treatment at home was effective in safely achieving a reduced length of stay of 847 days in endocarditis patients and 201 days in heart-failure-at-home patients. We call for further studies to facilitate combined home care and hospital cure budgets in cardiology to confirm this concept.

2021 ◽  
Kelsey Renning ◽  
Brittney van de Water ◽  
Shelley Brandstetter ◽  
Chisomo Kasitomu ◽  
Netsayi Gowero ◽  

Abstract Background Significant improvements in under-five mortality in Malawi have been demonstrated over the past thirty years; however, Malawian healthcare remains with gaps in availability and access to quality paediatric critical care nursing training and education. To improve expertise of paediatric critical care nurses in Malawi, Kamuzu College of Nursing (KCN), Queen Elizabeth Central Hospital (QECH), and Mercy James Center (MJC) entered a partnership with Seed Global Health, a US non-governmental organization. A needs assessment was conducted to understand the training needs of nurses currently working in paediatric critical care and in preparation for the development of a specialized Master’s in Child Health pathway in Paediatric Critical Care (PCC) Nursing at KCN. Methods The needs assessment was completed using a survey questionnaire formatted using an ABCDE (Airway, Breathing, Circulation, Disability, and Exposure) framework. The questionnaire had Likert scale and yes/no questions. Data was manually entered into excel and was analyzed using descriptive statistics. Results One hundred and fifty-three nurses at QECH and MJC responded to the survey. Most nurses were between the ages of 25 and 35 years (N = 98, 64%), female (N = 105, 69%), and held either a Bachelors (N = 72, 47%) or diploma (N = 70, 46%) in nursing. Nurses had high rates of confidence in certain skills: airway management (N = 120, 99%), breathing assessment & management (N = 153, 100%). However, nurses demonstrated little to no confidence in areas such as: mechanical ventilation (N = 68, 44%), ECG evaluation (N = 74, 48%), and arterial blood gas collection & interpretation (N = 49, 32%). Conclusion It is important to identify priority areas for training and skills development to address in the PCC master’s within the child health pathway at KCN. Ideally this partnership will produce practice-ready PCC nurses and will establish a recognized PCC nursing workforce in Malawi.

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e70762
Rayara de Souza Julio ◽  
Luciano Garcia Lourenção ◽  
José Gustavo Monteiro Penha ◽  
Adriane Maria Netto de Oliveira ◽  
Vagner Ferreira do Nascimento ◽  

Objective: to analyze the levels of anxiety, depression, and work engagement among nursing professionals in Primary Health Care. Methods: cross-sectional, descriptive, and correlational study with nursing professionals from Family Health Units. We used: the Beck Anxiety Inventory; the Beck Depression Inventory; and the Utrecht Work Engagement Scale. Results: we observed moderate anxiety among nurses and mild anxiety among nursing assistants/technicians; and mild depression among nurses and nursing assistants/technicians. Anxiety and depression were positively and moderately correlated (r:0.562; p=0.000). The professionals presented elevated levels of work engagement. Conclusion: important levels of anxiety and depression were evidenced among professionals, indicating progress to levels that compromise health and quality of life. Despite the compromised mental health, the professionals showed willingness to work and an important resilience capacity.

2021 ◽  
Vol 30 (16) ◽  
pp. S12-S20
Angie Perrin ◽  
Maddie White ◽  
Jennie Burch

One of the biggest challenges for specialist stoma care nurses (SCNs) caring for anyone living with a stoma is that of being confronted with a problematic stoma. This can be described as an ostomy that continues to cause leakage issues for the patient which, if persistent can quickly impact negatively on their quality of life. A convex stoma appliance, also termed convexity, is a possible solution to a problematic stoma. However, the use of a convex appliance should be considered only after a thorough assessment has been undertaken by a specialist SCN. Professionally, stoma care nursing has advanced greatly in recent years and there has been a realisation that there is a need for clinical guidelines to direct practice and offer a process for the novice SCN to follow. This realisation has been the catalyst behind the development of the new guideline for the assessment and use of convexity by the Association of Stoma Care Nurses UK, which was published this year ( ). This article explores the concept of convexity and how the guideline can assist the practice of specialist SCNs, as well as that of ward and community-based nurses who wish to gain more information on using convexity within the specialist sphere of stoma care.

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