Explaining the Status of Clinical Nursing Education: A Qualitative Research in Iran

Background: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education. Objectives: This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran. Methods: This qualitative study based on the conventional content analysis approach was conducted at Jahrom University of Medical Sciences in 2018 - 2019. Data were collected through holding 10 semi-structured face-to-face focus group discussions (FGDs) with 110 nurses, head nurses, instructors, and students. Purposeful sampling was used and the interviews were analyzed by Graneheim and Lundman method by MAXQDA Software. Results: We obtained 626 in-vivo codes, 46 primary codes, eight subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, students' confusion in the clinical setting, and non-participatory planning), and three main categories (planning challenges, implementing challenges, and evaluation challenges). Conclusions: Educational leaders are recommended to shift to three areas, including democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods based on the participation of learners and other stakeholders.

Efficiency of emergency service for COVID-19 patients in Indonesia: management system, public policies, and medical action

Since the implementation of physical distancing and Large-Scale Social Restrictions (PSBB) on March 20, 2020, there was a decrease in patients at Cicendo Eye Hospital as much as 67.9% from March to April 2020. Encouragement to the public to keep their distance, avoid crowds, and the advice to stay at home resulted in a flow the process of health care during the COVID-19 pandemic has changed, such as the implementation of standard precautions for all patients and ensure early identification and source control. The existence of COVID-19 policies in the form of screening, service procedures, and the changing flow of the service process is thought to also affect patient satisfaction and the quality of nursing services. To analyze the quality of nursing services during the COVID-19 pandemic at Cicendo Eye Hospital. Using the Importance Performance Analysis (IPA) method. Data collection is carried out in outpatient and inpatient settings. Cicendo Eye Hospital. Sources of data in the form of primary data through questionnaires Responsiveness, Assurance, Tangible, Empathy and Reliability (RATER) and secondary data in the form of patient satisfaction data and service quality in 2019.

Perbandingan Model Asuhan Keperawatan Profesional Tim dengan Primary Nursing dalam Peningkatan Kualitas Asuhan Keperawatan di Rumah Sakit Kota Medan

The development of science and technology that continues to progress, especially in the health sector requires changes in terms of service so that in providing more professional services in hospitals, nursing care must be of high quality. Nursing Law Number 38 of 2014 Article 3B states that nursing arrangements aim to improve the quality of nursing services, therefore the provision of quality nursing services is important in today's health services. The model of professional nursing care is divided into several models, namely primary, team and case nursing. Based on the results of a survey of research journals, the researchers concluded that there was no research that compared the professional nursing care team model with primary nursing in improving the quality of nursing care. The purpose of this study was to identify the use of the professional nursing care team model with the primary nursing model in improving the quality of nursing care. This type of research is a quantitative research type with a comparative design. The population in this study were all patients at the Inpatient Hospital where the study was conducted. The sampling technique used was purposive sampling technique. Data collection on the quality of nursing care used a quality scale patient assessment instrument – the acute care version (PAQS-ACV). This instrument was developed to assess the quality of nursing care. Data analysis in this study used an independent t-test. normality test using the Kolmorogov-Smirnov test with a significance value (p > 0.05). The results showed that there was a significant difference between the quality of nursing care in the team group and the quality of nursing care in the primary nursing group where the value of sig (2-tailed) was 0.008 where > 0.05, the results also showed that based on the results of the frequency distribution test the quality of nursing care was using the team model and the primary nursing model has a high majority value of nursing care quality, but there is a difference in the average value (mean) where the quality of nursing care in the nursing care model group in the team method group is 144.86 and the quality of nursing care in the primary nursing model group is 155.83. These results indicate that the quality of nursing care with the primary nursing model has a higher quality of care value than the group nursing care model with the team method. Based on the results of this study, it is recommended that hospitals can apply a professional nursing practice model, especially the primary nursing model to further improve the quality of nursing care provided.

Standardization of quality of diagnoses, interventions, and outcomes (Q-DIO) measurement instrument for use in Slovenia

Purpose To describe the cross-cultural adaptation of the Quality of Diagnoses, Interventions and Outcomes (Q-DIO) Instrument into the Slovene language. Methods Based on general international guidelines, a six-step process of localization to translate and adjust the instrument from English into the Slovene language was used. Content validity was quantified based on an agreement of eight experts. The instrument was tested using a sample of 140 nursing documentations from two Slovenian tertiary hospitals. Results 26 of 29 items showed an excellent content validity index ranging from 0.857 to 1.000, and a modified kappa index above 0.856. The content validity indexes of the three remaining items adjusted based on experts’ comments were subsequently estimated at 1.000. Construct validity was significantly different between the two groups of documentations. The Cronbach coefficient for the whole questionnaire was 0.860. Cronbach’s alpha if item deleted reamins above 0.80 for all items. The criteria for the difficulty grades of items and discrimination validity were acceptably met for more than 75% of items. Conclusion Based on the results of the study, it may be concluded that Q-DIO is a reliable instrument for measuring the quality of nursing documentation. The deviations in the results of some items are due to poor nursing documentation quality, and indicate that nursing classifications have not yet been fully implemented into practice in the study setting. Additional testing of the instrument is recommended.

Using “Integrated Reminders of Nursing Written Assignment” to Reduce the Interruptions in Nursing Care

Nursing interruptions can suspend the nursing process and distracting the nurses’ attention. In a nursing information system, there are lots of pop-up windows to notify the nurses to complete the nursing records. These notifications can also interrupt the original work. We proposed an “Integrated Reminders of Nursing Written Assignment” system to reduce the number of interruptions from the nursing information system. The result showed that the number of pop-up windows decreased from 489.48 to 0 per shift. The completeness of the nursing records raised from 97.3% to 100%. The “Integrated Reminders of Nursing Written Assignment” can effectively reduce the frequency of nursing interruptions and improve the quality of nursing records.

Correlation between job burnout and Fear of COVID-19 among ICU and CCU Nurses (Case study: Shahid Madani Cardiac Hospital, Tabriz, Iran)

Background: Occupational burnout among nurses is one of the major factors which affect the quality of nursing care. Assessing the relationship between burnout and its associated factors is one of the most basic things that should be done so that later, actions can be taken to reduce burnout. Fear of COVID-19 is one of the factors that can increase the burnout of nurses during the Coronavirus Disease 2019(COVID-19) pandemic. Aim: To investigate the relationship between job burnout and fear of COVID-19 among ICU and CCU nurses. Methods: The Maslach Burnout Inventory (MBI) and the Fear of COVID-19 Scale (FCV-19S) were distributed to ICU and CCU nurses (n = 170) at Shahid Madani Cardiac Hospital, Tabriz, Iran, and the correlation between job burnout and fear of COVID-19 was calculated. Results: The results show that the level of emotional exhaustion and reduced personal accomplishment among participants of this study is average, and depersonalization is at a low level. Also, the level of fear of coronavirus is below average among the respondents. The research showed that emotional exhaustion and fear of COVID-19 were positively correlated (p < 0.05), but there was not any significant correlation between depersonalization and fear of Coronavirus; as the relationship between reduced personal accomplishment and fear of COVID-19. In addition, there were significant correlations between age and reduced personal accomplishment, as well as marital status and reduced personal accomplishment (p < 0.05). On the other hand, the results showed that there were not any significant correlations between gender and burnout dimensions, nor between educational degree and burnout dimensions. Conclusion: As job burnout reduces the quality of nursing care, managers must take strategies that reduce job burnout. One of the strategies that they can take is to reduce the fear of COVID-19 by taking wise strategies.

Effect of Simulation-based Medical Education in Small Groups on Improving the Quality of Nursing Care in Patients Under Electroconvulsive Therapy

Background: Considering the high risk and vital nature of electroconvulsive therapy (ECT) process, as well as the subsequent intensive, essential, and life-saving cares, it is necessary to promote the skills of nurses providing this kind of care. Objectives: This study aimed to determine the effect of simulation on developing the quality of care in nurses working in the ECT department. Methods: This experimental study compared two groups before and after the intervention. Fifty nurses who met the inclusion criteria were randomly allocated into two groups of intervention and control. Low-tech (static) task trainer was used for simulation-based medical education (SBME) in the intervention group. Data were collected using a checklist to investigate the quality of nursing care before and after the intervention. Results: The mean scores obtained from initial preparation subscales, preparation of tools and equipment, measures during ECT, post-ECT measures, and checking patient’s status in pre-test and post-test in the intervention group were significantly different. This suggests that simulation intervention in small groups is effective in improving the quality of nursing care in ECT (P < 0.05). Conclusions: Our results showed that promoting ECT nursing care knowledge among the nurses in small groups by simulation method is an effective intervention.