“Negotiating, Navigating, and Networking”: Three Strategies Used by Nursing Leaders to Shape the Adoption and Incorporation of Simulation into Nursing Curricula—A Grounded Theory Study

Background. Implementing simulation requires a substantial commitment of human and financial resources. Despite this, little is known about the strategies used by academic nursing leaders to facilitate the implementation of a simulation program in nursing curricula. Methods. A constructivist grounded theory study was conducted within 13 nursing programs in Ontario, Canada. Perspectives of key stakeholders (n=27) including nursing administrators (n=6), simulation leaders (n=9), and nursing faculty (n=12) were analyzed using the constant comparison method. Results. Nursing leaders, specifically nursing administrators and simulation leaders who successfully led the adoption and incorporation of simulation into nursing curricula, worked together and utilized negotiating, navigating, and networking strategies that impacted the adoption and incorporation of simulation into nursing curricula. Conclusions. Strategies that were found to be useful when planning and executing the adoption and incorporation of an innovation, specifically simulation, into nursing curricula provide practical approaches that may be helpful to nurse leaders when embarking upon an organizational change.

The Efficacy of Optimism: Benefit Finding in the Treatment of Diabetes in Iranian Patients

The incidence of diabetes mellitus is on the rise around the world. Middle Eastern countries will be facing a vast increase in the number of diabetes mellitus cases by 2030. Diagnosis of a chronic disease such as diabetes mellitus can be a shocking and life-altering event. Conversely, a diagnosis of a chronic illness can also offer the patient opportunities to change unhealthy behaviors such as poor diet, smoking, and lack of exercise, making them healthier than before their diagnosis. This is referred to as “benefit finding”. This study reveals the many benefit findings of Iranian patients who have been diagnosed with diabetes mellitus and illustrates how benefit finding can be an integral part of long-term patient care.

Job Burnout, Mood State, and Cardiovascular Variable Changes of Doctors and Nurses in a Children’s Hospital in China

Aims. This study examines mood and cardiovascular variables related to job stress and burnout in hospital personnel. Main Methods. 400 nurses and physicians from a children’s hospital in China were recruited. Participants completed job stress, burnout, and mood state questionnaires. Cardiovascular variables such as body mass index (BMI), triglyceride (TG), and high density lipoprotein (HDL) were measured. Key Findings. Job stress and burnout were significantly associated with mood state. Statistically significant correlations were found between triglyceride levels and job stress scores (r=0.175, P<0.01), BMI and job stress scores (r=0.121, P<0.05), and HDL levels and job stress scores (r=-0.117, P<0.05). Significance. Mood state changes may be related to job stress and job burnout, in turn, associated with triglycerides and HDL levels. Public health implications and interventions are discussed.

Challenges of Introducing Participant Observation to Community Health Research

Participant observation elicits unique observation data from both an insider’s and an outsider’s perspectives. Despite the growing tendency to adopt participant observation strategies in health care research regarding health-related beliefs and types of behavior, the use of participant observation in current research is mostly limited to structured clinical settings rather than community settings. In this paper, we describe how we use participant observation in a community health research study with Chinese-born immigrant women. We document discrepancies between these women’s beliefs and types of behavior regarding health and health promotion. We further discuss the ethnical, time, and setting challenges in community health research using participant observation. Possible solutions are also discussed.

What Factors Facilitate Good Learning Experiences in Clinical Studies in Nursing: Bachelor Students’ Perceptions

Clinical studies constitute 50% of the bachelor program in nursing education in Norway, and the quality of these studies may be decisive for the students’ opportunities to learn and develop their professional competences. The aim of this study was to explore what bachelor students’ in nursing perceived to be important for having good learning experiences in clinical studies. Data was collected in a focus group interview with eight nursing students who were in the last year of the educational program. The interview was transcribed verbatim, and qualitative content analysis was used for exploring and interpreting the content of the interview text. One main theme emerged from the analysis: “being in a vulnerable and exposed position characterized by conflicting needs.” Four categories were found: “aspects related to the clinical setting”, “aspects related to the nurse supervisor,” “aspects related to the student,” and “aspects related to the student-supervisor relationship”. The findings revealed that the students' learning experiences and motivation were related to individual, relational, and organizational aspects. The students highlighted their own as well as their supervisors' attitudes and competences and the importance of positive relationships. In addition, feeling welcomed, included, and valued in the ward improved their motivation, self-confidence, and self-respect.

Light Reduction Capabilities of Homemade and Commercial Incubator Covers in NICU

Reduction of high-risk neonates’ exposure to aversive light stimulation is an important component of developmentally supportive care. In neonatal intensive care unit (NICU), usually light is reduced by reducing the room’s light level or by using incubator covers. Many types of incubator covers are in use, including homemade and commercial covers. A comparative study was used to determine the light reducing capabilities of 19 homemade incubator covers, 2 commercial covers, and 1 receiving blanket. The covers were tested by covering and uncovering an incubator and an oxygen hood in the NICU during daytime and nighttime lightings. The light reducing capabilities value was determined for each cover using an Extech light dosimeter when the cover was placed over and removed from an oxyhood, and an incubator. The study showed that the light reducing capability of the commercial covers was 91.2%, the homemade covers capability was 72.1%, and the receiving blankets capability was 55.1%. A significant difference between the commercial and homemade covers was found (F=452.50, P<0.00). Commercial incubator covers are the most effective covers to achieve light reduction; homemade covers can be effective if made large enough so that they completely cover all sides of the incubator.

Reasons for Nonattendance across the Hepatitis C Disease Course

This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 interrelated nonattendance themes: self-protection, determining the benefits, competing priorities, knowledge gaps, access to services, and restrictive policies. Factors within the themes varied with the disease course, type of provider/service, and patient context. Nonattendance could span months to years and most frequently began at diagnosis where providers either advised that followup was not necessary or did not recommend any followup. The way services were organized (low barrier access) and delivered (nonjudgmental approach) and higher HCV knowledge levels of patients and providers encouraged attendance. This is the first study to explore the reasons for nonattendance for HCV care throughout the disease course and validate them from multiple perspectives. There are missed opportunities for providers to encourage attendance throughout the disease course beginning at diagnosis. Interventions required include development of integrated health and social service delivery models; mechanisms to improve knowledge dissemination of the disease, its management, and treatment; and implementation of standardized followup protocols for liver disease monitoring in primary care.

Study on Situational Influences Perceived in Nursing Discipline on Health Promotion: A Qualitative Study

Introduction and Objectives. Nurses, as behavioral models, play a key role in health promotion, and their attitudes towards health promotion highly influence their health and performance. The aim of this study is to explore nursing students' perception of studies in nursing discipline as a situational influence on health promotion. Materials and Methods. This study was conducted using directed content analysis, by means of 20 deep semistructured interviews with nursing students. The participants were selected on purposive sampling. Data was analyzed by the qualitative content analysis method. All interviews were recorded, transcribed, and reviewed, and all codes were extracted and summarized. The codes were subcategorized on the basis of centralization and were categorized after review of subcategories, and finally, a theme was determined. Findings. The theme of nursing discipline's situational influence on nursing students' health promotion was revealed. This theme consisted of “choosing the field,” “unfavorable environmental factors,” “negative impacts of studies in nursing discipline on health,” “positive effects of studies in nursing discipline on health”, “needs,” “attractiveness (aesthetics),” and “coping with negative situational influences in nursing discipline.” Conclusion. The perception of studies in nursing discipline as a health-promoting behavior is under influence of social environment. Considering the importance of the students' positive perception of the existing situation, it is essential to pay attention to their attitudes and perceptions so that they can provide better services to patients.

Young Registered Nurses' Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study

In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process.

Implementation Interventions Used in Nursing Homes and Hospitals: A Descriptive, Comparative Study between Austria, Germany, and The Netherlands

Translating guidelines into nursing practice remains a considerable challenge. Until now, little attention has been paid to which interventions are used in practice to implement guidelines on changing clinical nursing practice. This cross-sectional study determined the current ranges and rates of implementation-related interventions in Austria, Germany, and The Netherlands and explored possible differences between these countries. An online questionnaire based on the conceptual framework of implementation interventions (professional, organizational, financial, and regulatory) from the Cochrane Effective Practice and Organization of Care (EPOC) data collection checklist was used to gather data from nursing homes and hospitals. Provision of written materials is the most frequently used professional implementation intervention (85%), whereas changes in the patient record system rank foremost among organisational interventions (78%). Financial incentives for nurses are rarely used. More interventions were used in Austria and Germany than in The Netherlands (20.3/20.2/17.3). Professional interventions are used more frequently in Germany and financial interventions more frequently in The Netherlands. Implementation efforts focus mainly on professional and organisational interventions. Nurse managers and other responsible personnel should direct their focus to a broader array of implementation interventions using the four different categories of EPOC’s conceptual framework.