Incorporating Simulation Based Training in the Initial Training of New Graduate Registered Nurses in a Blood and Marrow Transplant (BMT) Unit

Topic significance and study purpose/background/rationale: Nursing schools today have placed greater emphasis on online learning leading to limitations in clinical experience and communication skills. Staff turnover has also led to an increase in novice nurses entering the BMT specialty who are then trained by those with limited experience themselves emphasizing the need to incorporate new teaching methods in our nursing residency programs. Methods, intervention, and analysis: An orientation program was developed incorporating nursing competencies, communication skills, critical thinking, and oncology/BMT knowledge aligned with the hospital's new graduate RN residency program. In addition to formal classroom education covering basic nursing skills, institutional protocols, and foundational oncology/BMT knowledge, simulation scenarios were developed reviewing multiple complications often seen in a BMT unit, including febrile neutropenia, septic shock, and cellular therapy infusion reactions. Debriefing and surveys were conducted evaluating the nurse's level of comfort with the scenarios prior to and after simulation. Findings and interpretation: Each simulation lasted thirty minutes followed by one hour of debriefing, analysis, and evaluation. Individual nursing interventions utilized in the scenario were aligned with appropriate hospital policies and best nursing clinical practices. A survey was conducted rating the level of comfort before and after the simulation. 100% of the nurses reported feeling more comfortable with the situations reviewed after undergoing the simulation. Feedback also included novice nurses' lack of experience with oncologic emergencies during their orientation as preceptors often felt compelled to intervene leaving the resident with less hands-on experience. The novice nurses also felt the simulation provided them with the practical clinical experience that had been limited during the COVID-19 pandemic when more novice nurses were training simultaneously with less numbers of cellular therapy patients. Discussion and implications: Simulation provides a safe and effective way of teaching novice nurses about the cellular therapy specialty and common complications when hands-on experience is limited. By incorporating simulation into training, the nurse residents feel more comfortable practicing independently. Greater confidence, enhanced critical thinking, and improved patient outcomes were advantages noted with this educational method. The benefits and success of these simulations will lead to more scenarios being incorporated into training as the BMT specialty continues to evolve.Copyright © 2023 American Society for Transplantation and Cellular Therapy

Respiratory nursing post-COVID consultation

Introduction: Due to the pandemic caused by SARS-COV2, a great number of infections occurred, so the Respiratory Nursing Unit of the Hospital Virgen del Rocio, proposed the creation of the post - COVID Nursing Consultation for the follow-up of those patients who needed hospitalization produced by SARS CoV2 infection. Objective(s): to assess the patient's symptoms after being discharged and to analyze the degree of adherence to treatment. Method(s): Cross-sectional descriptive observational study based on the analysis of a cohort of 120 patients. Data collection from July 2020 to March 2021: time of admission, associated symptoms, adherence to treatment, sex. The consultation is carried out by the nursing team of the unit in person and by telephone once a week with quarterly reviews until completing the year with discharge if appropriate. We use the validated scales of mMRC, Barthel and Goldberg. Result(s): Cohort of 120 patients, 53 women and 67 men. First visit: 1 month +/- 1 week after hospital discharge. Symptomatology associated with the process: dyspnea: 80% after Intensive Care Unit, 20% after hospitalization. Anxiety: 60% after ICU, 75% after hospitalization. Depression: 58% after ICU, 42% after hospitalization. Adherence to pharmacological treatment: 51 women, 57 men. Adherence to non-pharmacological treatment: 42 women, 47 men. Second visit: Three months +/- 1 week after hospital discharge. Dyspnea: 50 patients. Anxiety: 22 patients. Depression: 31 patients. Adherence to pharmacological treatment: 52 women, 65 men. Adherence to nonpharmacological treatment: 50 women, 56 men. Conclusion(s): The nursing intervention in the post - COVID follow-up demonstrates a decrease in patients and anxiety and depression and an increase in adherence to treatment.

Improving Knowledge and Attitudes in Pregnant, Postpartum, and Lactating Women toward Preventing COVID-19 Transmission and Self-Care with Health Education Packages using Android Applications

BACKGROUND: The Covid-19 outbreak is rapidly increasing as evidenced by the number of cases, deaths and countries affected. However, limited data is available on pregnant women with Covid-19 on which to base recommendations for pregnancy and post-partum care. AIM: Identify the effectiveness of nursing intervention with health education via an android application about self-care and prevention of Covid-19 transmission toward the knowledge and attitudes of pregnant, post-partum and lactating women. METHODS: This study was done in three stages. Stage one was identifying the existing nursing intervention for respondents with Covid-19, stage two involved the health education formulation and built it in to an android application, stage three measured the differences in knowledge attitude of respondents before and after health education by using the android application. 152 respondents pregnant, post-partum and lactating with Covid-19 women participated in this study. RESULTS: Stage one showed that nursing intervention has been done comprehensively. Stage two established the health education: http://cegahcovidbumil.000webhostapp.com;Stage three found that there were differences between pre and post health education via an android application in the knowledge and attitudes during pregnancy, post-partum and lactating women in self-care and prevention of Covid-19 transmission. Significancy was found among post-partum and lactating women (p=0.018*). CONCLUSION: There was a difference in knowledge and attitudes among respondents in self-care and prevention regarding the spread of Covid-19 before and after health education via an android application. Study recommended that health care providers use this method in their intervention to improve health status and prevent further spread of Covid-19. Further research to explore more health indicators is needed.

Qur’anic Bibliotherapy Intervention in Pregnant Women Experiencing Anxiety During the COVID-19 Pandemic in Indonesia: A Qualitative Exploratory Study

BACKGROUND: The disease caused by coronavirus-19 (COVID-19) has been stated as a global epidemic by the WHO. The COVID-19 pandemic adds many risk factors to maternal mental health during the perinatal period. The impact of anxiety during pregnancy is adverse obstetric consequences such as premature birth, inadequate antenatal care, requests for elective cesarean delivery, low APGAR scores of infants, and postpartum depression. Nursing interventions to overcome anxiety can be done through spiritual and religious intervention approaches. One of the spiritual interventions for the Muslim population to improve religious coping is Qur’anic Bibliotherapy (QB) as Islamic bibliotherapy. AIM: This study aimed to explore the use of QB interventions for pregnant women experiencing anxiety during the COVID-19 pandemic. METHODS: A qualitative exploratory study was conducted to explore the experience of the intervention given to the informant. The qualitative samples were ten respondents with moderate-to-severe anxiety levels. The anxiety instrument used was the Zung Anxiety Scale. RESULTS: The themes obtained from in-depth interviews with semi-structured interviews were recognizing COVID-19 and its perceived impact, the impetus for changing resilience to the COVID-19 pandemic, parents’ role, and the benefits of QB for pregnant women in the COVID-19 pandemic. CONCLUSIONS: QB encourages informants’ positive thinking, feeling, spiritual, and attitude patterns. QB can be used as a complementary Islamic intervention for health workers, especially nurses, in providing nursing care to Muslim patients.

Retrospective analysis of individualised melatonin regimens and a multidisciplinary targeted approach in managing insomnia during the second wave of COVID-19

Introduction: The therapeutic benefits of sleep in the critically ill has been extensively studied in the medical literature.1 Chronic insomnia increases a patient's risk of delirium, cortical atrophy, diabetes, cancer, cardiovascular death from arterial hypertension, myocardial infarction and heart failure.2 Insomnia reduces interaction during videocalls with family and limits co-operation with physiotherapy, medical and nursing interventions, potentially delaying rehabilitation and recovery. Objectives: To improve sleep by introducing an individualised melatonin regimen and a multidisciplinary targeted approach to managing insomnia in an adult intensive care unit. Methods: A retrospective analysis was conducted in a single centre UK adult ICU. Data was retrieved from pharmacy dispensing records, electronic medical notes and prescriptions from September 2020 to March 2021. The primary outcome was resolution of insomnia. Other information collected included causes of insomnia, referral to psychology for cognitive behavioural therapy (CBT), prevalence and resolution of delirium, adverse effects, and death. Each patient received a tailor made regimen based on Bellapart et al's original concept of mimicking the natural endogenous secretion of melatonin.3 However, unlike previous studies3,4,5 dosing was modified and adjusted according to patient response. A loading dose of 0.75 to 3mg was administered at 21:00 followed by a smaller hourly dose of 0.25 to 0.5mg between 22:00 and 03:00. Additionally, the duration of treatment continued for as long as therapeutic benefit was realised, which included post discharge from ICU. Prior experience of conventional melatonin dosing did not demonstrate therapeutic benefit from the original pilot study and when nursing staff inadvertently omitted the hourly dose between 10pm and 3am. Adverse effects were documented. Sleep hygiene measures were introduced and standardised where possible e.g. ear plugs, eye mask, dim lights, environmental noise reduction and minimal night time physical interventions from nursing and medical staff. The principal investigator referred to psychology patients who expressed fear and anxiety as a cause of insomnia. Results: 132 patients were admitted during September 2020 to March 2021. 30 patients received tailor made melatonin regimens (22.7%). The medical notes of four (13.3%) patients could not be accessed for data collection and were, therefore, excluded from the study. The primary outcome of resolution of insomnia occurred in 23 out of 26 (88.4%) patients. At the time of ICU discharge, delirium had occurred in 15 patients (57.7%), resolved in 10 patients (66.7%), three (20%) patients remained intermittently delirious, one remained continuously delirious, and one died. Mechanical ventilation, environmental noise, necessary medical and nursing interventions throughout the night and infection accounted for 23 (88.4%) of patients' insomnia. Fear or anxiety were expressed by eight (30.8%) patients as a cause of insomnia whilst medicines e.g. steroids, beta blockers accounted for six patients (26.1%). Seven patients (26.9%) expressing fear or anxiety were referred to psychology for adjunctive CBT. One patient experienced excessive daytime drowsiness, which resolved with dose regimen adjustment. One patient died of a cause unrelated to melatonin. Conclusion: An individualised melatonin regimen combined with a multidisciplinary targeted approach can result in resolution of insomnia in ICU patients, with minimal risk of adverse effects.

STUDY 'aR-CAT INICI': MANAGEMENT of EARLY RHEUMATOID ARTHRITIS in CATALONIA

Background: Given the progressive change in the management of infammatory diseases,an observational study was conducted on the management of Early Rheumatoid Arthritis (ERA) in Catalonia. Objectives: To know the management of ERA in Catalonia, to assess whether the recommendations of the EULAR/ACR guidelines are followed and to study the causes of management variability,to set improvement objectives. Methods: An observational,descriptive,and cross-sectional study was conduct-ed,with data collection from June 15 to 30, 2021.The rheumatologists' partners of the Catalan Society of Rheumatology were the object of study. An online survey was conducted with 304 members on the management of the ERA. Variables related to the characteristics of the respondents,the derivation and variables of the disease including clinical variables,type of treatment and outcomes used for follow-up including the impact of the SARS-CoV2 pandemic were included. The univariate study was performed using a study of proportions with Pearson's correlation. Results: A total of 105 members (34.5%) responded to the survey.11.6%>60 y, only 7.8% <30y. 99% were in public assistance.The number of rheuma-tologists per service is 7.2[1-17],but 34.2% had< 5 rheumatologists,with a reference population of 200,000-300,000p in 42% of respondents.The number of weekly visits made is 67.5[20-130].42.2% do not have a monographic RA or ERA dispensary and 30.4%not have specialized nursing.Characteristics of ERA:77.5% are derived from primary care(PC),52% have been between 6 weeks,42.1%>3 months.54.9% make a frst visit within 2-4 weeks of PC referral and 14.7%> 8 weeks.100%provide previous analysis,only 47% had had RX performed.98% were previously treated(50.4%NSAIDs + CG,36.1%NSAIDs,12.3% CG).4.3% had GC doses>10 mg/day,11.3%> to 20mg/day.The treatment:DMARDs of choice in 100% is MTX,44.1% start doses of 10mg/week and 3.9%7.5 mg/week.The route of choice is oral(55.9% vs 44.1%).92.2% associate GC and 31.7% have not withdrawn them after 6 m.57.8% consider the maximum of MTX 25mg/W.87.1% use doses<10 mg/day,with the most used dose being 5 mg/day(35.6%).Follow-up after the start of DMARDs is performed 72.5% between 4-6 weeks and 12.7% is performed by nursing.100% use DAS 28 and 53.5% also CDAI.31.4% perform PROs(HAQ 83.3%,RAPID 3 14.3%).The use of systematic ultrasound is collected in 33%, being himself who performs it in 59.9% and an expert rheu-matologist in 46.1%.Finally, when asked about incidence of pandemic in the follow-up,53.3% consider that it is doing the same as before. 46.1% consider that telephone visits are not suitable for the follow-up of the ERAvs14.7% who consider that Yes.When questioning the situations in which they consider them to be appropriate,75.9% that it was adequate in the control after the beginning of the DMARDs.Regarding the treatment of ERA, 66% delayed the onset of biological DMARDs, 72.1% due to difficulty of follow-up and only 8.8% due to an increased risk of infection. When performing the univariate analysis, it is evident that having a monographic dispensary is associated with earlier onset of MTX(p< 0.001)and at doses≥15 mg/W(p = 0.05),greater nursing intervention(p< 0.001),greater use of PROs(p = 0.008)and there is a tendency to a shorter waiting time for frst visits(p = 0.07).It is also associated with not considering telephone visits(p< 0.001), making them in less than 25%(p< 0.0001).Similarly,hospital level is directly proportional to initiation at higher doses of MTX(p< 0.0001),lower use of GC<10mg.Among the rest of the variables, no association has been found. Conclusion: The recommendations of EULAR/ACR in the treatment and follow-up of ERA are consistently followed,although the wide use of MTX orally is striking.It is evident that the variable that most influences the early onset of FAME and at higher doses,is a monographic dispensary,as well as greater presence of nursing and performance of PROs.

Social Support and Loneliness Among Black and Hispanic Senior Women Experiencing Food Insecurity: The Nurse as Primary, Secondary, and Tertiary Intervention.

The impact of social determinants of health (SDOH) is understudied and until recently not a focal point in nursing education. The new Essentials coupled with the impact of the coronavirus (COVID-19) pandemic deem it necessary to address the intersection of SDOH and population health. The impact of COVID 19 disproportionately affects Black and Hispanic families. Couple the disproportionate numbers of COVID 19 among these groups with the growing incidence of food insecurity, and there is a need to explore intersecting links. Emerging research link the lack of social support systems and loneliness to food insecurity. In alignment with addressing competency-based education, it is critical to assess factors such as social support systems and loneliness and the intersection of its effects on such determinants as food insecurity. The article provides an overview for its readers in examining the incidence of food insecurity in older ethnic minority women along with postulated social attributes as contributing factors to the growth rates of food insecurity. The incidence of food insecurity among older ethnic minority women has grown exponentially amid the pandemic. The authors illustrate the role nurses can play in addressing primary, secondary, and tertiary interventions using Neuman's Theory. The intervention pathways are delineated through the lens of nursing theoretic framework created by Betty Neuman Systems Model.

Nursing intervention in intensive care on Biosafety for the care of patients with COVID-19

Introduction: Intensive care nursing staff are exposed to different biological risk factors from the care of patients with COVID-19, therefore biosafety acquire special importance in these units. Objective: To evaluate the effectiveness of the nursing intervention in intensive care on biosafety for the care of patients with COVID-19. Methods: Descriptive and observational study, at the “Enrique Cabrera” General Teaching Hospital in Havana, between April 1 and June 30, 2020. The study population consisted of 60 nurses, to whom a questionnaire was applied and performance observation. Absolute and relative frequency distribution were used, in the case of quantitative variables the mean and standard deviation were used. To assess the results before and after the nursing intervention, Pearson's Chi-square test of independence was applied. Results: The female sex and the ages between 20 to 29 years prevailed. Once the overcoming actions were carried out, positive changes were evidenced in the level of knowledge about COVID-19 and biosafety standards. The most difficult aspects in the initial observation of performance were: use of personal protection equipment, hand washing, precautions in techniques and procedures, handling of biological waste. Conclusions: The nursing intervention was effective and responded to the learning needs about biosafety for the care of patients with COVID-19 in intensive care.

The Effect of Coffee Aromatherapy on Reducing Fatigue and Stress Levels of Female Caregivers Caring for the Elderly in Hospitals

BACKGROUND: The exploration of coffee as an aromatherapy in the health service has not been widely carried out. In many cases, aromatherapy has been shown to reduce stress and fatigue. PURPOSE: The purpose of the study was to analyzes the effect of coffee aromatherapy on the fatigue and stress levels of female caregivers caring for the elderly at the University of Sumatera Utara Hospital (USU Hospital), in Medan. METHODS: This is a quasi-experiment one group pre-test post-test design. The research involved 16 caregivers were given a treatment of coffee oil by inhalation for 15 min for 3 consecutive days, without coffee oil inhalation and 10% of coffee oil concentration on the 1st day, 20% on the 2nd day, and 30% on the 3rd day. Each sample received a pre-test and post-test in the form of stress and fatigue instruments. The data analysis performed was univariate in order to describe the properties of each variable examined and analyze the mean score. Similarly, bivariate analysis with the analysis of variance (ANOVA) statistical test was used to determine the effect of coffee aromatherapy on reducing the fatigue and stress level. RESULTS: The result showed that most caregivers were elderly children with an average age of 38 years, 81.3% assisted in caring for the elderly, and actively working outside the home. Based on the ANOVA test, the data showed that the administration of coffee aromatherapy for 3 consecutive days has no effect on female caregivers’ fatigue and stress level. However, the mean score showed a decrease in fatigue and stress level before and after coffee oil inhalation in 3 days. CONCLUSION: It is necessary to provide coffee oil aromatherapy intervention with a longer duration to have an effect on reducing caregiver fatigue and stress in the future, so the results are expected to form the basic data for the design of nursing interventions based on complementary therapies in order to reduce the fatigue and stress of caregivers while providing care to the hospitalized elderly.

Application of Prone Position for Patient with Corona Virus Disease: An Interventional Program for Nursing Staff

Background: The coronavirus disease (COVID19) epidemics began in Wuhan, China, in December and have since grown into a serious public health challenge for not only China but also countries around the world. Supportive therapy with advanced hypoxemic respiratory failure management has been demonstrated to improve oxygenation in COVID-19 patients, and the prone position has been proven to improve oxygenation in COVID-19 patients Aims of the study: Assessment of nurses' knowledge toward application of prone position for patient with corona virus, and Assessment of an effectiveness of Educational program on nurses' knowledge toward application of prone position for patient with corona virus Methodology: Pre-experimental study design was used with the application of pre and two post-tests approach. The study was carried out in Kut City/Wasit Province, at AL-Zahraa Teaching Hospital. A non-probability "purposive" sample had been consisted of (69) nurses were selected from at AL-Zahraa Teaching Hospital Results: The results indicate that the nurses at the pre-test are fail at all studied items (M ≤1.66) except, the items number (1 and 21) the responses were fair (M=1.67-2.33). While, after the application of intervention program, nurses expressed significant increased knowledge scores (p< 0.05). Conclusion: There were improving in nurses' knowledge and practices after posttest due to intervention program concerning application of prone position..

Establishing best practice in violence risk assessment and violence prevention education for nurses working in mental health units.

OBJECTIVES: To explore and evaluate extant and potential methods used in risk assessment and aggression prevention training. This study was also designed to consider the most appropriate method for educating nurses in use of a novel risk assessment instrument linked to a structured nursing intervention protocol (the electronic application of the Dynamic Appraisal of Situational Aggression and Aggression Prevention Protocol). BACKGROUND: Organisational and personal concerns have led to the development of training programs designed to prevent and manage aggression in mental health units. DESIGN: This descriptive qualitative study explored experts' opinions about effective training approaches. METHODS: Data were collected via focus groups (a total of four discrete groups), with each of the four focus groups repeated after four weeks. A semi-structured guide was used to guide the focus group discussions. RESULTS: Seventeen experts with experience coordinating and facilitating training in prevention and management of aggression in mental health units in New Zealand and Australia participated in this study. Three themes emerged from the data 1) existing training can be "like pulling teeth without anaesthetic" 2) the need to "breathe life" into the training and 3) a vision of the "gold standard" for practice and training. CONCLUSIONS: Training is optimal when it is place-based, responsive to local needs and inclusive of relevant clinical, cultural, consumer/carer and contextual factors. Training may benefit from a focus on the application of the knowledge, skills and attitudes learnt and there is a need for ongoing reinforcement of training in the clinical setting, beyond initial introduction and provision of information and orientation to relevant skills.

Ergonomic Risk-prone Activities toward Nurses in the Intensive Care and Emergency Room

BACKGROUND: Nurses have the risk of ergonomic hazards in providing nursing care, especially with increasingly dynamic health services such as during Coronavirus disease-19 pandemic like today. AIM: The aim of the study was to evaluate activities prone to produce ergonomic risks during the implementation of nursing care in intensive care and emergency room (ER) of a hospital in Riau, Indonesia. METHODOLOGY: This study was conducted by observing the routine activities conducted by the nurses and using similar task group techniques equipped with Rapid Entire Body Assessment instrument. Those observed activities were obtained from 17 intensive care room nurses and ten ER nurses. There were six activities observed in the intensive care room: Bathing, transferring the patient, wounds dressing, taking blood samples for the AGDA examinations, as well as inserting the intravenous needle and electrocardiograms. Meanwhile, there were two activities observed in the ER: Transferring the patient and inserting the intravenous needle. RESULTS: The highest ergonomic risks activity in the intensive care room was bathing the patient with a total score of 13. At the ER, the highest risk score was transferring the patient with a total score of 12. Both activities were at level 4, indicating a high-risk condition. Thus, examinations and changes should be immediately initiated. CONCLUSION: The results are significant to be paid attention by the related parties at the hospital to facilitate some improvements immediately. In addition, the ergonomic approaches that can be suggested to the nurses are regular stretching, physical exercises, and applying ergonomic principles while working. © 2021 Dewi Sartika, Elly Nurrachmah, Dewi Irawaty Sukirman, Muchtaruddin Mansyur, Basuki Supartono.

Investigating the Association between Stress Coping Strategies and Social Support in COVID-19 Survivors

Background: The global spread of COVID-19, due to its pathogenesis and high mortality rate, has caused high levels of stress among various levels of societies. Hence, it is necessary to investigate social support interventions concerning their effectiveness and accessibility. Objectives: The study aimed to determine the association between coping strategies and social support in survivors of COVID-19. Methods: Following a descriptive-correlational design, using the census method, 158 discharged cases with a definitive diagnosis of COVID-19 in 2020 were recruited. Data collection tools included the demographic characteristics questionnaire, CISS-48 stress-coping methods, and Wax’s social support questionnaire. Data were analyzed using descriptive and inferential statistics of Pearson correlation coefficient and multivariate regression in SPSS version 22. Results: The most and least frequent stress coping strategies used by patients were problem-oriented (48.49 ±9.99) and avoidance-oriented stress strategies (24.48 ± 4.11), respectively. Family support (39.02 ± 4.20) was the major source of support. There was a significant correlation between the score of social support and the total score of stress, problem-oriented, and avoidance-oriented stress. According to the regression analysis, there was a significant association between the score of coping strategies and educational level. Conclusions: By increasing the awareness of COVID-19 patients about problem-based coping strategies, their stress can be reduced. Also, due to the high level of social support provided by the family, planning for family-centered nursing interventions and engaging family members in the care of COVID-19 patients are important.

Nursing role in the covid-19 pandemic: Systematic review

The role of the nurse is based on providing comprehensive quality care to the healthy or sick person and accompanying him/her in the healing and rehabilitation process, and if nec-essary, at the time of death. Objective: To examine the role of nursing in the Covid-19 pandemic through a systematic review. Methodology: A systematic investigation was carried out in the scientific databases PubMed, SciElo, Google Scholar, Nursing Journal combining the Boolean operators AND and OR, in Spanish, English and Portuguese. Results: The literary search reported 1243 documents after the ap-plication of the selection criteria and evaluative reading, 32 articles were included for analysis due to their belonging and contribution to the fulfillment of the objective. Conclusions: It is possible to affirm that the pandemic caused by Covid-19 placed the health systems in different challenges, where the nurse played a transcendental and recognized role, standing out for being the heart and fundamental pillar in the different levels of care, demonstrating their safety and leadership by being in a frontline scenario. © 2021, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

The evidence base of nurse-led family interventions for improving family outcomes in adult critical care settings: A mixed method systematic review.

BACKGROUND: The COVID-19 pandemic has exacerbated the consequences of a patient's admission to critical care settings, causing families to face more psychosocial issues than in previous years. Thus, nurses and other clinicians need to keep abreast of interventions that support the families of critical care patients. OBJECTIVE: To provide evidence of nurse-led family interventions and their family outcomes in adult critical care settings. DESIGN: A mixed method systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. DATA SOURCES: The search included both a screen of relevant databases (PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Library) and the screening of citations in relevant articles. Studies published in the English language between January 2010 and October 2020 were considered. The final database searches were performed on 20 October 2020. METHODS: Screening and eligibility assessment were conducted using the Rayyan software. Studies describing the family outcomes of nurse-led interventions in adult critical care settings through either qualitative or quantitative methods were included, i.e., the mixed method synthesis permitted the inclusion of either qualitative or quantitative findings. Article quality was evaluated by three authors using the Joanna Briggs Institute's critical appraisal tools. FINDINGS: A total of 15 studies - two trials, eight quasi-experimental studies, four qualitative, and one mixed method met the inclusion criteria. The described interventions were organized into five categories: educational/informational; family involvement in care; diary; communication; and bundled interventions. These categories varied in terms of elements, delivery, and family outcomes. Nurse-led interventions that resulted in small to medium improvements in family outcomes included educational interventions with digital storytelling, a bundled approach, informational nursing interventions, and nurse-driven emotional support. The included studies (n = 2) that investigated family rounds in the ICU reported that this approach did not noticeably influence family outcomes. CONCLUSION: The differences in the intervention elements, tools, and outcomes evaluated in this review reflect the diversity of family needs, and that numerous interventions have already been developed to promote family health in critical care settings. The evidence suggests that interdisciplinary nurse-led family interventions can improve family outcomes. Tweetable abstract: Interprofessional nurse-led family interventions draw on diverse approaches and improve family outcomes in adult critical care settings.

Surgery cancellation: A scoping review of patients' experiences.

AIMS AND OBJECTIVES: To review the literature on patients' experiences of surgery cancellation to gain knowledge of nursing care needs and identify gaps in evidence. BACKGROUND: Surgery cancellations are an ongoing challenge in healthcare systems with negative impacts on healthcare costs, hospital staff and patients. Most research addresses the reasons for cancellation and implementation of preventive interventions, but limited knowledge exists about patients' experiences of cancellation. DESIGN: The scoping review was undertaken using the methodology recommended by the Joanna Briggs Institute for Scoping Reviews and the Reporting Cheklist for Scoping Reviews (PRISMA-ScR). METHODS: A systematic search was conducted by two independent researchers in Cochrane Library, CINAHL, PubMed and PsycINFO. A forward and backward citation search was performed in Scopus, and references in relevant studies were explored. The tool Covidence was applied to select, compare and discuss relevant articles. The Mixed Methods Appraisal Tool was used for critical appraisal. RESULTS: Surgery cancellation is emotionally harmful with negative effects on patients. Four themes were identified: 'Initial reactions to cancellation', 'Reactions during a new waiting period at home and during readmission to hospital', 'Information about cancellation' and 'The experience of new practical arrangements'. Patients whose surgery was cancelled experienced initial feelings such as anger, rejection and anxiety and physical/psychosomatic symptoms in the extended waiting period. Patients prefered early sufficient information about cancellation from the surgeon. The practical arrangements were stressfull for the patients. CONCLUSION: Nursing care and identification of vulnerable patients are essential to prevent negative effects in the extended waiting period. Provision of timely, sufficient and professional information about cancellation from the surgeon is important. Further research assessing consequences of cancellation is needed. RELEVANCE TO CLINICAL PRACTICE: Patients would benefit if hospitals find systems to minimise cancellation, and healthcare professionals could systematically develop professional supportive interventions tailored to patients' individual needs.

Non-Pharmacological Nursing Interventions for Prevention and Treatment of Delirium in Hospitalized Adult Patients: Systematic Review of Randomized Controlled Trials.

Delirium is a common neurobehavioral complication in hospitalized patients that can occur in the acute phase and lead to poor long-term outcomes. The purpose of this study was to identify non-pharmacological nursing interventions for the prevention and treatment of delirium in hospitalized adult patients. We conducted a systematic review to synthesize the findings of published studies. We searched the PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL databases for randomized controlled trials in January 2021. We report this systematic review according to the PRISMA 2009 checklist. The study was registered on PROSPERO (CRD42021226538). Nine studies were systematically reviewed for non-pharmacological nursing interventions for the prevention and treatment of delirium. The types of non-pharmacological nursing interventions included multicomponent intervention, multidisciplinary care, multimedia education, music listening, mentoring of family caregivers concerning delirium management, bright light exposure, ear plugs, and interventions for simulated family presence using pre-recorded video messages. These results could help nurses select and utilize non-pharmacological nursing interventions for the prevention and treatment of delirium in clinical nursing practice.

The effect of refined nursing intervention on patients undergoing maintenance hemodialysis in the hemodialysis center during the COVID-19 epidemic.

BACKGROUND: The outbreak of novel coronavirus pneumonia has exerted considerable psychological pressure on patients undergoing hemodialysis, resulting in unhealthy psychological emotions. Therefore, it is of great significance to carry out strict management and refined nursing intervention for patients undergoing maintenance hemodialysis during the prevention and control of novel coronavirus. This study aims to analyze and discuss the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the coronavirus disease 2019 (COVID-19) epidemic. METHODS: This was a prospective cohort study. In this study, we used the Symptom Checklist-90 (SCL-90) or the Chinese adult SCL-90 norm to conduct nursing interventions for patients undergoing maintenance hemodialysis to investigate the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the COVID-19 epidemic. RESULTS: The scores for all the factors of SCL-90 of patients undergoing maintenance hemodialysis were higher than those of the Chinese SCL-90, and patients with a single factor score ≥ 2 had a higher level of depression and anxiety, with extremely significant difference (p < 0.01). The depression and anxiety of the patients were reduced after the intervention, and there was a statistical difference. Among the 172 patients, the results of both nucleic acid tests were negative. CONCLUSION: During the COVID-19 epidemic, providing patients undergoing maintenance hemodialysis with refined nursing intervention can regulate negative emotions, reduce related complications, improve their quality of life, and improve the nurse-patient relationship.

Nursing care for people with chronic diseases and pulmonary infection by coronavirus: An integrative review

Objective: To identify the implications, for Nursing, of pulmonary infections by coronavirus in people with chronic non-communicable diseases and to propose actions for care. Materials and method: A literature review, with a search for primary studies in the Biblioteca Regional Virtual de Saúde, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and Scopus databases, from March 15th to March 30th, 2020, in Portuguese, English, and Spanish, with a quantitative and qualitative approach, in adults with chronic non-communicable diseases with respiratory infection by viruses of the coronavirus family, from 2010 to 2020. Results: A total of 11 articles were analyzed, which made it possible to identify guidelines for Nursing actions at the community and hospital levels and in critical care;among the care actions proposed for people with chronic diseases are education in health, encouragement to control the disease, immunization and lifestyle change, monitoring of suspected and confirmed cases, and use of masks in public environments. Conclusions: The study highlights the role of Nursing at all health care levels and the possibilities for learning and improving care actions through the use of evidence obtained from previous experiences. © 2021, Universidad de La Sabana. All rights reserved.