The Predictors of Perceived Barriers and Facilitators of Applying Sepsis Six Guidelines Among Critical Care Nurses.

BACKGROUND: Sepsis is a life-threatening condition that demands quick and cautious interventions from nurses, as they are the frontline caregivers, so they are essential in recognizing early signs of sepsis, initiating prompt healthcare interventions, and providing comprehensive care to improve patient outcomes. This study aimed to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses. METHODS: This cross-sectional descriptive study was conducted on a convenience sample of 180 nurses working in critical care settings (ICU, critical care unit, ED, burning unit, dialysis unit) at a university hospital. A valid and reliable questionnaire was used to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses. RESULTS: This study revealed that the main barriers faced by critical care nurses are lack of sepsis recognition during observational rounds and delay in sepsis diagnosis by medical staff. For the most common facilitators of applying Sepsis Six guidelines, the participating nurses reported the presence of a written tool/protocol for sepsis identification and management. CONCLUSIONS: The study emphasized the importance of the presence of evidence-based protocols for sepsis assessment and management and nurses' compliance with guidelines. Ongoing education training for nurses and providing step-by-step written checklists are a cornerstone to improving nurses' knowledge and the practical skills of early identification and management of sepsis.

The association of traditional obesity parameters with the length of stay among patients with coronary artery disease: A cross-sectional study.

There is a strong association between obesity and coronary artery disease (CAD). Obesity is measured using traditional obesity parameters, such as body mass index, body adiposity index, waist circumference (WC), and hip circumference. The aim of this study is to explore the association between traditional obesity parameters and the length of stay (LOS) among hospitalized CAD patients. An original correlative descriptive study was carried out using secondary data analysis, in which 220 hospitalized Jordanian CAD patients were recruited from Jordan northern and middle regions. Age, WC, triglycerides, and high- sensitivity C-reactive protein were all positive predictors of the total hospital LOS among hospitalized patients with CAD. The WC, age, triglycerides, and high-sensitivity C-reactive protein levels were significantly positively associated with total LOS. Healthcare providers, including nurses, should take into account these significant positive predictors of LOS to achieve better health outcomes and improve patient satisfaction.

Sepsis assessment and management in critically Ill adults: A systematic review.

BACKGROUND: Early assessment and management of patients with sepsis can significantly reduce its high mortality rates and improve patient outcomes and quality of life. OBJECTIVES: The purposes of this review are to: (1) explore nurses' knowledge, attitude, practice, and perceived barriers and facilitators related to early recognition and management of sepsis, (2) explore different interventions directed at nurses to improve sepsis management. METHODS: A systematic review method according to the PRISMA guidelines was used. An electronic search was conducted in March 2021 on several databases using combinations of keywords. Two researchers independently selected and screened the articles according to the eligibility criteria. RESULTS: Nurses reported an adequate of knowledge in certain areas of sepsis assessment and management in critically ill adult patients. Also, nurses' attitudes toward sepsis assessment and management were positive in general, but they reported some misconceptions regarding antibiotic use for patients with sepsis, and that sepsis was inevitable for critically ill adult patients. Furthermore, nurses reported they either were not well-prepared or confident enough to effectively recognize and promptly manage sepsis. Also, there are different kinds of nurses' perceived barriers and facilitators related to sepsis assessment and management: nurse, patient, physician, and system-related. There are different interventions directed at nurses to help in improving nurses' knowledge, attitudes, and practice of sepsis assessment and management. These interventions include education sessions, simulation, decision support or screening tools for sepsis, and evidence-based treatment protocols/guidelines. DISCUSSION: Our findings could help hospital managers in developing continuous education and staff development training programs on assessing and managing sepsis in critical care patients. CONCLUSION: Nurses have poor to good knowledge, practices, and attitudes toward sepsis as well as report many barriers related to sepsis management in adult critically ill patients. Despite all education interventions, no study has collectively targeted critical care nurses' knowledge, attitudes, and practice of sepsis management.

Nurses' Death Anxiety and Ageism towards Older Adults Amid the COVID-19 Pandemic: The Moderating Role of Symbolic Immortality.

The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of individuals' lives and behaviors, including the behaviors of nurses. Specifically, the pandemic has impacted the way that nurses treat older adults and has led to the spread of ageism among nurses. This study was conducted using self-report tools on 163 nurses to examine the problem of ageism amid the COVID-19 pandemic. The results suggest that critical care nurses have higher levels of death anxiety and ageism in comparison to medical/surgical nurses. After controlling for the work department, low levels of symbolic immortality were associated with high levels of ageism and death anxiety among nurses. These results might provide an insight into the development of a psychological intervention to reduce nurses' death anxiety and ageism toward older adults.

Demographic Data Differences in Perceived Control over Nursing Practice among Nurses Caring for Nursing Home Residents.

INTRODUCTION: Control over nursing practice is crucial for improved quality of life for nursing home (NH) residents. Nevertheless, little is known about the association of nurses' demographic data with their perceived control over nursing practice in Jordan and beyond. Therefore, this study aimed at examining the differences in nurses' levels of perceived control over nursing practice based on their demographic characteristics. METHODS: This descriptive-correlational study was conducted on a convenience sample of 163 nurses caring for NH residents. Nurses' perceived control over nursing practice was measured by the Control Over Nursing Practice (CONP) scale. RESULTS: The participating nurses were found to have low levels of perceived control over nursing practice which varied between the nurse groups according to gender, level of experience, and type of NHs. DISCUSSION/CONCLUSION: This study is the first quantitative study to examine association between nurses' demographic characteristics, such as age or years of nursing experience, and their perceived control over nursing practice. Despite the preliminary findings of this study, the findings of this study provide a better understanding of the impact of nurses' sociodemographic and professional characteristics on their levels of perceived control over nursing practice.

The effectiveness of branching simulations in improving nurses' knowledge, attitudes, practice, and decision-making related to sepsis assessment and management.

BACKGROUND: Nurses have a key role in the early assessment and management of sepsis, which is crucial for optimal quality of care and better patient outcomes. However, sepsis in critical care patients is underrecognized and untreated due to nurses' poor knowledge, attitudes, practice, and decision-making skills related to sepsis assessment and management. OBJECTIVES: This study aimed to test the effectiveness of branching simulations in improving nurses' knowledge, attitudes, practices, and decision-making related to sepsis assessment and management. METHODS: This experimental study was conducted on a convenience sample of 70 nurses (35 nurses in each of the intervention and control groups) with at least one year of experience working in an emergency room at a university hospital. The nurses' knowledge, attitudes, and practices were measured using a knowledge, attitudes, and practices survey, whilst their decision-making modes were assessed using the Nursing Decision-Making Instrument. RESULTS: Compared to the control group, a significant improvement in practices (F (1, 68) = 10.77, p = 0.002, η2 = 0.137) and decision-making (F (1, 68) = 10.68, p = 0.002, η2 = 0.136) was observed among the nurses in the intervention group both immediately and two weeks post the branching simulations intervention. Compared to the baseline data, a significant improvement in knowledge (F (2, 136) = 27.93, p < 0.001, η2 = 0.291), practices (F (2, 136) = 41.00, p < 0.001, η2 = 0.376), and decision-making modes (F (2, 136) = 29.15, p < 0.001, η2 = 0.300) was observed both immediately and two weeks post branching simulations only among the nurses in the intervention group. CONCLUSIONS: Education programs integrated with an interactive strategy of learning (branching simulations) can improve nurses' knowledge, attitude, practice, and decision-making related to sepsis assessment and management. Therefore, continuous education and professional training programs following an evidence-based intervention protocol/guideline are recommended for better nurse and patient outcomes.