Effects of psychological intervention and relevant influence factors on pregnant women undergoing interventional prenatal diagnosis.

BACKGROUND: This study aims to explore the effects of psychological intervention on eliminating anxiety and fear in pregnant women caused by interventional prenatal diagnosis, and the success rate of surgery. METHODS: A total of 100 pregnant women who scheduled for interventional prenatal diagnosis were included in this study, and were randomly divided into two groups: control group and intervention group. Women in the control group were given routine nursing care, and women in the intervention group were given psychological intervention in different stages of the operation. Psychological status were assessed by the symptom checklist-90 (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and visual analogue scale (VAS). Furthermore, the success rate of surgery and the incidence of postoperative complications were tracked. RESULTS: Compared with the control group, the SCL-90 test scores of pregnant women in the intervention group were significantly lower in the following five factors: somatization, interpersonal sensitivity, depression, anxiety, and fear (p < 0.05). Furthermore, postoperative SAS, SDS, and VAS scores in the intervention group were significantly lower than in the control group; and the differences were statistically significant (p < 0.01). CONCLUSION: Before pregnant women undergo interventional prenatal diagnosis, nurses should understand their psychological status and give psychological guidance in time, calm their anxiety, tension and fear, and help them build confidence to weather the pregnancy stages before and after the operation. This would improve the success rate of puncture and reduce the incidence of complications.

Application of fast-track surgery in the perioperative period of laparoscopic partial nephrectomy for renal tumors.

OBJECTIVES: This study aimed to examine application of fast-track surgery (FTS) in the perioperative period of laparoscopic partial nephrectomy for renal tumors, and to discuss its effects and safety. METHODS: Eighty patients who received laparoscopic partial nephrectomy in urinary surgery from January 2016 to December 2017 were selected and randomly classified as the observation group (n = 40) and control group (n = 40). Traditional treatments were performed in the control group, while FTS was applied in the observation group. The complication rate after the operation was recorded. RESULTS: The duration of the operation and intraoperative blood loss were not different between the groups. The duration of anesthesia and fluid transfusion volume on the day of the operation were significantly less in the observation group than in the control group. The rates of infection of the incisional wound, nausea and vomiting, and anastomotic stomal bleeding were not significantly different between the groups. However, the rates of postoperative urinary tract infection, abdominal distension, thirst, hypothermia, and pulmonary infection were significantly lower in the observation group than in the control group. CONCLUSION: Application of FTS in laparoscopic partial nephrectomy contributes to postoperative recovery and reduction of postoperative complications.

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

AIMS AND OBJECTIVES: To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. BACKGROUND: Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. DESIGN: Secondary data analysis. METHODS: A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. RESULTS: During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. CONCLUSIONS: The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. RELEVANCE TO CLINICAL PRACTICE: This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations.

Examining the effects of an interprofessional crew resource management training intervention on perceptions of patient safety.

This article reports the results from a study that employed an interprofessional crew resource management (CRM) education programme in the emergency and critical care departments. The study aimed to investigate the effectiveness of this intervention of participants' satisfaction and safety attitude changes using a satisfaction questionnaire and the Human Factors Attitude Survey (HFAS). Overall, participants responded positively to the CRM training-93.4% were satisfied, 93.1% agreed that it enhanced patient safety and care quality, 85.7% agreed that it increased their confidence, 86.4% agreed that it reduced practice errors, and 90.8% agreed that it would change their behaviours. Overall, the participants reported positive changes in their attitudes regarding 22 of the 23 HFAS questions.

Development of a situational initiation training program for preceptors to retain new graduate nurses: Process and initial outcomes.

BACKGROUND: Most preceptor training programs consist of classroom-based courses, and only a few programs are conducted using films. Preceptors have identified most training courses as inapplicable in various clinical situations. OBJECTIVES: To describe the systematic development of a situational initiation training program (SITP) for preceptors and to evaluate its impacts on the stress levels of preceptors and new graduate nurses (NGNs), the preceptor-NGN relationship, support provided by preceptors to NGNs, and the intention to leave among NGNs during a 1-year preceptorship. DESIGN: The conceptual framework of development, implementation, and evaluation was used for program completion. PARTICIPANTS AND SETTINGS: Preceptors and NGNs working at a teaching medical center in Taipei participated. METHODS: The 1-day SITP workshop comprised four films, reflection time, and four classroom-based courses. Training outcomes were evaluated using a questionnaire survey for preceptors and NGNs at months 3, 6, 9, and 12 after employing the NGNs. Data were analyzed using descriptive statistics and analysis of variance with repeated measures. RESULTS: The annual turnover rate of NGNs was 10.5%. During the first preceptorship year, the NGNs reported moderate stress levels, good to excellent relationships with their preceptors, moderate to excellent support from their preceptors, and low intention to leave their current jobs. Similarly, preceptors reported moderate stress levels, except at month 12 (mean=4.8), and good to excellent relationships with their NGNs. The SITP considerably improved the preceptor-NGN relationship for both NGNs and preceptors, whereas no improvement was observed in the stress levels, except in the stress levels of preceptors. CONCLUSIONS: The SITP is clinically effective for preceptors; thus, nurse educators may apply the SITP for redesigning the existing preceptor training programs to develop highly skilled preceptors and improve training outcomes.

Perceptions and experiences of nurse preceptors regarding their training courses: a mixed method study.

BACKGROUND: Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited. OBJECTIVES: To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors. DESIGN: A mixed method design was conducted. PARTICIPANTS AND SETTINGS: Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study. METHODS: A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach. RESULTS: The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources. CONCLUSIONS: The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results.

Comparisons of self-ratings on managerial competencies, research capability, time management, executive power, workload and work stress among nurse administrators.

AIMS: To assess the level of and the differences in managerial competencies, research capability, time management, executive power, workload and work-stress ratings among nurse administrators (NAs), and to determine the best predictors of managerial competencies for NAs. BACKGROUND: Although NAs require multifaceted managerial competencies, research related to NAs' managerial competencies is limited. METHOD: A cross-sectional survey was conducted with 330 NAs from 16 acute care hospitals. Managerial competencies were determined through a self-developed questionnaire. Data were collected in 2011. RESULTS: All NAs gave themselves the highest rating on integrity and the lowest on both financial/budgeting and business acumen. All scores for managerial competencies, research capability, time management and executive power showed a statistically significant correlation. The stepwise regression analysis revealed that age; having received NA training; having completed a nursing project independently; and scores for research capability, executive power and workload could explain 63.2% of the total variance in managerial competencies. CONCLUSION: The present study provides recommendations for future administrative training programmes to increase NAs' managerial competency in fulfilling their management roles and functions. IMPLICATIONS FOR NURSING MANAGEMENT: The findings inform leaders of hospitals where NAs need to develop additional competencies concerning the type of training NAs need to function proficiently.

Comparison of family partnership intervention care vs. conventional care in adult patients with poorly controlled type 2 diabetes in a community hospital: a randomized controlled trial.

BACKGROUND: Although there is a significant correlation between the degree of family support and clinical outcome, little research has focused on the effectiveness of family partnership intervention care (FPIC) for patients with poorly controlled type 2 diabetes. OBJECTIVES: This study aimed to compare FPIC with conventional care (CC) across a number of outcome measures in patients with poorly controlled type 2 diabetes. DESIGN: The study was performed using a randomized controlled trial design. PARTICIPANTS: Patients with poorly controlled type 2 diabetes who were solely treated with oral antidiabetic agents and had at least two out of three hemoglobin A1C readings equal to or above 7% in the previous 12 months, were randomly assigned to the FPIC group (n=28) and to the CC group (n=28). METHODS: Baseline and 6-month follow-up scores were compared using the following outcome measures: (1) hemoglobin A1C, (2) BMI, (3) lipid profile, (4) family supportive behaviours, (5), knowledge of and attitudes toward diabetes, and (6) diabetes self-care behaviours. Descriptive and non-parametric statistics were employed to compare differences in outcome measures between the groups. RESULTS: There were no significant differences in the reduction of hemoglobin A1C levels (p=0.46), lipid profile values (p>0.05), and improvement of diabetes self-care behaviours (p=0.61) between the groups at 6 months post-intervention. However, there were significant differences in the scores of family supportive behaviours (p=0.031) and patients' knowledge of and attitudes toward diabetes between the groups (p<0.05). CONCLUSION: These findings support the use of FPIC to enhance family supportive behaviours, and to improve patients' knowledge of and attitudes toward diabetes. Thus, the study is of value in helping policy decision-makers to develop more effective diabetes control intervention programmes.

[Project to improve perinatal care effectiveness in Vietnamese women].

The number of new immigrant female spouses, particularly from Vietnam, continues to increase steadily in Taiwan. However, these women are nearly all young and become pregnant early, while still in an immature psychosomatic status. Furthermore, various life adaptations are stacked against their maintaining good personal health or providing good healthcare to their babies. Therefore, the aim of this project was to understand the problems faced by Vietnamese women during the perinatal period in order to improve care effectiveness. Following data analysis, problems identified included lack of completeness of perinatal care processes, a dearth of education tools in the Vietnamese language and poor communications, which resulted in poor nursing education outcomes and a low 1.64-point satisfaction with nursing service (total = 4 points). After (1) revising perinatal care processes, (2) producing Vietnamese communication cards, nursing education pamphlets, CD of notices during pregnancy, and video-CDs for baby bathing and breast feeding skills, and (3) holding mother classes in cooperation with health stations, perinatal checkups during pregnancy increased from 26% to 83.9%; proper practice of Lamaze during labor rose from 43% to 80.6%; accurately performed postnatal uterus massage increased from 46% to 90.3%; use of proper baby bathing techniques rose from 39% to 77.4%; proper breastfeeding increased from 57% to 100% and satisfaction with nursing services increased to 3.78 points. These improvements achieved project aims. This project not only improved the effectiveness of perinatal care for Vietnamese women, but also improved their satisfaction with nursing services.