Staff attitudes and perceptions towards the use of coercive measures in psychiatric patients.

The failure of efforts to significantly reduce the use of physical coercive measures (PCMs) in psychiatric hospitals remains a global concern. There is a gap in the understanding of staff's characteristics that may affect their attitudes and perceptions towards PCMs. This study used a cross-sectional design to examine the attitudes and perceptions of staff working at a mental health centre in Israel regarding the use of PCMs and to explore whether staff attitudes differed depending on their professional and demographic background. This study also sought to explore staff willingness to accept a policy of reducing the use of PCMs. The data were collected from 149 staff members (nurses, physicians, and auxiliary staff) working at mental health centre, using a questionnaire developed for this study. The findings indicate a low degree of support for use of PCMs among participants who were older, female, more qualified psychiatric nurses, with longer duration of employment, and those who have not participated in coercive intervention in the past year. The majority of the sample reported a low willingness to reduce the use of PCMs, and a lack of institutional support after participating in a coercive event. High hospital occupancy and insufficient staffing were perceived as contributing factors to coercive incidents. Therefore, availability of trained and experienced staff, elimination of organizational barriers, along with creating and maintaining a safe clinical environment should be a priority. Alternative non-coercive interventions should further be taught and used for managing aggressive and violent behaviour in the psychiatric clinical settings.

Attitudes, perceptions, self-efficacy and knowledge levels of Israeli nurses in relation to opioid misuse: A cross-sectional survey.

BACKGROUND: In an opioid epidemic that is imposing heavy health burdens on individuals, families and health systems, nurses are the main front-line caregivers in the battle against the unrelenting increase in opioid medication misuse. Yet, little research has been conducted on nurses' opinions and knowledge surrounding this issue worldwide and in Israel as well. OBJECTIVES: To evaluate Israeli nurses' attitudes, their knowledge about opioid use and misuse, their perception of institutional support, and their perception of their role and self-efficacy in preventing and treating opioid misuse. DESIGN: Cross-sectional study. METHODS: The data were collected through an electronic questionnaire from 414 Israeli registered nurses using the Qualtrics platform for on-line surveys. RESULTS: The majority of the sample perceived their role positively, held positive attitudes toward people with opioid addiction, and were willing to take care of persons who misused opioids. Nurses reported low scores on knowledge, perceived institutional support, and self-efficacy relating to the issues surrounding opioid pain medication use and misuse. CONCLUSIONS: The results clearly indicate a lack of up-to-date knowledge among nurses concerning opioids use. This situation must be urgently corrected through revisiting the subject of opioids across undergraduate, graduate, and continuing nursing education programs. Improved knowledge, combined with a supportive organizational culture, should strengthen nursing care provided to this frequently neglected patient population. CLINICAL RELEVANCE: Broad insight into nurses' attitudes, their level of knowledge about opioid use and misuse, and their perceptions of their own role in preventing and treating such misuse are essential for creating targeted, relevant educational interventions for nurses with the aim of providing safe and effective opioid treatment for individuals with pain.

Survey of risks and benefits communication strategies by research nurses.

BACKGROUND: An ethical, informed consent process requires that potential participants understand the study, their rights, and the risks and benefits. Yet, despite strategies to improve communication, many participants still lack understanding of potential risks and benefits. Investigating attitudes and practices of research nurses can identify ways to improve the informed consent process. RESEARCH QUESTION: What are the attitudes, practices, and preparedness of nurses involved in the informed consent process regarding communication of risks and benefits? RESEARCH DESIGN: A survey was developed and administered online to a national purposive sample of 107 research nurses with experience obtaining informed consent for clinical trials. Survey responses stratified by selected work-related characteristics were analyzed. ETHICAL CONSIDERATIONS: Participants were instructed they need not answer each question and could stop at any time. They consented by clicking "accept" on the email which linked to the survey. The study was approved by the Northeastern University Institutional Review Board, Boston, Massachusetts (NU-IRB Protocol #: 13-06-17). FINDINGS: Most research nurses (87%) used a teach-back method to assess participant comprehension, while 72% relied on their intuition. About one-third did not feel prepared to communicate related statistics. About 20% did not feel prepared to tailor information, and half did not feel competent using supplemental materials to enhance risks and benefits comprehension. Only 70% had received training in the informed consent process which included in-person training (84%), case studies (69%), online courses (57%), feedback during practice sessions (54%), and simulation, such as role playing (49%) and viewing videos (45%). Perceived preparedness was significantly associated with greater informed consent experience and training. CONCLUSION: Research nurses may have inadequate training to encourage, support, and reinforce communication of risks and benefits during the informed consent process. Relevant purposeful education and training should help to improve and standardize the ethical informed consent process.

Communicating Risks and Benefits in Informed Consent for Research: A Qualitative Study.

Multiple studies have documented major limitations in the informed consent process for the recruitment of clinical research participants. One challenging aspect of this process is successful communication of risks and benefits to potential research participants. This study explored the opinions and attitudes of informed consent experts about conveying risks and benefits to inform the development of a survey about the perspectives of research nurses who are responsible for obtaining informed consent for clinical trials. The major themes identified were strategies for risks and benefits communication, ensuring comprehension, and preparation for the role of the consent administrator. From the experts' perspective, inadequate education and training of the research staff responsible for informed consent process contribute to deficiencies in the informed consent process and risks and benefits communication. Inconsistencies in experts' opinions and critique of certain widely used communication practices require further consideration and additional research.

The association of positive and negative feedback with clinical performance, self-evaluation and practice contribution of nursing students.

BACKGROUND: Providing consistent and high-quality feedback is a crucial component of clinical instruction. Such feedback can improve the students' ability to reflect themselves more accurately. However, giving feedback, especially negative is intricate. OBJECTIVES: To evaluate the level of feedback provided to nursing students during clinical practice and investigate their association with related outcomes, such us clinical performance, self-evaluation of achievements and contribution of the practice to the professional skills. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: 124 third-year nursing students during their "Emergency Nursing" (EN) clinical practice were instructed, criticized and graded by three teachers from the university staff. METHODS: Following their clinical practice the students filled-out a questionnaire, in which they evaluated the feedback provided by their teachers, the contribution of the practice to their professional skills and their personal performance. Additionally, the teachers' grades of students' achievements were collected. Accuracy of students' self-evaluation was calculated as the arithmetical difference between the students' grades and the teachers' grades. RESULTS: The mean grades of positive and negative feedback were 74.5/100 and 70.7/100, respectively. Higher-quality positive feedback was associated with higher teachers' grade (p=0.027) and with "very high" evaluation of the contribution of the practice (p=0.022). Higher-quality positive feedback was associated with student's over-self-evaluation (p=0.02), whereas higher-quality negative feedback was associated with more accurate self-evaluation (p=0.015). CONCLUSIONS: High-quality positive feedback is associated with higher grades, higher contribution of the clinical practice to the student and over-self-evaluation whereas high-quality negative feedback is related to an accurate self evaluation of the students' performance. Teachers should pay more attention to administering high-quality positive and negative feedback.