Decolonizing nursing knowledge: Challenging Eurocentrism centering Global South voices.

BACKGROUND: Exploring decolonization in nursing knowledge, particularly through Latin American nursologists, is crucial. Initially focused on underrecognized thought schools in Latin America and the concept of "Cuidado" versus Eurocentric paradigms, this paper extends the discussion on decolonization as potentially colonizing. PURPOSE: This paper examines the decolonization discourse in nursing reinforcing colonization, arguing that the nursing metaparadigm remains Eurocentric, neglecting Global South contributions. METHODS: The article critically discusses emerging theoretical ideas and situational theories from Latin America relevant to decolonizing nursing knowledge, providing analysis and proposing decolonization paths in nursing. DISCUSSION: The paper calls for genuine decolonization, urging Global North scholars to engage with indigenous, marginalized, and non-Western perspectives. It stresses the importance of acknowledging historical injustices, fostering cultural sensitivity, and revising nursing curricula for inclusivity and equity. CONCLUSION: Ultimately, the paper advocates for a transformative approach to nursing knowledge that challenges colonial legacies, promoting a more inclusive and equitable field.

The CKD-DETECT V2.0 study: A randomised controlled trial evaluating the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' knowledge and learning efficiency about chronic kidney disease risk factors and best practice screening procedures.

AIMS AND OBJECTIVES: To evaluate: (a) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' knowledge about chronic kidney disease risk factors and best practice screening procedures and (b) the effectiveness of an infographic poster compared with an e-learning program on general practice nurses' learning time and learning efficiency. BACKGROUND: The screening and early detection of chronic kidney disease is essential in reducing its burden on the health system and those affected by it. General practice nurses are well-positioned to assist in its early detection. DESIGN: Parallel-group, single-blinded, pre-post interventional randomised control design. METHOD: This study was reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT). Participants were registered or enrolled nurses working in general practice settings across Australia. The intervention group (n = 173) received an infographic poster about chronic kidney disease risk factors and best practice screening procedures, whereas the control group (n = 170) received an interactive e-learning program. Data were collected using an 8-item pre-post knowledge evaluation instrument. Time spent learning were collected through a self-reported log and a login/logout method. RESULTS: The overall intervention effect demonstrated no statistical significance in knowledge scores from the baseline scores between the intervention and control group. The intervention group demonstrated higher learning efficiency in comparison to the control group. CONCLUSION: The study demonstrated an infographic poster is as effective as an e-learning program on improving knowledge scores. However, in comparison to an e-learning program, an infographic poster is a more efficient way of learning. RELEVANCE TO CLINICAL PRACTICE: Infographic posters can be an efficient educational modality to enhance healthcare professionals' knowledge and could be used as public health campaigns in clinical settings to educate the community.

Delirium Diagnosis, Complication Recognition, and Treatment Knowledge among Nurses in an Italian Local Hospital: A Cross-Sectional Study.

Delirium, a multifactorial condition with an acute onset and diverse clinical manifestations, poses a significant challenge in the care of hospitalized individuals aged 65 years and older. This study aimed to evaluate the level of knowledge among nursing healthcare personnel regarding the diagnosis, recognition of complications, and treatment of delirium. A paper questionnaire consisting of 18 multiple-choice questions was distributed to nurses in twelve operational units located in four facilities within a local hospital in a specific geographical region under the jurisdiction of the Romagna Local Health Authority in Italy. Out of 194 respondents, the overall acceptance rate was 64.2%. The findings revealed an insufficient understanding of delirium among the nursing staff, with more than 40% of respondents answering incorrectly to five out of nine questions related to delirium knowledge, diagnosis, prevention, and treatment. Notably, gender emerged as a significant determinant, with female participants exhibiting a substantial odds ratio (OR) of 3.50 (p = 0.011 and CI95% = 1.34-9.16) compared to their male counterparts, indicating a higher likelihood of receiving delirium training among females. Furthermore, prolonged tenure within the same work context was associated with a reduced likelihood of receiving delirium training compared to those with less than two years of experience (OR = 0.21, p = 0.034, and CI95% = 0.05-0.89 for 6-10 years of tenure; OR = 0.22, p = 0.038, and CI95% = 0.05-0.92 for over 10 years of tenure). This study underscores the urgent need for enhanced delirium education and improved strategies among nurses to effectively manage patients with delirium. The results advocate regular educational sessions utilizing diverse formats to comprehensively address knowledge gaps among nursing staff. This study was not registered.

Registered nurses' knowledge and practice of preoperative fasting and medication administration.

Background: Knowledge of fasting or Nil Per Os (NPO) guidelines is an essential component of nursing care in the preoperative period. Aim: To describe registered nurses' (RNs) knowledge and management of the preoperative NPO period. Setting: Selected surgical wards in a tertiary hospital in the Western Cape, South Africa. Methods: Quantitative descriptive, cross-sectional study utilising a structured questionnaire. The population consisted of RNs working in selected surgical wards. Convenience sampling was used and adequate knowledge was determined as ≥ 90%. Results: The response rate was 100%. Of the 68 participants, 48 (70.6%) held a diploma and 20 (29.4%) held a degree as the highest academic qualification achieved. Sixty-one (89.7%) participants knew the correct reason for keeping patients NPO. Sixty-five (95.6%) knew the correct answer for the NPO time for solids while only 27 (39.7%) knew the correct answer for clear fluids. Only 30 (44.1%), 26 (38.2%) and 33 (48.5%) participants, respectively, answered the questions about oral analgesia, oral antibiotics and chronic medication administration during the NPO period correctly. Significantly more degree participants knew the correct answer for the fasting time for non-human milk (p = 0.005) and more diploma participants would administer chronic medication during the NPO period (p = 0.037). Conclusion: Inadequate knowledge of NPO times for various fluids and unsatisfactory practice of medication administration for oral and chronic medication require attention. Contribution: This study highlights the importance that ongoing education is needed to ensure that patients receive the most up-to-date evidence-based care during the NPO period.

Evaluation of Malnutrition Knowledge among Nursing Staff in the Czech Republic: A Cross-Sectional Psychometric Study.

Construct: The Knowledge of Malnutrition - Geriatric 2.0' (KoM-G 2.0) instrument was designed to quantify nursing staff malnutrition knowledge in inpatient medical and rehabilitation care facilities, as well as home health care. It has been used to assess grasp of current clinical practice guidelines and proficiency in addressing issues related to malnutrition. It provides insight into familiarity with and capacity to tackle issues pertaining to malnutrition in clinical practice. Furthermore, it has been used assess the effectiveness of educational interventions aimed at improving nursing professionals knowledge and awareness of malnutrition. Background: The quality of nursing education affects malnutrition risk assessment, monitoring of food intake, and effectiveness of nutrition care. Improvements in malnutrition education require determining the current level of knowledge and benchmarking with other countries. In the Czech Republic, no nationwide assessment of nursing staff malnutrition knowledge has ever been conducted. Approach: The purpose of the study was to translate the KoM-G 2.0 instrument, gather initial validity evidence, and evaluate nursing staff knowledge of malnutrition in inpatient medical, rehabilitation care facilities, and home care in the Czech Republic. All inpatient healthcare facilities and home healthcare facilities in the Czech Republic were invited to participate. The Czech version of the internationally standardized KoM-G 2.0 (KoM-G 2.0 CZ) was used to assess nursing staff malnutrition knowledge between 3 February 2021 and 31 May 2021. A total of 728 nurses began the questionnaire, and 465 (63.9%) of respondents completed it and were included in the study. Data analyses examined instrument difficulty, discriminability, and reliability, as well as sources of variation in knowledge scores. Findings: The psychometric characteristics of the KoM-G 2.0 CZ instrument included the difficulty index Q (0.61), the discriminant index (ULI 0.29, RIT 0.38, upper-lower 30% 0.67), and Cronbach alpha (0.619). The overall mean of correct answers was 6.24 (SD 2.8). There was a significant impact of educational attainment and nutrition training on KoM-G 2.0 CZ scores. Conclusions: Our findings provide initial validity evidence that KoM-G 2.0 CZ is useful and appropriate for assessing malnutrition knowledge among Czech nursing staff. Our research identified gaps in knowledge and examples of good practice in understanding malnutrition that can be applied internationally. The knowledge of academic nurses was greater; therefore, we suggest they play a key role in nutritional care. We recommend continuous education to improve understanding of malnutrition in this setting.

Dialectical Pluralism for Nursing Knowledge Development.

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts. DP can help nurses appreciate the diversity of worldviews and recognize the importance of implicit worldviews to generate more practical nursing knowledge. DP as a philosophical approach can enable nurses to communicate between diverse worldviews, become tolerant of conflicting differences, and develop an array of nursing knowledge.

A New Nursing Aesthetic.

Conceptions of the art and aesthetics of nursing traditionally focus on the nurse and nursing practice. My purpose here is to propose a shift in thinking from this traditional focus that dominates the "art of nursing" literature, to consider a new nursing aesthetic that focuses on human beings proper: health as wellbecoming. I present a framework based on everyday aesthetics, feminist aesthetics, and Deweyan perspectives, along with attention to the nursing disciplinary perspective of health and well-being. I conclude with a look ahead to philosophical questions and scientific issues regarding theorizing and scientific inquiry about the health as wellbecoming aesthetic to advance nursing knowledge.

A Dialogue with Dr. Marilyn A. Ray: Nurse Scholar and USAF Veteran.

Dr. Marilyn A. Ray, nurse scholar and retired United States Air Force (USAF) veteran and former flight nurse, began her nursing scholarship in Canada. She was influenced by the experiences and interprofessional scholarly ideas that she encountered along her career trajectory. Her early love of the air and space led her to the United States Air Force Nurse Corps, where she served as a flight nurse during the Vietnam war era, followed by leadership positions in nursing education, administration, practice, and research. Dr. Ray's contributions to nursing knowledge includes two nursing theories and a caring inquiry methodology. Dr. Ray is helping to create a new caring science certificate program at Florida Atlantic University, Christine E. Lynn College of Nursing. In this column, Dr. Ray shares the story of her scholarly influences and how they helped her care for her husband and gain insight into her contributions to nursing knowledge development.

Intervention to improve acute care nurses confidence and knowledge in hospital dementia care.

PROBLEM: Acute care nurses are the front line of hospital care for persons with dementia (PwD), yet many have inadequate dementia education and lack the confidence to appropriately manage PwD in the hospital setting. IMPLEMENTATION: Two acute care units with high rates of PwD in a large tertiary-care hospital were provided an education intervention involving interactive case-based discussion of the challenges of inpatient dementia care. RESULTS: Out of 190 nurses, 171 completed a one-hour virtual educational session, 142 completed pre/post-session confidence surveys, and 123 completed pre/post-session knowledge tests. There was a statistically significant improvement in knowledge scores from 75.8% pre-session to 88.4% post-session (p < 0.001), and pre/post-session dementia care confidence increased from 3.49 to 4.44 ( + 27.22%; p < 0.001) CONCLUSION: An interactive virtual education intervention improves acute care nurses' confidence and knowledge in managing PwD in the acute care setting and may improve hospital outcomes for this population.

A meta-analysis of the impact of the problem-based method of learning combined with mind mapping on nursing instruction.

BACKGROUND: Nowadays, there are a variety of viewpoints on problem-based learning (PBL) and mind mapping teaching outcomes in nursing education, but there are not many thorough assessments that are pertinent. OBJECTIVES: We performed a meta-analysis to evaluate the effect of the PBL method combined with mind mapping on nursing instruction. MATERIAL AND METHODS: A systematic literature search up to July 2022 was performed, and 1765 related studies were evaluated. The chosen studies comprised 1473 nursing teaching participants as the trial's baseline, with 770 of them using the PBL model with mind mapping and 703 enrolled as controls. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (95% CIs) were calculated to assess the effect of the PBL method combined with mind mapping on nursing instructions using dichotomous and continuous methods with a random or fixed effect model. The study protocol was registered in PROSPERO (registration No. CRD 42022432130). RESULTS: The PBL model with mind mapping reached a significantly higher results of nursing knowledge test (MD: 7.29, 95% CI: 6.88-7.71, p < 0.001) and pediatric practice test (MD: 9.89, 95% CI: 9.04-10.74, p < 0.001), as well as higher students' ability of independent learning (OR: 3.49, 95% CI: 2.11-5.76, p < 0.001) compared to the controls in nursing teaching. CONCLUSION: The PBL model with mind mapping resulted in a significantly higher results of nursing knowledge test, pediatric practice test and students' ability of independent learning compared to controls in nursing teaching.

A response to Michael Clinton's On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science.

My purpose in this short response to Clinton's interesting article On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science, which is published in this issue, is not to provide any counterargument to Clinton's interpretation of my own argument; readers are welcome to interrogate both articles at their leisure and make their own conclusions. What I will do instead is provide a brief critical assessment of my own (il)logic re bringing in the notion of mechanism as conceived by Machamer, Darden and Craver into an argument for models versus theories as a carrier of nursing knowledge.

Nurses' knowledge and attitudes regarding children's pain assessment and management in Nepal.

Pain is frequently experienced by children in hospital, and international guidelines for appropriate pain assessment and management are available. Optimal management of paediatric pain has important long-term health, psychosocial, and economic benefits. However, evidence indicates that globally there are deficits in nurses' understanding of paediatric pain assessment and management. This study explored knowledge and attitudes regarding paediatric pain assessment and management among nurses at a tertiary children's hospital in Nepal. In this cross-sectional study all 140 nurses at a tertiary children's hospital in Nepal, were invited to complete the validated Paediatric Nurses Knowledge and Attitudes Survey. Findings revealed substantial deficits in nurse's knowledge and erroneous attitudes towards pain assessment and management in children. Test scores ranged from 14% to 56%, with mean scores of 38%, with no nurses achieving a recommended pass score of 80% regarding knowledge and attitudes in paediatric pain management. Consistent with previous research, nurses had insufficient knowledge and attitudes that did not reflect best practice regarding pain assessment and management in children. Education programmes targeting both trainees and registered nurses are essential to enable nurses to deliver evidence-based care and improve outcomes for children and their families.

Nursing students' perception of nursing knowledge: A qualitative study.

AIM: To explore nursing students' perception of nursing knowledge. DESIGN: Qualitative interview study. METHODS: Semistructured individual interviews with nine nursing students in their third year were conducted via a cloud-based video communication app. Transcriptions were analysed based on Braun and Clarke's thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist for qualitative research was used. RESULTS: The findings show that the participants emphasised that values are the prerequisites of and basis for performing professional nursing. The students found it difficult to define nursing knowledge and to distinguish nursing knowledge from other subjects. The thematic analysis resulted in two themes: values-a prerequisite of nursing knowledge, and nursing knowledge-an umbrella of knowledge. CONCLUSION: Nursing knowledge seems to be difficult both to clarify and to demarcate for the students. However, the participants considered values to be important and vital to becoming a professional nurse. IMPLICATIONS FOR THE PROFESSION: This study addresses students' perceptions of values, nursing knowledge and what it consists of, and how this is experienced. An understanding of the nursing students' perceptions of what they consider to be important values and how they understand nursing knowledge is important in making the profession clearer and more distinguishable. IMPACT: The impact of this study means that nurse education needs to emphasise a more argumentative and visible education where nursing knowledge and values are more prominent than today. REPORTING METHOD: COREQ. PUBLIC CONTRIBUTION: No patient or public contribution.

Construction of nursing knowledge in commodified contexts: Views and experiences of nurses regarding primary care.

The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed-methods study was conducted that included a closed-question survey and in-depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in-depth interviews. The main findings of the survey were related to workload and limited time for nursing care. Six themes emerged from the in-depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing.

"Their tenacity to just keep going": Nurses' experiences in medical hotel quarantine during the COVID-19 pandemic.

AIM: To explore how nurses and nursing knowledge contributed to the success of an Australian nurse-led medical hotel quarantine facility during the COVID-19 pandemic. The facility was established to accommodate returning travellers who were COVID-19 positive or at risk of becoming positive, to travellers requiring complex care and expanded to community members who could not quarantine at home. DESIGN: This descriptive qualitative study explored how nurses and nursing knowledge in the quarantine facility contributed to the low transmission incidence of COVID-19 infection. METHOD: Twelve semi-structured interviews were conducted via ZOOM from February to May 2022 with all levels of nursing staff (nurse managers to assistants in nursing) who had worked in the facility for 3 months or more. The nurses were asked to describe their experiences, the challenges they faced and how they overcame them. The data were rich and were analysed using Braun and Clarke's six-step thematic analysis. RESULTS: Four broad themes were generated demonstrating how nurses played a pivotal role in the success of the facility. First: nursing knowledge was evident through the development of policies, which minimized risks to nurses and patients. Second: a community of learning was developed as nurses supported upskilling and capacity building of staff, particularly new graduates with the facility. Third: a supportive management structure promoted teamwork and a positive workplace culture. And finally: the nurses were encouraged to develop techniques that promoted self-care which enabled them to develop resilience. CONCLUSION: This was a nurse-led service that developed strategies to manage care delivery and overcame unanticipated difficulties in a unique clinical setting. REPORTING METHOD: The quality of the research design was ensured by using the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

What constitutes philosophical activity in nursing? Toward a definition of nursing philosophy based on an interpretive synthesis of the recent literature.

Nursing claims a significant history of engaging philosophical inquiry. To better understand the rationale for this engagement, and what nursing understands itself to achieve through philosophical inquiry, we conducted an interpretive synthesis of the recent nursing literature to identify what nurses are doing when they say they are doing philosophy. The overarching finding was that while vanishingly few articles articulated any definition of philosophy, the synthesis showed how nursing considers philosophical engagement a generative mode for asking and answering questions in/for nursing. Whatever aspects of nursing were focused on in these articles, and they were myriad, philosophy was invoked as an appropriate modality to work through that aspect rigorously, critically, and with an expectation that something "knowledgeable" would result from the effort. Based on the synthesis, we conclude that nursing philosophy could be considered a specific modality of nursing practice by which nursing is both done and delineated, a discursive practice in which we continually assess and explore and adapt and advance our understanding of the discipline in service to advancing our unique efficacy. This definition of "nursing philosophy" provides an opening for further inquiry helping to illuminate its functionalities and potentialities for outputs that can facilitate rigorous practice, education, and scholarship.

[Holism at the heart of nursing knowledge: a proposed model for teaching it in nursing]. / L'holisme au cœur du savoir infirmier : proposition d'un modèle pour l'enseigner en sciences infirmières.

The concept of holism remains difficult to grasp and to teach because of its polysemous nature. In the current reflections on the construction of nursing curricula, it seems necessary to propose some reference points in the meaning given to this widely used but little conceptualized notion. Nursing shares a unique and holistic view of patients, yet nursing education, rooted in the substance of nursing, remains undefined. Drawing on the work of English-language theorist Hesook Suzie Kim, this article explains part of her model of nursing practice analysis. This model is composed of four distinct domains that address the need to identify the holistic dimension of nursing knowledge to be taught.

Breaking the chains: Decolonizing the language of Nursology.

In this article, I discuss the concept of 'Decolonizing Nursing', answering what this process is about, and how and when it should be done. I introduce the idea of epistemological dominance and the concepts of colonization and decolonization of nursing knowledge. I describe my experiences of coming from Latin America and facing Anglo-Saxon academy to discuss core disciplinary nursing knowledge and provide reflections around the decolonization of nursing language.

En este artículo discuto el concepto de "La descolonización de enfermería", respondiendo qué es este proceso, cómo y cuándo debe ser llevado a cabo. Introduzco la idea de dominación epistemológica y los conceptos de colonización y descolonización del conocimiento de enfermería. Describo mis experiencias al venir de América Latina y enfrentarme a la academia anglosajona para discutir el conocimiento disciplinar de la enfermería y proporciono reflexiones en torno a la descolonización del lenguaje de enfermería.

Neste artigo discuto o conceito de "A descolonização da enfermagem", respondendo que é este processo, como e quando deve ser levado a cabo. Introduzo a ideia de domínio epistemológico e os conceitos de colonização e descolonização do conhecimentos na enfermagem. Descrevo as minhas experiências desde minha origem na América Latina e me confrontar com a academia anglo-saxónica para discutir conhecimentos disciplinares de enfermagem e forneço reflexões sobre a descolonização da língua de enfermagem.

A reflection on the decolonization discourse in nursing.

Colonialism, in its many forms and stages is often imposed as being central to the narratives of colonizedpeople and their cultures, as well as the genesis of their knowledge. In colonial discourse, lands and the occupants of these lands were 'discovered', further implying that colonized people did not have their own ways of knowing (nor even existence) before colonization. This narrative has been embedded within Euro-American fields of study, including nursing, in which caring and healing practices that exist outside of a colonial lens are dismissed and complicity with colonialism is downplayed or sanitized. This paper is a reflection on the current discourse on decolonizing nursing shaped by postcolonial, critical and Black feminist philosophies. After examining the decolonization discourse in nursing, I argue that current calls to decolonize nursing lack a clear description of the goals and process of doing so, making it unfeasible to hold those in the process of decolonizing accountable. In addition, the lack of intentionality in reckoning with past and current forms of colonialism embedded in nursing hinders the ability to engage with lessons that could shape the future. I conclude this discourse by discussing practical steps toward centrering diverse ways of knowing, and ensuring this process prioritizes communities and nurse scholars who have historically been silenced.

Revisiting the nursing metaparadigm: Acknowledging technology as foundational to progressing nursing knowledge.

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and the environment, all of which support theory development by giving direction to our focus as a scientific body. Nursing scientists make their mark in biotechnological applications, mobile health, informatics, and human factors research. We give voice to the patient through design feedback and incorporating technological advancements in our evolving nursing knowledge; however, we have not formally acknowledged technology in our metaparadigm. To continue patient-centered care in this age where machines are enmeshed in daily human life, we propose technology must be a domain of the metaparadigm to continue advancing nursing science and knowledge. In this paper, we propose a separate domain of technology within the metaparadigm to challenge nurses to consider approaches within their research and practice of how technology will impact patient care and their personal development within the profession. A technology-specific domain within the metaparadigm also is a signal to other bodies of science of our willingness and ability to run at pace with novel, exciting new discoveries while adding our perspective. Nurses may become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation. Emerging and continuing nurse leadership has set the stage for the next era of nurse-led innovation and technology development, which provides an opportunity to embed technology as a core aspect of the nursing metaparadigm.