Best evidence summary of sleep protection in premature infants in the neonatal intensive care unit: a narrative review.

Background and Objective: Sleep influences the interaction between infants and their environment, as well as the achievement of crucial milestones in motor and language development. This is particularly significant for preterm infants in vulnerable positions. However, prematurely born infants in the neonatal intensive care unit (NICU) are exposed to various stimuli such as noise and light, which disrupt their normal sleep patterns. This study assesses and consolidates the existing evidence on non-pharmacological strategies for protecting and promoting sleep in preterm infants. By providing an evidence-based data repository, it offers a valuable reference for clinical interventions. Methods: We conducted computer-based searches using various databases and resources, including UpToDate, BMJ Best Practice, Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), Joanna Briggs Institute (JBI), World Health Organization (WHO), Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data, and China Biology Medicine disc (CBM). The search period spanned from January 2014 to May 2024. Key Content and Findings: We have included a total of 22 articles in our review, comprising two guidelines, 11 systematic reviews, 1 evidence summary, 1 technical report, 2 practice recommendations, and 5 randomized controlled trials. The evidence was synthesized from eight domains: sleep team construction, risk factor assessment, sleep assessment tools, positional management, noise control, light management, sensory stimulation, and hospital-home transition sleep management, resulting in 27 pieces of evidence. Conclusions: This study summarizes the optimal evidence for the management of sleep in premature infants, providing empirical support for standardizing the management of sleep in premature infants. It is recommended that healthcare professionals judiciously apply the best evidence while considering the clinical context, thus promoting safe sleep for premature infants.

Impact of Evidence-Based Nursing on Self-Efficacy, Quality of Life and Treatment Compliance in Patients Undergoing Urological Surgery: Retrospective Study.

BACKGROUND: Urological surgery presents unique challenges to patients, necessitating specialised aftercare nursing. Evidence-based nursing has emerged as a strategy to improve patient outcomes through tailored education, self-management strategies and psychological support. However, its specific impact on post-operative outcomes in patients undergoing urological surgery has not been extensively explored. METHODS: This study assessed postoperative self-efficacy, quality of life, treatment compliance and nursing satisfaction. Self-compiled percentage of satisfaction scale was used to assess the degree of satisfaction with nursing work in both groups. Patients' self-care ability was evaluated using the Self-Care Ability Scale, and their quality of life scores were assessed with Short Form 36 Health Survey (SF-36). Patients' anxiety and depression levels were examined using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Statistical analysis was conducted using SPSS 29.0 statistical software. RESULTS: This retrospective study analysed 231 patients undergoing urological surgery and categorised them into a usual care group (n = 99) and an evidence-based nursing group (n = 132). Post-operative outcomes in the evidence-based nursing group included significantly higher self-care abilities (p < 0.001), improved quality of life scores (p < 0.001), lower anxiety and depression levels (p < 0.001) and higher treatment compliance rates (p < 0.05) compared with the usual care group. Additionally, nursing satisfaction was higher in the evidence-based nursing group (p = 0.001). CONCLUSIONS: The findings provide compelling evidence regarding the favourable impact of evidence-based nursing on various post-operative outcomes in patients undergoing urological surgery. Evidence-based nursing shows promise in enhancing patients' self-efficacy, well-being, treatment compliance and satisfaction. The results underscore the potential benefits of evidence-based nursing in optimising aftercare nursing and driving positive patient-centred outcomes in urological surgery setting.

What is needed for nurses to work with evidence-based practice? A qualitative study.

BACKGROUND: Transformation of healthcare is necessary to ensure patients receive high-quality care. Working with the evidence-based practice (EBP) principles enables nurses to make this shift. Although working according to these principles is becoming more common, nurses base their actions too much on traditions and intuition. Therefore, to promote EBP in nursing practice and improve related education, more insight into nurses' needs is necessary to overcome existing EBP barriers. OBJECTIVE: To identify the current needs to work with EBP principles among hospital and community care nurses and student nurses. DESIGN: A qualitative, exploratory approach with focus group discussions. METHODS: Data was collected between February and December 2020 through 5 focus group discussions with 25 nurses and student nurses from a hospital, a community care organisation, and nursing education schools (bachelor and vocational). Data were analysed using reflexive thematic analysis, and the main themes were synchronised to the seven domains from the Tailored Implementation for Chronic Diseases (TICD) checklist. RESULTS: Nurses and student nurses experience EBP as complex and require more EBP knowledge and reliable, ready-to-use evidence. They wanted to be facilitated in access to evidence, the opportunity to share insights with colleagues and more time to work on EBP. The fulfilment of these needs serves to enhance motivation to engage with evidence-based practice (EBP), facilitate personal development, and empower nurses and student nurses to take more leadership in working according to EBP principles and improve healthcare delivery. CONCLUSION: Nurses experience difficulties applying EBP principles and need support with their implementation. Nurses' and student nurses' needs include obtaining more EBP knowledge and access to tailored and ready-to-use information. They also indicated the need for role models, autonomy, incentives, dedicated time, and incorporation of EBP in daily work practice.

Developing evidence-based medication therapy management tools for psychiatric nurses: An evaluative qualitative case study.

RATIONALE, AIMS AND OBJECTIVES: Clinical use of psychotropic medications involves diverse risks, addressable by nursing interventions. The research had a dual purpose: developing an "Evidence-Based Medication Therapy Management Guideline" and a "Medication Administration-Tracking Chart" and evaluating their use through an evaluative case study. METHODS: Evidence-based guideline and chart development and evaluative case study. Initially, Evidence-Based Medication Therapy Management Guideline and Medication Administration Tracking Chart for managing medication in a psychiatric unit were developed. Subsequently, their efficacy was evaluated in a case study involving 10 participating nurses used in the psychiatric unit with 123-bed of a training and research hospital in Turkey. Data was collected through personal forms, interviews, medication charts, and researcher observations, and the analysis employed Merriam's case study method. RESULTS: Three themes (inception, implementation, termination, and sustainers) and 12 sub-themes emerged. Nurses stated that the research tools filled their information gaps, enhancing the medication therapy management process's effectiveness and safety, improving nursing care quality and continuity, and benefiting patient outcomes. Nurses expressed a desire to consistently use the tools in the unit and provided suggestions. CONCLUSION: Nurses highlighted the tools' potential to enhance medication safety, psychiatric care, and patient outcomes. However, their stance on using evidence-based tools revealed an approach/avoidance conflict, balancing benefits and barriers. Experience emerged as a hindrance in embracing evidence-based clinical tools. This study is among the first to comprehensively develop evidence-based medication management guideline and administration-tracking chart for psychiatric nurses globally and in our country. Routine use of the tools is expected to enhance nurses' expertise in psychotropic medication management, leading to improved patient outcomes in medication-related aspects.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review.

BACKGROUND: Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP. AIMS: The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs. METHODS: The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis. RESULTS: Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal. LINKING EVIDENCE TO ACTION: Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

The supportive care needs of stroke patients: A scoping review.

The aims of the current review were to identify the current supportive care needs of stroke patients, categorize those needs according to the supportive care needs framework (SCNF), and to form a SCNF of stroke patients. Preferred Reporting Items for Systematic Reviews and Meta-Extension for Scoping Reviews (PRISMA-ScR) and Guidance for conducting systematic scoping reviews were followed. Ten databases were searched, including six English databases: PubMed, Embase, Web of Science, Cumulative Index to Nursing Allied Health Literature, Cochrane Library, and PsycINFO, and four Chinese databases: China National Knowledge Infrastructure, Wan Fang, China Biology Medicine Database and Chongqing VIP. The search period covers from the establishment of the database to December 31, 2022. Three thousand twenty-nine hits were screened resulting in the inclusion of 34 articles in the final literature review. The greatest need identified by stroke patients was information, followed by psychological, social, rehabilitation, practical, physical, emotional, and spiritual needs. The supportive care needs of stroke patients were identified. A preliminary SCNF of stroke patients was developed according to Fitch's SCNF. The multitude of existing needs of stroke patients need to be addressed. This review may represent the first time that SCNF for stroke patients has been developed. This work may lay the foundation for future research on the supportive care needs of stroke patients and provide a framework for the implementation of supportive care in clinical stroke units.

The effects of mindfulness therapy on infertile female patients: A meta-analysis.

BACKGROUND: About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4-6 couples. It is thus essential to find effective psychological treatment. OBJECTIVE: To conduct a systematic review of previous meta-analyses on mindfulness-based therapy outcomes in infertile female patients and a meta-analysis of studies nested within these meta-analyses. METHODS: Randomized controlled trials (RCTS) on the efficacy of mindset-based interventions in infertile female patients were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNI, VIP Database, and Wanfang Database until March 1, 2023. Two researchers screened the literature, extracted data according to inclusion and exclusion criteria, and conducted quality control according to Cochrane Handbook 5.1.0. When there was ambiguity, a third party determined it. The meta-analysis was performed using RevMan 5.3 software. RESULT: 14 randomized controlled trials involving 1784 patients were included. Meta-analysis showed that compared with conventional care, mindfulness-based intervention can effectively relieve anxiety in female infertility patients [SMD =-2.25, 95% CI (-2.90, -1.60), P< 0.00001], depression [SMD =-2.25, 95% CI (-2.99, -1.52), P< 0.00001], perceived stress [SMD =-0.99, 95% CI (-1.27, -0.71), P< 0.00001], improved quality of life, physiological function [MD = 14.03, 95% CI (11.98, 16.07), P< 0.00001], Role limitations due to physical problems [MD = 11.30, 95% CI (5.71, 16.90), P< 0.0001], vitality [MD = 11.55, 95% CI (9.46, 13.65), P< 0.00001], mental health [MD = 17.32, 95% CI (15.29, 19.35), P< 0.00001]. CONCLUSION: Existing evidence shows that mindfulness therapy can effectively relieve the anxiety and depression of infertile women, reduce the level of stress, and improve the quality of life and sleep quality. However, due to the limited quantity and quality of the literature, multi-center, large-sample, and high-quality randomized controlled studies should be conducted in the future.

Managing nurse redeployment during the Covid-19 pandemic, lessons for future redeployment: A qualitative study.

BACKGROUND: The mass redeployment of nurses was critical across countries necessitated by the acute health impact of Covid-19. Knowledge was limited regarding how to manage nurse redeployment or the impact that redeployment might have. Redeployment continues, particularly in response to the current staffing crisis and surges such as winter pressures. This study aims to address these gaps in evidence to inform guidance on how best to manage nurse redeployment in practice. OBJECTIVES: First, to understand the processes and underpinning decisions made by managers when managing nurse redeployment prior to and during the Covid-19 pandemic. Second, to identify the lessons that can be learned to improve the management of on-going nurse redeployment. DESIGN: Qualitative study utilising semi-structured interviews and focus groups with nurse managers (ISRCTN: 18172749). SETTING(S): Three acute National Health Service (NHS) Trusts in England with geographical and ethnic diversity, and different Covid-19 contexts. PARTICIPANTS: Thirty-two nurse managers and four Human Resource advisors responsible for redeploying nurses or receiving and supporting redeployed nurses. METHODS: Participants took part in face-to-face or virtual semi-structured interviews from February 2021 to November 2021 and virtual focus groups from July to December 2021. Qualitative data were analysed using reflexive thematic analysis. RESULTS: Four themes were evident in the data, capturing four distinctive phases of the redeployment process. There was a fundamental mismatch between how different parts of the nursing and managerial workforce conceived of their decision-making responsibilities across different phases. This led to managers taking inconsistent and sometimes contradictory approaches when redeploying nurses, and a disconnect between nursing staff at all levels of the chain of command. Furthermore, in conjunction with limited guidance in operationalising redeployment and the distressing experiences vocalised by nurses, nurse managers found nurse redeployment logistically and emotionally challenging; and felt 'caught in the middle' of meeting both their managerial and mentoring responsibilities. This became increasingly challenging during subsequent phases of redeployment and remained challenging once the pandemic waned. CONCLUSIONS: The approach to nurse redeployment in response to the Covid-19 pandemic prioritised nurse staffing numbers over personal well-being. Key principles of good practice relating to nurse redeployment during the Covid-19 pandemic can be applied to improve future redeployment of nurses and support positive outcomes. Having a planned approach for staff redeployment during normal service delivery comprising operational guidance for those tasked with implementing redeployment, that is scalable in a crisis setting, would be beneficial for the nursing workforce.

Summary of the best evidence on self-management support schemes for patients with inflammatory bowel disease based on mobile health systems.

Objective: Self-management support services can improve patients' self-management ability. This study summarized the best evidence on a self-management support scheme for patients with inflammatory bowel disease based on a mobile health system to accurately describe the current status of the field and provide recommendations for healthcare workers. Methods: Two researchers retrieved studies from computer decision support systems, guideline websites, official association websites, and databases from the establishment of the database until October 2023. The quality of the included studies was independently evaluated by two authors using the Appraisal of Guidelines for Research and Evaluation Instrument II and the 2016 version of the corresponding evaluation standards of the Australian Joanna Briggs Institute Evidence-based Health Care Center. The classification of evidence and recommendation level adopted the 2014 version of the Australian Joanna Briggs Institute evidence pregrading and recommending level system. Results: Fifteen studies were included, comprising one guideline, two expert consensuses, four systematic reviews, four quasi-experimental studies, and four qualitative studies. The overall quality of the included studies was moderate to high. Thirty-six pieces of best evidence were compiled for seven elements, namely, mobile health system type and functional support; mobile health system application preparation; health information recording, uploading, and presentation; zoning management of diseases and early warning of the active period; support related to health education; healthcare support team formation and services; and virtual communities. Conclusions: Our study evaluated the quality of the included studies and summarized a self-management support scheme for patients with inflammatory bowel disease based on a mobile health system. The main scheme was divided into 7 parts and 36 items, which can be used as a reference for healthcare workers so that they can provide more comprehensive and scientific self-management support services for patients with inflammatory bowel disease through mobile health systems.

[Nursing science put to the epistemological test]. / La science infirmière à l'épreuve de l'épistémologie.

Today, we are witnessing the emergence of a nursing discipline that is clearly seeking to base its legitimacy primarily on science. However, only an epistemological approach can assure us of the relevance of such an approach. While the nursing discipline must unquestionably be based on a rational, scientific approach, can we not nevertheless assume that an irreducible element of mystery will forever remain at the heart of care?

Summary of the best evidence for the prevention and management of myasthenic crisis after thymectomy.

Background: Myasthenic crisis (MC) may occur after thymectomy in patients with myasthenia gravis (MG), but effective preventive interventions can reduce the occurrence of this complication. Previous research on MC focused on risk factors, emergency treatment, etc., which was relatively scattered and did not form a comprehensive management framework. This study sought to retrieve and summarize the relevant evidence on the prevention and management of postoperative MC to provide a theoretical reference for clinical medical staff. Methods: According to the evidence pyramid model, relevant articles were retrieved from UpToDate, British Medical Journal (BMJ) Best Practice, World Health Organization (WHO), Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Australian Joanna Briggs Institute (JBI) Healthcare Database, Medlive, PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang. The types of evidence included clinical guidelines, expert consensus articles, clinical decisions, systematic reviews, and randomized controlled trials (RCTs). The quality evaluations were conducted using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool for guidelines, the Australian JBI Evidence-Based Healthcare Center evaluation tool for expert consensus articles, the Critical Appraisal for Summaries of Evidence (CASE) evaluation tool for clinical decisions, the Assessment of Multiple Systematic Reviews (AMSTAR) evaluation tool for systematic reviews, and the Cochrane risk-of-bias tool for RCTs. Results: A total of 12 articles were included in this study, including three clinical guidelines, three expert consensus articles, three clinical decisions, two systematic reviews, and one RCT. From these articles, we summarized 39 pieces of evidence on the prevention and management of postoperative MC. Conclusions: This study summarized the best evidence on the prevention and management of postoperative MC and provided to clinical staffs evidence-based clinical approaches to help reduce the incidence of this complication.

[The bibliography group, between dream and reality in nursing practice]. / Le groupe de bibliographie, entre rêve et réalité de l'exercice infirmier.

The shock of reality that nursing students face when they start out will affect the nursing profession even more in the future, as it faces a recruitment crisis in the midst of renewal. Restoring meaning to the nursing profession is a complex and daunting challenge. By providing access to scientific literature, the bibliography group can contribute to this, based on an Evidence-Based Nursing approach. This initiative, which is beneficial for professionals whose skills development is thus encouraged, is designed to be simple and accessible to as many people as possible.

Person-centred care and online pedagogy in nursing education: a discussion paper.

AIM: To discuss person-centred care in nursing education and the role of online pedagogy to facilitate meaninful learning. BACKGROUND: The core principles and values of person-centred care are at the centre of national and international healthcare education. Person-centred care recognises partnerships and relationships between nurses, healthcare practitioners and individual patients, carers and their families and part of the training of healthcare professionals. However, the literature on how person-centred care is taught to facilitate meaningful learning in nursing education particularly in the context of online pedagogy is limited. DESIGN: A critical discussion paper. METHODS: A critical discussion of person-centred care and online pedagogy that can facilitate teaching practices are presented, drawing on authors' positionality and case exemplars. RESULTS: Teaching person-centred care using online pedagogy appears to have a promising impact on undergraduate and postgraduate nursing students' experiences. Engaging students in critical examination and reflection on the complexities of person-centred care in practice creates meaningful experiential learning for both students and educators. CONCLUSION: Evidence suggests that the use of online pedagogy is a beneficial and effective way to incorporate the teaching of person-centred care into nursing education, yet more evidence is needed to evaluate its impact on nursing practice.