Student to nurse transition and the nurse residency program: A qualitative study of new graduate perceptions.

BACKGROUND: In past years, the attrition of new graduate nurses has been predicted to grow and this is what has been occurring recently due to challenging role transitions. Nurse residency programs are meant to help new graduate nurses transition into their new roles. These programs have been evaluated in a variety of ways. PURPOSE: The purpose of this study was to explore more about new graduate nurses' transition perspectives and the function of nurse residency programs in mediating this shift. METHODS: At a major university hospital in Saudi Arabia, 29 Saudi nurses participated in a qualitative phenomenological study through focus group discussions. RESULTS: Two major themes emerged from thematic analysis in this study. The first theme was namely "Challenges of transition", where nurses expressed the lack of experience, high caseloads, and difficulty communicating with physicians. The second theme was namely, "Residency transition support", where the nurses expressed that it provided them with enhanced learning, peer communication and support, and helped them in building relationships. CONCLUSION: The themes that emerged indicate that the journey from student to registered nurse is complicated and multidimensional. These findings imply that structures and practices meant to promote the shift, such as the residency program, can help new nurses have a better transition experience.

Perspectives of Nursing Students on Promoting Reflection in the Clinical Setting: A Qualitative Study.

BACKGROUND: Reflection increases meta-cognitive capacities, promotes student-instructor relationships, overcomes the theory-practice gap, and enriches learning. This study aims at exploring nursing students' perspectives on the facilitators of reflective practices in the clinical setting. METHODS: Semi-structured interviews were conducted among 21 Saudi nursing students at one major university in Saudi Arabia. RESULTS: Two major themes were prevalent upon thematic analysis, namely, "Personal Drivers of Reflection" which consisted of "Motivation to Learn", "Desire to develop", "Ethical Regard", and "Responsibility towards patients" and "External Drivers of Reflection" which consisted of "Patient characteristics", "Case complexity", and "Competent Instructors". CONCLUSION: As per the results of the study, nursing students perceived that they underwent reflection as a response to personal motivational and external educational aspects. According to the findings, instructors should assist students through clinical reflection, with a special focus on their interactions and motivation.

COVID-19 quarantine stressors and management among Lebanese students: a qualitative study.

The aim of this research paper is to examine the current situation, emotional reactions of university students and their coping mechanisms during and after the COVID-19 quarantine. The study was undertaken in a major higher education institution in Lebanon. An exploratory qualitative research design was adopted. A phenomenological qualitative method was employed where, semi-structured interviews were carried out among 20 university students during and 3 months after release from quarantine. The qualitative analysis have revealed 5 themes during quarantine period namely "Concerns regarding learning and evaluation methods", "Overwhelming load", "Dealing with technical difficulties", "Confinement", and "Coping with problems", in addition to 3 themes after the quarantine period namely "Relief of academic stress", "Fear of becoming infected and jeopardizing family health", "Stigma of being infected". The quarantine has inflicted multiple psychological challenges among university students, which should be highlighted and mediated by higher education institution in order to support the students' learning and their academic achievement.

The psychological experiences of Lebanese ground zero front-line nurses during the most recent COVID-19 outbreak post Beirut blast: A qualitative study.

BACKGROUND: For the past 2 months the number of COVID-19 cases in Lebanon has been on the rise, while frontline nurses after the Beirut Blast of August 4th have been practicing through limited resources and a challenging context. AIM: This paper aims at exploring the psychological experiences of Lebanese frontline nurses serving at ground zero hospital during the current COVID-19 outbreak. SETTING: This study was carried out in three main ground-zero hospitals in Beirut which are receiving COVID-19 cases. METHOD: This study have employed a phenomenological exploratory qualitative research design, where virtual interviews were conducted with 18 frontline nurses during the second week of January 2021. RESULTS: Thematic analysis of the data expressed by the frontline nurses working in the approached ground-zero hospitals gave rise to five themes, namely 'helplessness and impending doom', 'increased mortality rates and depressive mood', 'fear of death and obsessive thinking', 'flashbacks, panic, and incompetence', and 'public recklessness, governmental responsibility, and anger'. CONCLUSION: The frontline nurses working at ground zero hospitals in Beirut are facing significant psychological challenges that should be mediated by the government and health policymakers in order to safeguard the quality of care and avoid higher mortality rates.

Nurses' evaluation of critical care pain observation tool (CPOT) implementation for mechanically ventilated intensive care patients.

Despite the fact that self-report of pain is considered the most consistent indicator of its presence, pain assessment for the critically ill mechanically ventilated patients is quite challenging, as the altered level of consciousness, sedation and the presence of life support devices commonly affect the self-report mechanism. However, in Lebanon, nearly no research articles or local professional organizations have raised this topic. Therefore, addressing and introducing the "Critical Care Pain Observation Tool" (CPOT) is of great importance and would help the healthcare providers especially "Critical Care Nurses" (CCN) in identifying and managing the patient's hidden pain Curry Narayan, 2010. The data followed a non-experimental post-test only design to gather data from a sample of 30 critical care registered nurses where well-established psychometric instruments were used in primary data collection method, which is Critical Care Pain Observation Tool and the Feasibility and clinical utility CPOT Questionnaire. The data in this article provides demographic data about critical care nurses and their evaluation of the Critical Care Pain Observation Tool (CPOT) implementation for mechanically ventilated intensive care patients. The analyzed data is provided in the tables included in this article.

Alternating ibuprofen and acetaminophen in the treatment of febrile children: a pilot study [ISRCTN30487061].

BACKGROUND: Alternating ibuprofen and acetaminophen for the treatment of febrile children is a prevalent practice among physicians and parents, despite the lack of evidence on effectiveness or safety. This randomized, double-blind and placebo-controlled clinical trial aims at comparing the antipyretic effectiveness and safety of a single administration of alternating ibuprofen and acetaminophen doses to that of ibuprofen mono-therapy in febrile children. METHODS: Seventy febrile children were randomly allocated to receive either a single oral dose of 10 mg/kg ibuprofen and 15 mg/kg oral acetaminophen after 4 hours, or a similar dose of ibuprofen and placebo at 4 hours. Rectal temperature was measured at baseline, 4, 5, 6, 7 and 8 hours later. Endpoints included proportions of afebrile children at 6, 7 and 8 hours, maximum decline in temperature, time to recurrence of fever, and change in temperature from baseline at each time point. Intent-to-treat analysis was planned with statistical significance set at P < 0.05. RESULTS: A higher proportion of subjects in the intervention group (83.3%) became afebrile at 6 hours than in the control group (57.6%); P = 0.018. This difference was accentuated at 7 and 8 hours (P < 0.001) with a significantly longer time to recurrence of fever in the intervention group (mean +/- SD of 7.4 +/- 1.3 versus 5.7 +/- 2.2 hours), P < 0.001. Odds ratios (95%CI) for defervescence were 5.6 (1.3; 23.8), 19.5 (3.5; 108.9) and 15.3 (3.4; 68.3) at 6, 7 and 8 hours respectively. Two-way ANOVA with repeated measures over time revealed a significantly larger decline in temperature in the intervention group at times 7 (P = 0.026) and 8 (P = 0.002) hours. CONCLUSION: A single dose of alternating ibuprofen and acetaminophen appears to be a superior antipyretic regimen than ibuprofen mono-therapy. Further studies are needed to confirm these findings.

Predicting neonatal outcomes: birthweight, body mass index or ponderal index?

AIMS: To compare birthweight (BW), body mass index (BMI) and ponderal index (PI) as predictors of selected short-term (ST) outcomes, namely Neonatal Intensive Care Unit (NICU) admission and prolonged hospitalization (PH), among newborn (NB) infants. METHODS: Data was collected prospectively on 9,226 infants born during one year at nine tertiary care hospitals in Greater Beirut, Lebanon. The predictive abilities of BW, BMI and PI were compared using the area under the receiver operator characteristic (ROC) curves and sensitivity analysis was performed at the optimal cut-off points for the best anthropometric measurement. RESULTS: The area under the ROC curve suggested superior discriminative power for BW as compared to BMI or PI, as a predictor of NICU admission (ROC area = 0.73) and PH (ROC area = 0.74). The optimal BW cut-off point was 2750 g (sensitivity: 0.49; specificity: 0.89) and 2950 g (sensitivity: 0.62; specificity: 0.78) for NICU admission and PH, respectively. CONCLUSION: In our population of NB infants, BW--a crude measure of fetal growth--is a better predictor than either BMI--a measure of adiposity in adults and children--or PI--a measure of thinness at birth--for selected ST outcomes in NB infants.

Impact of maternal age on preterm delivery and low birthweight: a hospital-based collaborative study of nulliparous Lebanese women in Greater Beirut.

OBJECTIVES: To analyze the impact of maternal age at first childbirth on the incidence of preterm delivery and low birthweight among single live births delivered to nulliparous Lebanese women in Greater Beirut. STUDY DESIGN: Eligible subjects were selected from a consecutive sample of neonatal admissions to nine National Collaborative Perinatal Network participating hospitals over a three-year period (April 1, 1999 to March 31, 2002). Chi-square tests and logistic regression analyses were applied. RESULTS: Out of 5556 nulliparous mothers, 5.4% had a preterm delivery and 5.2% a low-birthweight infant. In the multivariate analysis, preterm delivery was not significantly affected by old maternal age. Mothers aged 25 years or more remained a high-risk group for low birthweight even after controlling for potentially confounding characteristics. CONCLUSIONS: Maternal age at first childbirth above 25 years is an independent risk factor for low birthweight, but not for preterm delivery, an outcome influenced mainly by obstetric complications.