Effect of peri-intubation non-pharmacological interventions on postoperative laryngeal symptoms: A systematic review with meta-analysis and meta-regression.

OBJECTIVES: To evaluate the effectiveness of peri-intubation non-pharmacological interventions in reducing postoperative sore throat (POST), cough (PEC), and hoarseness in surgical patients. DESIGN: A systematic review with meta-analysis and meta-regression. SETTING: Elective surgery under general anesthesia in operating rooms. MAIN OUTCOME MEASURES: Evaluate the impact of non-pharmacological interventions, including pre-intubation (gargling with Sodium Azulene Sulfonate, licorice, or using Strepsils tablets of honey and lemon lozenge), during-intubation (inflating the TT cuff with normal saline and softening the ETT cuff with warm normal saline), and post-intubation (cold vapor therapy, gargling with honey lemon water, and using green tea gargle), on the occurrence of POST, PEC, and hoarseness. RESULTS: Nineteen trials with 2,136 participants were included. Pre-intubation intervention significantly reduced POST immediately after extubation (n = 861; OR: 0.28, 95 % CI: 0.20-0.38, P < 0.001), and 24 h post-extubation (n = 1006; OR: 0.21, 95 % CI: 0.16-0.28, P < 0.001). During-intubation intervention did not show significant effects on POST. Pre-intubation intervention also reduced POST-associated pain score at 24 h post-extubation (n = 440; MD: -0.50, 95 % CI: -0.81 to -0.18, P < 0.001). Post-intubation interventions were effective in reducing POST-associated pain scores at different time points post-extubation (P < 0.05). Pre-intubation intervention significantly reduced PEC (OR: 0.13, 95 % CI: 0.02-0.70, P = 0.02) and hoarseness (OR: 0.36, 95 %CI: 0.15-0.86, P = 0.02) at 24 h post-extubation. However, during-intubation interventions did not reduce hoarseness at 24 h post-extubation. CONCLUSION: Pre-intubation non-pharmacological interventions were found to be the most effective in reducing the incidence and severity of POST, PEC, and hoarseness. IMPLICATIONS FOR CLINICAL PRACTICE: Implementing pre-intubation non-pharmacological interventions can be beneficial for bedside nurses and healthcare professionals in reducing postoperative complications and nurses can contribute to improving patient comfort and recovery outcomes following surgery. SYSTEMATIC REVIEW PROTOCOL: The protocol was registered in the PROSPERO international prospective register of systematic reviews on 2 January 2024 (CRD42023492813).

Roles, experience and views of nurses working in robotic surgery settings: A mixed-methods study.

Robotic-assisted surgery has benefits for patients, but there are challenges to working in this field. In Turkey, training is not provided for nurses working in robotic-assisted surgery, and national legislation on nurses' roles in these settings has not been implemented. This study aimed to demonstrate the roles and experiences of nurses in robotic-assisted surgery in Turkey. This study was conducted as a mixed-methods research. The qualitative data were analysed by content analysis. More than half of the nurses had received basic training in robotic-assisted surgery. Qualitative data consisted of five themes, including the effects of robotic surgery, feelings and thoughts on robotic surgery, working as a nurse in robotic surgery settings, responsibilities of nurses and competence of nurses working in robotic surgery settings. Determining the working conditions and roles of nurses working in robotic-assisted surgery settings by policymakers in regulations is crucial for improving the quality of nursing care and the outcomes of patients.

The Effect of Clinical Decision Support Systems on Patients, Nurses, and Work Environment in ICUs: A Systematic Review.

This study aimed to examine the impact of clinical decision support systems on patient outcomes, working environment outcomes, and decision-making processes in nursing. The authors conducted a systematic literature review to obtain evidence on studies about clinical decision support systems and the practices of ICU nurses. For this purpose, the authors searched 10 electronic databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE, Science Direct, Tr-Dizin, Harman, and DergiPark. Search terms included "clinical decision support systems," "decision making," "intensive care," "nurse/nursing," "patient outcome," and "working environment" to identify relevant studies published during the period from the year 2007 to October 2022. Our search yielded 619 articles, of which 39 met the inclusion criteria. A higher percentage of studies compared with others were descriptive (20%), conducted through a qualitative (18%), and carried out in the United States (41%). According to the results of the narrative analysis, the authors identified three main themes: "patient care outcomes," "work environment outcomes," and the "decision-making process in nursing." Clinical decision support systems, which target practices of ICU nurses and patient care outcomes, have positive effects on outcomes and show promise in improving the quality of care; however, available studies are limited.

Structural and psychological empowerment and burnout among nurses: A systematic review and meta-analysis.

AIM: This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses. BACKGROUND: Nurses are key healthcare providers, who experience higher levels of burnout due to uncertainty and role conflicts about nursing roles and responsibilities and poor management. Nurse empowerment is an effective approach to reduce nurse burnout and enhance patient care quality. INTRODUCTION: Positive working conditions along with positive attitudes and perceptions for nurses are crucial in the workplace. Nurse empowerment in the workplace results in quality improvements in work life and the provision of healthcare. METHOD: We conducted a systematic review in accordance with the recommendations of the Joanna Briggs Institute and the PRISMA guideline. Relevant studies published between 2007 and 2022 were identified via PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE (R), Science Direct and Turkish scientific literature databases. Studies that reported correlation coefficients were pooled to conduct a meta-analysis. RESULTS: Random-effects meta-analyses showed a negative association between structural and psychological empowerment and emotional exhaustion. The overall findings showed a moderate and negative association between the six dimensions of structural empowerment and depersonalization. There was a positive association between structural empowerment and personal accomplishment. DISCUSSION: There is a relationship between decreased burnout levels and nurse empowerment. The causal relationship between empowerment and burnout levels needs to be investigated in various healthcare settings in several countries. CONCLUSION: The relationship between structural and psychological empowerment and burnout levels emphasizes that empowerment can reduce nurse burnout. Nurse empowerment is a critical management strategy for improving the quality of life for nurses, increasing the quality and effectiveness of patient care and achieving positive outcomes. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The encouragement and empowerment of nurses for prompt decision-making and effective resource utilization, reduces nurse burnout, enhancing nurses' job commitment, productivity, satisfaction and competence along with increased quality of care. The encouragement of nurses as empowered managers at the macro, meso and institutional levels not only improves the overall quality of health services but also helps to find solutions for the issues concerning healthcare service users and the health system environment.

Structural and psychological empowerment among newly graduated nurses and related factors: A mixed methods study.

AIMS: To discuss the levels of structural empowerment (SE) and psychological empowerment (PE) and the factors that influence perceptions of empowerment among newly graduated nurses (NGNs). DESIGN: Mixed methods study. METHODS: The quantitative part of the study was conducted with 220 NGNs with <1 year of job experience. The study was conducted between February and May 2023. Focus group discussions were conducted with 30 NGNs. Data were collected by using the Conditions for Work Effectiveness Questionnaire (CWEQ-II), the Psychological Empowerment Scale (PES) and a Semi-Structured Interview Form. Quantitative data were analysed using stepwise regression analysis. Content analysis was used to analyse qualitative data. RESULTS: CWEQ-II and PES were moderate. The regression analysis showed that NGNs' SE scores increased in association with the following factors, including an increase in the total score on the PES, being married/having a partner, working a day shift, having career planning, increased satisfaction with the orientation programmes of the institution and increased satisfaction with the employing institution. As a result of the descriptive analysis of the focus group interviews conducted to determine the empowerment perceptions of NGNs, we identified three contexts along with the associated themes and subthemes. These three contexts were the 'concept of power', 'professional impression' and 'empowerment process'. CONCLUSION: The results of this study indicate that the SE and PE levels of NGNs are moderate, and their empowerment perceptions are influenced by many factors that can be individual, organizational and work environment relevant. IMPACT: This study's findings will guide policymakers, educators, researchers and administrators in empowering NGNs essential to the healthcare workforce. REPORTING METHOD: The paper adheres to the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis.

PURPOSE: These systematic review and meta-analysis were conducted to discuss the financial toxicity (FT) level among breast cancer (BC) patients and the associated demographic and economic factors. METHODS: A systematic review and meta-analysis of single means were used by following the Joanna Briggs Institute guidelines and PRISMA guidance. Untransformed means (MRAW) were used to estimate the confidence interval for individual studies, while I2 and tau2 statistics were used to examine heterogeneity among pooled studies. Electronic databases were PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE(R), Science Direct, and Turkish databases were used to find relevant studies published in the last 15 years (between 2008 and 2023). RESULTS: A total of 50 studies were reviewed in the systematic review, and 11 were included in the overall and subgroup meta-analyses. The majority of reviewed studies were from the USA (38 studies), while there were four studies from China and eight studies from other countries having different types of health systems. The overall estimated FT level based on 11 pooled studies was 23.19, meaning mild level FT in the range of four categories (no FT score > 25, mild FT score 14-25, moderate FT score 1-13, and severe FT score equal to 0), with a 95% CI of 20.66-25.72. The results of subgroup meta-analyses showed that the estimated FT levels were higher among those patients who were single, with lower education levels, stage 3 patients, younger, lower income, unemployed, and living in other countries compared to those who were married, more educated, and stages 1 and 2 patients, more aged, more income, employed, and patients in the USA. CONCLUSION: The cost-effectiveness of the treatment strategies of BC depends on the continuity of care. However, FT is one of the leading factors causing BC patients to use the required care irregularly, and it has a negative effect on adherence to treatment. So, removing the economic barriers by taking appropriate measures to decrease FT will increase the efficiency of already allocated resources to BC treatments and improve the health outcomes of BC patients.

Same place but different experience: A qualitative study on gender and the nursing work environment.

AIM: This study aimed to reveal the opinions and experiences of male and female nurses concerning the nursing work environment in hospitals. BACKGROUND: The quality of the nursing work environment greatly impacts the improvement of the patient, nurse and organizational outcomes. Therefore, a better understanding of the experiences of male and female nurses can contribute to the creation of a more positive work environment. METHODS: In this descriptive qualitative study, data were collected with semi-structured interviews conducted in 2020 with 18 nurses who were recruited via purposive and maximum variation sampling. Data was analysed with content analysis. RESULTS: The content analysis revealed two major themes (the effects of gender on workplace practices and the image of nursing and gendered communication in the nursing work environment) and eight subthemes. CONCLUSION: This study concluded that male and female nurses experience advantages/disadvantages and similarities/differences in the nursing work environment and that both male and female nurses experience challenges regarding workplace relations and the work environment. IMPLICATIONS FOR NURSING MANAGEMENT: A better understanding of the problems associated with the different experiences of male and female nurses in the workplace may help nurse managers to create a more positive work environment.

Effects of nurses' individual, professional and work environment characteristics on job performance.

AIMS AND OBJECTIVES: This study aimed to examine the effects of nurses' individual, professional and work environment characteristics on their job performance levels. BACKGROUND: Nurses' job performance is important in the effective and efficient provision of health care. DESIGN: A descriptive, cross-sectional study. The STROBE guidelines were used in this study. METHODS: The sample of this descriptive, correlational and cross-sectional study comprised 370 nurses working at one private and two university hospitals in Turkey. A demographic information form, the Practice Work Environment Scale of the Nursing Work Index (PES-NWI) and the Nursing Job Performance Scale (JPS) were used to collect the data. Data were analysed using descriptive statistics, Spearman's correlation and multiple linear (stepwise) regression. RESULTS: There was a significant and positive correlation between the scores on the PES-NWI and the JPS (r: 0.65, p < .05). Regression analysis showed that nurses' job performance was affected by five variables (R2 : 59%, p < .05, Durbin-Watson: 2.06). CONCLUSION: The results of the study show that three sub-dimensions of the PES-NWI (nursing foundations for quality of care; staffing and resource adequacy; nurse manager abilities, leadership and support for nurses), colleague solidarity and education level were important factors affecting job performance. RELEVANCE TO CLINICAL PRACTICE: The job performance of nurses is a priority issue in delivering quality healthcare services. Further efforts need to be pursued to nurse managers ensure a positive work environment to increase their nurses' job performance.

The relationship between demographic and occupational variables, transformational leadership perceptions and individual innovativeness in nurses.

AIM: This study aimed to describe innovativeness among nurses and examine the impact of transformational leadership and demographic and occupational variables on individual innovativeness in nurses. BACKGROUND: Staff nurses must be innovative in order to solve problems occurring in health care environments and implement evidence-based practice. METHODS: This descriptive, correlational cross-sectional study comprised 300 nurses working in two hospitals in Turkey. The data were collected with a demographic and occupational questionnaire, the Individual Innovativeness Scale and the Transformational Leadership Scale. Data were analysed using descriptive statistics, Pearson's correlation and backward regression. RESULTS: Most nurses were categorized as "early majority" (45.3%) or "early adopter" (39.3%) for innovativeness. Education level, position, high self-perceptions of leadership skills and/or perceiving transformational leadership as a high-performance expectation were associated with high levels of individual innovativeness. CONCLUSION: Almost half of the nurses were early adopters who can be role models to other nurses in the diffusion of innovation. Having higher education levels, positions, leadership skills and expectations from management affected nurses' individual innovation more positively. IMPLICATIONS FOR NURSING MANAGEMENT: It can be helpful for nurse managers to understand the adopter categories and affective variables of innovativeness for the diffusion of innovative practices and evidence-based standards at hospitals.