Factors Influencing COVID-19 Vaccination among Primary Healthcare Nurses in the Pandemic and Post-Pandemic Period: Cross-Sectional Study.

The decision to vaccinate against COVID-19 is primarily a personal choice influenced by numerous factors. Vaccine acceptance and a positive attitude towards vaccination among nurses have an impact on patients' willingness to vaccinate. To assess COVID-19 vaccination coverage among primary healthcare nurses and to associate socio-demographic factors, comorbidity, self-rated health, and unhealthy lifestyle with the decision to be vaccinated, we conducted an online cross-sectional study from March to May 2023 using a self-administrated questionnaire. Probability sampling was used to select 32 health centers and nurses were invited via email. Among the 560 participants who completed survey, 78.3% and 50.8% received the primary two-dose course and at least one booster dose of COVID-19 vaccine, respectively. Primary care nurses who were ≥41 years of age, physically less active, and those who were overweight opted statistically significantly more often for the primary vaccination scheme (p = 0.00, 0.015 and 0.017, respectively). Education and the living environments of primary care nurses did not significantly influence the decision to receive two primary COVID-19 doses. Likewise, good self-rated health and comorbidity did not contribute significantly to the vaccination decision. Nurses that were vaccinated with booster doses were significantly more often overweight (p = 0.034) and ≥41 year of age (p = 0.000).

The role of critical care nurses in organ and tissue donation: A position statement of the Australian College of Critical Care Nurses.

INTRODUCTION: Australian organ and tissue donation rates are low compared to other countries. Acknowledging that donation practices vary across Australia, the Australian College of Critical Care Nurses supported the development of a position statement to explicate critical care nurses' role in supporting organ and tissue donation. Several Australian peak professional organisations provide guidance to inform and support organ and tissue donation. AIM: The aim of this study was to develop a position statement using contemporary Australian research evidence to build upon and complement existing guidance, focussing on the role of critical care nurses in organ and tissue donation in Australian critical care. METHOD: An approach similar to a rapid review was used, providing a streamlined approach to synthesising evidence. A comprehensive search using Medical Subject Headings, keywords, and synonyms was undertaken using Medline and CINAHL Complete via EBSCOhost to identify peer-reviewed Australian research evidence about critical care nurses' role, obligations, expectations, and scope of practice during organ and tissue donation. Narrative synthesis was used to synthesise the research evidence. FINDINGS: The importance of separating death from organ donation in discussions with family, the timing and the approach to organ donation conversations, and working in collaboration with the DonateLife Donation Specialist Nurses were identified. The importance of understanding family perspectives, caring for families, and collegial support for critical care clinicians were also identified. With the guidance of peak professional organisations, the research evidence was then used to develop practice recommendations for critical care units, leaders, and critical care nurses. DISCUSSION AND CONCLUSION: The recommendations explicate the important contribution critical care nurses can make to ensuring timely, sensitive communication, providing high-quality end-of-life care, supporting families irrespective of the donation decision and supporting colleagues from the wider critical care team, thereby optimising the processes related to organ and tissue donation in Australian critical care settings.

Critical care nurses' role in rapid response teams: A qualitative systematic review.

AIM: To analyse the qualitative evidence on the role of critical care nurses in rapid response teams. DESIGN: Qualitative systematic review. METHODS: This qualitative systematic review employed Bettany-Saltikov and McSherry's guidelines and is reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. Two pairs of blinded researchers screened the articles. The data were synthesised using a thematic analysis approach. DATA SOURCES: A systematic literature search was conducted using the CINAHL, Embase and MEDLINE databases. RESULTS: Seven studies were included, and three main roles were identified: (1) balancing between confidence and fear in clinical encounters, (2) facilitating collaboration and (3) managing challenging power dynamics in decision-making. CONCLUSION: Critical care nurses possess extensive knowledge and skills in providing critical care to patients experiencing deterioration on general wards. They play a vital role in facilitating collaboration between team members and ward staff. Furthermore, within the rapid response team, critical care nurses assume leadership responsibilities by overseeing the comprehensive coordination of patient care and actively engaging in the decision-making process concerning patient care. IMPLICATIONS FOR THE PROFESSION: Highlighting the central role of critical care nurses in rapid response teams as well such a team's benefits in healthcare organisations can promote applications for funding to support further quality assurance of rapid response teams and thus enhance patient safety. IMPACT: Health care organisations can assure the quality of rapid response team by providing economical resources and training. The education providers should facilitate and standardise curriculum for critical care nursing students to achieve necessary knowledge and skills as members in rapid response teams. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Reflection on the impact of the COVID-19 pandemic on a community specialist palliative care nurse team.

BACKGROUND: A global COVID-19 pandemic was declared by the World Health Organization in March 2020. AIM: To explore COVID-19's impact on one specialist community palliative care nurse (SCPCN) team 8 months after the first COVID-19 wave in the UK. METHOD: The Gibbs Reflective Cycle was used. FINDINGS: This SCPCN team described the COVID-19 pandemic as the most difficult and challenging time experienced at work, due to the increased workload and having to provide unsustainable levels of support for patients and their families. CONCLUSION: Despite the COVID-19 pandemic's significant demands on community palliative care, the SCPCN team was able to adapt accordingly. This resulted in an increasingly collaborative, reflexive, responsive, skilled and resilient team, proud of the personalised support offered to patients, their families and to other services.

Interprofessional teams with and without nurse practitioners and the level of adherence to best practice guidelines in cardiac surgery: A retrospective study.

AIM: To examine the level of adherence to best-practice guidelines of interprofessional teams with acute care nurse practitioners (ACNPs) compared to interprofessional teams without ACNPs. DESIGN: A retrospective observational study was conducted in 2023. METHOD: A retrospective cohort was created including 280 patients who underwent a coronary artery bypass graft and/or a valve repair and hospitalised in a cardiac surgery unit of a university affiliated hospital in Québec (Canada) between 1 January 2019 to 31 January 2020. The level of adherence to best-practice guidelines was measured from a composite score in percentage. The composite score was created from a newly developed tool including 99 items across six categories (patient information, pharmacotherapy, laboratory tests, post-operative assessment, patient and interprofessional teams' characteristics). Multivariate linear and logistic regression models were computed to examine the effect of interprofessional teams with ACNPs on the level of adherence to best-practice guidelines. RESULTS: Most of the patients of the cohort were male and underwent a coronary artery bypass graft procedure. Patients under the care of interprofessional teams with ACNP were 1.72 times more likely to reach a level of adherence higher than 80% compared to interprofessional teams without ACNPs and were 2.29 times more likely to be within the highest quartile of the scores for the level of adherence to best-practice guidelines of the cohort. IMPACT: This study provides empirical data supporting the benefits of ACNP practice for patients, interprofessional teams and healthcare organisations. RELEVANCE FOR PRACTICE: Our findings identify the important contributions of interprofessional teams that include ACNPs using a validated instrument, as well as their contribution to the delivery of high quality patient care. REPORTING METHOD: This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Broadening their horizons: A rural and urban nursing student exchange program in primary care.

Educational strategies that allow students to experience patient care in both rural and urban settings are imperative to the recruitment and retention of nurses for medically underserved populations or health professional shortage areas. Two state schools of nursing (one urban-oriented and one rural-oriented) in the Mid-Atlantic region were awarded Health Resources and Service Administration (HRSA) project funding to educate nursing students and registered nurses in community-based primary care settings. This article will discuss an innovative rural-urban baccalaureate nursing student exchange model intended to increase understanding of enhanced RN roles in community-based primary care settings. Two project teams collaborated to create a new learning model, a rural-urban exchange, by implementing a Primary Care Camp. The camp included shared didactic content, reflection exercises, historical and cultural considerations, and clinical immersion to allow students in both programs to have on-site rural and urban learning experiences. Faculty collected informal voluntary student feedback through a debrief after their Primary Care Camp experience to assess their understanding of the enhanced RN Role in primary care and how it may affect their future nursing practice. Student feedback suggests that the students met project goals and appreciated the rural and urban exchange experience. This project is an innovative approach that offers guidance for implementing primary care education in a way that supports the current primary care RN role, builds the future workforce, and provides suggestions for replicability.

A respiratory critical care nurse training program for settings without a registered respiratory therapists: A protocol for a multimethod study.

BACKGROUND: The increasing elderly population and prevalence of chronic diseases have raised the need for ICU beds. However, limited bed availability often causes delays in admission, leading to wasted treatment time. OBJECTIVES: This study aims to create and implement a training program for respiratory critical care nurses (RCCNs) in settings without registered respiratory therapists (RRTs). METHODOLOGY/DESIGN: The study will use a multimethod sequential research design, including a scoping review, content analysis, Delphi methods, and a randomized clinical trial. The scoping review will gather extensive information on respiratory care for critically ill patients and the responsibilities of RCCNs. Content analysis and expert interviews will identify opportunities and challenges in RCCNs' provision of respiratory care. The Delphi method will integrate the results to develop a comprehensive training program for RCCNs. Subsequently, five RCCNs will undergo theoretical and practical examinations after completing the three-month training program, and the impact of RCCNs on critically ill patients' outcomes will be evaluated through a clinical trial. ANTICIPATED FINDINGS: The study aims to provide a comprehensive training program for RCCNs and investigate its impact on the outcomes of critically ill patients through a clinical trial. CONCLUSION: The training program will equip RCCNs with the necessary skills and knowledge to provide respiratory critical care from the emergency department to hospital discharge. This pioneering study aims to improve patient outcomes in settings without RRTs by offering a unique program for RCCNs. IMPLICATIONS FOR CLINICAL PRACTICE: The development and implementation of this training program for RCCNs in settings without RRTs will address the gap in respiratory care and potentially improve patient outcomes. By empowering RCCNs with specialized training, healthcare facilities can ensure the provision of high-quality respiratory care throughout a patient's critical illness journey, enhancing the efficiency and effectiveness of healthcare teams, especially in resource-limited settings.

Intrahospital transport of critically ill patients: Nurse anaesthetists' and specialist ICU nurses' experiences.

BACKGROUND: Intrahospital transport (IHT) is often performed by nurse anaesthetists and specialist intensive care nurses. Studies have shown that IHT increases the risk of mortality and morbidity, with up to 71% negative incidents. Using checklists when preparing for an IHT is important. Several international guidelines exist to ensure IHT safety and reduce the risk of complications. However, existing guidelines are often problematic in clinical practice. AIM: This study aimed to describe the experiences of nurse anaesthetists and specialized intensive care nurses during the IHT of adult patients with critical illnesses. STUDY DESIGN: This study adopted a mixed-methods approach. METHODS: Data were collected through a questionnaire completed by 66 nurses with specialist education in anaesthesia or intensive care. The data were analysed with qualitative content analysis, and the quantitative data were analysed with descriptive statistics. RESULTS: Two categories with two subcategories each emerged from the analysis of the responses of nurse anaesthetists and specialist intensive care nurses regarding their IHT experiences: creating good circumstances (subcategories: being risk-conscious and the importance of meticulous preparations) and the importance of routines and education (subcategories: following guidelines and having adequate training). CONCLUSION: IHT was described as a high risk for patient safety and complications. Routines with good compliance and education can positively impact patient safety during IHT. Checklists and scenario training can better prepare nurse anaesthetists and specialist intensive care nurses to manage complications that may arise during IHT, resulting in safer patient care. RELEVANCE FOR CLINICAL PRACTICE: The findings underscore the importance of written guidelines for IHT, emphasizing awareness and adherence by the entire team. Careful pre-IHT preparations, coupled with an understanding of potential risks, are vital for ensuring patient safety. Clinical training and discussions following incidents during IHT play a crucial role in raising the collective awareness of patient safety within the entire team.

A theoretical framework for Acute Care Nurse Stress Appraisal: Application of the transactional model of stress and coping.

AIM: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic. DESIGN: A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic. METHODS: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses. RESULTS: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities. CONCLUSION: The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary. IMPACT: To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years. REPORTING METHOD: No patient or public contribution.

Interventions to support critical care nurse wellbeing: A scoping review.

INTRODUCTION: Recruitment and retention of qualified nurses in critical care is challenging and has been further exacerbated by the COVID-19 pandemic. Poor staff wellbeing, including sickness absence and burnout contribute to a high staff turnover and staff shortages. This scoping review charts wellbeing interventions targeting nurses who work in adult critical care. METHODS: Following the Joanna Briggs Institute scoping review methodology, five databases were searched: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Embase, Ovid PsycINFO, and the Cochrane Library alongside a search for grey literature targeting national and international critical care nurse organisations. Primary research studies (qualitative, quantitative and mixed methods), as well as quality improvement studies and policy frameworks published from January 1997 to September 2022 were included. Studies conducted outside an adult critical care setting or not including adult critical nurses were excluded. Extracted data were charted using a series of tables. RESULTS: 26 studies met the inclusion criteria. Most of the interventions targeted personal rather than organisational strategies, focusing on resilience training, mindfulness-based interventions, and other psychological approaches. One intervention was not evaluated. Most of the rest of the studies reported their interventions to improve wellbeing. However, only one study evaluated the intervention for longer than six months. CONCLUSION: Current evidence identified that critical care nurse wellbeing is an international concern affecting recruitment and retention. Most available wellbeing interventions take a psychological, personal approach. However, these may not address the complex interaction of organisational factors which impact adult critical care nurses. IMPLICATIONS FOR CLINICAL PRACTICE: Further work is needed to identify and evaluate organisational approaches to improving wellbeing and to evaluate wellbeing interventions over a longer period of time. Critical care nurses should be included in the design of future wellbeing interventions.

Certified Registered Nurse Anaesthetists' and Critical Care Registered Nurses' perception of knowledge/power in teamwork with Anaesthesiologists in Sweden: a mixed-method study.

Efficient teamwork is crucial to provide optimal health care. This paper focuses on teamwork between Anaesthesiologists (ANES), Certified Registered Nurse Anaesthetists' (CRNA) and Critical Care Registered Nurses (CCRN) working in challenging environments such as the intensive care unit (ICU) and the operating room (OR). Conflicts are common between physicians and nurses, negatively impacting teamwork. Social hierarchies based on professional status and power inequalities between nurses and physicians plays a vital role in influencing teamwork. Foucault was a famous thinker especially known for his reasoning regarding power/knowledge. A Foucauldian perspective was therefore incorporated into this paper and the overall aim was to explore CCRN/CRNA perception of knowledge/power in teamwork with ANES.Methods A mixed-method approach was applied in this study. Data was collected using a web-based questionnaire containing both closed-end and open-ended questions. A total of 289 CCRNs and CRNAs completed the questionnaire. Data analysis was then conducted through five stages as outlined by Onwuebugzie and Teddlie; analysing quantitative data in SPSS 27.0 and qualitative data with a directed content analysis, finally merging data together in ATLAS.ti v.23.Results The result reveals a dissonance between quantitative and qualitative data; quantitative data indicates a well-functioning interdisciplinary teamwork between CCRN/CRNA and ANES - qualitative data highlights that there are several barriers and inequalities between the two groups. Medicine was perceived as superior to nursing, which was reinforced by both social and organisational structures at the ICU and OR.Conclusion Unconscious rules underlying current power structures in the ICU and OR works in favour of the ANES and biomedical paradigm, supporting medical knowledge. To achieve a more equal power distribution between CCRN/CRNAs and ANES, the structural hierarchies between nursing and medicine needs to be addressed. A more equal power balance between the two disciplines can improve teamwork and thereby reduce patient mortality and improve patient outcomes.

The reality of occupational harm incurred by Japanese home health care nurses, the hazardous situations they face, and protective measures: a cross-sectional study.

Objectives: To gain a comprehensive understanding of the occupational hazards encountered by home health care nurses in Japan and to elucidate the reality of harm they incur, the hazardous situations, and the protective measures taken.Methods:A questionnaire survey of managers of home health care nursing agencies in Japan was conducted, and 355 valid responses were obtained. The survey questions concerned the occupational hazards experienced by home health care nursing staff. The occupational hazards were classified into 6 categories, and responses were obtained regarding harm, hazardous situations, and protective measures in each category.Results: The types of harm that occurred at highest rates during the previous 3 years were emotional abuse by the patient or their family members, lower back pain resulting from improper posture while providing care, sexual harassment by the patients and their family members, automobile accidents while traveling to home care sites, and allergic reactions to the environment at home care sites. Some hazardous situations were caused by the unique environments of home care sites.Conclusions: In order to prevent the occurrence of harm, the development of risk assessment tools, educational initiatives to increase awareness of occupational hazards, and consideration of the financial and technical support that will enable the use of assistive devices in the practice of nursing techniques were considered necessary. The development of effective guidelines and manuals specific to the occupational hazards encountered by home health care nurses is an important challenge.

A Multimethod Evaluation of a Specialist Breast Care Nurse-Led Survivorship Clinic in Australia.

OBJECTIVES: To compare the needs and issues faced by breast cancer survivors (BCSs) who received chemotherapy as part of their treatment with those who did not and assess satisfaction with a specialist breast care nurse-led survivorship clinic. SAMPLE & SETTING: BCSs who attended a specialist breast care nurse-led survivorship clinic at a Western Australian private, not-for-profit hospital. METHODS & VARIABLES: A multimethod evaluation included surveys, quality-of-life assessments, and reviews of wellness plans. RESULTS: A total of 68 BCSs participated; the majority had received chemotherapy as part of their treatment and were female. BCSs experienced a diverse range of issues. Significant differences were found between chemotherapy and nonchemotherapy groups for financial difficulties (p = 0.002), body image (p = 0.017), future perspective (p = 0.022), and arm symptoms (p = 0.007). Participants indicated that the specialist breast care nurse-led clinic was appropriately timed and highly valued. IMPLICATIONS FOR NURSING: Specialist breast care nurse-led clinics can identify and address BCSs' ongoing needs.

Knowledge and practice of nurses regarding the care of patients with head trauma in intensive care units in the West Bank.

Background: Nurses in the intensive care unit are responsible for the continuous assessment and management of physiological parameters associated with head trauma. Nurses have a vital and significant role in the care of patients suffering from moderate-to-severe head trauma, both during acute and non-acute care.The purpose of this study was to investigate the Knowledge and Practice of nurses regarding the care of patients with head trauma in an intensive care unit. Design and methods: The study was designed as a cross-sectional study. The study recruited 165 nurses who work at intensive care unit (ICU) nurses in Palestinian hospitals. The data collected by a self-administered questionnaire developed by the researcher. Results: Among the 165 intensive nurses, the study findings revealed the majority of nurses 99 (60.0%) have low level knowledge regarding Care of Patients with a head trauma, and showed that most of the nurses 115 (69.7%) have poor level practice regarding Care of Patients with a head trauma. Conclusions: According to the results of the current study, approximately two-thirds of the studied nurses had unsatisfactory knowledge level regarding head trauma care. More than two-thirds of the studied nurses had poor level practice regarding head trauma care. Also, the study confirmed no statistical significant relation between knowledge and demographic characteristics. There was significant differences between total practice scores and both experience in general and experience in ICU.

Determining Knowledge and Opinions of Neonatal Intensive Care Unit Nurses on Wet-Nursing and Human Milk Banks: A Cross-Sectional Study in Türkiye.

BACKGROUND: Wet nursing and human milk banks are vital sources of human milk for infants unable to breastfeed. RESEARCH AIM: This study aims to determine the knowledge and opinions of neonatal intensive care unit nurses regarding wet-nursing and human milk banks in Türkiye. METHODS: This descriptive cross-sectional study was conducted with 219 neonatal intensive care unit nurses using an online survey comprising 20 questions. The data were collected between August and September 2021. RESULTS: Among the participants, 64.4% (n = 141) expressed that they would be a wet-nurse and 59.8% (n = 131) would search for a wet-nurse if necessary. Some, 47.0% (n = 103) of participants did not know if there were any human milk banks in Türkiye, 53.9% (n = 118) would like to be a donor if human milk banks were established, and 71.7% (n = 157) stated that the establishment of human milk banks should be supported. Religious concerns were the basis for reluctance to donate milk to human milk banks for 60% (n = 51) of the participants. Knowledge was greater and opinions about wet-nursing and human milk banks were more positive for participants with higher education, more time in the neonatal intensive care unit, or work at a tertiary care center. CONCLUSION: The approaches of neonatal intensive care unit nurses towards personally being wet-nurses and milk sharing were generally positive, although more information about human milk banks is needed. Religious beliefs are an important consideration when providing information about milk sharing.

[Project to Improve FloTrac Cognition and Skill Accuracy in Nurses Working in the Intensive Care Unit].

BACKGROUND & PROBLEMS: FloTrac is used to monitor hemodynamics in patients. Insufficient awareness of and inexperience with this machine put patients at risk. PURPOSE: A project was developed to increase FloTrac cognitive accuracy from 57.6% to 85% and skill accuracy from 73.3% to 91% in ICU nurses. Also, FloTrac installation time was intended to be reduced to less than 8 minutes and 38 seconds. RESOLUTION: Create a pithy, easy-to-remember formula; make operation teaching videos, operation manuals, and reminder cards; arrange educational training; and monitor quality regularly. RESULTS: FloTrac cognitive accuracy increased from 57.6% to 90.4%; FloTrac skill accuracy increased from 73.3% to 99.7%; and installation time was shortened from 8 minutes and 38 seconds to 5 minutes and 42 seconds. CONCLUSIONS: After implementation of the project, nurses improved their professional knowledge and were better able to help doctors obtain hemodynamic data efficiently to provide patients with accurate and rapid treatment.

Exploring the competencies of Chinese critical care nurses in mobile medical teams based on the onion model: A qualitative study.

BACKGROUND: With frequent conflicts, natural disasters, and public health emergencies globally, mobile medical teams (MMTs) are becoming increasingly critical. Importantly, the competency of critical care nurses in MMTs can substantially affect the effectiveness and quality of its rescue efforts. Yet, these nurses' competencies are not well understood. AIM: This study examined the competencies of critical care nurses in MMTs using the Onion Model. DESIGN: A qualitative descriptive method was used to describe the competencies of Chinese MMT critical care nurses. METHODS: From April to May 2022, a convenience sample of 18 participants (14 critical care nurses and 4 surgeons) from 10 MMTs was recruited for semi-structured interviews. Deductive and inductive coding methods were combined for content analysis. RESULTS: In total, 29 competencies were identified, which were grouped into four major domains using the Onion Model. From the outer to inner layers, these domains were knowledge and skills, professional abilities, professional quality, and personal traits. Several novel competencies emerged, including field medical equipment operation skills, on-site hazard identification and safety prevention skills, triage knowledge, and field survival skills. CONCLUSIONS: Using the Onion Model, this study furthers the understanding of the competency of critical care nurses in MMTs, especially by revealing the novel competencies. Further, the results can be used to recruit, evaluate, and train critical care nurses for MMTs. RELEVANCE TO CLINICAL PRACTICE: Understanding MMT critical care nurses' competencies can help managers plan and provide relevant training and education before deployment, which can improve nurses' performance, and especially reduce the mortalities and disabilities from trauma.

Correlation between nurses' attitude and practice toward communication with patients of decreased level of consciousness and its relationship with ethical care in ICU: A cross-sectional study.

Background and Aims: Communication between intensive care unit (ICU) nurses and patients with decreased Level of Consciousness (DLOC) is now regarded as a difficult task. Proper communication is regarded as a crucial component of care and stems from the attitude and practice of nurses. Intensive care nurses are responsible for providing care to patients with DLOC in accordance with ethical principles because care and ethics cannot be separated. To better understand ICU nurses' attitudes and practice toward communicating with patients who have decreased levels of consciousness and how this affects the provision of ethical care, the current study was conducted. Methods: This is a cross-sectional study. Two hundred ICU nurses from southeast Iran took part in this study. Three questioners, including attitude and practice toward communicating with patients who decreased Levels of consciousness, and ethical Care were used as data collection tools. Results: The mean score for ICU nurses' attitude, practice, and ethical care towards communicating with patients with DLOC were, respectively, 4.02 ± 0.45,2.91 ± 0.49. The findings demonstrated a very weak correlation between the ICU nurses' attitude score and communication practice for DLOC patients (p = 0.04; r = 0.14). Conclusion: Nurses who had a more positive attitude toward communicating with DLOC patients performed better in this area. It is suggested that nurses employed in ICUs should be monitored and judged based on how well they communicate with DLOC patients through workshops and conferences. By doing this, they would become more cognizant of the necessity for and effective methods of communication with these patients as well as the repercussions of their poor communication practice.

Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study.

OBJECTIVES: To investigate how anxiety, depression, stress, burnout, and sleep quality impact on Quality of life of critical care nurses. BACKGROUND: Several studies reported that critical care nurses are exposed to a high risk of anxiety, depression, burnout, stress, and sleep quality, but we do not know the impact of critical care nurses. DESIGN: A cross-sectional study. METHODS: We have included all critical care nurses working in the intensive care unit for at least six months. Data were collected from December 1, 2021, to March 18, 2022. We evaluated the critical care nurses using the Depression Anxiety Stress Scale (DASS), Maslach Burnout Inventory scale, Pittsburgh Sleep Quality Index and Nurse Quality of Life. The primary endpoint is Quality of Life. Associations were tested using multivariate modelling. RESULTS: A total of 140 critical care nurses were included. Multivariate regression showed the relation between emotional QoL and emotional exhaustion and DASS total score [OR = 0.14; 95% CI (0.03-0.73); p = 0.019 and OR = 3.64; 95% CI (1.07-12.32); p = 0.038, respectively]. Personal accomplishment and DASS total score have a direct relationship on quality of work-life [OR = 0.21; 95% CI (0.05-0.82); p = 0.024 and OR = 4.18; 95% CI (1.01-17.33); p = 0.049, respectively]. CONCLUSIONS: The physical quality of life is not optimal in critical care nurses, while burnout and the DASS score directly impact the emotional and work-life quality of life. IMPLICATIONS FOR CLINICAL PRACTICE: Our research has highlighted the importance of detecting the quality of life of critical care nurses. The nurses should take proper care of their health by adopting the right health behaviours to create correct work conditions and increase the quality of care for critically ill patients.

Dental and nursing collaboration in oral healthcare research in palliative care inpatient settings.

Collaboration between palliative care nurses and oral health professionals has been frequently recommended to ensure optimal oral healthcare. However, the importance of this collaboration to the success of evidence-based protocols, involving oral healthcare interventions in the inpatient palliative care setting, is less discussed. Feasibility requires consideration during the planning, intervention and implementation phases of any clinical trial; all of which typically rely on good collaboration with nursing staff. Therefore, it is imperative that nursing staff appreciate the need for oral healthcare at the end of a person's life. Nursing and dental collaboration is critical to the feasibility of running research trials in this group and can help overcome some of the logistical and ethical challenges in this vulnerable population.