Impact of IPMOE on nursing tasks in the medical ward: A time-motion study

Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong Kong.It was a local developed close-loop system including prescription,dispensing and administration modules.Evaluation on its impact on nursing tasks would be important for practice improvement and subsequent system enhancement.Objective:The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE,including change in the tasks and time patterns before and after IPMOE implementation.Methods:This was a prospective observation study in medical wards before (Jan 2014-Jun 2014) and after (Mar 2015-Jun 2015) the implementation of IPMOE.We conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing tasks.Statistical inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after implementation.Result:The average number of medication-related tasks was significantly reduced from 61.07 to 29.81,a reduction of 31.26 episodes per duty (P < 0.001,95% CI 22.9-39.63).The time for the medication-related tasks was reduced from 32 min (SD =21.57) to 26.57 min (SD =11.35) and the medication administration time increased from 37.93 min (SD-14.78) to 44.37 min (SD 19.45),but there was no overall significant difference in the time spent on each duty (P =0.315) between the two groups.An improving trend in the delayed effect was observed (P =0.03),which indicated a run-in period for new application was needed in clinical setting.Conclusion:Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical setting.Through classification of activities,validation,objective measurement and longitudinal evaluation,the method could be applied in various systems as well as different clinical settings in measure efficiency.

Correlation between time management disposition and ability confidence of chinese nursing students： a meta-analysis

Objective： To evaluate the correlation between time management disposition and ability confidence of Nursing Students in China through the Pearson correlation coefficient. Methods： Electronic databases including the Cochrane library, PubMed, EMBASE, the Web of Science, CBM, Wanfang, VIP and CNKI were searched from inception to October 2017 to collect literature on the correlation between time manage-ment disposition and ability confidence of Chinese nursing students. The studies were examined according to the inclusion and exclusion criteria. After extracting data and evaluating the quality of the included studies. Meta-analysis was carried out using Stata 12.0 software. Results： A total of 7 articles with 1632 nursing students were included, and the quality of the literature was at medium level. Meta-analysis shown the total score of time management disposition of Chinese nursing students and its three dimensions were related to ability confidence. The summary correlation coefficient between time management disposition and ability confidence was 0.52 （0.43 to 0.59） ; There is a weak correlation between time value and ability confidence （r, 0.33; 95% CI, 0.25 to 0.39）; There was a moderate level of correlation between time control and ability confidence （r, 0.49; 95% CI, 0.43 to 0.54）; There was a moderate level of correlation between time efficacy and ability confidence （0.47, 0.41, 0.53）.And the relevance of nursing time management disposition and behavioral confidence varies with the nursing student＇s area, nursing student＇s diploma, measurement tools and sample size. Conclusion： The time man- agement disposition of Chinese nursing students is moderately related to ability confidence. When there are different in nursing students in the area, nursing diploma, measurement tools and sample size, the relevance is very different. The time management disposition of Chinese nursing students and their ability confidence are mutually reinforcing, and the time management disposition and their ability confidence should be further strengthened in the future.

护理专案改善活动在提高手术Time-Out准确执行中的应用

目的:对护理专案改善在提升临床手术Time-Out准确执行中的应用效果进行探讨。方法:本院自2016年3月开始开展护理专案改善活动,以提升手术Time-Out准确执行;以2016年活动开展前1~2月的640例手术作为对照组,选取2016年活动开展后8~9月的653例手术作为研究组,对两组Time-Out执行的准确率及手术不良事件进行比较分析。结果:对照组的执行的准确率为81.25%,手术不良事件发生率0.94%,研究组执行的准确率为94.95%,手术不良事件发生率0,差异有统计意义(P<0.05)。结论:实施护理专案改善能够有效提升手术Time-Out执行的准确率,提高手术安全性和手术效果,有着重要的临床意义。

TIME-H原则在慢性下肢静脉溃疡整体护理中的应用

目的观察TIME-H原则在慢性下肢静脉溃疡整体护理中的应用效果。方法将62例下肢静脉溃疡患者随机分成2组,对照组使用常规伤口护理方法,观察组在常规伤口护理的基础上实施"TIME-H"干预下的整体护理。结果观察组伤口治愈总体有效率为96.77%,显著高于对照组的77.42%(P<0.05);观察组患者满意率为98.60%,显著高于对照组的90.50%(P<0.05);观察组患者创面愈合时间、换药次数、渗液天数均较对照组显著缩短或减少(P<0.05);观察组实施TIME-H原则方案后平均评估分值显著降低(P<0.05)。结论将TIME-H原则应用在下肢静脉溃疡的整体护理中,为伤口护理提供了全面性、框架式的指南,可对患者提供更为科学、人性化的优质护理。

Times管理方案在心内科护士多参数心电监护仪警报疲劳中的应用

探讨Times管理方案在心内科护士多参数心电监护仪警报疲劳中的应用效果,以提高护士临床警报知识水平,改善警报管理态度和行为,减轻护士的警报疲劳,降低心电监护仪错误警报发生率。

Timing theory continuous nursing,resistance training:Rehabilitation and mental health of caregivers and stroke patients with traumatic fractures

BACKGROUND Stroke is the leading cause of adult lifelong disability worldwide.A stroke is an acute cerebrovascular disease with a variety of causes and corresponding clinical symptoms.Around 75%of surviving stroke patients experience impaired nerve function,and some suffer from traumatic fractures,which can lead to special care needs.AIM To determine the effect of timing theory continuous care,with resistance training,on the rehabilitation and mental health of caregivers and stroke patients with traumatic fractures.METHODS Between January 2017 to March 2021,we selected 100 hospital admissions with post-stroke hemiplegia complicated with a traumatic fracture.Two participant groups were created:(1)Control group:given resistance training;and(2)Observation group:given timing theory continuous care combined with resistance training.The degree of satisfaction and differences in bone and phosphorus metabolism indexes between the two groups were compared.The self-perceived burden scale(SPBS)and caregiver burden questionnaire were used to evaluate the psychological health of patients and caregivers.The Harris hip function score,ability of daily living(ADL)scale,and global quality of life questionnaire(GQOL-74)were used to evaluate hip function,ability of daily living,and quality of life.RESULTS Data were collected prior to and after intervention.Alkaline phosphatase(ALP),osteocalcin,and vitamin D3 in the observation group and control group increased after intervention(P<0.05),and carboxy-terminal peptide of type I collagenβSpecial sequence(β-CTX)decreased(P<0.05).ALP and osteocalcin in the observation group were higher than in the control group(P<0.05).There was no significant difference inβ-CTX and vitamin D3 between the two groups(P>0.05).The SPBS score of the observation group was lower and the ADL score was higher than the control group.The burden score was lower and the Harris hip function and GQOL-74 scores were higher than that of the control group(P<0.05).The observation group’s satisfaction rating was 94.00%,which was higher than the rating from the control group(P<0.05).CONCLUSION Timing theory continuous nursing with resistance training can reduce hip dysfunction in stroke patients with a traumatic fracture and enhance quality of life and mental health of patients and caregivers.

The Relationship between Time Pressure and Burnout Syndrome: A Cross-Sectional Survey among Jordanian Nurses

Burnout among nurses is well documented in literature. Precursors of burnout such as time pressure need further study for better understanding. In Jordan literature, studies regarding time pressure and burnout among Jordanian nurses are scarce. This study aimed to 1) evaluate the relationship between time pressure and burnout, and 2) identify participants’ characteristics that may have relationship with time pressure and burnout. A descriptive correlational design was utilized using a self-reported cross-sectional survey to collect data from 175 Jordanian nurses. Participants reported high level of time pressure (24.8 out of 126) and burnout (72.9 out of 126). Time pressure was correlated with emotional exhaustion and depersonalization (r = 0.561, 0.491, P < 0.01, respectively). Burnout was highest on the emotional exhaustion (72%) compared to 53.9% for depersonalization and 49.2% for personal achievement. Depersonalization showed the most frequent correlation with participants’ characteristics. Burnout was found to be common among Jordanian nurses, and time pressure is a precursor of this phenomenon, giving rise to the consequences on both patients’ and nurses’ health. Healthcare administrators have to modify the nursing work environment to be less stressful and more appealing to overcome the causes of nurses’ burnout.

手术室护士对Time out程序认知和态度的质性研究

目的:深入了解手术室护士对Time out程序认知和态度,并对Time out程序的执行提供建议。方法:采用现象学研究法,于2021年8月—2021年10月对14名手术室护士进行半结构访谈,采用Colaizzi 7步分析法对资料进行分析,提炼主题。结果:执行Time out程序的意义有促进手术安全、减轻护士工作压力、优化手术流程;执行Time out程序的障碍因素有手术医生不配合、担心耽误手术进度、缺乏Time out程序正确认知;执行Time out程序的相关建议有展开相关宣教、争取管理层支持、采用多方式提醒。结论:建议医院对手术团队展开相关宣教,并争取管理层支持以期提高Time out程序执行率。

Time out程序在手术安全核查中的应用研究进展

综述了Time out程序内容、国内外应用现状,建议在国内广泛应用Time out程序,树立手术室安全文化,提高Time out程序执行率,减少手术不良事件,提高手术安全,为推动手术室护理安全管理发展提供参考。

Characteristic Duties of Critical Care Nurses in Japan: A Time-Study Comparison with Neurology Ward Nurses

Background: The importance of the acute phase in hospitals has been increasing. While administering high-level critical care, the working styles of critical care nurses, the types of clinical care they provide, and the way in which they prioritize tasks, remain unclear. Aim of this study was to elucidate the characteristic duties of critical care nurses through a comparison with neurological ward nurses. Methods: We recorded the duties of critical care nurses and neurology ward nurses (10 each) using a time-study design. Duties were measured separately by action, classified using a classification table, and differences between the two groups were compared. Results: No differences in the number of actions were observed between the two groups. The top five items that required the most time for critical care nurses were, “Movement”, “Administration and oxygen management”, “Handover process/Doctor’s rounds”, “Preparation for entry and exit management of patients”, and “Bed bathing (for bedbound patients)”. Of the 195 items, significant differences between the groups were noted for 34 items, while the duties of critical care nurses were best characterized by bed bathing (for bedbound patients), changing position, confirmation of infusion tubes, handover process/doctor’s rounds, and preparation for entry and exit management of patients. Conclusion: A characteristic of critical care nurses is that they must remain near patients and perform tasks while moving only a short distance. Moreover, the promotion of tasks while communicating with physicians is presumed to play a role in the promotion of team medicine. Furthermore, much time was spent caring for patients in bed, and a lot of time was devoted to the preparation and finalizing of treatments and care, suggesting the possibility that more time can be spent on caring for patients through a revision of duties.

Time Management of the Clinical Nurses at Public Hospital in Bangladesh

Nursing is a very intense and focused career, so picking the right time and its proper management can help to relieve personal stress, manage tasks properly and achieve patients and organizational outcome. Objective: This study aimed to explore perceived time management skill of the clinical nurses. Methods: This was a descriptive correlational study design using simple random sampling. A total of 77 clinical nurses working in Mugda Medical College Hospital, Dhaka, Bangladesh were selected as study participants. The data were collected through structure questionnaire which consisted of demographic questionnaire and five dimensions of Time Management Skill Questionnaire (TMSQ). Results: The overall mean score of time management skill was 2.63 (SD = 0.28) reflecting a medium level of nurses perceived time management skill. The results also revealed that nurses age (r = 0.39, p = 0.000), monthly income (r = 0.294, p = 0.017) and service experience (r = 0.248, p = 0.030) were statistically significant correlated with nurses’ perceived time management skill. Conclusion: The outcome of this research would add to develop a strategy for nurse administrators to take an initiative for how nurses could improve the time management and utilize their limited time effectively. It specifies that proper time management can influence to provide quality care and achieving organizational goal.

The Influence of Sound Awareness on the Level of Sound Generated during Nursing Activity in a Pseudo-Ward

Sound generated in a ward can be classified into 1) generated by medical staff, 2) generated by patients and their visitors, and 3) others, such as from in-hospital broadcasting microphones and nurse calls. Among these sounds, the incidence from medical staff, in particular, is reportedly high. The study objective is to investigate whether sound awareness is effective in regulating the sound environment even in a busy situation, such as in a real clinical setting, and to examine the extent to which sound awareness affects sound level. Nursing students were asked to perform a series of nursing activities in a pseudo-ward, and the changes in the sound level generated during the nursing activities with or without time and sound awareness were examined. Under varying experimental conditions, the sound and time levels associated with the nursing activities were measured in the following order: condition 1, without sound or time awareness;condition 2, with time awareness but without sound awareness;and condition 3, with both sound and time awareness. The time to perform nursing activities was longer with sound awareness. However, when aware of time only, the sound level from nursing activities rose by 2.3 dB, whereas when aware of both time and sound, the sound level dropped by 3.0 dB. With both time and sound awareness, there is a distinct drop in the sound level from nursing activities, such as wagon handling, handling of items (trays, bowls), working at the sink, and opening and closing the microwave oven door. These results suggest that even in a pseudo-clinical setting it is possible to regulate the environmental sound through the environmental sound awareness of the medical staff, resulting in a drop in the sound level generated while performing nursing activities.

Part-Time Nurse Faculty Intent to Remain Employed in Academia: A Cross-Sectional Study

The purpose of this study was to test and refine a model of part-time nurse faculty intent to remain employed in the academic organization. Cross-sectional survey methods were used. A total of 282 part-time nurse faculty working in colleges or universities in Ontario, Canada were invited to participate. Survey instruments and items measured demographic, workplace, nurse responses to the workplace, and external variables. Correlation, multiple regression, and mediation analyses were conducted using data from 119 participants (47.6% response rate). Of the 19 variables hypothesized to affect intent to remain employed in the academic organization, seven influenced intent to remain. The resulting model indicated that the older the part-time nurse faculty member, the lower the level of intent to remain and the more years worked in the organization, the higher the level of intent to remain. The more opportunities perceived to exist outside of the employing organization, the higher the level of intent to remain. Additionally, the more satisfied part-time nurse faculty were with their job overall, the higher their level of intent to remain. In the workplace, the more support from the leader, the more formal or informal recognition received, and the more fair work procedures were perceived to be, the higher levels of part-time nurse faculty intent to remain employed in the academic organization, mediated by job satisfaction. Although age, organizational tenure, and external career opportunities are non-modifiable variables, deans and directors can encourage part-time nurse faculty to remain employed in their academic job by focusing on enhancing overall job satisfaction. Effective strategies may include formal or informal acknowledgement of good performance, consistent verbal and behavioural support, and implementation of procedural practices, such as performance evaluations and pay raises in a fair manner.

护理专案改善在临床手术Time-Out准确执行中效果研究

目的:探究护理专案改善在提升临床手术Time-Out准确执行中的应用效果。方法:将医院收治的60例患者随机分为对照组(实施常规基础护理,30例)和观察组(实施护理专案改善活动,30例),比较两组患者Time-Out执行准确率、不良反应发生率、焦虑SAS评分、护理满意程度VAS评分。结果:观察组Time-Out执行准确率和不良反应发生率优于对照组(P<0.05);观察组焦虑SAS评分和护理满意程度VAS评分优于对照组(P<0.05)。结论:护理专案改善在提升临床手术Time-Out准确执行中的应用效果显著,同时还可以减少不良反应的发生。

“TIME”原则联合自制负压引流装置在1例主动脉夹层术后切口脂肪液化病人中的应用

总结1例主动脉夹层术后切口发生脂肪液化的护理经验,运用伤口床原则评估切口情况,根据评价结果,基于“TIME”伤口床准备原则制定伤口管理方案,包括清除坏死组织、控制感染、使用负压引流装置进行引流以控制伤口湿度平衡、促进伤口边缘生长,并结合营养支持、疼痛管理、心理护理等措施,病人切口愈合佳,顺利出院。

基于共同养育理念的剖宫产产妇泌乳分期护理方案构建及实施

目的探讨基于共同养育理念的泌乳分期护理在剖宫产产妇母乳喂养中的应用效果。方法将200对行剖宫产手术的产妇及配偶按照住院时间分为对照组和试验组各100对。对照组给予常规护理,试验组采用基于共同养育理念的泌乳分期护理,将泌乳过程分为乳腺分化期、乳腺活化期、泌乳建立、泌乳维持4个阶段给予针对性的主题教育及干预措施。结果对照组和试验组分别95对和97对产妇及配偶完成研究及随访。试验组首次母乳喂养得分显著高于对照组,泌乳启动时间显著早于对照组(均P<0.05);试验组中配偶母乳喂养知识水平、出院时纯母乳喂养率、产后6周产妇感知配偶母乳喂养支持总分及各维度得分显著高于对照组(均P<0.05)。结论基于共同养育理念的泌乳分期护理可提高首次母乳喂养得分、新生儿父亲母乳喂养知识水平,缩短泌乳启动时间,提升出院时纯母乳喂养率,改善产妇感知配偶母乳喂养支持情况,从而促进母乳喂养。

癌症病人时间感知的研究进展

对癌症病人时间感知的概念、转变特点、影响因素、干预措施等方面进行综述,指出国内关于癌症病人时间感知的研究较少,可借鉴国外相关研究的优点与不足,并进一步探索癌症病人时间感知影响因素,开展纵向前瞻性研究,以探讨其时间感知的纵向变化特征。

以Cameron适时理论为基础的全程护理模式在烧伤后瘢痕整形患者中的应用

目的:研究以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者的干预效果。方法:选择2021年9月-2022年6月笔者医院收治的60例烧伤后瘢痕整形患者为研究对象,采用随机数字表法分为对照组(30例)和观察组(30例)。对照组给予常规护理干预,观察组在对照组的基础上采用以Cameron适时理论为基础的全程护理模式进行干预,两组均干预8周。统计比较两组瘢痕恢复效果、并发症发生情况、心理状态、应对方式及护理满意度。结果:干预后,观察组创面渗出持续时间、疼痛持续时间均短于对照组(P<0.05);两组创面愈合时间、色素沉着率比较差异无统计学意义(P<0.05)。干预8周后,观察组瘢痕恢复总有效率显著高于对照组(P<0.05);观察组心理韧性评分高于对照组(P<0.05),焦虑、抑郁、心理困扰评分低于对照组(P<0.05);观察组屈服、回避评分低于对照组(P<0.05),面对评分高于对照组(P<0.05);观察组护理总满意率高于对照组(P<0.05)。干预期间,观察组总并发症发生率低于对照组(P<0.05)。结论:以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者进行干预,可有效促进患者创面愈合,改善患者心理状态及应对方式,降低并发症发生率,患者满意度高,具有较好的应用价值。

新入职护士时间管理倾向与临床实践行为的调查研究

目的探讨新入职护士时间管理倾向与临床实践行为的现状、相关性及影响因素。方法于2022年1月选取九江市的市级、县级5家医院的145名新入职护士作为调查对象,采用问卷调查的方式,对护士进行一般人口学特征6项,时间管理倾向量表3个维度及临床实践行为3个维度的调查,比较不同人口学特征护士的时间管理倾向、临床实践行为,采用Pearson检验分析护士时间管理倾向与临床实践行为的相关性,采用多元线性回归分析临床实践行为的影响因素。结果145名护士的时间管理倾向量表总分为(3.74±0.62)分,其中时间价值感、时间监控观、时间效能感得分较高。临床实践行为评分总分为(4.15±0.64)分,其中认知、情感、操作技能得分较高。不同学历、生源地、所在医院级别、是否担任班干部的护士时间管理倾向评分比较,不同学历、生源地、所在医院级别的护士临床实践行为评分比较,差异有统计学意义(P<0.05)。时间管理倾向量表3个维度评分及总分,与临床实践行为3个维度评分及总分呈正相关(P<0.05)。多元线性回归分析显示,护士的学历、生源地、医院级别、时间管理倾向3个维度评分及总分为临床实践行为的影响因素(P<0.05)。结论新入职护士时间管理倾向与临床实践行为处于较高水平,而且呈现正相关,其中生源地、市级医院、时间管理倾向为临床实践行为的影响因素,因此需加强时间管理技巧的培训,提高护士的临床实践行为,研究价值较高。

基于时间节点为导向的院内快速急救模式在急性心肌梗死中的应用

目的 分析基于时间节点为导向的院内快速急救模式在急性心肌梗死(AMI)应用方面的效果。方法 挑选2020年1月—2021年6月新疆医科大学第一附属医院治疗的AMI患者597例设为对照组,实施常规急救护理干预,选取2021年7月—2022年12月急诊收治的597例AMI患者设为观察组,实施基于时间节点为导向的院内快速急救模式干预。比较两组救治流程时间、心肌酶谱水平、抢救效果及护理满意度情况。结果 观察组分诊时间、完成院内首份心电图时间、急诊球囊开通时间、急诊室停留时间、经皮冠状动脉介入(PCI)术治疗时间均比对照组短(P<0.05)。出院前1 d观察组心肌酶谱指标心肌肌钙蛋白(cTnT)和肌酸激酶同工酶(CKMB)水平均比对照组低(P<0.05)。观察组住院时间比对照组短(P<0.05),并发症出现的概率及病死率方面,观察组(分别为3.69%、1.68%)均比对照组(11.22%、7.71%)低(P<0.05)。观察组护理总满意度(95.64%)比对照组(79.06%)高(P<0.05)。结论 基于时间节点为导向的院内快速急救模式在了AMI患者救治过程中能有效缩短各个救治流程时间,减少心肌损伤,提升救治效果及护理满意度,改善患者预后。