Prevalence and Influencing Factors on Fatigue of First-line Nurses Combating with COVID-19 in China:A Descriptive Cross-Sectional Study

Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan,China,and to analyze its influencing factors on fatigue.A multi-center,descriptive,cross-sectional design with a convenience sample was used.The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3,2020 to March 10,2020 in Wuhan of China.A total of 2667 samples from 2768 contacted participants completed the investgation,with a response rate of 96.35%.Social-demographic questionnaire,work-related questionnaire,Fatigue Scale-14,Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Chinese Perceived Stress Scale were used to conduct online survey.The descriptive statistic of nurses'social-demographic characteristics was conducted,and the related variables of work,anxiety,depression,perceived stress and fatigue were analyzed by Z-tests,nonparametric test and Pearson's correlation analysis.The significant factors which resulted in nurses'fatigue were further analyzed by multiple linear regression analysis.The median score for the first-line nurses'fatigue in Wuhan was 4(2,8).The median score of physical and mental fatigue of them was 3(1,6)and 1(0,3)respectively.According to the scoring criteria,35.06%nurses(w=935)of all participants were in the fatigue status,their median score of fatigue was 10(8,11),and the median score of physical and mental fatigue of them was 7(5,8)and 3(2,4)respectively.Multiple linear regression analysis revealed the participants in the risk groups of anxiety,depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses'fatigue,the frequency of exercise and nurses'fatigue had a statistically significant negative correlation,and average daily working hours had a significantly positive correlation with nurses'fatigue,and the frequency of weekly night shift had a low positive correlation with nurses'fatigue(P<0.01).There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan,China.Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors,and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses,and to enhance their health status and provide a safe occupational environment worldwide.Promoting both medical and nursing safety while combating with the pandemic currently is warranted.

Gender and managerial competence:a comparison of male and female first-line nurse managers in Indonesia

Objective:First-line nurse managers are more likely to work according to gender beliefs and stereotypes,which may affect their managerial competence.This study is aimed at comparing managerial competence of male and female first-line nurse managers in public hospitals in Indonesia.Methods:This study employed a descriptive comparative approach with a cross-sectional survey with a total of 256 participants selected from 18 public hospitals.To measure managerial competence,the managerial competence scale for Indonesian first-line nurse managers was used.Data were analyzed using descriptive analyses using mean,standard deviation,and Independent t-test.Results:Managerial competence of male and female first-line nurse managers was not significantly different(P=0.555).Female nurse managers descriptively reported/received higher ranking in facilitating spiritual nursing care,managing self,staffing and professional development,utilizing informatics,and applying quality care improvement.Male nurse managers repor ted higher in leadership and financial management.Conclusions:Female and male first-line nurse managers should be treated equally for leadership and managerial development.

Enhancing competency of clinical research nurses:A comprehensive training and evaluation framework

The Sun et al's training program for clinical research nurses(CRNs)in the World Journal of Clinical Cases is a comprehensive and scientific approach.It includes structured frameworks for CRN training,aiming to improve CRN competency.This program emphasizes practical abilities,updates training content,and improves evaluation methods.The cultivation of CRN talents focuses on enhancing the training system,establishing a multifaceted evaluation framework,and continuously refining the training programs.Regular feedback and evalua-tion are essential to improve CRNs'competency in practical settings.

Culturally competent care across borders: Implementing culturally responsive teaching for nurses in diverse workforces

The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home countries.The World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].

Factors Promoting Retention of Nurses in Three Private Hospitals of Lahore: A Cross Sectional Descriptive Survey

Introduction: Pakistan has a large number of professional nurses but a higher rate of turnover contributes towards the shortage of nurses which is intensified by nurses’ immigration, lack of recruitment of new nurses and retirement of senior nurses. Aim: The study aimed at examining the factors that increase retention of nurses. Research Method: The study is descriptive cross sectional with a sample of 150 nurses including both the genders, from 3 private hospitals located in Pakistan. A convenient sampling technique was used. The data collection was done through close ended questionnaires based on 20 questions. Data collection was done quantitatively and then data was entered in SPSS. Correlation and regression tests were performed. Findings: The analysis revealed that 91.3% nurses are loyal to their hospitals but, 8.7%nurses can switch the hospital for different reasons. It was also found that the idea of leaving the job based on the intention of moving to abroad and public sector was higher than the retirement and other causes. Resultantly, enhancements in nurses’ work environments have the ability to decrease nurses’ job burnout and turnover and increase patients’ satisfaction. Recommendations: Hospital leaders should implement effective strategies to encourage nurses to continue their job by motivation, strengthening management skills within the hospital and improving a positive work environment by promoting teamwork, continuous learning, trust, respect and flexible arrangements which can lead towards achieving better results.However, further studies quantitatively and qualitatively can explore more factors related to dissatisfaction of nurses. Health systems policy makers should lead by developing related strategies for the retention of nurses.

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

Background: Implementing invasive procedures is an important part of patient management by clinical nurses;however, there are gaps between nurses’ actual knowledge and skills and expected professional care capacity. Purpose: This scoping review aimed to map the existing literature related to recent institution-provided educational programs for invasive procedures involving clinical nurses. This study seeks to understand the contents of educational programs and the methods for assessing educational effects. Methods: This scoping review was completed using the following four databases: PubMed (MEDLINE), Embase, Cochrane Library, and Emcare for the period 2000-2022. We included studies that used all forms of educational approaches (e.g., didactic lectures, hands-on training, or on-the-job training). This scoping review considered peer-reviewed publications published in English using quantitative, qualitative, or mixed approaches. A total of 83 studies underwent in the final analysis. Results and Conclusion: A combination of didactic lectures and hands-on training was provided as an educational program in most studies. Contrary to our prediction, educational interventions with advanced technologies such as VR are extremely rare, suggesting that the effectiveness of advanced technologies in learning invasive procedures should be examined to facilitate and retain educational effects more efficiently in future studies. Regarding the assessment of educational effects, nurses’ cognitive (i.e., theoretical knowledge about procedures), psychomotor (i.e., implementing procedures), and psychological aspects (e.g., confidence and self-efficacy in procedures) were evaluated using questionnaires and observational methods. While most studies used a one-group pretest-posttest design, the ratio of randomized controlled trials (RCT) was relatively low. Thus, an RCT design should be introduced in future studies to test the validity of the developed educational program more accurately.

A Survey of Digital Content Required for STD Prevention Education Taught by School Nurses

Purpose: In recent years, there has been concern in Japan about the increase in STDs among adolescents aged 15 - 19. In order to prevent STDs and guide adolescents toward desirable sexual behavior, this study’s goal was to examine the actual state of STD prevention education taught by school nurses as part of the school curriculum, as well as the kinds of digital content they wish to have for teaching on the subject. Method: An anonymous, self-administered questionnaire was distributed by email and leaflet. Targeting the 100 valid responses received from the surveyed school nurses, descriptive statistics were made for each survey item and comparisons were made between the early- and mid-career groups based on years of experience. Results: 70.0% of respondents reported teaching about STDs in Health & Physical Education classes. School nurses in the early-career group used ready-made materials, while the mid-career group used both ready-made and self-made materials. 95% of respondents reported that they had little or no knowledge of STDs, while 84% reported that they were “good” or “fairly good” at teaching classes on sexuality. Both groups reported difficulty with the topics of “phimosis” and “nocturnal emissions” in the physiological category, “sexual behavior” in the “sex-adjacent” category, and “sexual and reproductive issues” in the psychosocial category. Respondents expressed a need for digital content covering the topics of “sexual violence”, “sexual abuse”, “sexually transmitted diseases”, and “how to turn down sex”. The mid-career group desired digital content for more items than the early-career group, with significant differences in the pathogens involved in sexually transmitted diseases and sex-adjacent items. 32.0% of respondents answered that they had done self-study for sex education classes in the past three years, and both groups desired self-study on “sexually transmitted diseases”, with the mid-career group significantly higher than the early-career group on “cervical cancer & HPV”, “emergency contraceptives”, and “media literacy”. Conclusion: Health & Physical Education is the main subject that covers STDs, and pre-existing materials are commonly used. It is expected that this is due to nurses’ busy schedules and the fact that only one school nurse is assigned to each school. The data collected suggested that nurse teachers want categorized digital content that can be used in the classes they are responsible for, rather than educational content on topics they are not comfortable with. In addition, given the changing environment surrounding sex, it was clear that they wish to understand the realities and needs of the high school students they teach, and desire self-study opportunities to improve their teaching methods.

Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Outcome of Nurses with Occupational Dermatitis

Background: Occupational dermatitis is considered as the second most common occupational disease. It accounts for 25% of all lost workdays. Several international studies reported a prevalence of occupational dermatitis in healthcare workers between 17% and 55%. This study aims to identify factors that affect the professional outcome of nurses suffering from occupational dermatitis. Methods: This was a multicenter cross-sectional study concerning nurses declared having occupational dermatitis in the central region of Tunisia. A synoptic sheet related to socio-professional and administrative data was completed. A self-administered Questionnaire going over medical and occupational characteristics was completed during a direct interview. Results: The study involved forty nurses working in four public hospitals in the center of Tunisia. Only 37 workers were included in the study. A professional reclassification was introduced among 19 workers (51% of study population). Work-station adaptation was requested in 14 cases (38%). Exposure to allergens in the workplace was eliminated in 20 cases. Two study participants were transferred to other departments (5.4%) and three people retired (8.1%). A statistically significant association was found between professional reclassification and a history of allergic manifestations (p = 0.003). Similarly, a significant association was found between professional reclassification and the allergic agent (p = 0.014). Workstation layout was significantly associated with a history of allergic manifestations (p = 0.039), the palm hand location (p = 0.04), professional eviction (p Conclusion: This study identified the main factors influencing the occupational outcome of nurses suffering from occupational dermatitis. This outcome depended on a history of atopy (especially allergic rhinitis) and sensitization to allergens (thiuram mix).

New Nurse Perceptions of Preparedness: Elements of Academic-Practice Gap

The education-practice gap, also known as the academic-practice gap is recognized as the difference between what a nursing student is taught and what the new nurse will experience in practice. This study evaluated specific education outcomes of schools of nursing in New Hampshire through surveys of new nurses and their employers. The responses were explored in relation to identified factors such as curriculum and clinical hours. The findings suggest that the new nurses felt prepared for practice, except in relationship to provision of care and medication administration for six or more patients. Of note is that 61% percent of participants were involved in errors and of these, 37.5% indicated that their education did not prepare them to administer medications to large groups. Evaluation of employer responses points to at least one and sometimes two levels of lower perception of perceived preparedness by the employer. The results highlight the differences between perceptions of preparedness of new nurse and employer, differences in perception of preparedness based on program type for specific gap elements, and the high rate of errors among new nurses. These results underscore the need for further research regarding the education practice gap, error factors, perceptions of preparedness for practice, and practice-readiness expectations of employers.

Enhancing Patient Safety in the Operating Room: A Comprehensive Guide from a Nurse’s Perspective

Ensuring patient safety within the operating room is a paramount concern in contemporary healthcare, and this guide aims to provide an in-depth exploration of this crucial aspect from the perspective of nurses. Nurses play a pivotal role in supporting surgeons and maintaining a safe environment for patients undergoing various medical procedures.

Investigation of Student Nurses’Attitudes towards End-of-Life Care and Their Influencing Factors

Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey student nurses enrolled in one of four nursing colleges in China from January 2023 to December 2023. Student nurses’ general demographic and prior related information, attitudes towards death and attitudes towards end-of-life care were determined using a general information questionnaire, the Death Attitude Profile—Revised scale and the Professional End-of-Life Attitude Scale (PEAS), respectively. Results: The total PEAS score was 122.91 ± 16.123. Significant differences were noted in the attitude towards end-of-life care scores according to sources of end-of-life care knowledge (P Conclusions: Student nurses lacked an optimistic attitude towards end-of-life care, which was influenced by differences in the sources of end-of-life care knowledge.

Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

Current state and influencing factors in airbag management among emergency department nurses:A multicenter study

BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.

Nurse anesthetists’perceptions and experiences of managing emergence delirium:A qualitative study

BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Facilitating and hindering factors of community nurses'emergency and critical care treatment abilities:A qualitative study

BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.

Application and Promotion of Whole-Process Capacity Management Model for CHF Patients Led by Specialist Nurses in “Heart Failure Center Alliance Unit”

Objective: To implement the whole-process capacity management model led by specialist nurses, improve the capacity management behavior of medical staff, and build a standardized, standardized and operable CHF capacity management system. Methods: According to the evidence pyramid principle and search strategy, 2 evidence-based nursing backbone completed literature search in both Chinese and English, and finally included 7 literatures. Results: Around the three key links of capacity assessment, monitoring and management, stakeholders were invited to evaluate each evidence according to the FAME principle, that is, the feasibility, suitability, effectiveness and clinical significance of evidence. Finally, 11 best evidences were obtained and 5 clinical review indicators of the cost project were transformed. This study formulated the competence management plan for CHF patients based on the current situation, established competence load evaluation criteria for CHF patients, and determined the target “dry weight” value for CHF patients. Conclusion: The whole-course volume management model of CHF patients guided by specialist nurses should be established and applied and promoted in the “heart failure Center Alliance unit”, so as to improve the capacity management ability of medical staff for CHF patients, enhance the self-management ability of CHF patients, improve the capacity management behavior and health outcomes, and effectively reduce the hospitalization rate and mortality rate of CHF patients in the region.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Practical Exploration of Strengthening Team Communication and Cooperation in Head Nurse Nursing Management

This study explores the practical application of nursing management led by head nurses to enhance team communication and collaboration within clinical settings.By integrating leadership theories with nursing practice,this research adopts a qualitative methodology to examine the effects of strategic communication and teamwork enhancement initiatives.Through interviews,observations,and the analysis of case studies in various hospital departments,the study identifies key barriers to effective team communication and collaboration,including hierarchical structures,lack of standardized communication protocols,and insufficient training.Solutions implemented involve targeted communication skills training,the establishment of interdisciplinary teamwork protocols,and leadership workshops for head nurses.The outcomes indicate significant improvements in team efficiency,patient care quality,and staff satisfaction.This research underscores the importance of head nurses in fostering an environment conducive to open communication and collaborative practice,thereby advancing patient care and team performance.

Core competencies and perceived training needs of nurses in the background of Internet plus nursing service:a qualitative descriptive study

Background:The Internet plus nursing service program is being piloted in China,which has become a new home nursing service model led by nurses.To enable safe and effective homecare service delivery,nurses working in the program need a high level of competency.However,the content of these core competencies and the training needs of nurses for Internet plus nursing services are still unknown.Aim:To describe nurses’perceptions of core competencies and training needs to work in the Internet plus nursing service program,thereby providing a reference for the development of training programs.Methods:A qualitative descriptive study using semi-structured interviews was conducted on 15 nurses with experience of working in the Internet plus nursing service program.Interviews were audio-recorded and transcribed verbatim,and the data were analyzed using thematic analysis.Results:Core competencies involved comprehensive assessment competence,direct care practice competence,health education and consulting competence,risk estimation and response competence,and communication competence.Training needs involved complex operational items,knowledge of chronic disease management,professional communication,risk identification and response,nursing standards,norms,and procedures,and utilization of information technology.Conclusions:The training system may be developed based on nurses’core competencies and their training needs to promote professional development of the Internet plus nursing service.