Experiences of Practical Nurses in Promoting the Rehabilitation of the Elderly and Their Education - A Secondary Publication

The significance of rehabilitation-promoting nursing care is emphasized in aging Finland. According to studies, rehabilitation-promoting nursing care enhances the functional capacity of the elderly. The Elderly Services Act obliges municipalities to create a plan to support the elderly population, emphasizing home care and rehabilitation measures. A large portion of graduated practical nurses will be working with the elderly, so the education of practical nurses must meet the needs of the workforce. The study aimed to produce new information on the implementation of rehabilitation- promoting nursing care in the elderly service system and on the education of rehabilitation-promoting nursing care for the elderly in vocational institutions. The research data was collected in the autumn of 2020 through individual thematic interviews with practical nurse students (n = 8). The data was analyzed using inductive content analysis. Practical nurse students’ experiences of rehabilitation-promoting nursing care for the elderly were related to nurses’ time management, organizational practices, nursing competence, nurses’ attitudes, nurses’ practices, organizational development, implementation and development of practical education, factors affecting the use of aids, and technological aspects of aids in the future. In conclusion, it can be stated that the content of education and practical work life do not align. It is essential to increase competence in rehabilitation-promoting nursing care and to develop organizational practices.

Exploration and Application of the Flipped Classroom Based on Outcome-Oriented Educational Principles in Vocational Nursing Practical Training

Purpose:To explore the practical effects of using the flipped classroom approach based on outcome-oriented educational concepts in nursing practical training at vocational colleges.Methods:From February 2023 to February 2024,a total of 62 nursing trainees from our school were sampled and randomly divided into a study group and a control group using a randomized controlled trial design,with 31 students in each group.The control group received conventional training,while the study group received practical training based on the outcome-oriented educational concept in flipped classrooms.Comparison was made between the two groups on assessment scores,teaching satisfaction,and self-directed learning ability ratings.Results:Statistical comparisons showed that the study group’s assessment scores,teaching satisfaction,and self-directed learning ability ratings were significantly higher than those of the control group(P<0.05).Conclusion:The flipped classroom model based on outcome-oriented educational concepts in nursing practical training at vocational colleges can improve students’assessment scores and self-directed learning abilities,and enhance teaching satisfaction,demonstrating potential for wider application and dissemination.

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing,China:A cross-sectional study

Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

A Bibliometric Study on The Application of Progressive Muscle Relaxation Training in The Nursing Field in China

Objective:To systematically analyze the research status and application of progressive muscle relaxation training(PMRT)in the nursing field in China,and provide a reference basis for scientific research in this field.Methods:The bibliometric method was adopted in“progressive muscle relaxation training”or“PMRT,”and“nursing.”The established database was included in the China National Knowledge Infrastructure(CNKI)and the Wanfang Medical Network.The relevant articles in the Chinese Science and Technology Periodical Database(VIP)were analyzed.Results:A total of 169 literatures were included.The journals,years,and regions of literature publication were uneven,mainly originating from the eastern region(43.19%),and listed the application of progressive muscle relaxation training in the field of nursing in China.Intervention literature information was mainly dominated by experimental studies(97%).Conclusion:The related research and application of progressive muscle relaxation training in nursing in China is increasing,but there is a lack of objective evaluation of outcome indicators and a short intervention period.Further research should be conducted in the future to effectively guide the development of PMRT in the field of nursing in China.

Current status of clinical nursing specialists and the demands of osteoporosis specialized nurses in China's Mainland

The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.

A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease(COPD)

Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

Perceptions of the effectiveness of Advanced Practice Nurses on a neurosurgery unit in a Canadian Tertiary Care Centre:A pre-and-post implementation design

Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,education and leadership.The goal of this study was to evaluate perceptions of the effectiveness of the implementation of an innovative APN role on an in-patient Neurosurgery unit.Methods:A pre-and-post implementation design,incorporating both qualitative and quantitative data,was utilized.An innovative APN role was implemented within the Neurosurgery program focusing on the clinical domain and required the successful candidates to be NP prepared.This APN role was designed to improve patient flow,documentation,communication and patient and staff satisfaction.Three primary outcomes were measured:pre-implementation questionnaire(nurses),post-implementation questionnaire(nurses and residents)and number of pages to the on-call resident.Results:Survey scores by nurses and residents indicated improvement across all aspects studied.Average scores increased from 1.1 to 2.6,reflecting an overall statistically significant increase.The number of pages to the on-call resident also showed a decrease.Conclusion:Perceptions of patient care delivery and professional collaboration improved following implementation of the APN role.Responses indicated that APNs significantly impacted patient care and improved nurses and residents'job satisfaction.

Studying the Reinforcement Effect of a Seminar on Ethical Practices among Pediatric Nurses

Aim: This study aimed to examine the effect of a seminar to continuously reinforce ethical nursing practices among pediatric nurses. Methods: This seminar was based on a 24-point pediatric nursing care model (PNCM) that provided specific examples of basic ethical nursing practices for children undergoing medical procedures and their families. Participants’ knowledge level and application frequencies, regarding these practices, were assessed face-to-face in the first session and via email 2 and 5 months later, using the PNCM checklist and qualitative data about ethical practices. Results: Results revealed that 8 PNCM items about frequency remained the same as the first session after 5 months;however, 16 items reported increased application. The qualitative data collected 2 months later suggested that the nurses could have adapted better to implement ethical pediatric nursing;however, the one collected 5 months later confirmed the effect of the seminar on ethical nursing practices with children and their families. The continuous effect of the seminar became more evident from the responses received 5 months later than those received 2 months later. Conclusions: The findings confirmed a reinforced effect on ethical pediatric nursing practice with child patients and their parents after 5 months.

Realities,scope,challenges,and facilitators for implementation of nurse practitioner's role in India:A review

India is in dire need of an alternative to general medical practitioners to overcome a severe shortage of doctors,especially in rural and underprivileged regions.Empowering nurses through nurse practitioner(NP)role is the superlative solution to provide quality health care in primary care setting.Based on conceptions and research findings of the NP's role,we analyzed and examined the realities,scope,and barriers for implementing the NP's role in India and propose future strategies to create a NP cadre.

A survey of moral distress in certified registered nurse anesthetists:A theoretical perspective for change in ethics education for advance practice nurses

Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 CRNAs.Results:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed important.Conclusion:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral distress.Findings indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.

Development of the Emerging Theory of Encountering Nursing in a Nurse-Nursed Dyadic Relationship (ThENNDyR)

Encounters are celebrated experiences between persons with connectedness in human situations as expectation. While being in a human dynamic and rhythmic interaction, nursing encounters are dyadic relationships illuminated as patterns of an interconnected relationship moving between the nurse and the nursed, and reflecting person-and-otherness events. The purpose of this paper is to describe the theory of Encountering Nursing in a Nurse-Nursed Dyadic Relationship (ThENNDyR) and to illuminate the four nursing practice processes on which the theory is founded: Knowing as appreciating relational moments;Reflecting as engaging moments;Realizing as patterns of living moments;and Transcending as celebrating moments. Nursing practice occurs in moments in which dyadic relationships transpire as nursing encounters. As fleeting as moments are, the four processes of nursing simultaneously take place as understanding conditions that the who and what of the person warrants persons. “Encountering nursing” is a momentary co-existence of persons in a person-and-otherness situation communicating connectedness-interconnectedness in distinct patterning. Interactions in nursing exist as persons remain wholes and complete in the moment.

Nurses Perception of Advance Nurse Practitioners Roles in Public Hospitals: A Qualitative Study

Aim: To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. Background: Advanced nurse practitioners are one of the leading professionals who contribute to health promotion, disease prevention, health counseling and patient education. However, misunderstandings of their roles may have an impact on the performances of the function that limits their access and the use of significant resources that can help patients to obtain treatment. Methods: This is a qualitative exploratory study conducted on nurses working in three public hospitals. Semi-structured interviews were conducted among fourteen nurses between October-January 2020. The three public hospitals were based in Eastern (1) and Central (2) Saudi Arabia regions. Data analysis was conducted through thematic analysis utilizing inductive and deductive coding. Results: The study found that the role of Advanced Practice Nurses will enhance, motivate, and sustain the status of nurses in Saudi Arabia. Findings indicated that advanced practitioners’ educational preparedness, organizational, and contextual factors are important factors that need to be addressed to promote their role and to improve nurse’s perception about the APN role in clinical practice. Conclusion: This research provided new evidence to support the need to raise understanding of the role of advanced nurse practitioners among nurse members, advanced nurses and clinical nurse specialists who wish to enhance quality healthcare delivery and job satisfaction in the Kingdom of Saudi Arabia. Recognizing the factors that comprise the function and status of APNs will assist health-care officials to make informed decisions when designing a national policy and a plan for the implementation and the development of the role of APNs.

What are the barriers to implementing nurse practitioners’ role in health settings?

Background:Nurse practitioners can assist the healthcare system by administering care to patients with medical or complex or chronic conditions by providing medical and nursing care in an expanded scope of practice.However,there are barriers that influence the implementation of nurse practitioners'role in health settings.Influences among systemic or organization levels have impeded nurse practitioners'role implementation.All 10 studies included in this integrative review are critically explained based on the relevant information categorised into three themes:a lack of clarity regarding nurse practitioners'role,fees for service physician remuneration and resistance from other health professionals.The 10 studies included in this integrative review reveal barriers to nurse practitioners'role implementation in health settings.Objectives:The aim of this integrative literature review is to identify the barriers to implement the nurse practitioners'role.Therefore,the following research question is posed:"What are the barriers to implementing the nurse practitioners'role in health settings?".Methods:An integrative review of the medical and nursing research literature has been conducted using a systemic search accessing CINAHL,Medline,Scopus and PubMed databases.The identified 287 articles have been narrowed to 10 articles based on specific inclusion and exclusion criteria.A limitation search was applied at the beginning of the search phase to assist in identifying the range and type of studies potentially available for synthesis.The srearch was limited to human,peer reviewed and full text articles available in English language without a date limitation to obtain a large number of avilable studies that were relevant to the topic.Finding:The literature search resulted in 10 primary studies that met the inclusion criteria.All studies included in this integrative review reveal barriers to nurse practitioners'role implementation in health settings.All studies found three barriers that can impact on the implementation which are:the lack of clarity of nurse practitioners'role,fees for service physician remuneration and resistance from other health professionals.Conclusion:Health settings must prepare the surrounding environment and the culture before implementing a new role,such as that of nurse practitioners.Implementing new roles into the organization is not straightforward:multiple influences can affect the implementation,such as barriers.Understanding the involvement of nurse practitioners'role in health settings by health care providers have to be visible and clear and changes that may occur as a result of implementing the role need to be identified to ensure the successful implementation.

Surgical Site Infection Prevention Practices and Associated Factors among Nurses Working in Government Hospitals of Harari Regional State and Dire Dawa City Administration, Eastern Ethiopia

Background:Surgical site infections are the most frequent type of preventable hospital acquired infections with a serious and undesirable outcome of surgery associated with increase morbidity,mortality rate,hospital stay,readmission and excess cost.Surgical site infection prevention is one of the most important challenge in delivering optimal nursing care.Studies suggest that the nurses’practices of surgical site infection prevention is not well addressed.Moreover,there is clearly paucity of information,in Africa including the study area.Objective:The aim of this study was to assess surgical site infection prevention practices and associated factors among nurses working in government hospitals of Harari Regional State and Dire Dawa City Administration,Eastern Ethiopia from March 01 to 28,2019.Method and Materials:An institutional based cross-sectional study design was employed for a total of 515 nurses.Simple random sampling method was used to select study participants.Data were collected using pretested structured self-administered questionnaire supplemented by observation.Data were checked,coded,entered and cleaned using Epi-data version 3.1 and exported to SPSS version 20 for analysis.Bivariate and multivariate analysis were undertaken and P values less than 0.05 at 95%confidence interval were considered as statistically significant.Result:The overall self-reported level of SSI prevention practice was found to be 40.8%(95%CI:36.9%,45.4%).Nurses with BSc and above[Adjusted odds ratio(AOR)=2.52,95%CI(1.14,5.54)],trained on infection prevention[AOR=2.22,95%CI(1.29,3.82)],good knowledge[AOR=2.21,95%CI(1.32,3.71)],good attitude[AOR=5.11,95%CI(3.05,8.57)],got supply of personal protective equipment[AOR=2.57,95%CI(1.46,4.49)],had management support[AOR=3.41,95%CI(1.90,6.12)],experience of 5 to 10 years[AOR=5.38,95%CI(2.82,10.27)]and≥11 years[AOR=3.48,95%CI(1.47,8.25)],were found to be statistically and positively associated with nurses SSI prevention practice.Conclusion:In this study,the level of surgical site infection prevention practice was poor.Being BSc and above,being knowledgeable and good attitude,got personal protective equipment,had management support,serving for≥5 years and trained on infection prevention were found to be significantly associated with surgical site infection prevention practice.Updating knowledge and practice of nurses through in-service education and training on latest evidence-based practice,regularly supplying of personal protective equipment,developing hospital policy and procedures for surgical site infection prevention practice is recommended.

Construction and Evaluation of a Nutrition Nurse Specialist Training Center Impact Statement

Background: To construct and evaluate the new Clinical Nutrition Nurse Practice Training Center in Guangdong Province. Methods: Seventy-four specialized nutrition nurses were trained from 2019-2020. Their core abilities and performance of duties were evaluated using the Clinical Nutrition Specialty Nurses Core Competence Self-evaluation Scale. This study adhered to the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines. This study was approved by the Ethics Committee of “The Third Affiliated Hospital of Sun Yat-sen University”. Results: The nurses obtained higher results one year after graduation compared with before training. Except for the areas of writing and participation, all training dimension differences were statistically significant (p Conclusions: The results indicate that the training provided in the Clinical Nutrition Nurse Practice Training Center is effective in improving the quality of specialist nursing as a whole.

Effect of Supportive Measures Guidelines on Nurses’ Practices during Labor

Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.

Telehealth utilization among Egyptian population and health institutional readiness:An exploratory study

Objective:This study aimed to assess the public’s perspectives and the health institutions’readiness for telehealth utilization in Egypt.Methods:A cross-sectional study design was employed,and data were collected from a convenient sample of 800 Egyptian citizens and 26 nursing administrators and information technology personnel from 16 governmental hospitals and 10 private hospitals between January and March 2022.The Egyptian community utilization of telehealth questionnaire and the telemedicine hospital readiness assessment were used to collect the data.Results:The results revealed that 35.1%of the general Egyptian population used telehealth services and 43%expressed willingness to use them in future.As perceived by the general Egyptian population,the most prevalent barriers to telehealth utilization were communication barriers(97.6%),lack of confidence in health professionals(77.6%),technological limitations(72.5%),the need for physical examination(25%),and privacy concerns(10%).Regarding hospital readiness,42%of governmental hospitals were not taking any initiative to implement telehealth services,and 15.4%were at the beginner level,meaning that some steps had been taken.However,the hospital was still far from being able to implement telehealth services.In contrast,private hospitals were either at the beginner or advanced level.Conclusion:Although the use of telehealth services in Egypt has increased,there is a need to address the barriers to public utilization and improve hospitals’readiness to implement telehealth services to enhance public usage.

Theory Critique of Kristen Swanson’s Theory of Caring

Theory is considered essential for integral assessment, adopting its foundations and concepts is of great utility. The theory provides different templates to help nurses provide care that respects patients and improves outcomes. Through understanding the intersection of nursing, patients, health, and the environment, theories aim to simplify the complicated, ever-evolving relationship that nurses have with their profession. Nursing theory helps distinguish nursing as a separate discipline from medicine and related sciences, and assists nurses in understanding their patients and their needs. The behaviors of healthcare providers affect how patients participate in and experience care situations. In the nursing discipline, the theoretical structures of caring have been established as the core concept of guidance in all nurses’ work. The aim of this paper is to develop a critique of Kristen Swanson’s theory of caring—a theory structured around five caring principles (maintaining belief, knowing, being with, doing for, and enabling) by applying it to nursing practice. When applied to nursing practice, each of these five stages stimulates the caregiver’s attitude, which in turn improves the overall patient’s well-being. Implications to nursing practice are mentioned [1] [2].

A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China

This paper provides an overview of Advanced Practice Nursing(APN)in the USA,Canada,Australia and Hong Kong.It is based upon documents presented to the China Medical Board(CMB)China Nursing Network(CNN)as background for discussions held by the CNN in Shanghai.It discusses the APN role in these countries and regions according to topics identified by the CNN.These are APN educational preparation;role legitimacy;capacity requirements;scope of practice,domains of activities and limited rights for prescription and referral;professional promotion ladder;accreditation system;and,perfor-mance evaluation system.Both Canada and Australia have adapted many aspects of the USA model of APN to fit their specific legislative requirements and local conditions.Hong Kong has taken a different path which may be of interest in the Chinese context.

Strategic directions and actions for advanced practice nursing in China

There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs) improve health care and outcomes.The China Medical Board (CMB)China Nursing Network (CCNN) began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities.This paper presents the discussion,recommendations and action plans developed at the inaugural planning meeting on June 26,2015 at Fudan University in Shanghai.The recommendations are:Develop standards for advanced nursing practice;Develop Master's level curricula based on the standards;Commence pilot projects across a number of University affiliated hospitals;and Prepare clinical tutors and faculty.The strategic directions and actions are: Develop a clinical career ladder system;Expand the nursing role from hospital to community;and Build a specialty nurse accreditation system.