Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Evaluation of the Effect of Assessment Method Reform in “Nursing Research” Course

Objective:This paper aims to evaluate the implementation effect of the diversified course assessment method reform.Methods:A diversified assessment method was implemented for 196 undergraduate nursing students.Students’mastery of key knowledge in“Nursing Research”was assessed through group reports on topic selection and literature retrieval,as well as the proposition level of the final examination.Results:81.6%of the students agreed with the course assessment method,and 97.9%believed studying“Nursing Research”would be helpful for future scientific research applications.Conclusion:Diversified assessment methods can help improve undergraduate nursing students’scientific research skills and comprehensive quality.

Observation of the Effect of Video Assessment Method on the Operation Skills of Individual Nurses

Objective:To explore the application effect of video assessment method in clinical nurses’nursing operation skills.Method:To select 58 nurses who participated in the individual soldier standard in the children’s hospital in 2019 and 2020 as the research objects,among which the nurses who participated in the individual soldier standard in 2019 were the nurses who participated in the individual soldier standard in 2019 and 2020.A total of 29 people in the first batch were set as the control group,using traditional assessment methods.In 2020,the second batch of 29 nurses who participated in the individual soldier standard reached the experimental group.Using the video assessment method,there was no significant difference in general information between the two groups(P>0.05).After the assessment,the scores,coping with work pressure,and proactiveness of the two groups of research subjects were compared.Results:The experimental group’s nursing operation assessment scores,coping with work pressure,and proactiveness were significantly better than those of the control group,the difference was statistically significant(P<0.05).Conclusion:The application of the video assessment method improves the passing rate of nurses’operational skills examination,enhances nurses’initiative in learning,reduces examination pressure,and can be accurately,timely,and safely applied to clinical nursing work,which is worthy of study and promotion.

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

Objectives: Comprehensive nursing assessment,as the first step in the nursing process,involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process.The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.Methods: A randomized controlling design was conducted.Of 84 undergraduate nursing students,42 students were allocated to the intervention or control group.In clinical education,a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process,while the control group received traditional methods.The data were gathered using a demographic information questionnaire,skills in nursing process development checklist,and attitudes towards nursing process questionnaire.Results: The average scores for students' attitude and skills in developing nursing process in the intervention group were greater than those of the control group.Conclusion: Applying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.

Barriers in performing physical assessment among nursing students:An integrative review

Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.

The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review

Suicide risk assessment is a critical skill in preventing suicide. Yet most nurses do not feel confident in assessing suicide risk. Development of this potentially life-saving skill needs to begin at the undergraduate nursing level. As simulation is an effective pedagogical tool utilised within nursing education, the aim of this paper was to explore the potential of simulation in preparing student nurses’ for suicide risk assessment. Literature was examined to identify what simulation modalities were employed within nursing education and the outcomes associated with these. The findings suggest that to varying degrees all simulation modalities have the potential to decrease student anxiety, and increase student confidence, knowledge and communication skills when working with people at risk of suicide. However the use of Standardised Patient (SP) simulation adds an authenticity to the experience and allows for the assessment of a wider range of human responses, including key nonverbal communication skills. The sense of realism provided by SP allows for more in-depth understanding into the person’s experiences, which is critical in the assessment of a person’s mental health needs and risk of suicide. The majority of simulations identified were located within a mental health setting. Given that student nurses may encounter a person who is suicidal in any clinical setting, further research is needed on simulation which integrates mental health assessments and suicide risk assessment into a variety of clinical areas.

Application of Criterion-Meeting Assessment Method in Fundamentals of Nursing

To investigate the results of criterion-meeting assessment method used for the operation test in fundamentals of nursing, 101 nursing undergraduates who entered Nursing College, Beihua University in 2007, were randomly divided into experimental group and control group. The students in the control group were examined with the traditional assessment method, namely, the points were given the students one-time and estimated in a way of quantitative analysis. The students in the experimental group were examined with criterion-meeting assessment methods. The average score of students in the experimental group was higher than that in the control group (P <0.001), the difference was statistically significant, and 100% students in the experimental group got 90-100 points of the assessment standards. Our studies suggest that the method is not only conducive to fully mobilizing the enthusiasm of the students and students’ establishing critical thinking, but also gives help to improve the overall quality of teachers. It can strengthen the experimental teaching, improve teachers’ and students’ senses of responsibility in teaching and learning and contribute to the good teaching result.

Thought Processes of Nurses in Nursing Assessment: Analysis of Nursing Problems and Patient Strengths, Patient Information

Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, including presenting illness, vital signs, and other findings from admission until 09:00 on the day after surgery, was shown to the participants. After reading the case report, the nurses presented their assessments. Based on these assessments, nursing problems, patient strengths, and patient information were identified. Nursing problems and patient strengths were described by various words and sentences, and were classified according to similar content. Results: The number of nursing problems ranged from 1 to 8 and patient strengths from 0 to 6 for each nurse. The mean number of nursing problems was 4.7 ± 1.8, and the mean number of patient strengths was 2.2 ± 1.4. The main nursing problems were respiratory complications, postoperative wound pain, and anxiety, and the main patient strength was family cooperation. Patient information as evidence of respiratory complications included history of smoking, chest radiography results, postoperative vital signs, sputum color and properties. Patient information as evidence of postoperative wound pain included complaints of pain, epidural anesthesia, use of patient-controlled anesthesia and its effect. Patient information indicating family cooperation included family structure, preoperative visits by family, and presence of family while providing informed consent. Significant differences were seen in the number of nursing problems and patient strengths according to cognitive style. Conclusions: Postoperative complications were the nursing problems most commonly extracted by nurses. To clarify nursing problems and patient strengths, the nurses made assessments on the basis of information such as patient complaints, vital signs, and test results. However, extracted nursing problems and patient strengths were diverse, suggesting that nursing problems and patient strengths as determined by nurses differed between individual nurses.

Nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.

Evaluation of undergraduate students’nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient

Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.

Problem-Based Learning <i>in Situ</i>Applied to Students in the Assessment of Nursing Process

Background: Nursing is considered a science in the making that recognizes the nursing process (NP) as the scientific and methodological tool to provide care. The NP is composed of five stages of which the assessment is the first and fundamental to identify the health problems of the people. This research aimed to evaluate a pedagogical didactic strategy that is based on situated constructivism, the Based-Problem Learning (BPL), in order to improve significant learning. Methods: Quantitative research with an explanatory scope, was transversal, and it was applied to 30 students of the first year of the nursing career at the Faculty of Higher Studies Iztacala, National Autonomous University of Mexico. The sample was chosen considering the inclusion criteria. Data were collected using a Likert-type instrument validated in a previous investigation. Results: The average value obtained from the Likert scale to evaluate the intervention was 103.4, the highest score was 135 and the lowest was 83, which reflects that it was evaluated as good and particularly good. The grade given to the teacher as an agent of the ZPD, was between agree and totally agree, the highest percentages scored at 93%, since it provoked challenge in their thinking, and favored interaction among classmates. Conclusions: The application of the in situ teaching strategy, BPL favored significant learning of the assessment stage, the students were able to carry out the assessment in the hospital, the experience contributed to generate significant learning when students face real scenarios, which showed the effectiveness of the method.

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

The study identified priorities of the Patient Assessment Data (PAD) using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS&copy;) derived from 644 psychiatric nurses’ responses who were practicing in specific units: Acute Care Units (ACU), General Care Units (GCU), Long-term Care Units (LCU), physically Complicated Disease Care Units (CDCU), and Dementia Care Units (DCU). Secondary analysis of the PsyNACS&copy;on-line survey data using four levels of “importance” was used to determine the priorities: 1) unnecessary;2) quite important;3) important and 4) very important. The Mean Factor Points (MFP) and the Welch’s ANOVA were calculated. PsyNACS&copy;score of 3 or higher indicates the PAD as priority. The results showed that in the ACU PAD1, “Psychological symptom”, “Stress coping”, and “Mood disorder and aggression”, and PAD2 “Information of adherence”, and “Information of the psychiatry rehabilitation”, and PAD7 “Situation of the family and social life”, “Relationship to the health care providers”, and “Relationships with others” are high priority (high importance). Other PADs showed results below PsyNACS&copy;score of 3. The GCU had PAD 3 “Balance of water”, the LCU had PAD 4 “Intention/Point of view”, and “Thoughts of the patient” and PAD 7 “Disease and family”. The CDCU showed PAD 2 “Blood test”, PAD 3 “Excretion situation”, and PAD 5 “General health condition”, “Respiratory and chest symptom”, and “Vital signs”, and the DCU had PAD 1 “Cognition function”, and “Delirium and derangement capacity to register failure”, PAD 3 “Function of eating”, PAD 6 “Egestion and cleanliness” and PAD 8 “Activity and sleeping”, and “Mobility capability”. These classifications indicated levels of importance in the CAD comprising the PAD below the score of “2”. Japanese psychiatric hospitals specify assessments according to functional areas. By prioritizing the CAD for each PAD, more effective and efficient assessments can be performed according to practice unit.

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)

The purpose of this study was to develop the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©. This study used the on-line survey method from February to April 2015. There were 644 respondents comprised of professional nurses with minimum qualification of 3 years’ experience being in a psychiatric unit of a stand-alone 200-bed or more Psychiatric Hospital in Japan. Assessment items were derived from 211 specific items selected from nursing textbooks, excluding the North-American-Nursing-Diagnosis-Association (NANDA). The questionnaire contained Cover Letter, Demographic Data Sheet, and the PsyNACS© questionnaire. There were 644 questionnaires accessed but only 435 were completed and valid. Item levels of importance were evaluated: 1) Unnecessary, 2) Not very important, 3) Important and 4) Very important. Data analysis used descriptive and multivariate statistics. Factor analysis (principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin (KMO) and the Bartlett’s test of Sphericity assessed the adaptive validity of the factor analysis. Factor loadings were set at 0.4 or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Mean factor points were calculated, including standard deviation, range, and confidence interval at 95%. Statistical significance was at 0.05 level. Nine Patient Assessment Data (PAD) with 2 to 5 Cluster Assessment Data (CAD) each were categorized. Thirty one CADs comprised the Patient Assessment Data: (PAD1) Psychological symptom and stress, (PAD2) Information about treatment, (PAD3) Function of eating and balance of water, (PAD4) Life and value, (PAD5) Vital signs and health assessment, (PAD6) Self-care, (PAD7) Social support, (PAD8) Activity, sleeping and mobility capability, and (PAD9) Sexual function and sexual behavior. The PsyNACS© is a classification of items assessing health care needs within the Japanese psychiatric nursing care environment, and also can be used in various psychiatric patient care situations in all psychiatric units.

Clinical nursing competency assessment:a scoping review

Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency assessment.This review explored current practices in clinical competency assess­ment of nursing students as part of a larger study aimed at developing an evidence-based,context-specific framework for clinical competency assessment in a sub-Saharan African(SSA)country.Methods:A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR)was conducted.Results:Findings from 28 out of 1151 studies identified from Scopus,PubMed,CINAHL,Wiley Online Library,and ProQuest were included and synthesized.Results show that a good assessment system must be valid,reliable,transparent,feasible,fair,objective,and must provide feedback and continually improve to have an educational impact.Clinical competency assessment systems must be developed on sound empirical evidence,pilot tested,and involve thorough training and evaluation of the examiners.Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system.Only one of the included studies was conducted in Africa.Conclusions:The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context.Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

Research on the Reform and Practice of “Basic Nursing Skills Practice” Course Assessment

Objective: “Basic Nursing Skills Practice” is a key course connecting classroom and clinical teaching in nursing specialty teaching. Nursing practice ability is one of the core abilities of nurse practitioners. Therefore, the teaching quality of this course is directly related to the quality of nursing work. To improve the teaching quality of practical course, the assessment reform of the “Basic Nursing Skills Practice” course was carried out among the nursing undergraduates to explore a reasonable and fair assessment mechanism. Method: In the assessment of “Basic Nursing Skills Practice” course, the assessment included individual skill operation assessment, virtual simulation assessment and team comprehensive skill assessment. The assessment proportion was adjusted from 100% for the final examination to 50% for the middle and final examinations respectively. The assessment method was changed from individual skills assessment at the end of the term to a combination of individual skills assessment at the midterm and virtual simulation assessment and team skills assessment at the end of the term. The method has changed from summative evaluation to a combination of formative evaluation and summative evaluation, and self-made questionnaire was used to investigate the effect. Results: After implementing the assessment reform, 86.84% of the students were satisfied with the assessment reform, and the percentage of students with scores above 80 reached 100%. The highest score is 93.0, while the lowest score is 83.0, and the average score was 88.0. Conclusions: High satisfaction of students with basic nursing skills examination reform promoted the learning effectiveness and professional emotions, cultivated comprehensive quality and ability, promoted the realization of talent training objectives.

Discussion on the Graduation Practical Ability Assessment Model for Master of Nursing Specialist Students

Objective: To explore graduation practical ability assessment mode of graduate students in nursing (Master of Nursing Specialist, MNS). Methods: All 28 MNS 2020th graduate students in a university were selected as subjects by convenient sampling method, using the improved 4-station objective structured examination (Objective Structured Clinical Examination, OSCE) model. The assessment content included nursing assessment, nursing diagnosis, basic nursing operation, specialist nursing operation, theoretical written test and oral test and overall evaluation. And self-made questionnaire was used to evaluate the effect of the assessment model and the improvement of clinical practice ability of graduate students. Results: The overall satisfaction rate of graduation assessment was 89.51%, the overall satisfaction rate of graduation assessment mode and practical ability improvement evaluation was 84.66%, the pass rate of assessment results was 100%, and the excellent rate was 71.42%. Conclusion: The MNS graduation practical ability assessment model has a high degree of satisfaction, objectively evaluates the knowledge, skills, attitudes and emotions of graduate students, promotes the comprehensive quality and ability of graduate students, which is worthy of promotion.

Effect of Nursing Intervention Based on Caprini Risk Assessment Scale for Venous Thromboembolism in Perioperative Patients with Liver Cancer

Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.

The Impact of Repeated Death Conference Participation on Nurses’ Terminal Care and Nursing in Death Conference Using the Death Conference Nursing Self-Assessment Sheet

Background: Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing minds. Therefore, there is a need for further evidence on the impact of repeated DC experiences on nurses’ terminal care. Aim: This study aims to clarify the impact of repeated DC experiences on nurses’ terminal care and nursing in DC using the prepared Death Conference Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, Chukyo Gakuin University, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Death Conference Nursing Self-Assessment Sheet. Its evaluation items in the Death Conference Nursing Self-Assessment sheet consist of four categories (Cooperation, Future direction of nursing, Specific measures for nursing, and Feeling of the nurse) and 14 questions. The questionnaires were conducted on 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform Fisher’s exact test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: Thirty-four participants (23.6%) who answered the number of DC experiences were included in the final analysis. Seventeen nurses had DC experiences, and 17 had no experience. There were significant differences in all of the above categories impacting nurses’ terminal care and nursing in DC. Conclusion: Repeated DC affected nurses’ terminal care and nursing in DC using the Death Conference Nursing Self-Assessment Sheet. In the future, verification of the reliability, validity of the questionnaire, and more evidence of the way of terminal concerns by raising the quality of DC for developing nursing minds will be needed.

Development of the Diabetes Oral Health Assessment Tool ©for Nurses

Although some studies had suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT ?) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT ?, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach’s alpha coefficient for all assessment items were 0.931, indicating high reliability: Factor 1, Patient’s oral health status (α = 0.831);Factor 2, Implementation of oral health behaviors (α = 0.890);Factor 3, Information transmission regarding dental visits (α = 0.862);and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT ? was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT ?, despite recognizing their importance.

Physical assessment ability of nurses and midwives on maternal care in Mongolia

This study examined the physical assessment ability of Mongolian nurses and midwives engaged in maternal care and the factors that could influence this ability. We found that nurses and midwives from prefectural hospitals had higher scores than those from national and district (soum) hospitals. The latter group could not perform more than half of the 28 tested procedures on their own, even though most had over 10 years’ experience. Therefore, to decrease the Mongolian maternal mortality ratio, we argue that in-service training for nurses and midwives in both the capital city and peripheral areas is needed.