Consistency of Nursing Directors, Nursing Supervisors, and Nursing Quality Specialists’ Perception about Nursing-Sensitive Indicators in Acute Care Settings

Introduction: Nursing-Sensitive Indicators (NSIs) is a critical concept for the advancement of the nursing profession. However, different managerial positions may have a different perspective on the appropriate NSIs that should be used in hospitals for the monitoring of nursing care quality. This study aims to find if there is a difference between three groups of nursing managerial positions on the appropriateness of NSIs for the monitoring of nursing care quality. Methods: Descriptive cross-sectional approach was employed to evaluate if there is a difference among the three managerial groups in their evaluation for the appropriateness of using a cluster of NSIs in acute care settings. The study was conducted in Jordan between February and March 2020. Result: The study participants were 60 nurses from different managerial positions. The mean scores of the participants were: directors of nursing (200.6), nursing supervisors (199.1), and nursing quality specialists (198.62). The findings revealed no statistical difference between the three groups of their evaluation of the appropriateness of the NSIs. Conclusion: Standardizing the nursing mangers perspectives of NSIs may advance utilization of the NSIs for the monitoring and reporting of nursing care quality. Implications for Nursing Management: Consistent understanding of the measures that can be used to monitor quality of nursing care can establish the foundation for quality measurement and quality improvement in acute care 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.

Effectiveness of Comprehensive Nursing Management in Enhancing Blood Donation Outcomes and Donor Experience: A Comparative Study

Objective:To assess the management effect of comprehensive nursing management on blood donation services in blood stations.Methods:Sixty-four individuals who donated blood at a blood station between September 2021 and September 2023 were selected and randomly assigned into two groups of 32 each.The first group received comprehensive nursing management,while the second group received routine nursing management.Blood donation indexes and observational indexes such as adverse reactions were compared between the groups.Results:The total blood donation volume and qualified blood donation volume were higher in the first group than in the second group.The amount of discarded blood and the rate of blood discards were lower in the first group compared to the second group(P<0.05).Additionally,the adverse reaction rate in the first group was lower,the blood donation comfort scores were higher,the psychological state scores were lower,and the quality of care scores were higher than those in the second group(P<0.05).Conclusion:Comprehensive nursing management can improve the efficiency of blood donation,reduce the rate of blood discards,decrease the incidence of adverse reactions,alleviate negative psychological states of blood donors,and enhance both the comfort level of blood donation and the quality of care provided.

Advancing the quality of care and nursing practice through emancipatory reflection

Reflection is a fundamental skill of health-care professionals and plays an important role in ensuring the quality of care in health-care practice. It is believed that undertaking reflection in practice can help nurses develop an awareness of a sense of personal power and agency, cultivate their critical thinking ability and help them promote their professional development. However, reflection has not been introduced widely as a nursing curriculum in China, and literature shows that some clinical nurses lack critical thinking skills and critical reflective practice skills by reason of not receiving systematic education on reflection when they were at nursing college.Therefore, we present a series of seven articles focused on prevalent and interesting practice-based events to reflect on in this special issue. The main aim is to disseminate reflective methodology and techniques and present examples of reflective writing for nurses.It is expected that these articles will help to lead Chinese nurses to adopt critical emancipatory reflective processes to bring about transformative actions.

Predictors of critical care nurses’ intention to leave the unit, the hospital, and the nursing profession

Nursing turnover and shortage are acknowledged as worldwide issues: understanding the factors that foster nurses’ intention to leave (ITL) is essential in retaining them. The present study aims at providing insight into the factors influencing critical care and intensive care nurses’ ITL the unit, the hospital, and the nursing profession. The study was conducted in two hospitals, by a questionnaire administered to all nurses employed in critical and intensive care units. 512 questionnaires (89.4%) were returned. Results revealed that a low job satisfaction (JS) for interaction with physicians and nurses, seniority ≥20 years, and working in Emergency are related to higher ITL the unit. Low JS for work organization policies, seniority ≥11 years, working in a private hospital, and higher educational level are related to higher levels of ITL the hospital. Low JS for professional status, for pay, and for work organization policies, age ≥40 years, part-time schedule are related to higher ITL the nursing profession. The research permitted detection of various predictors of different kinds of ITL, enhancing the importance of regular monitoring of ITL. In order to limit ITL, it would be important to work on the relationship with physicians and colleagues, work demands, organizational policies, and acknowledgement of competence.

Nursing Care Management Strategies in Isolation Wards during the COVID-19 Outbreak

Coronavirus disease 2019 (COVID-19) is highly infectious and has spread worldwide. Medical staff may be exposed to the infection under circumstances of medical supply shortages and improper protection. How to better protect medical staff has become the focus of all walks of life. Therefore, during the COVID-19 outbreak, timely adjustments and optimization of nursing management strategies in isolation wards are important for improving care quality and reducing the infection of medical staff. Based on a literature review and clinical nursing management practices, this article summarizes the nursing management strategies in isolation wards during the COVID-19 outbreak, aiming to provide references for clinical nursing managers.

Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Objective:Rheumatoid arthritis(RA)requires comprehensive management.Structured nursing protocols may enhance outcomes,but evidence is limited.This study evaluated the effect of a structured nursing protocol on RA outcomes.Materials and Methods:In this one-group pre-post study,30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education,psychosocial support,and self-management promotion.Assessments included clinical evaluation of joint counts,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and patient-reported Arthritis Self-Efficacy Scale(ASES),Health Assessment Questionnaire(HAQ),Visual Analog Scale(VAS)for pain,and Hospital Anxiety and Depression Scale(HADS).Results:The study demonstrated significant improvements in both clinical-and patient-reported outcomes.Joint count decreased from 18.4±4.2 to 14.2±3.8(P<0.001),ESR from 30.1±6.8 mm/h to 25.5±6.8 mm/h(P<0.01),and CRP levels from 15.2±3.6 mg/L to 11.8±2.9 mg/L(P<0.01)postintervention.Patient-reported outcomes showed a marked increase in ASES score from 140±25 to 170±30(P<0.001)and reductions in HAQ from 1.6±0.4 to 1.3±0.3(P<0.01),VAS pain score from 7.8±1.7 to 6.2±1.2(P<0.001),and HADS anxiety and depression scores from 11±3 to 8±2(P<0.05)and 10±2 to 7±1(P<0.05),respectively.Conclusion:A structured nursing protocol significantly improved clinical disease activity,physical functioning,pain,self-efficacy,and emotional well-being in RA patients.A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

Effect of High-Quality Nursing on Patients with Hemorrhagic Fever with Renal Syndrome

Objective:To explore and analyze the effect of high-quality nursing on patients with epidemic hemorrhagic fever with renal syndrome.Methods:Ninety patients with epidemic hemorrhagic fever with renal syndrome treated in Huyi District People’s Hospital from October 2021 to January 2022 were randomly divided into an experimental group and a control group,with 45 cases in each group.The control group received routine nursing and the experimental group received high-quality nursing.The effect of routine nursing and high-quality nursing were compared and analyzed based on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),the degree of satisfaction with nursing care,and the patients’quality of life.Results:Before nursing,there was no significant difference in the patients’psychological state between the two groups(P>0.05);after nursing,there was significant difference in the patients’psychological state between the two groups(P<0.05);the degree of satisfaction with nursing care of the experimental group was significantly higher than that of the control group(P<0.05);comparing the quality of life of the two groups,the quality-of-life score of the control group was significantly lower than that of the experimental group(P<0.05).Conclusion:For patients with epidemic hemorrhagic fever with renal syndrome,high-quality nursing can significantly and effectively improve their psychological state,level of satisfaction with nursing care,and quality of life.

Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响

目的探讨分析Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响。方法简单随机选取2022年1月—2023年9月山东省泰安荣军医院收治的60例老年骨质疏松症患者为研究对象,按随机数表法将其分为常规组(实施常规护理干预),模式组(在常规组的基础上给予Guided Care护理模式干预),每组30例,两组均持续干预2个月,比较两组患者干预前后的健康认知水平、跌倒风险、自我管理能力、生活质量、护理满意度。结果干预2个月后,模式组的健康认知水平评分高于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的跌倒风险评分低于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的自我管理能力评分高于常规组,生活质量评分低于常规组,差异有统计学意义(P均<0.05)。干预2个月后,模式组的护理满意度为93.33%,高于常规组的护理满意度73.33%,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论在老年骨质疏松症患者中,应用Guided Care护理模式,可以有效地提升患者的健康认知水平及自我管理能力,提高患者的生活质量,降低患者跌倒的风险。

体外循环心脏术后危重患者体温信息化管理实践研究

目的基于信息化管理平台,开发体外循环心脏术后危重患者体温信息化管理平台并探究其临床应用效果。方法成立研究团队,通过文献回顾、小组讨论、专家函询等方法开发体外循环心脏术后危重患者体温信息化管理平台,选取2023年10月—12月在青岛市某三级甲等医院行体外循环心脏手术的患者作为研究对象,进行临床应用并评价应用效果。结果体外循环心脏术后危重患者体温信息化管理平台应用后,患者发热率、低体温率、疼痛评分、气管插管时间较应用前显著降低(均P<0.05);热舒适度、脑氧饱和度较应用前均有显著提升(均P<0.05)。结论体外循环心脏术后危重患者体温信息化管理平台能够对患者体温实施精准化管理,有利于综合评估与精准干预,有效加强医护协作,促进患者术后康复。

医养结合的延续性护理在老年慢性病患者中的应用效果

目的:观察医养结合的延续性护理在老年慢性病患者中的应用效果。方法:选取2022年1月至2023年1月该院收治的150例老年慢性病患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各75例。对照组实施常规护理,观察组实施医养结合的延续性护理。比较两组护理前后疾病认知评分、孤独程度[加利福尼亚大学洛杉矶分校(UCLA)孤独量表]评分、自我管理能力[成年人健康自我管理能力测评量表(AHSMSRS)]评分、生命质量[生活质量综合评定问卷(GQOLI-74)]评分。结果:护理后,两组疾病认知能力评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组UCLA孤独量表评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组自我管理行为、自我管理认知、自我管理环境等各项AHSMSRS评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组躯体功能、心理功能、社会功能、物质生活等各项GQOLI-74评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:医养结合的延续性护理应用于老年慢性病患者可提高疾病认知能力、自我管理能力和生命质量评分,以及降低孤独程度评分的效果优于常规护理效果。

精益管理改进优质护理工作应用在静配中心管理中的效果分析

目的分析精益管理改进优质护理工作应用在静脉用药调配中心管理中的效果。方法选取2022年1—12月中国贵航集团三〇二医院3756张药物配置处方,将2022年1—6月实施传统常态化管理的1894张药物配置处方作为对照组,2022年7—12月实施精益管理改进优质护理工作的1862张药物配置处方作为观察组。两组为同一组调配人员,共17名。比较两组差错事件发生情况、调配人员调配技能及工作效率、临床科室对调配人员满意度。结果观察组差错事件总发生率低于对照组,调配人员调配理论评分和调配实践评分均高于对照组,贴标签时间、排药时间、配药时间均短于对照组,临床科室对观察组调配人员总满意度高于对照组,差异有统计学意义(P<0.05)。结论精益管理改进优质护理工作能够降低静脉用药调配中心差错事件总发生率,提高调配人员调配技能及工作效率,提升临床科室对其满意度。

康复护理自我管理在慢性阻塞性肺疾病患者中的应用效果

目的:探究康复护理自我管理在慢性阻塞性肺疾病患者护理中的应用效果。方法:选取2022年1—12月遵义市道真仡佬族苗族自治县人民医院收治的慢性阻塞性肺疾病患者78例,采用随机数字表法分为对照组与观察组,每组39例。对照组采用常规护理,观察组在对照组基础上采用康复护理自我管理。比较两组肺功能指标、自我护理能力、生活质量。结果:干预后,两组用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积/用力肺活量升高,观察组高于对照组(P<0.05);干预后,两组自护责任感、健康知识水平、自我概念、自我护理技能评分升高,观察组高于对照组(P<0.05);干预后,两组心理功能、社会功能、躯体功能、物质生活评分升高,观察组高于对照组(P<0.05)。结论:康复护理自我管理在慢性阻塞性肺疾病患者护理中的应用效果显著,能改善患者肺功能,提高其自我护理能力及生活质量。

基于NVivo分析改进上海市“互联网+护理服务”的对策建议

目的:分析上海市三级、二级和一级医院护士开展“互联网+护理服务”的重要性和制约因素,为推进“互联网+护理服务”提供对策建议。方法:采用目的抽样法,选取上海市2所三级综合医院、2所三级专科医院、2所二级综合医院以及3所一级医院(社区卫生服务中心)共36名临床护理人员或管理者进行半结构式访谈,使用三级编码法,借助NVivo 12 Plus软件的项目图、矩阵编码分析等功能对访谈资料进行内容分析。结果:共构建重要性、制约因素和对策建议3个一级节点、13个二级节点和11个三级节点。按照参考点数量分析,重要性依次体现在服务对象福祉、护士价值和医院发展上;制约因素依次排序主要是安全问题、人力问题、政策问题和平台问题。对策建议依次排序主要是服务定价、服务项目、服务安全、服务标准、服务平台和服务对象。通过框架矩阵比较分析发现,不同级别医院开展“互联网+护理服务”存在的制约因素和对策建议侧重点不同。结论:不同级别医院护士开展“互联网+护理服务”的制约因素不同,建议加大政策支持、明确管理制度和服务规范、优化人力资源配置、合理服务定价、持续改进“互联网+护理服务”项目,加快信息平台建设,多措并举,推进优质护理服务共建共享。

Establishing Patient Safety in Intensive Care—A Grounded Theory

Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

质量控制小组管理模式在护理质量管理中的应用价值

目的探讨质量控制小组管理模式在呼吸与危重症医学科临床护理质量管理工作中的应用价值。方法选取2021年1月至2022年6月实施质控小组管理模式工作后的呼吸危重症患者50例为观察组,2020年1月至2020年12月质控小组实施前的呼吸危重症患者50例为对照组,观察两组患者对护理工作满意度以及实施期间总护理不良事件发生情况,评估实施质控管理小组前后护理人员护理质量。结果观察组总护理不良事件发生率低于对照组,差异有统计意义(P<0.05);观察组患者护理总满意度高于对照组,差异有统计意义(P<0.05);实施质量控制小组管理模式前护理人员的基础护理质量评价、护理病历书写质量评价、健康教育宣教质量评价、应急专科能力质量评价、护理操作质量评价、消毒隔离质量评价均低于实施后,差异有统计意义(P<0.05)。结论质量控制小组管理的工作模式不仅能有效提高呼吸危重症患者对护理人员工作的满意度,减少临床工作中护理不良事件发生,还能提高护理人员护理工作质量。

6S管理模式在消化内镜中心护理质量控制中的应用效果

目的探讨消化内镜护理质量控制中实施基于整理-整顿-清扫-清洁-素养-安全(6S)管理模式的应用效果。方法选取2023年1—6月绵阳市中心医院内镜中心实施常规管理模式的80件消化内镜、行消化内镜检查的2317例患者作为A组,另选取2023年7月绵阳市中心医院消化内镜中心实施6S管理模式的80件消化内镜,行消化内镜检查的2483例患者作为B组。A组实施常规管理模式,B组在A组基础上实施6S管理模式,比较2组清洗消毒合格率、器械损坏率及患者护理满意度。结果干预后,B组清洗消毒合格率(98.75%)高于A组(81.25%),而器械损坏率(1.25%)低于A组(11.25%),差异有统计学意义(P<0.05)。干预后,与A组患者护理满意度各维度评分比较,B组均偏高(P<0.05)。结论消化内镜护理质量控制中采用基于6S管理模式能有效提高清洗消毒合格率,降低器械损坏率,患者护理满意度较高。此文的研究结果为消化内镜护理后期标准制订提供了借鉴内容。

重症监护病房护理缺失现状及原因分析

目的:调查重症监护病房(ICU)内护理缺失现状并分析其原因,为减少ICU护理缺失,提升重症患者护理质量提供参考。方法:采用便利抽样法,于2023年12月1日至30日在湖南省5家医院选取305名ICU护士作为研究对象,使用一般资料调查表以及ICU护理缺失量表进行调查。结果:ICU护理缺失得分为(64.48±20.60)分,有91.8%的护士报告了他们在工作期间至少发现了一项护理缺失活动。其中缺失最多的项目为重症患者心理社会评估、早期康复、心理护理以及肌力和营养状况评估。ICU护理缺失受护士学历、职称、所在ICU类型的影响(P<0.05)。ICU护理缺失原因得分为(61.29±16.28)分,最主要的原因是护士人力资源不足。结论:护理缺失在ICU内发生率高,其发生受多种因素影响,提示护理管理者应重视ICU内护理缺失的发生现状及原因,并采取相应措施,进一步提高ICU护理质量。

ICU医疗设备警报管理策略及应用成效的范围综述

目的 对ICU医疗设备警报管理策略及其应用成效进行范围综述,为优化临床警报管理实践提供参考。方法 采用Arksey和O`Malley的范围综述方法为框架,检索中国知网、万方数据库、维普数据库、PubMed、Web of Science核心合集、Embase、EBSCO数据库中ICU医疗设备警报管理相关研究,检索时限为建库至2024年6月30日。对纳入文献进行筛选,并对警报管理策略进行归纳。结果 纳入30篇文献,干预策略主要为护士主导的多学科协作、集束化警报管理策略、护士培训教育、警报管理制度流程优化,干预后总警报数量降低11.2%~88.5%、警报持续时间缩短、护士警报管理知识和能力得到提升,护士警报疲劳程度改善存在差异。结论 警报管理能显著提升ICU警报管理质量,优化警报管理的关键重在提升ICU护士的主导能力,以及团队合作的规范化管理;而管理的目的仍以患者安全为首,兼顾护理人员的警报疲劳。

全程优质护理干预在致命性出血患者中的应用

目的 探讨全程优质护理干预在致命性出血患者救治中的应用效果。方法 以2018年1月至2020年1月湖南省人民医院致命性出血的196例患者为对照组,2020年2月至2022年2月致命性出血的200例患者为观察组。对照组实施传统的护理干预,观察组实施基于MEWS评分、SBAR交接模式、医护同组责任制管理等的全程优质护理干预。比较两组患者的并发症发生率、病死率、入住ICU总时长、医疗护理服务质量(包括护理不良事件发生率和患者护理满意度)。结果 观察组的并发症发生率、致死率、不良事件发生率以及入住ICU总时长均低于对照组(P<0.05)。患者护理满意度高于对照组,差异有统计学意义(P<0.05)。结论 实施基于MEWS评分、SBAR交接模式、医护同组责任制管理等的全程优质护理干预能显著提高致命性出血患者救治成功率,降低其不良事件的发生率,改善愈后,提升患者对护理工作的满意度。