Advances in the application of action learning in nursing practice

In this paper, we elucidate the concept and characteristics of action learning as well as summarize the re？exivity, cooperativeness, and subjectivity of this approach. Furthermore, we describe the effects and limitations of action learning when applied in nursing management, nursing education, and clinical practice, among various ？elds.

Physical restraint using,autonomy,ethics among psychiatric patients in nursing practice in China

The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.

Nursing Practice in Recovery Room: A Case of Kibuye Hope Hospital and Mutoyi Hospital

Background: Nursing care in the recovery room is oriented to take into account the patient’s condition after surgery intervention with its main purpose of providing direct and continuous patient observation in emergence from general or regional anesthesia. In the absence of professional assistance, patients can develop complications that can lead them into shock or death. This study aims to understand the place of nurses in guiding nursing care in recovery room in two hospitals of Gitega Province by assessing the nurse’s knowledge and attitudes for the promotion of quality nursing care for post-operative patients. Methods: A cross sectional study design was used to assess the practice of nurses in managing nursing care in the recovery room in these two hospitals. A purposive sampling method was used to select the 82 nurses working in the recovery room for these two hospitals and Alain Bouchard’s formula was used to calculate the sample size. Data were collected using a self-report method involving questionnaire completion with five components addressing participants identifications, factors related to the work organization, factors related to the work environment, factors related to healthcare system, and nursing interventions in recovery room. Results: Findings revealed a significant lack of knowledge among the participants and their attitudes were slightly poor as for most of the variables of factors related to healthcare system as their score was less than 50% and their knowledge for nursing interventions was also poor as most of variable scores were less than 25%. Conclusions: The study findings were slightly poor as their scores were less than 50% in most of the variables;therefore, it was recommended that in-service training and workshops should be organized by these healthcare facilities for the purpose of empowering the nurse’s knowledge and practice. Moreover, these institutions should provide and encourage nurses to use nursing guidelines and protocols.

Pain and Care： Interventions in Daily Nursing Practice

Pain is a common symptom in humans, which differs significantly depending on their status of health. This review lists the specific features of pain that are necessary for its evaluation and treatment by the health professionals. Extensive review of the recent literature was conducted in electronic databases （PubMed, Medline and Iatrotek） and scientific journals in Greek and English. Pain is perceived as any uncomfortable feeling, and emotional experience that occurs anywhere in the body when there is some kind of injury. The assessment of pain in humans is a complex and demanding process. Pain should be treated early with appropriate pharmaceutical or other treatment. Each pain has a different cause and treatment. The objective of health professionals＇ interventions is to cure or at least reduce pain and to relieve those who are in pain.

Examining advanced nursing practice in Hong Kong and Guangzhou

Objective:There were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China,but there was no attempt to make a comparison of practice between them.This study employed a case study method to examine and compare advanced nursing practice in Hong Kong and Guangzhou.Method:Purposive sampling method was used to recruit 24 advanced practice nurses(APN)who came from the specialty of medical,surgical and pediatric in Hong Kong and Guangzhou.A questionnaire survey and semi-structured interview were conducted to solicit quantitative and qualitative data for exploring the structure-process-outcome of advanced nursing practice.The structure component explored the factors influencing advanced nursing practice.The process part examined APN role components and illustrations of exemplary advanced nursing practice.The outcomes described outcome indicators that best reflected advanced nursing practice.Findings:Findings revealed that in the structure domain,APN education and career development,team approach in healthcare,and support from management,physicians and professional associations were important contextual factors for APN development in both cities.For the process domain,participants had at least 80%of their time practicing independently/interdependently and were engaged in APN activities including direct/indirect patient care,research/project work,initiation of staff and patient protocols.All participants demonstrated competencies with impacts on patient,service and profession in their description of exemplary practice.Participants from both cities ranked patient-related outcomes as top indicators for their advanced nursing practice.Conclusion:This study has revealed that APNs in Guangzhou and Hong Kong shared similar work involvement and impacts and their demonstrated competencies were on par with international counterparts.Continued efforts need to be put in establishing formal APN education,clear clinical career pathway and title protection to empower nurses to provide optimal care to the fullest extent that they are prepared for.

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.

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.

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.

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.

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.

Nursing Theory and Its Practices in Two Health Care Facilities of Bujumbura

Introduction: Nursing theory provides a systematic explanation and description of nursing phenomena. It is very important during nursing practice in healthcare facilities (HCFs) because it guides nurses on how to collect data, which data to collect, decide how to interpret the data through the perspective of the theorist, how to plan and implement care, how to make a change and how to evaluate the patient’s outcomes. This study aims to illustrate how nursing theory can be applied during the implementation of nursing care in HCFs of Burundi by orienting the nurses to understand its application during practice. Methods: A cross-sectional study design was used to assess the use of nursing theories in healthcare facilities. A purposive sampling method was used also to select 81 nurses working full and part by applying Alain Bouchard’s formula and the questionnaire was used as the data collection instrument. Results: The current study had revealed a poor knowledge among the participants on the use of nursing theory in these two HCFs as for all variables, their average scores were almost 24.1% whilst those who had no notion related to nursing theory reach a percentage of 75.9%. Conclusion: The study findings were slightly poor as for all variables, they scored less than 40%. Therefore, the use of theories to guide their practice was highly recommended to enhance the patients’ outcomes based on the use of scientific-based experts which could result from continuous education.

Effects of the information–knowledge–attitude–practice nursing model combined with predictability intervention on patients with cerebrovascular disease

BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.

Contextualisation of Early and Enhanced Clinical Exposure Model through Development of Curricula for Advanced Practice Nursing and Midwifery

Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.

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.

A theoretical framework for interaction of nursing discipline with genetics and genomics

Background:Since the completion of the Human Genome Project,health science has been strongly influenced by the advances in genetics and genomics.However,the progress of embracing genetics and genomics into nursing discipline is limited.One of the main barriers is lack of understanding on the relevancy of genetics and genomics to nursing discipline.Objectives:This paper aims to synthesize and develop a theoretical framework for the interaction of nursing discipline with genetics and genomics.Methods:Through content analysis and constant comparative method,a theoretical framework was developed from synthesis of the studies regarding nursing and genetics/genomics indexed in multiple English and Chinese databases.Results:Four main theoretical statements were constructed in the framework:1)There are three ways to show how genetics and genomics can influence nursing discipline:a new specialty,new technologies and a new lens;2)The significant contribution of nursing discipline to genetics and genomics lies in how nurses could focus on the association between human responses and genes and how nurses could advocate for their clients in the genetic and genomic era;3)A paradigm shift occurs after a constant interaction of nursing discipline with genetics and genomics;4)Implementation strategies could be used to facilitate the integration of genetics and genomics to nursing discipline and advance the paradigm shift.Conclusions:The framework will help to understand the relationship between nursing discipline and genetics and genomics and implicate the future studies integrating genetics and genomic science into nursing discipline.

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.

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.

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.

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.

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.