Search

Aims: To explore and summarise the literature on the concept of 'clinical deterioration' as a nurse‐sensitive indicator of quality of care in the out‐of‐hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out‐of‐hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded. Data Sources: Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute. Results: Thirty‐four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting. Conclusions: Little is known about the work of nurses or midwives in out‐of‐hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non‐acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings. Implications for the profession and/or patient care: Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out‐of‐hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care. Impact: What Problem Did the Study Address?: Factors that impact a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting are not examined to date. What Were the Main Findings?: A range of factors were identified that impacted a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation. Where and on whom will the research have an impact? Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out‐of‐hospital setting. This in turn will impact patient survival and satisfaction. Reporting Method: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review guidelines guided this review. The PRISMA‐Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study." No Patient or Public Contribution: Not required as the Scoping Review used publicly available information. [ABSTRACT FROM AUTHOR]

Background. Missed nursing care adversely affects nurse and patient outcomes in healthcare settings. Comprehensive bibliometric overview of research output in this field is limited, which restricts knowledge of this complex phenomenon in terms of research trends, author's productivity, and thematic focus of scientific publications. This study aims to examine publications on missed nursing care by conducting a comprehensive bibliometric analysis. Methods. A search was performed in the Scopus database to identify 276 published studies on missed nursing care from inception to 20th February 2022. A bibliometric approach was used to comprehensively analyse retrieved publications based on trend, thematic focus, and scientific production. The R based software was used for data analysis. Results. The result from this bibliometric analysis indicates that the first study performed on the concept of missed nursing care was published in 2006. The United States of America (USA) ranked first in number of publications, and the study by Ball et al. published in 2014 was the most cited paper among the documents analysed. The results also identified names of prolific authors such as Kalisch B.J., Ausserhofer D., Willis E., Papastavrou E., Schubert M., Palese A., Simon M., and Aiken L. H. and relevant institutions in this field. Trending keywords identified included "missed nursing care," "unfinished nursing care," "patient safety," and "care left undone." In addition, thematic analysis showed emerging themes such as "neonatal intensive care unit," "patient satisfaction," "health resources," "failure to maintain," and "adverse events." Conclusion. Findings from this study reveal a lack of bibliometric analysis in missed nursing care research. This study provides significant contribution by presenting a comprehensive overview on thematic focus, hotspots studies, and directions for future research in this field. Findings from this study can guide scholars in defining research focus and aspects of research on missed nursing care for future exploration. [ABSTRACT FROM AUTHOR]

Background: Patients with Class III obesity pose unique challenges to health care staff and organisations. Care requirements of this population are unique and require specialised equipment and knowledge to meet these needs, maintain the quality of care, as well as the safety of patients and staff. Aim: To synthesise the evidence on the nursing care of Class III obese patients in acute care settings. Methods: A scoping review informed by JBI. CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase were searched for primary research articles about the nursing management of people classified as Class III obese in acute care. Methodological quality of included studies was assessed; data extracted and synthesised into themes. Results: Fourteen studies were included in the review. The synthesis generated three themes: Access to equipment, knowledge and training, patient care, and opportunities to improve care. Conclusions: A paucity of high-quality evidence informs the nursing care of people with Class III obesity in acute care. Access to appropriate equipment dominated the findings of this review. Adequate provision of equipment and education on its use are required. Education to promote engagement with patients, adapting clinical practice and promotion of self-care could improve care and outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the accuracy of traditional clinical predialytic fluid assessment by renal nurses and the efficacy of 2 additional fluid assessment methods focussing on the potential preventative effect for intradialytic hypotension (IDH). Background: Predialytic fluid assessment remains a daily challenge for renal nurses, when aiming for adverse event free haemodialysis treatments. Adding further objective parameters obtained through noninvasive methods into pre‐ and intradialytic fluid assessment could potentially improve health outcomes for haemodialysis patients. Design: Comparative, observational study of three fluid assessment methods on their reliability on volume status and correlation to clinical outcomes. Methods: Clinical predialytic nursing fluid assessments in 30 haemodialysis patients were compared with additional initial bioimpedance spectroscopy (BIS) measurements, and 3 serial intradialytic ultrasound scans of the inferior vena cava (IVC‐US) performed by a second renal nurse concurrently during the same session. A retrospective data analysis compared all measurements in each individual for the predictive value for IDH. A STROBE checklist for observational cohort studies was used for the reporting of results. Results: Seven subjects experienced episodes of symptomatic intradialytic hypotension (S‐IDH), which would have been anticipated by IVC‐US or by BIS in 5 patients (71%). Using an algorithm to predict IDH would have provided a sensitivity of 100% and specificity of 95%. Conclusion: Both additional fluid assessment methods would have provided critical information before and during each haemodialysis session. Therefore, we consider them as being potentially effective for the prevention of intradialytic hypotension, with IVC‐US being similar to BIS. Relevance to clinical practice: Traditional clinical nursing fluid assessment methods in haemodialysis patients do not provide sufficient information to prevent episodes of IDH. Additional objective fluid assessment methods are useful and likely to lead to improved health outcomes in HD patients when applied by renal nurses. A combination of IVC‐US, MAP and BIS has potential to reduce the risk of IDH events in HD patients significantly. [ABSTRACT FROM AUTHOR]

It is important to evaluate stakeholder feedback regarding any change to a clinical supervision model to maintain quality. The Quality Practical Experience (QPE) instruments offer both the nurse on the ward involved with supervising student learning and the student nurse the opportunity to evaluate their satisfaction with the supervision model. This paper reports on the evaluation of the construct validity and the reliability of the QPE instruments measuring nurse and nursing student satisfaction with the clinical supervision model. Methodological design for the reliability and validation of a measuring instrument. The nurse and the student QPE instruments were tested with convenience samples of 488 nurses and 1116 student nurses, respectively. Psychometric tests included internal reliability, test-retest reliability and factor analyses. Exploratory factor analysis for both QPEs supported a three-factor solution; the nurse QPE explained 48% and student nurse QPE 45% of variance. Internal reliability and test-retest reliability were stable over time (nurse QPE ICC = 0.82; student nurse QPE ICC = 0.71). Both QPE instruments were found to be valid and reliable. Feedback from all stakeholders involved with supporting student nurses during clinical placement is important. • It is important to have a variety of instruments that are valid and reliable to evaluate clinical supervision models. • The content of both the nurse and student nurse QPE was found to be both valid and reliable. • Both the nurse and student nurse QPE are useful to measure satisfaction of a clinical supervision model. [ABSTRACT FROM AUTHOR]