Search results for: nursing workloads

Authors: Liqun Zou, Ling Wang, Xiaoli Chen

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Objective: Through the questionnaire about emergency nurses’ knowledge and attitudes regarding pain management to understand whether they are well mastered and practiced the related knowledge about pain management, providing a reference for continuous improvement of the quality of nursing care in acute pain and for improving the effect of management on emergency pain patients. Method: The Chinese version questionnaire about KASRP (knowledge and attitudes survey regarding pain) was handed out to 132 emergency nurses to do a study about the knowledge and attitude of pain management. Meanwhile, SPSS17.0 was used to do a descriptive analysis and variance analysis on collected data. Results: The emergency nurses’ correct answer rate about KASRP questionnaire is from 25% to 65% and the average correct rate is (44.65 + 7.85)%. In addition, there are 10 to 26 items being given the right answer. Therefore, the average correct items are (17.86 ± 3.14). Moreover, there is no statistical significant on the differences about the correct rate for different age, gender and work experience to answer; however, the difference of the correct rate in different education background and the professional title is significant. Conclusion: There is a remarkable lack of knowledge and attitude towards pain management in emergency nurses, whose basic knowledge of pain is sufficient. Besides, there is a deviation between the knowledge of pain management and clinical practice, which needs to be improved.

Keywords: emergency nurse, pain, KASRP questionnaire, pain management

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Wladislaw Mill, Hariet Kirschner, Anna Zimmermann, Sashi Singh, Simon Forstmeier, Uwe Berger, Bernhard Strauss, Benedikt Werner

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Introduction: A promising method to improve mental health of elderly people are structured life-reviews. We report the evaluation of our newly developed manual for structured life-reviews. The manual was created with the emphasis on straightforward application so that it can be used by professionals and lay people alike. Method: A within-subjects pre-post design is used to evaluate the manual using a geriatric depression scale and a self-integrity measure. Participants are elderly people living by themselves and in nursing homes. Findings: It is shown that elderly people perceive the structured life-review as a very positive experience. More importantly, it is shown that a negative trend of self-integrity and geriatric depression is significantly reduced by the intervention. Conclusion: The data suggest that the manual contributes positively to self- perception and mental health. We conclude that this newly developed device is very valuable to augment elderly care.

Keywords: structured life-review, self-integrity, geriatric depression, preventation research

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Authors: Chanya Thanomlikhit, Pataraporn Kheawwan

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Transition from student to staff nurse can be difficult for nurses beginning their nursing profession. Objective: The purpose of this study was to explore the transition experiences during the first year of practice among new nurses in Thailand. Methods: A descriptive design using a survey questionnaire was used. One hundred seventy-eight new graduate nurses from one tertiary hospital in Thailand participated in this study. Data were collected using paper-and-pencil format of the Revised Casey-Fink Graduate Nurse Experience Survey. Results: Participants reported three types of difficulties they were experiencing during the first year of practice including role expectation, lack of confidence, and workload. New nurses reported uncomfortable to perform high risk skills such as code/emergency, ventilator care, EKG, and chest tube care. Organizing, prioritizing and communication were rated as difficult tasks during 12-month transition period. New nurses satisfied the benefit package they received from the institution, however, salary was lowest satisfied. Conclusion: Results inform transition program development for new nurses. Initiative of systems that support for the graduate nurse during the first year of practice is suggested.

Keywords: new graduate nurse, transition, nurse residency program, clinical education

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Authors: C. L. Wu, W. W. Tseng

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From the National Health Insurance (NHI) system was introduced in Taiwan in 2000, there have been some problems in transformed small-scale hospitals, such as mobility of patients, shortage of nursing staff, medical pipelines breaking fire compartments and insufficient fire protection systems. Due to shrinking of the funding scale and the aging society, fire safety in small-scale hospitals has recently given cause for concern. The aim of this study is to determine fire risk index for small-scale hospital through a systematic approach The selection of fire safety mitigation methods can be regarded as a multi-attribute decision making process which must be guaranteed by expert groups. First of all, identify and select safety related factors and identify evaluation criteria through literature reviews and experts group. Secondly, application of the Fuzzy Analytic Hierarchy Process method is used to ascertain a weighted value which enables rating of the importance each of the selected factors. Overall, Sprinkler type and Compartmentation are the most crucial indices in mitigating fire, that is to say, structural approach play an important role to decrease losses in fire events.

Keywords: Fuzzy Delphi Method, fuzzy analytic hierarchy, process risk assessment, fire events

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Authors: Basuki Supartono

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Introduction: Diabetic wound risks limb amputation, and the healing remains challenging. Chronic Hyperglycemia caused the insufficient inflammatory response and impaired ability of the cells to regenerate. Tissue Engineering Technique is mandatory. Methods: Tissue engineering (TE)-based therapy Utilizing mononuclear cells, plasma rich platelets, and collagen applied on the damaged tissue Results: TE technique resulting in acceptable outcomes. The wound healed completely in 2 months. No adverse effects. No allergic reaction. No morbidity and mortality Discussion: TE-based therapy utilizing mononuclear cells, plasma rich platelets, and collagen are safe and comfortable to fix damaged tissues. These components stop the chronic inflammatory process and increase cells' ability for regeneration and restoration of damaged tissues. Both of these allow the wound to regenerate and heal. Conclusion: TE-based therapy is safe and effectively treats unhealed diabetic lesion.

Keywords: diabetic foot lesion, tissue engineering technique, wound healing, stemcells

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Authors: Zumra Mehmedovic, Susan Luhrmann

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Treatment-resistant depression (TRD) is a debilitating mental health disorder for which there are very few available treatment options. Current research suggests that ketamine may be a safe and effective option for the treatment of TRD. Research utilizing a review of the literature was conducted to determine if ketamine in conjunction with antidepressants is more effective than antidepressants alone in the treatment of TRD. The literature consists of ten journal articles which include quantitative studies based on primary research. A critique of the literature was done to determine whether the findings are reliable, critiquing elements influencing the believability and robustness of the research. The research was based on the neuroplasticity theory of depression, hypothesizing that ketamine, in conjunction with antidepressants, will be more effective than antidepressants alone as they have different mechanisms of action. All the studies except one found ketamine in conjunction with antidepressants to be a more effective treatment than antidepressants alone in the treatment of TRD. Results of the studies indicate that ketamine is effective in treating TRD at various doses, settings, and routes of administration. Further research is necessary, though, to further explore and confirm the findings. Several gaps in literature were identified, including the optimal dose of ketamine, its long-term efficacy and safety, and effects of ketamine in repeated doses. The research topic is highly significant to advanced practice nursing, as based on the findings, ketamine can be utilized as a safe and effective treatment for TRD.

Keywords: ketamine, major depressive disorder, treatment-resistant depression, treatment

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Authors: Siriporn Sikkaphun

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Food is essential for living, and receiving correct, suitable, and adequate food is advantageous to the body, especially for patients because it can enable good recovery. Feeding through a gastrostomy tube is one useful way that is widely used because it is easy, convenient, and economical.To compare the effectiveness of using the clinical guidelines for feeding through a gastrostomy tube in critically ill surgical patients.This is a pre-post quasi-experimental study on 15 critically ill surgical or accident patients who needed intubation and the gastrostomy tube from August 2011 to November 2012. The data were collected using the guidelines, and an evaluation form for effectiveness of guidelines for feeding through a gastrostomy tube in critically ill surgical patients. After using the guidelines for feeding through a gastrostomy tube in critically ill surgical patients, it was found that The average number of days from the admission date to the day the patients received food through the G-tube significantly reduced at the level .05. The number of personnel who practiced nursing activities correctly and suitably for patients with complications during feeding significantly increased at the level .05.The number of patients receiving energy to the target level significantly increased at the level .05. The results of this study indicated that the use of the guidelines for feeding through a gastrostomy tube in critically ill surgical patients was feasible in practice, and the outcomes were beneficial to the patients.

Keywords: clinical guidelines, feeding, gastrostomy tube, critically ill, surgical patients

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Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: V. Miller, T. Jariel, C. Cooper-Chadwick

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Early treatment of stroke leads to higher survival and lower disability rates. Increasing knowledge to activate the emergency medical system for signs of stroke can improve outcomes for patients with stroke and decrease morbidity and mortality. Even though patients who get discharged from the hospital receive standard verbal and printed education, nearly 20% of them answer the question incorrectly when asked, “What will you do if you or someone you know have signs of stroke?” The main goal of this evidence-based project was to improve patients’ knowledge of what to do if they have signs of stroke. Evidence suggests that using video education in conjunction with verbal and printed education improves patient comprehension and retention. The percentage of patients who noted that they needed to call 911 for stroke symptoms increased from 80% to 87% in six months after project implementation. The results of this project demonstrate significant improvement in patients’ knowledge about the necessity of activation of emergency medical systems for stroke symptoms.

Keywords: emergency medical systems activation, evidence-based practice nursing, stroke education, video education

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Maha Ibrahim Mohamed Khalifa

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Background: Dental fear and anxiety lead to avoidance of dental treatment and deterioration of oral health. Aim of the study: To assess the levels of fear and anxiety among school-age children undergoing dental treatment. Setting: The study was conducted in Outpatient Dental Clinics at Benha Teaching Hospital. Research design: A descriptive research design was utilized to conduct the study. Sample: A purposive sample of 60 school-age children and their mothers attending at the previously mentioned setting was included. Tools: Three tools were used: Tool one: A structured interviewing questionnaire for Personal characteristics of children and their mothers. Tool two: Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Tool three: Modified Dental Anxiety Scale (MDAS). Results: It was illustrated that more than two-fifths (43.3%) of children had maximum fear and more than half of children (53.3%) had maximal anxiety. Conclusion: Many school-age children undergoing dental treatment suffer from high levels of fear and anxiety. Recommendations: The study recommended further research should be conducted to assess levels of fear and anxiety among children undergoing dental treatments and preferable nursing interventions for reducing their fears and anxieties.

Keywords: fear, anxiety, children, dental treatment

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Authors: N. Rashed, Z. Aysha, M. Fakher

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Patient satisfaction is one of the core objectives of health care facilities. It is difficult to evaluate patients response in the emergency setting. The current study aimed to evaluate patients and family aspects of satisfaction in both adult and pediatric emergency departments and their recommendations for improvement. Cross-section survey(Brief Emergency department Patient Satisfaction Scale (BEPSS), was translated and validated, then performed to evaluate patients satisfaction in two governmental hospitals Emergency departments. Three hundred patients and their families were enrolled in the study. The waiting time in the adult Emergency department ranged from (5 minutes to 120 minutes), and most admissions were at the morning shift while at the pediatric hospital the waiting time ranged from 5 minutes to 100 minutes) and most admissions were at the afternoon shift. The results showed that the main domain of satisfaction in BEPSS in the adult emergency department was respecting the patients family while in the pediatric emergency department, the main domain was the nursing care about treatment. The main recommendation of improvement in pediatric Emergency Department was modifying the procedures while in adult Emergency Department was improving the training of physicians.

Keywords: emergency, department-patient, satisfaction-adult-pediatric

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Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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Authors: Daniella Arieli

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As human population is ageing, globally, we are faced with the need to find solutions for the care of older people who have reached the stage of needing full-time nursing care. Basically, there are two basic alternatives: 1. moving the individual to an institutional setting, a care home, or other form of residency, and 2. Arranging care for them in their own home, what is known as “ageing in place”. As ageing in place is becoming popular in many parts of the world, there is a need to understand its’ everyday consequences for all the involved parties: the care recipient, her/his family members and the live-in care workers. This is crucial because choosing home care means that the role of the care recipient’s relatives becomes very demanding and requires a level of support and responsibility that is often beyond what families can offer. This is particularly challenging when the older person faces dementia. While most Western countries offer a range of social services, many citizens around the world find the care provided by governments and associated social support structures insufficient. Individuals and families find themselves in the position of having to take on the responsibility themselves and find a path for the care of frail members, while facing considerable personal burdens and challenging dilemmas. The aim of this work is to discuss those challenges. The study is based on an ethnographic study of home care for older people in Israel.

Keywords: aging in place, family caregivers, policy making, qualitative research

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Authors: Ayşegül Bilge, Merve Uğuryol, Şeyda Dülgerler, Mustafa Yıldız

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The purpose of this research is to prove the Attitude towards Using Complementary Treatments Scale reliability and validity. The research is a methodological type of research that has been planned to determine the validity and reliability of the Attitude towards Using Complementary Treatments Scale. The scale has been developed by the researchers. In the scale, there are 23 questions including complementary and modern therapies individuals apply when they have health problems 4-item Likert-type evaluation has been carried out in preparing the questionnaire. High score obtained from the scale indicates a positive attitude towards complementary therapies. In the course of validity assessment of the scale, expert opinion has been received, and the content validity of the scale has been determined by using Kendall coefficient correlation test (Wa=0.200, p = 0.460). In the course of the reliability assessment of the scale, total score correlations of 23 materials have been examined, and those under 0.20 correlation limit has been removed from the scale correlation. As a result, the scale was left to be 13 items. In the internal consistency tests of the analyses, Cronbach's alpha value has been found to be 0.79. As a result, of the validity analyses of the Attitude towards Using Complementary Treatments Scale, the content and language validity analyses has been found to be at the expected level. It has been determined to be a highly reliable scale as the result of the reliability analyses. In conclusion, Attitude towards Using Complementary Treatments Scale is a valid and reliable scale.

Keywords: alternative health care, complementary treatment, instrument development, nursing practice

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Authors: Jun-ya Nagase, Toshiyuki Satoh, Norihiko Saga, Koichi Suzumori

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In recent years, Japanese society has been aging, engendering a labour shortage of young workers. Robots are therefore expected to perform tasks such as rehabilitation, nursing elderly people, and day-to-day work support for elderly people. The pneumatic balloon actuator is a rubber artificial muscle developed for use in a robot hand in such environments. This actuator has a long stroke, and a high power-to-weight ratio compared with the present pneumatic artificial muscle. Moreover, the dynamic characteristics of this actuator resemble those of human muscle. This study evaluated characteristics of force control of balloon actuator using a predictive functional control (PFC) system with disturbance observer. The predictive functional control is a model-based predictive control (MPC) scheme that predicts the future outputs of the actual plants over the prediction horizon and computes the control effort over the control horizon at every sampling instance. For this study, a 1-link finger system using a pneumatic balloon actuator is developed. Then experiments of PFC control with disturbance observer are performed. These experiments demonstrate the feasibility of its control of a pneumatic balloon actuator for a robot hand.

Keywords: disturbance observer, pneumatic balloon, predictive functional control, rubber artificial muscle

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Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities

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Authors: Sarah Misplon, Wim Marneffe, Johan Helling, Jana Missiaen, Inge Decock, Dries Myny, Steve Lervant, Koen Vaneygen

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The aim of this study was twofold. First, we investigated whether the current funding from the national health insurance (NHI) of home hospitalization (HH) for oncological patients is sufficient in Belgium. Second, we compared patient’s experiences and preferences of HH to the standard of care (SOC). Two HH models were examined in three Belgian hospitals and three home nursing organizations. In a first HH model, the blood draw and monitoring prior to intravenous therapy were performed by a trained home nurse at the patient’s home the day before the visit to the day hospital. In a second HH model, the administration of two subcutaneous treatments was partly provided at home instead of in the hospital. Therefore, we conducted (1) a bottom-up micro-costing study to compare the costs and revenues for the providers (hospitals and home care organizations), and (2) a cross-sectional survey to compare patient’s experiences and preferences of the SOC group and the HH group. Our results show that HH patients prefer HH and none of them wanted to return to SOC, although the satisfaction of patients was not significantly different between the two categories. At the same time, we find that costs associated to HH are higher overall. Comparing revenues with costs, we conclude that the current funding from NHI of HH for oncological patients is insufficient.

Keywords: cost analysis, health insurance, preference, home hospitalization

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Authors: Mohamed Sameer Mughal, Andrew D. Ross, Damian J. Fearon

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Background: The fast-paced changing landscape of UK Higher Education Institution (HEIs) is poised by changes and challenges affecting Middle Managers (MM) in their job roles. MM contribute to the success of HEIs by balancing the equilibrium and pass organization strategies from senior staff towards operationalization directives to junior staff. However, this study showcased from the data analyzed during the semi structured interviews; MM job role is becoming more complex due to changes and challenges creating colossal pressures and workloads in day-to-day working. Current development programmes provisions by Human Resources (HR) departments in such HEIs are not feasible, applicable, and matching the true essence and requirements of MM who suggest that programmes offered by HR are too generic to suit their precise needs and require tailor made espousal to work effectively in their pertinent job roles. Methodologies: This study aims to capture demands of MM Development Needs (DN) by means of a conceptual model as conclusive part of the research that is divided into 2 phases. Phase 1 initiated by carrying out 2 pilot interviews with a retired Emeritus status professor and HR programmes development coordinator. Key themes from the pilot and literature review subsidized into formulation of 22 set of questions (Kvale and Brinkmann) in form of interviewing questionnaire during qualitative data collection. Data strategy and collection consisted of purposeful sampling of 12 semi structured interviews (n=12) lasting approximately an hour for all participants. The MM interviewed were at faculty and departmental levels which included; deans (n=2), head of departments (n=4), subject leaders (n=2), and lastly programme leaders (n=4). Participants recruitment was carried out via emails and snowballing technique. The interviews data was transcribed (verbatim) and managed using Computer Assisted Qualitative Data Analysis using Nvivo ver.11 software. Data was meticulously analyzed using Miles and Huberman inductive approach of positivistic style grounded theory, whereby key themes and categories emerged from the rich data collected. The data was precisely coded and classified into case studies (Robert Yin); with a main case study, sub cases (4 classes of MM) and embedded cases (12 individual MMs). Major Findings: An interim conceptual model emerged from analyzing the data with main concepts that included; key performance indicators (KPI’s), HEI effectiveness and outlook, practices, processes and procedures, support mechanisms, student events, rules, regulations and policies, career progression, reporting/accountability, changes and challenges, and lastly skills and attributes. Conclusion: Dynamic elements affecting MM includes; increase in government pressures, student numbers, irrelevant development programmes, bureaucratic structures, transparency and accountability, organization policies, skills sets… can only be confronted by employing structured development programmes originated by HR that are not provided generically. Future Work: Stage 2 (Quantitative method) of the study plans to validate the interim conceptual model externally through fully completed online survey questionnaire (Bram Oppenheim) from external HEIs (n=150). The total sample targeted is 1500 MM. Author contribution focuses on enhancing management theory and narrow the gap between by HR and MM development programme provision.

Keywords: development needs (DN), higher education institutions (HEIs), human resources (HR), middle managers (MM)

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Nuran Nur Aypar, Merlinda Alus Tokat

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The aim of the study is to determine the knowledge level of pregnant women with Gestational Diabetes Mellitus (GDM) about the disease and affecting factors. The data of this descriptive study were collected from 184 pregnant women who were followed up in Dokuz Eylul University Hospital (n=34), Izmir Ege Maternity Hospital, Gynecology Training and Research Hospital (n=133), and Egepol Private Hospital (n=17). Data collection forms were prepared by the researcher according to the literature. ANOVA test, Kruskal Wallis test, Mann-Whitney U test, Student’s t-test, and Pearson correlation test were used for statistical analyses. Average GDM knowledge score of pregnant women was 40.10±19.56. The GDM knowledge scores were affected by factors such as age, educational level, working status, income status, educational level of the spouse, and the GDM background. It has been shown in our study that the GDM knowledge scores were negatively affected by factors such as young age, low educational level, low-income level, unemployment, having a spouse with low educational level, the absence of the GDM story. It has been identified that 86.4% of the pregnant women were trained about GDM. The education provided in the antenatal period significantly increased GDM knowledge scores of pregnant women (p=0.000, U=515.0). It has been determined that GDM knowledge of the pregnant women with GDM is affected by various factors. These factors must be considered in order to determine new strategies.

Keywords: affecting factors, gestational diabetes mellitus (GDM), knowledge level, nursing, pregnancy

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Authors: Aremu Abdulmujeeb Babatunde

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Background: Low back pain was not only considered to be the most common reason for functional disability worldwide, but also estimated to have affected 90% of the universal population. This study aimed at determining the prevalence, consequences and socio-demographic factors associated with low back pain. Methods; A cross-sectional survey was employed and a total number of 150 self-structured questionnaire was distributed among healthcare workers and this was used to determine the prevalence of low back pain and work related absenteeism. Data was entered using Epi info soft-ware and analyzed using SPSS. Results; An overall response rate of 84% (n = 140) was achieved. The study established that majority (37%) of the respondents were in the age bracket of 20-39 years, 57% female (n=59) and 64% of them were married. the pint prevalence was 84%, 31% of the respondents took leave from work as a result of low back pain. There was high prevalence of sick leave among nursing staff 45.2%, Chi-square test shows that there was a statistically significant association between the respondents occupations and daily time spent during their work (P value 0.011 and 0.042) respectively. Socio-demographic factors like age, marital status and gender were not statistically significant at P<0.05. Conclusions; The medical and socio-professional consequences of low back pain among healthcare workers was as a result of their occupation designations and the daily time spent in carry out this occupations.

Keywords: low back pain, healthcare workers, prevalence, sick leave

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Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei

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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.

Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease

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Authors: Sevil Inal, Leman Yantiri, Meral Kelleci

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Aim: In this study, it was aimed to qualitatively analyze the feelings, thoughts and meanings of the nurses who had experience in child hematology in the past. Method: In this qualitative study, in-depth interviews were conducted with 15 nurses between 29 and 53 years of age who had previously worked in child hematology-oncology unit. Interviews were conducted with a semi-structured interview form. Each interview lasted 20-30 minute. Some of the questions are: ‘What kind of experiences do you experience when you think about the periods you are working in hematology-oncology service?’ ‘Do you explain the reason for living these feelings?’ The data were analyzed with QSR NVivo 7 software. Results: From the perspective of the nurses who had experience working in the pediatric hematology-oncology service in the past, five main themes and sub-themes related to emotions and thoughts towards this experiment were identified in the study. 1) Positive and negative emotions: (a) fear and anxiety, (b) desperation, pity, guilt, (c) burnout, (d) longing; 2) Being coping 3) Professional implications 4) Meaning of life 5) Unmet needs and suggestions. Conclusions: Working in hematology should be viewed as a multidimensional situation that affects the way nurses view their profession and life, leading to a wide range of emotional lives. Data obtained from this study can be used to strengthen hematologic nurses.

Keywords: cancer, child, care, hematology, nursing

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Authors: Yutong An

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Premature babies in the Neonatal Intensive Care Unit (NICU) are usually protected in individual incubators to ensure a constant temperature and humidity. Accompanied by 24-hour monitoring by medical equipment, this provides a considerable degree of protection for the growth of preterm babies. However, preterm babies are still continuously exposed to noise at excessively high decibels (>45dB). Such noise has a highly damaging effect on the growth and development of preterm babies. For example, in the short term, it can lead to sleep deprivation, stress reactions, and difficulty calming emotions, while in the long term, it can trigger endocrine disorders, metabolic disorders, and hearing impairment. Fortunately, musical interventions in the NICU have been shown to provide calmness to newborns. This article integrates existing research on three types of music that are beneficial for preterm infants and their respective advantages and disadvantages. This paper aims to present a possibility, based on existing NICU equipment and experimental data related to musical interventions, to reduce the impact of noise on preterm babies in the NICU through a system design approach that incorporates a personalized adjustable music system in the incubator and an overall music enhancement in the open bay of the NICU.

Keywords: music interventions, neonatal intensive care unit (NICU), premature babies, neonatal nursing

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Authors: Khader A. Almhdawi, Hassan Alrabbaie

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Background: Musculoskeletal disorders (MSDs) represent a significant challenge for registered nurses. To our best knowledge, there is no published study that investigated the prevalence of MSDs among nurses and their associated factors comprehensively in Jordan. This study aimed to find the prevalence of MSDs, their possible predictors among registered nurses in Jordanian hospitals. Methods: A cross-sectional design was used. Outcome measures included Nordic Musculoskeletal Questioner (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), IPAQ, and sociodemographic data. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were conducted to identify predictors of MSDs. Results: 597 nurses from different hospitals in Jordan participated in this study. Reported MSDs prevalence was the highest at neck (61.1%), followed by upper back (47.2%), shoulder (46.7%), wrist and hands (27.3%), and elbow (13.9%). Significant predictors of MSDs among Jordanian nurses included: being a female, poor sleep quality, high physical activity levels, poor ergonomics, increased workload, and mental stress. Conclusion: This study showed a high prevalence of MSDs among Jordanian nurses and identified their significant predictors. Future studies are needed to investigate the progressive nature of MSDs and their effective treatment strategies.

Keywords: musculoskeletal disorders, nursing, ergonomic, occupational stress

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Authors: Ching-Yuan Huang, Rhay-Hung Weng, Yi-Ting Chen

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Mentoring functions will improve new nurses' job performance, provide support with new nurses, and then reduce the turnover rate of them. This study explored the impact of transformational leadership and interpersonal interaction on mentoring functions. We employed a questionnaire survey to collect data and selected a sample of new nurses from three hospitals in Taiwan. A total of 306 valid surveys were obtained. Multiple regression model analysis was conducted to test the study hypothesis. Inspirational motivation, idealized influence, and individualized consideration had a positive influence on overall mentoring function, but intellectual stimulation had a positive influence on career development function only. Perceived similarity and interaction frequency also had positive influences on mentoring functions. When the shift overlap rate exceeded 80%, mentoring function experienced a negative result. The transformational leadership of mentors actually would improve the mentoring functions among new staff nurses. Perceived similarity and interaction frequency between mentees and mentors also had a positive influence on mentoring functions. Managers should enhance the transformational leadership of mentors by designing leadership training and motivation programs. Furthermore, nursing managers should promote the interaction between new staff nurses and their mentors, but the shift overlap rate should not exceed 80%.

Keywords: interpersonal interaction, mentoring function, mentor, new nurse, transformational leadership

Procedia PDF Downloads 309