Current issue of “Intensive and Critical Care Nursing” Volume 46 June 2018

The current issue content page can be accessed via this link.
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Articles published in this issue include; “The communication experience of tracheostomy patients with nurses in the intensive care unit: A phenomenological study”, “The effect of provision of information on serum cortisol in patients transferred from the coronary care unit to the general ward: A randomised controlled trial” and “Standardised simulation-based emergency and intensive care nursing curriculum to improve nursing students’ performance during simulated resuscitation: A quasi-experimental study”.
To access the full text of these articles direct from the journal’s homepage requires a personal subscription.  Individual articles can be ordered via the Rotherham NHS Foundation Trust Library and Knowledge Service.  Registered members of the library can make article requests online via this link.
Issues of Intensive and Critical Care Nursing from issue older than one year ago can have their full text accessed via this link.  A Rotherham NHS Athens password is required.  Eligible staff can register for an Athens password via this link.

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Implementation of an Evidence-Based Practice Nursing Handover Tool in Intensive Care Using the Knowledge-to-Action Framework

This article in the March 2018 issue of “Worldviews on Evidence Based Nursing” is by Spooner and colleagues.
Background:  Miscommunication during handover has been linked to adverse patient events and is an international patient safety priority. Despite the development of handover resources, standardized handover tools for nursing team leaders (TLs) in intensive care are limited.
Aims:  The study aim was to implement and evaluate an evidence-based electronic minimum data set for nursing TL shift-to-shift handover in the intensive care unit using the knowledge-to-action (KTA) framework.
Methods:  This study was conducted in a 21-bed medical-surgical intensive care unit in Queensland, Australia. Senior registered nurses involved in TL handover were recruited. Three phases of the KTA framework (select, tailor, and implement interventions; monitor knowledge use; and evaluate outcomes) guided the implementation and evaluation process. A post-implementation practice audit and survey were carried out to determine nursing TL use and perceptions of the electronic minimum data set 3 months after implementation. Results are presented using descriptive statistics (median, IQR, frequency, and percentage).
Results:  Overall (86%, n = 49), TLs’ use of the electronic minimum data set for handover and communication regarding patient plan increased. Key content items, however, were absent from handovers and additional documentation was required alongside the minimum data set to conduct handover. Of the TLs surveyed (n = 35), those receiving handover perceived the electronic minimum data set more positively than TLs giving handover (n = 35). Benefits to using the electronic minimum data set included the patient content (48%), suitability for short-stay patients (16%), decreased time updating (12%), and printing the tool (12%). Almost half of the participants, however, found the minimum data set contained irrelevant information, reported difficulties navigating and locating relevant information, and pertinent information was missing. Suggestions for improvement focused on modifications to the electronic handover interface.
Linking Evidence to Action:  Prior to developing and implementing electronic handover tools, adequate infrastructure is required to support knowledge translation and to ensure clinician and organizational needs are met.
The full text of this article as a PDF is available via link from this website

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

This article by Han et al was published in the Japan Journal of Nursing Science in December 2017.
Aim:  To examine theoxygen-502887_960_720 effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units.Methods:  A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared.

Results:  After education, there was a significant improvement in the nurses’ self-efficacy and clinical performance in emergency airway management situations.
Conclusion:  Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education.
Rotherham Foundation Trust Library members can order the full text of journal articles via our website using the article requests online via this link.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

This article by Han et al was published in the Japan Journal of Nursing Science in December 2017.hospital-834152_960_720
Aim:  To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units.
Methods:  A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared.
Results:  After education, there was a significant improvement in the nurses’ self-efficacy and clinical performance in emergency airway management situations.
Conclusion:  Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education.
Library members can order the full text of journal articles via our website using the article requests online via this link.

Nursing Care Disparities in Neonatal Intensive Care Units.

This article was published in the September 2017 issue of Health Services Research by Lake et al.

Objectives:  To describe the variation across neonatal intensive care units (NICUs) in missed nursing care in disproportionately black and non-black-serving hospitals. To analyze the nursing factors associated with missing nursing care.

Data sources:  Survey of random samples of licensed nurses in four large U.S. states.

Study design:  This was a retrospective, secondary analysis of 1,037 staff nurses in 134 NICUs classified into three groups based on their percent of infants of black race. Measures included the average patient load, individual nurses’ patient loads, professional nursing characteristics, nurse work environment, and nursing care missed on the last shift.

Data collection:  Survey data from a Multi-State Nursing Care and Patient Safety Study were analyzed (39 percent response rate).

Principal Findings:  The patient-to-nurse ratio was significantly higher in high-black hospitals. Nurses in high-black NICUs missed nearly 50 percent more nursing care than in low-black NICUs. Lower nurse staffing (an additional patient per nurse) significantly increased the odds of missed care, while better practice environments decreased the odds.

Conclusions:  Nurses in high-black NICUs face inadequate staffing. They are more likely to miss required nursing care. Improving staffing and workloads may improve the quality of care for the infants born in high-black hospitals.

The full text of this article will usually be only available via the internet to those who have a personal subscription though some articles may be available freely without a password.  Library members can order individual articles via the Rotherham NHS Foundation Trust Library and Knowledge Service using the article requests online via this link.

The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review.

This article was published in the September issue of Human Resources for Health and written by Woo and colleagues.

Background:  The prevalence of chronic illness and multimorbidity rises with population aging, thereby increasing the acuity of care. Consequently, the demand for emergency and critical care services has increased. However, the forecasted requirements for physicians have shown a continued shortage. Among efforts underway to search for innovations to strengthen the workforce, there is a heightened interest to have nurses in advanced practice participate in patient care at a great extent. Therefore, it is of interest to evaluate the impact of increasing the autonomy of nurses assuming advanced practice roles in emergency and critical care settings on patient outcomes.

Objectives:  The objectives of this study are to present, critically appraise, and synthesize the best available evidence on the impact of advanced practice nursing on quality of care, clinical outcomes, patient satisfaction, and cost in emergency and critical care settings.

Methods:  A comprehensive and systematic search of nine electronic databases and a hand-search of two key journals from 2006 to 2016 were conducted to identify studies evaluating the impact of advanced practice nursing in the emergency and critical care settings. Two authors were involved selecting the studies based on the inclusion criteria. Out of the original search yield of 12,061 studies, 15 studies were chosen for appraisal of methodological quality by two independent authors and subsequently included for analysis. Data was extracted using standardized tools.

Results:  Narrative synthesis was undertaken to summarize and report the findings. This review demonstrates that the involvement of nurses in advanced practice in emergency and critical care improves the length of stay, time to consultation/treatment, mortality, patient satisfaction, and cost savings.

Conclusions:  Capitalizing on nurses in advanced practice to increase patients’ access to emergency and critical care is appealing. This review suggests that the implementation of advanced practice nursing roles in the emergency and critical care settings improves patient outcomes. The transformation of healthcare delivery through effective utilization of the workforce may alleviate the impending rise in demand for health services. Nevertheless, it is necessary to first prepare a receptive context to effect sustainable change.

The full text of this article is available via the following link.  If you are having any problems please contact the Library and Knowledge Service.

Psychological recovery after intensive care

Outcomes of a long-term quasi-experimental study of structured nurse-led follow-up | Intensive and Critical Care Nursing

B0009841 Counselling for social anxiety disorder, illustration
Image source: Jasmine Parker – Wellcome Images // CC BY-NC 4.0

Objectives: To compare psychological recovery of patients receiving structured nurse-led follow-up and patients receiving usual care after intensive care discharge.

Results: The experimental group had significantly more symptoms of post-traumatic stress and anxiety than the control group over the 12 months. Patients from both groups had severe symptoms of post-traumatic stress. Patients with post-traumatic stress at three months had disturbing memories and psychological reactions.

Conclusion: The structured nurse-led follow-up did not improve patients’ measured outcomes of psychological recovery after intensive care. Patients with severe symptoms of post-traumatic stress are of concern. Emphasis needs to be placed on disturbing memories of the intensive care stay and psychological reactions when constructing intensive care nurse-led follow-up.

Full reference: Jónasdóttir, R.J. et al. (2017) Psychological recovery after intensive care: Outcomes of a long-term quasi-experimental study of structured nurse-led follow-up. Intensive and Critical Care Nursing. Published online: 21 July 2017