International journal of nursing studies
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Randomized Controlled Trial
The effectiveness of a nurse-led short term life review intervention in enhancing the spiritual and psychological well-being of people receiving palliative care: A mixed method study.
A life review is a promising intervention to enhance spiritual well-being in older people. Conventional life review interventions are lengthy and often led by psychologists. ⋯ The nurse-led short term life-review intervention demonstrated significant improvement effects in spiritual well-being. Participant feedback on nurses' performance was positive, finding the intervention acceptable and useful. The setting of the intervention has now been extended from bedside to home. It is recommended to incorporate life review into palliative nursing specialty training, empowering more nurses to deliver the intervention in their daily practice.
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Controlled Clinical Trial
Can proactive rapid response team rounding improve surveillance and reduce unplanned escalations in care? A controlled before and after study.
Unplanned escalations manifest as a breakdown of hospital care attributable to clinician error through missed or delayed identification of physiological instability, ineffective treatment, or iatrogenic harm. ⋯ This study reports a difference in the frequency of unplanned escalations using different rapid response models, with fewer unplanned ICU transfers occurring during the use of Early Warning Score-guided proactive rapid response team model while accounting for differences in admission volumes, age, gender and comorbidities. Implementation of this model has implications for patient outcomes, hospital operations and costs.
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Nursing discharge preparation is vital to successful hospital-to-home transitions. However, despite a wealth of evidence on its effectiveness, little is known of the structure- and process-related factors that facilitate or impede its use in clinical practice. Specifically, the associations between unit size and type, leadership support, skill mix, staffing, nurse and patient characteristics, discharge teaching and patient readiness for discharge have rarely been studied. ⋯ Patient readiness for hospital discharge is associated with process- and structure-related factors. Our findings suggest that, for successful uptake in clinical practice, the development and implementation of effective discharge preparation programs should consider the structural context, i.e., patient population, unit size, and experience of nurses within the team. Further research, using a more accurate measure of patient readiness for hospital discharge, is needed to test associations with the nurse work environment and staffing.
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Review Meta Analysis
Refugee women's experiences negotiating motherhood and maternity care in a new country: A meta-ethnographic review.
The aim of this meta-ethnographic review was to examine refugee women's experiences negotiating motherhood and maternity services in a new country with a view to identifying the specific needs of refugee women accessing maternity care in high income countries. ⋯ Liminality is a ubiquitous experience for refugee women seeking maternity care in high income countries. It impacts feelings of belonging and connection to services and society. It is often a challenging experience for many women and a time in which they reformulate their identity as a citizen and a mother. This review found that the experience of liminality could be perpetuated by social factors, and inequality of healthcare provision, where communication and cultural barriers prevented women accessing care that was equal, accessible, and meaningful. Findings revealed both positive and negative experiences with maternity care. Continuity, culturally appropriate care, and healthcare relationships played an important role in the positive experiences of women. The review also revealed the damaging effects of disparities in care experienced by refugee women.
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Prevalence of hospital-acquired pressure injuries has declined over time. However, it is unknown if this decline is consistent for different stages of pressure injuries. It is also unknown if risk factors differ between superficial (stage 1 and 2) and severe (stage 3, 4, deep tissue, and unstageable) pressure injuries. ⋯ A decline in superficial, but not severe, hospital-acquired pressure injuries suggests current prevention techniques might not adequately prevent severe pressure injuries. Generally, risk factors for superficial and severe pressure injuries were highly similar where all 14 of the risk factors were significant in both regression models. However, five risk factors in particular - ICU stay, presence of an ostomy, patient age, ambulatory status, and presence of a fecal management system - had substantially different effect sizes.