International journal of nursing studies
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New graduate nurses' competence is a concern for all healthcare organizations. Previous reports show heterogeneous levels of competency amongst them. As a positive association between competency and quality of care in clinical settings has been suggested, it is essential for researchers and clinicians to select valid, reliable, and responsive scales to assess new nurses' competence. However, a systematic evaluation of the measurement properties of scales measuring new nurses' competence had yet to be published. ⋯ There is little evidence on the measurement properties for each scale regarding their validity and reliability; responsiveness was not assessed for any scale. Every scale evaluated in this review had different characteristics (length, subscales, response options). Therefore, selection of the most appropriate scale depends on the context and purpose of the assessment. Prospero registration number: CRD42018109711 Tweetable Abstract: Systematic review of scales measuring new nurses' competence: we must do better and conduct more validity/reliability testing of existing scales.
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Hospital-based nurses can offer a unique perspective about factors that can contribute to a good end-of-life experience, including the location in which end-of-life care is delivered. ⋯ Nurses in this study value familiarity of environment and normalising the dying process. The majority do not wish to burden their family and friends at the end of their lives. Important next steps in providing services that meet the needs of people facing the end of their lives include understanding how nurses' personal views may influence decision-making conversations with patients and families about location of care at the end-of-life, as well as determining the capacity of available services to meet patient and family needs.
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Observational Study
Usability of the surprise question by nurses to identify 12-month mortality in hospitalized older patients: A prospective cohort study.
Palliative needs in older patients are often not timely identified. The Surprise Question (SQ) 'would I be surprised if this patient died in the next year?' is a well-researched tool that could aid in this effort. Most studies thus far involved physicians or specialist nurses, however the predictive value of the SQ when used by general nurses caring for hospitalized older patients is unknown. ⋯ The usability of the Surprise Question in predicting 12-month mortality in older acutely admitted patients is limited, due to the high false positive rate. The SQ when used by non-specialized nurses identifies vulnerable patients with an increased mortality risk and can be used as a first step in assessing a patients' palliative needs, but has limited use as a single criterion for referral to specialist palliative care.
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The pandemic of COVID-19 is growing, and a shortage of masks and respirators has been reported globally. Policies of health organizations for healthcare workers are inconsistent, with a change in policy in the US for universal face mask use. The aim of this study was to review the evidence around the efficacy of masks and respirators for healthcare workers, sick patients and the general public. ⋯ The study suggests that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit, and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings. Trials in healthcare workers support the use of respirators continuously during a shift. This may prevent health worker infections and deaths from COVID-19, as aerosolisation in the hospital setting has been documented.
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The concept of prefrailty lacks clarity. Often, prefrailty is defined in relation to frailty and less often as a distinct concept. Theoretical evidence for prefrailty is minimal unlike frailty, which has been examined for decades although consensus about how to measure frailty has not been achieved. ⋯ As a result of conducting this concept analysis, we found that prefrailty was defined as a clinically silent process that predisposes individuals to frailty. Prefrailty, as a concept, was derived from the Fried's operational definition for frailty. Attributes, antecedents, consequences, and related terms will help clinicians consider how prefrailty presents in older adults separate from frailty. Further research is needed to build upon our understanding from this concept analysis. Tweetable Abstract: Prefrailty is unclear as a concept - Research on sociodemographic characteristics of older adults living with frailty will help clarify.