Objective: Critical care nurses face some of the most daunting ethical challenges in clinical practice. Nurses who work in intensive care and emergency rooms, and other highly specialized settings must have the ability to recognize the various ethical issues they face in the care of patients daily and to be prepared to address them in collaboration with patients, families, colleagues and administrators. Ethical comportment skills are similar to clinical skills, in which they can be learned and can be improved over time through using of several strategies and appropriate role modeling. The aim of the work was to measure changes in attitude, practice and knowledge of undergraduate nursing students after receiving an educational intervention in ethical comportment in critical care nursing. Methods: The study design was a quasi-experimental research design. Setting: this study was conducted at Alexandria University, Faculty of Nursing, at Critical Care & Emergency Nursing Department. Subjects of this study included 70 nursing students who completed the study. The tool of this study is "ethical comportment in critical care nursing students' assessment tool". It is used to assess students' attitude, knowledge and practice regarding ethical comportment. Results: The levels of students' attitude, knowledge and practice towards items of ethical comportment increased after receiving an educational intervention in ethical comportment and the differences between attitude, knowledge and practice of student nurses towards items of ethical comportment pre and post the educational intervention were statistically significant. Conclusions: From the findings of the current study it can be concluded that performing an educational intervention in ethical comportment can help in developing ethical comportment skills in critical care nursing students. Recommendation: nurses training should begin in the undergraduate level and must focus on the development and promotion of attitudes from which and acts by which care is provided.
Background: Situation awareness could actively scan for risk across multiple domains. It has been defined as “the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future”. Situation awareness includes three levels; perception, comprehension, and projection. Perception is the first step in developing situation awareness as it includes students' perception of status, attributes, and dynamics of relevant elements in the ICU environment. Comprehension of the present situation is based on outputs of the perception. It includes understanding of the significance of the relevant elements. Finally, projection of future status includes the ability of students to predict the future actions of certain elements in the ICU environment. Appropriate situation awareness could increase the probability of a good task performance. In addition, feedback covers state of the ICU environment affected by both decisions and performance of the selected actions. While SBAR is acromion that represents the actual application of situational awareness through situation, background, assessment and recommendation. A representation of SBAR situational awareness has been depicted as an inner factor in the method for giving patient consideration and basic leadership that helps health care professionals to handle and process information about what is occurring. SBAR is a mechanism useful for framing any conversation, especially critical ones, requiring a practitioner's immediate attention and action to foster a culture of patient safety. Critical care nurses play an important role in their workplace related to patient safety. They should be able to recognize and analyze patient safety incidents using protocols, work in a team, learn from errors, and be able to identify actions and recommendations on how to prevent patient safety incidents through the use of SBAR situational awareness technique. Nursing students’ should recognize and understand what is going on around them. Consequently, they can plan ahead with greater knowledge to patient safety which arise the need to integrate SBAR situation awareness in their curricula.Method: A quasi experimental research design was used in this study in which two tools were used for data collection: “Self-Situational Awareness Assessment Questionnaire” and “Critical Care Nurse Students’ Safety Skills Checklist”.Results: There was a statistical significant difference between both groups of students in relation to situation awareness perception, process and skills (p < .001). Moreover, there was a statistical significant difference between the study and control groups in relation to the students' practices score regarding patients’ safety standards in the post-assessment phase (p < .001).Conclusion: In the current study, the SBAR situation awareness technique was used in training critical care nurse students to improve their situation awareness level to patient safety skills. Situation awareness perception, process and skills level were significantly increased for critical care nurse students who are subjected to the training program. Also, the students' skills regarding patients' safety standards practices were significantly improved.
Background and objective: Cognitive recovery after severe traumatic brain injury (TBI) is the biggest challenge facing the critical care nurses (CCNs). Several studies have been reported that the majority of CCNs are concerned with providing conventional nursing practices to severe TBI patients. These practices are directed to stabilize patients’ status rather than to enhance cognitive recovery after TBI. Application of integrative nursing practices for TBI patients can help in enhancing cognitive recovery. Aim: This study aimed to determine the effect of integrative nursing practices on cognitive recovery among severe traumatic brain injury patients.Methods: A quasi experimental research design was utilized. A convenience sample was conducted on 60 adult patients suffering from severe TBI who admitted to the intensive care units of Alexandria Main University Hospital. Patients were assigned into study group (30 patients) and control group (30 patients). One tool was used for data collection namely “Cognitive Recovery Assessment Tool”. This tool was used to assess recovery of cognitive function domains. It consists of level of consciousness using Full Outline of Un-Responsiveness (FOUR) score, level of cognitive functioning using Rancho Los Amigos (RLA) scale and basic cognitive sensory recovery assessment using Western Neuro Sensory Stimulation Profile (WNSSP) scale.Results: The implementation of integrative nursing practices for the study group was associated with statistically significant positive effects. Patients in the study group showed higher means of consciousness revealed by FOUR score and cognitive function revealed by RLA scale. The basic cognitive sensory recovery revealed by WNSSP scale in the study group was also significantly improved.Conclusions: Implementation of integrative nursing practices has been shown to enhance cognitive recovery among severe TBI patients. Thus, it is recommended for use in a nurse’s daily routine of care for severe TBI patients.
Background & Aim: Patients undergoing CABG might have increased complications postoperatively, especially prolonging post-operative Length of Stay (LOS). Perceived Control (PC) affects LOS post CABG and complications among different cardiac populations. However, this relation is not well-studied post CABG. This study aimed to determine whether PC was an independent predictor of LOS among patients post CABG. Methods & Materials: A prospective observational design was used. A consecutive sample consisted of 220 patients from four hospitals in Amman, Jordan, who underwent elective CABG between July 2020 and January 2021. PC was assessed using the Arabic Version of the Control Attitude Scale-Revised. LOS and other necessary information were retrieved from the patients' medical records. Data were analyzed using stepwise multiple regression. Results: 169 males and 51 females participated in this study. Age, female gender, as well as PC were found to be independent predictors for the hospital LOS. On the one hand, advanced age and female gender increased the hospital LOS, while higher levels of PC were protective. A one-year increase in age increased hospital LOS by 0.16 days, being female increased hospital LOS by 0.17 days, and a one-point increase in PC levels decreased LOS by 0.33 days. On the other hand, only female gender and PC were independent predictors for the ICU LOS. Similarly to hospital LOS, the female gender increased ICU LOS by 0.18 days while the one-point increase in PC decreased the ICU LOS by 0.21 days. Conclusion: PC was an independent predictor that affects LOS after CABG. Increasing PC among this population, especially females and the elderly, might improve outcomes of their CABG surgery decrease hospital's LOS and the resultant morbidity.
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