In recent years, great emphasis has been placed on the role of nonpharmacological self-management in the care of patients with diabetes. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors was designed. One hundred forty-two adults with type 2 diabetes were randomized to receive either usual diabetes care (control group) or usual care plus a nurse-led diabetes self-management education (intervention group). Duration of the intervention was 12 weeks. The primary outcome was glycosylated hemoglobin (HbA1c values). Secondary outcomes were changes in blood pressure, body weight, lipid profiles, self-efficacy (efficacy expectation and outcome expectation), self-management behaviors, quality of life, social support, and depression. Outcome measures were assessed at baseline and at 12-week and 24-week postrandomizations. Patients in the intervention group showed significant improvement in HbA1c, blood pressure, body weight, efficacy expectation, outcome expectation, and diabetes self-management behaviors. The beneficial effect of a nurse-led intervention continued to accrue beyond the end of the trial resulting in sustained improvements in clinical, lifestyle, and psychosocial outcomes. This trial is registered with IRCT2016062528627N1.

This study has identified a failure to adhere with evidence-based practice. Implementing and evaluating protocols for oral hygiene in the intensive care unit has the potential to improve patient outcomes.

Introduction: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs).  One factor causing VAP is aspiration of oral colonisation, which may result from poor oral care practice.  Oral care using tooth brushing can prevent formulation of dental plaque that can be a reservoir for microbes causing VAP. Methodology: A cross-sectional survey was conducted among 124 nurses, using a self-administered questionnaire, to determine methods used, frequency, and attitude of nurses toward oral care provided to mechanically ventilated patients in Malaysian ICUs.  Results: Methods for oral care and their frequency of use varied between nurses even in the same unit. Cotton with forceps was used by 73.4% of the nurses. Some nurses used forceps and gauze (65%) or spatulas and gauze (36%). Toothbrushes were used by 50.8% of the nurses. Nurses in this hospital reported to have positive attitude toward providing oral care. Conclusions: The survey showed the need to have standardised oral care protocols in ICUs to improve quality of oral care provided to ventilated patients.

Based on this review it appears that action research is a promising methodological approach to address clinical practice improvement in the ICU. Studies retrieved focussed primarily on process and formative evaluation but not on clinical outcomes. There is a need to incorporate outcome assessment in action research in the ICU to increase the framework of action research to improve clinical outcomes.

Background The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear. Purpose The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses. Methods This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019. Results Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive‐behavioural skills training and mindfulness‐based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses. Conclusion Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention‐related adverse events. Relevance to clinical practice This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

Aims: This study aimed to evaluate the effect of the stress management interventional program in reducing occupational stress and improving coping strategies among public health nurses. Design: A double-blind, cluster-randomized approach was used as a randomization method for this study to evaluate the stress management interventional program. Methods: A cluster-randomized controlled trial was carried out in eight comprehensive healthcare centres in Amman city, Jordan; four centres were randomly assigned to each experimental and control group. One hundred and seventy nurses were selected randomly from March 2019-August 2019 and data were collected by using the Nursing Stress Scale & brief COPE over three data collection times. Both descriptive and inferential statistics (repeated measure ANOVA, Independent t test, and chisquared) were used to answer the research questions of this study. Results: The results showed that both the levels of occupational stress and coping strategies were significantly different between the two study groups over the three data collection points (p < 0.05). Conclusion: Based on the findings of this study, the stress management program is an effective non-invasive method that can be used to reduce stress levels and improve coping strategies for public health nurses. The implementation of stress management interventions in health care is likely to help nurses manage occupational stress in practice. Impact: Nurses suffer from a high level of occupational stress. In particular, approxi-mately74% of nurses experience severe occupational stress, which can lead to many mental and physical disorders. However, nurses were less able to utilize the correct stress preventive strategies due to gaps in knowledge, skills, and awareness. This study contributed to the provision of empirical evidence of the effectiveness of the stress management program in reducing occupational stress and improving coping strategies among public health nurses. A stress management intervention program is a valuable non-invasive method that can be used by healthcare organizations to

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The results of the study could help neonatal nurses to develop an appropriate nursing intervention for parents with premature infants in the NICU.