BackgroundOne helpful strategy adopted for pain management in non-verbal, intubated patients is the use of a proper pain assessment scale. The purpose of the present study is to achieve a better and deeper understanding of the existing nurses’ challenges in using pain assessment scales among patients unable to communicate.MethodsThis qualitative study was conducted using content analysis. Purposive sampling was used to select the participants and continued until data saturation. The participants included 20 nurses working in intensive care units. Data was collected using semi-structured interviews and analysis was done using an inductive approach.ResultsFour categories and ten sub-categories were extracted from the experiences of the nurses working in the intensive care units in terms of nursing challenges in using non-verbal pain assessment scales. The four categories included “forgotten priority”, “organizational barriers”, “attitudinal barriers”, and “barriers to knowledge”.ConclusionsThe findings of the present study have shown that various factors might influence on the use of non-verbal pain assessment scales in patients unable to communicate. Identifying these challenges for nurses can help take effective steps such as empowering nurses in the use of non-verbal pain assessment scales, relieving pain, and improving the quality of care services.

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BACKGROUND:The impact of resiliency on professional burnout in nurses has been evaluated in several studies.AIM:This meta-analysis was conducted to examine the effect of resiliency on different aspects of nurses’ professional burnout.MATERIAL AND METHODS:Publications were identified through targeted literature review in national and international databases between 1980-2017, in Persian and English. Two independent coders assessed and extracted articles. Data analysis was done by a random effects model. Study heterogeneity was measured by the I2 test. The data were analysed by STATA software v. 14.RESULTS:Initially, 227 articles were extracted. After titles and abstract screening, 108 articles were selected for full-text review. Only five of them had the necessary inclusion criteria for analysis. The meta-analysis performed on these observational studies showed that the correlation between resiliency and burnout was -0.57 with a 95% confidence interval of -0.354 to -0.726.CONCLUSION:Regarding the inverse relationship between resiliency and burnout, it is recommended to plan for the interventions that can improve the resilience of nurses against burnout. Conducting interventional and resilient training courses for nurses in nursing education can be considered.

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Purpose Resilience can be of assistance to paramedics in order to maintain their own mental balance in stressful work environments. Since it is not well defined which personality traits are correlated with resilience in these personnel, the purpose of this paper is to explain the relationship between personality traits and levels of resilience. Design/methodology/approach This cross-sectional study was conducted on paramedics in Eastern Iran through field research. The study participants were selected by convenience sampling method. The data collection instruments included NEO-Five Factor Inventory-Short Form and Connor-Davidson Resilience Scale. The data obtained were also analyzed using descriptive and inferential statistics (correlation and regression analysis) through the SPSS 16.0 software. Findings A total of 252 paramedics with a mean age of 28.9±5.1 years participated in this study. The personality traits of neuroticism (r=−0.24), openness to experience (r=−0.22), and agreeableness (r=−0.18) were significantly correlated with resilience. In contrast, extraversion (r=0.26) and conscientiousness (r=0.32) were in a significant relationship with resilience. In this respect, the given personality traits could account for 31.5 percent of changes in resilience. Research limitations/implications It was concluded that the paramedics with lower scores of neuroticism had higher levels of resilience and they could similarly show better compliance with their work conditions in stressful situations and consequently maintain their mental health. Practical implications It is recommended to conduct psychological examinations of personality traits in recruitment and selection stages of medical emergency personnel and to implement psychological interventions for those medical emergency staff with the personality trait of neuroticism. Social implications Resilient paramedics may also perceive less stress and it may be negatively associated with burnout. Originality/value The study examined the relationship between personality traits and resiliency in order to clarifying recruitment criteria in emergency medical services.

BACKGROUND:Standardization of documentation has enabled the use of medical records as a primary tool for evaluating health care functions and obtaining appropriate credit points for medical centres. However, previous studies have shown that the quality of medical records in emergency departments is unsatisfactory.AIM:The aim of this study was improving the nursing care documentation in an emergency department, in Iran.MATERIAL AND METHODS:This collaborative action research study was carried out in two phases to improve nursing care documentation in cooperation with individuals involved in the process, from February 2015 to December 2017 in an affiliated academic hospital in Iran. The first phase featured virtual training, an educational workshop, and improvements to the hospital information system. The second phase involved the recruitment of human resources, the implementation of continuous codified training, the establishment of an appropriate reward and penalty system, and the review of patient education forms.RESULTS:The interventions improved nursing documentation quality score of 73.20%, which was the highest accreditation ranking provided by Iran’s Ministry of Health and Medical Education in 2017. In other words, this study caused a 32% improvement in the quality of nursing care documentation in the hospital.CONCLUSION:The appropriate practices for improving nursing care documentation are employee participation, managerial accountability, nurses’ adherence to documentation standards, improved leadership style, and continuous monitoring and control.

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