Intensive care nurses' knowledge of enteral nutrition: a descriptive questionnaire

BACKGROUND: Nurses have an important role in the delivery and management of enteral nutrition in critically ill patients, to prevent iatrogenic malnutrition. It is not clear how nurses source enteral nutrition information. 

Family centred care before and during life-sustaining treatment withdrawal in intensive care: a survey of information provided to families by Australasian critical care nurses

BACKGROUND: A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances.

OBJECTIVE: To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment.

DESIGN: An online cross-sectional survey.

METHODS: During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data.

RESULTS: From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (p<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided.

CONCLUSIONS: The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time.

Understanding the bereavement care roles of nurses within acute care: a systematic review

AIM AND OBJECTIVES: To investigate nurses' roles and responsibilities in providing bereavement care during the care of dying patients within acute care hospitals.

BACKGROUND: Bereavement within acute care hospitals is often sudden, unexpected and managed by nurses who may have limited access to experts. Nurses' roles and experience in the provision of bereavement care can have a significant influence on the subsequent bereavement process for families. Identifying the roles and responsibilities nurses have in bereavement care will enhance bereavement supports within acute care environments.

DESIGN: Methods: A mixed-methods systematic review was conducted utilising the databases Cumulative Index Nursing and Allied Health Literature (CINAHL Plus), Embase, Ovid MEDLINE, PsychINFO, CareSearch and Google Scholar. Included studies published between 2006 to 2015, identified nurse participants, and the studies were conducted in acute care hospitals. Seven studies met the inclusion criteria and the research results were extracted and subjected to thematic synthesis.

RESULTS: Nurses' role in bereavement care included patient-centred care, family-centred care, advocacy and professional development. Concerns about bereavement roles included competing clinical workload demands, limitations of physical environments in acute care hospitals and, the need for further education in bereavement care.

CONCLUSIONS: Further research is needed to enable more detailed clarification of the roles nurse undertake in bereavement care in acute care hospitals. There is also a need to evaluate the effectiveness of these nursing roles and how these provisions impact on the bereavement process of patients and families. 

Attitudes of nephrology nurses toward patient exercise during hemodialysis

Exercise programs are rare in hemodialysis clinics. The study goals were to 1) explorenephrology nurses’ attitudes toward exercise; 2) compare the attitudes between nephrologynurses who had been exposed and those who had not been exposed to an patient exerciseprogram; and 3) measure the psychometric properties of a survey tool to measurenephrology nurses’ attitudes toward intradialytic exercise. Nephrology nurse attitudeswere positive toward patients’ exercising; however, they did not believe it was theirresponsibility to conduct the exercise program. Nephrology nurses who had not seenpatients exercising during dialysis were more likely to perceive exercise barriers. Thisstudy developed a valid and clinically useful 16-item instrument to measure nephrologynurses’ attitudes about patient exercise in four areas: patient benefits, patient barriers,nurse barriers, and health professional enablers.

The impact of characteristics of nurses' relationships with their supervisor, engagement and trust, on performance behaviours and intent to quit.

AIMS: The aim of this study was to investigate the influence of characteristics of nurses' relationship quality with their manager on engagement and trust, onto in-role or discretionary behaviours and intent to quit. BACKGROUND: Nurses having a good relationship with their manager are seen as important, yet the mechanisms of how such relationships are beneficial, or which aspects of the relationship are important, is less clear. Two possible mechanisms are through the nurse being more engaged in work, or through building their trust in their employer. In turn, engagement and trust may impact in-role and discretionary behaviours as well as staff retention. DESIGN: Cross-sectional. METHOD: An online survey in 2013 of 459 nurses across Australia. RESULTS: Structural analyses indicated that the affect dimension of relationship quality was negatively related to engagement, whereas contribution and respect were positively related to engagement. The affect and respect aspects were positively related to trust. Engagement positively related to discretionary and in-role behaviours. Engagement and trust were negatively related to quit intention, as was the loyalty dimension of the nurses' relationship with their supervisor. However, perceptions of variability in their team's relationship quality with their leader was negatively related to trust and positively related to intent to quit. CONCLUSIONS: Nurse managers with a nuanced understanding of social exchange at work are likely to maintain more engaged, well-performing and stable nursing teams. In particular, a willingness by the supervisor to come to their nurses' defence and having a consistent standard of relationship quality across their nurses is likely to improve nurse retention.

Vein measurement by peripherally inserted central catheter nurses using ultrasound: A reliability study

Background Peripherally inserted central catheters (PICCs) are increasingly inserted by trained registered nurses, necessitating the development of specialized skills such as the use of ultrasound. The selection of an adequately sized vein is an important factor in reducing adverse events such as deep vein thrombosis. However, PICC nurses may receive minimal training in the use of ultrasound for vein measurement. Objective We aimed to demonstrate the reliability of a vein measurement protocol using ultrasound by a PICC nurse trained in sonography. Methods The diameter of the basilic, brachial, and cephalic veins in the left arms of healthy participants (n = 12) were measured using ultrasound by a PICC nurse and a sonographer. A PICC nurse performed the measurement twice and the sonographer once; the PICC nurse's results were compared for intra-rater reliability and compared with the sonographer for inter-rater reliability. The results were analyzed using intraclass correlation coefficients (ICCs). Results Inter-rater reliability between the PICC nurse and the sonographer was adequate, the ICC for the brachial vein was 0.60 (95% confidence interval [CI], 0.06-0.87), basilic vein ICC was 0.87 (95% CI, 0.58-0.96) and cephalic vein ICC was 0.77 (95% CI, 0.39-0.93). Intra-rater reliability of the PICC nurse was higher; the ICC for the brachial vein was 0.80 (95% CI, 0.44-0.94), basilic vein ICC was 0.92 (95% CI, 0.67-0.98), and cephalic vein ICC was 0.78 (95% CI, 0.40-0.93). Conclusions Using a suitable protocol, a PICC nurse was able to measure vein diameter reliably when compared with a sonographer and consistently replicate these results.