Thai nurses' experience of caring for persons who had a peaceful death in intensive care units

This phenomenological study describes the lived experience of caring for persons who had a peaceful death in the intensive care units. Ten intensive care nurses in south Thailand participated in individual interviews. Van Manen's approach was utilized to synthesize data. The lived experience of Thai nurses caring for persons who had a peaceful death is: understanding the other through valuing experience and enhancing relationships with others by recognizing time is short and is a priority. Boykin and Schoenhofer's theory of nursing as caring provided the theoretical lens for interpreting the meaning of the phenomenon.     

A survey on oral care practices for ventilator‐assisted patients in intensive care units in 3A hospitals of mainland China

Oral hygiene is a critical element of patient care, particularly among patients who need ventilator‐assisted equipment. The objective of this study was to explore the current status of oral care practices, attitudes, education and knowledge among intensive care unit (ICU) nurses caring for ventilator‐assisted patients in 3A hospitals in mainland China. To achieve this aim, an 18‐item self‐assessment questionnaire was mailed to head ICU nurses in 189 Grade 3A hospitals. Additional data were collected through in‐person interviews at 38 ICUs throughout Sichuan, Shanxi, Jiangsu provinces, as well as Chongqing and Beijing. We found that most ICUs conducted oral examinations at patient admission, and that this care was largely provided by nurses. The most common oral care methods were foam swabs and mouth rinse containing antibiotics or disinfectants. Although the majority of ICUs provided continuing training for oral care, and most training was conducted by head nurses, the content and scope of training were not consistent among the hospitals in the study. The most popular sources of oral care knowledge were academic journals, Internet and professional books. Overall, it is clear that an evidence‐based oral care standard manual is urgently needed for oral practice in ICUs in mainland China.     

Work‐related behaviour and experience patterns of nurses

Goetz K., Beutel S., Mueller G., Trierweiler‐Hauke B. & Mahler C. (2011) Work‐related behaviour and experience patterns of nurses. International Nursing Review 59 , 88–93 Introduction. Nursing working conditions are characterized by heavy workloads and extensive responsibilities. The aim of our study was to report and to compare the actual conditions of work‐related behaviour and experience patterns of nurses working on intensive care units (ICUs) and intermediate care in a reference sample of nurses. Methods: The study was designed as a cross‐sectional survey with a sample of ICU and intermediate care nurses in one hospital in Germany and a reference sample of nurses (n = 378). Data were analysed regarding 11 health‐relevant dimensions and four behaviour patterns examined by the questionnaire ‘Work‐Related Behaviour and Experience Patterns’. Group comparison was evaluated with independent t‐test. The survey also collected demographic data. Results: In total, 86 of 158 questionnaires (54.4%) were returned. ICU and intermediate care nurses mainly differed in the health dimensions ‘career ambition’ and ‘satisfaction with work’, and had equal mean scores in ‘experiences of social support’. The most common pattern for the majority in our sample was the withdrawal pattern (46.8 %). 17.7% showed the burnout pattern. One third of our sample showed a healthy pattern (25.3%). Conclusions: It was possible to identify clear risk patterns for our sample of ICU and intermediate care nursing staff and to demonstrate that an essential aim should be to minimize the risk of burnout by strengthening nurses' individual, as well as work‐related resources by applying a salutogenic approach. Leadership should reinforce motivational aspects to prevent staff withdrawal and to keep nurses in the workforce.     

Knowing the occasion of a peaceful death in intensive care units in Thailand

The purpose of this study was to describe how nurses know the occasion of a peaceful death. The data were generated from individual in-depth interviews with ten nurses who practised in adult intensive care units in the southern region of Thailand. Using a content analysis method, four processes of knowing the occasion of a peaceful death were isolated. They were visual knowing, technological knowing, intuitive knowing, and relational knowing.The clinical implications of these processes provide opportunities for nurses to practise the best end-of-life care during a critical time in a patient's life.This study also strengthens cross-cultural nursing during end-of-life care in high-technology settings, such as the intensive care unit.     

Thai nurses’ perspectives on the use of complementary and alternative medicine among Thai breast cancer survivors in northern Thailand

Breast cancer survivors are more likely to seek complementary and alternative medicine (CAM) for their health and well‐being than other cancer patients. The purpose of the study was to describe how Thai nurses perceive the use of CAM in Thai breast cancer survivors. An ethno‐nursing research method was used. Fifteen Thai nurses who had experience in taking care of Thai breast cancer survivors who used CAM from a tertiary care referral and resource centre in the lower northern part of Thailand were interviewed. Two major themes emerged from this study: Meaning of care practices in CAM was seen as: (i) an additional beneficial choice for health; and (ii) emotional and psychological healing. Nurses should be concerned about CAM use in Thai breast cancer survivors. Open communication about CAM helps ensure that safe and holistic care is provided. Further research to enhance integration of CAM into health care is needed.     

ICU护士对镇静镇痛集束化护理知信行的现状调查

目的 了解ICU护士镇静镇痛集束化护理知信行现状,分析影响在临床中开展镇静镇痛集束化护理策略的因素。方法 2018年3月—6月,采用自编问卷对北京市5所三级甲等医院的ICU护士进行横断面调查,问卷内容包括ICU护士镇静镇痛集束化护理的知识、态度和行为（42个条目）,满分42分,以及获得知识的来源及影响因素（2个条目）,问卷总内容效度为0.906。结果 共回收调查问卷282份。知识、态度、行为的得分分别为（6.01±2.06）分、（6.78±2.60）分和（11.40±3.64）分,总分为（24.18±5.72）分。不同职称护士知识得分差异具有统计学意义（P<0.05）;不同ICU类型护士态度得分差异具有统计学意义（P<0.05）;不同年龄、职称、受教育程度、护理工作年限、ICU类型及ICU工作年限的护士行为得分差异具有统计学意义（P<0.05）。多元线性回归分析显示,护理工作年限和护士所在ICU类型是ICU护士镇静镇痛集束化护理知信行总分的影响因素（P<0.05）。结论 ICU护士镇静镇痛集束化护理知识水平偏低,对镇静镇痛集束化护理的态度较积极,镇静镇痛集束化护理行为尚欠缺,神经重症ICU护士和护理工作年年限少于5年的ICU护士镇静镇痛集束化护理知信行总体水平高于其他护士,护理管理者应建立和完善镇静镇痛集束化护理培训体系,强化ICU护士的知识和行为,通过培训提高其镇静镇痛集束化护理的知信行水平。     

Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units

Aims and objectives. To provide an analysis of the scope of nursing practice and inter‐professional role responsibility for ventilatory decision‐making in Australian and New Zealand (ANZ) intensive care units (ICU). Background. Currently, little empirical data describe nurses’ role in decision‐making for ventilation and its weaning. Delineation of roles and responsibilities for ventilatory practices vary according to unit structure, staffing and skill‐mix, patient case‐mix and unit leadership models. Methods. Self‐administered questionnaire sent to nurse managers of eligible ICUs within ANZ. Results. Survey responses were available from 54/180 ICUs. The majority (71%) of responding ICUs were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4·7 in Australia and 4·2 in NZ, with 69% (IQR: 47–80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse‐to‐patient ratio for ventilated patients with 71% reporting a 1:2 nurse‐to‐patient ratio for non‐ ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision‐making. Decisions to change ventilator settings, including FiO₂ (91%, 95% CI: 80–97), ventilator rate (65%, 95% CI: 51–77) and pressure support adjustment (57%, 95% CI: 43–71), were made independently by nurses. Conclusions. The results of this survey suggest, within the ANZ context, nurses participate actively in ventilation and weaning decisions. In addition, the results support an association between the education profile and skill‐mix of nurses and the level of collaborative practice in ICU. Relevance to clinical practice. Mechanical ventilation may result in significant complications if not applied appropriately. Collaborative practice that encourages nursing input into decision‐making may improve patient outcomes and reduce complications.     

Self‐care behaviours and trajectory management by people with scleroderma in northeastern Thailand

Scleroderma, particularly systemic sclerosis, is a chronic illness that affects a person's physical, emotional, psychosocial, and spiritual dimensions. To investigate self‐care deficits, health behaviours, and trajectory management of Thai people with systemic sclerosis, an exploratory case study method was used through interviews and patient records. Self‐care deficit nursing theory and the chronic illness trajectory framework guided the research. Twelve patients with systemic sclerosis were purposively recruited at a hospital clinic in the northeastern region of Thailand. Thai people living with systemic sclerosis developed specific self‐care agencies in each of 3 identified trajectory patterns to improve their health and well‐being. By applying the theory and framework that guided the research, nurses can promote self‐care behaviours and recognize situations along an illness trajectory that require intervention and management. The results extend the understanding of how people live and cope with systemic sclerosis.     

Nursing workforce deployment and intensive care unit strain during the COVID-19 pandemic in Victoria,Australia

BackgroundThe COVID-19 pandemic demanded intensive care units (ICUs) globally to expand to meet increasing patient numbers requiring critical care. Critical care nurses were a finite resource in this challenge to meet growing patient numbers, necessitating redeployment of nursing staff to work in ICUs.ObjectiveOur aim was to describe the extent and manner by which the increased demand for ICU care during the COVID-19 pandemic was met by ICU nursing workforce expansion in the late 2021 and early 2022 in Victoria, Australia.MethodsThis is a retrospective cohort study of Victorian ICUs who contributed nursing data to the Critical Health Information System from 1 December 2021 to 11 April 2022. Bedside nursing workforce data, in categories as defined by Safer Care Victoria’s pandemic response guidelines, were analysed. The primary outcome was ‘insufficient ICU skill mix’—whenever a site had more patients needing 1:1 critical care nursing care than the mean daily number of experienced critical care nursing staff.ResultsOverall, data from 24 of the 47 Victorian ICUs were eligible for analysis. Insufficient ICU skill mix occurred on 10.3% (280/2725) days at 66.7% (16/24) of ICUs, most commonly during the peak phase from December to mid-February. The insufficient ICU skill mix was more likely to occur when there were more additional ICU beds open over the ‘business-as-usual’ number. Counterfactual analysis suggested that had there been no redeployment of staff to the ICU, reduced nursing ratios, with inability to provide 1:1 care, would have occurred on 15.2% (415/2725) days at 91.7% (22/24) ICUs.ConclusionThe redeployment of nurses into the ICU was necessary. However, despite this, at times, some ICUs had insufficient staff to cope with the number and acuity of patients. Further research is needed to examine the impact of ICU nursing models of care on patient outcomes and on nurse outcomes.     

The essential elements of spirituality among rural Thai elders

The essential elements of spirituality among rural Thai elders The purpose of the study reported here was to understand and describe the essential elements of spirituality among rural Thai elders. The research question that guided the study was: How do rural Thai elders experience and describe spirituality in their daily lives? This question was explored through in‐depth, audio‐taped, face‐to‐face interviews with 12 rural Thai elders living in the Nakhorn Prathom Province in the central part of Thailand during the period from January to March 1998. Prior to implementing the study, approval to conduct this study was granted from the Institutional Review Broad of the University of Alabama at Birmingham. Through the process of hermeneutic phenomenological data analysis, three categories and nine themes emerged. The findings of the study provide a knowledge base for Thai nurses to explore and explain spirituality to enhance nursing science and provide holistic nursing care. Further research should be conducted throughout the health and illness continuum with all age groups and with individuals of different cultures and belief systems.     

Personality,stress and coping in intensive care nurses: a descriptive exploratory study

Aim: The aim of the study was to investigate the relationship between personality traits, perception of workplace stress and coping among intensive care unit (ICU) nurses. Background: Research has indicated that ICUs are stressful environments. There is a tendency for research studies to investigate causes of stress and ways of coping, but few studies, particularly in recent years, have considered the personality traits of the staff who thrive in this challenging environment, the work stress they perceive and the coping strategies they use. Method: A convenience sample of critical care nurses (n = 46) completed three standardised questionnaires during September 2007: the revised NEO personality inventory (NEO‐PI‐R); the nurses stress scale (NSI) and the Brief Coping Orientations to Problems Experienced (COPE) scale. Findings: ICU nurses did not perceive their workplaces to be stressful. Certain personality traits, openness, agreeableness and conscientiousness, were associated with problem‐solving coping strategies such as active planning and reframing. Openness and extraversion were associated with less perceived stress from the ‘patients and relatives' dimension of the NSI; there were also negative correlations between conscientiousness and the ‘workload stress' and stress from lack of ‘confidence and competence’ dimensions of the NSI. Conclusion: Certain personality traits may have a buffering effect on workplace stress. Pre‐employment screening to identify staff that exhibit personality and coping traits associated with low perceived stress may be considered as part of the recruitment strategy to address problems relating to stress, sickness and retention. Relevance to clinical practice: The retention and recruitment of staff who have lower perceived workplace stress and who utilise problem‐focused coping may result in less reported absences and fewer critical incidents and errors.     

全员参与管理模式在ICU仪器管理中的应用

[目的]在重症医学科的仪器管理中应用全员参与管理模式,以更好地做好仪器的维护,提升病区仪器管理水平。[方法]建立树枝状分级的管理小组,全员参与仪器管理,建立完善的仪器管理规范,进行知识和技能培训。[结果]实施全员参与管理模式后,仪器的故障发生率由24.9%降至14.8%,护士使用仪器的满意度由59.9%升至91.2%,全科护士仪器使用理论和操作考核得分均有提高。[结论]实施全员参与仪器管理模式,确保了医疗质量和病人安全,提高了护士使用仪器的满意度,提高了全科护士的仪器使用技能,提升了护理质量,提高了对仪器等的管理能力。     

护理人员对插管患者口腔护理知识掌握状况的调查分析

目的:了解重症监护病房护士对经口气管插管口腔护理相关知识的掌握情况。方法:应用自设问卷,采用方便抽样方法向北京市6家三级甲等医院重症监护病房护士发放问卷105份。结果:口腔护理基本知识掌握较好,但对于新知识,如牙菌斑,机械通气性肺炎的发生机制等的了解较差;职称为护师的护理人员的知识掌握情况好于主管护师(P<0.05)。结论:应该针对不同层次护理人员开展口腔护理新知识的培训和宣传工作,并为拓宽护士的知识领域提供多元化的教育途径。     

共情能力在ICU护士死亡焦虑与临终关怀态度的中介作用

为了探讨ICU护士临终关怀态度与死亡焦虑、共情能力的现状及其相关性,探讨共情能力在死亡焦虑与临终关怀态度间的中介作用,采用一般资料调查表、中文版佛罗梅尔特临终关怀态度量表(FATCOD-B)、中文版死亡焦虑量表(CT-DAS)和人际反应指针量表(IRI)对大连地区某三级甲等医院的165名ICU护士进行问卷调查。结果显示ICU护士临终关怀态度为(97.3±10.4)分,死亡焦虑为(8.5±2.9)分,共情能力为(53.8±10.4)分；临终关怀态度与死亡焦虑呈负相关(r＝﹣0.226,P＜0.01),与共情能力呈正相关(r＝0.232,P＜0.01)；共情能力在死亡焦虑对临终关怀态度的影响中起部分中介作用。因此ICU护士临终关怀态度和共情能力偏低,死亡焦虑较高；改善死亡焦虑和提高共情能力能有效的促进临终关怀态度,提升临终关怀能力。