Volume 10, Issue 1

Integration of Evidence-Based Care Bundle in Traumatic Brain Injury Patients’ Care
Original Research
Traumatic brain injury (TBI) remains an increasingly prevalent cause of death and disability worldwide. Despite the growing evidence that supports the use of an evidence-based care bundle in the emergency department, little is known about this bundle in caring for TBI patients in Egypt. This study aimed to investigate the effect of implementing an evidence-based care bundle on the outcome of TBI patients. Design: A quasi-experimental research design was used. Setting: The study was conducted in the emergency department of the Emergency Hospital, Mansoura University in Egypt. Subjects: A convenience sample of 52 patients aged ≥ 18 years of both genders, who were admitted to the previously mentioned setting included in this study. The patients were divided into two groups: control and bundle groups, with 26 patients in each group. Tools: Data were collected using one tool: Traumatic Brain Injury Patients’ Assessment Sheet. The results: There was improvement in the bundle group patients’ GCS, pupil size and reactivity, and survival, which was statistically significant except for patients’ survival. Conclusion and Recommendations: Evidence-based care bundle improves TBI patients' outcomes. Therefore, it is recommended to use this bundle as a fundamental part of the initial nursing care for TBI patients in the emergency department.
American Journal of Nursing Research. 2022, 10(1), 34-40. DOI: 10.12691/ajnr-10-1-5
Pub. Date: March 01, 2022
Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients
Original Research
Falls are the most common cause of preventable injury. Being hospitalized puts patients at further risk for falls due to illness and the newness of the hospital environment. Unfamiliar surroundings, medications and treatments are considered the main reasons of falls that happened in the hospital setting. Literatures stated that, several strategies could be implemented to prevent fall, one of these strategies is Tailored Intervention Patient Safety (TIPS), which is known as a novel, evidence based program that is becoming a standard for engaging patients and families in the process of fall prevention. This study aimed to compare between tailored approach and routine interventions for fall prevention among hospitalized elderly patients. Method: A quasi-experimental design was used to conduct this study in medical wards. A purposeful sampling technique was utilized in this study. The number of participants was 108, 54 in each the study group and the control group. Data collection tools: Two tools were used in the current study: First tool was divided into two parts: First part, patient’s demographic data assessment; second part, Morse Risk Assessment Scale for fall; Second tool was used to assess implementing TIPS and routine interventions for fall prevention. Results: Revealed that those participants who were provided routine interventions to prevent fall have liability to fall 1.3 times in comparison to those participants who were provided tailored approach. Conclusion: This study concluded that, using tailored approach as patient-centered approach to reduce falls showed promising results. Recommendation: This study recommended using TIPS tailored approach for fall prevention, as it is considered as one of the successful novel strategies that helped to reduce fall rate among elderly hospitalized patients.
American Journal of Nursing Research. 2022, 10(1), 26-33. DOI: 10.12691/ajnr-10-1-4
Pub. Date: March 01, 2022
Nurses Perceptions of Nursing Leadership Styles in the Eastern Healthcare Cluster in Saudi Arabia
Original Research
The type of leadership style adopted by the manager and how it is perceived by nurses can play a critical role in influencing staff performance and healthcare outcomes. This study aims to examine nurses’ perceptions about the managers’ leadership and to determine whether the style used may play a role in determining the quality of patient care. Methodology: A cross-sectional quantitative study was conducted in Eastern Health Cluster was over a four- month period from April 5th to July 30th 2021. A purposive sampling technique was used whereby all nurses and midwives working in EHC facilities, 8,699 staff, were invited to participate in the research adopting multifactor leadership questionnaire (MLQX5) to rate leadership styles and outcomes in relation to transformational, transactional, and passive avoidant leadership styles. The questionnaire was evaluated by a panel of expert nurse leaders against construct validity then piloted to test reliability. Data were collected after ethical approval was granted from King Fahad Specialist Hospital. Results: 577 nurses provided a 3.98% margin of error at the 95% confidence level. Statistical analysis was conducted using SPSS version 23.0. Results show that nurses perceive that their managers are using transformational and transactional leadership styles more often than passive avoidant leadership style. There was a positive and highly significant correlation between leadership and outcome factors. The analysis shows a positive correlation between leadership outcome factors (effectiveness, extra effort and satisfaction) and transformational and transactional leadership styles and a negative correlation with passive avoidant leadership style. A comparison of sociodemographic characteristics within the nursing workforce found that there are no significant differences in perceived leadership styles relating to gender although mean scores show that females had a higher perception of transformational and transactional styles compared to men who had a higher perception of passive avoidant style. Recommendations and Implication for Nursing: Transformational leadership appears to be best suited for nursing as it has positive nursing outcomes There is a strong need to implement leadership education and training amongst all nurses and to continuously train and educate nurse leaders and those potential leaders under succession planning programs about leadership skills and competencies and how to promote a culture for transformational leadership. Conclusion: The transformation of the healthcare system in Saudi Arabia, and challenges that are inherent, emphasize the importance of ensuring that nurses are effective leaders if organizational needs are to be met in the future. It is therefore important to conduct further qualitative and quantitative nursing researches amongst this nurse population to provide evidence about how leadership style is perceived and how it may influence outcomes within the nursing workforce and work environment.
American Journal of Nursing Research. 2022, 10(1), 16-25. DOI: 10.12691/ajnr-10-1-3
Pub. Date: January 23, 2022
Nurse Management of Radial Arterial Lines: Quality & Safety
Original Research
Background: Radial arterial lines (RALs) are used to obtain precise measurement and provide continuous blood pressure monitoring of critically ill patients. Critical care nurses are the primary responsible clinician for maintaining the safety and effectiveness of radial arterial lines (RALs). Gaps exist in the practice literature about tools that help nurses stabilize the wrist joint for safe maintenance of RALs. Local Problem: The purpose of this study was to improve the quality and safety of RALs by establishing use, safety, and preferences of critical care nurses for tools that help them manage RALs. Methods/Intervention: A mix method approach provided in-depth qualitative and quantitative data in two phases: Phase I: Survey of critical care nurse management of RALs and Phase II: a Focus Group of Critical Care Nurse Experts exploring the use, safety, and perception of tools to manage RALs. Results: Nurses reported that visual inspection of the insertion site of an RAL (97.1%); adjustment of the wrist angle (98.5%) and stabilization of the wrist (88.2%) were critical areas for safe management. Nurses voiced concern about the lack of the availability of adequate tools to manage RAL. Conclusions: Too often the nurses' jury rig devices to stabilize a patient’s wrist and the nurses reported frequent adverse events such as infections, skin breakdown, and inaccurate blood pressure measurements. These outcomes are costly for hospitals and patients. Nurses reported preference for flexible/bendable armboards, but they were reported often not available. Nurses need up-to-date tools to perform best practices that keep patients safe.
American Journal of Nursing Research. 2022, 10(1), 7-15. DOI: 10.12691/ajnr-10-1-2
Pub. Date: January 23, 2022
The Association of Burnout Syndrome among Nursing Staff in King Abdullah Medical City - Makkah Based on Specialty
Original Research
Background: Burnout remain significant concerns in nursing, affecting both individuals and organizations. Burnout is a challenging health problem. This problem is harmful to humans and health systems. Therefore, in recent years, particular attention has been paid to research on burnout, especially among the nursing professions. Objective: The study aim was to investigate the association of burnout syndrome among nursing staff at King Abdullah Medical City (KAMC) in the city of Makkah, based on individual nursing specialization and examining the possible existing relationships between the magnitudes of burnout syndrome with some variables. Subjects and Methods: The Study type was a Cross-Sectional design. Undertaken in a specialized hospital, Makkah, Saudi Arabia. Sample collected from 376 nurses working in different specialties. Data collection was done by using a survey questionnaire that comprises of two segments. The first part of the survey was containing sociodemographic data (gender, age, nationality...etc). On the other hand, the second part of the survey consist of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results: The result showed that the emotional exhaustion has higher score which indicate the nurses have higher emotional exhaustion. Depersonalization shows lower score that means low burn out and personal accomplishment shows higher score that means the participants have more personal accomplishments. The finding shows that there is significance difference exist between Burn out among nursing staff with educational level and primary work area. There is no relationship exist between Burn out with years of experience and staff position. Conclusion and Recommendations: This research represents to the association of burnout syndrome among nursing staff. This finding can be used to identify contributing elements that are the primary causes of exhaustion among full-time nurses, as well as to investigate the scope and magnitude of burnout syndrome as experienced by full-time nurses. The hospital management should establish an action plan to reduce professional burnout among nurses by increasing participation and communication between professionals and management.
American Journal of Nursing Research. 2022, 10(1), 1-6. DOI: 10.12691/ajnr-10-1-1
Pub. Date: January 20, 2022