Volume 7, Issue 4

Barriers and Strategies of Implementing DKA Care Set in the Emergency Department within the Banner System as Perceived by Nurses
Original Research
There are different barriers and strategies for implementing diabetic ketoacidosis (DKA) care set in the emergency department (ED). However, there is limited research on DKA care set in the ED. The current research tries to determine the barriers and strategies of implementing diabetic ketoacidosis (DKA) care set within the Banner system as perceived by nurses in the ED. The study utilized a qualitative descriptive method using a semi-structured face-to-face interview. Twelve (12) nurses from the Emergency Room(ER) aged 24 to 48 were the participants of the study. The qualitative inductive content analysis revealed four (4) main categories and themes regarding participant’s perceptions about barriers of implementing the DK care set in E; these are; Knowledge, Experience and Competence in identifying cases of DKA, Communication, and Language. Findings demonstrate that it is essential that nurses should profound understanding of DKA to assess and distinguish its symptoms from other diseases. Hence, knowledge of DKA pathophysiology and competence to identify its symptoms is significant in delivering the appropriate management and care. The study posits that the identified barriers (knowledge, experience, and competence in identifying cases of DKA, communication, and language) significantly affect the success of implementing the DKA Care Set. A collaborative effort is significant in the care of DKA patient; therefore, there is a need for a nursing staff education and training to enhance protocol adherence of protocol throughout DKA.
American Journal of Nursing Research. 2019, 7(4), 664-669. DOI: 10.12691/ajnr-7-4-28
Pub. Date: June 24, 2019
3327 Views1219 Downloads
Effect of Self-Management Program on Quality of Life for Patients with Chronic Kidney Disease
Original Research
Background:Chronic Kidney Disease (CKD) is a serious medical and public health problem whose prevalence is increasing worldwide. Patients with CKD must cope with life changes and stresses to improve their quality of life (QoL). It is suggested that self-management is key to the effective care of chronic diseases, a process in which individuals carry out the daily functions of health care to manage chronic diseases. Aim of the study: This study aimed to evaluate the effect of self-management program on QoL among patients with CKD. Subjects and Method: A quasi-experimental research design [pretest -posttest] was conducted at Out-Patient Clinics of the New Mansoura General Hospital. The instruments used for data collection were Socio-demographic and Clinical Data Structured Interview Schedule and The 36-item Short-Form Questionnaire (SF-36). A convenience sampling of sixty nine patients with CKD completed the study after implementing the self-management program with 6 weekly sessions. Results: The present study findings revealed that there was highly statistically significant difference of all dimensions of QoL except pain and vitality/ energy dimensions between before and after implementing the self-management program. Conclusion: The current study revealed that the CKD self-management program had a positive effect on preventing QoL deterioration in patients with CKD. Recommendation:Self- management programs will be useful if it is accompanied by other therapeutic and welfare actions and comprehensive supports of public and private charity organizations.
American Journal of Nursing Research. 2019, 7(4), 657-663. DOI: 10.12691/ajnr-7-4-27
Pub. Date: June 19, 2019
3028 Views897 Downloads
Effect of Educational Session on Nursing Students’ Knowledge and Attitude toward Complementary and Alternative Medicine
Original Research
Background and objective: Complementary and alternative medicine consider an extensive group of healthcare performs, remedies and modalities. This study aimed to evaluate effect of educational session on nursing students’ knowledge and attitude toward complementary and alternative medicine. Methods: Research design: Quasi-experimental design. Setting: Faculty of Nursing at . Sample: 200 students from first academic level (100) and second academic level (100). Tool: Students assessment sheet: it has thee parts. Part I: Socio-demographic data of the students. Part 2: Students’ knowledge questionnaire. Part 3: Students’ attitude questionnaire. Results: There was a statistically significant difference between pre and post application of educational session as regarding nursing students’ knowledge and attitude toward complementary and alternative medicine. Conclusions and recommendations:Educational session had significantly effect on nursing students’ knowledge and attitude toward complementary and alternative medicine. Replicate the study on a larger study sample that includes students in four academic levels at Faculty of Nursing.
American Journal of Nursing Research. 2019, 7(4), 652-656. DOI: 10.12691/ajnr-7-4-26
Pub. Date: June 18, 2019
4321 Views1646 Downloads
The Oral Health Knowledge and Self-care Practices of Pregnant Women in Saudi Arabia
Original Research
Background. Pregnancy is a unique time in a woman's life and is characterized by complex physiological changes. These changes can adversely affect oral health. Oral health is a state of being free from chronic mouth and facial pain, oral and throat cancer, oral sores, periodontal (gum) disease, tooth decay and tooth loss, and other diseases, and disorders that affect the oral cavity. Risk factors for oral diseases include unhealthy diet, tobacco use, harmful alcohol use, and poor oral hygiene (WHO). Multiple studies have shown an association between periodontal infection and adverse pregnancy outcomes, such as premature delivery and low birth weight. Aim of this study assess women’s knowledge towards oral and dental health during pregnancy and to examine their self-care practices in relation to oral and dental health. Methodology The research will be conducted at randomly governmental primary health care centers and schools in Riyadh (Dawadmi region). A Quantitative Descriptive cross-sectional study was carried out. two-hundred Saudi pregnant women selected randomly. Women who gave informed consent were asked to complete a self-administered questionnaire and return it to the researcher A Structured questionnaire will be developed consisted of three parts, Demographic characteristics part, level of women`s Knowledge regarding oral health part & Self-care practice regard oral health care. Results, Conclusion & Recommendation. Age of participant women’s between 28 – 38 years (43.2%). Most of the participants had number of pregnancies between 4-6 (38.5 %). Regarding the level of knowledge about oral health, this study showed that 45% of mother had poor knowledge, and there is a significant relationship between the level of practice and the educational, professional status and attendance to antenatal clinic, which was started by 65% of the sample on time, however, they did not visit the dentist. This study recommends that the implementation of oral health programs in prenatal services is essential to delivery of dental care and decreasing the potential oral problems among pregnant women, as well as conducting careful screening of oral risks, and assisting women in obtaining regular dental care.
American Journal of Nursing Research. 2019, 7(4), 643-651. DOI: 10.12691/ajnr-7-4-25
Pub. Date: June 15, 2019
4636 Views1615 Downloads
Risk Factors Contributing to Needle Stick Injuries: Nurses' Self Reporting
Original Research
Needle stick injuries remain a common factor in exposure of healthcare workers especially nurses to blood-borne viruses. Objective:To assess riskfactors contributing to needle stick injuries reported by nurses. Design:A cross-sectional study was conducted. Setting: This study was conducted in three University Hospitals: Alexandria, Beni-Suef and Aswan. Subjects: 300 nurses (100 nurses from each hospital) working in the previously mentioned setting was taken represent different medical-surgical departments and outpatient clinics. Tool: Two tools was developed by the researchers in order to collect pertinent data in this study [10,13]. Tool I: Assessment interview qeustionnair sheet, it includes; Part I: Socio-demographic characteristics of nurses, Part II: Nurses' Knowledge Regarding Needle Stick Injuries. Tool II: Risk Factors Associated to Needle stick injuries, it includes Part I: Factors related to Nurses and part II:Factors related to organization. Results: The main results revealed that the most common factors contributed to Needle stick injuries were presence of stressors inside work, no hospital protocol regarding Needle stick injuries process management, lack of continuity of supervision regarding Needle stick injuries and lack of training about how to avoid Needle stick injuries respectively.Conclusion: The occurrence of Needle stick injuries is most often encountered among nurses in a heavy work area full of stressors in the absence of hospital protocol, supervision, and training program regarding Needle stick injuries prevention. Recommendation: Additional educational & training programs, regular reporting protocol, follow up and assessment of exposures are recommended for all nurses in the community involved in this study.
American Journal of Nursing Research. 2019, 7(4), 633-642. DOI: 10.12691/ajnr-7-4-24
Pub. Date: June 14, 2019
5980 Views1728 Downloads
Effect of Nursing Instructions on Diabetic Patients’ Knowledge about Peripheral Neuropathy and Foot Care
Original Research
Diabetic peripheral neuropathy occurs in about half of the diabetic patients and it increases the risk of foot problems.Aim: To assess the effect of nursing instructions on diabetic patients’ Knowledge about peripheral neuropathy and foot care. Research design: A quasi experimental research design was used. Sample: purposive sample was used to select 60 adult diabetic patients. Setting:outpatient diabetic clinic at King Khalid Hospital, Hail in KSA. Tools:-Structured interview questionnaire was developed by the researchers to assess sociodemographic, medical data and Diabetic patient’s knowledge about peripheral neuropathy and foot care. Results: There was a highly statistically significant improvement of the studied group total knowledge about diabetic peripheral neuropathy as well as about foot care after one week and after three months of intervention than pre intervention. Conclusion: Implementation of nursing instructions regarding peripheral neuropathy and foot care was effective in improving diabetic patients’ knowledge about them.Recommendations: Applying nursing instructions regarding peripheral neuropathy and foot care with a large sample in different settings to enhance and confirm the current results.
American Journal of Nursing Research. 2019, 7(4), 626-632. DOI: 10.12691/ajnr-7-4-23
Pub. Date: June 12, 2019
3584 Views1115 Downloads
Barriers Facing Nurses in Reporting Medication Administration Errors in Saudi Arabia
Book Chapter
The purpose of this study was to evaluate nurses’ perceptions and the barriers that decrease the likelihood of reporting a medical administration error. Medication administration errors are a significant problem within the healthcare community and may be underreported or not reported due to a variety of factors. These may include personal perceptions, fear, misunderstanding of what constitutes an error, whether the significance of the error changes the requirement that all errors should be reported, and apprehension of the consequences for reporting and handling the error. This study included a quantitative survey of nurses in the KSA region and asked questions relating to their fears, perceptions, potential barriers, perceived barriers, and beliefs regarding medication administration errors. As was found, nurses underreport errors and may not consistently understand that all errors, regardless of perceived significance, should be reported through the same channels as for all other errors. This study also found that nurses tend to lack honesty with regards to their beliefs about how they report their own medication administration errors in; leading to the assumption that nurses either do not understand the appropriate protocols for error reporting or do not believe they have committed errors when they have. Finally, this study has offered suggestions for changes to the error reporting framework to dispel misconceptions and ensure nurses understand that all errors need to be reported regardless of significance, perceptions, or related fears.
American Journal of Nursing Research. 2019, 7(4), 598-625. DOI: 10.12691/ajnr-7-4-22
Pub. Date: June 09, 2019
4062 Views767 Downloads
Examining the Time Management Training Program on Delegation Skills Regarding Nurse Manager
Original Research
The basic element of the universe is a time; time only goes through one way, and only comes once, the most effective way to be spent. The manager use the time management tools effectively will achieve their personal and professional goals, and allow one to spend time on important matter nurse managers are predicting to control and oversee the performance of other healthcare. The ability to delegate routinely is effectively to the success of this function. Aim of this study: To examine the effect of time management training program on delegation skills regarding nurse manager working at Kafrelsheikh General Hospital. Research design: A quasi-experimental intervention research design with pre-post assessment was used in the study. Study sample: A sample of nurse managers including all nurse managers available (39) at the time of data collection, working in all inpatient departments of the Kafrelsheikh General Hospital. Tools: Three tools were used for data collection in this study, these were: 1) The delegation questionnaire tool, 2) Time management tool, and 3) Time wasters’ tool. Results: There were statistically significant improvements in nurse managers’ knowledge related to time management, delegation, and time wasters between pre and posttest (p value < 0.001). Statistically significant positive correlations were detected between age and experience on all time management domains, total time management, delegation, and time wasters (internal & external). Recommendations:Educational program should be focused on the preparation of new graduates to undertake responsibilities of delegation and time management skills as theoretical components, and identify the time wasters during their work setting and what are the strategies to deal with them.
American Journal of Nursing Research. 2019, 7(4), 589-597. DOI: 10.12691/ajnr-7-4-21
Pub. Date: June 06, 2019
3711 Views1076 Downloads
Adopting Scenario Based Learning in Critical Care Nursing Education: Students’ Achievement and Feedback
Original Research
Scenario based learning (SBL) is up-to-date inventive teaching method that providing directive discussion for nursing students. Effective designed scenarios are considered the corner stone for teachers to integrate learning objectives into nursing students’ learning experience. Many studies reported that is a broad dynamic interactive teaching and learning strategy. It enhances students’ decision making skills and self-learning abilities. Aim: the current study aimed to explore fourth level nursing students’ achievement and feedback about scenario based learning at Faculty of Nursing, Mansoura University. Method: a descriptive research design was used. A total of 251 fourth level nursing students registered in critical care nursing course in the second semester of the academic year 2016-2017 were involved in the study. Two tools were used to collect data for the present study which was developed by the researcher. Tool one “Students’ Achievement Sheet” that involved eight main domains. Tool two is “Students’ Feedback about SBL” which folded 18 statements. Results:The majority of the students analyzed scenarios clearly by discovering the cues and inferences related to the scenario problem with high score ranged from good to excellent (61.25-96.25). Despite around 70% of the students’ perceived SBL as a very stressful learning method, it was exciting and enjoyable (62.7%) for them. Also, most of them (75%) agreed that the teachers were a good guide and facilitator for them. Conclusion: The findings of the current study support the argument that SBL is an effective and dynamic learning method and easy to be conducted. It enhances the nursing students’ skills and learning abilities to bridge the theory-practice gap.
American Journal of Nursing Research. 2019, 7(4), 581-588. DOI: 10.12691/ajnr-7-4-20
Pub. Date: June 04, 2019
4006 Views1553 Downloads2 Likes
Knowledge of Some Issues Related to Preconception Health and Pregnancy among Faculty of Nursing Students, Assiut University
Original Research
Background: Preconception health includes health of woman and man before pregnancy to reduce risks that woman may face during pregnancy and enhance fetal and maternal outcomes. This study aimed to:identify and increase knowledge of the undergraduate nursing students concerning preconception health and pregnancy. Methods: A descriptive cross-sectional study design implemented on 320 nursing students at Faculty of Nursing, Assiut University, tooldivided into three parts; part one included students’ personal data, part two included eight ended questions directed to students to identify their knowledge regarding preconception health issues and part three designed to evaluate issues related to pregnancy and contained ten ended questions. Results:38.4% and 31.6% of nursing students had good score of knowledge regarding preconception health and pregnancy respectively, there were statistical significant differences between preconception health and students’ gender, age, university grade and previous perceived obstetric course (P-values=0.013, 0.00, 0.00 and 0.00 respectively). Also, there was a relationship between score of students’ knowledge regarding pregnancy and their age, university grade and previous perceived obstetric course (P-values=0.00, 0.00 and 0.00 respectively). Conclusion: There were relationship betweentotal score of students’ knowledge regarding preconception health and pregnancy with student’s age, university grade and previous perceived obstetric course.Recommendation:Further research should include all university students in practical versus theoretical faculties to identify how the knowledge and information gaps.
American Journal of Nursing Research. 2019, 7(4), 574-580. DOI: 10.12691/ajnr-7-4-19
Pub. Date: June 01, 2019
4835 Views1782 Downloads
Applying Health Education Learning Package for Mothers Regarding Nocturnal Enuresis
Original Research
Introduction: Nocturnal enuresis is a common distressing disorder that carries a significant burden. This disorder has psychological, social and financial implications for the families and their children. Aim: This study aimed to assess the effect of applying health education learning package (HELP) on mothers having children with nocturnal enuresis. Method: A quasi-experimental research design with repeated measures was utilized. A convenient sample of (88) mothers and their children (88) was recruited from the urinary incontinence out-patient clinic that affiliated to Mansoura University Children's Hospital (MUCH), Egypt. Seven structured tools were used for data collection. Results: There were statistically significant differences in mothers’ knowledge, practices and attitude post-application of the HELP regarding nocturnal enuresis compared to pre-application (P=0.000). Additionally, the frequency of bedwetting and urination problems as polyurea and urinary tract infection among the affected children were decreased. Conclusion: Applying of health education learning packageregarding nocturnal enuresis showed a significant improvement in mothers' knowledge, practices and attitude. As well, the associated clinical manifestations among the affected children were decreased post-application of the HELP. Overall, the studied mother found the HELP is useful and effective in solving problems of the mothers and children related to nocturnal enuresis.
American Journal of Nursing Research. 2019, 7(4), 561-573. DOI: 10.12691/ajnr-7-4-18
Pub. Date: May 28, 2019
4571 Views1606 Downloads
Fatigue and Self-management among Multiple Sclerosis Patients
Original Research
Fatigue is considered as the most revealed symptoms in multiple sclerosis patients, reported by 88% of patients and has significant impact on all stages of life such as altering in daily living activity or psychosocial/mental functions. The pathogenesis of fatigue remain poorly understood and how its impact on self-management. The aim of study was to assess fatigue and self management among multiple sclerosis patients. A quantitative descriptive correlational design was used in this study. The study was conducted at both King Abdulaziz University Hospital and King Fahad Armed Forces Hospitals in Jeddah City from January till March 2018, data collected from outpatients’ clinic and Inpatients’ medical-wards. A convenience sample of 50 Multiple Sclerosis patients. Data was collected through the main one tool, it consists of three parts; Part I, Socio-demographic and clinical data constructed by the researchers. Part П, Modified Fatigue Impact scale; to assess the Impact of fatigue on physical, cognitive, and psychosocial functioning in patient with Multiple Sclerosis.. Part ПІ, Multiple Sclerosis Self Management Scale Revised; to provide a multidimensional and psychometrically assessment of self-management knowledge and behavior among Multiple Sclerosis patients. The study results showed there was a statistically significant negative correlations between fatigue subscales and overall self-management among Multiple Sclerosis patients with p-value (.019). Also, there was a statistically significant negative correlations between self-management factor scales and overall fatigue among Multiple Sclerosis patients with p-value (.019). It was concluded that there was a negative correlations between overall fatigue and overall self-management among Multiple Sclerosis patients, whenever fatigue severity increases, self-management decreases. It was a recommendation to encourage governmental policy and other decision makers in the Saudi community to develop periodically structure health education training program regarding self-management in MS and provide appropriate environments or facilities to conduct such programs, where nurses play a key role through health education and cooperate with other health care system.
American Journal of Nursing Research. 2019, 7(4), 550-560. DOI: 10.12691/ajnr-7-4-17
Pub. Date: May 27, 2019
4466 Views1689 Downloads
Educational Program on the Knowledge and Attitude of Pregnant Women Regarding Neonatal Jaundice
Original Research
Background: Early awareness of pregnant women about neonatal jaundice (NNJ) has an essential role in preventing severe hyperbilirubinemia and its dangerous complications. Aim: the study aimed to assess the level of knowledge and attitude of pregnant women regarding NNJ and to evaluate the effect of an educational program for neonatal jaundice among the target population. Subject and methods:three hundred pregnant women attended the Antenatal Clinic at Women Health Hospital in Assiut University were divided into 150 pregnant women as study and 150 as control groups. Quasi-experimental research design was applied. Tool: Using a structured interview questionnaire including five parts; personal data, obstetric, medical and family history, assessment of knowledge, attitude toward neonatal jaundice, and neonatal follow up. Results: There was a statistically significance difference between level of knowledge and attitude in pre- vs. post-test in the study group compared with the control group and there was statistical evidence of neonatal outcomes for improving women's breast feeding and decrease number of jaundice days. Conclusion: This study revealed that pregnant women had inadequate knowledge regarding NNJ and their attitude was negative while the application of an educational program has led to significant improvement in the level of women's knowledge and attitude in the study group, which was reflected on the newborn positively. Recommendations:Implementing a routine health education program for pregnant women about NNJ and raising awareness of the relatives as they were identified as the main source of knowledge.
American Journal of Nursing Research. 2019, 7(4), 542-549. DOI: 10.12691/ajnr-7-4-16
Pub. Date: May 26, 2019
5333 Views1782 Downloads
Effect of Vitamin D Supplementation on Glycemic Control in Children with Type 1 Diabetes Mellitus: A Randomized Clinical Trial
Original Research
Background:Vitamin D endocrine system is a potential immune system modulator and has been implicated in the pathogenesis of several autoimmune diseases including type 1 diabetes mellitus. A relationship between type 1 diabetes and vitamin D deficiency has been reported, in which low vitamin D levels are shown to have a negative effect on beta-cell function. The aims of the study were to investigate vitamin D status and to evaluate the effect of vitamin D3 supplementation on glycemic control in children with type 1 diabetes. Method:A randomized clinical trial including 80 children who were newly diagnosed with type 1 diabetes and randomly assigned into either control or intervention arm was used. Vitamin D status and Glycohemoglobin (HbA1c) were assessed initially for both the study two arms. Diabetic children of the intervention arm who had vitamin D deficiency and insufficiency were treated with 4000 units of vitamin D3 and calcium (500 mg/day) in oral liquid form. After the study interference (3 months later), HbA1C was measured again for both arms as an indicator for glycemic control. Differences in mean±SD HbA1C and body mass index were assessed before and after the study. Results: The mean of body mass index in intervention arm was 14.77±3.49, while in control arm was 17.84±3.87, with statistically significant deference between two arms P<.001. Furthermore, the mean change in HbA1c levels in intervention arm was 6.78±1.94 compared with 7.03±1.83 in control arm, with no statistically significant deference detected between children of the study two arms P<.460. Conclusion:Vitamin D3 supplement on the clinical base improves glycemic control in pediatrics with type I diabetes mellitus and vitamin D deficiency.
American Journal of Nursing Research. 2019, 7(4), 534-541. DOI: 10.12691/ajnr-7-4-15
Pub. Date: May 25, 2019
4724 Views1899 Downloads1 Likes
Effect of Antenatal Instructional Package on Pregnant Women' Knowledge, Attitude and Practices
Original Research
Background: Antenatal care is a careful, systematic assessment and follow-up of pregnant women that includes education, counseling, screening, and treatment to assure the best possible health of the mother and fetus. Aim of the research was to examine the effect of antenatal instructional package on pregnant women' knowledge, attitude and practices.Design: A quasi-experimental research design was adopted to fulfil the aim of this research. Setting: The research was conducted at obstetrics & gynaecological outpatient clinic in Benha university hospital. Sample: A purposive sample of one hundred and forty pregnant women among those attending the above mentioned setting. Tools: Data were collected through five main tools: A Structured interviewing questionnaire, maternal knowledge questionnaire, maternal health attitude questionnaire, maternal health practices questionnaire, and women's satisfaction sheet. Results: showed that nearly one third of studied women in both study group (41.4%) and control group (37.1%) had source of information from friends and families while minority of them had source of information from newspaper. Also there was no statistical significant difference regarding all knowledge, attitude and practice items about antenatal care between the study and the control group before instructional package implementation. However, a highly statistically significant difference (p-values < 0.001) was observed between the study and the control group one month after instructional package implementation. Additionally total knowledge, total attitude and total practices regarding antenatal care were greatly improved after instructional package implementation than pre implementation among study group while there were minimal improvements after instructional package implementation than pre implementation among control group. Also the majority of pregnant women in the study group were satisfied with the antenatal instructional package implementation. Conclusion: the study concluded that research hypotheses are supported and the antenatal instructional package had appositive effect on improvement of pregnant women' knowledge and in turn attitude and practices were also improved in study group compared to control group .Also the majority of pregnant women in the study group were satisfied with the antenatal instructional package implementation. Recommendations: From time to time, the antenatal instructional package should be restructured and reviewed to meet up with the health needs of the pregnant women.
American Journal of Nursing Research. 2019, 7(4), 519-533. DOI: 10.12691/ajnr-7-4-14
Pub. Date: May 24, 2019
6487 Views1923 Downloads
Palliative Intervention for Mitigating Fatigue and Sleep Inefficiency among Chronic Obstructive Pulmonary Disease Clients
Original Research
Chronic obstructive pulmonary disease is a public health problem cause mortality. Palliative intervention is supportive in managing, and helping clients living with chronic obstructive pulmonary disease. Aim: This study aims to evaluate the effect of palliative care intervention for mitigating fatigue and sleep inefficiency among chronic obstructive pulmonary disease clients.Design: A quasi-experimental design was used. Setting: The study was conducted in Chest Outpatient Clinic, Ain Shams University Hospitals. Sample: A purposive sample comprised of 70 clients. Tools: A structured interview questionnaire was used to collect the data and included three parts: Part I. Client's demographic characteristics. Part II. The Pittsburgh Sleep Quality Index. Part III. Fatigue Severity Scale. Results:The sleep quality index was improved from 7.1% of clients had good sleep quality pre intervention to 85.7% post intervention and also fatigue severity was improved from 90% of them had high fatigue pre intervention to 4.3% post intervention with highly statistically significant positive correlation between total fatigue and sleep quality index among chronic obstructive pulmonary disease clients (p= <0.001). Conclusion: The palliative care intervention had a positive effect on chronic obstructive pulmonary disease clients and helped them to mitigate sleep inefficiency, which led to reduce fatigue. Recommendations: An illustrated booklet containing information about benefits of gradual relaxation exercises should be available in all chest outpatient clinics. Training of the nurses on how to apply the palliative care intervention to chronic obstructive pulmonary disease clients.
American Journal of Nursing Research. 2019, 7(4), 509-518. DOI: 10.12691/ajnr-7-4-13
Pub. Date: May 24, 2019
4749 Views1745 Downloads
Experiences of Saudi Female Students towards the Phenomena of Bullying Behaviors during Nursing Education Program
Original Research
Bullying is a growing problem in nursing education from the academia area to the clinical setting that is under-reported and tolerated by nursing students. Aim: The main aim is to explain the phenomena of bullying behaviors among Saudi female students during their study in nursing education program. Design: The study utilized a cross-sectional quantitative descriptive design. Setting: It conducted in the College of Applied Medical Sciences (CAMS) at University of Hafr Al-Batin (UHB) in Saudi Arabia. Participants: The sample consisted of (130) Saudi female nursing students. Tools: The instrument consists of four parts; the first part involves personal information. The second part contains 25 items of different types of bullying and the third part covers the consequences of bullying. The final part includes four closed ended questions about widespread learning environments (4 options), sources of bullying (7 options), coping strategies (9 options) and reasons for not reporting (8 options). Results: The current study confirmed that Saudi female nursing students experienced different forms of bullying behaviors in the traditional classroom and clinical settings. Recommendations: There is a need to establish policy for identifying the legal implications of bullying and integrating the bullying issue in the curriculum of nursing education program. Conclusion: There is an evidence for presence of bullying phenomena among Saudi female nursing students that deserve to be studied in nursing education and practice.
American Journal of Nursing Research. 2019, 7(4), 499-508. DOI: 10.12691/ajnr-7-4-12
Pub. Date: May 23, 2019
5786 Views1749 Downloads
The Effect of Early Ambulation on Hemodynamic and Perfusion Indices Post Cardiac Surgery
Original Research
Delayed mobilization of cardiac surgical patients (CSPs) postoperatively is a huge challenge for critical care nurses (CCNs). Early ambulation (EA) is a vital task with a significant priority of nursing practice in critical care units (ICUs). CCNs’ awareness of EA value for CSPs’ outcomes is the main concern. The inclusive aim of EA is to sustain hemodynamic stability and adequate organ perfusion. The current study aimed to examine the effect of EA on hemodynamic and perfusion indices post cardiac surgery. Sixty adult patients of both sexes undergoing cardiac surgery were involved in this study. Then they assigned randomly into two groups; EA group and hospital care (HC) group. Data were collected using one tool which encompasses three parts containing the patient preoperative basic health data, hemodynamic indices record and perfusion indices record. The findings presented that peripheral pulse (PP) and heart rates were decreased tenuously among the EA patients compared with HC patients. However, the systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were increased significantly in EA group than HC group post ambulation compared with preoperative readings. Additionally, perfusion indices were increased among the EA patients and HC patients post mobilization compared with preoperative readings. The current study showed that EA has better effect on the patients hemodynamic and perfusion indices postoperatively. Thus, CCNs should give a high priority to plan EA schedule when caring for CSPs. Furthermore, there is a need for EA algorithms in ICUs.
American Journal of Nursing Research. 2019, 7(4), 490-498. DOI: 10.12691/ajnr-7-4-11
Pub. Date: May 23, 2019
4711 Views1636 Downloads3 Likes
Pediatric Nursing Students' Experience of Bullying Behavior in Clinical Placements and the Role of Staff Faculty
Original Research
Bullying is widely recognized as a persistent problem in the profession of nursing, especially among individuals at particular risk because of limited authority and experience such as nursing students. Students assert that bullying experience impacts their learning and future employment choices. Aim of the study: was to investigate pediatric nursing students' experience of bullying behaviors in clinical placement and the role of staff faculty.Method: A quantitative descriptive method was adopted. The study was conducted at Faculty of Nursing Damanhour University, Egypt. Purposeful sample, all third year undergraduates nursing students (N = 147), registered at pediatric nursing course and 30 educators of third year from both pediatric and obstetric departments Faculty of Nursing Damanhour University. The study was done during the 1st term of the academic year (2018-2019).Two tools were used: Tool 1:The self-administered questionnaire to identify nursing students’ experiences with bullying. Tool II: to collect required data from the staff faculty to assess their role towards students' bullying. Results: The study reveals that nursing students experience bullying, the highest bullying behaviors, the nursing students experienced, were shouting in rage and negative remarks about becoming a nurse. Statistically significant differences were found between the bullying behaviors and the effect of bullying behaviors on the students in which bullying behaviors effect lead to academic failure, loss of self-confidence, intolerance to criticism, perceiving that this career is not suitable, concentration impairment, loss of motivation, intolerance to criticism, self-blame and physical impairment. The highest coping mechanism by nursing students was putting up barriers followed by speaking directly to the bully and finally, the use of unhealthy coping behavior. The most coping strategies used by the staff faculty were talking with the bully, and reporting to the responsible authority. Conclusion: Nursing students experienced a problem of bullying, which lead to threatening and frustrated academic environment.Recommendations:Addressing clear written policy for the staff faculty and the nursing students to be educated about bullying forms, strategies for prevention and intervention.
American Journal of Nursing Research. 2019, 7(4), 479-489. DOI: 10.12691/ajnr-7-4-10
Pub. Date: May 21, 2019
4590 Views1689 Downloads1 Likes
Impact of Child Labor on Physical, Psychological and Behavior Health Status among Technical Secondary Schools Students
Original Research
Background: Child labor is a persistent problem throughout the world and it is a global problem that appears to affect a major proportion of children in developing world. The study aimed to identify the impact of child labor on physical, psychological and behavior health among technical secondary schools students at Assiut city. A descriptive research design was used. A total number of 500 students with multi-stage random technique were participated in this. A self-administered questionnaire sheet included questions about demographic data, condition and hazards of work, physical, psychological and behavioral problems. Body Mass Index (BMI) also was measured. Results:63.8% of the studied students were working and 46.7% of them were working in commerce. 46.4% stated that the main cause of work return for helping their family income. There was statistically significant difference between BMI & work status. Also; there was statistically significant difference between type of work and behavioral problems, daily working hours and psychological & behavioral problems, time to entertain and psychological problems. Conclusion: Physical and psychological health of working children affected with labor. Recommendations: School nurse should be providing education about the physical, psychological and behavioral problems that working students may be exposed to it.
American Journal of Nursing Research. 2019, 7(4), 471-478. DOI: 10.12691/ajnr-7-4-9
Pub. Date: May 20, 2019
3171 Views707 Downloads
Bundle of Care for Improving Nurses’ Performance Related to Central Line Associated Blood Stream Infection
Original Research
Health care associated infections, particularly CLABSI, contributes to the greatest threat to patient safety in critical care units (CCUs) which lead to increase mortality, morbidity and hospital coast. The aim of this study was to assess the effect of implementation of bundle of care related to central line associated blood stream infection on nurses’ knowledge and practice. Design: A quazi experimental research design was used in this study. Setting: The study was carried in intensive care unit, coronary care unit and cardiothoracic intensive care unit at Suez Canal University Hospital, in Ismailia. Sample: A convenience sample of 70 nurses was used. Tools : The tools were used for data collection including nurses’ questionnaire sheet which include demographic characteristics, knowledge about central line, knowledge BSI and knowledge about component of CLABSI bundle of care and observational check list regarding central line insertion , care and maintaince of central lin. Results :There were highly statistical significant difference in total mean scores of nurses knowledge and practice about bundle of care related to CLABSI between pre- post and follow up of implementation of bundle. Conclusion:Implementation of bundle of care related to CLABSI improved nurse’s performance. Recommendations:Importance of upgrading nurses’ knowledge and practice about CLABSI prevention through workshops, seminars, conferences, group discussion, up to date scientific journals, books and posters.
American Journal of Nursing Research. 2019, 7(4), 465-470. DOI: 10.12691/ajnr-7-4-8
Pub. Date: May 18, 2019
3773 Views1026 Downloads
Effect of Educational Intervention on Knowledge and Attitudes Regarding Human Papillomavirus Infection and Its Vaccination among Nursing Students
Original Research
Background: Human papillomavirus (HPV) is the commonest viral sexually transmitted infection in the world and the leading cause of cervical cancer. Aim: of this study was to evaluate the effect of educational intervention on knowledge and attitudes regarding human papillomavirus infection and its vaccination among nursing students. Design: Quasi-experimental design was utilized. Sample: A purposive sample of 200 female nursing students who registered in the first academic year at Faculty of Nursing Benha University. Setting: The study was carried out at Faculty of Nursing Benha University. Tools: Data were collected through two main tools: A self-administered questionnaire to assess students’ general characteristics and knowledge regarding HPV infection and its vaccination, and Modified Likert’s Scale to assess students’ attitude regarding HPV infection and its vaccination. Results: showed that the mean age of studied sample 17.87±0551years. There was improvement with highly statistically significant difference observed in students’ knowledge and attitude regarding HPV infection and its vaccination at post-intervention phase compared with pre-intervention phase (p<0.001). There was positive statistical correlation between total knowledge and total attitude regarding human papilloma virus infection and its vaccination at pre-intervention phase (P> 0.05). While, there was a highly positive statistical significant correlation between total knowledge and total attitude regarding human papilloma virus infection and its vaccination at post-intervention phase (p<0.001). Conclusion: The educational intervention enhanced student’s knowledge and positively changed their attitude regarding human papilloma virus infection and its vaccination. Recommendation: Dissemination of educational program among all female university students regarding human papilloma virus infection and vaccination to prevent the risk of infection and cervical cancer.
American Journal of Nursing Research. 2019, 7(4), 453-464. DOI: 10.12691/ajnr-7-4-7
Pub. Date: May 17, 2019
4911 Views1633 Downloads
Measure Outcomes of Patients’ Instructions about Modifiable Risk Factors for Hypertensive Patients on Their Attitude and Lipid Profile
Original Research
Background: Hypertension is affecting 40.8% of females 38.7% of males in Egypt, and the total is affecting 39.7% of the population. High prevalence of hypertension connected to a wide range of severe medical disorders. Aim: to measure the outcomes of patients' instructions effects about modifiable risk factors for hypertensive patients on their attitude, and lipid profile. Subjects and Methods: A quasi-experimental design with one group pre, post, and follow-up was utilized to achieve the aim of the study. Sample: a convenience sample including 100 adult patients enrolled in this study. Setting: a study was conducted in cardiac and internal medicine outpatient clinics at Zagazig University Hospital and Beni-suef University hospital. Tools: The researchers prepared an interview form including three sections: I- Questionnaire to Patient Interview Questionnaire Sheet include Part 1: Assess patients’ demographic characteristics Part 2: Assess Patient 's family, past and recent medical history, assess the associated chronic disease, medications, allergies and previous source of health knowledge. Part 3: Patient's Physical Assessment and Laboratory Investigation Sheet. II- The lifestyle attitude assessment. Results: the present study showed that more than have of the study sample have 50+years, female, have work, secondary school, their blood pressure, lipid profile, blood glucose reading decreased at the follow-up with highly statistically significant,marked changes of lifestyle with highly statistically significant difference among study phases in all items except in exercise . also in knowledge, levels, and medical examination, there is Correlation between lipid profile and level of practice, Correlation between lab investigation and level of knowledge. Conclusions: study concluded that personalized, tailored nursing instructions could be adjusted blood pressure through improving hypertensive patients' attitude and normalize lipid profile. Therefore, the confident effect of the program is lifelong. Recommendations: study recommended nursing instructions should apply in various outpatients' cardiac clinics and medical service centers and training of nurses to provide this service. The informative booklet ought to be conveyed to all patients.
American Journal of Nursing Research. 2019, 7(4), 445-452. DOI: 10.12691/ajnr-7-4-6
Pub. Date: May 15, 2019
3685 Views928 Downloads
Undergraduate Nursing Students’ Experience in Studying Evidence-Based Practice by Application of Concept Map
Original Research
Background:Nowadays nurses should be competent in using knowledge in clinical decision-making for nursing intervention. Therefore, the application of evidence-based practice (EBP) in community healthcare settings is a crucial need that fortifies the quality of the provided services. The governmental policies mandate the application of EBP in healthcare services. The lack of EBP competencies among healthcare professionals including nurses is a barrier for achieving this mandate. Incorporating EBP in nursing curricula combined with interactive teaching strategy such as concept map would overcome this barrier. Aim: The study aimed at providing an overview of the experiences of undergraduate nursing students about studying evidence-based practice by the application of concept map as an educational strategy. Research Design: Qualitative phenomenology study design was used. Setting: The study was carried out at the faculty of nursing, Mansoura University, Egypt during the period from October 2018 until January 2019.Subjects and Sampling:Purposive sampling technique was used to recruit the study participants who were composed of 95 undergraduate nursing students registered at the courses of Community Health Nursing Department. Data collection: Focus group discussion (FGD) was used to collect the required data to achieve the aim of this study. Results:Undergraduate nursing students showed positive views regarding EBP and concept map. They showed interests in studying EBP and applying it in their future career. Nursing students were enthusiastic to use concept map in studying other courses because it helped them in understanding the course content and increased retaining of information. They found the concept map was very helpful in problem-solving.Conclusion and Recommendations:Teaching EBP by using concept map was accepted by undergraduate nursing students. The study recommended the continuity of teaching EBP for undergraduate nursing students and embedding the course of EBP in nursing curricula in post-graduate studies. Concept map would be used in teaching all nursing academic courses.
American Journal of Nursing Research. 2019, 7(4), 437-444. DOI: 10.12691/ajnr-7-4-5
Pub. Date: May 13, 2019
4666 Views1797 Downloads
Effect of Implementing Learning Package of Nesting and Swaddling for Premature Infants on Nurses' Knowledge and Performance in NICU
A Clinical Study
Premature infants surviving require advanced medical interventions and professional nursing care. Despite the innovative interventions in the medical field, they remain vulnerable for long-term complications, which is the result of early disruption of their intrauterine life and sudden exposure to an entirely unfamiliar NICU environment. One strategy for helping premature grows normally in NICU is developmental care, which includes positioning, nesting, and swaddling as daily routine care. This study aims to assess the effect of learning package regarding nesting and swaddling for premature on nurses knowledge and performance in NICU. A quasi-experimental research design using one group (pre, immediately post and three months later) was used for this study. Setting: The study was conducted at NICU in Abha Maternity and Child Hospital (AMCH), Abah city, Kingdom of Saudi Arabia.Subjects: 77 nurses who work in the previously mentioned NICU as a convenience sample. Tools: two tools used to collect the study: A Structured questionnaire sheet to assess nurses' knowledge regarding nesting and swaddling and the observation sheet to assess nurses' performance of nesting and swaddling in NICU. Results: There was a statistically significant difference regarding nurses' knowledge and performance about nesting and swaddling immediately after and three months later compared with before learning package. Conclusion: There was a significant positive effect of implementing learning package in improving nurses’ knowledge and performance about nesting and swaddling in NICU for premature infants. Recommendations:Neonatal nurses must be provided with the best evidence about applying nesting and swaddling techniques for premature infants as a standard of developmentally supportive care in the NICUs.
American Journal of Nursing Research. 2019, 7(4), 428-436. DOI: 10.12691/ajnr-7-4-4
Pub. Date: May 13, 2019
5192 Views1803 Downloads
Measurement of the Emotional Intelligence Competencies for Effective Leaders among Saudi Nursing Students at King Abdul Al Aziz University
Original Research
The concept of emotional intelligence (EI) is central to future nurses who will practice in the clinical settings. Aim: to measure emotional intelligence competencies to be effective leaders among Saudi nursing students at King Abdul Al-Aziz University. Research design: Cross sectional quantitative descriptive design. Sampling: Convenient sample of approximately 81 students invited to participate voluntarily. Data collection tool: Emotional intelligence questionnaire is a validated tool that was used to measure emotional intelligence competencies to be effective leaders among Saudi nursing students at King Abdul Al-Aziz University. Results: showed that students need attention in descending order, managing emotions, motivating oneself, empathy and social skill as well as self-awareness competencies of emotional intelligence in order to be effective leaders. Recommendations: nursing students needed to be empower and equipped by EI principles, skills and competencies to face complexities of clinical practice. Nursing faculty could mentor students by providing EI-related workshop to enhance students’ ability to control and emotions properly. (E.g. emotion management, interpersonal communication and self-development) through role-play enacting. Nursing educators may boost students’ self-motivation by creating EI training group and workshops, counseling session and other diverse learning activities. Mentors are valuable methods of counselling for students with special attention at developing self-awareness, interpersonal and social relationships and empathy.
American Journal of Nursing Research. 2019, 7(4), 420-427. DOI: 10.12691/ajnr-7-4-3
Pub. Date: May 08, 2019
4143 Views1701 Downloads1 Likes
The Effect of Foot Reflexology on Physiological Indicators and Mechanical Ventilation Weaning Time among Open-Heart Surgery Patients
Original Research
Shortening the length of mechanical ventilation (MV) and lowering dose of sedatives among critically ill patients can decrease complications, intensive care length of stay and mortality rate. Therefore, introducing non-pharmacologic interventions such as reflexology became an issue of concern for critical care nurses. The purpose of this study was to investigate the effect of foot reflexology on physiological indicators and mechanical ventilation weaning time in open-heart surgery (OHS) patients. Methods: Quasi-experimental study with a convenience sampling technique was used to recruit 80 patients who underwent open heart operation and admitted to cardiothoracic intensive care unit (ICU) of Mansoura University Hospital. Random assignment was allocated to the intervention group (foot reflexology) and the control group (routine care). Data were collected using participants' physiological indicators and MV weaning time assessment tool. Results: There were statistical significant differences between the foot reflexology group and the control group concerning all physiological indicators (p < 0.05). Statistical significant differences were also noted on shortening the length of weaning time between both groups (p < 0.05). Conclusion: Foot reflexology is an effective method for stabilizing physiological indicators and decreasing ventilator dependence among patients undergoing OHS. Therefore, it can be introduced as an adjunct to daily care of OHS patients in ICU.
American Journal of Nursing Research. 2019, 7(4), 412-419. DOI: 10.12691/ajnr-7-4-2
Pub. Date: May 05, 2019
4296 Views1788 Downloads4 Likes
Depression, Anxiety and Loneliness among Elderly Living in Geriatric Homes
Original Research
Background: Elderly “living in old age care homes” are expanding in numbers; and are prone to psychological stress such as depression, anxiety and loneliness. Aim: This study was to assess depression, anxiety, and loneliness among elderly living in old aged homes. Research design: A descriptive exploratory design was utilized in this study. Setting: The study was conducted at the geriatric home in Benha City, Kaluobia Governorate, and the geriatric home in Tanta City, Gharbiya Governorate. Sample: A purposeful sample of 50 elderly (males & females) residing in elderly homes was included for the conduction of this study.Study tools: Tool (1):Structured Interview Questionnaire Schedule; Tool (2): Beck's Depression Inventory;Tool (3): Geriatric Anxiety Scale (GAS); and Tool (4):UCLA Loneliness Scale (Version 3). Results:About three quarters of the studied elderly have depression and more than two thirds have anxiety, while the majority of them suffer from loneliness. Regarding depression levels, less than two thirds have severe depression; more than of one third of them have severe and moderate anxiety. Regarding level of the loneliness, majority of the studied sample have severe loneliness. There is a highly statistical significant correlation between total loneliness and total depression, also between total geriatric anxiety and depression at p value <0.001, while there is statistical significant correlation between total loneliness and geriatric anxiety at p value <0.05. Conclusion: The study concluded that the studied elderly living in geriatrics homes had higher levels of depression, anxiety and loneliness.Recommendations:Intervention program or measures to manage or overcome anxiety, depression and loneliness among elderly living in geriatric homes.
American Journal of Nursing Research. 2019, 7(4), 400-411. DOI: 10.12691/ajnr-7-4-1
Pub. Date: May 05, 2019
5167 Views2026 Downloads8 Likes