Conectar
To describe the point prevalence of cognitive impairment in hospitalised adults and evaluate the association with care needs and perceived risks of complications.
Multi-site cross-sectional study on a single day in May 2023.
Trained clinician auditors screened adult inpatients in acute medical, surgical, oncology, geriatric, mental health, convalescent, and rehabilitation wards for cognitive impairment using the 4AT in seven healthcare facilities and recorded need for support with basic activities of daily living, incontinence, and perceived risks of complications (falls, pressure injuries, and malnutrition). Data were summarised and compared across 4AT categories, and the strength of association between 4AT and each outcome was estimated using multivariable regression models.
Data were available for 1145 inpatients on 68 wards (mean age 68 years [SD = 18], 583 [58.9%] female, 449 [39.2%] on acute medical units). Cognitive impairment (4AT of 1 or more) was identified in 482 (42.1%) participants. Participants with 4AT 1–3 had 2.0–3.6 times the odds of need for supervision or assistance with activities of daily living, while those with 4AT 4 or more had 2.9–5.3 times the odds of need for assistance.
Cognitive impairment is very common in adult inpatients and is associated with significantly higher physical care needs.
Hospital care models must support staff to address the higher care needs in people with cognitive impairment to protect a large patient group from hospital-acquired harm.
No patient or public contribution.
This study adheres to the STROBE reporting guidelines.
To understand nurses' personal and professional experiences with the heat dome, drought and forest fires of 2021 and how those events impacted their perspectives on climate action.
A naturalistic inquiry using qualitative description.
Twelve nurses from the interior of British Columbia, Canada, were interviewed using a semi-structured interview guide. Thematic analysis was employed. No patient or public involvement.
Data analysis yielded three themes to describe nurses' perspective on climate change: health impacts; climate action and system influences. These experiences contributed to nurses' beliefs about climate change, how to take climate action in their personal lives and their challenges enacting climate action in their workplace settings.
Nurses' challenges with enacting environmentally responsible practices in their workplace highlight the need for engagement throughout institutions in supporting environmentally friendly initiatives.
The importance of system-level changes in healthcare institutions for planetary health.
To explore midwives' experiences of providing psychosocial interventions to parents following perinatal bereavement in maternity care settings.
A descriptive qualitative study.
Twenty-two midwives were recruited from three maternity services in Ireland using purposive and snowball sampling. Semi-structured interviews were conducted between July and November 2024. Reflexive thematic analysis was used to analyse the data.
Four themes were identified: (1) Building relationships as a foundation for psychosocial intervention delivery; (2) Psychosocial intervention as the core element of perinatal bereavement care; (3) Negotiating intervention delivery in a constrained system; and (4) Navigating emotional labour and professional growth. Midwives advocated provision of compassionate and relationship-based psychosocial interventions, but often faced systemic barriers, limited guidance, and insufficient training. Supportive structures and psychosocial intervention focused training were seen as critical to sustaining care quality and midwives' wellbeing.
Applying the Socio-Ecological Model (SEM) revealed that midwives' delivery of PSIs to support grieving parents after perinatal bereavement is influenced by multi-level factors, underscoring the need for policy integration, institutional support, and contextually grounded, midwife-led approaches.
Integrating SEM into intervention design can guide the development of multi-component PSIs that address multilevel influences and align with both parents' needs and midwives' capacities.
This adds to the understanding of how midwives deliver psychosocial interventions in perinatal bereavement care. Midwives view the delivery of these interventions as central to their role, while acknowledging the need for the development of, and training in structured, midwife-led psychosocial interventions in perinatal bereavement care.
COREQ.
Patients and members of the public were involved in study design, data collection and validation of findings. Their contributions included reviewing protocols and recruiting materials, facilitating recruitment and participating in advisory groups, ensuring the relevance and sensitivity of the research.
This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.
This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.
An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.
Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.
This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.
The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.
No patient or public contribution.
This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.
This study is reported according to STROBE guidelines.
FreshRSS 