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Professional quality of life and caring behaviours among clinical nurses during the COVID‐19 pandemic

Aims and Objectives

To investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID-19 pandemic. We also examined the influence of the nurses’ socio-demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID-19 pandemic.

Background

Caring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID-19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.

Design

Cross-sectional, descriptive study.

Methods

A purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short-form 24-item Caring Behavior Inventory from May–August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Results

The majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of ‘assurance of human presence’ while lowest in the ‘knowledge and skills’ in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.

Conclusions

Based on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses’ demographic characteristics predicted their professional quality of life and caring behaviours.

Relevance to clinical practice

The importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID-19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.

Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anaesthesia (THRIVE) randomised controlled trial in the USA: A protocol

Por: Tellor Pennington · B. R. · Janda · A. M. · Colquhoun · D. A. · Neuman · M. D. · Kidwell · K. M. · Spino · C. · Thelen-Perry · S. · Krambrink · A. · Huang · S. · Ignacio · R. · Wu · Z. · Swisher · L. · Cloyd · C. · Vaughn · M. T. · Pescatore · N. A. · Bollini · M. L. · Mashour · G. A.
Introduction

Millions of patients receive general anaesthesia every year with either propofol total intravenous anaesthesia (TIVA) or inhaled volatile anaesthesia (INVA). It is currently unknown which of these techniques is superior in relation to patient experience, safety and clinical outcomes. The primary aims of this trial are to determine (1) whether patients undergoing (a) major inpatient surgery, (b) minor inpatient surgery or (c) outpatient surgery have a superior quality of recovery after INVA or TIVA and (2) whether TIVA confers no more than a small (0.2%) increased risk of definite intraoperative awareness than INVA.

Methods and analysis

This protocol was co-created by a diverse team, including patient partners with personal experience of TIVA or INVA. The design is a 13 000-patient, multicentre, patient-blinded, randomised, comparative effectiveness trial. Patients 18 years of age or older, undergoing elective non-cardiac surgery requiring general anaesthesia with a tracheal tube or laryngeal mask airway will be eligible. Patients will be randomised 1:1 to one of two anaesthetic approaches, TIVA or INVA, using minimisation. The primary effectiveness endpoints are Quality of Recovery-15 (QOR-15) score on postoperative day (POD) 1 in patients undergoing (1) major inpatient surgery, (2) minor inpatient surgery or (3) outpatient surgery, and the primary safety endpoint is the incidence of unintended definite intraoperative awareness with recall in all patients, assessed on POD1 or POD30. Secondary endpoints include QOR-15 score on POD0, POD2 and POD7; incidence of delirium on POD0 and POD1; functional status on POD30 and POD90; health-related quality of life on POD30, POD90, POD180 and POD365; days alive and at home at POD30; patient satisfaction with anaesthesia at POD2; respiratory failure on POD0; kidney injury on POD7; all-cause mortality at POD30 and POD90; intraoperative hypotension; moderate-to-severe intraoperative movement; unplanned hospital admission after outpatient surgery in a free-standing ambulatory surgery centre setting; propofol-related infusion syndrome and malignant hyperthermia.

Ethics and dissemination

This study is approved by the ethics board at Washington University, serving as the single Institutional Review Board for all participating sites. Recruitment began in September 2023. Dissemination plans include presentations at scientific conferences, scientific publications, internet-based educational materials and mass media.

Trial registration number

NCT05991453.

¿El dolor producido por la punción directa influye en los resultados de la gasometría arterial?

Introducción. La punción arterial para el análisis gasométrico provoca dolor de intensidad variable. Este dolor podría alterar la dinámica ventilatoria y, por tanto, los parámetros respiratorios de la muestra sanguínea. Objetivos. Determinar la posible relación entre el dolor inducido por la punción arterial y los parámetros obtenidos del análisis gasométrico de estas muestras de sangre. Como objetivos secundarios, obtener la prevalencia del dolor provocado en la muestra estudiada y la posible asociación con el número de intentos. Metodología. Estudio transversal que incluyó 100 muestras arteriales de 61 pacientes durante el primer semestre de 2024. La intensidad del dolor, reportada mediante la escala NRS-11, fue la variable principal de estudio. Se analizó la asociación de esta variable con variables gasométricas (por ejemplo, pH, pO2, pCO2 y lactato) y con otras variables sociodemográficas y relacionadas con punción arterial. Resultados. La edad fue de 69,43 ± 13,07 y el 68% eran hombres. Respecto a la variable principal de resultado, la puntuación media del dolor fue de 4,03 ± 2,61. La intensidad del dolor no mostró asociación con ninguna variable gasométrica. Sin embargo, el número de intentos de obtener con éxito una muestra arterial mostró significación. Tras ajustar por otras variables, cada intento adicional aumentaba el dolor en 1,14 puntos. Discusión. No se encontró asociación entre el dolor de la punción arterial y los parámetros del análisis gasométrico, por lo que los resultados pueden interpretarse de forma robusta en situaciones en las que no es posible un manejo adecuado del dolor.

ABSTRACT

Introduction. Arterial puncture for gasometrical analysis causes pain of varying intensity. This pain could alter the ventilatory dynamics and therefore the respiratory parameters of the blood sample. Objectives. To determine the possible relationship between the pain induced by arterial puncture and the parameters obtained from the gasometrical analysis of these blood samples. As secondary objectives, to obtain the prevalence of pain caused in the sample studied and the possible association with the number of attempts. Methodology. Cross-sectional study involving 100 arterial samples from 61 patients during the first half of 2024. Pain intensity reported by the NRS-11 was the main study variable. The association of this variable with gasometrical variables (for example: pH, pO2, pCO2, lactate) and with other variables of different nature (sociodemographic and related to the arterial puncture itself) was analyzed. Results. The age was 69,43 ± 13,07 and 68% were men. Regarding the main outcome variable, the mean pain score was 4.03 ± 2.61. Pain intensity showed no association with any of the gasometric variables. However, the number of attempts to successfully obtain an arterial sample showed significance. After adjustment for other variables, each additional attempt increased pain by 1.14 points. Discussion. No association was found between arterial puncture pain and gasometric analysis parameters, so the results can be robustly interpreted in situations where adequate pain management is not possible.

Design and content validation of a checklist about infection‐prevention performance of intensive care nurses in simulation‐based scenarios

Abstract

Objective

To design, develop and validate a new tool, called NEUMOBACT, to evaluate critical care nurses' knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention through simulation scenarios involving central venous catheter (CVC), endotracheal suctioning (ETS) and mechanically ventilated patient care (PC) stations.

Background

Simulation-based training is an excellent way for nurses to learn prevention measures in VAP and CRB.

Design

Descriptive metric study to develop NEUMOBACT and analyse its content and face validity that followed the COSMIN Study Design checklist for patient-reported outcome measurement instruments.

Methods

The first version was developed with the content of training modules in use at the time (NEUMOBACT-1). Delphi rounds were used to assess item relevance with experts in VAP and CRB prevention measures, resulting in NEUMOBACT-2. Experts in simulation methods then assessed feasibility, resulting in NEUMOBACT-3. Finally, a pilot test was conducted among 30 intensive care unit (ICU) nurses to assess the applicability of the evaluation tool in clinical practice.

Results

Seven national experts in VAP and CRB prevention and seven national simulation experts participated in the analysis to assess the relevance and feasibility of each item, respectively. After two Delphi rounds with infection experts, four Delphi rounds with simulation experts, and pilot testing with 30 ICU nurses, the NEUMOBACT-FINAL tool consisted of 17, 26 and 21 items, respectively, for CVC, ETS and PC.

Conclusion

NEUMOBACT-FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation.

Relevance for Clinical Practice

Our validated and clinically tested tool could facilitate the transfer of ICU nurses' knowledge and skills learning in VAP and CRB prevention to critically ill patients, decreasing infection rates and, therefore, improving patient safety.

Patient or Public Contribution

Experts participated in the Delphi rounds and nurses in the pilot test.

Effectiveness of educational interventions for nurses caring for patients with chronic kidney disease in improving nurse outcomes: A systematic review

Abstract

Aim

The aim of the study was to evaluate the effectiveness of educational interventions for nurses caring for patients with chronic kidney disease in improving knowledge, nurse–patient interaction, performance, skills competence and clinical decision-making.

Design

Systematic review.

Methods

Search of literature for randomised controlled trials, quasi-experimental studies and pre-experimental studies on chronic kidney disease-related educational interventions for nurses was conducted across 10 databases. Two reviewers independently screened articles, appraised studies and extracted data.

Data Sources

PubMed, Cochrane, Embase, CINAHL Complete, ERIC, Social Science Database, ASSIA, Scopus, Web of Science and ProQuest Thesis and Dissertations Global databases were searched from date of inception to 21 December 2022.

Results

Three randomised controlled trials and eight pre-experimental studies were included in this review. Synthesis without meta-analysis was conducted due to high heterogeneity among studies. Interventions with teaching sessions, learning activities, self-study modules, discussion and a web-based training system were effective in improving nurses' knowledge, nurse–patient interaction, performance, skills competence and clinical decision-making. Patients experienced an improvement in nurse–patient interaction and no significant decrease in overall quality of life.

Conclusion

This review has shown the effectiveness of educational interventions for nurses caring for people with chronic kidney disease in improving outcomes for both nurses and patients, with sustained improvements up to a period of 1 year.

Implications for the Profession and/or Patient Care

Study findings can guide the scope of future training for nurses caring for patients with chronic kidney disease.

Impact

Nurses often lack in-service training on how to improve care for patients with chronic kidney disease. This study found that training nurses on how to care for such patients can improve outcomes for nurses, which can translate to higher quality of patient care.

Reporting Method

This paper adhered to the synthesis without meta-analysis (SWiM) reporting guideline.

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