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      The influential factors in humanistic critical care nursing

      1 , 2 , 3
      Nursing Ethics
      SAGE Publications

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          Abstract

          Background:

          One of the main concerns in critical care units is the development of humanistic approaches. In this regard, recognizing the factors affecting humanistic nursing can contribute to humanizing nursing care in these units.

          Objective:

          The objective was to recognize the influential factors of humanistic nursing in critical care units.

          Research design:

          This qualitative study was carried out using a phenomenology method. Thirty-nine in-depth unstructured interviews were performed. The data were analyzed using the phenomenological nursology approach. To guarantee trustworthiness, prolonged engagement, member check, triangulation of resources, and maximum variation sampling were used.

          Participants and research context:

          Purposeful sampling was employed to select 10 nurses, 8 patients, and 4 patient’s relatives from the intensive care unit and critical care unit departments.

          Ethical consideration:

          This study was approved by the ethics committee of Lorestan University of Medical Sciences with the code of LUMS.REC.1395.121.

          Finding:

          The participants’ experiences were reflected in the following three main concepts: (a) moral, educational, and existential nature of the two humans involved in the interaction; (b) maintenance of the nurses’ dignity; and (c) interactions in the cultural and social context.

          Discussion:

          The nurse and patient, organizational environment, and society give rise to a set of intertwined characteristics which influence the realization of humanistic nursing. By affecting the nurses’ educational background and maintaining their dignity, the atmosphere of the hospital and cultural readiness of the society pave the way for delivering the humanistic care.

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          Most cited references31

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          The humanization of healthcare: A value framework for qualitative research

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            The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide no. 10.

            Health professionals are increasingly expected to identify their own learning needs through a process of ongoing self-assessment. Self-assessment is integral to many appraisal systems and has been espoused as an important aspect of personal professional behaviour by several regulatory bodies and those developing learning outcomes for clinical students. In this review we considered the evidence base on self-assessment since Gordon's comprehensive review in 1991. The overall aim of the present review was to determine whether specific methods of self-assessment lead to change in learning behaviour or clinical practice. Specific objectives sought evidence for effectiveness of self-assessment interventions to: a. improve perception of learning needs; b. promote change in learning activity; c. improve clinical practice; d. improve patient outcomes. The methods for this review were developed and refined in a series of workshops with input from an expert BEME systematic reviewer, and followed BEME guidance. Databases searched included Medline, CINAHL, BNI, Embase, EBM Collection, Psychlit, HMIC, ERIC, BEI, TIMElit and RDRB. Papers addressing self-assessment in all professions in clinical practice were included, covering under- and post-graduate education, with outcomes classified using an extended version of Kirkpatrick's hierarchy. In addition we included outcome measures of accuracy of self-assessment and factors influencing it. 5,798 papers were retrieved, 194 abstracts were identified as potentially relevant and 103 papers coded independently by pairs using an electronic coding sheet adapted from the standard BEME form. This total included 12 papers identified by hand-searches, grey literature, cited references and updating. The identification of a further 12 papers during the writing-up process resulted in a total of 77 papers for final analysis. Although a large number of papers resulted from our original search only a small proportion of these were of sufficient academic rigour to be included in our review. The majority of these focused on judging the accuracy of self-assessment against some external standard, which raises questions about assumed reliability and validity of this 'gold standard'. No papers were found which satisfied Kirkpatrick's hierarchy above level 2, or which looked at the association between self-assessment and resulting changes in either clinical practice or patient outcomes. Thus our review was largely unable to answer the specific research questions and provide a solid evidence base for effective self-assessment. Despite this, there was some evidence that the accuracy of self-assessment can be enhanced by feedback, particularly video and verbal, and by providing explicit assessment criteria and benchmarking guidance. There was also some evidence that the least competent are also the least able to self-assess accurately. Our review recommends that these areas merit future systematic research to further our understanding of self-assessment. As in other BEME reviews, the methodological issues emerging from this review indicate a need for more rigorous study designs. In addition, it highlights the need to consider the potential for combining qualitative and quantitative data to further our understanding of how self-assessment can improve learning and professional clinical practice.
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              Nursing workload and occurrence of adverse events in intensive care: a systematic review

              Abstract OBJECTIVE To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). METHOD A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. RESULTS Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. CONCLUSION The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care.
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Nursing Ethics
                Nurs Ethics
                SAGE Publications
                0969-7330
                1477-0989
                May 2022
                February 11 2022
                May 2022
                : 29
                : 3
                : 608-620
                Affiliations
                [1 ]Critical Care Nursing, Student Research Committee, Lorestan University of Medical Sciences, Iran
                [2 ]Department of Emergency and Critical Care Nursing, School of Nursing and Midwiferry, Lorestan University of Medical Sciences, Khorramabad, Iran
                [3 ]Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
                Article
                10.1177/09697330211043274
                35144499
                90c5bc57-df3f-4dd3-a120-4c8ee354c570
                © 2022

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