PURPOSE: The purpose of this qualitative descriptive study was to describe critical care nurses’ experiences of moral challenges, moral distress, and moral resilience during the COVID-19 pandemic. The specific aims of this study were to: 1. Describe the moral challenges experienced by ICU nurses. 2. Describe moral resilience in terms of integrity, buoyancy, moral efficacy, self-regulation, and self-stewardship among ICU nurses (from Rushton’s framework). 3. Explore the relationship between moral distress and moral resilience to advance the concept of moral resilience in the face of the COVID-19 pandemic. FRAMEWORK: This study was undergirded by an adaptation of Rushton’s conceptual framework of moral concepts. DESIGN: A qualitative descriptive design was used. Participants were recruited between January to May 2021, and a semi-structured interview guide was utilized to interview participants. RESULTS: 17 participants were interviewed for the study. Participants described the four themes of moral challenges: death and dying, pain and suffering, being alone, and being helpless and not in control. Moral resilience was described as: integrity, buoyancy, moral efficacy, self-regulation, self-stewardship, and self-perception. The relationship between moral distress and moral resilience was described as iterative and fluid. CONCLUSION: The findings of the study provided a new domain of moral resilience called self-perception and a revised adaptation of the conceptual framework for moral resilience.

Bakgrund: I slutet av 2019 spreds sjukdomen Covid-19 och i mars 2020 deklarerades det som en pandemi. Sjukdomen resulterade i en stor mängd intensivvårdskrävande patienter vilket krävde stora resurser från hälso- och sjukvården. Historiskt har omfattande epidemier under 1900-talet påverkat vården på liknande sätt och sjuksköterskor som har arbetat under dessa har upplevt en stor arbetsbelastning vilket påverkat deras mående. Syfte: Att beskriva intensivvårdssjuksköterskors upplevelser och erfarenheter av att arbeta med intensivvårdskrävande patienter drabbade av Covid-19 under år 2020. Metod: Intensivvårdssjuksköterskor från tre intensivvårdsavdelningar i Mellansverige intervjuades i fokusgrupper angående deras upplevelser av att vårda patienter med Covid-19. Intervjuerna transkriberades och analyserades enligt Krueger och Caseys (2015) konstant jämförande metod. Resultat: Resultatet sammanställdes till 5 kategorier och 15 koder. Kategorierna var Personliga uppfattningar, Pandemins påverkan på vården, Relationen med patient och närstående, Arbetsgivarens hantering och Yrkets framtid. Konklusion: Intensivvårdssjuksköterskorna upplevde en ansträngd arbetssituation, där stress och utmaningar av att arbeta i skyddsutrustning var utmärkande. Arbetsbelastningen upplevdes leda till en hotad patientsäkerhet. Sjuksköterskorna upplevde en bristfällig beredskap inom organisationen. De saknade konkret klinisk information samt stöd från arbetsgivaren. För- och nackdelar av att inte ha närstående närvarande på avdelningen diskuterades och slutligen uttryckte sjuksköterskorna en oro inför framtiden. / Background: At the end of 2019, Covid-19 disease took spread and in March 2020 it was declared as a pandemic. The disease claimed large resources from the health care system. Epidemics during the 20th century have affected the health care system in a similar way and nurses working during these conditions have experienced a great workload, which affected their well-being. Aim: To describe the Critical Care Nurses [CCN] experiences working with patients suffering from Covid-19 during the year of 2020. Method: CCN from three critical care units in Sweden were interviewed in focusgroups regarding their experiences of caring for patients with Covid-19. The interviews were transcribed and analyzed according to Krueger and Casey's (2015) constant comparative method. Results: The results were compiled into 5 categories and 15 codes. The categories were Personal perceptions, The pandemic's impact on care, The relationship with the patient and their relatives, The management by the employer and The future for the profession. Conclusion: CCNs experienced a strained working situation, where stress and challenges of working in protective gear were characteristic. This led to a perceived endangered patient safety. The nurses experienced a lack of preparedness within the organization, they lacked information and support from their employer. Impacts of not having the patient's relatives present were discussed and finally the nurses expressed concern about the future.

No description available.

The purpose of this study was to explore and describe the knowledge that a cohort of 40 intensive care unit nurses had of evidence-based practice. It was assumed that they lacked the knowledge to locate, evaluate understand and apply research findings. Quantitative, non-experimental descriptive research was conducted to explore their knowledge and to formulate recommendations for promoting it. Data collection involved administering a structured questionnaire administered to the cohort in an intensive care unit. The findings revealed that, although they were familiar with the basic concept of evidence-based practice, they were reluctant and lacked the skills to adopt it in their practice. It is recommended that they be trained and empowered to develop research expertise from within their own ranks. Finally it is recommended that nursing management should play a more proactive role in identifying cost-effective strategies in overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)

Increased levels of stress in the workplace have led the American Psychological Association to predict a looming public health crisis. Critical care nurses (CCNs) are highly exposed to stressors in the workplace, more than other nurses. Tens of billion dollars were reported lost in productive work time yearly due to ill health from depression alone. An important gap remains in understanding the relationships of stressors with the amount of stress. Supported by the biopsychosocial stress theory, the purpose of this study was to determine the relationship between frequencies of perceived stressors (IVs) as a source of perceived levels of stress (DV) or allostasis. The mixed-methods study included an online questionnaire and an e-mail interview of 400 hospital-based CCNs from professional nurses' associations in the United States. The Nursing Stress Scale was used to determine the kinds and frequencies of IVs, while the Psychological Stress Measure was used to assess the DV. Multiple regression analysis assessed the strength and direction of the relationships between IVs and DV. Interviews fell short of the minimum sample size for saturation and were not analyzed. Quantitative findings indicated workload as the most frequently perceived stressor, correlating positively with allostasis (p = .0005). Death and dying, conflict with other nurses, and lack of support for CCNs were also statistically significant (p < .05). Implications to practice and social change include promoting changes in policy with management support to reduce workload, death and dying, conflict with other nurses, and lack of social support for CCNs. Personal behavior changes like relaxation and physical exercises as coping methods may also reduce levels stress.

Compassion fatigue (CF), also known as secondary traumatic stress (STS), impacts critical care nurses (CCN) through exposure to pain, suffering, and loss of those for whom they provide care and results in a reduction of compassion satisfaction (CS). High incidence of CF and turnover (TO) rates at the project site were identified among CCNs. The institution's CCN TO rate was at 81% in comparison to peers in other areas at 29%–35%. The practice-focused question asked whether leadership education on CF might ameliorate CF at the project site. The purpose of the Doctor of Nursing Practice project was to reduce the incidence of CF and TO among CCN through leadership education. Watson's theory of human caring was used as a framework. Two hundred twenty-nine CCNs completed the Professional Quality of Life survey that measures CS, STS, and burnout (BO). Comparison of 28 nursing leaders' pretest scores to posttest scores indicated a statistically significant improvement (z = -4.625, p < .001) and knowledge acquisition. BO and CF taken together explained 86% (adjusted R2 = .86) of the variance in CS (F [2, 227] = 691.33, p < .001). Identifying the nursing units with the highest CF scores and providing CF education to the leadership provides a path to reduce turnover and provide needed support to CCNs, a positive social change.

The purpose of this study was to explore and describe the knowledge that a cohort of 40 intensive care unit nurses had of evidence-based practice. It was assumed that they lacked the knowledge to locate, evaluate understand and apply research findings. Quantitative, non-experimental descriptive research was conducted to explore their knowledge and to formulate recommendations for promoting it. Data collection involved administering a structured questionnaire administered to the cohort in an intensive care unit. The findings revealed that, although they were familiar with the basic concept of evidence-based practice, they were reluctant and lacked the skills to adopt it in their practice. It is recommended that they be trained and empowered to develop research expertise from within their own ranks. Finally it is recommended that nursing management should play a more proactive role in identifying cost-effective strategies in overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)

The aim of this study was to determine the knowledge of critical care nurses regarding ventilator waveforms in order to develop an educational programme on this topic. A quantitative, descriptive, contextual research design was used, and convenience sampling implemented. A survey, using a questionnaire as measuring instrument, was conducted among critical care nurses in selected private hospitals in Gauteng. The response rate was 69%. Cronbach’s alpha indicated that the questionnaire was fairly reliable. The total average percentage achieved by the group of 111 respondents was 40,28%, which is 19.72% below the set competency indicator of 60%. Only 15 respondents achieved a percentage of or above the competency indicator. Results proved that the respondents required intensive training on the topic. A user-friendly education programme in the format of a PowerPoint presentation was developed to address knowledge deficiencies in critical care nurses’ interpretation of ventilator graphics. / Dissertation (MCur (Clinical))--University of Pretoria, 2007. / Nursing Science / MCur / unrestricted

Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions of self-concept development. A total of 32 critical care unit nurses participated in the evaluation of the teach-back method. Demographic data were collected from these 32 participants, and the results of a frequency analysis were obtained. Deidentified CAUTI data were provided by the organization prior to the educational intervention. The postintervention CAUTI rate and increase in nurses' knowledge level were evaluated 1 month after the educational intervention using a 1-sample t test. The finding was statistically significant (p < .001). The incidence of CAUTI was followed, and the outcomes indicated that the overall incidence of CAUTI in these patients was decreased. The education program was effective in improving critical care unit nurses' knowledge of evidence-based practices to prevent CAUTIs. Improving nurses' knowledge to decrease CAUTI rates is a strategy that may be effective in many healthcare settings. This educational intervention may create social change by improving the health of patients and serving as an educational resource for nurses.

Bakgrund: Runt om i världen och på svenska sjukhus och , överrapporteras dagligen flertaletpostoperativa patienter mellan anestesi-och intensivvårdssjuksköterskor. Vad somkommunicerats har stor betydelse för patienternas fortsatta vård och sjuksköterskornasupplevelse av överrapportering. Bristande överrapportering kan få konsekvenser som sämrevårdkvalité och ökad risk för komplikationer för patienterna. Syfte: Att beskriva anestesi-ochintensivvårdssjuksköterskors upplevelser av överrapportering av postoperativa patienter. Metod:Intervjuer genomfördes i form av fokusgrupper, en med anestesisjuksköterskor och en medintensivvårdssjuksköterskor. Materialet analyserades enligt kvalitativ innehållsanalys. Resultat:Fem huvudkategorier: Behov av att dubbelkolla och dubbeldokumentera, att inte veta vilkeninformation som är relevant och sakna förståelse för varandra, att den postoperativaavdelningen är rörig och orsakar störningar i överrapportering, attoperationssjuksköterskornas överrapportering är viktig och behov av att överrapportera vidpatienterna och upprätthålla fullständig sekretess. Slutsats: Tydliga rutiner behövs gällande vadpostoperativ överrapportering ska innehålla, samt utveckling av samarbete mellan de som deltar iöverrapportering. Behov av att kunna genomföra överrapportering vid patienterna men ändåupprätthålla sekretess var ett komplext område. Operationssjuksköterskans deltagande iöverrapportering var ett av de största förbättringsområden som framkom denna studie.