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General Nursing, Content validity, Nurse leaders, Nursing, Direct patient care, Documentation, Psychology, Patient satisfaction, Content validation, Rationalisation, and Job satisfaction

AIM To develop a validated tool to measure nursing and midwifery documentation burden. BACKGROUND While an important record of care, documentation can be burdensome for nurses and midwives and may remove them from direct patient care, resulting in decreased job satisfaction, associated with decreased patient satisfaction. The amount of documentation is increasing at a time where staff rationalisation results in decreasing numbers of clinicians at the bedside. No instrument is available to measure staff perceptions of the burden of clinical documentation. DESIGN Survey development, followed by rwo rounds of content validation (April and May 2019). METHODS Based on the literature a 28 item survey, with items in 6 subscales, representing key areas of documentation burden was developed. Item (I-CVI), subscale (S-CVI/Ave by subscale) and overall content validity indexes (S-CVI/Ave) were calculated following two review rounds by an expert panel of clinical and academic nurses and midwives. RESULTS Level of agreement for the first iteration of the survey was low, with many items failing to reach the critical I-CVI threshold of 0.78. No subscale reached a S-CVI/Ave above 0.8 and the overall scale only achieved a S-CVI/Ave score of 0.67. Thirteen items were removed, seven were edited and five new items added, based on the expert panel feedback, substantially improving the content validity. All individual items achieved an I-CVI ≥0.78, the S-CVI/Ave was above 0.85 for all subscales and the total S-CVI/Ave was 0.94. CONCLUSION The Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey can be considered as content valid, according to the content validity analysis by an expert panel. IMPACT The BurDoNsaM survey may be used by nurse leaders and researchers to measure the burden of documentation, providing the opportunity to review practice and implement strategies to decrease documentation burden, potentially improving patient satisfaction with the care received.

Emergency Medicine, Nerve block, medicine.medical_treatment, medicine, business.industry, business, Placebo, Femoral fracture, medicine.disease, Fascia iliaca, Surgery, medicine.medical_specialty, Randomized controlled trial, law.invention, law, Hip fracture, Femur, and Femoral nerve

OBJECTIVE To determine if an ultrasound-guided femoral nerve block (FNB) is superior to an ultrasound-guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture. METHODS A double-blind randomised controlled trial was conducted. All participants received two blocks, one active and one placebo. An active FICB was administered to 52 participants and 48 participants received an active FNB. RESULTS Analysis was completed on data collected from 100 participants. Most patients were elderly and the majority were female. Both FICB and FNB achieved clinically significant mean reductions in pain scores (2.62 for FICB and 2.3 for FNB). There was no significant difference in reduction in pain scores between the two cohorts, P = 0.408. CONCLUSIONS Ultrasound-guided FNB is not superior to ultrasound-guided FICB, with both facilitating an equivalent analgesia effect in patients with a neck of femur or proximal femur fracture.

Infectious Diseases, Public Health, Environmental and Occupational Health, General Nursing, Chlorhexidine, medicine.drug, medicine, Population, education.field_of_study, education, Patient experience, Cross-sectional study, Thematic analysis, business.industry, business, Response rate (survey), Surgery, medicine.medical_specialty, Chlorhexidine gluconate, Psychological intervention, and Physical therapy

Objectives To explore patient experience, understanding and compliance with using Chlorhexidine Gluconate (CHG) preoperative washes. Methods A cross-sectional survey was conducted over a ten week period with adult inpatients who had undergone a surgical procedure at the study hospital. The survey consisted of 17 questions which participants self-completed. Closed and open-ended questions were included in the survey to allow both statistical and thematic analysis. Results A 74% (n = 194) sample response rate was attained. The sample obtained was representative of the wider hospital surgical patient population. Although 85% (n = 159) of participants reported they used CHG prior to their surgical procedure only 63% (n = 101) used the wash the recommended two times. Across all age groups in the survey 20% (n = 36) of participants reported they received too little information about CHG washes. Open-ended questions revealed three key themes; lack of information, issues with time or access and inconsistencies across the hospital. Conclusion This project revealed the current experience of patients undergoing surgery in relation to preoperative washing. Lack of information regarding CHG, issues with timing of information and access, as well as inconsistencies between different surgical specialities within the hospital were identified as barriers to participants using CHG. These are areas which could be targeted with a suite of interventions which aim to provide patients with clear, consistent information in a timely manner.