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The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on nursing or other clinical topics then use Trip today.
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Nurse-Initiated Acute Stroke Care in Emergency Departments Background and Purpose- We aimed to evaluate the effectiveness of an intervention to improve triage, treatment, and transfer for patients with acute stroke admitted to the emergency department (ED). Methods- A pragmatic, blinded, multicenter, parallel group, cluster randomized controlled trial was conducted between July 2013 and September 2016 in 26 Australian EDs with stroke units and tPA (tissue-type plasminogen activator) protocols (...) . Hospitals, stratified by state and tPA volume, were randomized 1:1 to intervention or usual care by an independent statistician. Eligible ED patients had acute stroke <48 hours from symptom onset and were admitted to the stroke unit via ED. Our nurse-initiated T3 intervention targeted (1) Triage to Australasian Triage Scale category 1 or 2; (2) Treatment: tPA eligibility screening and appropriate administration; clinical protocols for managing fever, hyperglycemia, and swallowing; (3) prompt (<4 hours
Using Multi-source Feedback and Other Practice Assessments for Quality Assurance in Nursing Rapid Synthesis Using Multi-source Feedback and Other Practice Assessments for Quality Assurance in Nursing 25 February 2019McMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Using Multi-source Feedback and Other Practice Assessments for Quality Assurance in Nursing 60-day response 25 February 2019 Using Multi-source Feedback and Other Practice Assessments for Quality Assurance (...) in Nursing 2 Evidence >> Insight >> Action McMaster Health Forum The McMaster Health Forum’s goal is to generate action on the pressing health-system issues of our time, based on the best available research evidence and systematically elicited citizen values and stakeholder insights. We aim to strengthen health systems – locally, nationally, and internationally – and get the right programs, services and drugs to the people who need them. Authors Kerry Waddell, M.Sc., Lead Evidence Synthesis, McMaster
Implementation of a multicomponent intervention to prevent physical restraints in nursing homes (IMPRINT): A pragmatic cluster randomized controlled trial Despite clear evidence for the lack of effectiveness and safety, physical restraints are frequently applied in nursing homes. Multicomponent interventions addressing nurses' attitudes and organizational culture have been effective in reducing physical restraints.To evaluate the effectiveness of two versions of a guideline and theory-based (...) multicomponent intervention to reduce physical restraints in nursing homes.Pragmatic cluster randomized controlled trial.The study was conducted in 120 nursing homes in four regions in Germany.All residents living in the participating nursing home during follow-up, newly admitted residents were also included. A total of 12,245 residents included in the primary analysis (4126 and 3547 residents in intervention group 1 and 2 and 4572 residents in the control group).Intervention group 1 received an updated
Effect of Addition of an Intimate Partner Violence Intervention to a Nurse Home Visitation Program on Maternal Quality of Life: A Randomized Clinical Trial. Intimate partner violence (IPV) is a public health problem with significant adverse consequences for women and children. Past evaluations of a nurse home visitation program for pregnant women and first-time mothers experiencing social and economic disadvantage have not consistently shown reductions in IPV.To determine the effect on maternal (...) quality of life of a nurse home visitation program augmented by an IPV intervention, compared with the nurse home visitation program alone.Cluster-based, single-blind, randomized clinical trial at 15 sites in 8 US states (May 2011-May 2015) enrolling 492 socially disadvantaged pregnant women (≥16 years) participating in a 2.5-year nurse home visitation program.In augmented program sites (n = 229 participants across 7 sites), nurses received intensive IPV education and delivered an IPV intervention
Hospital nurse-staffing models and patient- and staff-related outcomes. Nurses comprise the largest component of the health workforce worldwide and numerous models of workforce allocation and profile have been implemented. These include changes in skill mix, grade mix or qualification mix, staff-allocation models, staffing levels, nursing shifts, or nurses' work patterns. This is the first update of our review published in 2011.The purpose of this review was to explore the effect of hospital (...) nurse-staffing models on patient and staff-related outcomes in the hospital setting, specifically to identify which staffing model(s) are associated with: 1) better outcomes for patients, 2) better staff-related outcomes, and, 3) the impact of staffing model(s) on cost outcomes.CENTRAL, MEDLINE, Embase, two other databases and two trials registers were searched on 22 March 2018 together with reference checking, citation searching and contact with study authors to identify additional studies.We
Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis. Having nurses take on tasks that are typically conducted by doctors (doctor-nurse substitution, a form of 'task-shifting') may help to address doctor shortages and reduce doctors' workload and human resource costs. A Cochrane Review of effectiveness studies suggested that nurse-led care probably leads to similar healthcare outcomes as care delivered (...) by doctors. This finding highlights the need to explore the factors that affect the implementation of strategies to substitute doctors with nurses in primary care. In our qualitative evidence synthesis (QES), we focused on studies of nurses taking on tasks that are typically conducted by doctors working in primary care, including substituting doctors with nurses or expanding nurses' roles.(1) To identify factors influencing implementation of interventions to substitute doctors with nurses in primary care
Effect of a Nurse-Led Preventive Psychological Intervention on Symptoms of Posttraumatic Stress Disorder Among Critically Ill Patients: A Randomized Clinical Trial. A meta-analysis of outcomes during the 6 months after intensive care unit (ICU) discharge indicate a prevalence for clinically important posttraumatic stress disorder (PTSD) symptoms of 25%.To determine whether a nurse-led preventive, complex psychological intervention, initiated in the ICU, reduces patient-reported PTSD symptom (...) was completed December 2017.Twenty four ICUs were randomized 1:1 to the intervention or control group. Intervention ICUs (n = 12; 669 participants) delivered usual care during a baseline period followed by an intervention period. The preventive, complex psychological intervention comprised promotion of a therapeutic ICU environment plus 3 stress support sessions and a relaxation and recovery program delivered by trained ICU nurses to high-risk (acutely stressed) patients. Control ICUs (n = 12; 789
Nurse education models and frameworks Nurse education models and frameworks: A Scoping Review 1 Nurse education models and frameworks Citation Yap G. & Melder A. 2018. Nurse education models and frameworks: A Scoping Review. Centre for Clinical Effectiveness, Monash Health, Melbourne, Australia. Executive Summary Background The Nursing and Midwifery Education and Strategy is reviewing and revising their education framework to support organisational developments and uphold contemporary nursing (...) and midwifery education planning and delivery across Monash Health. The Center for Clinical Effectiveness (CCE) was commissioned to undertake a literature review to inform the development of knowledge and understanding of education frameworks. This includes contemporary planning and delivery of nursing and midwifery education models that may be used as a benchmark to support the development of a revised framework at Monash Health. Objective The literature review will aim to address the following sub-topics
Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones Advance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).To assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally (...) , quality of death and dying was assessed in patients who died during 2-year follow-up.A multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.165 patients were
Nurse Home Visiting for Families Experiencing Adversity: A Randomized Trial Nurse home visiting (NHV) may redress inequities in children's health and development evident by school entry. We tested the effectiveness of an Australian NHV program (right@home), offered to pregnant women experiencing adversity, hypothesizing improvements in (1) parent care, (2) responsivity, and (3) the home learning environment at child age 2 years.A randomized controlled trial of NHV delivered via universal child (...) and family health services was conducted. Pregnant women experiencing adversity (≥2 of 10 risk factors) with sufficient English proficiency were recruited from antenatal clinics at 10 hospitals across 2 states. The intervention comprised 25 nurse visits to child age 2 years. Researchers blinded to randomization assessed 13 primary outcomes, including Home Observation of the Environment (HOME) Inventory (6 subscales) and 25 secondary outcomes.Of 1427 eligible women, 722 (50.6%) were randomly assigned; 306
Nurse staffing levels linked to reports of missed care in adult wards Nurse staffing levels linked to reports of missed care in adult wards Discover Portal Discover Portal Nurse staffing levels linked to reports of missed care in adult wards Published on 10 July 2018 doi: Nurses are more likely to report omitting necessary care in acute inpatient wards when registered nurse staffing levels are low, even if there are additional healthcare assistants. Care categorised as planning (...) and communication is reported as missed more often than clinical care. NHS hospitals are responsible for ensuring that the number and skills mix of nursing staff matches patient needs. Previous reviews have shown links between lower registered nurse staffing levels and poor patient outcomes such as higher mortality. This review of 18 observational studies sought to clarify if measuring levels of reported ‘missed nursing care’ might partly explain these relationships. The findings of this international review
Individual support of nurses using electronic medicine monitors can improve HIV treatment Individual support of nurses using electronic medicine monitors can improve HIV treatment Discover Portal Discover Portal Individual support of nurses using electronic medicine monitors can improve HIV treatment Published on 10 October 2017 doi: Use of electronic pill bottles that record when they are opened and follow-up discussion of the printed readouts with nurses improved HIV outcomes. It is thought (...) of medication usage so that strategies could be discussed to improve adherence. As non-adherence is the main barrier to effective management of HIV, any measures that improve it are welcomed. However, the intervention tested here requires several hours of training for the nurses delivering it and may not be that easy to introduce in practice. Evaluation of the approach in non-trial settings is necessary before wider implementation. Share your views on the research. Why was this study needed? HIV infection
Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Discover Portal Discover Portal Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Published on 6 December 2016 doi: On the face of it, nurses are well placed to safeguard children, but asking them about their experiences reveals barriers which hinder that role. The research (...) points towards areas where support could help nurses fulfil their legal and ethical duties better. In a review of published qualitative research, including surveys, interviews and focus groups, nurses say they have insufficient confidence to report child abuse issues. They often feel a need to convince other professionals, viewed as above them in the hierarchy, before taking action. Some see child protection services as unhelpful; lacking faith that they will take appropriate safeguarding action
Nurses and pharmacists can prescribe as effectively as doctors Nurses and pharmacists can prescribe as effectively as doctors Discover Portal Discover Portal Nurses and pharmacists can prescribe as effectively as doctors Published on 21 March 2017 doi: Prescribing by suitably-trained pharmacists and nurses offers similar outcomes to prescribing by doctors, at least in the management of chronic conditions. This Cochrane review pooled clinical outcomes and patient satisfaction across 45 studies (...) of nurse or pharmacist prescribing compared with doctor prescribing. Most studies were of chronic disease management in primary care settings in high income countries (25 from the US and six from the UK). Independent and supplementary prescribers in the NHS include not only the nurses and pharmacists, as covered in this review, but also other professions such as podiatrists, optometrists, and physiotherapists. At a time of high demand for NHS resources, with shortages of doctors in some specialties
How nurses support families of intensive care patients towards the end of life How nurses support families of intensive care patients towards the end of life Discover Portal Discover Portal How nurses support families of intensive care patients towards the end of life Published on 22 November 2016 doi: Families of people dying in intensive care need to receive personalised communication and ongoing support, and be involved in the dying process. Researchers gathered evidence on how nurses care (...) , for example by clarifying the gradual change expected when medically focussed life-sustaining treatments are withdrawn and family centred end-of-life care begins. Lastly they described a common focus on making the nursing contribution more visible, such as using techniques to build lasting memories for families. Describing care in this specific setting is a crucial first step to improving palliative care. It may guide training for other healthcare professionals in the quality and consistency of care given
A systematic review of workplace factors associated with PTSD among nurses in psychiatric inpatient settings Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files
Building capacity among nurses working in long-term care: a systematic review of qualitative evidence Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files
The impact of critical care step-down reviews by either Outreach Nurses or ICU Liaison Nurses on readmission to critical care and mortality: a systematic review and narrative synthesis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility
The association between maternal morbidity and nurse work environment: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites
Systematic review of the exposure undergraduate nursing and midwifery students had with genomics or genetics education Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any