Modern Care Journal
Volume:20 Issue: 4, Oct 2023

Context: 

Leadership is the process of influencing people to achieve common goals. In all nurses’ roles, leadership is emphasized since nurse leaders’ attitudes influence nurses’ job satisfaction and retention and, consequently, the quality of care.

This study aimed to explore the scientific literature concerning different aspects of leadership in nursing.

This is an integrative review of qualitative studies in which four electronic databases (Medline, PubMed, Scopus, and Google Scholar) were searched. Articles published in the last ten years (2013 - 2022) were searched by titles using the descriptors "qualitative," "leadership," and "nursing" linked by the Boolean Operator AND. The search carried out in July 2022 was not limited by the publication language. A total of 63 studies were identified, and 11 original primary research articles were included. The quality of articles was assessed using the Critical Appraisal Skills Program (CASP). Qualitative content analysis was performed to analyze the obtained data.

The results were organized into three categories: (1) the importance of nursing leadership and leaders’ roles; (2) ethical leadership; and (3) nursing leadership education. Personal characteristics of nurse leaders and leadership skills were indicated as factors influencing staff nurses’ attitudes and reflecting on the quality of care. Training in nursing leadership since the early years of nursing education is essential for future nursing leaders.

Nurse leaders influence other team members and patients; consequently, nursing leadership impacts the quality of care. Therefore, training on leadership should be addressed in nursing schools in undergraduate and postgraduate courses and health institutions through continuing education.

In patients with active systemic lupus erythematosus (SLE),inflammatory markers such as erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) are often elevated. Increases in these inflammatory biomarkers have been linked to periodontal diseases.

This study aimed to investigate the impact of oral health education on inflammatory markers in patients with SLE.

In this field trial study, 40 SLE patients with no dental plaque were assigned to the intervention and control groups by block randomization design. The intervention group was educated in a 20-minute session based on Bass’s method of tooth brushing. Before and 3 months after the intervention, the dental plaque, CRP, ESR, and double-stranded DNA (anti-dsDNA) levels were determined in the two groups. Data were analyzed with SPSS software using independent t-test, Wilcoxon, Mann-Whitney, and univariate covariance analysis at 0.05 significance level.

In terms of basic variables, there was no significant difference between the two groups. O’Leary’s plaque index in the intervention group showed a significant decrease over time, but no significant reduction was observed in the control group. The difference between the two groups was statistically significant (P < 0.001). The results of covariance analysis and controlling for the effect on patients’ performance showed that the health education intervention had a significant impact on ESR (effect size = 9.6%). However, the intervention had a slight effect on CRP, dsDNA, and SLE Disease Activity Index (SLE-DAI). Moreover, CRP, ESR, and dsDNA showed a significant decrease in both groups after the intervention; however, the difference was not significant.

According to the results of the study, it is recommended to implement educational programs in the field of oral and dental hygiene and the correct way of brushing teeth for patients with SLE.

The self-confidence and anxiety levels of nursing students in making clinical decisions about patient care are important.

This study aimed to determine the anxiety and self-confidence of nursing students in the clinical decision-making process during the COVID-19 pandemic.

This descriptive and correlational study was conducted on nursing students in the spring semester of the 2021-2022 academic year at a state university in Turkey during the pandemic period. The research was carried out on 382 students who voluntarily participated. Data was collected using the Introductory Information Form and the Nursing Anxiety and Self-confidence with Clinical Decision-Making Scale (NASC-CDM). The SPSS software version 21.0 was used for data analysis. Independent samples t-test and Mann-Whitney U test were used to compare the data of the two groups. I˙n addition, the data were compared between more than two groups by one-way ANOVA and KruskalWallis-H test.

We observed that 77.72% of the participants were female, with amean age of 21.120 ± 1.118 years, and 70.7% were third-year students. More than half of the students reported that preventive measures against COVID-19 were taken sufficiently in surgical clinics. It was found that the mean self-confidence score was 113.68 ± 26.18 (range: 27.00 - 162.00), and the mean anxiety score was 65.53 ± 27.37 (range: 27.00 - 162.00). There was a statistically significant difference between the scale score mean and the characteristics of the students, such as class level, the reason for choosing the department of nursing, the desire for graduate education, COVID-19 history, fear of contracting COVID-19, follow-up of surgical patients with positive COVID-19 test (P < 0.05).

Despite the COVID-19 pandemic, itwasfound that nursing students’ self-confidence levels were high, andtheir anxiety levels were low.

Infections associated with healthcare services spread not only among patients but also among healthcare professionals. The risk of transmission is higher in intensive care units (ICUs).

This study aimed to identify the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection status and compliance with isolation precautions among doctors and nurses working in ICUs during the pandemic.

This cross-sectional study was conducted from March to May 2021 in three different status hospitals (i.e., Education and Research Hospital, University Research Hospital, and City Hospital) in two cities in eastern Turkey. The sample size was calculated at 205 individuals who were selected using the sampling method with a known population. Participants were included in the sample using the convenience sampling method. The data were collected through the sociodemographic form and compliance with isolation precautions scale (Cronbach’s alpha = 0.85, explained variance ratio = 50.50%, Kaiser-Meyer-Olkin = 0.872, Bartlett’s test: P < 0.05). The data were analyzed in SPSS software (version 18) using descriptive and inference statistics.

The participants’ average age was 29.95 ± 7.16 years. Moreover, 66.3% of the participants were females, and 77.6% were nurses. The doctors and nurses displayed good compliance with isolation precautions (77.6% [n = 159] and 22.4% [n = 46] of the participants were nurses and doctors, respectively). Furthermore, 40% of the ICU healthcare professionals had a SARS-CoV-2 infection diagnosis, anda significant relationshipwasobservedbetweenhaving this diagnosisandthe diagnosis of other individuals who were sharing the same house (P < 0.001). In addition, statistically significant relationships were observed between having a SARS-CoV-2 infection diagnosis and the duration of working with SARS-CoV-2 patients, hand hygiene and related attitudes, removing masks in common areas, implementing procedures producing aerosols, and inadequacies in the use of protective equipment during close contact with SARS-CoV-2 patients (P > 0.05).

The transmission of SARS-CoV-2 in healthcareworkers was not related to the interventions they made in the hospital. Healthcare workers should pay attention to domestic contamination.

Patent ductus arteriosus (PDA) is a common condition in premature babies, with a prevalence rate of 30 - 60%, and often requires medical or surgical intervention.

This study aimed to assess the effectiveness of 2 different brands of ibuprofen in PDA closure in preterm infants weighing less than 1500 g.

This single-blind clinical trial study was performed on 75 premature neonates with PDA in the pediatric ward of Vali-Asr Hospital in Birjand from March 2014 to March 2019. Patients were treated with two brands of ibuprofen at doses of 10 mg/kg for the first day and 5 mg/kg for the second and third days (24 and 48 hours afterward). Before and three days after the last dose, the children were examined by pediatric cardiologist echocardiography. The data were input into SPSS version 23 and analyzed using descriptive statistics, such as mean and SD. Inferential statistics, such as the chi-square test, were also employed with a significance level of P-value < 0.05.

There was a significant difference between the rate of PDA closure, 78.8% in the Pedea group vs. 54.8% in the Ibuprofen group (P = 0.03). In the Ibuprofen group, there was no difference in drug efficacy in PDA closure between male and female neonates (P = 0.663). Also, in the Pedea group, there was a significant difference in terms of efficacy between male and female neonates (P = 0.049). No significant difference was observed in PDA closure between the two medications based on their sizes (P = 0.616 in small size, P = 0.266 in medium size, and P = 0.175 in large size).

Pedea is more effective than Ibuprofen. It reduces complications and the need for surgery. However, there was no significant relationship between the two drugs based on the PDA sizes. Therefore, it seems logical to use the Iranian brand of ibuprofen, considering the benefits equal to the foreign one.

Interprofessional communication between nurses and paramedics is a crucial and challenging issue for safe and effective patient care, but it has not been addressed enough. The most important action for improving these communications is to identify their obstacles and challenges.

The aim of this study was to explain the obstacles to interprofessional communications between nurses and paramedics.

This study used the qualitative content analysis method. The participants of this research were 11 nurses and paramedics who were selected using purposeful sampling and took part in semi-structured in-depth interviews. The data were collected from May to September 2022. Data analysis was carried out by the conventional content analysis method proposed by Graneheim and Lundman. Guba and Lincoln’s criteria were used to assess the rigor and accuracy of the collected data.

The findings of this research disclosed 3 main themes; human resources challenges, lack of coordination between nursing and paramedics departments, and emergency situations.

The challenges of interprofessional communication between nurses and paramedics are influenced by different human and managerial factors, and identifying them is a significant step toward improving this communication. With regard to the findings of this study, managers and planners of healthcare centers can mitigate challenging factors and improve the communication between nurses and paramedical staff and, therefore, prepare the context for high-quality care of patients and boost the satisfaction of health professionals with their work conditions.

 Nearly all cases admitted to intensive care units (ICUs) suffer from poor nutritional status. Accordingly, the type of parenteral nutrition administered can influence these patients’ health conditions.

 This study aimed to compare the effects of parenteral nutrition with the amino acid alone and amino acid-intralipid combination on vital signs and rate of diuresis in ICU patients.

 This prospective cohort study was conducted over two years, from March 2021 to March 2023. Patients under intravenous nutrition with amino acid (Group A) and amino acid-intralipid (Group B) for three days (as ordered by the ICU specialist) were examined. The patients' vital signs and laboratory findings were recorded before and after the nutrition. The data were analyzed using SPSS v. 26.

 The patients were homogeneous regarding age, sex, disease history, and diagnosis (P < 0.05). After parenteral feeding, urine and blood urea nitrogen/creatinine ratio respectively increased and decreased in Group B. Moreover, the serum bilirubin level significantly decreased in Group B, and SGOT and SGPT increased in Group A. In addition, the breathing rate significantly increased in Group A after intravenous feeding (P < 0.001).

 Although intravenous amino acid-intralipid nutrition increased and decreased urine and blood urea nitrogen/creatinine, respectively, the patients who received amino acid alone also experienced an increase in urine volume and respiratory rate. Therefore, intravenous amino acid nutrition alone can be cost-effective.