The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature

BACKGROUND: Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS: To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN: Systematic, narrative review. DATA SOURCES: Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS: The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS: Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. CONCLUSION: Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level

A reflective framework to foster emotionally intelligent leadership in nursing

AIM: To propose a reflective framework based on the perspective of emotional intelligence (EI) in nurse leadership literature. BACKGROUND: Emotional intelligence is a self-development construct aimed at enhancing the management of feelings and interpersonal relationships, which has become increasingly popular in nurse leadership. Reflection is an established means to foster learning. Integrating those aspects of emotional intelligence pertinent to nurse leadership into a reflective framework might support the development of nurse leadership in a practical context. METHOD: A sample of 22 articles, retrieved via electronic databases (Ovid/Medline, BNI, psycArticles, Zetoc and CINAHL) and published between January 1996 and April 2009, was analysed in a qualitative descriptive content analysis. RESULT: Three dimensions that characterise emotional intelligence leadership in the context of nursing - the nurse leader as a 'socio-cultural architect', as a 'responsive carer' and as a 'strategic visionary' - emerged from the analysis. To enable practical application, these dimensions were contextualised into a reflective framework. CONCLUSION: Emotional intelligence skills are regarded as essential for establishing empowering work environments in nursing. A reflective framework might aid the translation of emotional intelligence into a real-world context. IMPLICATIONS FOR NURSING PRACTICE: The proposed framework may supplement learning about emotional intelligence skills and aid the integration of emotional intelligence in a clinical environment

Malnutrition in care home residents with dementia

Objectives: To investigate the malnutrition prevalence in Dutch care home residents with dementia over the years. Secondly, to examine the relationship of malnutrition and dementia and the role of care dependency and co-morbidity within this relationship. Design: This study is a secondary analysis of data of the annual independent Dutch National Prevalence Measurement of Care Problems of Maastricht University. The design involves a cross-sectional, multicenter point prevalence measurement. Setting: Care homes. Participants: 75399 residents older than 65 years (4523 resident with dementia) participated over 5 years (2006-2010). Sixty organizations measured 4 times, 31 organizations 3 times, 68 organizations 2 times, 511 organizations 1 time. Measurements: A standardized questionnaire was used to register amongst others data of weight, height, nutritional intake, undesired weight loss, comorbidity, dementia, and care dependency. Results: The study was able to show that there is a significant decline in malnutrition prevalence in the group of non-demented residents over the years (Non-demented group p <0.001). The prevalence of malnutrition in the demented group showed no significant reduction over the years. GEE analysis showed that malnutrition and dementia are related and that care dependency and age are important influencing factors in this relation. Conclusion: The results show that compared to the non-demented residents, the prevalence of malnutrition does not decline in demented care home residents over the years. Moreover, the findings of this study stress that malnutrition and dementia are related, while care dependency and age are confounding factors in this relationship

Risk and associated factors of pressure ulcers in hospitalized children over 1 year of age

Purpose This study aimed to identify factors for the development of pressure ulcers (PU) in hospitalized patients between 1 and 18 years of age. Design and MethodsA multicenter, descriptive, cross-sectional study in 13 hospitals was conducted in Switzerland. ResultsThe prevalence of PUs in this population of 204 children was 26.5%, with 83% category 1 PUs. A third of all PUs developed along external devices. Older children developed more PUs because of ineffective positioning and limited mobility. Practice ImplicationsIt is important to assess each child's activity, mobility, and the risk associated with the use of external devices