Validation of the Helsinki University Hospital prevent pressure Injury Risk Assessment Tool : a prospective observational study

Background Pressure injures are a common adverse event in a hospital, and they are one of the most important quality indicators of patient care. Risk assessment is recommended as the first step in the prevention of pressure injuries. A Prevent Pressure Injury Risk Assessment Tool is a new tool for risk assessment that was developed by the Helsinki University Hospital. Aim The aim of this study was to evaluate the predictive validity and the concurrent validity of the Prevent Pressure Injury Risk Assessment Tool in acute care. Method The prospective observational study was conducted in 19 in-patient wards representing internal medicine, neurology, and surgery during 2017-2018. The participants' inclusion criteria were: age >= 18 years old, no pressure injury on admission to the hospital and consenting to participate. The data collected by physical assessment of patients was combined with data from electronic patient records. Each patient was assessed by two different nurses with the Prevent Pressure Injury Risk Assessment Tool and the Braden Scale at patient admission. Furthermore, skin condition was observed throughout the hospital stay. Results Of the 637 patients accepted for the study, 10 (1.6%) developed a pressure injury during the hospital stay. Poisson regression analysis showed that pressure injuries were more likely in high-risk patients compared to those with low-risk. The sensitivity of the Prevent Pressure Injury Risk Assessment Tool was adequate (75%), while specificity was poor (40%). A moderate correlation was found between the Prevent Pressure Injury Risk Assessment Tool and the Braden Scale. Conclusions The Prevent Pressure Injury Risk Assessment Tool may be useful for identifying the adult pressure injury risk patients in acute care. Further research is needed to evaluate interrater reliability, and usability and validity with different patient populations.Peer reviewe

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.Peer reviewe

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Delirium in a surgical context from a nursing perspective : A hybrid concept analysis

Publisher Copyright: © 2022Background: The term delirium has been defined in medical diagnosis criteria as a multidimensional disorder, and the term acute confusion is included in nursing classifications. Delirium can be a serious complication assessed in a patient after a surgical procedure. Still, the patient's delirium frequently remains unrecognised. Care of patients with delirium after surgical procedure is complex, and it challenges nursing expertise. From the nurses’ viewpoint, delirium is associated with ambiguity of concepts and lack of knowledge. Therefore, reseach on how nurses perceive patients with delirium in a surgical context is needed. Objective: The aim of this study was to describe the concepts of delirium and acute confusion, as well as the associated dimensions, in adult patients in a surgical context from the nursing perspective. Design: The study used Schwartz and Barcott's hybrid concept analysis with theoretical, fieldwork, and final analytical phases. Settings: Surgical wards, surgical intensive care units, and post-anaesthesia care units. Data sources: A systematic literature search was performed through Pubmed (Medline), Cinahl, PsycInfo, and Embase. Participants: Registered nurses and licensed practical nurses (n = 105) participated in the fieldwork phase. Methods: In the theoretical phase, the concepts’ working definitions were formulated based on a systematic literature search with the year limitations from 2000 until February 2021. At the fieldwork phase, the nurses’ descriptions of patients with delirium were analysed using the deductive content analysis method. At the final analytical phase, findings were combined and reported. Results: The concepts of delirium, subsyndromal delirium, and acute confusion are well defined in the literature. From the perspective of the nurses in the study, concepts were seen as a continuum not as individual diagnoses. Nurses described the continuum of delirium as a process with acute onset, duration, and recovery with the associated dimensions of symptoms, symptom severity, risk factors, and early signs. The acute phase of delirium was emphasised, and preoperative or prolonged disturbance did not seem to be relevant in the surgical care context. Patients’ compliance with care may be decreased with the continuum of delirium, which might challenge both patients’ recovery from surgery and the quality of nursing care. Conclusions: In clinical practice the nurses used term confusion inaccurately. The term acute confusion might be used when illustrating an early stage of delirium. Nurses could benefit from further education where the theoretical knowledge is combined with the clinical practice. The discussion about the delirium, which covers the time both before surgery and after the acute phase should be increased.Peer reviewe

Validation of Finnish Neecham Confusion Scale and Nursing Delirium Screening Scale using Confusion Assessment Method algorithm as a comparison scale

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The Criterion Validity, Reliability, and Feasibility of an Instrument for Assessing the Nursing Intensity in Perioperative Settings

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The nurse manager's role in perioperative settings : An integrative literature review

AimTo describe the nurse manager's role in perioperative settings. BackgroundThe nurse manager's role is complex and its content unclear. Research in this area is scarce. We need to better understand what this role is to support the nurse manager's work and decision-making with information systems. EvaluationAn integrative literature review was conducted in May 2018. Databases CINAHL, Cochrane, PubMed and Web of Science were used together with a manual search. The review followed a framework especially designed for integrative reviews. Quality of the literature was analysed with an assessment tool. Nine studies published between 2001 and 2016 were included in the final review. Key issueThe findings from the review indicate that the nurse manager's role requires education and experience, and manifests in skills and tasks. A bachelor's degree with perioperative specialisation is the minimum educational requirement for a nurse manager. ConclusionResearch lacks a clear description of the nurse manager's role in perioperative settings. However, the role evolves by education. More education provides advanced skills and, thereby, more demanding tasks. Information technology could provide useful support for task management. Implications for Nursing ManagementThese findings can be used to better answer the current and future demands of the nurse manager's work.Peer reviewe

A Digital Service Logistics Information System for Emergency Department Care Coordination - Professionals' Experiences

The aim was to describe nurses' and physicians' perceptions of a digital service logistics information system from an operative management perspective in emergency departments (EDs). A total of 24 professionals were interviewed. Based on the results the information systems support operative management of EDs but the professionals desire more detailed information about patients and staff to support situational awareness in the operative management of these units.Peer reviewe