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Occupational health nursing services in two countries

Lim HH

Public Health, 1983 Jul;97(4):221-7.
PMID: 6622644
Matched MeSH terms: Occupational Health Nursing/standards
Attitudes of Hong Kong high school students towards the nursing profession

Rossiter JC, Foong A, Chan PT

Nurse Educ Today, 1999 Aug;19(6):464-71.
PMID: 10693494

The increased development of hospital services in Hong Kong over the last decade has given rise in the demand for more recruits to join the nursing profession. Despite the advancement in education and the improvement in the working conditions, the problems of attracting sufficient new recruits remain critical. This study aimed to examine high school students' attitudes towards the nursing profession and to identify the contributing factors affecting shortage of nurses within the context of Hong Kong. A convenience sample of 375 high school students was recruited. A questionnaire was used to measure their knowledge, attitudes and intention to study nursing. Descriptive and inferential statistics were used to describe their career preferences and to compare knowledge, attitudes and intention scales between gender and nursing exposure groups. Results indicated that the students were generally knowledgeable about nursing but were reluctant to pursue nursing as a career. However, students who were socially acquainted with a nurse demonstrated a slightly more positive attitude towards nursing and slightly higher intention to pursue nursing as a career compared with those having no social acquaintance with a nurse. Implications for promotion of nursing profession and limitations of the study were discussed.

Matched MeSH terms: Nursing/standards*
Assessment of cognitive bias in decision-making and leadership styles among critical care nurses: a mixed methods study

Lean Keng S, AlQudah HN

J Adv Nurs, 2017 Feb;73(2):465-481.
PMID: 27601180 DOI: 10.1111/jan.13142

AIMS: To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery.
BACKGROUND: The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan.
DESIGN: Two-phase mixed methods sequential explanatory design and grounded theory.
SETTING: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20).
METHODS: Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis.
RESULTS: Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance.
CONCLUSION: There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making.

Matched MeSH terms: Critical Care Nursing/standards
Does good critical thinking equal effective decision-making among critical care nurses? A cross-sectional survey

Ludin SM

Intensive Crit Care Nurs, 2018 Feb;44:1-10.
PMID: 28663105 DOI: 10.1016/j.iccn.2017.06.002

BACKGROUND: A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia.
AIM: To understand whether critical care nurses' critical thinking disposition affects their clinical decision-making skills.
METHOD: This was a cross-sectional study in which Malay and English translations of the Short Form-Critical Thinking Disposition Inventory-Chinese Version (SF-CTDI-CV) and the Clinical Decision-making Nursing Scale (CDMNS) were used to collect data from 113 nurses working in seven critical care units of a tertiary hospital on the east coast of Malaysia. Participants were recruited through purposive sampling in October 2015.
RESULTS: Critical care nurses perceived both their critical thinking disposition and decision-making skills to be high, with a total score of 71.5 and a mean of 48.55 for the SF-CTDI-CV, and a total score of 161 and a mean of 119.77 for the CDMNS. One-way ANOVA test results showed that while age, gender, ethnicity, education level and working experience factors significantly impacted critical thinking (p<0.05), only age and working experience significantly impacted clinical decision-making (p<0.05). Pearson's correlation analysis showed a strong and positive relationship between critical care nurses' critical thinking and clinical decision-making (r=0.637, p=0.001).
CONCLUSION: While this small-scale study has shown a relationship exists between critical care nurses' critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses' perceived high level of critical thinking and decision-making also needs further investigation.

Matched MeSH terms: Critical Care Nursing/standards*
Improving safety-related knowledge, attitude and practices of nurses handling cytotoxic anticancer drug: pharmacists' experience in a general hospital, Malaysia

Keat CH, Sooaid NS, Yun CY, Sriraman M

Asian Pac J Cancer Prev, 2013;14(1):69-73.
PMID: 23534806

BACKGROUND: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions.
MATERIALS AND METHODS: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates.
RESULTS: The mean age of nurses was 32.2∓6.19 years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from 45.5∓10.52 to 73.4∓8.88 out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from 7.6∓5.51 to 15.3∓2.55 out of 20 (p<0.001).
CONCLUSIONS: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.

Matched MeSH terms: Oncology Nursing/standards
Fulltext Impact of education on ventilator-associated pneumonia in the intensive care unit

Subramanian P, Choy KL, Gobal SV, Mansor M, Ng KH

Singapore Med J, 2013 May;54(5):281-4.
PMID: 23716155

INTRODUCTION: Ventilator-associated pneumonia (VAP) is a common risk among critically ill ventilated patients. This study aimed to investigate the effects of nurse-led education on: (a) knowledge of and compliance with ventilator care bundle (VCB) practices among intensive care unit (ICU) nurses; and (b) reduction in the rates of VAP post intervention.

METHODS: A quasi-experimental design with pretest-posttest evaluation and observation was used to investigate nurses' knowledge of and compliance with VCB practices, and the incidence of VAP. The study was conducted among 71 nurses, and the intervention involved structured education on VAP and its prevention using VCB in an ICU setting. Data were analysed using descriptive and inferential statistics.

RESULTS: Nurse-led education significantly increased nurses' knowledge of (t[70] = -36.19; p < 0.001) and compliance with (t[65] = -21.41; p < 0.001) VCB practices. The incidence of VAP, which was 39 per 1,000 ventilator days during the two-month period before intervention, dropped to 15 per 1,000 ventilator days during the two-month period following intervention.

CONCLUSION: Our findings show that nurse-led education on VAP and VCB significantly increased knowledge of and compliance with VCB practices among ICU nurses, and was associated with a reduction in the incidence of VAP among intubated and mechanically ventilated ICU patients. Inclusion of recent knowledge and evidence-based VCB guidelines for VAP prevention when educating anaesthetists, nurses, physiotherapists and other healthcare providers in the critical care setting is recommended.

Matched MeSH terms: Nursing/standards