The professional practice environment is a factor that can have a significant impact on missed nursing care. The study aimed to find a relationship between nurses' perceptions of their professional practice environment and missed nursing care and job satisfaction. An additional aim was to find differences in nurses' perceived rating of the professional practice environment according to hospital location and job position. A descriptive correlational study was performed. The sample included 513 general and practical nurses providing direct care in nine Czech hospitals. The Revised Professional Practice Environment scale and the Missed Nursing Care (MISSCARE) survey were used to collect data. The professional practice environment was most correlated with satisfaction with the current position (0.4879). The overall score of missed care correlated most strongly with the subscale "staff relationships" (-0.2774). Statistically significant differences in the rating of two subscales, "control over practice" and "cultural sensitivity", were found between nurses from hospitals in district capitals and those from hospitals in smaller cities. Statistically significant differences in the rating of the "leadership and autonomy in clinical practice" and "teamwork" subscales were found between general nurses and practical nurses. The professional practice environment is related to nurse satisfaction and missed nursing care.

• Klíčová slova
• missed care, nurse satisfaction, professional environment,
• MeSH
• lidé MeSH
• nemocnice MeSH
• odborná praxe * MeSH
• osobní uspokojení * MeSH
• personál sesterský nemocniční psychologie   MeSH
• pracoviště MeSH
• pracovní uspokojení * MeSH
• vůdcovství MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: To examine nurse managers' perspectives on missed nursing care (MNC) on surgical units. BACKGROUND: The phenomenon of MNC is an important concern for nurse researchers. However, the reality of how it is experienced by clinical nurse managers is largely unexplored. Understanding nurse managers' experiences with MNC could help develop useful approaches to reducing levels of MNC. METHODS: A descriptive qualitative study was conducted between December and June 2020, using face-to-face semistructured interviews with 10 nurse managers. RESULTS: Five themes were identified: 1) awareness of MNC; 2) rationale for MNC; 3) consequences of MNC; 4) questions of reporting; and 5) management of MNC. CONCLUSIONS: Nurse managers must use their positions and leadership skills to expect appropriate staffing approaches and material resources for surgical units, effective process for newly hired nurses, and the establishment of a reporting system for MNC to reduce the phenomenon in practice.

• MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• ošetřovatelská péče * MeSH
• vůdcovství MeSH
• zdravotní sestry v řízení a kontrole * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Health economic evaluations of the implementation of evidence-based interventions (EBIs) into practice provide vital information but are rarely conducted. We evaluated the health economic impact associated with implementation and intervention of the INTERCARE model-an EBI to reduce hospitalisations of nursing home (NH) residents-compared to usual NH care. METHODS: The INTERCARE model was conducted in 11 NHs in Switzerland. It was implemented as a hybrid type 2 effectiveness-implementation study with a multi-centre non-randomised stepped-wedge design. To isolate the implementation strategies' costs, time and other resources from the NHs' perspective, we applied time-driven activity-based costing. To define its intervention costs, time and other resources, we considered intervention-relevant expenditures, particularly the work of the INTERCARE nurse-a core INTERCARE element. Further, the costs and revenues from the hotel and nursing services were analysed to calculate the NHs' losses and savings per resident hospitalisation. Finally, alongside our cost-effectiveness analysis (CEA), a sensitivity analysis focused on the intervention's effectiveness-i.e., regarding reduction of the hospitalisation rate-relative to the INTERCARE costs. All economic variables and CEA were assessed from the NHs' perspective. RESULTS: Implementation strategy costs and time consumption per bed averaged 685CHF and 9.35 h respectively, with possibilities to adjust material and human resources to each NH's needs. Average yearly intervention costs for the INTERCARE nurse salary per bed were 939CHF with an average of 1.4 INTERCARE nurses per 100 beds and an average employment rate of 76% of full-time equivalent per nurse. Resident hospitalisation represented a total average loss of 52% of NH revenues, but negligible cost savings. The incremental cost-effectiveness ratio of the INTERCARE model compared to usual care was 22'595CHF per avoided hospitalisation. As expected, the most influential sensitivity analysis variable regarding the CEA was the pre- to post-INTERCARE change in hospitalisation rate. CONCLUSIONS: As initial health-economic evidence, these results indicate that the INTERCARE model was more costly but also more effective compared to usual care in participating Swiss German NHs. Further implementation and evaluation of this model in randomised controlled studies are planned to build stronger evidential support for its clinical and economic effectiveness. TRIAL REGISTRATION: clinicaltrials.gov ( NCT03590470 ).

• Klíčová slova
• Cost-effectiveness analysis, Health economics, Hospitalisation, Implementation science, Nurse-led care model, Nursing home, Time-driven activity-based costing,
• MeSH
• analýza nákladů a výnosů MeSH
• hospitalizace MeSH
• lidé MeSH
• pečovatelské domovy s kvalifikovanou péčí MeSH
• pečovatelské domovy * MeSH
• role ošetřovatelky * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH

We examined the effect of Winter Storm Uri on daily direct-care nurse staffing levels in 1,173 Texas nursing homes (NHs) from February 13th to 19th, 2021. We used data from Payroll-Based Journaling and the Care Compare website. Linear mixed effects models were used to estimate the linear and non-linear change in staffing. During Winter Storm Uri, Texas NHs experienced a linear decrease in daily staffing levels with subsequent non-linear increase for registered nurses (RNs; p < .001) and certified nursing assistants (CNAs; p < .001), and staffing increased linearly for licensed practical nurses (LPNs; p < .001). Compared to 1 week before the storm, Texas NHs reported lower staffing levels across all three types of staff, but most dramatically among LPNs and CNAs. In supplemental analyses, urban and lower quality NHs fared slightly poorer than rural and higher-quality NHs. Winter storms pose a particular challenge to NHs and their ability to maintain direct-care nurse staffing levels.

• Klíčová slova
• disaster medicine, disaster preparedness, staffing shortages,
• MeSH
• lidé MeSH
• pečovatelské domovy MeSH
• personální obsazení a rozvrh * MeSH
• pomocní ošetřovatelé * MeSH
• pracovní síly MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Texas MeSH

AIMS: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards. BACKGROUND: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications. DESIGN: The prospective observational study was carried out in accordance with the STROBE guidance. METHODS: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model. RESULTS: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength). CONCLUSIONS: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered. IMPLICATION FOR THE PROFESSION AND PATIENT CARE: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.

• Klíčová slova
• inpatient, medication administration, medication error, multidisciplinary team, nurse, patient safety,
• MeSH
• dospělí MeSH
• hospitalizace * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• medikační omyly * ošetřování   statistika a číselné údaje   prevence a kontrola   MeSH
• personál sesterský nemocniční statistika a číselné údaje   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

OBJECTIVE: The aim of this study was to determine the effects of a nurse-led school-based sun protection programme in Turkey. METHODS: A randomized controlled trial was performed at two public schools between February and October 2014. Children with written consent from their parents were screened by nurses for skin type, and 80 children at moderate to high risk for skin cancer were included in the study. The sample was randomized by age, gender and skin type. Stratified and block randomizations were used. The participants were separated into an intervention group (n=40) and control group (n=40). Data were collected using a personal information form and two scales for sun protection behaviour and self-efficacy. RESULTS: In the intervention group, the pretest mean score for sun protection behaviour was 19.25±5.44 and increased significantly in the posttest assessment (33.05±4.23, p<0.001). Self-efficacy scores also increased significantly after the intervention (pretest 20.50±6.68, post-test 35.85±4.70, p<0.001). However, there were no significant increases in mean sun protection behaviour or self-efficacy scores in the control group (p>0.05). CONCLUSION: A nurse-led school-based sun protection programme effectively promoted children's self-efficacy and sun protection behaviour.

• Klíčová slova
• nurse, children, sun protection, skin cancer, school-based, Turkey,
• MeSH
• dítě MeSH
• hodnocení programu statistika a číselné údaje   MeSH
• lidé MeSH
• nádory kůže prevence a kontrola   MeSH
• ochranné oděvy MeSH
• přípravky chránící proti slunci terapeutické užití   MeSH
• průzkumy a dotazníky MeSH
• školní ošetřovatelství metody   MeSH
• školní zdravotnické služby * MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• zdravotní výchova metody   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Turecko MeSH
• Názvy látek
• přípravky chránící proti slunci MeSH

BACKGROUND: Safe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of the labour market. OBJECTIVES: To assess pharmaceutical care competences of final-year nursing students of different educational levels. DESIGN: A cross-sectional survey design. SETTINGS: In 14 European countries, nursing schools who offer curricula for level 4 to 7 students were approached. PARTICIPANTS: Through convenience sampling 1741 final-year student nurses of level 4 to 7 were included. Sampling strategies were country-specific. METHODS: A web-platform was developed with an assessment of the level in which students mastered pharmaceutical care competences. Knowledge questions, case studies (basic/advanced level), self-reported practical skills and attitudes were evaluated. RESULTS: Mean scores for knowledge questions differed significantly (p < 0.001) between level 5 (56/100), level 6 (68/100) and level 7 students (72/100). For basic cases level 5 students reached lower scores (64/100) compared with level 6 (71/100) and level 7 (72/100) students (p = 0.002 and p = 0.005). For more advanced cases no difference between levels was observed (overall mean 61/100). Most students (63-90 %) considered themselves skilled to perform pharmaceutical care and had positive attitudes towards their participation in pharmaceutical care (65-97 %). CONCLUSIONS: Relatively low knowledge scores were calculated for final-year student nurses. In some domains, lower levels of students might be insufficiently prepared to take up responsibilities in pharmaceutical care. Our assessment can be used as a tool for educators to evaluate how prepared nursing students are for pharmaceutical care. Its further implementation for students of different educational levels will allow benchmarking between the levels, both within and between countries.

• Klíčová slova
• Attitudes, Competences, Education, Knowledge, Nursing, Pharmaceutical care, Skills,
• MeSH
• farmaceutické služby * MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• studenti ošetřovatelství * MeSH
• studium ošetřovatelství bakalářské * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries. OBJECTIVES: To describe and compare the CM's role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries. DESIGN: A case study design. PARTICIPANTS AND SETTING: A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA). METHODS: A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country. RESULTS: In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden. CONCLUSIONS: Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation.

• Klíčová slova
• Clinical mentor, European countries, Nursing education, Placement, Standard of nursing clinical education,
• MeSH
• Evropská unie MeSH
• organizační politika MeSH
• školitelé * MeSH
• studium ošetřovatelství bakalářské organizace a řízení   MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND: A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits. OBJECTIVE: The study aimed to explore the experiences of patients who participated in the NeCR program. METHODS: A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile, >35th percentile, and > 70% percentile) in the improvement of health-promoting behaviors. RESULTS: Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers. CONCLUSIONS: Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.

• Klíčová slova
• Cardiac rehabilitation, Nurse-led, Process evaluation, Qualitative, eHealth,
• MeSH
• kardiovaskulární rehabilitace * metody   MeSH
• koronární nemoc * rehabilitace   MeSH
• lidé MeSH
• následná péče MeSH
• propuštění pacienta MeSH
• reprodukovatelnost výsledků MeSH
• role ošetřovatelky MeSH
• telemedicína * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Continuous elimination methods are part of complex therapeutic methods used in critically ill patients after burn injuries. We have been using CVVH (continual veno-venous hemofiltration) in our center since 1995. We use CVVH in patients after burn injury who present with systemic inflammatory syndrome, multiorgan dysfunction or multiorgan failure. From 1995 till 2001, elimination was performed under the supervision of an intensive care unit nephrologist. In recent years we have provided CVVH to burn patients independently. A nurse places sets in the device, flushes the sets with saline with heparine and subsequently drains this off into a collecting bag. After the device is tested it is ready to be used on a patient. The nurse calls a MD and under his supervision begins the elimination. Elimination parameters are set by the attending MD, and the nurse has a full written record of this throughout the elimination. The MD is informed of any complications during the elimination. If an alarm goes off the nurse initiates correction in co-operation with the MD. During the whole procedure the patient is clinically observed, and changes of his status are noted in a shock record and elimination protocol. Since 1995, 60 eliminations have been performed, occupying a total time of 7,400 hours. The work is very demanding and interesting; the patient's status improves significantly.

• MeSH
• hemofiltrace * MeSH
• lidé MeSH
• mimotělní oběh MeSH
• popálení komplikace   terapie   MeSH
• role ošetřovatelky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH