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This prospective study aimed to explore the effectiveness of an oral care intervention with Tegaderm on the oral mucosal health of intubated patients. A total of 70 intubated patients were included and randomly assigned to 1 of 3 groups, clean water brushing teeth (n = 23), brushing teeth combined with mouthwash (BTM) (n = 23), and brushing teeth combined with mouthwash and Tegaderm (BTMT) (n = 24). The Oral Mucositis Assessment Scale (OMAS) was applied to evaluate the patient's oral mucosal health before and after oral care intervention. The BTMT group had lower OMAS scores in almost all regions of the oral cavity, compared to the brushing teeth and BTM groups. The general linear model for repeated measurement indicated the BTMT group had the lowest total OMAS scores from Day 2 to Day 4 after the initiation of baseline OMAS evaluation. Of the 3 intervention groups, the BTMT group had the shortest length of endotracheal intubation. The BTMT group had the lowest incidence rate of ventilator-associated pneumonia; however, no significant between-group differences were found. BTMT effectively reduced the decline in oral mucosal health that was caused by endotracheal intubation and shortened the length of endotracheal intubation. • The effectiveness of a nurse-led oral care intervention in intubated patients was demonstrated. • The oral care intervention helps maintain integrity of oral mucosa in intubated patients. • The oral care intervention reduces the risk of VAP in intubated patients. [ABSTRACT FROM AUTHOR]

• Simulation training had higher self-efficacy in reporting confirmed cases of CAN and outcome expectation of reporting. • Simulation training benefited different aspects for nurses with different levels of clinical experience. • Both simulation and conventional training improved post-training scores in cognition, knowledge, and self-efficacy in reporting CAN. Emergency nurses need effective skills to identify and report child abuse and neglect (CAN) because they are often the first healthcare professionals to encounter these cases. This study aims to evaluate the effectiveness of simulation-based training in improving self-efficacy in child abuse and neglect (CAN) reporting among emergency nurses. Participants (n = 105) were randomly assigned to receive simulation-based or conventional training. Outcomes were post-training mean differences in CAN reporting self-efficacy scale. Both groups had significant improvement in CAN cognition, knowledge, and efficacy expectation-suspected (EES). Simulation training had higher efficacy expectation-confirmed (EEK) and outcome expectations (OE) for CAN reporting. Regression analysis showed simulation training was associated with improvement in EEK (1-3yr nursing experience) and OE (10+yr nursing experience) (all p <.05). Simulation-based training improved self-efficacy in reporting CAN, supporting its integration as part of a training program for emergency nurses. [ABSTRACT FROM AUTHOR]

The complexity of healthcare and concurrent advances in technology have promoted Interprofessional Education (IPE) in healthcare schools to prepare students to collaborate on interdisciplinary teams. Since 2016, healthcare curricula in Taiwan have incorporated IPE-based capstone courses to enhance creativity. To better understand the predictors of team creativity could help educators improve IPE and outcomes for nursing students and patients. To determine whether nursing students' demographic characteristics, individual creativity, and perceived team interaction behaviors, team swift trust, team conflict, and team task interdependence may predict high perceived team creativity in IPE settings. A cross-sectional study design included nursing students (N = 99) at a science and technology university in Taiwan. Data from self-report questionnaires included variables for demographic characteristics, individual creativity, and perceived team characteristics. A hierarchical multiple regression analysis revealed predictors of high perceived team creativity. Nursing students who perceived high team creativity also perceived higher interaction behaviors and lower process conflict than those who perceived less creativity. Spontaneous communication and team task conflict predicted high perceived team creativity. Nursing educators could increase team creativity in IPE by encouraging spontaneous communication and constructive task-oriented conflict management. This may benefit patient outcomes in the future. • Nursing students in IPE programs in Taiwan perceived high team creativity. • Spontaneous communication and task conflict predicted high team creativity. • To foster spontaneous communication and manage conflict may boost team creativity. [ABSTRACT FROM AUTHOR]

Deductive logic has often been used to develop critical thinking. However, inductive logical thinking, essential to care decision-making, has yet to be emphasized. This study aimed to explore visual thinking learning among undergraduate nursing students by asking them to draw situated patient pictures in order to integrate theoretical knowledge and promote inductive logical thinking. A mixed-methods research design was used to obtain quantitative and qualitative data from a convenience sample of 100 students. The study was conducted in a Taiwanese university from September 2022 to January 2023. In the quantitative component, learners' views of situated patient pictures were captured based on 15 paired identifiers and two questions: (a) What word should be used in describing the situated patient's picture? (b) How strongly do you feel about the selection? Written feedback was analyzed using qualitative content analysis. Quantitative analysis identified specific, unpretentious, humorous, harmonious, conservative, realistic, rational, entire, image performance, professional performance, understandable, expressive, static performance, rigorous, and profuse with a reasonable degree of choice. Qualitative analysis identified four stages in participants' development of inductive reasoning through situated patient pictures and visual thinking learning. These were: exploration, intuition, theme, and logic and creation. The results suggest that visual thinking learning is a practical pedagogical approach to increasing learners' communication abilities, group cooperation, theoretical knowledge integration, and logical thinking. Neither educators nor learners required any artistic skills. Nonetheless, participants demonstrated creativity and innovation through continuous visual thinking learning. • Visual thinking learning is an effective and practical approach for undergraduate nursing students. • Patient pictures assist in the development of inductive logic. • The stages represent a process of constructing inductive reasoning skills. • Visual thinking learning enhances communication, cooperation, knowledge integration, and logical thinking. [ABSTRACT FROM AUTHOR]

Highlights • Seeing the work role as a profession and taking responsibility. • Seeing people's needs and taking care of them as the mission of a professional nurse. • Seeing an overcrowded ED and taking work responsibility bravely. • Seeing difficult work and taking challenges. Abstract Purpose Professional resilience has become increasingly important for nurses in adverse work environments to reduce the negative results and increase the positive outcomes of stress. This study aimed to explore and understand the experiences of resilience among nurses in an overcrowded emergency department (ED) and increase knowledge about what nurses identified as protective factors, which may be useful for future planning. Methods A construction-grounded theory (CGT) approach was adopted. Purposive sampling and snowball technique were employed to recruit 13 participants, which proved sufficient to achieve theoretical saturation. In-depth interviews were conducted and audiotaped. Results Doubting work value and maintaining optimism were the 2 main themes in the core category of seeing and taking work difficulty and responsibility. Nurses described how their passion for their profession gradually diminished, but they assessed the situation and took responsibility for their jobs. Conclusion This study found that nurses retain their compassion, which sustains them in their work. The issue of ED overcrowding led to pessimism among nurses. However, work rewards encouraged nurses to adopt a more proactive attitude toward work-related adversity. [ABSTRACT FROM AUTHOR]

Background Workplace violence (WPV) is a serious problem in health care in Taiwan, as it is worldwide. Among all nursing staff, emergency department (ED) nurses are at the highest risk of WPV; yet, little attention has been paid to nurses as WPV victims. Purpose The purpose of the study was to understand ED nurses' WPV experiences and perspectives. Methods An interpretive qualitative phenomenographic design was used to answer the following research question: what are the qualitatively different ways in which nurses in Taiwan experience WPV in the ED? Thirty ED nurses who identified as experienced with WPV were interviewed, and phenomenographic analysis was used to assess the data. Findings Four categories of description emerged. WPV was seen as a continuing nightmare, a part of daily life, and a direct threat, and it had a negative impact on nurses' passion for emergency care. WPV adversely affected nurses on physical, psychological, social, personal, and professional levels. Conclusion The findings of this study have practical implications for in-service WPV training programs and may be used to inform potential changes to policy and legislation designed to establish a safer ED environment for staff. [ABSTRACT FROM AUTHOR]

Background Nursing competency is a standard component of the nursing curriculum in baccalaureate nursing education in Taiwan. However, limited studies have been found on the development of a measurement for assessing Taiwanese baccalaureate-level nursing competency. Objective The aim of this study was to develop and validate a Nursing Students Competence Instrument (NSCI) for Taiwanese baccalaureate-level nursing students. Design The items of this newly developed scale were derived from a previous published qualitative study by the authors. Validity and reliability of the instruments were assessed with exploratory factor analysis. In considering external validity and homogenous characteristics, data were collected from two periods of time: February 2011 and 2012. Setting Four hundreds nursing students enrolled in the 2-year baccalaureate-level at the study university in Taiwan were invited to participate in the study. Participants Two hundreds and nine nursing students in the 2-year baccalaureate-level program were recruited. Methods Descriptive statistics and exploratory factor analysis were used to determine validity of the instrument. Cronbach alpha, split-half coefficients and item analysis verified the reliability of instrument. Results Significant levels of reliability and validity for the newly developed Nursing Student Competency Instrument were found. The competency instrument comprised four dimensions with 27 items for graduates to meet to determine their nursing competency. Four factors were analyzed and categorized as integrating care abilities, leading humanity concerns, advancing career talents, and dealing with tension, and explained 22.29%, 18.59%, 15.99% and 11.23% of total variance, respectively; these four explained 68.09% of the total variance. Conclusions Results support validation of the new nursing competence assessment scale for Taiwanese nursing students at baccalaureate levels. The authors recommend that the NSCI could be applied in the nursing schools to evaluate the learning outcomes of nursing students' competence. [ABSTRACT FROM AUTHOR]

Introduction Family members’ experience a range of physiological, psychological and emotional impacts when accompanying a critically ill relative in the emergency department. Family needs are influenced by their culture and the context of care, and accurate clinician understanding of these needs is essential for patient- and family-centered care delivery. The aim of this study was to describe the needs of Taiwanese family members accompanying critically ill patients in the emergency department while waiting for an inpatient bed and compare these to the perceptions of emergency nurses. Methods A prospective cross-sectional survey was conducted in a large medical center in Taiwan. Data were collected from 150 family members and 150 emergency nurses who completed a Chinese version of the Critical Care Family Needs Inventory. Results Family members ranked needs related to ‘communication with family members,’ as most important, followed by ‘family member participation in emergency department care’, ‘family member support’ and ‘organizational comfort’; rankings were similar to those of emergency nurses. Compared to nurses, family members reported higher scores for the importance of needs related to ‘communication with family members’ and ‘family members’ participation in emergency department care’. Conclusions Family members place greater importance than emergency nurses on the need for effective communication. [ABSTRACT FROM AUTHOR]

Background The personal spiritual health of nurses may play an important role in improving their attitudes toward spiritual care and their professional commitment and caring capabilities. Purpose The purpose of this study was to explore the impact of nurses' personal spiritual health on their attitudes toward spiritual care, professional commitment, and caring. Methods A total of 619 clinical nurses were included in this cross-sectional survey. The measurements included the spiritual health scale-short form, the spiritual care attitude scale, the nurses' professional commitment scale, and the caring behaviors scale. Structural equation modeling was used to establish associations between the main research variables. Results The hypothetical model provided a good fit with the data. Nurses' spiritual health had a positive effect on nurses' professional commitment and caring. Nurses' attitudes toward spiritual care could therefore mediate their personal spiritual health, professional commitment, and caring. Conclusions The findings indicated that nurses' personal spiritual health is an important value and belief system and can influence their attitudes toward spiritual care, professional commitment, and caring. [ABSTRACT FROM AUTHOR]

Medical and Surgical Nursing (MSN) is a core course in baccalaureate nursing programs that requires active and effective teaching and learning strategies to enhance students' engagement. To develop and implement an effective learning process for students undertaking the MSN course. This participatory action research study used reflection as the center of action in the cycle of planning, acting, observing and reflecting and re-planning. The study was conducted at a University in southern Taiwan. Thirty nursing students in their second year of a bachelor program in nursing, aged 19 to 20 years, were recruited via email and completed the study. The data were collected from February to June 2019 through reflective workshops, group discussions, individual interviews, and field notes. A qualitative content analysis was performed. Four criteria were considered to ensure the trustworthiness of the study process: reliability, validity, transferability, and authentic citations. Four key themes – two challenges and two adaptive strategies - emerged in relation to the spiral process of improving teaching and learning in the MSN course. Participants experienced two main challenges: the large amount of multidisciplinary knowledge expected, and the rapid pace of the course. The two adaptive strategies were: recognizing their own unique way of learning and becoming an active learner and achiever. The project helped students to identify their own learning challenges, recognize the need to modify their attitudes and approaches to learning, improve teaching and learning in the MSN course, and identify the characteristics relevant to becoming an active learner and achiever. [ABSTRACT FROM AUTHOR]

The study aimed to determine the impact of an elective spiritual education course for nursing students on spiritual competencies. A convenience sample of nursing students (N = 92) was recruited from a baccalaureate school of nursing between February and July 2016. The intervention group (n = 45) was comprised of students enrolled in the elective spiritual education course which integrated non-Christian Eastern cultural beliefs; the control group was comprised of students not enrolled in the elective (n = 47). A quasi-experimental design examined pretest, posttest, and follow-up data from students' self-administered questionnaires. The intervention effect of the course was analyzed using generalized estimation equation. The results indicated posttest scores among nursing students in the intervention group were significantly better than the comparison group for spiritual health. Practicum stress and professional commitment were significantly better at follow-up. Spiritual care attitudes, caring behavior, and religious belief were significantly improved from pretest to posttest, and at follow-up for the intervention group compared with the control group. In conclusion, a spiritual education course should be considered as a regular course in the nursing curriculum, which could improve students' spiritual competencies, individual spiritual growth, and the ability to care for patients. [ABSTRACT FROM AUTHOR]

Recently, empirical researchers have observed direct associations between conflict and interaction behaviors within organizational teams. However, research concerning indirect links between conflict and interaction behaviors on interdisciplinary teams in nursing school is scant, particularly in Taiwan. The aim of this study was to explore the relationships among various types of conflict and interaction behaviors on interdisciplinary nursing education teams. This study utilized a cross-sectional, quantitative, descriptive design. The authors collected survey data from 99 nursing students who participated in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Questionnaires assessed the nursing students' perceptions about their teams' conflicts (of task, process, and relationship), and interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication). The authors used descriptive statistics to compare demographics, conflict scores, and interaction behavior scores for collocated and distributed interdisciplinary teams. A Pearson's analysis identified correlations among the variables and their components, and the SPSS PROCESS macro showed moderating effects of spontaneous communication on the relationship between distributed team and conflict subscales. After confirming the distributed team experienced significantly more conflict than the collocated team, we found significant negative correlations between constructive controversy and both process conflict and relationship conflict on the distributed team. Another interaction behavior, spontaneous communication, had a moderating effect on the relationships between the distributed team and both task conflict and relationship conflict. In interdisciplinary educational settings for nursing students, spontaneous communication may moderate the types of conflict that distributed teams are more likely than collocated teams to experience. Constructive controversy may be especially effective at mitigating conflict on distributed teams. Nursing educators may refer to these insights to improve outcomes for educational interdisciplinary healthcare teams. [ABSTRACT FROM AUTHOR]

Workplace violence against emergency nurses is common worldwide. This study aimed to gain a more thorough overview of the point prevalence of workplace violence against emergency nurses and the preventive measures used in emergency departments in Taiwan. In this multicenter, descriptive, cross-sectional study, the questionnaire, Violence Against Nurses Working in Emergency Departments, was used to collect data from 407 nurses working at 5 emergency departments in Taiwan from May to October 2015. The results revealed that 378 emergency nurses (92.9%) experienced workplace violence over the last 2 years. The average visual analog scale score (1-10) of security effectiveness in preventing workplace violence was 5.0 (SD = 1.97). The average visual analog scale score of perceived safety level in terms of workplace violence was 4.38 (SD = 2.06). The average visual analog scale score of meeting nurses' needs was 5.72 (SD = 2.23). This questionnaire survey revealed that the current preventive measures for workplace violence against emergency nurses in Taiwan were not effective. The relevant measures should be improved, thereby reducing the prevalence and severity of workplace violence against emergency nurses. [ABSTRACT FROM AUTHOR]