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- Dimensions of clinical leadership among pre-registration nursing students: A cross-sectional study between two countriesPublication . Baron, Sue; Grinberg, Keren; Sousa, Joana; Neves, Hugo; Harnett, Gerardina; Bianchi, Monica; Luiking, Marie-Louise; Nilsson, Stefan; Frazer, Kate; Jack, Kirsten; Scammell, Janet; Warshawski, SigalitAims: To explore a) pre-registration students’ self-perceptions of clinical leadership behaviours and b) differences in students’ self-perceptions of leadership behaviours between two countries (UK and Israel). Background: Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students’ perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years. Design and methods: A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1% (Israel) and 17.9 % (England). Results: Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05). Conclusions: Differences in students’ clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care.
- Nursing knowledge of people with paresis of voluntary muscles: a living scoping review protocolPublication . Neves, Hugo; Parente, Paulo; Gomes, João; Queirós, Carmen; Sousa, Joana; Parola, Vítor; Sousa, Paula; Brito, Alice; Paiva e Silva, Antónia; Morais, Ernesto Jorge; Cardoso, Alexandrina; Cruz, Ines; Machado, Natália; Oliveira, Fernando; Bastos, Fernanda; Pereira, Filipe; Prata, Paula; Paiva e Silva, Abel; Sequeira, Carlos; Sousa, PaulinoObjective: This review aims to continuously map the nursing knowledge about people with paresis of voluntary muscles in any context of care. Introduction: Muscle paresis is a condition that significantly impacts quality of life. Nurses have a crucial role in managing this condition, particularly paresis of voluntary movement muscles. However, nursing knowledge about patients with paresis of voluntary muscles is dispersed, hampering the integration of evidence within the structure of information systems. Mapping how the nursing process components are identified is the first step in creating a Nursing Clinical Information Model for this condition, capable of integrating evidence into information systems. Inclusion criteria: This scoping review will consider studies focusing on the nursing process regarding people with paresis of voluntary muscles in all care contexts. The review will include quantitative, qualitative, and mixed methods study designs, systematic reviews, clinical guidelines, dissertations, and theses. Methods: The review process will follow JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews. Screening of new literature will be performed regularly, with the review being updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched will include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, and the Cochrane Central Register of Controlled Trials. Searches for unpublished studies will include OpenGrey and Repositorios Científicos de Acesso Aberto de Portugal. Studies published in English and Portuguese from 1975 will be considered for inclusion.
- A Pilot Randomised Controlled Trial on the Effectiveness of an Anti-Stress Ball Technique for Pain Reduction during Vascular Access Cannulation in Haemodialysis PatientsPublication . Dinis, Magda; Sousa, Joana PereiraBackground: Pain in patients under haemodialysis affects the quality of life of chronic renal patients. Distraction has been effective in controlling pain induced by the insertion of needles. Once applied adequately, distraction promotes endorphin release, with efficacy in acute pain management. This study evaluates pain perception while puncturing the haemodialysis device, using an anti-stress ball as a distraction strategy. Methods: This study is a retrospectively registered pilot randomised controlled trial of 47 chronic renal patients undergoing regular haemodialysis programs in a dialysis unit, in the central region of Portugal. Patients were randomly allocated into control and intervention groups. The intervention group received an anti-stress ball on the opposite limb of the vascular access, while the control group underwent pain evaluation without any intervention. Pain was monitored using a numeric pain scale. The study aimed to evaluate pain during vascular access cannulation and explore the potential benefits of using an anti-stress ball to reduce this pain. Results: Patients in the intervention group experienced significantly lower pain scores (−1.23; p < 0.05) during vascular access cannulation compared to the control group (−0.51). Conclusion: Distraction through an anti-stress ball reduces the perception of pain experienced by the chronic renal patients undergoing haemodialysis. However, the trial’s retrospective registration may introduce a risk of selective-outcome reporting. Further research with prospectively registered trials is recommended to validate the findings.
- Boas práticas na fase pré-analítica de hemoculturas: um estudo quase experimental em um serviço de emergênciaPublication . Baptista, Tânia; Pereira Sousa, JoanaIntrodução:A hemocultura identifica inequivocamente o microrganismo responsável por uma infeção da corrente sanguínea. O seu valor diagnóstico depende da qualidade de cada momento da fase pré-analítica, sendo o cumprimento integral das boas práticas recomendadas um aspeto essencial. O enfermeiro deve implementar as recomendações mais atuais, suportadas pela evidência científica, para evitar a contaminação externa da amostraeobter uma taxa de contaminação inferior a 3%.Objetivo: Analisar o impacto de intervenção formativa noconhecimento e na prática dos enfermeiros sobre a fase pré-analítica das hemoculturas.Métodos:Este estudo segue uma metodologia quasi-experimental, prospetivae longitudinal, através de aplicação deum questionário de avaliação de conhecimentos, com base numa pesquisa narrativa da literatura, elaboração de um plano de formação e a construção de um Procedimento Específico. O questionário de avaliação de conhecimento foi aplicado em dois momentos -antes e após a formação aos enfermeiros.Resultados: Participaram no estudo 60% dos enfermeiros de um Serviço de Urgência, constituindo uma amostra não probabilística de conveniência. Antes da intervenção, os participantes acertaram em 60,4% das questões, aumentando para 78,3% dois meses após a intervenção. Observou-se uma mudança positiva em todas as questões colocadas, com 67,4% da amostra a evidenciar um aumento de conhecimento. A taxa de contaminação das hemoculturas atingiu12,1% dois meses antes da intervenção, sem redução após a mesma. Conclusão:O conhecimento dos enfermeiros melhorou após realização de formação em serviço e implementação de um Procedimento Específico (p<0,001). Todavia, não ocorreu redução da taxa de contaminação, verificando-se resistência à mudança comportamental. É necessário manter a intervenção educativa e acrescentar outras estratégias adequadas às características da equipa, de forma a reduzirefetivamentea taxa de contaminação das hemoculturas.
- Changes in Clinical Training for Nursing Students during the COVID-19 Pandemic: A Scoping ReviewPublication . Lobão, Catarina; Coelho, Adriana; Parola, Vitor; Neves, Hugo; Pereira Sousa, Joana; Gonçalves, Rui(1) Background: The COVID-19 pandemic has cost social, economic, cultural, and educational life, distressing nursing training and practice. This study aimed to map the literature on changes in clinical training for nursing students during the COVID-19 pandemic. (2) Methods: A scoping review was conducted according to JBI methodology’s latest guidance. A set of relevant electronic databases and grey literature was searched to report results published in English, Spanish, and Portuguese. (3) Results: A total of 12 studies were included in the study, addressing changes in clinical training in undergraduate nursing students due to COVID-19 pandemic activity, published between 2020 and 2022. (4) Conclusions: Nursing schools made an effort to replace traditional clinical training with several activities, primarily based on simulation or virtual activities. However, contact with others is essential, and simulation programs or scenarios cannot provide it.
- Programa De Formação de Primeiros Socorros, Suporte Básico de Vida e Desfibrilhação Automática Externa do Instituto Politécnico de LeiriaPublication . Henriques, Carolina Miguel da Graça; Santos, Cátia Alexandra Suzano dos; Costeira, Cristina Raquel Batista; Lisboa, Felisbelo Rodrigues; Duarte, Hugo Miguel Santos; Sousa, Joana Sofia Dias Pereira deO Instituto Politécnico de Leiria está fortemente comprometido em garantir uma comunidade académica saudável e feliz. Neste sentido e com vista a que os socorristas do IPLeiria se sintam seguros na sua atuação desenvolveu-se este manual para que seja possível a todos que possuam formação no âmbito do socorrismo sedimentarem os seus conhecimentos e competências, através de uma revisão dos conteúdos lecionados. Uma prestação de primeiros socorros de forma correta faz toda a diferença quando os acidentes acontecem. Este manual é destinado a difundir conhecimentos gerais de primeiro socorro e foi elaborado no quadro de uma política institucional de salvaguarda pela saúde e segurança da comunidade académica do Instituto Politécnico de Leiria.
- Nursing Care in Peripheral Intravenous Catheter (PIVC): Protocol of a Best Practice Implementation ProjectPublication . Catarino, Fernando; Lourenço, Cristina; Correia, Célia; Dória, João; Dixe, Maria; Santos, Cátia; Sousa, Joana; Mendonça, Susana; Cardoso, Daniela; Costeira, Cristina R.Background: The use of a peripheral intravenous catheters (PIVC) is a common invasive practice in healthcare settings. It is estimated that about 70% of people with PIVCs will develop associated complications, such as infections. It is the consensus that best practices could reduce the appearance of such complications and reduce the length of stay in hospital. Methods: A project will be applied to implement the best approach in peripheral venous catheterization, provided by clinical nurses from an inland hospital in Portugal. The Joanna Briggs Institute methodology will be used on evidence implementation projects, which will be developed in three phases. First, a baseline audit will be performed. The second phase implements corrective measures, and the third phase is a follow-up audit. Conclusions: This project will improve the practice of the nursing team on peripheral venous catheterization nursing cares, positively influencing the quality of nursing care and patient safety. The implementation and dissemination of this project could boost its replication in other centres.
- Leadership Development in Undergraduate Nursing Students: A Scoping ReviewPublication . Costa, Patrícia; Pereira de Sousa, Joana; Nascimento, Tiago; Cruchinho, Paulo; Nunes, Elisabete; Gaspar, Filomena; Lucas, PedroBackground: Leadership is present at all levels of nursing and is essential to ensure the continuous improvement of nursing practice environments and the quality of the care provided to patients. This reality, coupled with the growing complexity of today’s health contexts, emphasises the importance of promoting the development of leadership skills in undergraduate nursing students, thus training nurses who are capable of acting as leaders and agents of change. To this end, a scoping review was carried out to map the available scientific evidence on the development of leadership in undergraduate nursing students. Methods: The scoping review was conducted according to two systematic review guidelines. The searches were conducted across a total of five databases for published studies and two databases for the unpublished/grey literature. The data extraction and analysis were performed by two reviewers, who independently screened and extracted data from the selected studies. Results: This review included 25 articles, and four thematic categories were identified—students’ perceptions of leadership; strategies to train leaders in nursing; the evaluation of leadership development; and conceptual models and curricula. The main conclusions highlight the need to reformulate existing curricula, the importance of integrating student-centred pedagogical approaches to promote leadership development, the impact that evaluating leadership development has on the whole process, contributing to the construction of an identity as a leader, and the need for it to be done in a structured and progressive way. Conclusions: The teaching of leadership should be promoted from the beginning of training, in a transversal, continuous, consistent, sustained, and articulated way, incorporating different disciplines, because only in this way will it be possible to train competent nurse leaders who are capable of acting in today’s complex and dynamic health contexts.
- A Complex Intervention to Minimize Medication Error by Nurses in Intensive Care: A Case StudyPublication . Coelho, Fábio; Furtado, Luís; Tavares, Márcio; Pereira, Joana SousaBackground/Objectives: Medication errors are the most frequent and critical issues in healthcare settings, often leading to worsened clinical outcomes, increased treatment costs, extended hospital stays, and heightened mortality and morbidity rates. These errors are particularly prevalent in intensive care units (ICUs), where the complexity and critical nature of the care elevate the risks. Nurses play a pivotal role in preventing medication errors and require strategies and methods to enhance patient safety. This study aims to develop a comprehensive and evidence-based intervention to minimize medication errors by nurses in ICUs. Methods: This qualitative case study forms a part of a broader research project that commenced with a scoping review. Building on the review findings, a complex intervention was designed to address nurses’ medication errors. A focus group of experts was conducted to validate the intervention designed, evaluating its contextual feasibility and relevance. Results: This study led to the development of a complex intervention whose relevance lies in its potential implementation within the studied context. The resulting intervention was structured around four main components—educational interventions, verification and safety methods, organizational and functional modifications, and an error reporting system—meticulously designed to leverage the ICU’s existing resources. Conclusions: In conclusion, the proposed intervention has the potential to positively impact healthcare quality by reducing errors and promoting a culture of safety. Furthermore, this study’s findings provide a relevant foundation for future research and practical applications, driving advancements in healthcare service excellence.
- Mask selection at the beginning of Non-Invasive Mechanical Ventilation for patients with acute respiratory failurePublication . Romano, Ana; Sousa, Joana; Cunha, MadalenaIntrodução: A Ventilação Mecânica Não Invasiva (VMNI) pressupõe um suporte ventilatório que consiste na aplicação de uma pressão positiva nas vias aéreas através de uma máscara/interface. As intervenções de Enfermagem ao doente sob VMNI são determinantes para o bem-estar do doente e para o sucesso da técnica, nomeadamente a escolha e adequação da máscara. Objetivo: Capacitar a equipa de Enfermagem relativamente à seleção da máscara mais adequada ao doente com IR no início da VMNI, num serviço de medicina; comparar o desempenho do uso entre as MON (máscara oro-nasal) e MFT (máscara facial-total) nas 24 horas de VMNI. Métodos: Realizou-se um estudo quantitativo prospetivo experimental. Para colheita de dados foi submetido um questionário aos enfermeiros sobre os cuidados de enfermagem ao doente sob VMNI. Para análise dos conteúdos, foram recolhidos dados relativos aos valores de gasometria, em doentes submetidos a VMNI, nos anos de 2021-2022. Resultados: Constatou-se que as variações mais pronunciadas ocorreram na utilização da MFT na IRA hipercápnica, com uma taxa de variação de 85,7% da MFT para 85,0% da MON no pH; e de 78,6% (MFT) para 70,0% (MON) na variável PaCO2, demonstrando variações estatisticamente muito significativas (p<0,01). Conclusão: A MFT é a mais adequada para o início da VMNI em doentes com IRA hipercápnica, em comparação com a MON. A formação em serviço promove a atualização de conhecimentos e melhoria da prestação de cuidados aos doentes sob VMNI.