SM Journal of Nursing

Archive Articles

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Adverse Events on Hospitalized Patients: A Barely Known Reality

Introduction: Currently, the patient’s safety is a fundamental component of the health care quality, more specifically of the nursing care quality and it constituted a preoccupation to the hospital managers by the influence it has on the cost of the care. The incurrence of Adverse Events (AE) associated to the nursing care is underestimated in Portugal, not allowing a real knowledge about this issue.

Material and Methods: A descriptive study, cross-sectional and quantitative approach with a sample of 628 nurses, who work in 43 internment services at 8 Portuguese hospitals.

Results: The psychometric properties evaluation of the Subscale of Assessing Risk and Occurrence of Adverse Events, demonstrated its suitability to evaluate the phenomenon in study. The Risk/Occurrence of Medication Errors proved to be the typology of AE that occurs less frequently or which is less likely to occur (AE_7 M=2, 20). For its turn, the Risk/Occurrence of HCAI (Health Care Associated Infections) is the type of AE that showed a higher average value (AE_6 M=4, 21). The Risk of Falls and Pressure Ulcers is moderate (AE_8 M=3.07), but the Occurrence of Falls and Pressure Ulcers is low (AE_9 M= 2.33).

Conclusion: The characterization of AE associated to the nursing care in terms of typology and occurrence frequency is very relevant, allowing us to analyze its causes, to develop and implement corrective and preventive measures to minimize the damage and improve the patients’ safety.

Maria João Baptista dos Santos de Freitas PhD¹* and Pedro Miguel Dinis Parreira PhD²


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Effect of a Self-Instruction Package on Cognitive Performance among Egyptian and Saudi Pediatric Nursing Students

Nursing educators should recognize the need to develop innovative teaching strategies that would enhance student learning. Aim: The study aimed to evaluate the effect of applying a self-instruction package on cognitive performance among pediatric nursing students in Egyptian and Saudi settings. Methods: This quasi-experimental study was carried out at the Faculty of Nursing, Cairo-University, Egypt and the College of Nursing, Hail University, Kingdom of Saudi Arabia (KSA) on a sample of convenience of 100 Egyptian and 90 Saudi nursing students. A self-instruction unit addressing lower respiratory infections, especially pneumonia was prepared and applied. The effectiveness was measured through pre-post-testing. Results: The results showed that the students in both samples had high levels of success in the posttests reaching in total 99.0% in the Egyptian sample and 100.0% in the Saudi sample. The lowest level of success in both samples were in the “compare” level of knowledge, 91.0% and 94.4% in the Egyptian and Saudi samples, respectively. As for the rates by question type, it reached 100.0% for “MCQ” and “list” types in both samples. Saudi students had significantly higher scores in the “know” level of knowledge (p=0.04), and in the “list” (p=0.02) and “compare/match” (p=0.004) types of questions, but with no statistically significant difference in total score (p=0.20). In multivariate analysis, the module was the main statistically significant independent positive predictor of the knowledge score improvement at all levels of knowledge. The Egyptian nationality was a positive predictor for the “know” and “analyze” levels. Meanwhile, the female gender was a positive predictor of the “apply” level of knowledge. Additionally, the Egyptian nationality was a positive predictor for the “MCQ” and “list” types. Conclusion: the self-instruction package is effective in improving the cognitive performance of nursing students in Egypt and Saudi Arabia in all cognitive levels and used various types of questions. The study recommends the use of the package in nursing schools, and development of similar ones in different topics.

Azza Abdel Moghny Attia* and Eman Abdel Fattah Hassan


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Assess patient

This research attempts to measure patient’s satisfaction of nurses working in counseling and nursing services centers under supervision of the Shahid Beheshti University of Medical Sciences. To do so, a descriptive and inferential study is conducted, in which 202 patients in such centers were surveyed. Cluster sampling was used to choose the sample. Moreover, a standard questionnaire was used to conduct survey. Thus, expert validity was checked and test retest method’s result was 0.73. Results showed that most of the patients (55.4%) were satisfied regarding nursing skills, and 73.3% were satisfied of emotional-communication aspects of the services. Regarding caring and training, 57.9% and 41.6% of the patients were almost satisfied of, respectively, nursing and training services. Moreover, emotional-communication and caring-training were significantly correlated. Results revealed that both of the mentioned aspects significantly affect patient’s satisfaction. However, home care services moderately satisfied the patients. Thus, it is highly advised that nurses pay attention to these two aspects in order to improve patient’s satisfaction.

Shokouh Kabirian Abyaneh¹ and Parvin Rezaei²*


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Collection Technique and Sample Processing for Impression Cytology of the Ocular Surface

Introduction: The impression cytology of ocular surface is a minimally invasive technique that allows the analysis of conjunctival and corneal cells, as an alternative to smears and punch biopsies. These specific guidelines will help health professionals, such as nurses and doctors, to ensure better samples of ocular surface without hurting patients, and will provide a new method of fixation for impression cytology of ocular specimens.

Objective: The aim of this study was to present a technique of collecting, fixing and staining for impression cytology of ocular specimens.

Materials and Methods: 50 samples of bulbar conjunctiva taken from 50 ESTeSL volunteers were analyzed. The material was collected on a strip of cellulose acetate from Millipore Corporation, then fixed on SureThin and stained with Papanicolaou stain. The slides were analyzed by three independent evaluators, using an evaluation grid with the following parameters: cell size, detail and nuclear membrane, detail and cytoplasmic membrane, ratio N / C and tinctorial affinity.

Results: The filter paper with apex helped to correctly position the paper in the eye and the procedure that was applied allowed an effective collection of cells with 50-70% of the filter surface being filled without the need for topical anesthesia. The SureThin fixative presented quality in cell preservation, in addition to being more economical. The Papanicolaou technique proved to be ideal in the coloring of ocular epithelial cells. This developed methodology presented a response of 80, 9% to a maximum score 2.

Conclusions: The presented method proved to be very effective in evaluating of ocular cell samples, while simultaneously proving to be a very cheap and comfortable technique for the patient.

Kátia Amaral Freitas and Paula Mendonça


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Application of the Omaha System in the Determination of Healthcare Needs of Individuals Receiving Home Healthcare Services

Home care services are generally provided to promote and protect an individual’s wellbeing or to restore his/ her to health either by health professionals or by family members in the person’s own home or the place where he/she lives. The aim of this study was to detect the needs of individuals receiving home healthcare and to create guidance data for initiatives to be planned for this purpose by demonstrating the availability of the Omaha system in determining the care needs of these people.

The sample of their search field of homecare services unit formed individuals (N=97). A total of 50 patients were included in the study. The data collection tools used in the study was the 5-item socio-demographic characteristics questionnaire and OMAHA Problem Classification Scheme (PCS).

According to the OMAHA PCS, 29 problems were identified. The problems identified, 49% were in the physiological domain, 28.8% in the health-related behaviors domain, 15.4% in the psychosocial domain and 6.8% in the environmental domain. With the nursing diagnoses, 2326 actual symptoms-signs were determined. It was determined that the OMAHA PCS could be used to identify healthcare needs of people receiving home care services.

Betül Aktaş¹, Medine Yilmaz², Nazife Kaplan³, and Banu Çankiri⁴