Factors associated with death anxiety and nurses’ preparedness to care for the dying patients with COVID-19
Authors : Alrafati, S.A., Zeilani, R. & Othman, E.H.
Abstract : Death is the most traumatic life experience among humans. Nurses' caring for dying patients increases their death anxiety, especially during pandemics. This study examined factors associated with nurses' death anxiety and preparedness to care for dying patients diagnosed with COVID-19 in Jordan. A cross-sectional correlation study recruited 400 nurses from six hospitals with specialized COVID-19 units in Jordan. Nurses have moderate levels of death anxiety and preparedness to care for the dying. Furthermore, the result revealed statistically significant differences in death anxiety levels and nurses’ readiness to care for dying patients according to their demographic and professional characteristics. As nurses’ death anxiety is negatively associated with their preparedness to care for dying patients, implementing adequate assessment of nurses' death anxiety to encourage early intervention through counseling and organizing training programs to improve their preparedness to care for the dying is highly recommended.
Keywords : COVID-19, Death anxiety, Hospice care, Nursing, Terminal care
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Public awareness and knowledge of palliative care in Jordan
Authors : Abu Elzait A., Zeilani R., Othman E.O.
Abstract : Background: Public perceptions of palliative care (PC) are crucial to enhance access to palliative care services and foster a sense of control over health decisions for people at the end of life. Purpose: To assess public knowledge of palliative care in Jordan. Method: A descriptive cross-sectional design with a stratified self-administered sample of 430 Jordanian citizens from all sectors in Jordan. Participants filled out the Palliative Care Knowledge Scale questionnaire. Data were analysed using IBM Statistical Package for the Social Sciences Statistics; descriptive, t-test, Analysis of Variance and regression test. Results: The mean score on the 13-item Palliative Care Knowledge Scale was 3.51±4.71 (out of 13). This indicates a low level of knowledge about PC among participants, and 78.6% (n=338) of the participants had not heard about PC. Participants who worked in health fields, had post-graduate degrees and a high incomes showed higher awareness of PC than others in the study. Most participants learnt about PC from family members. Conclusion: There is a lack of knowledge of palliative care in Jordanian public society. There is a crucial need to raise public awareness, and implement educational interventions to improve public awareness about palliative care.
Keywords : palliative care, knowledge, public, Jordan
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Do nurses participate in end-of-life decision making?
Authors : Othman E.O., Zeilani R. Alosta M., Khalaf I.,
Abstract : Background: To explore how Jordanian nurses participate in the end-of-life (EoL) decision-making process. Methods: Interviews with 10 patients and family caregivers, and focus group discussions with seven healthcare professionals (HCPs), were conducted. Interviews were audio-recorded, transcribed and analysed following inductive thematic analysis. Findings: The participants agreed that nurses are not fully engaged and did not have a direct role in the EoL decision-making process. However, the participants highlighted that ‘nurses bridge the gaps in the decision-making process’, where nurses act as mediators to facilitate the decision-making process. Lastly, nurses were viewed as ‘nurturers and supporters during the journey of the patient’s illness’; they were always available to answer their questions, offer help and advise when necessary during palliative referral and throughout the illness. Conclusions: Although nurses did not directly participate in EoL decisions, they have several vital contributions that need to be rearranged into structured decisional coaching.
Keywords : end of life, decision making, nurse
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Jordanian nursing students’ engagement and satisfaction with e-learning during COVID-19 pandemic
Authors : AlOsta M., Khalaf I., Othman E.O.
Abstract : Background Nursing education was affected by the COVID-19 pandemic as most institutions shifted to e-learning. The aim of the current study was to examine students’ engagement and satisfaction levels with e-learning during the COVID-19 pandemic. Methods A descriptive correlation design was used to guide this study. A voluntary response sampling method was used to recruit undergraduate nursing programs in Jordan. Data were collected using an electronic link to a self-reported questionnaire. Results A total of 1,562 undergraduate nursing students responded to the questionnaire. The study showed that most students have high engagement in the emotional, skills, and performance subscales and low engagement in the participation subscale. Further, they were moderately satisfied with e-learning during the COVID-19 pandemic. Conclusions Students identified several issues regarding their e-learning, which must be considered to improve their engagement and satisfaction. Further, the study revealed several shortcomings in preparing students to attend e-learning classes.
Keywords : COVID-19; e-learning; education outcomes; nursing students; students engagement; students satisfaction
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Death and Dying Through the Lens of Jordanian Muslim Patients and Caregivers
Authors : Othman E.O., Khalaf I., Alosta M., Abualruz H., & Zeilani R.
Abstract : The current phenomenological-qualitative study explored the meaning of death and dying from a Jordanian-Muslim perspective. Data were collected through face-to-face interviews with eight patients and five family caregivers, then analyzed following the Braun and Clarke steps. The analysis revealed two main themes; confronting death and preparing for a good death. The experience of terminal illness compelled the patients and their family caregivers to think of imminent death and want to prepare for it. On the other hand, Muslim terminally-ill patients accepted death and surrendered to God’s decree; however, they feared the unknown of the dying experience. Furthermore, the patients were concerned about being a burden to their families during the last days of their lives. Additionally, Muslim patients and caregivers identified five components of a ‘good death’ from the Arab-Muslims’ perspectives, including having a good closure, dying with dignity, coming to peace, not dying alone, and having a religious engagement.
Keywords : Death, dying, good death, hospice, Muslims, terminally ill
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Preventive and Avoidant Behaviors Followed by Jordanians During COVID-19 Pandemic
Authors : Darawad M., Othman E.O., Saleh A., & Rezk-Hanna M
Abstract : Objective: During the coronavirus disease 2019 (COVID-19), individuals’ compliance with protective behaviors was the most effective strategy to break the infection chain and prevent disease spread, even with vaccine availability and use. Understanding protective behaviors within the Jordanian context will shape health promotion campaigns and guide decision-makers to facilitate required resources and support Jordanian citizens. The objective of this study was to identify personal protective (preventive and avoidant) measures used by the Jordanian population during the COVID-19 pandemic to protect themselves from infection. Methods: A cross-sectional study with an exploratory, descriptive design was used to collect data using an online self-reported questionnaire from Jordanian people. The survey included the Protection from Infection Scale and the Infection Avoidance Scale. Results: A total sample of 1053 Jordanian citizens was included in the study. The participants exhibited a moderate level of self-care behaviors and high levels of protective and infection avoidance behaviors. Their most common behaviors were getting enough sleep, wearing masks, washing hands, and avoiding travel to infected areas. Contrariwise, the least adopted behaviors were exercising, wearing gloves, and leaving their jobs or schools. Conclusions: During pandemics, policy-makers must understand public concerns and protective behaviors, then provide them with tailored education through health promotion campaigns to enhance healthy behaviors.
Keywords : COVID-19, Jordan, preventive behaviors, protective factors, public health practice
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Fatigue among post–hematopoietic stem cell transplant patients in Jordan: prevalence and associated factors
Authors : Abdalrahman, O.A., Othman, E.H., Khalifeh, A.H. & Suleiman, K.
Abstract : Background: During hematopoietic stem cell transplant (HSCT), patients underwent various serious prolonged treatments, including conditioning and immunosuppressive drugs, resulting in several symptoms and alterations in the patient’s functioning. One of the most commonly reported symptoms is fatigue. Aim: To assess fatigue levels and associated factors during the first 100 days post-HSCT among Jordanian patients. Methods: A descriptive cross-sectional design assessed fatigue and associated factors during the first 100 days post-HSCT among Jordanian patients. A convenient sample was used to recruit post-HSCT patients. Data were collected using the demographic survey and the Brief Fatigue Inventory (BFI) scale. Results: The findings of this study demonstrated that 40.5% of the participants had severe total fatigue scores, while the mean BFI intensity average score was 5.01 and the mean interference of fatigue with patients’ daily life was 5.06. In terms of fatigue interference with daily activities, the highest interference was with the patient’s mood and normal work, while the lowest interference was with the walking ability. The analysis revealed a strong positive correlation between the fatigue intensity and its interference with the daily activities (r = .98, p ˂.001). Besides, a significantly strong negative correlation was found between the number of days post-HSCT and fatigue scores (r = − .92, p ˂.001). Conclusion: Post-transplant, patients experienced increased fatigue intensity, reduced physical activity, interference with the patient’s mood, and diminished functional capacity. Patients who have HSCT require a significant nursing care immediately post-transplant.
Keywords : Fatigue, Cancer, Hematopoietic stem cell transplant, Physical activity
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Attitude and Associated Factors toward End of life Care among Nurses Working in Kuwait Hospitals: A Cross-sectional Study
Authors : Alenezi, E., Zeilani R., Othman E.H.
Abstract : Objective: The current study assessed the attitude toward end of life (EOL) care among nurses working in Kuwait hospitals. Material and Methods: A descriptive, cross-sectional design was used to recruit 900 nurses from nine public, private and military hospitals in Kuwait. Data were collected using a self-administered questionnaire of the Frommelt Attitude Toward the Care of Dying questionnaire. Results: The results showed that nurses in Kuwait had a favourable and supportive attitude towards EOL care, mainly toward the families’ need for emotional support, care for the dying patients, involving the family in care, and accepting death. Further, attitude scores differed significantly based on nurses’ age, year of experience, education level, nationality, type of hospital, and place of work. Conclusion: Nurses working in Kuwait have a favourable attitude toward care for dying patients but an unfavourable perception toward making conversation with patients about death. Hence, providing appropriate awareness to nurses about death and dying in Kuwait might be a promising intervention to improve their attitude and sensitise the concept of death among them.
Keywords : Attitude to death, End of life, Kuwait, Nurses, Terminal care
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An Islamic cultural perspective of family presence during resuscitation. Letter to Editor
Authors : Othman, E. H., Al Omar S., Abualruz H., Safadi R.
Abstract :
Keywords : Cardiopulmonary resuscitation, Family, Islam
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Title: Decision Making Near End of Life. A Qualitative Exploration of the Lived Experiences of Jordanian Healthcare Providers
Authors : Othman, Elham H.; Khalaf, Inaam; Zeilani, Ruqayya; Majali, Sawsan; Nabolsi, Manar; Abdalrahim, Maysoon
Abstract : Background: Discussions related to a patient's prognosis and interventions near end of life are challenging and stressful for healthcare providers. Many reported experiencing emotional distress and discomfort during the decision-making process. Objectives: The aim of this study was to describe the lived experience of nurses and physicians who participate in decision making near the end of a patient's life. Methods: A descriptive, phenomenological approach was used with a purposive sample of 7 nurses and 6 physicians from 2 palliative and end-of-life care institutions in Jordan. Data derived from focus group discussions conducted online via the ZOOM video communication application, and analysis followed Colaizzi's qualitative methodology. Results: Three major themes emerged from the healthcare providers' experiences. Initially, the participants described how they "strive toward optimal decision-making near end of life," "the overwhelming experience of decision making near end of life," and finally, their struggle in sharing details about the end of life when patients ask and whether to tell or not to tell them as "the time for hard talk." Conclusions: The healthcare providers' experiences revealed several issues of decision making near a patient's end of life, such as a lack of appropriate training and administrative support, emotional distress, fear of legal liability, and the burden of a hard talk with patients. These findings necessitate institutional support of setting appropriate policies and guidelines, staff counseling, and healthcare provider support. Implications for practice: Institutions providing palliative and end-of-life care can use this study's findings to support their staff by setting appropriate practice guidelines and providing staff training and counseling.
Keywords : Decision making; End-of-life; Qualitative study
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The experience of nurses caring for patients with infectious diseases in isolation rooms: A qualitative approach
Authors : Abdelrahim Z., Abu Tabar N., Abualruz H., Othman E.H., Sawalha M., Alqurneh M., Alshraideh J., Al-Hussami M
Abstract : Background: Nurses proved unique experiences while caring for patients with several infectious diseases in isolation rooms. Purpose: This study aimed to explore the experiences of nurses caring for patients with infectious diseases in isolation rooms. Methodology: The study used a descriptive phenomenological approach using face to face in depth interviews from recruiting ten participants. The data were analyzed using Moustakas thematic analysis approach. Findings: The experiences of being a nurse caring for isolated patients were reflected in four major themes: (a) Risk perception and negative emotions, (b) Challenged with limited resources, (c) Isolation precautions interfere with optimum care, and (d) Knowledge and education. Discussion: Nurses encounter many challenges in caring for patients in isolation rooms, including fear and stress, inability to use precautions that increase disease transmission, and communication difficulties. Nurses should update their knowledge and competence regarding infection control precautions through a new standard of education and training.
Keywords : Infectious diseases, Isolation rooms, Jordan, Distress and uncertainty
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Nursing Diagnoses among Oncology Patients in Medical Units, a Study of Patients’ Records
Authors : Othman, E. H., Alosta, M. R., & Alshraideh, J. A
Abstract : Objective: Nursing care plans for oncology patients are complex and overlapping enough to warrant the need for systematized documentation that ensures high quality, flawless and comprehensive care. Addressing the patients’ needs through nursing diagnoses is the initial step that shapes the subsequent care. Therefore, the current study aimed to identify the frequent NANDA-I diagnoses reported in nursing care plans for medical oncology patients. Data sources: A retrospective design was used to collect data from 260 electronic nursing care records of oncology patients admitted to medical floors at an accredited oncology center in Jordan. Conclusion: The complexity of nursing care for oncology patients can be inferred from the high number of reported nursing diagnoses. This study summarizes the most common nursing diagnoses and their combinations that can be used as a guide to formulate nursing care plans for oncology patients in medical units. Implications for nursing practice: Oncology nurses may refer to this study to guide and support their care and documentation to maintain a high standard of nursing practice. Besides, the reported diagnoses can be integrated to generate pre-printed, standardized nursing care plans, where diagnoses are listed for nurses to select the applicable ones for their patients. Similarly, the combinations of nursing diagnoses may guide nurses to search for a concurrent diagnosis, thus improving patients’ outcomes. This study revealed the complexity of patients’ care in medical oncology units, which alarms the nursing managers to reconsider the nurse–patient ratio in these settings to meet patients’ care demands and maintain their safety.
Keywords : classification, documentation, nursing diagnosis, oncology nursing, patient care planning, standardized nursing terminology
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The Psychological Impact of the COVID-19 Pandemic on Jordanian Healthcare Workers
Authors : Fawaris, F., Othman, E.H., AlBashtawy, M., Abu Alfwares, A
Abstract : Introduction: Healthcare workers face incomparable work and psychological demands that are amplified throughout the COVID-19 pandemic. Aim: This study aimed to investigate the psychological impact of the COVID-19 pandemic on health care workers in Jordan. Method: A cross-sectional design was used. Data was collected using an online survey during the outbreak of COVID-19. Results: Overall, of the 312 healthcare workers, almost 38% and 36% presented with moderate to severe anxiety and depression consecutively. Nurses reported more severe symptoms than other healthcare workers. And both anxiety and depression were negatively correlated with well-being. Getting infected was not an immediate worry among healthcare workers; however, they were worried about carrying the virus to their families. Implications for Practice: Stakeholders must understand the impact of COVID-19 on healthcare workers and plan to provide them with the required psychological support and interventions at an early stage.
Keywords : Anxiety, COVID-19, Depression, Healthcare Workers, Jordan, Psychological Impact
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Involvement of Jordanian Patients and their Families in Decision-making near End of Life, Challenges and Recommendations
Authors : Othman, E., Khalaf I., Zeilani R., Nabolsi M., Majali s., Abdalrahim M., Shamieh O
Abstract : This study aims to explore the challenges in involving patients and their families in decision making near end of life and to provide recommendations to overcome these challenges. A qualitative descriptive phenomenological approach was used with a purposive sample of 8 patients, 7 family caregivers, 7 nurses, and 6 physicians from 2 institutions that provide palliative and end-of-life care services in Jordan. Data were collected using interviews with patients and family caregivers and focus group discussions with nurses and physicians. Colaizzi's method was used to analyze the data. The thematic analysis revealed 5 themes representing the participants' experiences of challenges with decision making near end of life. The identified challenges are (1) struggle with lack of information; (2) improper communication; (3) patient's or family's decision: the cultural taboo; (4) health care providers prefer staying in their comfort zone; and (5) the paradox of surviving and letting go. In addition, the participants endorsed several recommendations to raise public awareness of palliative and end-of-life care, amplify the patients' voice, and raise the bar of communication sensitivity. Decision making near the end of life is a challenge. However, the current study highlighted several areas for improvement that can improve the process and optimize patients' and their families' involvement.
Keywords : challenges, decision making, patient participation, qualitative research, recommendations, terminal care
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Shared Decision-Making Measures: A Systematic Review
Authors : Ahmad, M., Tabar, N. A., Othman, E. H., & Abdelrahim, Z
Abstract : This review used the recent COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) rating system, which gives the reader the ability to find appropriate instruments in a simple way. Shared decision-making (SDM) is part of health professionals', nurses', and patients' interaction about fundamental and special nursing care issues. The objective of this study was to critically appraise instruments that measure SDM in health care–related decisions according to the COSMIN criteria. Methods: This review was reported in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline. A thorough search identified SMD measures via PubMed, Cochrane Library, MEDLINE, EBSCO Host, Ovid journals, SAGE journals, and Google Scholar search engine through November 2018 and updated on March 24, 2019. A rating system with “very good,” “adequate,” “doubtful,” or “inadequate” for COSMIN was used. Results: The 17 instruments reported in this review are varied in the measured perspectives; observer-based viewpoint, patient questionnaires, provider questionnaires, and physician questionnaires, or even mixed perspectives. Only one instrument (OPTION 12 Scale) received an excellent rating across all 5 COSMIN validity rating sections in content, structural, and criterion validity. Conclusion: Most of the instruments scored poorly on the COSMIN checklist. Despite the vast number of instruments measuring SDM, researchers must undertake critical appraisal before selecting an acceptable instrument that meets the specific research goal, as well as the quality requirements.
Keywords : COSMIN systematic review , health care , psychometric properties , shared decision-making measures
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Nurses' Compliance With Bar-code Medication Administration Technology: Results of Direct Observation of Jordanian Nurses' Practice
Authors : Othman, E. H., & Darawad, M. W
Abstract : Medication administration using bar-code medication administration technology enhances the verification of medication administration rights. Nurses' compliance with bar-code medication administration procedure is essential to maximize the benefits. This study evaluated the current rate of nurses' compliance with bar-code medication administration use through direct observation. A descriptive design was used and 134 RNs were recruited from two public hospitals located in the middle region of Jordan. Compliance with bar-code medication administration was evaluated using an evidence-based checklist of 17 items. Participants' compliance with the bar-code medication administration was 55%, which had a significant positive correlation with their level of comfort using bar-code medication administration, usefulness, and ease of use, perceived job productivity, and overall rating of bar-code medication administration. Stakeholders can benefit from assessing end-user acceptance and perceptions regarding the bar-code medication administration technology to promote acceptance and compliance.
Keywords : BCMA , Jordan , Medication administration technology , Nurses' compliance , Observational study
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Reporting Nursing Interventions Classification and Nursing Outcomes Clas-sification in Nursing Research: A Systematic Review
Authors : Othman, E. H., Shatnawi, F., Alrajabi, O., & Alshraideh, J. A
Abstract : Background: Nursing classification systems are used to report nursing practices and maintain a unified documentation language. Nursing interventions classification (NIC) and nursing outcomes classification (NOC) are among the recognized terminology systems. Aim: To examine the extent of reporting NIC/NOC in nursing research. Design: A systematic review following PRISMA guidelines. Data Sources: A literature search in three electronic databases was performed. Results: A total of (18) articles were included. Nine studies were conducted to describe the commonly used NIC/NOC, six studies validated the effectiveness of classification systems, and two studies compared different nursing classification systems. Conclusion: The available evidence is limited by the quality of the studies. We recommend examining the use of NIC/NOC in nursing documentation using an experimental design.
Keywords : International classification for nursing practice, NIC terminology, NOC terminology, nursing classification systems, nursing interventions classification, nursing outcomes classification, standardized nursing terminology, systematic review
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Patients' Involvement in Decision Making at End of Life; a Systematic Literature Review
Authors : Othman, E.H, Khalaf I., Zeilani R
Abstract : Background: involving patient in end of life decision is important to understand their wishes and preference, which will help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review; examined patient involvement in end of life discussions; full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review; there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end of life decision making through; describing current practices; understanding perspectives of end of life discussions; investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end of life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in EOL decisions were recognized; lack of awareness; lack of education, training and experience; concerns about ethical and legal issues; and personal preferences of doctors or nurses were among the most commonly identified barriers.
Keywords : Advance Directives, Advance Care Planning, Decision Making at End of Life, Patients’ Involvement, Patients’ Preferences, and Systematic Review
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Nurses’ satisfaction with barcode medication-administration technology: Results of a cross-sectional study
Authors : Darawad, M. W., Othman, E. H., & Alosta, M. R
Abstract : Medication administration is a critical task of nurses that, if not done appropriately, can lead to fatal errors. New technologies, including barcode medication administration, are intended to decrease medication errors and enhance verification of medication-administration rights. Therefore, in this study, we examined the effect of introducing barcode medication administration on nurses' satisfaction and identified correlates of nurses' satisfaction with barcode medication administration. A descriptive, cross-sectional design using self-reported questionnaires was utilized to recruit 207 nurses from three public hospitals. Participants reported being moderately satisfied with barcode medication administration, especially with its efficacy and safety aspects. Their satisfaction had a significant negative correlation with their age, nursing experience, and experience using barcode medication administration, and a significant positive correlation with barcode medication-administration training satisfaction, computer competence, comfort with using barcode medication administration, and perceived job productivity using barcode medication administration. This study provides important information about Jordanian nurses' satisfaction with barcode medication-administration technology and provides greater understanding of different clinical correlates to barcode medication-administration satisfaction. It is recommended that effective barcode medication-administration training and computer skills training be provided prior to establishing barcode medication administration in hospitals and that the safety features of barcode medication administration be integrated in clinical education and training.
Keywords : barcode medication administration, cross-sectional study, electronic health solutions, Jordan, nurses' satisfaction
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Knowledge and nursing practice of critical care nurses caring for patients with delirium in intensive care units in Jordan
Authors : Hamdan-Mansour, A. M., Farhan, N, Othman, E. H., & Yacoub, M. I
Abstract : Delirium can have serious consequences in terms of morbidity, mortality, and increased health care costs. An extensive literature review showed that delirium is not well understood, recognized, or managed by medical and nursing professionals. The goal for this study was to determine the level of knowledge and management skills among critical care nurses caring for patients with delirium who were treated in intensive care units (ICUs) in Jordan. A total of 232 critical care nurses, employed in different ICUs in Jordan, completed self-reported questionnaires. The nurses in critical care units who completed the questionnaires identified a need for more delirium-specific knowledge and skills to assess and manage this condition more effectively. To enhance health outcomes for patients treated in the ICU who have delirium, nurses need to receive education on current assessment and management modalities. These regular education programs should be complemented with evaluative research focusing on both nursing care and patient outcomes.
Keywords : Delirium, Intensive care, Knowledge, Nurses, Practice
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