A DESCRIPTIVE STUDY TO ASSESS THE FACTORS INFLUENCING THE JOB STRESS AMONG THE INTENSIVE CARE UNIT NURSES AT ERODE, TAMIL NADU, INDIA

ABSTRACT When the working system is in demand of more efficiency, individual resource stress is felt. Perception of stress occurs when there is a mismatch between the expectations and accomplishment. Because of workload and working environment seen in hospitals, health professionals frequently suffer from stress. In India prevalence of occupational stress amongst nurses has been estimated to be 87.4%. The present study was planned for assessing factors affecting occupational stress among Intensive Care Unit (ICU) nurses. So the Nurse manager and Chief of the hospital should take initiatives to overcome this problem and help them reduce the job stress by providing commensurate workload according to their abilities and lend proper recognition to their efforts and skills, and motivate them to contribute their thoughts to take decisions in their work, assign them responsibilities to do their work and help them improve their relations with their co-workers. Key Words: Job Stress, Intensive care unit, Workload.

A critical incident study of ICU nurses during the COVID-19 pandemic

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers’ university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being.

Magnitude and associated factors of low back pain among nurses working at intensive care unit of public hospitals in Amhara region, Ethiopia

Background Low back pain is a common public health problem throughout the world with a global prevalence from 28% to 86%. Nurses working in intensive care units are handling people who are critically ill and helpless, which requires more assistance for transferring and handling activities. This possesses a risk for low back pain but little is known about it in Ethiopia. This study aimed to assess the magnitude of low back pain and associated factors among nurses who work at intensive care units in Amhara region public hospitals, North Ethiopia. Methods A multi-centered institution-based cross-sectional study was conducted at Amhara region public hospitals from March 1-30, 2020. A simple random sampling technique after proportional allocation was used to select the study participants. Data were collected using a standard modified Nordic musculoskeletal assessment tool. After data were checked for completeness and consistency, it was entered into Epidata version 3.1 and exported to Statistical Package for Social Science software version 26 for analysis. Descriptive statistics were computed. A binary logistic regression model was used to identify factors associated with low back pain. Finally, those variables with a p-value of <0.05 in multivariable analysis were considered statistically significant. Result Study was conducted among 412 intensive care unit nurses giving a response rate of 97.6%. The magnitude of low back pain was 313 (76%) [95% CI: (71.6%-79.9%)]. Being female [AOR = 2.674 (1.404, 5.076)], unavailability of assistive device for patient handling [AOR = 2.139 (1.035, 4.410)], lack of training on intensive care [AOR = 2.017 (1.092, 3.943)], lack of regular exercise [AOR = 2.164 (1.164, 4.108)] and job stress [AOR = 3.66 (1.955, 6.498)] were factors significantly associated with low back pain. Conclusions In this study the magnitude of low back pain was high. Being female, unavailability of an assistive device for patient handling, lack of training on intensive care, lack of regular exercise and job stress were factors associated with low back pain. Policymakers and concerned bodies should emphasize the accessibility of assistive devices for patient care, provision of training on intensive care, and adaptive working environment for intensive care unit nurses.

Using Simulation to Improve Adherence to Get With the Guidelines Time to First Shock

Background Evidence demonstrates that shocking patients in ventricular fibrillation or pulseless ventricular tachycardia in 2 minutes or less leads to improved outcomes. At our facility in Orlando, Florida, 4 of 7 time to first shock fallouts occurred in the intensive care unit. No standardization for conducting code situations existed in the intensive care unit. Objective To develop nurse simulation education and training to standardize intensive care unit code processes and improve compliance with timely defibrillation. Methods The sample consisted of intensive care unit nurses. Interventions included online education, simulation, and a postintervention survey. Analysis was conducted using the Get With the Guidelines program as well as descriptive statistics. Interventions Online education assigned to all intensive care unit nurses included electrocardiogram recognition and code documentation. Nurses and physicians collaborated to develop a diagram to identify roles needed for successful conduct of a code situation. A code simulation video was created, reflecting these roles, and embedded in the online education. The education was graded and remediated one-on-one with nurses. Intensive care unit nurses completed structured code simulations, allowing them to practice serving as the leader. Three months after the intervention, a survey was distributed to nurses. Results The time to first shock fallouts in the intensive care unit decreased by 100%, and the facility’s fallouts decreased by 71%. The facility’s adherence to the time to first shock metric increased from 42% to 83%. In a postintervention survey, 89% of nurses reported perceived improvement in knowledge, team leadership and communication, and confidence associated with code events. Conclusions Online education and code simulation positively affected time to first shock in code situations and empowered nurses to confidently function in these situations.

Cross-cultural Adaptation and Validation of the Korean Version of the Moral Identity Scale in Intensive Care Unit Nurses

Background: Korean intensive care unit (ICU) nurses face a variety of moral conflict situations. What makes nurse give up other values and choose moral values? To answer this question, scholars began to study a concept termed “moral identity.” However, despite the increased importance of nurses’ moral identity, it has not been thoroughly studied using empirical data analysis. Instruments developed to predict moral behavior need evidence of their reliability and validity for rigorous research. The purpose of this paper is to report psychometric properties of the Korean version of the Moral Identity Scale in Intensive Care Unit nurses. Methods: The aim of this study was to assess the reliability and validity of the Korean version of the MIS (K-MIS) developed by Aquino & Reed. Data were collected from 207 ICUs. Exploratory and confirmatory factor analysis were used to test the construct validity. Research question/aim/objectives: The aim of this study was to assess the reliability and validity of the Korean version of the MIS (K-MIS) developed by Aquino & Reed.Results: The results of exploratory factor analysis showed that the Eigen values ranged from 1.63 to 4.47 and comprised 52.17% of the total explained variance. Confirmatory factor analysis showed acceptable model fit indices (χ2 (p) = 28.822 (.051), df = 18, root mean square error of approximation = .076, GFI = .937, Tucker-Lewis index = .93, comparative fit index = .955) and standardized factor loadings (.45 to.82). Conclusion: As a professional, the ICU nurse must protect and advocate for the patient. In this respect, K-MIS is a acceptable tool to measure the moral identity of ICU nurses in Korea. Therefore, it is expected that the K-MIS will be used in nursing education programs to improve the moral identity of ICU nurses.

Pain Assessment and Management in Intensive Care Unit: Nurses' Practices, Perceived Influencing Factors, and Educational Needs

Background: Critically ill patients and those mechanically ventilated or unable to communicate may not be able to report any pain they experience. Consequently, pain assessment and management (PAM) is challenging and underestimated in intensive care units (ICUs), where patients suffer alteration of consciousness, sedation, invasive procedures and mechanical ventilation. Aim: This study aimed to investigate ICU nurses’ PAM practices, their perceptions of influencing factors, and their related educational needs. Methods: A descriptive cross-sectional design was employed, using a valid self-reported questionnaire. Results: Among the sample of 171 nurses, 55% were male and 83% held a bachelor’s degree. 60% reported performing pain assessment for patients able to report pain and 50% for those unable to do so. Almost 40% of participants reported that pain management plans and scores were not discussed in medical rounds. Workload and lack of guidelines were reported as the most common barriers to PAM, while the most common enablers were perceived to be prescribing analgesia and considering pain a priority. Nurses recognized the need for education regarding pain, especially the physiological (50%) and psychological (47%) consequences of untreated pain. Conclusion: Nurses’ reported performance of pain assessment for ICU patients remains suboptimal. Therefore, healthcare professionals, organizations, nursing schools, and policymakers should work together to improve nurses’ PAM knowledge and practices.