The pivotal role of nursing personnel in burn care

Challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers: A qualitative study

BACKGROUND

Burn injuries in childhood create serious trauma for both children and their caregivers. Burn injuries require extensive nursing care to reduce complications and to restore optimal functional health conditions. When children receive burn treatment and their caregivers are migrants with different languages, religions, and habits, nurses must adopt a cultural approach while caring for such patients.

AIM

This descriptive qualitative study aimed to reveal the challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers.

METHOD

Purposive sampling was used to recruit the nurses (n = 12). Semi-structured face-to-face interviews were conducted with nurses using an interview guide, and the interviews were recorded. Thematic analysis was used to create themes in the study.

RESULTS

The data were gathered around three main themes: "challenges" with the subcategories "communication," "trust relationship," and "care burden"; "expectations for better care" with the subcategories "translator support" and "hospital environment"; and "intercultural care" with the subcategories "cultural-religious differences" and "intercultural sensitivity."

CONCLUSIONS

The results of this study provide a novel insight into nurses' experiences with migrant child patients and their caregivers, and can be used to develop action plans to provide effective cultural care for patients receiving burn treatment and their caregivers.

The Living Experience of Patients with Burn Injuries from Art Nursing Care: An Unspoken Mystery

Background

Although art and aesthetics are important aspects in nursing care, there is scarcity of literature regarding this area, particularly in relation to patient expectations of art nursing care. This study aims to explore the perceptions of patients with burn injuries regarding art nursing care.

Materials and Methods

The present phenomenological study was conducted on 14 patients with burn injuries based on convenience and purposive sampling. Data were collected through deep open-ended and semi-structured interview. Data analysis was performed based on van Manen's Hermeneutic Phenomenology.

Results

Patients' experience of art nursing care emerged in the form of three main themes, including "being a healer for patients' wounds", "skilled and specialized care", "praiseworthy care", and six subthemes.

Conclusions

The patients in the burn unit demonstrated an understanding and appreciation for the qualities of patience, hard work, compassion, and love that the nurses possess. They also noted the meticulous attention paid by the nurses to their needs, which exemplifies the purest human traits and professional characteristics in patient care and can be seen as an art form in nursing.

Clinical Nurses' Continuing Education Needs in Acute Burn Care

OBJECTIVE

The purpose of this research was to explore clinical nurses' continuing education needs in caring for patients with acute burns.

METHOD

A descriptive research design was applied. To explore clinical nurses' continuing education needs in caring for patients with acute burns, focus group interviews were conducted. Educational needs assessments in acute burn care knowledge and skills were developed based on a content analysis of the focus group interviews. The participants were clinical nurses at a burn treatment hospital. Collected data were analyzed.

RESULTS

The nurses showed a high educational need for nursing knowledge and skills in caring for patients with acute burns. They indicated a need for educational content covering comprehensive nursing knowledge and skills for this care, including emergency treatment and psychosocial nursing care for the physical changes induced by acute burns.

CONCLUSION

A systematic continuing education program needs to be developed for nurses who care for patients with acute burns and delivered using blended learning approaches. [J Contin Educ Nurs. 2022;53(2):77-82.].

Patient safety culture in burn care units from the perspectives of healthcare providers: across-sectional study

Creating a positive patient safety culture is a key step in the improvement of patient safety in healthcare settings. PSC is a set of shared attitudes, beliefs, and perceptions about PS among healthcare providers. This study aimed to assess PSC in burn care units from the perspectives of healthcare providers. This cross-sectional descriptive study was conducted in 2020 in the units of a specialty burn center. Participants were 213 healthcare providers recruited to the study through a census. A demographic questionnaire and the Hospital Survey on Patient Safety Culture were used for data collection. Data were managed using the SPSS16 software and were summarized using the measures of descriptive statistics. The mean of positive responses to PSC items was 51.22%, denoting a moderate-level PSC. The lowest and the highest dimensional mean scores were related to the no punitive response to error dimension (mean: 12.36%) and the teamwork within departments dimension (mean: 73.25%), respectively. Almost half of the participants (49.3%) reported acceptable PS level in their workplace and 69.5% of them had not reported any error during the past twelve months before the study. Given the great vulnerability of patients with burn injuries in clinical settings, improving PSC, particularly in the no punitive response to error dimension, is essential to encourage healthcare providers for reporting their errors and thereby, to enhance PS. For quality care delivery, healthcare providers in burn care units need a safe workplace, adequate managerial support, a blame-free PSC, and an incentive error reporting system to readily report their errors.

Emotional impact of clinical practice in Burns Unit among nursing students: a qualitative study

Background and aim of the work.

In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative.The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit.

Methods.

A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview.

Results.

Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth.

Conclusions.

In light ofthe results, we highlight that nurse trainers should support studentsto take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably. (www.actabiomedica.it)

Effect of Nursing Quality Management on the Nosocomial Infection Rate and Psychology State of Patients with Burn and Plastic Surgery

BACKGROUND

To explore the effect of nursing quality management on the nosocomial infection rate and Psychology State of patients with burn and plastic surgery.

METHODS

Overall, 92 patients with burn and plastic surgery admitted to Qilu Hospital, Jinan, China from Apr 2017 to Jul 2018 were selected, in which 46 cases were randomly selected as a control group for routine nursing management, and another 46 cases as a research group to strengthen nursing quality management. The incidence of nosocomial infection, nursing satisfaction and nurse-patient disputes were compared. MMAS-8 scale was used to compare the compliance of the two groups. SAS and SDS score were used to compare the psychological status. The recovery and discharge were compared.

RESULTS

The incidence of nosocomial infection in the study group was significantly lower than that in the control group (P<0.05). The total satisfaction rate of the study group was significantly higher than that of the control group (P<0.05). The incidence of nurses-patients disputes was significantly lower than that of the control group. The SAS and SDS score of the study group were significantly better than the control group (P<0.05). The healing time, blood circulation recovery time of skin wounds and discharge time in the study group were significantly better than those in the control group.

CONCLUSION

Strengthening nursing quality management can effectively reduce the nosocomial infection rate of burn and plastic surgery. It helps to further accelerate the recovery of patients and make patients 'psychological state better.

A concept analysis of burn care in nursing

BACKGROUND

Burn is a life-threatening injury that requires long-term treatment and concomitant hospital stay. Relevant clinical studies in burns have been accomplished and published in the literature. However, none of these studies reported the concept analysis of burn care in nursing. Therefore, analysing the concept of burn care acts as an imperative strategy to provide comprehensive management of burn injury.

OBJECTIVE

The study aims to describe the concept of burn care in nursing.

METHOD

Walker and Avant's method (2013) was used to achieve the objective of the study.

FINDINGS

A model of burn care in nursing was generated that consists of assessment and diagnosis, intervention and evaluation. In addition, the biopsychosocial model developed by George L. Engel (1977) was also integrated to examine how these aspects play a significant role in burn care.

CONCLUSION

Implementing the concept of burn care will improve the quality of nursing care, cosmetic outcomes and vice versa, reduce the comorbidities on burn injury.

Nurses Experiences in the Burn Unit: A Qualitative Research

Background:

Nurses form the largest group of burn care treatment team. They have valuable experiences regarding the care of burned patients that needs to be explored. Therefore, the present study was aimed to explain the experiences of nurses who work in the burn unit.

Materials and Methods:

This qualitative study was conducted in the burn units of Zabol and Zahedan Hospitals in 2018. Accordingly, the data were collected through a semi-structured deep interview with 16 nurses. Purposeful sampling method was used for data collection. The data were analyzed using a thematic analysis approach.

Results:

The data analysis ultimately led to the development of 4 themes and 16 sub-themes. The extracted themes included burden of burn unit, toil of burn unit as a deal with God, need for continuing the education program, and work-life imbalance.

Conclusions:

Nurses in burn unit experience many challenges that can affect their job and life, which require special attention of the authorities, their families, and other colleagues. For better patient care, there is a need for up-to-date facilities and training. The hospital managers should pay more attention to the nursing staff of the burn units through increasing staff number, changing the working units, and offering financial and motivational vacations.

Nutrition: reducing the hypermetabolic response to thermal injury

Nutritional support is seen as a vital component in the battle to attenuate the extreme hypermetabolic response experienced by patients suffering from large thermal injuries. Protein catabolism precipitating protein malnutrition places patients at greater risk of wound infection and sepsis due to delayed wound healing. Underfeeding, aggressive feeding, feeding routes, timing of initiation of feeding and tight insulin control have all been explored extensively in the quest to understand what nutritional treatment will best attenuate the hypermetabolic response. Despite this it is suggested that the majority of patients with large thermal injuries do not receive adequate nutritional support immediately post injury. Nurses have a pivotal role to play in ensuring that thermal injury patients receive appropriate nutritional support based on the best available evidence.

The Effect of Short-Term Training Course by Nurses on Body Image in Patients with Burn Injuries

BACKGROUND

Burn is the fourth most common cause of trauma worldwide and is the fourth among the injuries and surgeries requiring medical care. This study was designed to determine the effect of a short-term training course by nurses on body image in patients with burn injuries.

METHODS

This study was a semi-experimental single-group survey assessing before and after interventions. Totally, 130 subjects (65 women and 65 men) were enrolled. The training course was held in 3 sessions of two hours. The contents of the group training course (a group of 5 people) were in relation to the body image and the factors affecting it, and the ways to improve the body image. The data collection instrument was the satisfaction with appearance scale (SWAP).

RESULTS

The mean scores of the body image of patients before and after the intervention were 49.44±11.39 and 41.63±11.89, respectively. There was a significant difference between the mean scores of body image before and after educational interventions (T=6.013, P≤0.001). The mean score of body image in women before and after intervention was 49.2±10.9 and 41.2±11.65, respectively (T=4.51, P≤0.000). The mean score of body image in men before and after intervention was 49.6±11.89 and 42.07±12.19, respectively (T=4.51, P≤0.000).

CONCLUSION

Short-term courses held by nurses were shown to have a significant role in improving the body image of burn patients.

Comprehensive physical domain care needs of burn patients: a qualitative study

INTRODUCTION

Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients.

METHODS

The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method.

RESULTS

By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients.

CONCLUSION

According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.

Nurse knowledge of emergency management for burn and mass burn injuries

A survey was conducted on 353 registered nurses working in Emergency and Trauma departments of district and provincial hospitals in Vietnam. Contents of the survey included first aid and initial care for burn and mass burn injuries. Only 15.3% of participants correctly answered over 50% of the items. The average percentage of correct answers was 39.7%. For cases of mass burn injuries, 53.6% of nurses recognized oral fluid resuscitation to be an appropriate method. Pre-transportation intubation for suspected inhalation injury was indicated by 44.6% of participants. Meanwhile, only 5.4% of nurses gave the correct answer regarding burn triage. A significantly higher knowledge level was recorded among nurses who had attended training courses in the past (54.8 ± 10.5% vs. 38 ± 9.7% respectively; p < .001). Meanwhile, work experience and place did not influence knowledge level. To improve the burn emergency management of nurses, further and continuing education is highly recommended.

Nursing research on a first aid model of double personnel for major burn patients

This study explored the effect of a first aid model employing two nurses on the efficient rescue operation time and the efficient resuscitation time for major burn patients. A two-nurse model of first aid was designed for major burn patients. The model includes a division of labor between the first aid nurses and the re-organization of emergency carts. The clinical effectiveness of the process was examined in a retrospective chart review of 156 cases of major burn patients, experiencing shock and low blood volume, who were admitted to the intensive care unit of the department of burn surgery between November 2009 and June 2013. Of the 156 major burn cases, 87 patients who received first aid using the double personnel model were assigned to the test group and the 69 patients who received first aid using the standard first aid model were assigned to the control group. The efficient rescue operation time and the efficient resuscitation time for the patients were compared between the two groups. Student's t tests were used to the compare the mean difference between the groups. Statistically significant differences between the two groups were found on both measures (P's < 0.05), with the test group having lower times than the control group. The efficient rescue operation time was 14.90 ± 3.31 min in the test group and 30.42 ± 5.65 min in the control group. The efficient resuscitation time was 7.4 ± 3.2 h in the test group and 9.5 ± 2.7 h in the control group. A two-nurse first aid model based on scientifically validated procedures and a reasonable division of labor can shorten the efficient rescue operation time and the efficient resuscitation time for major burn patients. Given these findings, the model appears to be worthy of clinical application.

An epidemiologic study of burns: Standards of care and patients' outcomes

BACKGROUND

Many people suffer from burn injuries every year, and burns make the patients undergo surgeries and years of rehabilitation. Burns lead to more years of disability, compared to cancer or heart diseases. Epidemiologic studies are needed to reveal the span, impact, and related factors of burns to help take appropriate efforts to reduce its mortality and morbidity.

MATERIALS AND METHODS

This study was conducted in two phases. The first phase was a descriptive retrospective study conducted on 836 burn patients who were admitted to the main special burn hospital of Isfahan, Iran. Data were collected from archived patients' files using a checklist approved by the faculties of epidemiology and nursing. In the second phase, a survey was done based on the professional task checklist of burn ward nurses to assess the fulfillment of each task by the nurses.

RESULTS

Burns were found to occur more among those in the age groups of 20-30 (26.2%) and 0-10 years (22.9%). The most common causes of burns were flammables and gas explosions due to imprudence at home and workplaces, or self-infliction. Mortality rate was 21.7% due to sepsis, shock, and inhalation injuries, respectively. Nurses gave 19.78 out of 50 points (39.56%) to their performance in the prevention of sepsis.

CONCLUSIONS

Based on the findings of this study, it can be concluded that there is still an increasing need for safety education and using environmental safety measures, as well as developing high-quality methods to transport burn patients and administer care to decrease the mortality and morbidity associated with burns.