Parent Perceptions of Transitioning From a 6-Bed Pod to a Single Family Room in a Mixed-Room Design NICU

BACKGROUND

As some neonatal intensive care units (NICUs) shift toward mixed-room designs, with different room types available throughout family's stays, there is a need to better understand parent perceptions of this transition.

METHODS

This study used a qualitative descriptive design to describe parent perceptions of transitioning from a 6-bed pod to a single family room in a mixed-room design NICU. Purposive sampling was used to recruit 10 mothers and 7 fathers who were regularly present on the unit before and after the transition. Semistructured telephone interviews were conducted a minimum of 2 days after the transition occurred. Interviews were transcribed and then analyzed using reflexive thematic analysis.

FINDINGS

Four themes were identified: going into the unknown; approaching the finish line; becoming comfortable in the new reality and seeing the benefits; and gaining autonomy and confidence in parenting.

CONCLUSION

These results further our understanding of the transition process from a 6-bed pod to a single-family room for parents in the NICU. Staff should be sensitized to this experience to provide tailored information and support for parents throughout the transition.

The Effect of Music on Pain in the Adult Intensive Care Unit: A Systematic Review of Randomized Controlled Trials

CONTEXT

Multimodal analgesic approaches are recommended for intensive care unit (ICU) pain management. Although music is known to reduce pain in acute and chronic care settings, less is known about its effectiveness in the adult ICU.

OBJECTIVES

Determine the effects of music interventions on pain in the adult ICU, compared with standard care or noise reduction.

METHODS

This review was registered on PROSPERO (CRD42018106889). Databases were searched for randomized controlled trials of music interventions in the adult ICU, with the search terms ["music*" and ("critical care" or "intensive care")]. Pain scores (i.e., self-report rating scales or behavioral scores) were the main outcomes of this review. Data were analyzed using a DerSimonian-Laird random-effects method with standardized mean difference (SMD) of pain scores. Statistical heterogeneity was determined as I² > 50% and explored via subgroup analyses and meta-regression.

RESULTS

Eighteen randomized controlled trials with a total of 1173 participants (60% males; mean age 60 years) were identified. Ten of these studies were included in the meta-analysis based on risk of bias assessment (n = 706). Music was efficacious in reducing pain (SMD -0.63 [95% CI -1.02, -0.24; n = 10]; I² = 87%). Music interventions of 20-30 minutes were associated with a larger decrease in pain scores (SMD -0.66 [95% CI -0.94, -0.37; n = 5]; I² = 30%) compared with interventions of less than 20 minutes (SMD 0.10 [95% CI -0.10, 0.29; n = 4]; I² = 0%). On a 0-10 scale, 20-30 minutes of music resulted in an average decrease in pain scores of 1.06 points (95% CI -1.56, -0.56).

CONCLUSION

Music interventions of 20-30 minutes are efficacious to reduce pain in adult ICU patients able to self-report.

Predictable prosthesis length on a high-resolution CT scan before a stapedotomy

OBJECTIVE

(1) To assess the correlation between preoperative high-resolution CT (HRCT) imaging measurement from the long process of the incus to the footplate and the length of intraoperative selected prosthesis. (2) To determine if HRCT has a predictive value of prolapsed facial nerve during stapedotomy.

MATERIALS AND METHODS

We evaluated in our tertiary care center, in a retrospective case series, 94 patients undergoing primary stapedotomy. Preoperative temporal bone HRCT scans were reformatted in the plane of the stapes to measure on the same section the distance between the long process of the incus and the footplate. Measurement was performed by otolaryngology resident and neurotologist. We analyze the interobserver correlation and the mean length measured on the HRCT to the selected prosthesis size intraoperatively.

RESULTS

Mean HRCT measurement of the incus long process/footplate distance assessed by the otolaryngology resident and neurotologist was 4.34 and 4.38 mm, respectively. Interobserver correlation was statistically significant [intraclass correlation coefficient (ICC) of 0.679 (p < 0.001)]. Mean selected prosthesis length intraoperatively was 4.36 mm. Correlation between the mean selected length prosthesis and the mean HRCT measurement was also statistically significant [ICC of 0.791 (p < 0.001)]. Postoperatively, a statistical improvement was shown in air conduction (p < 0.001), bone conduction (p < 0.001) and air-bone gap reduction (p < 0.001). 2 cases of facial nerve covering one-half of the oval window were identified by HRCT and confirmed intraoperatively.

CONCLUSION

HRCT is a valuable tool to predict preoperatively the length of the stapedotomy prosthesis. Moreover, it might be helpful to identify a potential prolapsed facial nerve, to confirm the diagnosis of otosclerosis and to rule out other abnormalities. Ultimately, it may optimize the stapedotomy procedure planning.

Evaluation of Nurse Empathy Perceived by the Standardized Patient in Simulation: A French Validation of the Jefferson Scale of Patient Perceptions of Physician Empathy

PURPOSE

The aim is to validate a French version of the Jefferson Scale of Patient Perceptions of Physician Empathy (F-JSPPPE).

METHODS

Twenty-six intensive care nurses took part in a standardized clinical simulation (SCS). For each nurse, a standardized simulated patient completed the F-JSPPPE and three observers filled the French version of the Reynolds Empathy Scale (F-RES).

RESULTS

The expert committee concluded that the F-JSPPPE has a good content validity. The internal consistency was good. A positive correlation was observed between the F-JSPPPE and the F-RES, suggesting good convergent validity.

CONCLUSIONS

The F-JSPPPE validated with a standardized patient in SCS is the first reliable and valid instrument available in French to measure patient's perception of intensive care unit (ICU) nurse's empathy. Future study is needed to evaluate test-retest reliability.

Evaluation of Nurse Empathy Perceived by the Standardized Patient in Simulation: A French Validation of the Jefferson Scale of Patient Perceptions of Physician Empathy

Purpose: The aim is to validate a French version of the Jefferson Scale of Patient Perceptions of Physician Empathy (F-JSPPPE). Methods: Twenty-six intensive care nurses took part in a standardized clinical simulation (SCS). For each nurse, a standardized simulated patient completed the F-JSPPPE and three observers filled the French version of the Reynolds Empathy Scale (F-RES). Results: The expert committee concluded that the F-JSPPPE has a good content validity. The internal consistency was good. A positive correlation was observed between the F-JSPPPE and the F-RES, suggesting good convergent validity. Conclusions: The F-JSPPPE validated with a standardized patient in SCS is the first reliable and valid instrument available in French to measure patient's perception of intensive care unit (ICU) nurse's empathy. Future study is needed to evaluate test–retest reliability.

Association between job strain, mental health and empathy among intensive care nurses

BACKGROUND

Nursing shortage is a worldwide issue. It could influence factors such as job strain, nurses' mental health and nurse empathy towards patients.

AIM

The aim of the study is to explore the associations between job strain, psychological distress, psychological well-being and empathy in intensive care units (ICUs).

DESIGN

A cross-sectional descriptive correlational design.

METHODS

Data were collected using questionnaires and an observation tool completed by three observers during a standardized clinical simulation (SCS). A total of 26 nurses practicing in three ICUs participated in the study, which took place over 3 days in December 2011.

RESULTS

One dimension of job strain, psychological demand, was associated with two subscales of mental health (psychological distress positively and psychological well-being negatively). Positive correlations were demonstrated between psychological distress and nurse empathy as perceived by both the observers and the actor who played the role of patient.

CONCLUSION

Some associations have been confirmed between job strain, psychological distress, psychological well-being and empathy in the ICU while others needs further investigation.

RELEVANCE TO CLINICAL PRACTICE

It is important to reduce psychological demand among intensive care nurses in order to prevent psychological distress. The exploration of the connection between empathy and psychological distress should be advanced. This study suggests that SCSs provide an innovative approach that is useful for research.

Relationship Between Empathy and Well-Being Among Emergency Nurses

INTRODUCTION

A large number of patients who are in pain upon arriving at the emergency department are still in pain when they are discharged. It is suggested that nurses' personal traits and their level of empathy can explain in part this issue in pain management. The purpose of this study was to better understand the shortfalls in pain management provided by emergency nurses by considering nurses' characteristics.

METHODS

A cross-sectional descriptive correlational design was used for this pilot study. French validated self-administrated questionnaires (sociodemographic characteristics, empathy, psychological distress, and well-being) were presented to 40 emergency nurses. Thirty emergency nurses completed all questionnaires during work hours. Descriptive statistics, group comparisons, and correlation analyses were used for the data analysis.

RESULTS

Emergency nurses appear to have low levels of empathy. High levels of psychological distress and low levels of well-being were also observed in our sample. Among these variables, only empathy and well-being appear to be related, because we found higher empathy scores in nurses with higher well-being.

DISCUSSION

The poor mental health we found among emergency nurses is alarming. A clear need exists for supportive interventions for nurses. Finally, well-being was the only variable related to empathy. To our knowledge, this is the first study to report this relationship in nurses.

Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting

Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p < .001) for the whole tool, with variations from 0.619 to 0.920 (p < .01) between dimensions. The expert panel was satisfied with the content and face validity of the tool. The psychometric qualities of the NOTPaM developed in this study are satisfactory. However, the tool could be improved with slight modifications. Nevertheless, it was useful in assessing intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose.

Influence of the wettability on the boiling onset

Experimental investigation of pool boiling is conducted in stationary conditions over very smooth bronze surfaces covered by a very thin layer of gold presenting various surface treatments to isolate the role of wettability. We show that even with surfaces presenting mean roughness amplitudes below 10 nm the role of surface topography is of importance. The study shows also that wettability alone can trigger the boiling and that the boiling position on the surface can be controlled by chemical grafting using for instance alkanethiol. Moreover, boiling curves, that is, heat flux versus the surface superheat (which is the difference between the solid surface temperature and the liquid saturation temperature), are recorded and enabled to quantify, for this case, the significant reduction of the superheat at the onset of incipient boiling due to wettability.