Factors Affecting Hospital Readmission Rates Following An Acute Coronary Syndrome

Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates.

source: J Clin Nurs

Summary

A Systematic Review

[Posted 27/Sep/2022]

AUDIENCE: Nursing

KEY FINDINGS: Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates. It is recommended that nurses are supported to influence discharge planning and lead the development of nurse-led interventions to ensure discharge planning is both coordinated and person-centred.

BACKGROUND: Objective of this study is to synthesise quantitative evidence on factors that impact hospital readmission rates following ACS with comorbidities.

DETAILS: The search strategy included keywords and MeSH terms to identify English language studies published between 2001 and 2020. The quality of included studies was assessed by two independent reviewers, using Joanna Briggs Institute (JBI) critical appraisal tools. Twenty-four articles were included in the review. All cause 30-day readmission rate was most frequently reported and ranged from 4.2% to 81%. Reported factors that were associated with readmission varied across studies from socio-demographic, behavioural factors, comorbidity factors and cardiac factors. Findings from some of the studies were limited by data source, study designs and small sample size.

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Copyright © John Wiley & Sons Ltd. All rights reserved.

Source: Rashidi, A., Whitehead, L., and Glass, G. (2022). Factors Affecting Hospital Readmission Rates Following An Acute Coronary Syndrome: A Systematic Review. Journal of Clinical Nursing. 2022; Published: July, 2022. DOI: 10.1111/jocn.16122.



Prehospital Noninvasive Positive Pressure Ventilation For Severe Respiratory Distress In Adult Patients

Adult patients with NIPPV treatment for severe respiratory distress had a significantly lower intubation rate and shorter hospital and ICU stay, compared with those with standard care.

source: J Clin Nurs

Summary

An Updated Meta-Analysis

[Posted 6/Dec/2022]

AUDIENCE: Nursing

KEY FINDINGS: Adult patients with NIPPV treatment for severe respiratory distress had a significantly lower intubation rate and shorter hospital and ICU stay, compared with those with standard care. However, no effect of NIPPV on in-hospital mortality was observed. Further study is needed by enrolling large-sample original studies.

BACKGROUND: Purpose of this study is to compare the effect of prehospital noninvasive positive pressure ventilation (NIPPV) and standard care for severe respiratory distress. Severe respiratory distress is an important cause of death in adult patients. There is a growing body of research exploring the benefits of nasal intermittent positive pressure ventilation (NIPPV) for patients undergoing severe respiratory distress. However, a systematic review is needed to synthesise and summarise this body of knowledge to identify the effectiveness of NIPPV. This is an update of a meta-analysis first published in 2014.

DETAILS: Databases including PubMed, Embase, Scopus and the Cochrane Library databases were electronically searched to identify randomised controlled trials (RCTs) that reported NIPPV therapy for adult patients with severe respiratory distress. The retrieval time is limited from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Meta-analysis was performed by using STATA 11.0 software. A total of 10 studies involving 1465 patients were included. The meta-analysis results showed that compared with standard care, CPAP therapy decreased intubation rate (RR = 0.43, 95% CI: 0.27-0.67, p < .001, I2 = 0.0%), reduced hospital stay (WMD = -4.19, 95% CI: -5.62, -2.77) and ICU stay (WMD = -0.65, 95% CI: -1.09, -0.20) for patients with severe respiratory distress. However, no significant effects of NIPPV were observed on in-hospital mortality (RR = 0.83, 95% CI: 0.64-1.07) and ICU admission rate (RR = 0.93, 95% CI: 0.73-1.19).

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Source: Meng, M., Zhang, J., Chen, L., et al. (2022). Prehospital Noninvasive Positive Pressure Ventilation For Severe Respiratory Distress In Adult Patients: An Updated Meta-Analysis. J Clin Nurs. 2022; 31(23-24): 3327-3337. Published: December, 2022. DOI: 10.1111/jocn.16224.



Effectiveness of Clown Intervention For Pain Relief In Children

Clown intervention may be a promising way to relieve acute pain in children, especially those aged 2–7 years.

source: J Clin Nurs

Summary

A Systematic Review And Meta-Analysis

[Posted 22/Nov/2022]

AUDIENCE: Nursing

KEY FINDINGS: Clown intervention may be a promising way to relieve acute pain in children, especially those aged 2–7 years. It also seems to shorten the duration of crying and the length of hospital stays, but the effect on cortisol levels is still uncertain. More high-quality randomised controlled trials are needed to confirm these results and take into account different age groups, cultural backgrounds and specific populations.

BACKGROUND: Pain is common in children receiving medical procedures, and there is a lack of adequate awareness and management. In addition, children who undergo medical procedures involving pain may also experience stress, crying and prolonged hospitalisation. Clown intervention is a promising nonpharmacological intervention. However, studies on the effectiveness of clown intervention in pain management have reported conflicting findings. Aim of this study is to evaluate the effectiveness of clown intervention in relieving pain in children, as well as its effects on cortisol levels, crying duration and length of hospital stay.

DETAILS: Two reviewers independently used the Cochrane risk of bias tool to assess the risk of bias of the included studies. Meta-analysis was conducted when data were available, otherwise, a narrative description was provided. Data were analysed using Review Manager 5.3. The review process is reported according to PRISMA. Nine studies including 852 children met the inclusion criteria. The results showed that compared with standard care, clown intervention was beneficial for relieving pain. Further subgroup analysis showed that it was more effective with children aged 2–7 years. The duration of crying after the procedure and the length of stay were shortened, but there was no significant difference in cortisol levels.

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Source: Ding, Y., Yin, H., Wang, S., et al. (2022). Effectiveness of Clown Intervention For Pain Relief In Children: A Systematic Review And Meta-Analysis. J Clin Nurs. 2022; 31(21-22): 3000-3310. Published: November, 2022. DOI: 10.1111/jocn.16195.



Caring for Twins During Infancy

The parents of twins could benefit from additional and specially developed advice from health professionals for considering and implementing adequate sleep and feeding practices that reduce parental fatigue and stress, as well as promote parent-twin relationships.

source: J. Neonatal Nurs.

Summary

A Systematic Review Of The Literature On Sleeping And Feeding Practices Amongst Parents Of Twins

[Posted 8/Nov/2022]

AUDIENCE: Nursing

KEY FINDINGS: Caring for twins presents unique challenges that require specific choices to be made. The parents of twins could benefit from additional and specially developed advice from health professionals for considering and implementing adequate sleep and feeding practices that reduce parental fatigue and stress, as well as promote parent-twin relationships.

BACKGROUND: Purpose of this study is to better investigate how the parents of twins approach the care of their infants in terms of feeding and sleeping practices after birth by examining the sleeping and feeding behaviours of parents with twin babies.

DETAILS: Three electronic databases (PubMed, PsycINFO, and ScienceDirect) were searched, and studies published between 2006 and 2016 were included. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses (Moher et al., 2015) was adopted. Key findings were extracted and synthesised. Fourteen studies were included (three focused on sleeping, seven focused on feeding, and four focused on sleeping but considered feeding to be a secondary issue).

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Copyright © Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.

Source: Ionio, C., Macheroni, E., Landoni, M., et al. (2022). Caring for Twins During Infancy: A Systematic Review Of The Literature On Sleeping And Feeding Practices Amongst Parents Of Twins. J. Neonatal Nurs.. Published: October, 2022. DOI: 10.1016/j.jnn.2021.08.017.



Comparison Of Correlation Between Spiritual Health Of Parents and Level Of Their Attachment To The Preterm Neonate

Considering the significant correlation between spiritual health and attachment, as well as the stronger correlation in mothers compared to fathers, it is possible that applying educational programs to improve the attachment of parents, especially in the mother, can play a significant role in the field of spiritual health.

source: J. Neonatal Nurs.

Summary

[Posted 1/Nov/2022]

AUDIENCE: Nursing

KEY FINDINGS: Considering the significant correlation between spiritual health and attachment, as well as the stronger correlation in mothers compared to fathers, it is possible that applying educational programs to improve the attachment of parents, especially in the mother, can play a significant role in the field of spiritual health.

BACKGROUND: A neonate's hospitalization in the NICU causes physical, mental, and emotional separation of the neonate from the parents, thus interrupting the creation of the natural process of maternal-paternal-neonatal attachment. Spiritual health affects all dimensions of health including the process of communication with others and the environment. Attachment is also a form of communication. Thus, the present study compared the correlation between the spiritual health of parents and their level of their attachment to their preterm neonate.

DETAILS: This descriptive-correlational study was conducted on 226 parents with preterm neonates hospitalized in the NICU by a convenient sampling method. The research instruments included a demographic information questionnaire of parents and neonates, Spiritual Well-Being Scale, and a Maternal & Paternal Postnatal Attachment Scale. The data were analyzed with SPSS20. The mean "religious health" of mothers (54.30 ± 3.69) was significantly higher than in fathers (53.03 ± 4.94) (P = 0.03). There was no statistically significant difference between the average "existential health" of mother and father (P = 0.24) and the total "spiritual health" score between them (P = 0.27). The mean total score of maternal and paternal attachment to their preterm neonate were 83.86 ± 4.23 and 78.32 ± 5.61, respectively. Regarding the correlation between spiritual health and maternal and paternal attachment, all of the correlation coefficients were positive, and for a one unit increase in the score of spiritual health, the total score of maternal and paternal attachment increased by 0.27 and 0.20, respectively, meaning that the correlation between the mother's spiritual health and level of her attachment to her preterm neonate was stronger compared to this attachment in the father.

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Copyright © Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.

Source: Malmir, S., Farahani, A. S., Nourian, M., et al. (2022). Comparison Of Correlation Between Spiritual Health Of Parents and Level Of Their Attachment To The Preterm Neonate. J. Neonatal Nurs.. Published: October 19, 2022. DOI: 10.1016/j.jnn.2022.10.001.



Premedication for Nonemergent Neonatal Intubation

Findings in this review support the recommendation that opioids and vagolytic agents should be used for premedication for nonemergent neonatal intubation and adjuvant sedation and muscle relaxants should be considered.

source: J Perinat Neonatal Nurs.

Summary

A Systematic Review

[Posted 25/Oct/2022]

AUDIENCE: Nursing

KEY FINDINGS: Findings in this review support the recommendation that opioids and vagolytic agents should be used for premedication for nonemergent neonatal intubation and adjuvant sedation and muscle relaxants should be considered.

BACKGROUND: Intubation is a common procedure in the neonatal intensive care unit (NICU). It is performed for many reasons including resuscitation, apnea, surgery, and mechanical ventilation. Unmedicated neonatal intubation is often poorly tolerated and leads to physiologic instability and vital sign changes including bradycardia, oxygen desaturation, hypertension in any system, and hypotension.

DETAILS: This systematic review evaluates research regarding the use of premedication for nonemergent neonatal intubation. Unmedicated intubation is associated with adverse outcomes such as physiologic instability and decompensation, repeat and prolonged intubation attempts, and trauma. Included studies compared medicated intervention groups against an unmedicated control. Medications vary greatly across studies and include anesthetics, opioids, benzodiazepines, barbiturates, vagolytics, and neuromuscular blockades (muscle relaxants). A comprehensive search of randomized control trials, retrospective cohort studies, and prospective observational studies was completed from the electronic databases of CINAHL EBSCOhost, Ovid MEDLINE, PubMed, EMBASE, Google Scholar, Cochrane Collaboration, and ClinicalTrials.gov and footnotes were used to complete the search. Twelve studies are included in this review dating back to 1984 and are from 5 countries. Outcome measures include changes in heart rate, oxygen saturation, and blood pressure; number and duration of attempts to intubate; and trauma to the oral cavity and upper airway. Twelve studies are included in this review and include 5,410 patients. No studies were excluded based on level of evidence or quality appraisal.

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Copyright © Wolters Kluwer Health, Inc. and/or its subsidiaries. All rights reserved.

Source: O'Connor, T L. (2022). Premedication for Nonemergent Neonatal Intubation: A Systematic Review. Journal of Perinatal and Neonatal Nursing. 2022; 36(3): 284-296. Published: July/September 2022, 2022. DOI: 10.1097/JPN.0000000000000613.



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