Recent Research About Nursing, October 2013

Oct 2, 2013, 9:00 AM

This is part of the October 2013 issue of Sharing Nursing's Knowledge.

Modeling Poor Infection-Prevention for Nursing Students

Clinical practice is a critical part of nursing students’ education, a chance to learn by watching and working alongside trained professionals in a real-world setting. But a new study from Great Britain suggests that in at least one important area of care, students could pick up some bad habits along the way.

An online survey of student nurses, conducted by researchers at Cardiff University and City University, London, found that all 488 respondents had witnessed lapses in infection-prevention and -control practices during their clinical practicums. According to the study, “Over 75 percent reported witnessing failure to cleanse hands between patient contacts, 61.2 percent reported health workers wearing rings (in addition to wedding bands), and 60 percent reported health workers wearing painted nails or nail extensions. Failure to comply with isolation precautions, poor standards of cleaning in the near patient environment, not changing personal protective equipment between patients, and poor management of sharp instruments had each been witnessed by over half the sample.” The researchers conclude, “The study findings indicate that ensuring safe infection control practice remains a challenge in the United Kingdom despite its high priority.”

Survey respondents received their clinical training in National Health Service (NHS) “trusts,” including hospitals, as well as in nursing homes outside the NHS system. The study was published in the September issue of the American Journal of Infection Control.

Read the study.
Read an Advance for Nurses story on the study.

Study: ‘Compassion Fatigue’ Intervention Produces Positive Results

The seemingly constant exposure to stress brought on by long shifts and pressure-laden decision-making while working with patients and families facing illness takes a toll on nurses and other health care professionals, giving rise to what has come to be called “compassion fatigue” and burn-out.

Many hospitals recognize the potential negative implications for workforce retention and quality of care. In 2010, one such institution, Barnes-Jewish Hospital in St. Louis, Missouri, recruited a certified traumatologist to develop a “resiliency” program for staff, and then over a period of several years, measured its results.

In an article published in the December 2013 issue of Nursing Administration Quarterly, Patricia Potter, PhD, RN, FAAN, and two colleagues at Barnes-Jewish describe the program’s key components. “ Through self-regulation, participants learned relaxation skills as a way to reduce negative arousal during times of perceived threat,” they write. “Learning to relax while engaged in caregiving activities helps individuals to relieve sympathetic nervous system dominance. Living intentionally emphasizes the importance of developing and following one's professional covenant of doing his or her very best each day and living by one's professional values…. Perceptual maturation emphasizes the importance of striving to live and work with integrity and seeking self-validation rather than acceptance and acknowledgement from others. Connection emphasizes the importance of cultivating social support in the workplace to identify those who can appreciate and share the stresses of caregiving. Finally, self-care activities are necessary for a health care professional to refuel each day and be able to sustain a passion for caregiving.”

Potter and colleagues write that the program has significantly reduced the risk of burnout and “secondary traumatic stress”—the emotional burden of bearing witness to the suffering of others—among nurses and other providers.

“It helps remind caregivers that they’re doing this to relieve patient suffering, or to give hope,” says Cheryl Palmer, manager of spiritual care services at Barnes-Jewish. “Being able to help patients through stressful times, to help them recover, to comfort their family, to changes lives and to witness people’s lives being changed can be immensely moving and fulfilling. It’s more than a job. It’s a calling for some people to work in health care.”

Read an abstract of the article by Potter et al in Nursing Administration Quarterly.
Read a description of the program on the Barnes-Jewish Hospital website.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.