Nursing Practice Today

Just culture, a neglected culture in health system

Esmaeil Moshiri, ali abbaszadeh, Seyed Hossein Shahcheragh — Mon, 03 Mar 2025 06:02:18 +0330

Patient safety incidents have emerged as a significant global concern, impacting healthcare systems worldwide, as highlighted by the WHO's report of 134 million adverse events annually in hospitals. Healthcare professionals often hesitate to report such incidents due to stigma and the fear of criticism. To combat this, the implementation of a "no-blame culture," introduced by James Reason in 1997, has gained traction, evolving into the concept of a just culture—an environment fostering open discussion of safety-related information without fear of retribution. This approach facilitates an effective incident reporting system and enhances staff capabilities while building organizational trust and accountability. Previous research indicates that adopting a just culture can lead to increased reporting of patient safety incidents, enabling healthcare staff to learn from them, thus reducing the likelihood of future incidents. It’s critical to recognize that a just culture focuses on systemic issues rather than individual blame, which encourages reporting and corrective action. However, this culture is not yet widespread due to misunderstandings. Healthcare leaders and policymakers are urged to promote a just culture by implementing strategies like transparent reporting mechanisms, clear error identification processes, exemplary leadership, and ongoing assessments, ultimately prioritizing patient safety.

Psychometric evaluation of the Farsi version of the stressor scale for emergency nurses

Fazel Dehvan — Mon, 03 Mar 2025 00:00:00 +0330

Background: Emergency department nurses experience unique stressors that contribute to elevated levels of occupational stress. Most existing instruments assess general occupational stress without addressing workplace-specific factors. This study aims to evaluate the psychometric properties of the Farsi version of the Stressor Scale for Emergency Nurses (F-SSEN).

Methods: Face and content validity were assessed by five clinical nurses and five nursing experts, respectively. Construct validity, known group validity, and convergent validity were tested on 198 emergency nurses. The test-retest reliability was evaluated in 21 nurses over a two-week interval. Internal consistency was measured using Cronbach's alpha and McDonald's omega coefficients.

Results: Face and content validity were found to be satisfactory. Exploratory factor analysis (EFA) identified four factors—conflicts, life and death situations, patients' families' actions and reactions, and technical and formal supports—which explained 60.64% of the total variance. Convergent validity showed a correlation of 0.554 between job stress scores based on SSEN and Brief Nursing Stress Scale (BNSS). Known group validity revealed that occupational stress scores were higher in women than in men, and there was a significant negative correlation between occupational stress scores and work experience in the emergency department. Cronbach's alpha and McDonald's omega coefficients were 0.953 and 0.954, respectively, and the intraclass correlation coefficient was 0.943.

Conclusions: The Farsi version of the stressor scale for emergency nurses demonstrates strong psychometric properties, making it reliable for measuring occupational stress in emergency nurses.

Comparison effect of Lavender Oil Inhalation and Tea on Sleep Quality, Fatigue, and Pain in Hemodialysis Patients: A Randomized Clinical Trial

Khadijeh Nasiri — Mon, 17 Feb 2025 09:50:16 +0330

Background & Aim: The pain of arteriovenous fistula, fatigue and sleep disturbances are common problems in hemodialysis patients. Using lavender products can help reduce these problems. This study aimed to comparison the effects of lavender aromatherapy and lavender tea consumption on reducing pain and fatigue, as well as improving sleep quality in HD patients.

Methods and Materials: This study is a randomized clinical trial without blinding conducted at the Dialysis Center in Tabriz University of Medical Science from May to December 2022. Random allocation was done by randomizing the moved blocks. HD patients were allocated to one of the three study groups: control (n=30), lavender inhalation (n=30), and lavender tea (n=30). At the baseline and the end of the study, Participants' sleep quality with PSQI, fatigue with FSS, and pain of needle insertion in arteriovenous fistula with Vas scale were assessed. The data analysis was performed using SPSS software The Analysis of covariance (ANCOVA) test was used to compare the mean of variables between the study groups.

Results: The results showed that the scores of pain, fatigue and sleep quality after the intervention were statistically significant (P < 0.05) compared to before in the lavender tea group and lavender aromatherapy group; but in the control group there was no statistically significant difference (P < 0.05). Also, no statistically significant difference was observed between the lavender tea group and lavender aromatherapy group regarding the scores of sleep quality (P=0.428), fatigue (P=0.570), and pain (P=0.997).

Participants in the lavender tea group and lavender aromatherapy group had a lower score of subjective sleep quality (P<0.001), sleep latency, sleep duration, use of sleep medication, day time dysfunction (P for all <0.001), sleep disturbances (P=0.035), Total score of PSQI (P<0.001), fatigue (P<0.001), and pain (P<0.001) following the intervention compared to the control group. Following the intervention,

Conclusions: The findings of this study showed that the effects of lavender on the nervous system can be useful in improving the problems of dialysis patients, such as sleep quality, fatigue, and pain caused by needle insertion.

Hemodialysis, Lavandula, Fatigue, Sleep Quality, Pain, aromatherapy, complementary medicine

Fiduciary duty in error reporting

Yusrita Zolkefli — Mon, 17 Feb 2025 09:49:33 +0330

The letter centres around a recent study published in the Nursing Practice Today, titled “Medication errors occurrence and reporting: A qualitative study of the Jordanian nurses” (1), which sheds light on the experiences of Jordanian nurses regarding medication error incidence and factors that may influence their decisions to report or not. The study deserves praise for its insightful look at the critical issues of medication errors. Most importantly, this study calls for serious reflection on one’s moral duty in error reporting. Following this call, this commentary will be set on the fiduciary duty of the individual nurse and organization.

Challenges and Barriers to Noncommunicable Disease Management at Community Health Centers in South Sumatera Province, Indonesia: A Qualitative Study

M Agung Akbar, Junaiti Sahar, Etty Rekawati, Rayu Ayu Dewi Sartika — Mon, 17 Feb 2025 09:44:29 +0330

Background: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, heavily impacting low- and middle-income countries like Indonesia. Community Health Centers (CHCs) play a critical role in providing healthcare, including NCD management, but face significant challenges. This study explores the barriers to NCD management at CHCs in South Sumatra Province, Indonesia.

Methods: A qualitative descriptive phenomenological approach was employed to gain an in-depth understanding by healthcare workers in managing NCDs. Data were collected through semi-structured interviews with 12 health workers consist of nurses, doctors, midwives, and public health workers. Thematic analysis was used to data analysis.

Results: The thematic analysis identified five themes, namely Workload and limited resources; Lack of effective interprofessional collaboration; Social and cultural issues ; Work area coverage; and Government policy and support.

Conclusion: These findings highlight the complex challenges faced by CHCs. Addressing them requires a comprehensive strategy to enhance NCD care and primary healthcare services. Policymakers and health system managers can use these insights to develop targeted interventions. Further research is recommended to assess the effectiveness of specific strategies in overcoming these barriers in low-resource settings.