Difficulties and strategies associated with nurse integration in critical care provision: a scoping review
Abstract
Introduction: The nurses’ integration in specialized care provision to critically ill patients is an increasing concern in the context of hiring and mobilizing nursing professionals. An adequate integration is crucial for the nurses’ success and adaptation to the new service, as well as to ensure the quality and safety of the provided care.
Objective: To map the existing knowledge on the difficulties experienced by nurses, as well as on the strategies that facilitate their integration in specialized care provision to the critically ill.
Method: A scoping review was conducted, following the method proposed in the Joanna Briggs Institute Reviewers’ Manual 2015. The following were used as inclusion criteria: Population - nurses; Concept - the experienced difficulties and the strategies employed to facilitate the nurses’ integration; Context - the provision of care to the critically ill. A total of 13 articles, published until May 2020, were included.
Results: The following difficulties were reported: communication issues with the team, as well as with the patients and/or their relatives; overall stress; dealing with complex health conditions, as well as with intricate procedures and/or techniques; work overload; high staff turnover rate between services; dealing with a patient’s death and/or with organ donation planning. The following were pointed out as facilitating strategies: simulated practice; performing teamwork; assignment of a nursing supervisor/tutor; receiving feedback; developing resilience mechanisms.
Conclusion: As regards care provision, the nurses’ integration process requires planning and the inclusion of facilitating strategies is crucial. Simulated practice leads to the acquisition of fundamental skills, as does the assignment of a nursing supervisor/tutor and receiving feedback on the conducted tasks. In addition to overcoming the difficulties experienced, these strategies also allow developing resilience and coping mechanisms, which help prevent burnout and the adverse effects caused by the high staff turnover rate between services.
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References
Silvestre M do C de J. Integração De Enfermeiros Em Instituições Hospitalares: Estudo De Caso. Universidade de Aveiro; 2012.
Benner P, Queiroz AA, Lourenço B. O Modelo Dreyfus de Aquisição de Competências Aplicado À Enfermagem. In: De iniciado a perito: excelência e poder na prática clínica de enfermagem. Coimbra: Quarteto Editora; 2001. p. 42–63.
Ballester-Arnal R, Gómez-Martínez S, Gil-Juliá B, Ferrándiz-Sellés MD, Collado-Boira EJ. Burnout y factores estresantes en profesionales sanitarios de las unidades de cuidados intensivos. Rev Psicopatología y Psicol Clínica. 2016;21(2):129–36.
Yu H, Qiao A, Gui L. Predictors of compassion fatigue, burnout, and compassion satisfaction among emergency nurses: A cross-sectional survey. Int Emerg Nurs. 2021;55:100961.
Taveira CAO. Enfermagem … Um Percurso No Saber. Universidade Católica Portuguesa Porto; 2011.
Diário da República. Regulamento de competências específicas do enfermeiro especialista em Enfermagem Médico-Cirúrgica na Área de Enfermagem à Pessoa em Situação Crítica. Regulamento n.o 429/2018 Portugal: Ordem dos Enfermeiros; 2018 p. 19359–64.
Torres RS, Lopez NB, Pedraz OC, Martinez MDCG, Garcia HG, Diez DH, et al. IMPLANTATION OF THE FIGURE “NURSE-TUTOR” FOR TRAINING AND TEACHING STAFF IN AN ICU. Salamanca; 2011.
Villemure C, Tanoubi I, Georgescu LM, Dubé J-N, Houle J. An integrative review of in situ simulation training: Implications for critical care nurses. Can J Crit Care Nurs. 2016;27(1):23–31.
Rice Y, DeLetter M, Fryman L, Parrish E, Velotta C, Talley C. Implementation and Evaluation of a Team Simulation Training Program. J Trauma Nurs. 2016;23(5):298–303.
Linn AC, Caregnato RCA, Souza EN de. Clinical simulation in nursing education in intensive therapy: an integrative review. Rev Bras Enferm. 2019;72(4):1061–70.
Mealer M, Conrad D, Evans J, Jooste K, Solyntjes J, Rothbaum B, et al. Feasibility and acceptability of a resilience training program for intensive care unit nurses. Am J Crit Care. 2014;23(6):e97–105.
Apóstolo JLA. Síntese da evidência no contexto da translação da ciência. Escola Superior de Enfermagem de Coimbra, editor. Coimbra; 2017. 135 p.
Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, Kastner M, et al. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol. 2016;16:1–11.
Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18:1–8.
The Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual 2015: Methodology for JBI Scoping Reviews. The Joanna Briggs Institute. Adelaide: The Joanna Briggs Institute; 2015. p. 1–24.
Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party. JBI Levels of Evidence. Adelaide: The Joanna Briggs Institute; 2014. p. 1–5.
Simone S, McComiskey CA, Andersen B. Integrating Nurse Practitioners Into Intensive Care Units. Crit Care Nurse. 2016;36(6):59–69.
Ballangrud R, Hall-Lord ML, Persenius M, Hedelin B. Intensive care nurses’ perceptions of simulation-based team training for building patient safety in intensive care: A descriptive qualitative study. Intensive Crit Care Nurs. 2014;30(4):179–87.
Macedo APM de C, Padilha KG, Püschel VA de A. Professional practices of education/training of nurses in an intensive care unit. Rev Bras Enferm. 2019;72(2):321–8.
Machado DA, Louro TQ, Figueiredo NMA de, Vianna LMA. THE EXHAUSTION OF NURSING : A INTEGRATIVE REVIEW OF THE BURNOUT SYNDROME IN ICU. Rev Pesqui Cuid é Fundam online. 2012;4(4):2765–75.
Hynes P, Pinto M, Fortier W, Bennett J. The standardization of critical care nursing education and training: Strategies for advancing clinical practice in Ontario’s adult ICUs. Dyn. 2007;18(1):23–7.
Longpré C, Dubois C-A, Nguemeleu ET. Associations between level of services integration and nurses’ workplace well-being. BMC Nurs. 2014;13:1–12.
Fernandes APG, Geraldes JPM, Batista MPJ, Alves PMS. Integração de Enfermeiros no Serviço de Urgência Geral. Sinais Vitais. 2010;92:50–5.
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