Aim
To evaluate the simulation design characteristics that may influence the stress, anxiety and self‐confidence of undergraduate nursing students during learning.
Design
Systematic review with ...meta‐analysis.
Data Sources
Searchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation.
Review Methods
This review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi‐experimental studies that compared the effect of simulation on stress, anxiety and self‐confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta‐analytical methods.
Results
Eighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta‐analysis, the presence of prebriefing, duration of more than 60 min and high‐fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high‐fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self‐confidence.
Conclusions
Different modulations of simulation design components imply reduction of anxiety and increased self‐confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions.
Relevance to Clinical Practice
These findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice.
No Patient or Public Contribution.
Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution ...proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of an ED Triage Center for patients with suspected novel coronavirus disease (Covid-19) and characterize the patient flow.
In March 2020, we established a Covid-19 triage center close to the Liège University EDs. From March 2 to March 23, we planned to analyze the specific flow of patients admitted to this triage zone and their characteristics in terms of inner specificities, work-up and management. During this period, all patients presented to the ED with symptoms suggestive of Covid-19 were included in the study.
A total amount of 1071 patients presented to the triage center during the study period. 41.50% of the patients presented with flu-like symptoms. In 82.00% of the cases, no risk factor of virus transmission was found. The SARS-Cov2 positive patients represented 29.26% of the screened patients. 83.00% of patients were discharged home while 17.00% were admitted to the hospital.
Our experience suggests that triage centers for the assessment and management of Covid-19 suspected patients is an essential key strategy to prevent the spread of the disease among non-symptomatic patients who present to the EDs for care. This allows for a disease-centered work-up and safer diversion of Covid-19 patients to specific hospital units.
The COVID-19 pandemic disrupted the world beginning in Mar 2020. The impact of the pandemic was widespread, affecting how many interacted with the health care system, including nursing students. The ...safety of the traditional clinical learning environment (CLE) for nursing students was questioned as COVID-19 spread quickly, putting staff and nursing students at risk for catching and transmitting the virus. Here, Sferrazza et al investigate nursing students' perception of the quality of their experiences in the CLE as it changed with the pandemic.
Abstract Objectives: to analyze the effectiveness on health education to prevent nipple trauma in breastfeeding compared to other interventions. Methods: systematic literature review was carried out ...in January 2019, according to PRISMA recommendations. The searches were conducted in Cinahl, PubMed, Web of Science, Scopus, and in the references cited in the selected articles. The studies were assessed for quality and level of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: twelve studies were selected, all conducted at the maternities. The interventions were classified in two categories: health education on breastfeeding and the use of nipple covers. Health education on breastfeeding presents a moderate level of evidence on the prevention of nipple trauma. There is a moderate to high level of evidence on the positive effects of guaiazulene, gel or peppermint water applied in the postpartum period to prevent nipple trauma. Conclusion: health education on breastfeeding with clinical demonstration is an important strategy to prevent nipple trauma and requires more than one educational approach. The use of nipple covers requires some consideration, since they must be removed prior to breastfeeding. All interventions were conducted in the postpartum period, which points out for the necessity of clinical research to prevent nipple trauma in prenatal care.
Resumo Objetivos: analisar a eficácia da educação em saúde para a prevenção do trauma mamilar na amamentação comparado a outras intervenções. Métodos: revisão sistemática realizada em janeiro de 2019, segundo recomendações PRISMA. As buscas foram realizadas na Cinahl, PubMed, Web of Science, Scopus e referências citadas nos artigos selecionados. Os estudos foram avaliados quanto à qualidade e nível de evidência conforme o sistema Grading of Recommendations, Assessment, Development and Evaluation. Resultados: foram selecionados 12 estudos, todos executados em maternidades. As intervenções foram representadas em duas categorias: educação em saúde sobre amamentação e uso de coberturas mamilares. A educação em saúde sobre amamentação apresenta moderada evidência na prevenção do trauma mamilar. As coberturas de gel ou água de hortelã-pimenta, de guaiazulene, aplicadas no pós-parto, têm efeito positivo na prevenção do trauma mamilar, com moderada a alta evidência. Conclusão: a educação em saúde sobre amamentação, com demonstração clínica, configura-se importante estratégia para prevenção do trauma mamilar, devendo ser realizada mais de uma abordagem educativa. A implementação de coberturas mamilares precisa ser ponderada, pois todas exigiram remoção antes da mamada. Todas as intervenções foram conduzidas no pós-parto, o que aponta para a necessidade de pesquisas clínicas sobre a prevenção do trauma mamilar no pré-natal.
to develop and assess the serious game e-Baby Família with parents of premature infants.
a methodological study regarding the development of the serious game, with participatory design in scope ...definition, starting from parents' learning needs about premature infant care. A qualitative approach was performed in the assessment stage with parents, with content analysis of the speech of the eight participants.
the following categories emerged: Realistic appearance of the virtual setting and game content and Gameplay implications for the use of e-Baby Família. The game was satisfactorily assessed regarding content, appearance and dynamics use, motivating participants to learn.
in the context of prematurity as a public health problem in Brazil and the need to strengthen family health education for care, the serious game was assessed as motivating and appropriate for health learning.
This study aimed to analyze the effectiveness of breast shells in preventing pain and nipple injury during breastfeeding.
A non-randomized clinical trial was carried out with blinding to the ...evaluators of the study results. The study included women with ≥35 weeks of singleton pregnancy, no nipple changes, and a desire to breastfeed. Resulting in 62 lactating women. The experimental group used breast shells and health education with clinical demonstration (n = 29), whereas the control group used no breast shells (n = 33). Pain and nipple injury were assessed three times, twice prenatally and once up to 14 days postpartum.
Nipple injury (50.0%) and nipple pain (67.7%) presented with similar frequency in both groups (p = 1). Breast engorgement (35,5%) was associated with nipple pain (p = 0.019) and its onset was delayed in the experimental group (p = 0.001). Health education contributes to breast and nipple care and increases favorable breastfeeding patterns.
Breast shells do not prevent nipple pain or injury.
As far as we know, this is the first clinical research evaluating the use of breast shells since the antenatal care to prevent the occurrence of nipple pain and injury.
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