Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a heel puncture for screening using the Newborn Pain Scale (NIPS), measure the heart rate and compare the effectiveness of non-pharmacological methods of pain control. Design: Randomized clinical trial. No experimental factors. The test was performed during routine screening. Surroundings: Provincial Specialist Hospital in Olsztyn. Patients/Participants: Pain was assessed in 90 full-term newborns. The newborns were rooming in with their mothers in the hospital. Interventions: Newborns were divided into three groups. Three different methods of pain relief were used: breastfeeding, 20% glucose administered orally and non-nutritional sucking. Main Outcome Measures: The primary pain outcome was measured using the NIPS and the secondary pain outcome measures (heart rate, oxygen saturation) were measured using a pulse oximeter. Results: During capillary blood sampling from the heel, most newborns, n = 56 (62.2%), experienced no pain or mild discomfort, severe pain occurred in n = 23 (25.6%) and moderate pain occurred in n = 11 (12.2%). No significant statistical differences were found between the degree of pain intensity and the intervention used to minimize the pain p = 0.24. Statistically significant relationships were demonstrated between heart rate variability and the degree of pain intensity (p = 0.01). There were no statistically significant differences between the newborn’s pain intensity and the mother’s opinion on the effectiveness of breastfeeding in minimizing pain. Conclusions: This study did not answer the question of which pain management method used during the heel prick was statistically more effective in reducing pain. However, the results indicate that each of the non-pharmacological interventions (breastfeeding, oral glucose dosing and non-nutritive sucking) applied during heel puncture resulted in effective pain management in most of the newborns enrolled in the study. The relationship between heart rate variability and the severity of pain was confirmed. Mothers of newborns in the breastfeeding group were satisfied with the pain relief methods used in the child and the opportunity to console their newborn during painful procedures in a technologically invasive environment.

Background: The Clinical Learning Environment, Supervision and Nurse Teacher Scale(CLES+T) instrument is internationally used for the evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education.Purpose: To examine the basic psychometric properties of CLES+T in the context of clinical postgraduate nursing education in Poland.Methods: Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland.Results: Cronbach’s alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach’s alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52 ± 0.63 fornursing care on the wardto 4.73 ± 0.45 forrole of the nurse teacher.Conclusions: Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.

The presence of a central venous catheter (CVC) leads to a high risk of blood infections, which are considered major causes of morbidity, mortality and high medical costs. The aim of this study was to assess the knowledge of nursing staff working in intensive care units (ICUs) regarding the prevention of central-line-associated bloodstream infections (CLABSIs). A nationwide survey was conducted among ICU nurses from August 2016 to April 2017. A modified Polish version of the questionnaire developed by Labeau et al. was used to assess the nurses’ knowledge. Of the 750 questionnaires distributed, 468 were returned. Women accounted for 95.73% of all respondents, and over 80% were university educated. Most of the nurses surveyed (85.9%) had previously received training in CVC guidelines, and thus over 82% rated their knowledge as good or very good. The guidelines introduced in hospitals were the main declared sources of information. In addition, more than half (68%) of respondents also knew the international guidelines. The knowledge of nursing staff in the study area is not sufficient. Studies show that the guidelines for the prevention of CLABSIs in ICUs should be standardized, and continuous training of personnel in this field should be provided.

Purpose: To describe sleep assessment and strategies to promote sleep in adult ICUs in ten countries. Methods: Multicenter, self-administered survey sent to nurse managers. Results: Response rate was 66% with 522 ICUs providing data. lying quietly with closed eyes' was the characteristic most frequently perceived as indicative of sleep by > 60% of responding ICUs in all countries except Italy. Few ICUs (9%) had a protocol for sleep management or used sleep questionnaires (1%). Compared to ICUs in Northern Europe, those in central Europe were more likely to have a sleep promoting protocol (p < 0.001), and to want to implement a protocol (p < 0.001). In > 80% of responding ICUs, the most common non-pharmacological sleep-promoting interventions were reducing ICU staff noise, light, and nurse interventions at night; only 18% used earplugs frequently. Approximately 50% of ICUs reported sleep medication selection and assessment of effect were performed by physicians and nurses collaboratively. A multivariable model identified perceived nursing influence on sleep decision-making was associated with asking patients or family about sleep preferences (p = 0.004). Conclusions: We found variation in sleep promotion interventions across European regions with few ICUs using sleep assessment questionnaires or sleep promoting protocols. However, many ICUs perceive implementation of sleep protocols important, particularly those in central Europe.