Historically, the nursing metaparadigm has been used to describe 4 concepts of nursing knowledge (person, environment, health, and nursing) that reflect beliefs held by the profession about nursing's context and content. The authors offer an assessment of the metaparadigm as it applies to community and public health nursing in urban settings and offer an amendment of the metaparadigm to include the central concept of social justice. Each of the metaparadigm concepts and the central concept of social justice is discussed as it applies to a model of urban health nursing teaching, research, and practice. PMID:17214656

biro a.l. (2012) Journal of Nursing Management 20, 1002-1011 Creating conditions for good nursing by attending to the spiritual Aim? To note similarities, differences, and gaps in the literature on good nursing and spiritual care. Background? Good nursing care is essential for meeting patient health needs. With growing recognition of the role of spirituality in health, understanding spiritual care as it relates to good nursing is important, especially as spiritual care has been recognized as the most neglected area of nursing care. Methods? Nursing research, reports and discussion articles from a variety of countries were reviewed on the topics of good nursing, spiritual care and spirituality. Key issues? A nurse's spirituality and the nurse-patient relationship are integral to spiritual care and good nursing. Conclusions? There are many commonalities between good nursing and spiritual care. Personal attributes of the nurse are described in similar terms in research on spiritual care and good nursing. Professional attributes common to good nursing and spiritual care are the nurse-patient relationship, assessment skills and communication skills. Implications for nursing management? Good nursing through spiritual care is facilitated by personal spirituality, training in spiritual care and a culture that implements changes supportive of spiritual care. Further research is needed to address limitations in the scope of literature. PMID:23151102

A valid and reliable nursing culture assessment tool aimed at capturing general aspects of nursing culture is needed for use in health care settings to assess and then reshape indicated troubled areas of the nursing culture. This article summarizes the Nursing Culture Assessment Tool's (NCAT) development and reports on a cross-sectional, exploratory investigation of its psychometric properties. The research aims were to test the tool's psychometric properties; discover its dimensionality; and refine the item structure to best represent the construct of nursing culture, an occupational subset of organizational culture. Empirical construct validity was tested using a sample of licensed nurses and nursing assistants (n = 340). Exploratory and confirmatory factor analysis (CFA) and logistical regression yielded a 6-factor, 19-item solution. Evidence supports the tool's validity for assessing nursing culture as a basis for shaping the culture into one that supports change, thereby accelerating, improving, and advancing nursing best practices and care outcomes. PMID:22523245

Background: The use of standardized patients is an established training technique in medical education. However, this problem-based learning approach is relatively new to the field of nursing education. Its benefits to undergraduate nursing education continue to be underinvestigated in the nursing literature. Purpose: The purpose of this study was to examine the effectiveness of using standardized patients in improving health assessment skills among first-year nursing students. Methods: A comparative design was conducted on a convenience sample of 108 first-year undergraduate nursing students. Study participants were recruited from a university and community college collaborative nursing program in southwestern Ontario. Results: Analysis of covariance results showed that after adjusting fo...

Maternal and child health (MCH) nurses are vital to caring for the nation's infants, children, and adolescents. A shortage of pediatric nursing educators has important consequences for the preparation of the next generation of MCH nurses. A Web-based survey of administrators and pediatric nursing faculty from U.S. schools of nursing with baccalaureate and advanced degree programs was conducted to assess perceptions of a pediatric nursing faculty shortage, and implications and solutions to such a shortage. Deans (n = 191) and pediatric faculty (n = 237) from schools of nursing responded to the survey. Institutions are representative of the 660 schools of nursing across the United States. Fifty percent of deans and 70% of pediatric nursing faculty members reported a shortage of pediatric nur...

Aims of this representative study were to assess the relevant differences between the work and organisational characteristics as well as the subjective resources and health status of nurses occupied in hospice care, compared to nurses from palliative stations. Further, the assessment of the predicti...

The aim was to describe and compare nursing assistants', enrolled nurses' and registered nurses' perceptions of quality of care, working conditions, competence and personal health in older peoples' care. Altogether 70 nursing assistants, 163 enrolled nurses and 198 registered nurses completed a questionnaire comprising Quality from the Patient's Perspective modified for caregivers, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items on education and competence and Health Index. The caregivers reported higher perceived reality of quality of care in medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere. In subjective importance, the highest rating was assessed in one of the physical-technical items. The organisational climate was for three of the dimensions rather close/reached the value for a creative climate, for seven dimensions close to a stagnant climate. In perceived stress of conscience, there were low values. Nursing assistants had lower values than enrolled nurses and registered nurses. The caregivers reported highest values regarding previous education making them feel safe at work and lowest value on the item about education increasing the ability for a scientific attitude. Registered nurses could use knowledge in practice and to a higher degree than nursing assistants/enrolled nurses reported a need to gain knowledge, but the latter more often received education during working hours. The health index among caregivers was high, but registered nurses scored lower on emotional well-being than nursing assistants/enrolled nurses. The caregivers' different perceptions of quality of care and work climate need further attention. Although stress of conscience was low, it is important to acknowledge what affected the caregivers work in a negative way. Attention should be paid to the greater need for competence development among registered nurses during working hours. PMID:23088213

It is thought that new technologies like computers at the patient's bedside, or point of care technology (PCT) improve nursing productivity, documentation, patient satisfaction and decrease costs. Using the Health Care Technology Assessment (HCTA) framework, (safety, cost, effectiveness, social impa...

Background: There is little research on nursing students' application of family health assessment in clinical practice. Objective: To examine the effect of an elective course, Family in Health and Illness (FHI), on year 4 nursing students' family health assessment and practice. Methods: A quasi-experimental design was used. One hundred and twenty students completed pre- and post-course questionnaires, after taking FHI (n=49) or a course in Women's Health (WH; n=71) in a baccalaureate nursing program in Hong Kong. Students rated their interest in family assessment and appraised their own confidence and competence in practicing family nursing before the courses commenced, immediately after, and three months post course completion. In addition, their perceived ease of applying family assessme...

NISHIYAMA M., WOLD J.L. &PARTSKHLADZE N. (2008) Building competencies for nurse administrators in the republic of Georgia. International Nursing Review55, 179-186 Aim: To assess the level of competency among nurse administrators in the Republic of Georgia (Georgia) and to recommend interventions to implement effective nursing management practices in a resource constrained setting. Background: The collapse of the Soviet Union in 1991 resulted in deterioration of the healthcare system in Georgia. Even though the 1995 healthcare reformers recognized that baccalaureate educated nurses were essential resources for quality health care, limited resources delayed further steps. Hence, Georgia has struggled to raise nursing education levels and to establish nursing as a professional occupation. Stu...

Medicine administration is a high risk activity that most nurses undertake frequently. In this paper, the views of registered mental health nurses and final year student nurses are evaluated about the usefulness of the Medicines with Respect Assessment of the Administration of Medicines Competency Framework. A questionnaire using 22 items with closed and open response questions was distributed to 827 practising mental health nurses and 44 final year mental health nursing students. This article presents a content analysis of written replies to the open response questions. Four overlapping themes were identified in response to the open questions posed in the survey: (1) reasons for undertaking the Medicines with Respect Framework; (2) positive aspects; (3) negative aspects; and (4) service u...

Aims. To assess the effects of exercise intervention on nurses' health-related physical fitness. Background. Regular exercise that includes gymnastics or aerobics has a positive effect on fitness. In Taiwan, there are not much data which assess the effects of exercise intervention on nurses' health-related physical fitness. Many studies have reported the high incidence of musculoskeletal disorders (MSDs) in nurses However, there has been limited research on intervention programs that are designed to improve the general physical fitness of nurses. Design. A quasi-experimental study was conducted at a medical centre in central Taiwan. Methods. Ninety nurses from five different units of a hospital volunteered to participate in this study and participated in an experimental group and a control...

This article assesses how well physicians, health administrators, patient-contact employees, and especially medical and nursing students understand patient expectations for service quality as measured by the SERVQUAL scale. Using a cross-sectional research design and discriminant analysis, it was found that health administrators were most likely to accurately estimate the service expectations of patients, while medical and nursing students were most likely to underestimate them. PMID:10808414

While studies have been conducted to assess nurse perception of electronic health records, once electronic health record systems are up and running, there is little to guide the use of features within the electronic health record for nursing practice. Alerts are a promising tool for implementing best practice for patient care in inpatient settings. Yet the use of alerts for inpatient nursing is understudied. This study examined nurse attitudes and reactions to alerts in the inpatient setting. Focus groups were conducted at three hospitals with 50 nurses. Nurses were asked about five different alert features. For each alert, participants were asked about their feelings and reactions to the alert, how alerts help or hinder work, and suggestions for improvements. Findings include clear preferences for alert types and content. Nurses preferred a dashboard style alert with functions included to accomplish tasks directly in the alert. While nurses reported positive reactions to certain alert pages, they also reported low use of those features and occasional distrust of the data included in alerts. Findings provide guidance for future use of alerts and design of new alerts. Findings also identify the important challenge of designing and implementing alerts for integration with nursing workflow. PMID:22045117

Abstract Aims.- This paper is a report of a study, which assessed levels of stress amongst nurses working in a healthcare telephone-advice service. We explored whether stress related to performance, sickness absence, and intention to leave. Background.- Nurses report high levels of stress, as do call-centre workers. The emergence of telephone health advice services means many nurses now work in call-centres, doing work that differs markedly from traditional nursing roles. Stress associated with these roles could have implications for nurses, patients, and service provision. Design.- This paper reports cross-sectional survey results. The design of the overall study included longitudinal elements. Method.- A comprehensive study of stress was conducted amongst nurses working for a telephone-a...

alligood m.r. (2011) Journal of Nursing Management19, 981-988-Theory-based practice in a major medical centre Aims- This project was designed to improve care quality and nursing staff satisfaction. Background- Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. Methods- An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Results- Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Conclusions- Modelling and Role-Modelling demonstrated capacity to structure n...

The main objective of the study is assessing knowledge, opinions and compliance with the procedures of health professionals (physician, nurses, medical and nursing students) about Hand Hygiene (HH). There is a number of research which indicates that physicians respect less than nurses Hand Hygiene, there are a smaller number which investigates the differences in the attitude of the aforementioned subjects during their studies. A questionnaire was administered to a sample of 756 participants (252 doctors, 268 nurses, 117 nursing students and 119 students of medicine) at a large University Hospital in Rome, to determine their knowledge, compliance and procedures with Hand Hygiene. Knowledge of medical students is lower than that of nursing students, as well as they have lower values in adherence to practice. In both HH Beliefs Scale (HBS) and HH Practicies Inventory (HHPI) questionnaires, nursing students have higher scores than nurses, doctors and medical students. The questions on the use of alcohol-based cleaners have been those where there was the lowest number of correct responses, across all professions. Physicians compared to nurses have a lower adherence to Hand Hygiene. Future research should clarify what the differences are in the construction of the study on the practice of washing hands, what are the barriers to health professionals and best methods for teaching habits, namely the effectiveness of hand washing. Professionals should be more involved in the fight against Healthcare-associated infections. PMID:22304723

ACCESSIBLE SUMMARY: •? Professional education and policy strategies increasingly stress the need for service users to be involved in the education of all nursing students, including students undertaking mental health field programmes. •? In this study, a sample of recently graduated mental health nursing students, are asked to describe their perceptions of increased service user involvement in mental health nursing programmes. •? The findings of the study demonstrated that recently graduated students were supportive of service user involvement. Study participants recognize the value of this involvement, the need to protect users who may be vulnerable and the clear benefits to both personal and service development, which will result from increased user engagement. ABSTRACT: Increasingly providers of mental health nurse education are required to demonstrate user involvement in all aspects of these programmes including student selection, programme design and student assessment. There has been limited analysis of how nursing students perceive user involvement in nurse education programmes. The aim of this study has been to explore mental health nursing student's perceptions of involving users in all aspects of pre-registration mental health nursing programme. Researchers completed a number of focus group interviews with 12 ex-mental health nursing students who had been recruited by purposeful sampling. Each focus group interview was recorded and analysed using a series of data reduction, data display and verification methods. The study confirms many of the findings reported in earlier user participation in education studies. Three main themes related to user involvement have been identified: the protection of users, enhanced student learning and the added value benefits associated with user involvement. PMID:22533371

Increasing interest has been focused on understanding the role working conditions play in terms of the serious issues facing hospitals today, including quality of patient care, nurse shortages, and financial challenges. One particular working condition that has been the subject of recent research, is the impact of organizational climate on nurses' well-being, including occupational health outcomes. To examine evidence-based research on the association between organizational climate and occupational health outcomes among acute-care registered nurses, a systematic review of published studies was conducted. Studies assessing the association between organizational climate variables and three common health outcomes in nurses (blood/body fluid exposures, musculoskeletal disorders, and burnout) were reviewed. Fourteen studies met the inclusion criteria. Although most were cross-sectional in design and variability was noted across studies with respect to operational definitions and assessment measures, all noted significant associations between specific negative aspects of hospital organizational climate and adverse health impacts in registered nurses. While evidence for an association between organizational climate constructs and nurses' health was found, data were limited and some of the relationships were weak. Additional studies are warranted to clarify the nature of these complex relationships.   

Objectives The purpose of this study was to develop a self-assessment tool for evaluating the quality of services provided in nursing homes in Japan and to test the validity of the imputation method for the analysis of missing data. Design A mailed survey based on a self-administered questionnaire. Setting Gifu Prefecture in central Japan. Participants We recruited 124 health care workers from 15 nursing homes located in the Gifu Prefecture. Measurements Demographic data, self-assessment of the quality of services provided in nursing homes, Maslach Burnout Inventory—General Survey, General Health Questionnaire, self-rated score of the nursing facility, and job satisfaction. Results Factor analysis with maximum-likelihood estimation extracted a factor in both the complete observed da...

The four most common types of abuse are physical, sexual, emotional, and economic. Abuse is often further categorized into child abuse, intimate partner violence, and elder abuse. This article describes the important role that nurses and health care providers play in detecting, assessing, and reporting abuse. Armed with increased knowledge about signs and symptoms of abuse, nurses can guide patients to the appropriate resources. PMID:22055896

Abstract Objective: To alter staff perceptions, and to examine alternative management processes for intoxicated patients brought to Ipswich ED under mental health emergency examination orders by comparing disposition outcomes with non intoxicated patients. Methods: Consultation Liaison mental health nursing staff completed surveys on all patients assessed under emergency examination orders over a 6 month period in 2008. Patients were classified as intoxicated if they recorded alcometer readings of greater than 0.05%, or self reported drug use during the events leading to their transport to the ED. Outcomes were retrospectively collated with entries in Clinical Liaison nursing logbooks. Outcome measures recorded were rates of admission, outpatient referrals to the Integrated Mental Health S...

Young adolescents, age 10-15 years, have increasing psychosocial and biomedical health care needs, yet are some of the lowest users of conventional health services. In eastern North Carolina, school-based health centers (SBHCs) provide primary health care to thousands of school-age children in the most rural, medically underserved areas. SBHCs receive reimbursement from local, state, and private funding sources and their viability depends on the demonstration of outcomes. Using the Guidelines for Adolescent Preventive Services (GAPS) assessment tool, an SBHC-university nursing partnership evaluated the use of preventive health services by fifth and sixth grade students (n = 690). Findings suggest that the vast majority of early adolescents needed a referral for a physical exam, nutrition, mental health, or health education services. This article describes key components for a successful SBHC-university nursing partnership that can evaluate and improve existing school health programs. (Contains 1 figure and 1 table.)

Background: Oral hygiene has an important role in maintaining the health and well-being of critically ill patients. Although a number of studies have examined nurses' oral hygiene practices, few were conducted among nurses caring for critically ill patients or involved Asian nurses. Objectives: The study aims to assess local nurses' knowledge, attitudes, and practices regarding oral care for critically ill patients. Methods: A descriptive cross-sectional design was used. We developed a 31-item questionnaire based on the literature, existing questionnaires, and focus group discussion. The tool covers three domains: beliefs and attitudes, prevailing practices, and knowledge. We sampled all nurses who worked in five intensive care units and high dependency during a 2-week period. We summarize...

Scand J Caring Sci; 2012; 26; 598-606 The patient satisfaction with nursing care quality: the psychometric study of the Serbian version of PSNCQ questionnaire Introduction:- Patient satisfaction with nursing is the most important predictor of patients- overall satisfaction with their hospital care. According to the Law of Health Care of Republic of Serbia monitoring of patients- satisfaction with hospital service is mandatory; however, the questionnaire applied to that purpose includes only several questions directly addressing the nursing care issue. Aim:- The aim of the present study was to evaluate psychometric properties of the Serbian version Patient Satisfaction Nursing Care Quality Questionnaire (PSNCQQ) and explore patients- satisfaction of nursing care they received and assess the...

Background: Deep tissue injuries are severe damages underneath the intact skin caused by long-endured, unrelieved pressure or shear forces. Empirical evidence regarding the magnitude of this health problem is limited. Objective: Investigation of the prevalence, characteristics of persons affected and identification of the most affected body locations. Design: Two cross-sectional studies in 2008 and 2009. Settings: Nursing homes and hospitals throughout Germany. Participants: 6919 (year 2008) and 8451 (year 2009) hospital patients and nursing home residents. Methods: Trained nurses conducted full skin assessments and collected demographic data based on written data collection forms. The Braden scale was used to measure pressure ulcer risk. Results: Pressure ulcer prevalence including grades...

Background HPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake. Methods and Findings A rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake. Conclusions Despite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities in childhood and adolescent vaccination programmes. PMID:21298291

...health aide, licensed practical nurse, or similarly trained individual...includes meetings with the OWCP nurse and the employer. The reduction...including charges for field nurses, vocational rehabilitation...third party are not payments in satisfaction of liability for causing...

Multiple-choice questions are a common assessment method in nursing examinations. Few nurse educators, however, have formal preparation in constructing multiple-choice questions. Consequently, questions used in baccalaureate nursing assessments often contain item-writing flaws, or violations to acce...

Evidence-based practice has become a dominant trend in the healthcare with the objective of providing efficient, high quality health care, and policy making. Traditional problem-solving methods may not adequately address consumer needs in the rapidly changing modern healthcare system. In order to make correct decisions, a systematic and scientific approach to the collection, assessment, and interpretation of clinical information is essential for the health care provider. Creating an evidence-based practice nursing culture is the most fundamental way for nurses to recognize the importance of evidence-based nursing and, subsequently, adapt to solving clinical problems. This paper elaborates the strategy for incorporating evidence-based nursing into the clinical ladder system used at the authors' affiliated medical center. Three strategies are introduced. These are: (1) including the EBN concept in newcomer in-service training; (2) adopting evidence-based nursing practice competence as a criterion in the clinical ladder system, with various evidence-based, ladder-related reports required for promotion; and (3) providing support to nurses through centralized and decentralized education as well as individual consultation. The proposed strategy is provided as a practical reference for educators and policy makers working to foster evidence-based practice nursing cultures. PMID:21455895

Abstract in english Background: Not all the techniques for the correct use of metered dose inhalers are used by patients and health care professionals. Aim: To assess the techniques and errors in the use of metered dose inhalers among patients and health care professionals. Material and methods: Evaluation of the inhaling technique, using a validated questionnaire, used by 68 patients, 30 physicians and 30 nurses working in a hospital at Concepción, Chile. Results: The "closed mouth" techni (more) que is used by 84% of patients, 40% of physicians and 73% of nurses. The rest uses the "open mouth" technique. The aerochamber is used by 12% of patients, 37% of physicians and 27% of nurses. The most frequent inhaling errors detected were not shaking the inhaler (26% of patients, 30% of physicians and 7% of nurses), not applying the puff at the start of inspiration (28% of patients, 7% of physicians and 13% of nurses), and not maintaining an apnea after the inhalation (41% of patients, 7% of physicians and 10% of nurses). Sixty percent of patients, 67% of physicians and 40% of nurses have not received instructions about the inhaler use. Conclusions: There is a high frequency of errors in the use of inhalers and most users have not been trained in its use. (Rev Méd Chile 2001; 129: 413-20)

The journal impact factor (JIF), and how best to rate the performance of a journal and the articles they contain, are areas of great debate. The aim of this paper was to assess various ranking methods of journal quality for mental health nursing journals, and to list the top 10 articles that have received the most number of citations to date. Seven mental health nursing journals were chosen for the analysis of citations they received in 2010, as well as their current impact factors from two sources, and other data for ranking purposes. There was very little difference in the top four mental health nursing journals and their overall rankings when combining various bibliometric indicators. That said, the International Journal of Mental Health Nursing is currently the highest ranked mental health nursing journal based on JIF, but publishes fewer articles per year compared to other journals. Overall, very few articles received 50 or more citations. This study shows that researchers need to consider more than one ranking method when deciding where to send or publish their research. PMID:22583749

an important role in establishing endogenous analgesia during visceral pain ...... 48 p Prepared in cooperation with Harvard School of Public. Health, Boston, MA ... the clinical assessments by the nurse practitioners and the subjects' physicians ...... achieving technology readiness for the Initial Lunar Outpost by. 1995-97.

We assessed the association between a glutamine repeat polymorphism in AIB1 and breast cancer risk in a case-control study (464 cases, 624 controls) nested within the Nurses' Health Study cohort. We observed no association between AIB1 genotype and breast cancer incidence, or specific tumor characte...

Aims and objectives. This study examines the impact of implementing a new pay system (Agenda for Change) on nursing staff in the National Health Service (NHS) in the UK. This new pay system covered approximately 400,000 nursing staff. Its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. Background. The new system aimed to provide a simplified approach to pay determination, with a more systematic use of agreed job descriptions and job evaluation to price individual jobs, linked to a new career development framework. Design. Secondary analysis of survey data. Methods. Analysis of results of large scale surveys of members of the Royal College of Nursing of the United Kingdom (RCN) to assess the response of nurses to questions abou...

Obesity in children and adolescents has become an epidemic in the United States. The ramifications of obesity at a young age are longstanding and affect physical health, emotional health, and the economics of the health care industry. The Strong Pediatric Practice at Golisano Children's Hospital is a large inner-city practice serving more than 14,000 urban children and adolescents, the majority living below the poverty level. The Obesity Task Force, which comprises four nurse practitioners, two nurses, a nutritionist, and one physician, developed and implemented the "Passport to Health" tool in an attempt to encourage providers to assess and work with families around the issues of weight and activity, a need that was identified through chart audits. The Passport to Health supports the poli...

Background: Geriatric patients recently discharged from hospital are at risk of unplanned readmissions and admission to nursing home. When discharged directly from Emergency Department (ED) the risk increases, as time pressure often requires focus on the presenting problem, although 80% of geriatric patients have complex and often unresolved caring needs. Objective: To investigate a structured nursing intervention’s impact on geriatric patients’ unresolved problems and their use of help from the community health centre. Method: We conducted a prospective descriptive study of selected geriatric patients with nursing intervention at discharge and 1 and 6 months follow-up. Included were geriatric patients 70+ years discharged to their home October 2006-June 2008. Intervention: After detecting the geriatric patients planned to be discharged, the geriatric nurse in the ED did a brief standardised nursing assessment developed by McCusker et al. comprising a checklist of physical, mental, medical and social problems. Focus was on unresolved problems that required medical intervention, new/different home care services or comprehensive geriatric assessment. After assessment the nurse made relevant referrals to geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: 150 geriatric patients participated, mean age 81.7 (70-99). At discharge they had in mean 2 164 (0-9) unresolved problems, after 1 month 0.8 (0-5), and after 6 months 0.5 (0-4). Before baseline ED visit 85 % of the patients received home care services, 1 and 6 months after discharge it was 96 %. Relevance to clinical practice: Structured nursing assessment and intervention in the ED could be a way of discovering geriatric patients’ unresolved problems and preventing further functional decline and readmission. To confirm the effect a randomized controlled trial including 270 patients is carried out as part of my PhD study at University of Southern Denmark. Data is collected from Copenhagen University Hospital Amager.

... team may include: • specialized nurse care managers • pharmacists • clinical health educators • dietitians, • social workers, and • specialists in ... failure may include: • specialized nurse care managers • pharmacists • clinical health educators • dietitians, • social workers, and • specialists in ...

ABSTRACT Occupational health has been considered a subset of public health nursing for years. The first industrial or occupational health nurses were employed by large companies in the 1890s but the role evolved quickly in the early 20th century. By mid-century, many large companies employed a physician and nurse(s) to provide examinations, screenings, episodic care, and trauma intervention for workers. Occupational health nurses faced different problems than community-based public health nurses in generalized nursing service. The intersection of public health and employee health was apparent, though, because large industries often constituted the main workplace for a smaller community and sickness could spread throughout a town if the occupational health nurse was not well-prepared in pri...

Whilst the experience of a patient suicide is likely to have a significant impact upon the nurses who had been providing care, little work has actually explored this experience in any depth. In this article we explore how two psychiatric nurses construct and orient to accountability when talking of their experiences of a patient suicide. Discourse analysis was used to explore particular phases that the nurses oriented to in their accounts: scene setting; risk assessment; attributing for the suicide. Findings highlight the different, sometimes contradictory, ways the nurses attended to interactional concerns relating to implicit accountability and potential inferences of blame. Analysis of the nurses’ talk can make a valuable contribution to understanding the nature and the impact of ‘accountability’ in a mental health setting and so help nurses and other professionals gain an insight into their practice. The results from this study suggest that as a consequence of internalising fundamentally unrealisable expectations regarding suicide prevention, nurses can hold themselves to blame raising significant concerns around their needs in terms of support, which may not be recognised. This paper also makes a valuable contribution to our methodological understanding and the value of using discourse analysis in this setting.

Traditionally in the UK, the transportation of the critically ill child to a paediatric intensive care unit has been carried out by a medically led team of doctors and nurses. However, in countries such as the USA and Canada, appropriately trained nurse practitioners have proven to be competent in the transportation of these vulnerable children. This nurse-led team model has also been shown to be successful in the speciality of neonatal care in the UK. The impact of changes in the National Health Service (NHS) has led to an increased demand for the transportation of the child requiring paediatric intensive or high-dependency care, the lifting of restrictions on nursing practice and the reduction of doctors' hours in keeping with the European Working Time Directive. This has led to one NHS Trust in the UK developing the role of paediatric retrieval nurse practitioners (RNP): nurses who lead the retrieval team. The purpose of this article is to describe a pilot initiative to develop the role of RNPs. The comprehensive process of recruitment, training and assessment of competency will be detailed. Personal reflection on the project will also explore the pertinent nursing issues around; role impact and definition, conflict and change management, communication, legislation and personal and professional growth. Recommendations for future initiatives will also be explored. PMID:17883631

To create a presence in Second Life (SL) the university college of nursing (CON) purchased four virtual islands in December 2007. The intent was to enhance distance education with immersion learning experiences for nursing students in SL. The Pollock Alumni House, classrooms, faculty offices, a library, a student welcome center, a public health office, a disaster scenario, a clinic, a hospital, and several patient avatars were created. Houses are being built for nursing students to experience different patient care scenarios during home visits. At least 20 nursing faculty and academic staff and three cohorts of accelerated nursing students (77) have avatars and have experienced class sessions. Faculty and students schedule office hours, engage in synchronous chats, and utilize the public health department and SL support groups for class exercises. Current exercises in the public health department include a module in which the student learns the role of the sanitarian. Students use a checklist to inspect restaurants and bars in SL. They are also able to view a video of an interview with a sanitarian. Another module introduces them to the WIC (Women, Infants, and Children) program. Future student activities related to public health include disaster planning, bioterrorism, evacuations, community assessment, windshield surveys, fund raising, and health education as well as other activities suggested by public health nurses and students. The possibilities are limitless because of the resources that exist in the virtual world, SL. The purchase of the first two islands, the initial buildings, and the creation of the public health department was funded by a research grant. Virtual environments offer many advantages for nursing education. Many nursing students say they learn best when they actually "do something," which indicates that they often prefer experiential learning. Rare but life-threatening patient situations can be experienced since the clinical environment can be realistically simulated. The student has the opportunity to practice repeatedly without causing harm to patients. During these simulations, active learning takes place, immediate feedback can be given for both correct and incorrect actions, errors can be corrected, and consistent experiences can be reproduced for all students. This technology is revolutionizing education and will meet the needs of the media savvy generations to come. It can also provide virtual experiences that nursing students may encounter in the clinical setting which are high risk and low volume, thus enhancing patient safety. PMID:19592919

Background & aims. We aimed to study the personal compliance of physicians and nurses with recommendations for the administration of iron supplements for their own children and their compliance with the routine child and maternal health care surveillance recommended during the first year of life.Methods. Five hundred physicians and nurses from Haifa and Tel Aviv area working in hospitals and the community were asked to answer a self administered questionnaire. The questionnaire included questions assessing their compliance (using a 100 mm analogue visual scale) with iron and vitamin A + D supplementation, immunizations and routine examinations at the child and maternal health care center for their children.Results. One hundred and forty one physicians and 135 nurses (55.2%) cooperated and ...

kaitelidou d., kontogianni a., galanis p., siskou o., mallidou a., pavlakis a., kostagiolas p., theodorou m. & liaropoulos l. (2012) Journal of Nursing Management20, 571-578 Conflict management and job satisfaction in paediatric hospitals in Greece Aim- To assess the major causes of conflict and to identify choices of strategy in handling conflicts. Background- Conflict is inherent to hospitals as in all complex organizations, and health personnel deal with internal and external conflicts daily. Methods- The sample consisted of 286 participants. A five-part questionnaire, specific for conflicts in hospitals, was administered to health personnel. Results- Of the participants 37% were physicians and 63% were nurses and nursing assistants. As far as choice of strategy in conflict management i...

Screening patients' nutritional status on admission to hospital is recommended by evidence-based guidelines on malnutrition. In practice, self-reported values for body weight and height are often used by nurses and dieticians. This study assessed the accuracy of self-reported body weight and height and whether these self-reported values might be influenced by the nature of the health-care worker involved. Patients (n?=?611) on admission reported their body weight and height to a nurse and a dietician. Reported values were analysed and compared with the measured values. Self-reported values for body weight and height on admission are not always accurate. Patients do report different values to different health-care workers. Self-reported values for body weight to nurses were more accurate as compared with dieticians. Self-reported values for body weight and height are subject to observer bias and should be used with caution in nutritional screening and multi-professional nutritional care. PMID:23009381

The practice, theory, and preparation associated with nursing people with mental health issues has changed in profound ways in recent decades. This has in part been reflected by a shift in nurses identifying as being mental health rather than psychiatric nurses. Context, theory, and values shape what it means to be a mental health nurse. Thirty experienced mental health nurses in Ireland completed a survey on what good mental health nursing is and a definition induced from their responses. Mental health nursing is a professional, client-centered, goal-directed activity based on sound evidence, focused on the growth, development, and recovery of people with complex mental health needs. It involves caring, empathic, insightful, and respectful nurses using interpersonal skills to draw upon an...

ContextThe effect of suffering among patients with advanced dementia on their family members’ mental health has not been investigated. ObjectivesTo describe family members’ exposure to distressing symptoms among nursing home (NH) residents with advanced dementia and associations between such exposure and family members’ mental health. MethodsData were obtained from an 18-month prospective cohort study of NH residents with advanced dementia and their family member health care proxies (HCPs). Exposure to resident symptoms and associated fear and helplessness was measured quarterly using the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale (range 0-120). HCP mental health was assessed quarterly using the Composite International Diagnostic Interv...

The aim of an Intensive Care Nurse Consultant (ICNC) service is to optimise care of complex ward patients and reduce adverse events. Despite their widespread implementation, specific assessment of ward nurses' attitudes towards such is lacking. Accordingly, we surveyed ward nurses' attitudes towards our ICNC service in five domains: (a) accessibility and approachability; (b) perceived ICNC skill and knowledge; (c) perceived influence on patient management; (d) usefulness as a resource of clinical information; (e) impact upon adverse outcomes. To achieve this, an anonymous Liker-type questionnaire was distributed to 208 ward nurses in our hospital. We also included space for free text. Completed questionnaires were entered manually into a SURVEYMONKEY™ pro-forma to permit automatic report generation and results summary. The major findings were that ICNC staff were perceived as being approachable and good communicators, were skilled at early detection of deteriorating patients, and that they reduce serious adverse events. In addition, nurses believe the ICNC service provides continuity of care post discharge from the intensive care unit (ICU), as well as assisting staff to prioritise clinical issues following medical emergency team (MET) review or ICU discharge. The ward nurses did not believe that the ICNC service reduced their skills in managing ward patients. In contrast, respondents stated that the ICNC service needed to improve the processes of referral to allied health and education of ward staff regarding deteriorating patients. Finally, ward nurses suggest they would call the MET service rather than the ICNC service for patients who had already deteriorated. This survey suggests that the ICNC service is valued, and is perceived to prevent the development of adverse events, rather than playing a major role in the management of the deteriorating patient. There is a need to improve referrals to allied health and further educate ward nurses. PMID:22088555

An Internet tool for monitoring, personalized feedback and referral was developed to support routine adolescent preventive care and was compared with usual practice using paper and pencil (P&P). A total of 1071 students (average age 15 years) from seven secondary schools were randomly assigned to the Internet or P&P group. The Internet group received a health and health-behavior assessment, tailored feedback on health and health behavior (specifically fruit consumption), and an online referral to see a physician/nurse if necessary. The P&P group received the same assessment, preprinted generic advice on fruit consumption and a mailed referral (where applicable). Students and physicians/nurses completed evaluation forms to assess indicators of feasibility, acceptability (i.e. satisfaction) and quality of each administration mode. Student participation rate was 87%. The electronic health feedback was positively evaluated. Students perceived the Internet-tailored fruit advice as more pleasant, more personally targeted and more enjoyable, but less credible than the generic preprinted advice (P less than 0.01). No differences in indicators of acceptability and quality of consultation were found (P [greater than or equal to] 0.05). Thus, the Internet can be a valuable tool to support physicians/nurses in the field of preventive care. It is recommended to further optimize and evaluate the Internet as a tool. (Contains 6 tables and 2 figures.)

The Nursing, Midwifery Council (NMC) Standards to Support Learning and Assessment in Practice (SLAiP NMC, 2008) were implemented aiming to ensure that all pre-registration nursing students are assessed by mentors in practise who are knowledgeable, up to date and who can ensure that students are safe practitioners at the time of registration. These new standards place the responsibility on the sign off mentor (SOM) for ensuring that the pre-registration students are safe in practise, and 'suitable at point of entry to the register' for their practise, (NMC, 2008). Similarly the universities are responsible for signing off the theoretical aspects of the programme and confirming the students' good health and good character (Nursing and midwifery Council, 2010, 2010). However due to the extens...

The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent decision making for processing of cues? Theory development was based on an in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a North Central State. This study consisted of face to face interviews with 12 registered nurses, nine of whom were observed during their work day. Eleven of the 12 participants were interviewed a second time, during which they reviewed their transcripts and the emerging themes and categories as a method of member checking. Directors of nursing from the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. This study revealed novice nurses were able to identify varying cues for decision making, including patient vital signs and patient assessments. These cues were often compared to the nurses' previous encounters with the patients through the health care system or through contact in the community. Familiarity with a diagnosis, such as chest pain, was explained by participants as knowledge they had gained during formal education and in patient encounters within their first year of practice. Where cues were more subtle, participants turned to coworkers to confirm or deny their hunches and to help them decide on actions. They did not, as has been suggested in the literature, turn back to textbooks or linear decision making models to help them analyze the situations. Recommendations were made for nurse educators, who have been tasked with facilitating critical thinking in all nursing students in the preparation of the graduate generalist practitioner. Researchers have been provided suggestions for future exploration of decision making processes in rural nursing. Those who practice rural nursing in either leadership or supportive work roles were given recommendations related to mentoring the new nurse while fostering decision making skills. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.

Objectives: To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. Methods: PubMed, EMBASE, PsychINFO, CINAHL and The Cochrane Library were searched for studies published before October 2010. Fifty studies were included and assessed on methodological quality. Results: Twenty-eight studies reported significantly favorable health outcomes following communication-related BCTs. In these studies, 'behavioral counseling' was most frequently used (15 times), followed by motivational interviewing (eight times), education and advice (both seven times). Physicians and nurses seem equally capable of providing face-...

Nursing as a profession is practiced worldwide in hospitals, clinics, health centres, and individual homes. While there are universal definitions of nursing and universal criteria for training student nurses, the working reality that nurses face differs widely. This ethnography provides insights int...

Summary This paper demonstrates the processes of designing a nursing curriculum that integrates health care and educational reforms, regulatory requirements and the needs of a modern nursing workforce. In particular, the paper illustrates the application of a curriculum design process. In 2008, the School of Nursing and Midwifery at the University of South Australia completed the challenging task of designing and implementing a Bachelor of Nursing curriculum to ensure that nursing graduates meet projected health care delivery needs within the Australian context. Creating an educational experience necessary to support Graduates to attend to priorities associated with the projected Australian health demographic was challenging. Through the use of integrating themes, domains of nursing practi...

Dramatic changes in workplace structure and environment have increased the importance of psychosocial factors and job insecurity in working life. Job insecurity is shown to have a negative impact on mental and physical health. Health care transformation in Turkey increases the threat of job insecurity for many workers in the health care sector. Therefore the aim of this cross-sectional study was to determine the effects of perceived job insecurity on perceived depression and anxiety in nurses working in the private health sector in Izmir, Turkey. There were 16 private hospitals in Izmir of which 11 accepted to participate. Perceived quantitative (5 items) and qualitative (4 items) job insecurity were measured by means of structured questionnaires. The hospital anxiety and depression scale was used to evaluate subjective anxiety and depression. Job strain was assessed by the Demand-Control-Support Questionnaire. ?2 and logistic regression tests were used for analysis. A total number of 462 nurses were surveyed. Perceived anxiety (OR: 2.2, 95% CI: 1.2-3.9) and depression (OR: 2.5, 95% CI: 1.6-4.1) were significantly associated with qualitative job insecurity. Similarly quantitative job insecurity was associated with perceived anxiety (OR: 3.4, 95% CI: 1.9-6.2) and depression (OR: 2.2, 95% CI: 1.4-5.6) in nurses. It has been concluded that qualitative and quantitative job insecurity significantly affected perceived anxiety and depression levels in nurses working in private hospitals. Prevention oriented research is needed for policy development.   

In today's society, citizens are called to play an increasingly active role in decision planning related to the various aspects of work, social and political life. This trend has been also confirmed in the health’s field. In fact, the citizen is also required to have the skills to take responsibility for his/her own health, to have knowledge of the health care system, understand the advice and instructions of health professionals, actively participating with them in the therapeutical path. The lack or an inadequate level of these skills will affect both the health of the individual and the costs related to the National Health System. The nursing staff that interfaces between physicians and patients plays a key role in health’s promotion as an important determinant of health and welfare of the patient-citizen. With regard to osteoporosis, due to better knowledge of its determining causes, it is now possible an easy access to diagnosis and treatment options before fragility fractures occur, providing a real prevention to such complications. Prevention must be addressed to two different, but related, objectives: 1) prevention of osteoporosis; and 2) prevention of fragility fractures in patients with osteoporosis. In the context of both primary and secondary prevention, the nurse can better informed the patients and/or citizens about either the risks related to an inappropriate behavior or situations and events particularly dangerous to health, as well as provide information to simply and effectively implement protective measures. This project aims to raise awareness and create competent and specialized nurse figures, with a good understanding of the bone diseases, through the organization of seminars and training courses. Thus, it will be create clinical pathways and welfare in which the figure of the "Bone Care Nurse” will be responsible for administration of questionnaires relating to lifestyle and, for patients in drug treatment, questionnaires designed to assess the relevance of the adherence/compliance to the prescribed therapy. The "Bone Care Nurse” will also provide specific information leaflets aimed at improving lifestyle, compliance and adherence to therapy prescribed by physician. Specifically, this program will cover not only the prevention of fragility fractures in patients with low bone mass but also will provide general information on healthy lifestyles, such as adequate diet and physical activity, helpful to prevent cardiovascular disease, diabetes, obesity. An increase patient’s compliance in taking the antiosteoporotic therapy, as also other concomitant medications will be obtainable. The information collected will be stored in an electronic database, subject to statistical analysis and will be informative on both the degree of knowledge of disease by the patient at the first and follow-up meetings of the Bone Care Nurse project.

In modern health-care , nursing managers play a strategic role in improving the quality of care and the skills of carers, since management and leadership strategies are known to be decisive in the deployment of resources and professional development. The aim of this study is to present the opinions and expectations of nursing coordinators regarding their managerial role. During the creation of a nursing service unifying the management of 3 local health authorities in Northern Italy, with different organizational and professional features, nursing coordinators were asked to fill in a questionnaire. Results showed that a priority aspect of the managerial role is to assess the appropriateness of care and the use of resources Their answers showed that they hoped for a style of management founded on aspects related to clinical government. For the style of leadership, they emphasized dedication to work, participation of staff in decision-making, group information and providing support in areas needing improvement. Although the study was territorial , it confirmed international guide-lines regarding the policies which give value to investments in the quality of organization and can be considered a point of reference for planning and creating future nursing services. PMID:22304727

...income, assets, satisfaction with health plans and...health opinions and satisfaction with health care for adults 18 and older. The satisfaction with health care items...physician assistants and nurse practitioners...

Occupational health and safety programs involve professionals in occupational medicine and nursing, industrial hygiene, safety and accident prevention, psychology, sociology and health physics. Occupational health programs should allow regular health evaluations of workers, and the recognition, eval...

: This article is reprinted with permission from Nursing Administration Quarterly, Volume 36.3. This NAQ issue focused on Timeline 2020 and can be found at www.NAQJournal.com. ABSTRACT: The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates. PMID:23169187

Occupational health has been considered a subset of public health nursing for years. The first industrial or occupational health nurses were employed by large companies in the 1890s but the role evolved quickly in the early 20(th) century. By mid-century, many large companies employed a physician and nurse(s) to provide examinations, screenings, episodic care, and trauma intervention for workers. Occupational health nurses faced different problems than community-based public health nurses in generalized nursing service. The intersection of public health and employee health was apparent, though, because large industries often constituted the main workplace for a smaller community and sickness could spread throughout a town if the occupational health nurse was not well-prepared in principles of infection control and health promotion. Excerpts from this July 1949 article about building relationship between public health and industrial nurses illustrate the benefits hoped for when they were formally connected to one another through cross-training and in-service education. The author, Margaret Schwem, was a supervisor at the Rensselaer County Department of Health in Troy, New York. In the original article, Schwem included a list of reference materials for those interested in public health and industrial nursing. PMID:19573217

1. Information technology has moved "work" out of a centralized location. Employees who telecommute pose significant challenges and considerations for the practice of occupational health nursing. 2. Employer and employee benefits associated with telecommuting are reportedly associated with high levels of job satisfaction. However, the occupational health and safety risks of this new work environment need to be fully assessed and understood. 3. The ergonomic controls to minimize the risk of repetitive motion injuries are the same for both office and home locations. Additional attention need to be paid to implementing risk controls for other physical hazards and psychosocial considerations, as well as personal safety and security issues. 4. The scope of occupational health nursing practice needs to remain dynamic, recognizing the impact new technologies have on the workplace, to continue to meet the needs of the changing workplace. PMID:11249378

Research during the past 40 years has reported negative attitudes toward older people by nurses and nursing students. To date, nurse educators' perceptions have not been specifically studied. Interview data from 14 baccalaureate nurse educators using a grounded theory approach described their personal perspectives related to long-term care settings. The study highlighted four major themes that clearly supported the view that these nurse educators harbored many of the same negative perspectives that nurses, nursing students, and other health care providers have about long-term care settings. One gerontology nurse specialist shed some positive perspectives on this topic. This study makes a recommendation for gerontology specialists to be directly involved in nurse education. Future research is needed with culturally diverse nurse educators in other national and international nursing programs. PMID:19715257

ObjectivesTo assess whether health-related quality of life is an independent prognostic factor for mortality or nursing home placement in frail elderly patients. DesignA prospective, multicenter study with a 12-month follow-up. SettingNine French hospitals. ParticipantsA total of 1306 patients aged 75 and older hospitalized through an emergency department. MeasurementsData obtained from sociodemographic characteristics, Comprehensive Geriatric Assessment and the Duke Health Profile (DHP) were used into a Cox model to identify prognostic variables for 12-month mortality and institutionalization. ResultsCrude mortality and nursing home placement rates were 34.1% (n = 445) and 16.1% (n = 210), respectively. Independent prognostic factors identified for mortality were: Comorbidity level (moder...

Objective: Self-management education and the issuing of a written action plan improve outcomes for asthma. Many do not receive a plan and some cannot use the written word. We have developed an electronic pictorial asthma action plan (E-PAAP). Methods: A pictorial action plan was incorporated into a software package. 21 general practices were offered this tool and the software was loaded onto 63 desktop computers (46 GPs and 17 nurses). Usage was assessed and health care professionals questioned as to its use. Results: 190 plans had been printed in a 4-month period (17 for test purposes). The individual usage rate ranged from 0 to 28 plans. Doctors printed 73% (139/190) a mean of 3 per doctor and nurses printed 27% a mean of 2 per nurse (37/190). Excluding the test copies, 116/173(67%) were...

Mental health nursing is focused on patients moving along the continuum between failing and thriving in terms of emotional functioning. This differs dramatically from a medical model of disease/cure. A variety of nursing theorists have both directly and indirectly identified the importance of patient's "will to thrive" although this term has never been used. Peplau spoke of self-efficacy and self-esteem. Barrett's model focuses on the patient's participation in their own recovery as a key component. This article explores the concept, akin to failure to thrive in infants, of the will to thrive in the chronically ill and its role in assessment and nursing intervention. A particular emphasis on the importance of patient responsibility is identified as vital to the process of true change.

Purpose: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving and satisfaction following job transition. Design and Methods: A random sample of CNAs identified through the Pennsylvania Department of Healths CNA registry, working?30 hr weekly in a nursing facility was surveyed by telephone at baseline and 1 year later. Results: Of the 620 responding to both surveys, 532 (85.8%) remained (stayers), 52 (8.4%) switched to another facility (switchers), and 36 (5.8%) left the industry (leavers). At baseline, swit...

... Special Enrollment Period Medicare uses information from member satisfaction surveys, plans, and health care providers to give ... medicine, geriatric medicine, or pediatric medicine; or a nurse practitioner, clinical nurse specialist, or physician assistant. Quality ...

Abstract Introduction and questions of exploration In a first step this paper outlines the global context of and international influences on nurse migration. Liberalization of health markets is identified as a trigger point steering movements of nurses globally. Facts an...

This paper reports on a small exploratory study that investigates the place and role of reciprocal learning within a partnership-based home visiting program for mothers experiencing depression. The study is one important example of an increased focus on reciprocal learning within practice that has significant implications for the development of professional education and, more generally, for workplace learning and ongoing professional development. The study addresses two major gaps in the research literature: a lack of detailed accounts of how partnership based approaches are taken up and developed in Australian health care; and a lack of attention to learning as a focus and outcome of partnership-based practice. Using information from in-depth interviews with nurses and mothers we describe and analyse the experience of participants, their learning and knowledge development, the techniques used to facilitate learning, and the development of a relationship between mother and nurse, and mother and child. We identify a fundamental repositioning in practice that was being enacted and learned by all nurses, and a shift in practice strategy from expert assessment and knowledge provision, to practice as a process of shared inquiry and learning. We identify key relational strategies developed by the nurses and commented on by the mothers. We identify a shift in how the mothers experienced the locus of knowing and decision making in relation to their child/children and their parenting. Nurses enhanced their ability to formulate effective interventions for mothers, to build a deeper understanding of mothers' experience, and to challenge or reinforce their own existing beliefs and knowledge. We suggest much of what was described by both the nurses and mothers within this study can usefully be described in terms of reciprocal learning, or as pedagogy. Such findings, we argue, have significant implications for the conceptualisation of health professional practice, the identification of the capabilities required to deliver partnership forms of practice, and, critically, for the redesign of curriculum in the area of health professional education.

Aims: One of the potential hazards for health care workers (HCWs) is needle-stick and sharp injuries (NSSIs). The objective of the study was to assess the knowledge and attitude of health care workers about the NSSIs. Settings and Design: This was a cross-sectional survey conducted in the tertiary care cardiac center. The participants were health care workers including doctors, nurses, technicians, and housekeeping staff from the different areas of the hospital. Methods and Materials: This cross-sectional survey was conducted in the institute using a self-administered validated questionnaire. The participants consisted of a total of 190 HCWs namely doctors, nurses, technicians, and housekeeping staff. Statistical Analysis Used: Nil. Results: Results showed maximum participant were in the age group of 20-30 years. 94.7% were aware about standard precautions. 91.5% knew about the procedure for reporting of NSSIs. Only 50.2% HCWs gave correct answers regarding disease transmission through needle stick and sharp injury. The prevalence of NSSIs was highest among nurses (38.4%), and needle on the disposable syringe (76.9%) was the most common source of NSSIs. Conclusions: The survey revealed few gaps in the knowledge amongst HCWs about NSSIs like risks associated with needle-stick injuries and use of preventive measures, disassembling of needles prior to disposal. These gaps can be addressed by extensive education. As nurses were the most affected victim for the NSSIs, more emphasis should be given towards them for reducing the NSSIs. PMID:23006418

Chronic pelvic pain (CPP) is one of the most common pain conditions affecting women and can have a significant impact on quality of life. Assessment of women with CPP is best approached in a comprehensive, systematic manner that includes exploration of physiological and psychological causes. A range of treatment options that draw from conventional medicine and complementary and alternative modalities should be offered. The women's health nurse plays a pivotal role in all aspects of care. PMID:22861823

The context for nursing informatics research has changed significantly since the National Institute of Nursing Research-funded Nursing Informatics Research Agenda was published in 1993 and the Delphi study of nursing informatics research priorities reported a decade ago. The authors focus on 3 specific aspects of context—genomic health care, shifting research paradigms, and social (Web 2.0) technologies—that must be considered in formulating a nursing informatics research agenda. These influences are illustrated using the significant issue of healthcare associated infections (HAI). A nursing informatics research agenda for 2008–18 must expand users of interest to include interdisciplinary researchers; build upon the knowledge gained in nursing concept representation to...

Primary Health Care (PHC) is seen as the sector of Health Services most appropriate to develop practices of Health Education (HE) and PHC nurses are seen as the key personal. The objectives of the present study were: (i) to identify nurses’ conceptions of health education, (ii) to characterise their...

OBJECTIVE.- To develop deeper understandings about nurses' perceptions of meaningful work and the contextual factors that impact finding meaning in work. BACKGROUND.- Much has been written about nurses' job satisfaction and the impact on quality of health care. However, scant qualitative evidence exists regarding nurses' perceptions of meaningful work and how factors in the work environment influence their perceptions. The literature reveals links among work satisfaction, retention, quality of care, and meaningfulness in work. METHODS.- Using a narrative design, researchers interviewed 13 public health nurses and 13 acute care nurses. Categorical-content analysis with Atlas.ti data management software was conducted separately for each group of nurses. This article reports results for acute...

The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates. PMID:22677961

Purpose To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. Methods This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6?10?months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). Results Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.2...

Aim To assess the professional?s knowledge of a public health and family health specialization course in the city of Jo?o Pessoa (PB) regarding oral health care for children aged between 0 and 36?months. Subject and methods This was a descriptive cross study which adopted a structured questionnaire as data collection strategy. In all, 121 health professionals which were regularly enrolled in this specialization course were selected. Results Most of the subjects were women, working as nurses and aged between 20 and 35?years of age. The results have shown gaps in the understanding of preventive practices in children?s dental care, which could be interfering in the health care provided to children. Communication between parents and professionals from primary health care, especially during the...

The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the resul...

The National Action Plan to Improve Health Literacy is a framework that all clinical and public health professionals, including nurses, can use to identify and address health literacy barriers that negatively affect patient care and individual and community health outcomes. Of all the clinical disciplines, nursing has a unique relationship to health literacy because nurses are responsible for the majority of patient, caregiver and community health education, and communication. The information in the Action Plan is applicable to many fields and disciplines, such as healthcare, public health, communication, and education. Leading educators, researchers, practitioners, and administrators in each relevant discipline have a responsibility to be informed about health literacy issues and identify...

Sorensen R., Iedema R. &Severinsson E. (2008) Journal of Nursing Management16, 535-544 Beyond profession: nursing leadership in contemporary healthcare Aim(s) To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management. Background As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursing's power and authority in the organization. Method(s) An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with ...

There are still weaknesses in the practical skills of newly graduated nurses. There is also an escalating pressure on existing clinical placements due to increasing student numbers and structural changes in health services. Innovative educational practices and the use of tools that might support learning are sparsely researched in the field of clinical education for nursing students. This paper reports on an action research study that promoted and investigated use of The Model of Practical Skill Performance as a learning tool during nursing students' clinical placement. Clinical supervisors and two cohorts of nursing students placed in a hospital setting shared their experiences on the use of the model in six focus group interviews. Data was also generated through the supervisors' reflective logs. The model was viewed as highly applicable in the planning of learning situations as well as during practice, performance and formative assessment of practical skills learning. It provided a common language about practical skills and enhanced the participants' understanding of professionalism in practical nursing skill. In conclusion, the model helped to highlight the complexity in mastering practical skills, afforded help in sequencing a learning process that supported the novice, and contributed to a more nuanced feedback by supervisors.

Scand J Caring Sci; 2012 Work experiences among nurses and physicians in the beginning of their professional careers - analyses using the effort-reward imbalance model The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effort-reward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross-sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effort-reward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effort-reward imbalance, compared with physicians. Women scored higher on work-related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work-related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work-related stress research among healthcare personnel, gender-specific aspects of working conditions must be further highlighted to develop more gender-sensitive analyses. PMID:22533720

...Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee...Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee...School of Nursing, an Area Health Education Center (AHEC) Program...

This document contains the text of the Nurse Reinvestment Act, which amends the Public Health Service Act to address the increasing shortage of registered nurses by instituting a series of policies to improve nurse recruitment and nurse retention. Title I details two initiatives to boost recruitment of nurses. The first initiative includes the development and broadcasting of public service announcements and grant-based funding of state and local public service announcements to advertise and promote the nursing profession, highlight the advantages and rewards of nursing, and encourage individuals to enter the nursing profession. The second initiative concerns revision of provisions of the National Nurse Service Corps related to items such as loan repayments, scholarships, eligibility requirements, reporting requirements, and funding. Title II, which presents policies designed to improve nurse retention, consists of provisions related to the following areas: (1) building career ladders and retaining quality nurses through nurse education, practice, and retention grants; (2) funding and developing comprehensive geriatric education; (3) establishing and operating a nurse faculty loan program to increase the number of qualified nursing faculty; and (4) requiring reports by the General Accounting Office to identify local variations in nursing shortages, hiring differences among certain private entities, and the impact of nursing scholarships. (MN)

The study assesses the role and impact of nursing in an ongoing trial of integrated primary cares, carried out in a health district in northern Italy, started in 2004. The goals were to establish a joint collaboration with general practitioners (GP), in order to improve the follow-up of chronic patients. As a first stage, the trial focuses on COPD (chronic obstructive pulmonary disease), diabetes mellitus, hypertension, cardiovascular failure and patients following anticoagulant therapy. The district???s project covers up to 60,000 patients treated by the team of GPs and nurses. Benefits for users are represented by easier access to cares, dedicated projects for chronic disease, follow-up, health education and multidisciplinary work. This first reports presents the questionnaire data accor...

This study examined school nurses' communication with community physicians and its relationship to school nurse satisfaction with school health services. A stratified random sample of school nurses in Pennsylvania (N = 615) were surveyed about communication effectiveness with community physicians, satisfaction with school health services for students, perception of leadership, and students' health care needs. Additional information from national/state education data on student poverty, nurse-to-student ratio, and rural/urban location was included. Findings indicate that having a leadership role in influencing school health policy is related to school nurses' communication with community physicians and satisfaction with school health services. Effective communication with physicians was found to be a salient issue influencing satisfaction with school health services, suggesting the importance of stressing communication as well as leadership skills in school nurse education. (Contains 3 tables.)

merrell j., carnwell r., williams a., allen d. &griffiths l. (2007) A survey of school nursing provision in the UK. Journal of Advanced Nursing59(5), 463-473 Abstract Title. A survey of school nursing provision in the UK Aim. This paper is a report of a study to map school nursing provision across the health and education sectors in Wales to identify the number, age, qualifications, terms of employment, location, functions and access to continuing professional development and clinical supervision of school nurses. Background. School nurses are important in promoting the health of school-aged children. Increased demands have arisen from changes in patterns of health, illness and lifestyles. Methods. An interview survey was conducted with a purposive sample of school nursing/health visiting ...

The School Nurse Impact Committee of the Columbus Public Schools in Columbus, Ohio, initiated a survey to determine staff satisfaction with the delivery of health services. School nurses need the cooperation and support of the staff to successfully deliver school health services, therefore, the staff's satisfaction with school health services is crucial to the school nurses' ability to fulfill their role. The objectives of the survey were to (a) determine staff satisfaction with school nurse interventions, (b) determine staff satisfaction with the effectiveness of interventions, (c) identify areas of health service delivery which may need improvement, and (d) determine areas of school health services where school nurses may need to more effectively communicate their involvement. Critical elements of school nurse practice included staff health, safety and environment, classroom education, medication, school system collaboration, and program management. Several key issues were identified through the survey. School system collaboration issues need more school nurse involvement. School nurses also need to improve their visibility regarding school system collaboration, and in classroom and individual pupil education. Traditional school nurse functions were adequately covered. Results indicate that staff would be more satisfied if they had more nursing support in the classroom and more nurse time in their building. (Contains 2 tables.)

With the advent of accountable care organizations, bundled payments, value-based purchasing, and penalties for preventable hospital readmission, tight connections and collaboration across the care continuum will become critical to achieve successful patient outcomes and to reduce the cost of care delivery. Lehigh Valley Health Network (LVHN), the largest provider of health services in eastern Pennsylvania, set out on a journey to build collaborative relationships with skilled nursing facilities (SNFs) in their eastern Pennsylvania community. LVHN desired SNF partners with mutual interests in improving quality of care and lowering costs of delivery where possible. Recognizing that not all SNFs are alike, LVHN developed a Collaborative Partner Prioritization Tool to assess and prioritize ski...

A recent national assessment of emergency planning in Canada suggests that health care professionals are not properly prepared for disasters. In response to this gap, an interprofessional course in disaster management was developed, implemented and evaluated in Toronto, Canada from 2007 to 2008. Undergraduate students from five educational institutions in nursing, medicine, paramedicine, police, media and health administration programs took an eight-week online course. The course was highly interactive and included video, a discussion forum, an online board game and opportunity to participate in a high fidelity disaster simulation with professional staff. Curriculum developers set interprofessional competency as a major course outcome and this concept guided every aspect of content and act...

The Colonies settlements along the United States-Mexican border are reflective of third-world communities. Although most of the residents are U.S. citizens, they lack the basic educational and work opportunities found in most parts of the country. Because of the limited infrastructure, diseases controlled in most parts of the world are epidemic within these communities. Using the Giger and Davidhizar Transcultural Assessment Model, public health nurses can be instrumental in coordinating services in partnership with community members to enhance health and social service programs. PMID:10499019

This resource sets the standard for school nurses concerning the formulation of individualized healthcare plans designed to fit the unique health needs of students. Eighteen chapters focus on special issues and school nursing concepts. Computer software, which accompanies the manual, assists in the development and creation of individualized healthcare plans and includes: (1) nursing diagnosis; (2) interventions; (3) outcomes; and (4) a column to add assessment data. Concept chapters include the coverage of evidence-based nursing practice; standardized nursing language; HIPPA, FERPA, and privacy; special education, using Individual Healthcare Plans (IHPs) with 504 plans and the reimbursement process, responding to students needs in times of crisis, and wellness promotion. Special student issues include chronic health conditions, psychosocial aspects of student with chronic health conditions, medically fragile students, immigrants and refugees, homeless students, and chromosomal abnormalities. In addition to 18 special issue and concept chapters, the book includes 57 IHPs covering abuse & neglect, ADHD, anaphylaxis, anxiety, asthma, autism spectrum disorder, bipolar, brain injury, brain & spinal cord tumors, burns, cancer, cardiovascular disease, celiac disease, cerebral palsy, depression/ suicide, Down syndrome, Duchenne muscular dystrophy, eating disorders, encopresis, Fragile X, GERD, hearing deficit, hemophilia, viral hepatitis, HIV/ AIDS, immune thrombocytopenic purpura, immunodeficiency disorders, mono, IBD, latex allergy, Lyme disease, Marfan syndrome, medically fragile children, metachromatic leukodystrophy, migraines, mitochondrial disorders, neurofibromatosis, neurology/ seizures, organ transplant, osteogenesis imperfecta, PTSD, Prader-Willi, pregnancy, prenatal alcohol & drug exposure, Rett syndrome, school phobia, scoliosis, Sickle Cell disease, skin disorders, spina bifida, spinal cord injury, substance abuse, systemic lupus, Tourette's syndrome, tuberculosis, and vision deficits. [Book and Software included.

Aims and objectives.? To present the Careful Nursing philosophy and professional practice model which has its source in the skilled practice of 19th century Irish nurses and to propose that its implementation could provide a relevant foundation for contemporary nursing practice. Background.? Nursing models are widely considered not relevant to nursing practice. Alarming instances of incompetent and insensitive nursing practice and experiences of powerlessness amongst nurses are being reported. Professional practice models that will inspire and strengthen nurses in practice and help them to address these challenges are needed. Nursing history has been suggested as a source of such models. Design.? Discursive. Methods.? Content analysis of historical documents describing the thinking and practice of 19th century Irish nurses. Identification of emergent categories and subcategories as philosophical assumptions, concepts and dimensions of professional nursing practice. Results.? A philosophical approach to practise encompassing the nature and innate dignity of the person, the experience of an infinite transcendent reality in life processes and health as human flourishing. A professional practice model constructed from four concepts; therapeutic milieu, practice competence and excellence, management of practice and influence in health systems and professional authority; and their eighteen dimensions. Conclusion.? As a philosophy and professional practice model, Careful Nursing can engage nurses and provide meaningful direction for practice. It could help decrease incidents of incompetent and insensitive practice and sustain already exemplary practice. As a basis for theory development, it could help close the relevance gap between nursing practice and nursing science. Relevance to clinical practice.? Careful Nursing highlights respect for the innate dignity of all persons and what this means for nurses in their relationships with patients. It balances attentive tenderness in nurse-patient relationships with clinical skill and judgement. It helps nurses to establish their professional practice boundaries and take authoritative responsibility for their practice. PMID:22985322

The health of adolescents and the adults they will become can be linked to the health-related behaviors they adopt as children. To replicate a pilot study with a more culturally diverse population a descriptive, correlational study was undertaken with 379 seventh grade students. Key findings from this study include (a) students exposed or involved in violence (e.g., fighting and carrying a weapon) were more likely to report smoking cigarettes, (b) nearly a quarter (24%) of students have smoked cigarettes at some time, and (c) almost half of the students (48%) reported having at least one alcoholic drink. Middle school can be critical time in the life of an adolescent who may be faced with opportunities to experiment with and participate in health risk behaviors. School nurses, practitioners, and other health care professionals are in an ideal position to assess the type of and level of participation by an adolescent in a health risk behavior. (Contains 3 tables.)

Proceedings are presented from a research conference to promote nursing research as a basis for policymaking in nursing practice, education, and health care services. The keynote address, by Patricia Jones, describes issues in health care financing in the 1980s and urges researchers to provide the kind of data and guidelines needed to support professional nursing services. The second paper, by Ora L. Strickland, names establishment of an acceptable and stable economic base for the provision of nursing services as the most important public policy issue facing nursing and gives pointers on collaborative research as one approach to contributing to the knowledge base. The third presentation, by Jeanette Lancaster, exhorts nurse researchers to affect policy by identifying critical study areas and initiating research. Abstracts follow of 32 studies, with almost equal numbers focusing on clinical practice, education, and the delivery of health care areas; the majority have implications in all three areas. They generally underscore the interrelatedness of research, education, and service. Specific topics include nurse-patient negotiations, predictive factors of supply and salaries of nurse practitioners, cultural determinants of health and self-care, job satisfaction, skills of nurse administrators, continuing education, nursing gestalt, nurses' decision making, and factors related to student success in completing a baccalaureate nursing education. (YLB)

Multiple-choice questions are frequently used in high-stakes nursing assessments. Many nurse educators, however, lack the necessary knowledge and training to develop these tests. The authors discuss test development guidelines to help nurse educators produce valid and reliable multiple-choice assessments. PMID:22513766

... Neurosciences Women's Health PATIENT CARE SERVICES Care Coordination/ Social Work Chaplaincy Interpreter Services Nursing Nutrition Patient and Family Relations All Patient Care Services Browse by Letter ...

...Federal Domestic Assistance numbers and titles for the programs affected by this document...dental schools, Medical devices, Medical research, Mental health programs, Nursing homes, Philippines, Reporting and recordkeeping...

Information technology (IT) has the potential to improve the clinical learning environment. The extent to which IT enhances or detracts from healthcare professionals' role performance can be expected to affect both student learning and patient outcomes. This study evaluated nursing students' satisfaction with a novel compartmental Picture Archiving and Communications System (PACS) for the automatic object-oriented integration and visualization of heterogeneous biomedical data. The compartmental PACS was specially designed to support client assessment and clinical education in the integrative health clinic of a university, which is run by a multidisciplinary service team. The sample was 63 nursing students, who were asked to complete a series of realistic tasks using the compartmental PACS. Upon completing the tasks, the Computer System Usability Questionnaire (CSUQ) was administered to assess their satisfaction with the system. Results from data analysis showed that nursing students who completed the evaluation had a satisfactory experience with the system. The Information Quality subscale mean was the highest mean of the CSUQ subscales. This is an important finding as the multidisciplinary data visualization feature of the system provides a technology-enhanced learning environment that can support nursing students' efforts to both organize and represent knowledge. Through the compartmental PACS, students are assisted in connecting relevant knowledge via various representations of medical data for the clinical conditions under study.

BackgroundThe first year of nursing practice is critical to developing new graduate nurses into safe practitioners. Many new graduate nurses leave the profession because of job stress, lack of organizational support, poor nurse-physician relations, unreasonable workloads, uncivil work environments, and difficulty transitioning into practice. In response, Nurse Residency programs reflect an organizational commitment to support new nurses, allowing them time and support to become competent professional nurses. Purpose and methodThirty-seven new graduate nurses employed in a hospital in a northwestern state participated in a descriptive qualitative study to examine the "lived experience" as new nurses and to assess the level of job satisfaction during the first year of their nursing practice....

The authors have developed and assessed 2 innovative, case-based, interactive training programs on substance abuse, one for health professional students on alcohol and one for primary care providers on screening, brief intervention, and referral to treatment (SBIRT). Both programs build skills in substance abuse SBIRT. Real-world effectiveness trials involving medical students (n = 10) and nursing students (n = 60) were completed; trials involving primary care providers (n = 65) are in progress during 2011. Medical students and nursing students had similarly low baseline scores on assessments that benefited from training: knowledge, confidence, and clinical performance measured via an online standardized patient case and encounter note all improved post-training. Preliminary results indicate that practicing providers improved on knowledge, attitude, and brief intervention skill performance after a similar training. Results suggest that SBIRT skills can be improved with this model for case-based interactive training programs, and thus, that this training has the potential to impact patient outcomes. (Contains 3 tables.)

Purpose: The purpose of this article is to present a framework for nurses to study the impact of built environment on health, particularly in vulnerable populations. Organizing Construct: The framework is adapted from Social Determinants of Health and Environmental Health Promotion, a framework describing how physical and social environments interact to influence individual and population health and health disparities via macro, community-level, and interpersonal factors. Methods: The original framework was modified for public health nursing using nursing research evaluating built environment and health, and supplemented with Nightingale's theory of nursing and health. Findings: The built environment affects health through regional-, neighborhood-, and individual-level factors. Nursing can affect the health of patients by evaluating the neighborhood built environment where patients reside, and by advocating for changes to the built environment. Conclusions: Through development of built environment research, nurses can provide valuable insight into the pathways linking built environment to health of vulnerable populations, providing evidence for public health nurses to advocate for these changes on a neighborhood, state, and federal level. Clinical Relevance: This framework can be used by public health clinicians to understand the pathways by which the built environment may be affecting the health of their patients, and by researchers to investigate the pathways, and to design and test community interventions. PMID:23062005

Summary Nursing education in the US today is at crossroads. The profession has made great strides in gaining public respect and recognition for the work that nurses do. Nurses' voices are being heard in important political debates about revolutionary changes in the problematic US health care system. Advanced practice nurses are becoming valued providers of primary care to US citizens. It is innovative educational programs and educators that have provided the foundation to help nursing use its voice and to propel the profession forward. However, nurse educators are finding that they face major challenges in keeping nursing on track to be in the forefront of health care in the future. Some of these challenges include confronting nursing and faculty shortages, eliminating inconsistent and con...

...responded to marketing efforts; (3) Assess patient satisfaction with: (a) The means by which patients were alerted...professionals (e.g., physicians, physician assistants, nurses and nurse practitioners, pharmacists). (2) Focus...

...responded to marketing efforts; (3) Assess patient satisfaction with: (a) The means by which patients were alerted...professionals (e.g., physicians, physician assistants, nurses and nurse practitioners, pharmacists). (2) Focus...

For example, in a study of Neonatal Intensive Care Unit nurses' clinical judgments, each nurse was asked to select an incident in which her patient assessment skills had made a difference to ..... to improve efficiency or passenger satisfaction.

Medical error involving nurses is a critical issue since nurses' actions will have a direct and often significant effect on the prognosis of their patients. To investigate the significance of nurse health in Japan and its potential impact on patient services, a questionnaire-based survey amongst nurses working in hospitals was conducted, with the specific purpose of examining the relationship between shift work, mental health and self-reported medical errors. Multivariate analysis revealed significant associations between the shift work system, General Health Questionnaire (GHQ) scores and nurse errors: the odds ratios for shift system and GHQ were 2.1 and 1.1, respectively. It was confirmed that both sleep and mental health status among hospital nurses were relatively poor, and that shift work and poor mental health were significant factors contributing to medical errors.   

ABSTRACT: BACKGROUND: As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. METHODS: Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. RESULTS: Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. CONCLUSION: Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others are supportive and see the potential the model has to provide accessible primary health care. Any further developments of nurse-led Walk-in Centres need to take into account the views of key stakeholders so as to ensure that the model is acceptable and sustainable. PMID:23126431

Calls for transformation in nursing education and practice abound. Nurses are part of a trusted profession, but they have been under-represented in conversations about health care compared with other, more vocal professionals. Nurses may not consider that they already have many leadership skills, and nurse educators in staff development roles are positioned to foster growth in other nurses. The relationship between nurse educators and their constituents provides the context for support that can motivate staff nurses to move beyond their concerns and accept challenges that may cause them some discomfort, such as writing for publication or public speaking. The leadership of nurse educators is essential to support colleagues who will shape the future of nursing. PMID:22263552

This report describes the Imperial Valley College nursing program, a program developed to provide for the nursing needs of Imperial County, California. The program provides part-time education to help train nursing assistants and to allow nursing assistants to upgrade their skills to vocational nurse level and vocational nurses to become registered nurses while working full time. The guide presents a schematic diagram of courses needed by health assistants, vocational nurses, and associate degree nurses. It also contains descriptions of all courses and an expected sequence for students. The guide provides a matrix of skills that shows at what point in the student's education these skills should be mastered. The final section of the guide is a 103-item bibliography. (KC)

Abstract Aim.- To report the development and psychometric testing of the Behavioral Health Care Competency survey, designed to measure hospital nurse perceptions of behavioral healthcare competency. Background.- Hospital nurses working in general or other non-psychiatric units may lack behavioral healthcare competency to manage disruptive behaviours associated with mental illnesses. Design.- Instrument development. Method.- A nurse study team including clinical experts and nurse researchers from three community hospitals in southern California (USA) reviewed content validity of each item and the 31-item instrument and created a behavioral health care competency conceptual model based on the nursing process. Separate institutional review board permissions were obtained from each hospital. T...

The nurse executive has a significant role, through active participation and leadership, in implementing and sustaining unit-level shared governance (ULSG). Additionally, the nurse executives participation promotes the enculturation of the shared decision-making process for the front-line staff. At Central Arkansas Veterans Healthcare System (CAVHS), the implementation of ULSG increased nurse satisfaction and retention by empowering staff nurses to be involved in decision making, which impacted their practice environment and the organizations health care mission.

Purpose: The aim of this study was to review literature exploring the emotional consequences of delirium and delusional memories in intensive care unit patients. Methods: A systematic review was performed using PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO. Results: Fourteen articles were eligible for this review. Five of them assessed delirium during intensive care unit admission, and the remainder assessed delusional memories during or after admission. No association was found for delirium and adverse emotional outcome. Data regarding delusional memories and emotional outcome were heterogenic. Some studies presented worse scores on posttraumatic stress disorder screening tools in patients with delusional memories, whereas other studies found bett...

Summary- Attitudes of healthcare professionals to the importance of hydration for health, wellness and performance were evaluated in six European countries. These included general medical practitioners (n-=-600), nurses (n-=-300), pharmacists (n-=-550), nutritionists (n-=-265) and dietitians (n-=-265), spread across France, Germany, Greece, Italy, Spain and the UK, who completed computer-aided web or telephone interviews. The interviews assessed attitudes to the importance of hydration, how commonly they assess the hydration status of patients, and knowledge about recommended water intakes, sources of water for consumption and contribution from different beverages. All responders considered hydration an important issue and there was little difference in opinion between different healthcare...

For the past 2 years I have been working as a mental health nurse (MHN) at Lyttleton Street Clinic, a general practice clinic in my hometown of Castlemaine in Victoria. My background is as a general and mental health nurse, more recently in the mental health sector at the Child and Adolescent Mental Health Service. I also have postgraduate qualifications in women's health and have recently trained as a yoga teacher. My position at the clinic is supported by the national Mental Health Nurse Incentive Program (MHNIP). The role has proven to be immensely satisfying; I have never felt so useful. PMID:22962637

A whole variety of new organisational solutions are being introduced nowadays, at an increasing pace, in health-care institutions, not always preceded by appropriate information related to the upcoming changes. The situation may be conducive to the feeling of discomfort and doubt among managerial staff, as to the ultimate result of imminent innovations. A necessity to relieve the perceived tension will then arise, for example, by way of smoking. The principal objective of the present study was to examine the occurrence of tobacco-smoking among the nursing executive personnel. Two groups of employees holding high-ranking positions in the nursing subsystem were included in the study. The initial part of the project was performed throughout the first quarter of 2010, and comprised 102 departmental female nurses. The concluding part is planned for October - November, 2010, and will address the second and third-level managers. A questionnaire-based, diagnostic survey was the employed research method. The questionnaires' return rate was 85%. The Fisher-Freeman-Halton test was applied in statistical calculations (for expected values < 5). The study revealed, so far, that the performance of managerial functions induced undesirable behavioural patterns, i.e., tobacco smoking. It also affected low self-assessment of their bio-psycho-social wellness. The majority of the respondents took part in various forms of in-service, refresher training which also included information concerning behavioural patterns detrimental to health. The latter influenced the participating nurses' self-assessment of the extent of their knowledge related to tobacco smoking and its harmful effect on their health. PMID:21360945

ABSTRACT: BACKGROUND: Nurses are an indispensable component of the work force in the health care system. However, many of them are known to work in a stressful environment which may affect their mental well-being; the situation could be worse in rapidly transforming societies such as China. The purpose of this study was to investigate anxiety symptoms and the associated factors in Chinese nurses working in public city hospitals. METHODS: A cross-sectional survey was performed for Chinese nurses in public city hospitals of Liaoning Province, northeast China. Seven hospitals in different areas of the province were randomly selected for the study. The Zung Self-Rating Anxiety Scale was used to measure anxiety symptoms. Effort-reward imbalance questionnaire and Job Content Questionnaire were used to assess the work stressors. Univariate analysis and stepwise multivariate logistic regression analysis were used to identify the factors associated with anxiety symptoms. RESULTS: All registered nurses in the seven city hospitals, totaling 1807 registered nurses were surveyed. Of the returned questionnaires, 1437 were valid (79.5%) for analysis. Utilizing the total raw score [GREATER-THAN OR EQUAL TO] 40 as the cut-off point, the prevalence of anxiety symptoms in these nurses was 43.4%. Demographic factors (education, chronic disease and life event), lifestyle factors (regular meals and physical exercise), work conditions (hospital grade, job rank, monthly salary, nurse-patient relationships, job satisfaction and intention of leaving), job content (social support and decision latitude), effort-reward imbalance and overcommitment were all significantly related to the anxiety symptoms. Multivariate logistic regression analysis showed main factors associated with anxiety symptoms were lower job rank (OR 2.501), overcommitment (OR 2.018), chronic diseases (OR 1.541), worse nurse-patient relationship (OR 1.434), higher social support (OR 0.573), lower hospital grade (OR 0.629), taking regular meals (OR 0.719) and higher level of job satisfaction (OR 0.722). CONCLUSIONS: A large proportion of Chinese nurses working in public city hospitals had anxiety symptoms, which warrants immediate investigation and intervention from the hospital administrators. Meanwhile, results of the study suggest that proper counseling, promotion of healthy lifestyle behavior and improvements to the social environment in the work place may be helpful toward reducing or preventing the anxiety symptoms. PMID:22978466

Abstract in spanish Se realizó una revisión bibliográfica con el objetivo de valorar la influencia del pensamiento humanista y filosófico en el modo de actuación profesional de enfermería. Es considerado en nuestro análisis el proceso de institucionalización de la enfermería profesional, así como la necesaria vinculación que se establece entre el pensamiento filosófico, los elementos más genuinos de la ética médica, la bioética y el Proceso de Atención de Enfermería, para e (more) stablecer estrategias de cuidados profesionales en los que el proceso de humanizar en el arte de cuidar, conduzcan hacia unos servicios en salud de excelencia en el presente siglo, como respuesta a la creciente demanda de personalización de la asistencia sanitaria. Se concluye que es necesario vincular conocimientos de otras ciencias a la Enfermería para materializar su objeto de estudio de manera holística, pues la calidad en la formación de este profesional no depende exclusivamente de los conocimientos, habilidades intelectuales y hábitos profesionales contemplados en el currículo universitario, sino también de sus motivaciones, de los intereses personales y colectivos, así como el sistema de valores que regulan su ética profesional, pues no se puede desligar la buena praxis del cuidar de los valores humanistas, a partir de una propuesta de filosofía de la Enfermería que incluye con enfoque sistémico a los componentes: seres humanos, medio ambiente, salud, enfermero y enfermería. Abstract in english A bibliographic review was made to assess the influence of humanistic and philosophical thinking in Nursing professional thinking. In our analysis, the institutionalization process of professional nursing is considered, as well as the necessary linking established among philosophical thinking, the most genuine elements of medical ethics, bioethics, and the nursing care process, to lay down strategies of professional care where the humanizing process in the art of care lea (more) ds to health services of excellence in this century, as an answer to the increasing demand of personalizing health care. It was concluded that it is necessary to link knowledges of other sciences with nursing to materialize its object of study in a holistic way, since the quality of training of this professional does not depend exclusively on knowledge, intellectual abilities, and professional habits registered in the university curriculum vitae, but also on his motivations, on his personal and collective interests, as well as on the system of values regulating his professional ethics, since it is impossible to separate the good praxis from taking care of the humanistic values, starting from a proposal of nursing philosophy that includes the following components with a systemic approach: human beings, environment, health, nurse, and nursing.

While the competencies and theory relevant to public health nursing (PHN) practice continue to be described, much less attention has been given to the knowledge derived from practice (clinical know-how) and the development of PHN expertise. A study was designed to address this gap by recruiting nurses with varied levels of experience and from various practice sites. A convenience sample of 28 public health nurses and seven administrators/supervisors were interviewed. A subsample, comprised of less-experienced public health nurses, were followed longitudinally over an 18-month period. Data included more than 130 clinical episodes and approximately 900 pages of transcripts and field notes. A series of interpretive sessions focused on identifying salient aspects of the text and comparing and contrasting what showed up as compelling, puzzling, and meaningful in public health nurses' descriptions. This interpretive analysis revealed changes in understanding of practice and captured the development of clinical know-how. In Part 1, we describe the sample, study design, and two aspects of clinical knowledge development--grappling with the unfamiliar and learning relational skills--that surfaced in nurses' descriptions of early clinical practice. In Part 2, which is to be published in the next issue of Public Health Nursing (SmithBattle, Diekemper, & Leander, 2004), we explore gradual shifts in public health nurses' understanding of practice that led to their engagement in upstream, population-focused activities. Implications of these findings for supporting the clinical learning of public health nurses and the development of expertise are described. PMID:14692984

Registered nurses (RN) coordinate acute mental health units on a 24-hour basis and it behoves researchers to actually ask these nurses what they think contributes to their ability to work with patients in optimistic ways. In this study, 40 RN working in acute mental health settings were asked a series of questions to explore positive aspects of nursing work, which includes therapeutic optimism. Three themes were identified: (i) different ways nurses foster therapeutic optimism; (ii) perceptions of how an optimistic environment is fostered, and (iii) improvement of ward culture. Findings show the pivotal role mental health nurses have in improving teamwork, good communication, sharing, and collaboration, in addition to preceptoring and supervision. Furthermore, effective clinical management is essential to therapeutic optimism and, in this research, is considered to be the aspect of acute mental health nursing most relevant to improving the ward culture. PMID:22417284

Infection control practice is a cornerstone of modern health care. However, there is minimal research into health professionals' perception of infection control practices and how those perceptions influence staff compliance with recommended protocols. The objective of this study was to explore health care professionals' perceptions of infection control practices in relation to the management of infectious diseases. A grounded theory approach was used as the research framework. Semi-structured interviews were completed with a sample of 16 nurses and doctors working at hospitals in Western Australia. Four major categories emerged from the data. These were: knowledge, culture, conflict, and risk assessment. The findings indicate the importance of both individual and organisational factors in determining clinicians' levels of compliance with recommended infection control practices. Identification of the factors that influence health professionals' level of compliance can be used to develop strategies to support long-term compliance with infection control practices. PMID:16863418

Today the multidimensional global shortage of nurses is negatively impacting the work environment of hospital nurses and causing, in a cyclical fashion, decreasing work satisfaction, increasing nurse turnover, and decreasing patient outcomes. While strategies aimed at causation of the nursing shortage must be addressed, to support nursing until resolution occurs, it is essential to focus on strategies aimed at retaining nurses within this challenging health care environment. Using qualitative research, narrative inquiry and personal narratives, this study documents the stories of six exemplary hospital nurses who not only have stayed and survived in this hostile and challenging environment of hospital nursing, but continue to grow professionally and provide exceptional nursing care; their story is a story of career satisfaction and career success. Using narrative analysis, these stories were co-constructed with the researcher and the exceptional hospital nurses from data obtained through two interactive narrative sessions. An in depth three dimensional analysis of both the individual and collective narratives was completed. The findings of this study revealed numerous exceptional nurse characteristics and traits which not only appear within, but transcend the individual nurse narratives. First and foremost, this study indicated that the concept of caring permeated all aspects of their personal and professional being. They not only cared for their patients but these exceptional nurses cared deeply for and respected their peers, their families, their profession and themselves. Life-long learning took precedence in their nursing career, and though they believed in formal education, few pursued advanced credentials. They unanimously believed the greatest educational emphasis in nursing should be on experiential learning. Along with exemplary and positive attitudes, the exceptional nurses in this study were extremely pragmatic, value-driven individuals and employed a solutions-focused approach to problem solving. Nursing was viewed by these nurses as a profession of rewards and they celebrated these rewards continually. When compared to the extant literature on the concept of resiliency, the exceptional hospital nurses in this study displayed many of the traits of resilient individuals. Implications for adult and narrative learning are explored within this research study and, based on the findings of this study, implications for nursing education, nursing practice and future nursing research are presented. Since few studies have been completed which identify the characteristics and traits of exemplary and/or resilient hospital nurses, this study serves to add to the body of knowledge on hospital nurse exceptionality, nurse retention and nurse resiliency. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.

Jones A (2007)Journal of Clinical NursingPutting practice into teaching: an exploratory study of nursing undergraduates' interpersonal skills and the effects of using empirical data as a teaching and learning resource Aim. To understand student nurse-patient interaction better and to assess the effectiveness of a teaching and learning resource consisting of tapes and transcriptions of actual nurse-patient interaction. Design. Applied conversation analysis and analysis of semi-structured lecture evaluation forms. Background. Little research discusses interpersonal skills (IPS) of student-nurses, even though policy initiatives and literature internationally promote patient-centred communication as being an indicator of high-quality healthcare. Literature also suggests that nursing education ...

AHMED A. & EL GUINDY S.R. (2011) Breastfeeding knowledge and attitudes among Egyptian baccalaureate students. International Nursing Review58, 372-378 Aim:- To assess the breastfeeding knowledge, attitudes and perceived adequacy of breastfeeding education among baccalaureate nursing students in Cairo, Egypt. Self-confidence to provide breastfeeding support for mothers was also investigated. Background:- Nurses play a crucial role in promoting breastfeeding. Studies in Western countries have found inadequate breastfeeding knowledge among undergraduate nursing students. No published literature about breastfeeding knowledge and attitudes among nursing students in Egypt was found. Method:- An exploratory descriptive study used a sample of 110 baccalaureate nursing students from Cairo, Egypt. St...

Nurses as professionals and as individual consumers are affected by health policy and bear a responsibility for participating in the health policy arena. Nursing's growing recognition of the importance of public policy issues is increasingly being translated into action by various groups within the profession. Persuading student nurses of the importance of health policy provides a special challenge to faculty. A clinical practicum was designed that requires senior baccalaureate students in various community settings to identify, analyze, and challenge health policy issues. The course design, integration into the curriculum, and evaluation can be models for faculty considering the challenge of stimulating student interest in health policy issues. PMID:8029184

Frequent pain assessment by the use of pain diaries for the follow-up of pain treatment can facilitate the caregivers' work with pain control in home health care. The aim was to explore and describe professional caregivers' experiences of palliative home health-care patients' use of pain diaries and digital pen technology for frequent pain assessment. A system for the follow-up of pain treatment was implemented in routine care and evaluated by means of a qualitative content analysis. Three nurses, two physicians and one secretary were interviewed. Additional analysis data were collected from patients' medical records, and the system log. The caregivers showed a shifting outlook towards the pain-assessment method, an initial cautious outlook due to low expectations of the patients' abilitie...

Ireland began actively recruiting nurses internationally in 2000. Between 2000 and 2010, 35% of new recruits into the health system were non-EU migrant nurses. Ireland is more heavily reliant upon international nurse recruitment than the UK, New Zealand or Australia. This paper draws on in-depth interviews (N=21) conducted in 2007 with non-EU migrant nurses working in Ireland, a quantitative survey of non-EU migrant nurses (N=337) conducted in 2009 and in-depth interviews conducted with key stakeholders (N=12) in late 2009/early 2010. Available primary and secondary data indicate a fresh challenge for health workforce planning in Ireland as immigration slows and nurses (both non-EU and Irish trained) consider emigration. Successful international nurse recruitment campaigns obviated the nee...

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The nursing shortage remains an acute problem at the national level and significantly endangers the provision of safe and effective health care. One of the most significant problems fueling the nursing shortage in the United States is the lack of faculty to educate the number of qualified individuals applying to nursing programs. A major factor driving the shortage of faculty emanates from the current trend in basic nursing education that is increasing the proportion of nurses with an associate degree in nursing (ADN) as their terminal professional education. Community colleges, that offer the associate degree, play a crucial role in providing access to nursing education. However, they now account for more than 2/3 of all new nursing graduates in the United States. With over 2/3 of our new...

van bruchem-van de scheur gg, van der arend ajg, abu-saad hh, van wijmen fcb, spreeuwenberg c &ter meulen rhj (2008) Journal of Clinical Nursing17, 1618-1626Euthanasia and assisted suicide in Dutch hospitals: the role of nurses Aim. To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions. Background. Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes. Method. A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital ...

In this study of 60 patients and 30 nurses the objectives were to identify the degree of concordance between patient and nurse ratings of post-operative pain, and to assess the use of pain control methods used by nursing staff In the control of post-operative pain. Discrepancies existed between nurs...

The purpose of this article is to present findings from a study which evaluated the effectiveness of a virtual community (an emerging pedagogical application) on student engagement and academic performance. Virtual communities mirror real-life through unfolding patient histories and relationship development over time. Students also become more engaged in learning by creating personally meaningful knowledge of a concept (Rogers & Stone, 2007). Virtual communities offer one teaching strategy to assist students in learning complex, health-related content in a contextualized manner. This quasi-experimental study involved first-semester baccalaureate nursing students enrolled in a course at two campuses of a nursing program at a large university in the Southwest. Three key strategies assessed t...

Introduction: The aim of the systematic review was to examine (i) the impact of afterhours primary care models on ED, ambulance services and or general practitioners and (ii) the effectiveness of these services (afterhours) on nurse practitioners and/or the medical doctors delivery of care. Method: Articles were assessed using the Critical Appraisal Skills Programme (CASP) making sense of evidence tools and covered the period from 1970 to 2011. The data sources searched were: Cumulative Index to Nursing and Allied Health literature, Medline, EMBASE, The Cochrane Database of Systematic Reviews, PubMed, Science Direct and Proquest. Results: A total of 2268 were retrieved and 419 studies were identified. Eighty-seven studies were found to be relevant. Nine countries are represented in the dat...

Follow-up visits by clinical nurse specialists are beneficial for patients with various chronic conditions. It is unknown whether patients with chronic nonmalignant pain can achieve similar benefit. The aim of this study was to assess outcomes of follow-up visits by clinical nurse specialists to chronic nonmalignant pain patients regarding health-related quality of life (HRQoL), pain, opioid treatment, quality of sleep, and depression. A total of 102 patients were enrolled in a prospective randomized controlled trial during a 2-year period after discharge from multidisciplinary pain treatment and randomized to intervention or control group. Intervention group patients (n = 52) received home visits every fourth month for 2 years. The findings showed that HRQoL improved generally more in the...

Even before the invasion of Kuwait by the Iraqis in August 1990, the Ministry of Health (MOH) hospitals were overcrowded with patients. This overcrowding was very obvious on surgical floors. Two major reasons for the overcrowding were the high rate of admissions and the overstaying of some patients. The main reasons for overstaying were postoperative complications and patients' anxiety regarding their wounds, both of which could have been prevented or minimized through preoperative patient teaching. This study was done in order to identify the major components of a preoperative patient teaching programme as viewed by Arab and non-Arab surgical nurses and patients, which will serve as a guide in formulating a structured teaching programme for surgical patients. It will also assess the adequacy of preoperative patient teaching done by nurses. PMID:7516939

Health care is a complex industry, consequently requiring a diverse group of health care executives leading initiatives for efficiency and effectiveness in patient care delivery. Value-based purchasing and pay for performance are at the top of the list for indicators of success, and many hospitals are merging into health care systems. The role of the system chief nurse executive is an evolving role to lead health care systems in clinical, operational, patient safety, and patient satisfaction processes and outcomes. The American Organization of Nurse Executives, being the voice for nursing leadership, convened a group of system chief nurse executives to address the role, function, and competencies needed for this significant and emerging role in health care. This article describes the role statement and system chief nurse executive competencies needed for success in the role. In addition, the next steps for addressing the needs of this group will be outlined in this article. PMID:22955216

The data model developed on behalf of the Nursing Service Commission of the Canton of Zurich (Pflegedienstkommission des Kantons Zürich) is based on the NANDA nursing diagnoses, the Nursing Outcome Classification, and the Nursing Intervention Classification (NNN Classifications). It also includes integrated functions for cost-centered accounting, service recording, and the Swiss Nursing Minimum Data Set. The data model uses the NNN classifications to map a possible form of the nursing process in the electronic patient health record, where the nurse can choose nursing diagnoses, outcomes, and interventions relevant to the patient situation. The nurses' choice is guided both by the different classifications and their linkages, and the use of specific text components pre-defined for each classification and accessible through the respective linkages. This article describes the developed data model and illustrates its clinical application in a specific patient's situation. Preparatory work required for the implementation of NNN classifications in practical nursing such as content filtering and the creation of linkages between the NNN classifications are described. Against the background of documentation of the nursing process based on the DAPEP(1) data model, possible changes and requirements are deduced. The article provides a contribution to the discussion of a change in documentation of the nursing process by implementing nursing classifications in electronic patient records. PMID:19943229

AIMS: To determine the impact of a Parkinson's medicine education program on nurses' knowledge and practices in two settings where people with Parkinson's disease are cared for: hospitals and residential aged care facilities. The Parkinson's Disease Medication Protocol Program aimed to increase nurse knowledge of Parkinson's medication administration and safety in care management in order to improve health outcomes, function and well-being for the person with Parkinson's. BACKGROUND: The ageing demographic of the developed world is concomitant with an increase in chronic disease, with Parkinson's disease being one of the most debilitating and costly. Individually complex medication regimens and unique spectrums of symptoms require disease-specific knowledge in nurses. People with Parkinson's disease admitted to hospitals and/or living in residential aged care facilities often have multiple co-morbidities, rendering care more complex still. Nurse ignorance of Parkinson's disease medicines, their uses, side effects and administration regimens, and safe care practices, can cause unnecessary distress and dysfunction for the person. METHOD: The two pilot studies employed an eighteen month pre/post-test/follow up design at different time frames, using a questionnaire developed by the study team and an expert panel to evaluate nurses' self-assessed 'perceived' knowledge and actual knowledge of Parkinson's disease, Parkinson's medicines and safe care practices, and satisfaction with the targeted Parkinson's education program. RESULTS/FINDINGS: Nurses in the hospital pilot (2006/8) revealed deficits in pre-test perceived and actual knowledge levels, which increased significantly at post-test and follow-up. In contrast, in the residential aged care pilot (2008/10) the nurses had higher perceived and actual (correct) knowledge relevant to experience at pre-test and these levels increased at follow-up. Both pilot study cohorts were very satisfied with the PDMPP as an education and support vehicle in Parkinson's management. CONCLUSION: These study results concur with the international literature which identifies that without targeted clinical education nurses do not necessarily have sufficient knowledge to effectively manage Parkinson's medicines and avoid unnecessary negative outcomes arising from delays, errors and omissions, nor do they know how to provide safe and effective care for persons with Parkinson's. A well-developed and resourced Parkinson's medicine education program, such as the PDMPP, has the potential to improve deficits in clinical practice. PMID:22626862

Information technology applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes in healthcare are still to remain a challenge for decision makers. The adoption of a school nursing information system is considered one of the most efficient ways in which to document health records as well as monitor health of school children conditions electronically. However, despite the importance of computerized health records in school nursing practice, few studies have examined user satisfaction of the school nursing information system. The aim of this study is to investigate the critical factors affecting school nurses? satisfaction with a school nursing information system utilizing a survey approach. Questionnaires were distributed to nurses working...

The purpose of this article was to bring to nursing science a theoretical framework and technology that can transport with it new ways of knowing by exploiting microperspectives and macroperspectives, both from "within the map" and globally. Nursing continues to find its voice, but it also must lend its voice to the forming of Geographic Information Systems and Science in a pan-disciplinary partnership with geography, cartography, sociology, public health, and information technology. It is proposed that nursing take advantage of the latest databases that hold "person" information and layer these over geographical maps holding "environment" and "health" information as a new way of seeing and applying the metaparadigms of nursing. By using Geographic Information Systems for understanding spatial, numeric, health, and population relationships as they relate to nursing practice, research, and teaching, nursing science will continue to evolve at a speed needed to be effective in the new millennia. PMID:15206686

A culturally diverse work force is vital to meeting the health care needs of an increasingly diverse population. The lack of minority faculty has been documented as a barrier to recruitment and retention of culturally diverse nursing students. Literature that addresses the nursing faculty shortage and the shortage of minority nurse educators is investigated. A double-loop approach to recruitment and retention of minority nursing faculty is proposed and includes the strategies of focused faculty searches, emphasizing internal resources of the academic institution, traditional and distance mentoring, nursing department initiatives, welcoming activities, and campus programs. PMID:21901996

newton s., pillay j. & higginbottom g. (2012) Journal of Nursing Management20, 534-550 The migration and transitioning experiences of internationally educated nurses: a global perspective Aim- To comprehensively review recent literature related to the migration and transitioning experiences of internationally educated nurses (IENs). Background- Many developed nations are redressing nursing deficits by recruiting IENs. Acquiring credentialing is historically recognized as a barrier to obtaining meaningful employment, yet broader issues of transition into global health care contexts are also significant. Methods- A database search of CINAHL, Medline, Scopus and Web of Science, and a hand-search of key nursing journals produced 239 combined hits, with 21 articles meeting the inclusion criteri...

The intent of criminal background checks (CBCs) is to provide a safeguard for the public by ensuring the good moral character of nurses. As the public demands more scrutiny, hospitals and schools of nursing are joining regulatory boards in requiring CBCs of nurse practitioners and students, citing their responsibility to protect public health and safety. Although this screening practice has been implemented across the nation, research is limited that addresses the best practices for screening in nursing licensure, education, and employment. Enhanced standards could mean that APRNs would not have to repeat CBCs for school, nursing licenses, and employers.

This article presents an argument for research on the practical outcomes of genetics education in professional nursing programs. Nurse educators should aggressively conduct educational outcomes research on the translation of genetics core competencies at all levels of clinical practice. There should be a systematic examination of the factors, that influence graduate nurses' applications of concepts to patient care including type of educational preparation in genetics. The best way to improve health is to understand normal genome biology and its relationship to disease biology. Assuring genetics and genomic literacy among all nurses is a crucial task for contemporary nursing education programs. PMID:23137604