Nursing practice in stroke rehabilitation: systematic review and meta-ethnography.

Science.gov (United States)

Clarke, David J

2014-05-01

To identify and synthesise the available research evidence in order to generate an explanatory framework for nursing practice in stroke rehabilitation. Although nurses are the largest professional group working with stroke survivors, there is limited understanding of nursing practice in stroke units. In particular, there is currently very little evidence in respect of nurses' involvement in poststroke rehabilitation. Meta-ethnography. A systematic review was undertaken. The review question was: 'What is the nature of nursing practice in the care and rehabilitation of inpatient stroke survivors?' Searches of 12 electronic databases identified 14,655 publications, and after screening, 778 remained; 137 papers were obtained and 54 retained for mapping. Sixteen qualitative studies were included in the meta-ethnography. Nurses' involvement in poststroke rehabilitation was limited. Contextual factors impacted on nurses' perceptions and practice. Nurses' integration of rehabilitation skills was perceived to be contingent on adequate nurse staffing levels and management of demands on nurses' time. Team working practices and use of the built environment indicated separation of nursing and therapy work. Physical care and monitoring were prioritised. Stroke-specific education and training was evident, but not consistent in content or approach. Stroke survivors and families needed help to understand nurses' role in rehabilitation. The review provides compelling evidence that there is an need to re-examine the role of nurses in contributing to poststroke rehabilitation, including clarifying when this process can safely begin and specifying the techniques that can be integrated in nurses' practice. Integrating stroke-specific rehabilitation skills in nurses' practice could contribute substantially to improving outcomes for stroke survivors. The explanatory framework developed from the review findings identifies issues which will need to be addressed in order to maximise nurses

Fostering nursing ethics for practical nursing

OpenAIRE

森田, 敏子; モリタ, トシコ; Morita, Toshiko

2014-01-01

Higher nursing ethics can raise nursing quality. The author attempts to define theproblem from the seedling of sensibility in practical nursing and focuses on the clinical environment surrounding nursing ethics from its pedagogical and historicalaspects. On the basis of these standpoints, the author discusses issues on the practical nursing as a practitioner of nursing ethics.

Emergency nurses' current practices and understanding of family presence during CPR.

LENUS (Irish Health Repository)

Madden, Eilis

2012-02-03

PURPOSE: To examine emergency nurses\\' current practices and understanding of family presence during CPR in the emergency department, Cork University Hospital, Republic of Ireland. METHOD: A quantitative descriptive design was used in the study. A questionnaire developed by ENA was distributed to emergency nurses working in a level I trauma emergency department at Cork University Hospital. The total sample number was 90, including all emergency nurses with at least 6 months\\' emergency nursing experience. RESULTS: Emergency nurses often took families to the bedside during resuscitation efforts (58.9%) or would do so if the opportunity arose (17.8%). A high percentage (74.4%) of respondents would prefer a written policy allowing the option of family presence during CPR. The most significant barrier to family witnessed resuscitation (FWR) was conflicts occurring within the emergency team. The most significant facilitator to FWR was a greater understanding of health care professionals on the benefits of FWR to patients and families, indicating the need for educational development. CONCLUSION: The findings of the study and previously published studies indicate the need for development of written polices and guidelines on the practice to meet the needs of patients, families, and staff by providing consistent, safe, and caring practices for all involved in the resuscitation process. Recommendations of the study include the development of a written policy and an educational programme on the safe implementation and practices of FWR.

Simulated learning environment experience in nursing students for paediatric practice.

Science.gov (United States)

Mendoza-Maldonado, Yessy; Barría-Pailaquilén, René Mauricio

The training of health professionals requires the acquisition of clinical skills in a safe and efficient manner, which is facilitated by a simulated learning environment (SLE). It is also an efficient alternative when there are limitations for clinical practice in certain areas. This paper shows the work undertaken in a Chilean university in implementing paediatric practice using SLE. Over eight days, the care experience of a hospitalized infant was studied applying the nursing process. The participation of a paediatrician, resident physician, nursing technician, and simulated user was included in addition to the use of a simulation mannequin and equipment. Simulation of care was integral and covered interaction with the child and family and was developed in groups of six students by a teacher. The different phases of the simulation methodology were developed from a pedagogical point of view. The possibility of implementing paediatric clinical practice in an efficient and safe way was confirmed. The experience in SLE was highly valued by the students, allowing them to develop different skills and abilities required for paediatric nursing through simulation. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Associate Degree in Nursing-to-Bachelor of Science in Nursing Graduates' Education and Their Perceived Ability to Keep Patients Safe.

Science.gov (United States)

Anbari, Allison Brandt; Vogelsmeier, Amy

2018-05-01

Associate Degree in Nursing (ADN)-to-Bachelor of Science in Nursing (BSN) programs are designed to advance the ADN-prepared RNs' clinical reasoning and analytical skills. However, little is known about exactly how their BSN education may improve their clinical practice, specifically in the area of patient safety. During semi-structured one-to-one interviews, ADN-to-BSN graduates were asked about their educational process and the perceived affect their education made on their ability to keep patients safe. Content analysis were used to identify emerging themes and categories. Three themes emerged from the data: (a) an unaltered approach to keeping patients safe, (b) experience as an ADN matters, and (c) BSN degree as a stepping stone. The call to increase the number of BSN-prepared nurses at the bedside is supported in the evidence and noteworthy of pursuit. However, as ADN-to-BSN programs increase in numbers to meet this demand, the outcomes of graduates need to be considered. [J Nurs Educ. 2018;57(5):300-303.]. Copyright 2018, SLACK Incorporated.

The role of internationally educated nurses in a quality, safe workforce.

Science.gov (United States)

D Sherwood, Gwen; Shaffer, Franklin A

2014-01-01

Migration and globalization of the nursing workforce affect source countries and destination countries. Policies and regulations governing the movement of nurses from one country to another safeguard the public by ensuring educational comparability and competence. The global movement of nurses and other health care workers calls for quality and safety competencies that meet standards such as those defined by the Institute of Medicine. This article examines nurse migration and employment of internationally educated nurses (IENs) in the context of supporting and maintaining safe, quality patient care environments. Migration to the United States is featured as an exemplar to consider the following key factors: the impact of nurse migration on the nursing workforce; issues in determining educational comparability of nursing programs between countries; quality and safety concerns in transitioning IENs into the workforce; and strategies for helping IENs transition as safe, qualified members of the nursing workforce in the destination country. Copyright © 2014 Elsevier Inc. All rights reserved.

Nursing Practice Environment and Outcomes for Oncology Nursing

Science.gov (United States)

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

Indigenous Methodology in Understanding Indigenous Nurse Graduate Transition to Practice

Directory of Open Access Journals (Sweden)

Donna L. M. Kurtz

2017-10-01

Full Text Available Increasing Indigenous health care professional presence in health care aims to reduce health inequities of Indigenous Peoples in Canada. Nurses are the largest health professional group and nurse graduates the main source of recruitment. The quality of graduate transition to practice is evident in the literature; however, little is reported about Indigenous new graduates. We describe using Indigenous methodology and two-eyed seeing (Indigenous and Western perspectives in exploring Indigenous transition experiences. Talking circles provided a safe environment for nurses, nurse educators and students, health managers, and policy makers to discuss Indigenous new graduate case scenarios. The methodology was critical in identifying challenges faced, recommendations for change, and a new collective commitment for cultural safety education, and ethical and respectful relationships within education, practice, and policy.

Safe practices and financial considerations in using oral chemotherapeutic agents.

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Bartel, Sylvia B

2007-05-01

Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed. Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy. Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.

Systems thinking and incivility in nursing practice: An integrative review.

Science.gov (United States)

Phillips, Janet M; Stalter, Ann M; Winegardner, Sherri; Wiggs, Carol; Jauch, Amy

2018-01-23

There is a critical need for nurses and interprofessional healthcare providers to implement systems thinking (ST) across international borders, addressing incivility and its perilous effects on patient quality and safety. An estimated one million patients die in hospitals worldwide due to avoidable patient-related errors. Establishing safe and civil workplaces using ST is paramount to promoting clear, level-headed thinking from which patient-centered nursing actions can impact health systems. The purpose of the paper is to answer the research question, What ST evidence fosters the effect of workplace civility in practice settings? Whittemore and Knafl's integrative review method guided this study. The quality of articles was determined using Chu et al.'s Mixed Methods Assessment Tool. Thirty-eight studies were reviewed. Themes emerged describing antecedents and consequences of incivility as embedded within complex systems, suggesting improvements for civility and systems/ST in nursing practice. This integrative review provides information about worldwide incivility in nursing practice from a systems perspective. Several models are offered as a means of promoting civility in nursing practice to improve patient quality and safety. Further study is needed regarding incivility and resultant effects on patient quality and safety. © 2018 Wiley Periodicals, Inc.

Implementing and Sustaining Evidence Based Practice Through a Nursing Journal Club.

Science.gov (United States)

Gardner, Kevin; Kanaskie, Mary Louise; Knehans, Amy C; Salisbury, Sarah; Doheny, Kim K; Schirm, Victoria

2016-08-01

The outcomes based emphasis in nursing and health care delivery requires identification of best available evidence in order to produce quality, safe, and effective patient care. Finding, critiquing, and ultimately implementing the best available evidence for practice is a formidable task for many clinical nurses. Development and implementation of a nursing journal club (NJC) became one organization's successful attempt to help clinical nurses better understand and use best available evidence in actual practice. The process and structure for the NJC evolved from an additional activity scheduled outside of work to a fully established endeavor of Nursing Research and Evidence Based Practice Council (NR&EBP). The Nursing Professional Practice Model was foundational to establishing the NJC as a formal component within the NR&EBP Council shared governance structure. Efforts to embed the NJC included taking advantage of resources available at an academic medical center and incorporating them into the council structure. Successful outcomes of the NJC include a quarterly schedule, with topics selected in advance that are based on nursing department as well as organizational driven goals and initiatives. The structure and process in place has eliminated frequently mentioned deterrents to evidence based practice such as not enough time, lack of knowledge, or no immediate application to practice. Incorporating the NJC as a component of NR&EBP Council has provided clinical nurses time away from clinical care that supports scholarship for nursing practice. Committed leadership and garnering of available resources have been key factors for success. Copyright © 2016 Elsevier Inc. All rights reserved.

Advanced practice nurses: starting an independent practice.

Science.gov (United States)

Lambert, V A; Lambert, C E

1996-01-01

Independent or private practice is the delivery of nursing services provided by nurses over which nurses have full control. With a changing healthcare system, nurses are in a prime position to negotiate the delivery of appropriate, acceptable, and cost-effective health care as independent practitioners. This article addresses the mission and goals of independent practice, community need, business structure of the practice, housing the practice, legal considerations, financing the practice, marketing issues, clientele, record keeping, and reimbursement.

Transformational leadership practices of nurse leaders in professional nursing associations.

Science.gov (United States)

Ross, Erin J; Fitzpatrick, Joyce J; Click, Elizabeth R; Krouse, Helene J; Clavelle, Joanne T

2014-04-01

This study describes the transformational leadership (TL) practices of nurse leaders in professional nursing associations (PNAs). Professional nursing associations are vehicles to provide educational opportunities for nurses as well as leadership opportunities for members. Little has been published about the leadership practices of PNA members. E-mail surveys of 448 nurse leaders in PNAs were conducted in 2013 using the Leadership Practices Inventory (LPI). The top 2 TL practices of these nurse leaders were enabling others to act and encouraging the heart. Respondents with more leadership training reported higher TL practices. This is the 1st study to describe TL practices of nurse leaders in PNAs. Results of this study show that nurse leaders of PNAs emulate practices of TL. Transformational leaders can mobilize and direct association members in reaching shared values, objectives, and outcomes. Understanding TL practices of nurse leaders in PNAs are important to the future of nursing in order to enable nurses to lead change and advance health through these organizations.

Relationship between nurses' practice environments and nursing outcomes in Turkey.

Science.gov (United States)

Topçu, I; Türkmen, E; Badır, A; Göktepe, N; Miral, M; Albayrak, S; Kebapçı, A; Serbest, Ş; Özcan, D

2016-06-01

This study aimed to understand nursing practice environment characteristics in Istanbul-area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. A well-known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. This cross-sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Almost half of nurses suffered from high-level burnout related to emotional exhaustion and personal accomplishment, and one-third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. There was a relationship between poor practice environments and nursing outcomes in Turkey. The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Poor practice environments, high-level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. © 2016 International Council of Nurses.

Emergency Nurses Association

Science.gov (United States)

... menu Join ENA Today! Membership in the Emergency Nurses Association offers a variety of benefits and allows ... a part of more than 42,000 emergency nurses working together to promote safe practice and safe ...

Developing the leadership skills of new graduates to influence practice environments: a novice nurse leadership program.

Science.gov (United States)

Dyess, Susan; Sherman, Rose

2011-01-01

The authors of the recently published Institute of Medicine on the Future of Nursing report emphasized the importance of preparing nurses to lead change to advance health care in the United States. Other scholars linked practice environments to safe quality care. In order for nurses to fully actualize this role in practice environments, they need to possess leadership skills sets that identify and respond to challenges faced. New nurses are no exception. This article presents a program with a 5-year track record that is designed to support transition and enhance the skill sets of leadership for new nurses in their first year of practice. Qualitative and quantitative evaluation measurements at baseline and postprogram provided data for evaluation of the first 4 cohorts in the program. Evaluative outcomes presented indicate that new nurses gained leadership and translational research skills that contributed to their ability to influence practice environments. Nonetheless, practice environments continue to need improvement and ongoing leadership from all levels of nursing must be upheld.

Experience and Perception of Sexual Harassment During the Clinical Practice of Korean Nursing Students

Directory of Open Access Journals (Sweden)

Sun-Kyoung Lee, PhD, RN

2011-09-01

Conclusion: Education program is needed to prevent sexual harassment and enhance the gender sensitivity of nursing students, who are in the high-risk group of sexual harassment during clinical practice. This will in turn contribute to a safe educational environment for clinical practice.

Clinical practice: new challenges for the advanced practice nurse.

Science.gov (United States)

Bartel, J C; Buturusis, B

2000-12-01

This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community?

Leader Influence, the Professional Practice Environment, and Nurse Engagement in Essential Nursing Practice.

Science.gov (United States)

Ducharme, Maria P; Bernhardt, Jean M; Padula, Cynthia A; Adams, Jeffrey M

The purpose of this study was to examine relationships between leaders' perceived influence over professional practice environments (PPEs) and clinical nurses' reported engagement in essential professional nursing practice. There is little empirical evidence identifying impact of nurse leader influence or why nursing leaders are not perceived, nor do they perceive themselves, as influential in healthcare decision making. A nonexperimental method of prediction was used to examine relationships between engagement in professional practice, measured by Essentials of Magnetism II (EOMII) tool, and nurse leaders' perceived influence, measured by Leadership Influence over Professional Practice Environment Scale (LIPPES). A convenience sample of 30 nurse leaders and 169 clinical nurses, employed in a 247-bed acute care Magnet® hospital, participated. Findings indicated that leaders perceived their influence presence from "often" to "always," with mean scores of 3.02 to 3.70 on a 4-point Likert scale, with the lowest subscale as "access to resources" for which a significant relationship was found with clinical nurses' reported presence of adequate staffing (P influence links structures necessary for an environment that supports outcomes.

Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes

Science.gov (United States)

Choi, JiSun; Flynn, Linda; Aiken, Linda H.

2012-01-01

Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…

Faculty Perceptions of Effective Practices for Utilizing a Framework to Develop a Concept-Based Curriculum in Nursing Education

Science.gov (United States)

Magorian, Kathryn G.

2013-01-01

All programs of healthcare education face increasing change and daunting challenges to prepare new graduates for the real world of practice as care providers in complex systems. The necessity for change in nursing education is at a critical level, called on from a variety of sources. New nurses must be able to enter practice as competent, safe,…

Nurses' perceptions of the organizational attributes of their practice environment in acute care hospitals.

Science.gov (United States)

Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Aaviksoo, Ain

2009-12-01

The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

Science.gov (United States)

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

Science.gov (United States)

Tarlier, Denise S; Browne, Annette J

2011-06-01

Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.

Factors influencing oncology nurses' use of hazardous drug safe-handling precautions.

Science.gov (United States)

Polovich, Martha; Clark, Patricia C

2012-05-01

To examine relationships among factors affecting nurses' use of hazardous drug (HD) safe-handling precautions, identify factors that promote or interfere with HD precaution use, and determine managers' perspectives on the use of HD safe-handling precautions. Cross-sectional, mixed methods; mailed survey to nurses who handle chemotherapy and telephone interviews with managers. Mailed invitation to oncology centers across the United States. 165 nurses who reported handling chemotherapy and 20 managers of nurses handling chemotherapy. Instruments measured the use of HD precautions and individual and organizational factors believed to influence precaution use. Data analysis included descriptive statistics and hierarchical regression. Manager interview data were analyzed using content analysis. Chemotherapy exposure knowledge, self-efficacy, perceived barriers, perceived risk, interpersonal influences, and workplace safety climate. Nurses were well educated, experienced, and certified in oncology nursing. The majority worked in outpatient settings and administered chemotherapy to an average of 6.8 patients per day. Exposure knowledge, self-efficacy for using personal protective equipment, and perceived risk of harm from HD exposure were high; total precaution use was low. Nurse characteristics did not predict HD precaution use. Fewer barriers, better workplace safety climate, and fewer patients per day were independent predictors of higher HD precaution use. HD handling policies were present, but many did not reflect current recommendations. Few managers formally monitored nurses' HD precaution use. Circumstances in the workplace interfere with nurses' use of HD precautions. Interventions should include fostering a positive workplace safety climate, reducing barriers, and providing appropriate nurse-patient ratios.

Patient safety in practical nurses' education: A cross-sectional survey of newly registered practical nurses in Canada.

Science.gov (United States)

VanDenKerkhof, Elizabeth; Sears, Nancy; Edge, Dana S; Tregunno, Deborah; Ginsburg, Liane

2017-04-01

Practical nurses have experienced an increasing scope of practice, including an expectation to care for complex patients and function on interdisciplinary teams. Little is known about the degree to which patient safety principles are addressed in practical nursing education. To examine self-reported patient safety competencies of practical nurses. A cross-sectional online survey (July 2014) and face-to-face interviews (June 2015). Ontario, Canada. Survey participants were practical nurses newly registered with the College of Nurses of Ontario between January 2012 and December 2013. Interview participants were faculty and students in a practical nursing program in Ontario. Survey respondents completed the Health Professional Education in Patient Safety Survey online. Self-reported competencies in various patient safety domains were compared between classroom and clinical settings. Faculty members were interviewed about educational preparation of practical nurses and students were interviewed to provide insight into interpretation of survey questions. The survey response rate was 28.4% (n=1104/3883). Mean domain scores indicated a high level of confidence in patient safety competence (Nurses of Ontario >2years and in those who obtained their education outside of Canada. Faculty believed their approach to teaching and learning instilled a deep understanding of the limits to practical nurse autonomous practice. Practical nurses were confident in what they learned about patient safety in their educational programs. The high degree of patient safety competence may be a true reflection of practical nurses understanding of, and comfort with, the limits of their knowledge and, ultimately, the limits of their individual autonomous practice. Further exploration as to whether the questionnaire requires additional modification for use with practical nurse populations is warranted. However, this study provides the first examination of practical nurses' perspectives and

Chief nursing officers' perceptions of the Doctorate of Nursing Practice degree.

Science.gov (United States)

Swanson, Michelle L; Stanton, Marietta P

2013-01-01

Nurse executives practice in a business environment, which requires a skill set that has traditionally not been included in advanced nursing curriculum. The Doctorate of Nursing Practice (DNP) essentials are designed to address this gap in education while maintaining the focus on advanced nursing practice and executive management competency. Current literature supports the appropriateness of the DNP with practice focus areas of advanced practice specialties and nursing leadership. Although certification and educational bodies, and some professional nursing organizations, have embraced the DNP as the terminal degree for non-research-focused nurses, there remains a gap in the literature in regards to the perceptions of validity of the DNP for nurse executives. The purpose of this capstone project was to investigate the perceptions of practicing chief nursing officers (CNOs) in the acute care setting regarding the application of the DNP degree for nurse leaders. Utilizing an online survey, specific perceptions investigated included application and appropriateness of the DNP in a business-based practice model and managing daily nursing operations. CNOs practicing in the acute care setting differed on their responses regarding whether the DNP should be the recommended or the required degree in CNO development programs. CNOs with tenure responded more positively to the perception that the DNP curricula contains advanced nursing knowledge content appropriate to nurse executive practice. Practicing CNOs in the acute care setting do perceive the DNP as an appropriate degree option for nurse executive roles at aggregate, system, and organizational levels. © 2013 Wiley Periodicals, Inc.

The development of professional practice standards for Australian general practice nurses.

Science.gov (United States)

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2017-08-01

The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.

[Centennial retrospective on the evolution and development of the nursing practice environment in Taiwan].

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Lin, Shou-Ju; Huang, Lain-Hua

2014-08-01

The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.

Safe Injection Practices in Primary Health Care Settings of Naxalbari Block, Darjeeling District, West Bengal.

Science.gov (United States)

Chaudhuri, Sudip Banik; Ray, Kuntala

2016-01-01

Unsafe injection can transmit many diseases to patients, injection providers and healthy people of community. To find out critical steps whether executed according to recommended best practice methods, availability of equipments in health facilities for safe injection practices and some important steps of waste disposal methods. This facility-based cross-sectional observational study was conducted among 30 Auxiliary nurse midwives (ANM) & 27 nursing staffs (NS) to assess certain aspects of their practice while administrating injection and disposal of the disposables. Health facilities were also observed to asses necessary equipments of safe injection and waste disposal methods. Among the health workers 93.3% ANM and 100% NS took sterile syringe from sterile unopened packet, all of the study subjects washed hand before giving injection, 13.3% of ANMs and 8% of NS are fully vaccinated against Hep B, 53.3% of ANM and all NS are practices non recapping. Only 13.33% sub centres along with PHC & BPHC had at least one puncture resistant leak proof container, 86.7% sub centres, PHC are free from loose needles. Transport for off side treatment is the method of waste disposal in case of 73.3% cases sub centres, PHC & BPHC. There is need to educate, train and motivate service providers in proper methods of giving injection along with improve the adequacy of supply of required equipments.

Safe use of ionizing radiations

Energy Technology Data Exchange (ETDEWEB)

1973-01-01

Based on the ''Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use'' (CIS 74-423), this handbook shows how hospital staff can avoid exposing themselves and others to these hazards. It is designed particularly for junior and student nurses. Contents: ionizing radiations, their types and characteristics; their uses and dangers; basic principles in their safe use; safe use in practice; explanation of terms.

Relationships between duration of practice, educational level, and perception of barriers to implement evidence-based practice among critical care nurses.

Science.gov (United States)

Phillips, Carswella

2015-12-01

Globally, a greater emphasis has been placed on the delivery of safe, patient-centered, evidence-based nursing care. As point-of-care providers, critical care nurses play a key role in ensuring that patients receive the safest, most effective treatment available. In order to deliver scientific-based care, critical care nurses must stay abreast of the current trends, as well as engage in the evidence-based practice process. This study aimed to describe research activities, to identify barriers to implement evidence-based practice and to explore professional factors related to the use of evidence-based practice among critical care nurses at three teaching hospitals in south-eastern United States. A survey design and convenience sampling method was used. A sample of 30 critical care staff nurses participated in the study. A 61-item online questionnaire composed of a demographic survey - BARRIERS scale - and Evidence-Based Practice Questionnaire was used. Simple descriptive statistics, Pearson's product moment correlations, and independent-sample t test procedures were used to analyze the data. Critical care nurses' reported positive attitudes, but viewed knowledge and use of evidence-based practice less favorably. These results may indicate that having a positive attitude towards evidence-based practice does not necessarily translate to knowledge and use of the evidence-based practice process in clinical practice. An unwillingness to change and time constraints were identified as the top barriers to use evidence-based practice in this study. Perceptions of barriers to use evidence-based practice were higher in those critical care nurses who had less practical experience and educational preparation. The results suggest that critical care nurses possess the foundation to engage in the evidence-based practice process; however, their knowledge, practice, and attitudes just need to be cultivated and strengthened. Understanding the nurses' professional factors, current use

Nursing practice environment: a strategy for mental health nurse retention?

Science.gov (United States)

Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda

2015-06-01

Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required. © 2015 Australian College of Mental Health Nurses Inc.

Gender Creative or Transgender Youth and Advanced Nursing Practice.

Science.gov (United States)

Kirouac, Nicole; Tan, Mabel

2017-06-01

The World Professional Association for Transgender Health (WPATH) defines gender dysphoria as "Discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)" (WPATH, 2016). Gender creative (GC) and transgender (TG) youth are at high risk for severe mental health disparities if they don't receive competent and timely gender transitioning care. Although awareness and early care of TG youth in specialty clinics is improving and increasing, there is still much effort that is required to eliminate barriers to care at many levels and thus improve outcomes. Nurses, particularly advanced practice nurses, are poised to lead the way in creating safe, inclusive, family centered spaces for TG and GC children, youth and their families as well as acting as vital mentors for other nurses. The purpose of this paper is to discuss the increasing prevalence of GC and TG youth, the significance of inclusive care for GC and TG youth, treatment guidelines, and the impact parents and advanced practice nurses can have on the journey of these youth as they explore and find their place on the gender spectrum. Copyright© of YS Medical Media ltd.

Substance Use Among Nurses and Nursing Students: A Joint Position Statement of the Emergency Nurses Association and the International Nurses Society on Addictions.

Science.gov (United States)

Strobbe, Stephen; Crowley, Melanie

Alcohol and other substance use by nurses potentially places patients, the public, and nurses themselves at risk for serious injury or death. Nursing students are also at risk for problems related to substance use. When viewed and treated as a chronic medical illness, treatment outcomes for substance use disorders are comparable with those of other diseases and can result in lasting benefits. Professional monitoring programs that employ an alternative-to-discipline approach have been shown to be effective in the treatment of health professionals with substance use disorders and are considered a standard for recovery, with high rates of completion and return to practice. It is the position of the Emergency Nurses Association and the International Nurses Society on Addictions that 1. health care facilities provide education to nurses and other employees regarding alcohol and other drug use and establish policies, procedures, and practices to promote safe, supportive, drug-free workplaces; 2. health care facilities and schools of nursing adopt alternative-to-discipline approaches to treating nurses and nursing students with substance use disorders, with stated goals of retention, rehabilitation, and reentry into safe, professional practice; 3. drug diversion, in the context of personal use, is viewed primarily as a symptom of a serious and treatable disease and not exclusively as a crime; and 4. nurses and nursing students are aware of the risks associated with substance use, impaired practice, and drug diversion and have the responsibility and means to report suspected or actual concerns.

Nursing students' perceptions of learning in practice environments: a review.

Science.gov (United States)

Henderson, Amanda; Cooke, Marie; Creedy, Debra K; Walker, Rachel

2012-04-01

Effective clinical learning requires integration of nursing students into ward activities, staff engagement to address individual student learning needs, and innovative teaching approaches. Assessing characteristics of practice environments can provide useful insights for development. This study identified predominant features of clinical learning environments from nursing students' perspectives across studies using the same measure in different countries over the last decade. Six studies, from three different countries, using the Clinical Leaning Environment Inventory (CLEI) were reviewed. Studies explored consistent trends about learning environment. Students rated sense of task accomplishment high. Affiliation also rated highly though was influenced by models of care. Feedback measuring whether students' individual needs and views were accommodated consistently rated lower. Across different countries students report similar perceptions about learning environments. Clinical learning environments are most effective in promoting safe practice and are inclusive of student learners, but not readily open to innovation and challenges to routine practices. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Does Faculty Incivility in Nursing Education Affect Emergency Nursing Practice?

Science.gov (United States)

Stokes, Pamela

Incivility in nursing education is a complicated problem which causes disruptions in the learning process and negatively affects future nursing practice. This mixed method research study described incivility as well as incivility's effects through extensive literature review and application of a modified Incivility in Nursing Education (INE) survey. The INE included six demographic items, four quantitative sections, and five open-ended questions. The survey examined emergency nurses' perceptions of incivility and how the experience affected their personal nursing practice. The INE was initially tested in a 2004 pilot study by Dr. Cynthia Clark. For this research study, modifications were made to examine specifically emergency nurse's perceptions of incivility and the effects on their practice. The population was a group of nurses who were members of the emergency nurses association in a Midwestern state. In the quantitative component of the Incivility in Nursing Education (INE) survey, the Likert scale questions indicated that the majority of the participants reported witnessing or experiencing the uncivil behaviors. In the qualitative section of the INE survey, the participants reported that although they have not seen incivility within their own academic career, they had observed faculty incivility with nursing students when the participants were assigned as preceptors as part of their emergency nursing practice.

Doctor of Nursing Practice: The Role of the Advanced Practice Nurse.

Science.gov (United States)

Walker, Deborah Kirk; Polancich, Shea

2015-11-01

To explore the evolution and emerging roles of the Doctor of Nursing Practice (DNP) Advanced Practice Nurse (APN). Published peer reviewed literature, cancer-related professional resources, and Web-based resources. The DNP education has prepared the APN for process improvement initiatives, providing quality care, and evidence-based practice translation, which are critical with the emerging trends in this complex health care environment. DNP-prepared APNs have the opportunity to impact oncology care across the cancer trajectory, in various settings, and in various innovative roles as entrepreneurs. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

Science.gov (United States)

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

The nursing human resource planning best practice toolkit: creating a best practice resource for nursing managers.

Science.gov (United States)

Vincent, Leslie; Beduz, Mary Agnes

2010-05-01

Evidence of acute nursing shortages in urban hospitals has been surfacing since 2000. Further, new graduate nurses account for more than 50% of total nurse turnover in some hospitals and between 35% and 60% of new graduates change workplace during the first year. Critical to organizational success, first line nurse managers must have the knowledge and skills to ensure the accurate projection of nursing resource requirements and to develop proactive recruitment and retention programs that are effective, promote positive nursing socialization, and provide early exposure to the clinical setting. The Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a network of teaching and community hospitals to develop a best practice toolkit in nursing human resource planning targeted at first line nursing managers. The toolkit includes the development of a framework including the conceptual building blocks of planning tools, manager interventions, retention and recruitment and professional practice models. The development of the toolkit involved conducting a review of the literature for best practices in nursing human resource planning, using a mixed method approach to data collection including a survey and extensive interviews of managers and completing a comprehensive scan of human resource practices in the participating organizations. This paper will provide an overview of the process used to develop the toolkit, a description of the toolkit contents and a reflection on the outcomes of the project.

Nurses' beliefs, experiences and practice regarding complementary and alternative medicine in Taiwan.

Science.gov (United States)

Smith, Graeme D; Wu, Shu-Chen

2012-09-01

, but is also important in understanding this issue from the nurses' perspective, to offer a series of recommendations for policy, nursing education, nursing practice and suggestions for further research. This study highlights the importance of nursing attitude in the use of complementary and alternative medicine. Clinical nurses have the potential to provide appropriate information to their patients to ensure safe complementary and alternative medicine use. © 2012 Blackwell Publishing Ltd.

Nurses' Perceived Skills and Attitudes About Updated Safety Concepts: Impact on Medication Administration Errors and Practices.

Science.gov (United States)

Armstrong, Gail E; Dietrich, Mary; Norman, Linda; Barnsteiner, Jane; Mion, Lorraine

Approximately a quarter of medication errors in the hospital occur at the administration phase, which is solely under the purview of the bedside nurse. The purpose of this study was to assess bedside nurses' perceived skills and attitudes about updated safety concepts and examine their impact on medication administration errors and adherence to safe medication administration practices. Findings support the premise that medication administration errors result from an interplay among system-, unit-, and nurse-level factors.

'Nursing research culture' in the context of clinical nursing practice

DEFF Research Database (Denmark)

Bøttcher Berthelsen, Connie; Hølge-Hazelton, Bibi

2017-01-01

for efficiency, nurses’ barriers to research use and the lack of definition of the concept of nursing research culture make it difficult to establish. Design Concept analysis. Data sources Data were collected through a literature review in PubMed, CINAHL and PsycINFO during March 2016. Methods Walker and Avant......Aim To report an analysis of the concept of nursing research culture in the context of clinical nursing practice. Background Nursing research culture should be valued for its contribution to improving patient care and should be considered as a routine hospital activity. However, the demand......'s eight-step framework for concept analysis. Results Five defining attributes of nursing research culture in the context of clinical nursing practice were identified: strong monodisciplinary nursing professionalism, academic thinking and socialization, research use as a part of daily nursing practice...

The experiences of student nurses on placements with practice nurses : a pilot study

OpenAIRE

Gale, Julia; Ooms, Ann; Sharples, Kath; Marks-Maran, Di

2016-01-01

To prepare the registered nurse of tomorrow in the United Kingdom (UK) to care for patients in general practice (GP)-led services, today's student nurses need to have the opportunity to experience placements with practice nurses to enable them to make positive career choices to become practice nurses in the future. The role of the practice nurse is described in the article. As a pilot project, seventeen students undertook placements with practice nurses in one of seven GP practices selected b...

The History of Evidence-Based Practice in Nursing Education and Practice.

Science.gov (United States)

Mackey, April; Bassendowski, Sandra

Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

The Importance of Reflective Practice in Nursing

Directory of Open Access Journals (Sweden)

Lauren Caldwell

2013-01-01

Full Text Available Reflection is an essential attribute for the development of autonomous, critical, and advanced practitioners (Mantzoukas & Jasper, 2004. According to Chong (2009, “Reflective practice should be a continuous cycle in which experience and reflection on experiences are inter-related” (p. 112. Studies have shown that nurses who take the time to reflect on their daily experiences provide enhanced nursing care, have a better understanding of theiractions, which in return develops their professional skills (Hansebo & Kihlgren, 2001. Reflective practice is the ability to examine ones actions and experiences with the outcome of developing their practice and enhancing clinicalknowledge. Reflective practice affects all levels of nursing, from students, to advanced practice nursing students, aswell as practicing nurses. Reflective practice is an important component of the nursing curriculum. Research has shown the relationship between student nurses and their mentors is vital. In order for reflection to be effective open-mindedness, courage, and a willingness to accept, and act on, criticism must be present (Bulmam, Lathlean, & Gobbi, 2012. This paper will explore the current literature and implications related to reflective practice in nursing.

Using Nursing Languages in School Nursing Practice. Second Edition

Science.gov (United States)

Denehy, Janice

2010-01-01

The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…

A social-ecological framework: A model for addressing ethical practice in nursing.

Science.gov (United States)

Davidson, Patricia; Rushton, Cynda Hylton; Kurtz, Melissa; Wise, Brian; Jackson, Debra; Beaman, Adam; Broome, Marion

2018-03-01

To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice. Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers. Conceptual framework development. A comprehensive literature review was undertaken using the social-ecological framework as an organising construct. This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic. Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research. Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can

Contested Practice: Political Activism in Nursing and Implications for Nursing Education.

Science.gov (United States)

Buck-McFadyen, Ellen; MacDonnell, Judith

2017-07-27

Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.

The Impact of the Nursing Practice Environment on Missed Nursing Care.

Science.gov (United States)

Hessels, Amanda J; Flynn, Linda; Cimiotti, Jeannie P; Cadmus, Edna; Gershon, Robyn R M

2015-12-01

Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Nurses missed delivering a significant amount of necessary patient care (10-27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.

Quality and safety in graduate nursing education: Cross-mapping QSEN graduate competencies with NONPF's NP core and practice doctorate competencies.

Science.gov (United States)

Pohl, Joanne M; Savrin, Carol; Fiandt, Kathryn; Beauchesne, Michelle; Drayton-Brooks, Shirlee; Scheibmeir, Monica; Brackley, Margaret; Werner, Kathryn E

2009-01-01

To ensure that nurse practitioners are prepared to deliver safe, high-quality health care, the National Organization of Nurse Practitioner Faculties (NONPF) publishes documents that outline the expected competencies for nurse practitioner (NP) practice (Domains and Core Competencies of Nurse Practitioner Practice and Practice Doctorate Nurse Practitioner Entry-Level Competencies). Having participated in the development of the Quality and Safety Education for Nurses (QSEN) competencies for graduate education, NONPF convened a task force to compare NONPF competencies with QSEN competencies for graduate education. This paper reports the first step of that cross-mapping process, comparing NONPF competencies with the QSEN knowledge objectives. Overall findings indicate close congruence across the 2 sets of competencies; however there are areas in which gaps are noted or for which clarification is required.

Rationing nurses: Realities, practicalities, and nursing leadership theories.

Science.gov (United States)

Fast, Olive; Rankin, Janet

2018-04-01

In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers' responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers' responsibilities are shaped to conform to institutional purposes. © 2017 John Wiley & Sons Ltd.

Self-perception of readiness for clinical practice: A survey of accelerated Masters program graduate registered nurses.

Science.gov (United States)

Cantlay, Andrew; Salamanca, Jennifer; Golaw, Cherie; Wolf, Daniel; Maas, Carly; Nicholson, Patricia

2017-05-01

Accelerated nursing programs are gaining momentum as a means of career transition into the nursing profession for mature age learners in an attempt to meet future healthcare workforce demands in Australia. With a gap in the literature on readiness for practice of graduates from accelerated nursing programs at the Masters level the purpose of this study was to evaluate the effectiveness of the program based on graduates' preparedness for practice and graduate outcomes. Using a descriptive, exploratory design an online survey was used to explore the perception of graduate nurses' readiness for clinical practice. Forty-nine graduates from a nursing Masters program at an Australian university completed the survey defining readiness for practice as knowledge of self-limitations and seeking help, autonomy in basic clinical procedures, exhibiting confidence, possessing theoretical knowledge and practicing safe care. Graduates perceived themselves as adequately prepared to work as a beginner practitioner with their perception of readiness for clinical practice largely positive. The majority of participants agreed that the program had prepared them for work as a beginner practitioner with respondents stating that they felt adequately prepared in most areas relating to clinical practice. This would suggest that educational preparation was adequate and effective in achieving program objectives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Culture care theory: a major contribution to advance transcultural nursing knowledge and practices.

Science.gov (United States)

Leininger, Madeleine

2002-07-01

This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

Developing a prenatal nursing care International Classification for Nursing Practice catalogue.

Science.gov (United States)

Liu, L; Coenen, A; Tao, H; Jansen, K R; Jiang, A L

2017-09-01

This study aimed to develop a prenatal nursing care catalogue of International Classification for Nursing Practice. As a programme of the International Council of Nurses, International Classification for Nursing Practice aims to support standardized electronic nursing documentation and facilitate collection of comparable nursing data across settings. This initiative enables the study of relationships among nursing diagnoses, nursing interventions and nursing outcomes for best practice, healthcare management decisions, and policy development. The catalogues are usually focused on target populations. Pregnant women are the nursing population addressed in this project. According to the guidelines for catalogue development, three research steps have been adopted: (a) identifying relevant nursing diagnoses, interventions and outcomes; (b) developing a conceptual framework for the catalogue; (c) expert's validation. This project established a prenatal nursing care catalogue with 228 terms in total, including 69 nursing diagnosis, 92 nursing interventions and 67 nursing outcomes, among them, 57 nursing terms were newly developed. All terms in the catalogue were organized by a framework with two main categories, i.e. Expected Changes of Pregnancy and Pregnancy at Risk. Each category had four domains, representing the physical, psychological, behavioral and environmental perspectives of nursing practice. This catalogue can ease the documentation workload among prenatal care nurses, and facilitate storage and retrieval of standardized data for many purposes, such as quality improvement, administration decision-support and researches. The documentations of prenatal care provided data that can be more fluently communicated, compared and evaluated across various healthcare providers and clinic settings. © 2016 International Council of Nurses.

Critical thinking of nurse managers related to staff RNs' perceptions of the practice environment.

Science.gov (United States)

Zori, Susan; Nosek, Laura J; Musil, Carol M

2010-09-01

BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Significant (p thinking confidence, and significant differences (p thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who

What GUIDES Your NURSING PRACTICE?

Science.gov (United States)

Hountras, Stacy C

2015-01-01

Nurses' personal belief systems or philosophies about nursing and people guides their nursing care, especially in difficult situations. Defining and articulating a personal philosophy helps the nurse better understand the motivation and reasoning behind his or her work. In this article, a nurse shares her philosophy of nursing, underlying beliefs, and discusses how this guides her practice. Questions to help nurses articulate their own personal philosophy of nursing are included.

Facets of private practice nursing: a conceptual model.

Science.gov (United States)

Wilson, Anne; Averis, Andrea

2002-04-01

This paper critically examines the literature relating to private practice nursing. Particular attention is given to the reasons nurses choose private practice and the major issues involved. A conceptual model has been developed based on this information. Nurses' roles are expanding into different work domains. Private practice nursing is one of the advanced practice options available. It also requires the nurse to develop business knowledge and skills. A literature search was conducted of Pub-Med, Cinahl, Medline and InfoTrac databases using the terms 'private practice', 'nurse entrepreneur', 'nurses in business', Inurse practitioners', 'self-employed nurse', 'advanced practice' and 'clinical nurse specialist'. Further relevant articles were identified from the reference lists of papers detected by this literature search. In addition, conference proceedings were examined for any other material on this topic. A thorough search of the existing literature revealed one unpublished theoretically based study which examined limited aspects of private practice nursing in Victoria. A reasonable number of articles and publications that provided anecdotal and personal accounts of being a nurse in business were identified. This review highlights the need for further theoretically based research in this area of nursing, so as to expand nursing knowledge. Suggestions are given for further research in this topical area. Existing research into private practice nursing is limited and not sufficient to inform changes to policy and nurse education. More research is needed.

Transcultural nursing practice described by registered nurses and baccalaureate nursing students.

Science.gov (United States)

Baldonado, A; Beymer, P L; Barnes, K; Starsiak, D; Nemivant, E B; Anonas-Ternate, A

1998-01-01

Using Leininger's Theory of Culture Care Diversity and Universality as a framework, this research examined transcultural practices of nurses and students. A survey was administered to a convenience sample of registered nurses and senior baccalaureate students with 767 usable questionnaires returned. Neither group expressed confidence in their ability to care for culturally-diverse patients. Registered nurses (RNs) reported assessing cultural factors and modifying practices more frequently than did students. Respondents reported their beliefs about transcultural nursing were influenced by being with people of other cultures, their own personal values, and education. Analysis of the open-ended questions revealed two major themes. First, both nurses and students perceive an overwhelming need for transcultural nursing. Second, nurses and students respond to cultural challenges by modifying their care. Modifications are based on language and communication, pain perception and relief, religious and spiritual dimensions, gender and family roles, and other values. Results suggest that nurses and students are aware of culture, recognize that culture influences the care they provide, and modify their health teaching and nursing care based on culture. The use of a conceptual framework to help make modifications in care was not mentioned.

Identifying emotional intelligence in professional nursing practice.

Science.gov (United States)

Kooker, Barbara Molina; Shoultz, Jan; Codier, Estelle E

2007-01-01

The National Center for Health Workforce Analysis projects that the shortage of registered nurses in the United States will double by 2010 and will nearly quadruple to 20% by 2015 (Bureau of Health Professionals Health Resources and Services Administration. [2002]. Projected supply, demand, and shortages of registered nurses, 2000-2020 [On-line]. Available: http:bhpr.hrsa.gov/healthworkforce/reports/rnprojects/report.htm). The purpose of this study was to use the conceptual framework of emotional intelligence to analyze nurses' stories about their practice to identify factors that could be related to improved nurse retention and patient/client outcomes. The stories reflected evidence of the competencies and domains of emotional intelligence and were related to nurse retention and improved outcomes. Nurses recognized their own strengths and limitations, displayed empathy and recognized client needs, nurtured relationships, used personal influence, and acted as change agents. Nurses were frustrated when organizational barriers conflicted with their knowledge/intuition about nursing practice, their communications were disregarded, or their attempts to create a shared vision and teamwork were ignored. Elements of professional nursing practice, such as autonomy, nurse satisfaction, respect, and the professional practice environment, were identified in the excerpts of the stories. The shortage of practicing nurses continues to be a national issue. The use of emotional intelligence concepts may provide fresh insights into ways to keep nurses engaged in practice and to improve nurse retention and patient/client outcomes.

Education of advanced practice nurses in Canada.

Science.gov (United States)

Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

2010-12-01

In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

Practice nursing: the pitfalls and the potential.

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Pearce, Lynne

2016-03-16

A survey by the Queen's Nursing Institute has confirmed that practice nursing is facing major pressures, with one third of practice nurses due to retire by 2020, patchy access to training and widespread discrepancies in pay. But there is also cause for optimism, as new initiatives aim to ensure practice nurses are better supported and rewarded.

WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.

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Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

2018-05-15

A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning

The experiences of student nurses on placements with practice nurses: A pilot study.

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Gale, Julia; Ooms, Ann; Sharples, Kath; Marks-Maran, Di

2016-01-01

To prepare the registered nurse of tomorrow in the United Kingdom (UK) to care for patients in general practice (GP)-led services, today's student nurses need to have the opportunity to experience placements with practice nurses to enable them to make positive career choices to become practice nurses in the future. The role of the practice nurse is described in the article. As a pilot project, seventeen students undertook placements with practice nurses in one of seven GP practices selected by the London GP Deanery and the university as having fulfilled the criteria to support student nurses in placements. A mentorship preparation programme was provided to prepare practice nurses for mentoring these students. An evaluation study was undertaken of this pilot project. Findings showed that students were highly positive about the experience; the majority rated this placement as being as good as or better than previous placement experiences. The evaluation also explored the impact on student learning and the value that the placement had. There was a positive impact on students' knowledge and skills in certain clinical areas especially related to health promotion. Students also indicated that they would like to have additional placements with practice nurses and would consider a career as a practice nurse in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of ...

Nurse-perceived Patient Adverse Events and Nursing Practice Environment

Directory of Open Access Journals (Sweden)

Jeong-Hee Kang

2014-09-01

Full Text Available Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%, nosocomial infections (51.7%, pressure sores (42.6% and medication errors (33.3%. Among the hospital-level explanatory variables associated with the nursing practice environment, ‘physician- nurse relationship’ correlated with medication errors while ‘education for improving quality of care’ affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

Safe injection practice among health care workers, Gharbiya, Egypt.

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Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

2005-01-01

A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

[A Study of the Evidence-Based Nursing Practice Competence of Nurses and Its Clinical Applications].

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Hsu, Li-Ling; Hsieh, Suh-Ing; Huang, Ya-Hsuan

2015-10-01

Nurses must develop competence in evidence-based nursing in order to provide the best practice medical care to patients. Evidence-based nursing uses issue identification, data mining, and information consolidation from the related medical literature to help nurses find the best evidence. Therefore, for medical institutions to provide quality clinical care, it is necessary for nurses to develop competence in evidence-based nursing. This study aims to explore the effect of a fundamental evidence-based nursing course, as a form of educational intervention, on the development of evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, and outcome expectations of evidence-based practice in nurse participants. Further the competence of these nurses in overcoming obstacles in evidence-based nursing practice. This quasi-experimental study used a pre-post test design with a single group of participants. A convenience sample of 34 nurses from a municipal hospital in northern Taiwan received 8 hours of a fundamental evidence-based nursing course over a two-week period. Participants were asked to complete four questionnaires before and after the intervention. The questionnaires measured the participants' basic demographics, experience in mining the medical literature, evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, outcome expectations of evidence-based practice, competence in overcoming obstacles in evidence-based nursing practice, and learning satisfaction. Collected data was analyzed using paired t, Wilcoxon Signed Rank, and McNemar tests to measure the differences among participants' evidence-based nursing knowledge and practice activities before and after the workshop. The nurses demonstrated significantly higher scores from pre-test to post-test in evidence-based nursing knowledge II, self-efficacy in evidence-based nursing practice activities, and outcome expectations of evidence-based practice

A comparison of ethical issues in nursing practice across nursing units.

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Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

2014-08-01

The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

Nursing practice environment, quality of care, and morale of hospital nurses in Japan.

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Anzai, Eriko; Douglas, Clint; Bonner, Ann

2014-06-01

The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.

The impact of nursing education and job characteristics on nurse's perceptions of their family nursing practice skills.

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Svavarsdottir, Erla Kolbrun; Sigurdardottir, Anna Olafia; Konradsdottir, Elisabet; Tryggvadottir, Gudny Bergthora

2018-04-25

Implementing family system nursing in clinical settings is on the rise. However, little is known about the impact of graduate school education as well as continuing education in family systems nursing (FSN) on nurses' perceptions of their family nursing practice. To evaluate the level of nursing education, having taken a continuing hospital educational course in family system nursing (FN-ETI programme), and the impact of job characteristics on nurses' perceptions of their family nursing practice skills. Participants were 436 nurses with either a BSc degree or graduate degree in nursing. The Job Demand, Control and Support model guided the study (R. Karasek and T. Theorell, 1992, Healthy Work: Stress, Productivity, and the Reconstruction of Working Life, Basic Books, New York, NY). Scores for the characteristics of job demands and job control were created to categorise participants into four job types: high strain (high demand, low control), passive (low demand, low control), low strain (low demand, high control) and active (high demand, high control). Nurses with a graduate education who had taken the FN-ETI programme scored significantly higher on the Family Nursing Practice Scale than nurses with an undergraduate education. Nurses who were characterised as low strain or active scored significantly higher on the Family Nursing Practice Scale than the nurses who were characterised as high strain. Further, the interaction of education by job type was significant regarding family nursing practice skills. Hierarchical regression revealed 25% of the variance in family nursing practice skills was explained by job control, family policy on the unit, graduate education and employment on the following divisions: Maternal-Child, Emergency, Mental Health or Internal Medicine. Graduate education plus continuing education in FSN can offer nurses increased job opportunities more control over one's work as well as increased skills working with families in clinical settings. �

2012 Beers criteria update: how should practicing nurses use the criteria?

Science.gov (United States)

2012-06-01

The continued development of explicit lists of medications to avoid in older adults, such as the Beers criteria, is a key initiative in geriatrics. The involvement of nurse in this endeavor is critical , and nursing research, education, and practice will help not only develop but also disseminate important pharmacological management information to the public and thereby decrease drug-related problems and improve the health of older adults. Lastly, we wish to acknowledge Dr. Mark Beers' tremendous leadership in conceptualizing the importance of medication management in older adults and in acknowledging the significance of the full-team approach in patient care. Mark, who passed away in 2009, was an incredible mentor and true champion of safe medication use in adults.

Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned.

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Knight, Kaye M; Kenny, Amanda; Endacott, Ruth

2015-04-09

Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the

Strategies and challenges for safe injection practice in developing countries.

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Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Time management strategies in nursing practice.

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Waterworth, Susan

2003-09-01

With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.

Evidence-Based Practice and School Nurse Practice: A Review of Literature

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Yonkaitis, Catherine F.

2018-01-01

School nurses report that evidence-based practice (EBP) is not a part of their daily practice, and most have had no formal education regarding EBP or its implementation. The purpose of this review is to identify what strategies might be effective to educate school nurses about EBP as a first step toward establishing EBP in school nurse practice.…

The practical skills of newly qualified nurses.

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Danbjørg, Dorthe Boe; Birkelund, Regner

2011-02-01

This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.

Invisible nursing research: thoughts about mixed methods research and nursing practice.

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Fawcett, Jacqueline

2015-04-01

In this this essay, the author addresses the close connection between mixed methods research and nursing practice. If the assertion that research and practice are parallel processes is accepted, then nursing practice may be considered "invisible mixed methods research," in that almost every encounter between a nurse and a patient involves collection and integration of qualitative (word) and quantitative (number) information that actually is single-case mixed methods research. © The Author(s) 2015.

Standards of practice for forensic mental health nurses--identifying contemporary practice.

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Martin, Trish; Maguire, Tessa; Quinn, Chris; Ryan, Jo; Bawden, Louise; Summers, Monica

2013-01-01

Forensic mental health nursing is a recognized field of nursing in most countries. Despite a growing body of literature describing aspects of practice, no publication has been found that captures the core knowledge, skills, and attitudes of forensic mental health nurses. One group of nurses in Australia have pooled their knowledge of relevant literature and their own clinical experience and have written standards of practice for forensic mental health nursing. This paper identifies the need for standards, provides a summary of the standards of practice for forensic mental health nurses, and concludes with how these standards can be used and can articulate to others the desired and achievable level of performance in the specialty area.

Conceptualizing clinical nurse leader practice: an interpretive synthesis.

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Bender, Miriam

2016-01-01

The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes. Interpretive synthesis design and grounded theory analysis were used to develop a theoretical understanding of clinical nurse leader practice that can facilitate systematic and replicable implementation across health-care settings. The core phenomenon of clinical nurse leader practice is continuous clinical leadership, which involves four fundamental activities: facilitating effective ongoing communication; strengthening intra and interprofessional relationships; building and sustaining teams; and supporting staff engagement. Clinical nurse leaders continuously communicate and develop relationships within and across professions to promote and sustain information exchange, engagement, teamwork and effective care processes at the microsystem level. Clinical nurse leader-integrated care delivery systems highlight the benefits of nurse-led models of care for transforming health-care quality. Managers can use this study's findings to frame an implementation strategy that addresses theoretical domains of clinical nurse leader practice to help ensure practice success. © 2015 John Wiley & Sons Ltd.

The role of practical wisdom in nurse manager practice: why experience matters.

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Cathcart, Eloise Balasco; Greenspan, Miriam

2013-10-01

To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

Grounding our practice in nursing professional development.

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Dickerson, Pamela S

2014-07-01

The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice. Copyright 2014, SLACK Incorporated.

Gendered nursing education and practice in Iran.

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Fooladi, Marjaneh M

2003-01-01

Through qualitative ethnographic methods, the researcher gendered nursing education and practice among human nursing students and faculty. Interaction with nursing students and faculty occurred in a familiar turf using the native language in interviews and on field observations. Settings included classrooms, skills laboratory, faculty offices, clinical areas, and informants' homes. Formal and informal interviews, observations, and printed materials provided useful data to reach consistent common patterns. Thematic analysis and triangulation of data identified gender variations in care and compassion, spirituality, economic motives, and practice preference. Integrated experiences of pre-Islamic period were used to describe the current developments of gendered nursing education and practice in the Islamic Republic of Iran. Study of gendered nursing education and practice brings attention to the cultural significance of gender issues. This body of knowledge will benefit American nurses and educators by increasing their cultural understanding of gender.

Leadership Practices in Hospital Nursing: A Self of Manager Nurses

Directory of Open Access Journals (Sweden)

Vânea Lúcia dos Santos Silva

Full Text Available Abstract OBJECTIVE To assess the frequency of the leadership practices performed by the manager nurses of hospital institutions and their association with the variables of the socioprofessional profile. METHOD Cross-sectional, descriptive, correlational study conducted in four hospitals in a city of the state of São Paulo. A sociodemographic questionnaire and the instrument Leadership Practices Inventory were used. Data collection and analysis were based on an exemplary Leadership Practices Model. RESULTS Eighty-four manager nurses participated in the study. The mean values of the leadership practices used by the nurses were: enable others to act (50.6; encourage the heart (48.2; model the way (46.7; challenge the process (43.3; and inspire a shared vision (43.1. Data analysis also evidenced a correlation between the practice encourage the heart and the variables time of care and employment relationship. Conclusion The study evidenced the presence of manager nurses exercising moderate leadership, and promoting teamwork, an environment of trust, and a horizontal vision. However, moderate values also reveal managerial aspects to be improved by the leaders by means of organizational strategies and/or tools aimed at best leadership practices.

Statistics for clinical nursing practice: an introduction.

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Rickard, Claire M

2008-11-01

Difficulty in understanding statistics is one of the most frequently reported barriers to nurses applying research results in their practice. Yet the amount of nursing research published each year continues to grow, as does the expectation that nurses will undertake practice based on this evidence. Critical care nurses do not need to be statisticians, but they do need to develop a working knowledge of statistics so they can be informed consumers of research and so practice can evolve and improve. For those undertaking a research project, statistical literacy is required to interact with other researchers and statisticians, so as to best design and undertake the project. This article is the first in a series that guides critical care nurses through statistical terms and concepts relevant to their practice.

Designing nursing excellence through a National Quality Forum nurse scholar program.

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Neumann, Julie A; Brady-Schluttner, Katherine A; Attlesey-Pries, Jacqueline M; Twedell, Diane M

2010-01-01

Closing the knowledge gap for current practicing nurses in the Institute of Medicine (IOM) core competencies is critical to providing safe patient care. The National Quality Forum (NQF) nurse scholar program is one organization's journey to close the gap in the IOM core competencies in a large teaching organization. The NQF nurse scholar program is positioned to provide a plan to assist current nurses to accelerate their learning about quality improvement, evidence-based practice, and informatics, 3 of the core competencies identified by the IOM, and focus on application of skills to NQF nurse-sensitive measures. Curriculum outline, educational methodologies, administrative processes, and aims of the project are discussed.

Nurses' maths: researching a practical approach.

Science.gov (United States)

Wilson, Ann

To compare a new practical maths test with a written maths test. The tests were undertaken by qualified nurses training for intravenous drug administration, a skill dependent on maths accuracy. The literature showed that the higher education institutes (HEIs) that provide nurse training use traditional maths tests, a practical way of testing maths had not been described. Fifty five nurses undertook two maths tests based on intravenous drug calculations. One was a traditional written test. The second was a new type of test using a simulated clinical environment. All participants were also interviewed one week later to ascertain their thoughts and feelings about the tests. There was a significant improvement in maths test scores for those nurses who took the practical maths test first. It is suggested that this is because it improved their conceptualisation skills and thus helped them to achieve accuracy in their calculations. Written maths tests are not the best way to help and support nurses in acquiring and improving their maths skills and should be replaced by a more practical approach.

Nurses' reflections on pain management in a nursing home setting.

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Clark, Lauren; Fink, Regina; Pennington, Karen; Jones, Katherine

2006-06-01

Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semistructured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain and their pain-assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process-improvement programs using a participatory research approach.

Starting a nursing consultation practice.

Science.gov (United States)

Schulmeister, L

1999-03-01

Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.

Supporting student nurses in practice with additional online communication tools.

Science.gov (United States)

Morley, Dawn A

2014-01-01

Student nurses' potential isolation and difficulties of learning on placement have been well documented and, despite attempts to make placement learning more effective, evidence indicates the continuing schism between formal learning at university and situated learning on placement. First year student nurses, entering placement for the first time, are particularly vulnerable to the vagaries of practice. During 2012 two first year student nurse seminar groups (52 students) were voluntarily recruited for a mixed method study to determine the usage of additional online communication support mechanisms (Facebook, wiki, an email group and traditional methods of support using individual email or phone) while undertaking their first five week clinical placement. The study explores the possibility of strengthening clinical learning and support by promoting the use of Web 2.0 support groups for student nurses. Results indicate a high level of interactivity in both peer and academic support in the use of Facebook and a high level of interactivity in one wiki group. Students' qualitative comments voice an appreciation of being able to access university and peer support whilst working individually on placement. Recommendations from the study challenge universities to use online communication tools already familiar to students to complement the support mechanisms that exist for practice learning. This is tempered by recognition of the responsibility of academics to ensure their students are aware of safe and effective online communication. Copyright © 2013 Elsevier Ltd. All rights reserved.

Delineating advanced practice nursing in New Zealand: a national survey.

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Carryer, J; Wilkinson, J; Towers, A; Gardner, G

2018-03-01

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

A new practice environment measure based on the reality and experiences of nurses working lives.

Science.gov (United States)

Webster, Joan; Flint, Anndrea; Courtney, Mary

2009-01-01

To explore the underlying organizational issues affecting a nurses' decision to leave and to develop a contemporary practice environment measure based on the experiences of nurses working lives. Turnover had reached an unacceptable level in our organization but underlying reasons for leaving were unknown. In-depth interviews were conducted with 13 nurses who had resigned. Transcripts were analysed using the constant comparative method. Information from the interviews informed the development a new practice environment tool, which has undergone initial testing using the Content Validity Index and Chronbach's alpha. Two domains ('work life' and 'personal life/professional development') and five themes ('feeling safe', 'feeling valued', 'getting things done', 'professional development' and 'being flexible') emerged from the interviews. A content validity score for the new instrument was 0.79 and Chronbach's alpha 0.93. The new practice environment tool has shown useful initial reliability and validity but requires wider testing in other settings. The reality and experiences of nurses working lives can be identified through exit interviews conducted by an independent person. Information from such interviews is useful in identifying an organization's strength and weaknesses and to develop initiatives to support retention.

Factors affecting Korean nursing student empowerment in clinical practice.

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Ahn, Yang-Heui; Choi, Jihea

2015-12-01

Understanding the phenomenon of nursing student empowerment in clinical practice is important. Investigating the cognition of empowerment and identifying predictors are necessary to enhance nursing student empowerment in clinical practice. To identify empowerment predictors for Korean nursing students in clinical practice based on studies by Bradbury-Jones et al. and Spreitzer. A cross-sectional design was used for this study. This study was performed in three nursing colleges in Korea, all of which had similar baccalaureate nursing curricula. Three hundred seven junior or senior nursing students completed a survey designed to measure factors that were hypothesized to influence nursing student empowerment in clinical practice. Data were collected from November to December 2011. Study variables included self-esteem, clinical decision making, being valued as a learner, satisfaction regarding practice with a team member, perception on professor/instructor/clinical preceptor attitude, and total number of clinical practice fields. Data were analyzed using stepwise multiple regression analyses. All of the hypothesized study variables were significantly correlated to nursing student empowerment. Stepwise multiple regression analysis revealed that clinical decision making in nursing (t=7.59, pempowerment in clinical practice will be possible by using educational strategies to improve nursing student clinical decision making. Simultaneously, attitudes of nurse educators are also important to ensure that nursing students are treated as valued learners and to increase student self-esteem in clinical practice. Finally, diverse clinical practice field environments should be considered to enhance experience. Copyright © 2015 Elsevier Ltd. All rights reserved.

Organising nursing practice into care models that catalyse quality: A clinical nurse leader case study.

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Bender, Miriam; Spiva, LeeAnna; Su, Wei; Hites, Lisle

2018-02-09

To determine the power of a conceptual clinical nurse leader practice model to explain the care model's enactment and trajectory in real world settings. How nursing, organised into specific models of care, functions as an organisational strategy for quality is not well specified. Clinical nurse leader integrated care delivery is one emerging model with growing adoption. A recently validated clinical nurse leader practice model conceptualizes the care model's characteristics and hypothesizes their mechanisms of action. Pattern matching case study design and mixed methods were used to determine how the care model's constructs were operationalized in one regional United States health system that integrated clinical nurse leaders into their care delivery system in 2010. The findings confirmed the empirical presence of all clinical nurse leader practice model constructs and provided a rich description of how the health system operationalized the constructs in practice. The findings support the hypothesized model pathway from Clinical Nurse Leader structuring to Clinical Nurse Leader practice and outcomes. The findings indicate analytic generalizability of the clinical nurse leader practice model. Nursing practice organised to focus on microsystem care processes can catalyse multidisciplinary engagement with, and consistent enactment of, quality practices. The model has great potential for transferability across diverse health systems. © 2018 John Wiley & Sons Ltd.

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

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Garrett, Bernard; Klein, Gerri

2008-08-01

The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless

Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: a constructivist grounded theory.

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Hoarea, Karen J; Millsc, Jane; Francis, Karen

2013-01-01

Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place.

Developing practical knowledge content of emergency nursing professionals.

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Chu, Wen; Hsu, Li-Ling

2011-06-01

There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

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Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

2015-01-01

Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.

Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.

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Galbany-Estragués, Paola; Comas-d'Argemir, Dolors

2017-10-01

Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.

Reflections on independence in nurse practitioner practice.

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Weiland, Sandra A

2008-07-01

To examine factors that influence the ability of nurse practitioners (NPs) to practice as independent primary care providers. Extensive literature search on CINAHL, OVID, MEDLINE, Internet journal sources, and professional association Web sites. The legal authority for NPs to practice independently is recognized; however, the ability to put that authority into practice is undermined by the historical failure of political, professional, and social entities to recognize NPs as providers capable of providing primary care autonomously. Nonrecognition is responsible for complex reimbursement policies (both federal and state) that economically and professionally restrain the NP role; hence, NPs remain in a financially dependent relationship despite 40 years of proven safe practice. NPs must articulate their independence as practitioners more vociferously in order to meet society's healthcare requirements, as well as to attain professional fulfillment and forge collegial relationships. NPs will never be seen as members of a profession by either themselves or others without the practicality of independence and autonomy. Although legal independence is a fact, real practice independence in the pragmatic sense is contingent upon reimbursement. Without fiscal sustainability, practice independence is an impossibility. And, without professional autonomy, NPs will have only an employee's voice in the dynamic healthcare system in which they are really key players in providing healthcare services to the poor and undeserved populations.

Ethics, culture and nursing practice in Ghana.

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Donkor, N T; Andrews, L D

2011-03-01

This paper describes how nurses in Ghana approach ethical problems. The International Council of Nurses' (ICN) Code for Nurses (2006) that serves as the model for professional code of ethics worldwide also acknowledges respect for healthy cultural values. Using the ICN's Code and universal ethical principles as a benchmark, a survey was conducted in 2009 to ascertain how nurses in Ghana respond to ethical and cultural issues in their practice. The study was qualitative with 200 participant nurses. Data were obtained through anonymous self-administered questionnaires. Descriptive statistics were used to analyze the data. Nurses' approaches to ethical problems in Ghana do not always meet expectations of the ICN Code for Nurses. They are also informed by local ethical practices related to the institutional setting and cultural environment in the country. While some cultural values complemented the ICN's Code and universal ethical principles, others conflicted with them. These data can assist nurses to provide culturally competent solutions to ethical dilemmas in their practice. Dynamic communication between nurses and patients/clients, intentional study of local cultural beliefs, and the development of ethics education will improve the conformity between universal ethical standards and local cultural values. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Experience and perception of sexual harassment during the clinical practice of korean nursing students.

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Lee, Sun-Kyoung; Song, Ju-Eun; Kim, Sue

2011-09-01

The purpose of this study was to identify the experience and perception of sexual harassment during the clinical practice of Korean nursing students. The descriptive study was conducted using a self-report questionnaire from December 2009 to January 2010. Participants were 542 nursing students recruited from 12 nursing colleges in Korea, who had finished 1,000 hours of clinical practice which is the minimum requirement for graduation. Data were analyzed by descriptive statistics. Ninety-seven participants (17.9%) reported that they experienced sexual harassment during clinical practice and 36 participants (6.7%) answered whether it was a sexual harassment or not. When sexual harassment was asked by the specific 18 items in the sexual harassment checklist, 52.0% (n = 282) of participants reported that they experienced at least 1 item among 18 items of sexual harassment. Sexual harassments were frequently made by the persons in their 40s (41.2%), men (97.9%) and patients (96.9%) and in the psychiatric wards (67.0%). Many respondents recognized that sexual harassment during clinical practice was caused by abnormal sexual desire of a pervert (34.5%) or men's sexual impulse (26.2%). Also, sexual harassment was perceived as a serious problem (19.4%) and education was necessary for prevention (88.3%). Education program is needed to prevent sexual harassment and enhance the gender sensitivity of nursing students, who are in the high-risk group of sexual harassment during clinical practice. This will in turn contribute to a safe educational environment for clinical practice. Copyright © 2011. Published by Elsevier B.V.

Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

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Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

2014-09-01

Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.

Essential elements of the nursing practice environment in nursing homes: Psychometric evaluation.

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de Brouwer, Brigitte Johanna Maria; Kaljouw, Marian J; Schoonhoven, Lisette; van Achterberg, Theo

2017-06-01

To develop and psychometrically test the Essentials of Magnetism II in nursing homes. Increasing numbers and complex needs of older people in nursing homes strain the nursing workforce. Fewer adequately trained staff and increased care complexity raise concerns about declining quality. Nurses' practice environment has been reported to affect quality of care and productivity. The Essentials of Magnetism II © measures processes and relationships of practice environments that contribute to productivity and quality of care and can therefore be useful in identifying processes requiring change to pursue excellent practice environments. However, this instrument was not explicitly evaluated for its use in nursing home settings so far. In a preparatory phase, a cross-sectional survey study focused on face validity of the essentials of magnetism in nursing homes. A second cross-sectional survey design was then used to further test the instrument's validity and reliability. Psychometric testing included evaluation of content and construct validity, and reliability. Nurses (N = 456) working at 44 units of three nursing homes were included. Respondent acceptance, relevance and clarity were adequate. Five of the eight subscales and 54 of the 58 items did meet preset psychometric criteria. All essentials of magnetism are considered relevant for nursing homes. The subscales Adequacy of Staffing, Clinically Competent Peers, Patient Centered Culture, Autonomy and Nurse Manager Support can be used in nursing homes without problems. The other subscales cannot be directly applied to this setting. The valid subscales of the Essentials of Magnetism II instrument can be used to design excellent nursing practice environments that support nurses' delivery of care. Before using the entire instrument, however, the other subscales have to be improved. © 2016 John Wiley & Sons Ltd.

Advanced practice nursing in child maltreatment: practice characteristics.

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Hornor, Gail; Herendeen, Pamela

2014-01-01

Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Building chronic disease management capacity in General Practice: The South Australian GP Plus Practice Nurse Initiative.

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Fuller, Jeffrey; Koehne, Kristy; Verrall, Claire C; Szabo, Natalie; Bollen, Chris; Parker, Sharon

2015-01-01

This paper draws on the implementation experience of the South Australian GP Plus Practice Nurse Initiative in order to establish what is needed to support the development of the chronic disease management role of practice nurses. The Initiative was delivered between 2007 and 2010 to recruit, train and place 157 nurses across 147 General Practices in Adelaide. The purpose was to improve chronic disease management in General Practice, by equipping nurses to work as practice nurses who would coordinate care and establish chronic disease management systems. Secondary analysis of qualitative data contained in the Initiative evaluation report, specifically drawing on quarterly project records and four focus groups conducted with practice nurses, practice nurse coordinators and practice nurse mentors. As evidenced by the need to increase the amount of support provided during the implementation of the Initiative, nurses new to General Practice faced challenges in their new role. Nurses described a big learning curve as they dealt with role transition to a new work environment and learning a range of new skills while developing chronic disease management systems. Informants valued the skills development and support offered by the Initiative, however the ongoing difficulties in implementing the role suggested that change is also needed at the level of the Practice. While just over a half of the placement positions were retained, practice nurses expressed concern with having to negotiate the conditions of their employment. In order to advance the role of practice nurses as managers of chronic disease support is needed at two levels. At one level support is needed to assist practice nurses to build their own skills. At the level of the Practice, and in the wider health workforce system, support is also needed to ensure that Practices are organisationally ready to include the practice nurse within the practice team.

Returns to nursing education: rural and nonrural practice.

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Pan, S; Straub, L

1997-01-01

This study uses data from a national sample of registered nurses to compare earnings of nurses in rural and nonrural practice. The comparisons, conditioned by the nurses' education level, are analogous to the concept of "returns to human capital investment" used in labor economics. A general linear model is applied within a framework of labor economics analysis. Results show that nurses with more education receive less for their investment if they practice in rural areas. Work experience and employment setting are also related to lower annualized earnings for rural practice. One exception to the otherwise consistent findings is that returns to advanced practice nursing are higher in rural areas. Results and policy implications are discussed.

Putting Safety in the Frame: Nurses' Sensemaking at Work.

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O'Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley

2015-01-01

Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.

Voices of chief nursing executives informing a doctor of nursing practice program.

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Embree, Jennifer L; Meek, Julie; Ebright, Patricia

The purpose of this article is to describe the business case framework used to guide doctor of nursing practice (DNP) program enhancements and to discuss methods used to gain chief nurse executives' (CNEs) perspectives for desired curricular and experiential content for doctor of nursing practice nurses in health care system executive roles. Principal results of CNE interview responses were closely aligned to the knowledge, skills and/or attitudes identified by the national leadership organizations. Major conclusions of this article are that curriculum change should include increased emphasis on leadership, implementation science, and translation of evidence into practice methods. Business, information and technology management, policy, and health care law content would also need to be re-balanced to facilitate DNP graduates' health care system level practice. Copyright © 2017 Elsevier Inc. All rights reserved.

The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation.

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Romain-Glassey, Nathalie; Ninane, Françoise; de Puy, Jacqueline; Abt, Maryline; Mangin, Patrice; Morin, Diane

2014-01-01

The objectives of this article were to systematically describe and examine the novel roles and responsibilities assumed by nurses in a forensic consultation for victims of violence at a University Hospital in French-speaking Switzerland. Utilizing a case study methodology, information was collected from two main sources: (a) discussion groups with nurses and forensic pathologists and (b) a review of procedures and protocols. Following a critical content analysis, the roles and responsibilities of the forensic nurses were described and compared with the seven core competencies of advanced nursing practice as outlined by Hamric, Spross, and Hanson (2009). Advanced nursing practice competencies noted in the analysis included "direct clinical practice," "coaching and guidance," and "collaboration." The role of the nurse in terms of "consultation," "leadership," "ethics," and "research" was less evident in the analysis. New forms of nursing are indeed practiced in the forensic clinical setting, and our findings suggest that nursing practice in this domain is following the footprints of an advanced nursing practice model. Further reflections are required to determine whether the role of the forensic nurse in Switzerland should be developed as a clinical nurse specialist or that of a nurse practitioner.

Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

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De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

2008-11-01

An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

Delegation knowledge and practice among rehabilitation nurses.

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White, Mary Joe; Gutierrez, Ann; Davis, Kerry; Olson, Rhonda; McLaughlin, Celeste

2011-01-01

Delegation is an essential process that allows nurses to function more effectively and efficiently. The Association of Rehabilitation Nurses' (ARN) Southeast Texas Chapter research committee developed a survey to study registered nurses (RN) practices and knowledge of delegation to unlicensed assistive personnel. State boards of nursing determine delegation practices, so the survey was sent only to Texas ARN members. Benners' Novice to Expert theory was used to study delegation practices based on years of experience, certification, and education. Survey Monkey was used with a questionnaire developed by the research committee. Descriptive statistics analyzed data from the survey's 73 respondents, and chi-square measured significance of differences based on years of experience and certification (yes or no). Data show that delegation knowledge does not necessarily translate to practice, especially when looking at specific tasks performed by certified rehabilitation registered nurses (CRRNs) and non-CRRNs. The data support continued study of this important issue; 93.7% of respondents say delegation requires further discussion.

Towards a strong virtue ethics for nursing practice.

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Armstrong, Alan E

2006-07-01

Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.

An exploration of how spiritual nursing care is applied in clinical nursing practice

Directory of Open Access Journals (Sweden)

Lydia V. Monareng

2013-05-01

Full Text Available Spiritual nursing care is a significant concept for nurses as they are expected to provide holistic care to patients. Many nurses have difficulty to understand and integrate it into practice and consequently neglect this aspect of care. The study was conducted to explore and describe how professional nurses provide spiritual care to patients. A generic qualitative, explorative and descriptive study was conducted based on Symbolic Interactionism as the philosophical base. The population comprised professional nurses from a public hospital. Participants were recruited through purposive and snowball sampling methods. Data were collected through the use of individual, focus group interviews and observation. Data analysis methods utilised included the NUD*ISTcomputer program, coding, constant comparison method and Tesch’s guidelines on data analysis. Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer with or for patients and singing spiritual songs had the highest count of interventions perceived to be effective. Recommendations suggest that the scope of practice and curriculum of training of nurses be reviewed to consider how spiritual nursing care can be evidenced and realised both in the classroom and in the clinical setting. Spiritual nursing care is still a neglected and seemingly complex component of patient care. However, the scientific worldview practices, beliefs and insufficient statutory endorsement of such care hamper its realisation in practice.

Evaluation of chosen determinants of the positive practice environments (PPE at Polish nursing wards

Directory of Open Access Journals (Sweden)

Dorota Kilańska

2016-04-01

Full Text Available Background: At many Polish hospitals, insufficient attention is given to positive work environment. In many cases nurses, similarly to the representatives of other professional groups, are not provided with facilities or tools to perform their professional tasks in safe conditions. The aspects of recruitment and retention of employees are often ignored. The aim of this study has been to assess the chosen determinants of work environment of nurses in Poland using the concept of the Positive Practice Environments (PPE. Material and Methods: The survey was carried out from 2008 to 2011 among 1049 nursing students of 3 randomly selected public medical universities that provided nursing education at the graduate level of the Master of Science. All the people qualified for the study group were practising nurses or midwives. The Polish Nursing Association coordinated the project, obtained the tool, translated it and adjusted it to the Polish conditions. The areas covered in the survey were: a place of employment, selected physical and social elements influencing the work conditions, and biographical information. Results: Access to as many as 8 factors identified as attributes of friendly environments was found unsatisfactory by over 50% of the nurses. For the purpose of objective assessment, the results were compared with the results obtained in the group of nurses in England. Conclusions: The majority of the surveyed nurses were not satisfied with their work environments. Polish nurse managers should ensure that aspects of recognized attributes of friendly, positive practice environments for nurses are established to support nurses’ satisfaction as a pre-condition for patients’ safety. Med Pr 2016;67(1:11–19

Safe delivery practices: experience from cross-sectional data of Bangladeshi women.

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Kabir, M A; Goh, Kim-Leng; Khan, M M H; Al-Amin, Abul Quasem; Azam, Mohammad Nurul

2015-03-01

This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy. © 2012 APJPH.

Clinical supervision of nursing students: challenges and alternatives ...

African Journals Online (AJOL)

Clinical supervision is described as a formal process of professional learning support in the clinical practice. The goal of clinical practice is to prepare nursing students develop and apply the necessary theoretical and empirical knowledge and skills in order for them to practice as safely and effectively as professional nurses.

Best practices in nursing homes. Clinical supervision, management, and human resource practices.

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Dellefield, Mary Ellen

2008-07-01

Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described. Copyright 2009, SLACK Incorporated.

Using flash cards to engage Indonesian nursing students in reflection on their practice.

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Wanda, Dessie; Fowler, Cathrine; Wilson, Valerie

2016-03-01

Reflective practice is now widely used as a critical learning tool in undergraduate and postgraduate nursing programs in most developed countries. However in developing countries, reflective practice is in its infancy. To introduce reflective practice to postgraduate students in an Indonesian nursing education institution. This paper presents the positive meanings of reflection and reflective practice experienced by the students and the way they used reflection within their practice. A descriptive qualitative study was conducted to explore the meaning of reflection or reflective practice using flashcards. A clinical reflective practice model taking into consideration Indonesian culture was developed and applied during students' clinical placement. A few weeks post clinical placement, 21 students participated in an evaluation session. The meaning of reflection or reflective practice was explored using flash cards containing images of people and environment with different situations and events. Students were asked to choose a card that represented their viewpoints about reflective practice and share it with the group. Data were digitally captured and analyzed using thematic analysis. Reflection provided a positive experience for the students. In their own words, they discussed their journey of using reflection during the clinical placement period. The use of reflection was identified as expanding their view of nursing practice, providing a safe place to explore their experiences and clarity when they encountered challenging situations during their clinical practice. Reflecting on practice experiences resulted in increased self-awareness, and enhanced their learning. The findings indicate that reflective practice can be implemented successfully in Indonesia and may have value for other Eastern countries that share similar cultural characteristics. The use of flash cards assisted the students describe through stories their experiences of participating in this

Microbiology Education in Nursing Practice?

OpenAIRE

Durrant, Robert J.; Doig, Alexa K.; Buxton, Rebecca L.; Fenn, JoAnn P.

2017-01-01

Nurses must have sufficient education and training in microbiology to perform many roles within clinical nursing practice (e.g., administering antibiotics, collecting specimens, preparing specimens for transport and delivery, educating patients and families, communicating results to the healthcare team, and developing care plans based on results of microbiology studies and patient immunological status). It is unclear whether the current microbiology courses required of nursing students in the...

E-mentoring in public health nursing practice.

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Miller, Louise C; Devaney, Susan W; Kelly, Glenda L; Kuehn, Alice F

2008-09-01

Attrition in the public health nursing work force combined with a lack of faculty to teach public health prompted development of a "long-distance" learning project. Practicing associate degree nurses enrolled in an online course in population-based practice worked with experienced public health nurse "e-mentors." Student-mentor pairs worked through course assignments, shared public health nursing experiences, and problem-solved real-time public health issues. Nursing faculty served as coordinators for student learning and mentor support. Over 3 years, 38 student-mentor pairs participated in the project. Students reported they valued the expertise and guidance of their mentors. Likewise, mentors gained confidence in their practice and abilities to mentor. Issues related to distance learning and e-mentoring centered around use of technology and adequate time to communicate with one another. E-mentoring is a viable strategy to connect nurses to a learning, sharing environment while crossing the barriers of distance, agency isolation, and busy schedules.

Empirical and pragmatic adequacy of grounded theory: Advancing nurse empowerment theory for nurses' practice.

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Udod, Sonia A; Racine, Louise

2017-12-01

To draw on the findings of a grounded theory study aimed at exploring how power is exercised in nurse-manager relationships in the hospital setting, this paper examines the empirical and pragmatic adequacy of grounded theory as a methodology to advance the concept of empowerment in the area of nursing leadership and management. The evidence on staff nurse empowerment has highlighted the magnitude of individual and organisational outcomes, but has not fully explicated the micro-level processes underlying how power is exercised, shared or created within the nurse-manager relationship. Although grounded theory is a widely adopted nursing research methodology, it remains less used in nursing leadership because of the dominance of quantitative approaches to research. Grounded theory methodology provides the empirical and pragmatic relevance to inform nursing practice and policy. Grounded theory is a relevant qualitative approach to use in leadership research as it provides a fine and detailed analysis of the process underlying complexity and bureaucracy. Discursive paper. A critical examination of the empirical and pragmatic relevance of grounded theory by (Corbin & Strauss, , ) as a method for analysing and solving problems in nurses' practice is provided. This paper provides evidence to support the empirical and pragmatic adequacy of grounded theory methodology. Although the application of the ontological, epistemological and methodological assumptions of grounded theory is challenging, this methodology is useful to address real-life problems in nursing practice by developing theoretical explanations of nurse empowerment, or lack thereof, in the workplace. Grounded theory represents a relevant methodology to inform nursing leadership research. Grounded theory is anchored in the reality of practice. The strength of grounded theory is to provide results that can be readily applied to clinical practice and policy as they arise from problems that affect practice and that

Psychological capital mediates the association between nurses' practice environment and work engagement among Chinese male nurses

Directory of Open Access Journals (Sweden)

Xiaokang Pan

2017-10-01

Full Text Available Objectives: This study aims to investigate the environmental and individual factors contributing to male nurses' psychological well-being and to explore the psychological mechanisms that may explain the links between nurses' practice environment and work engagement, thereby presenting the implications for nurse managers. Methods: A total of 161 male nurses from three tertiary first-class hospitals in Changsha City in China participated in the study. We collected the data using the Practice Environment Scale of the Nursing Work Index, the Psychological Capital Questionnaire, and the Utrecht Work Engagement Scale. Results: Scores of male nurses' practice environment (2.88 ± 0.31, psychological capital (4.42 ± 0.62, and work engagement (3.17 ± 1.39 were all above the midpoint; however, the subscales “the nursing staffing and resources adequacy” (2.72 ± 0.48, “hope” (4.33 ± 0.72, and “dedication” (2.96 ± 1.61scored lowest. Nurses' practice environment and psychological capital positively predicted nurses' work engagement; psychological capital fully mediated the influence of nurses' practice environment on work engagement. Conclusions: Creating a supportive nursing practice environment can increase male nurses' work engagement by developing their psychological capital. Nurse managers can then provide reasonable workload and pathways for male nurses to achieve goals, thereby fostering their hope. Keywords: Male nurses, Nurses' practice environment, Psychological capital, Work engagement

Orchestrating care: nursing practice with hospitalised older adults.

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Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

2015-12-01

The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

Nursing care documentation practice: The unfinished task of nursing care in the University of Gondar Hospital.

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Kebede, Mihiretu; Endris, Yesuf; Zegeye, Desalegn Tegabu

2017-09-01

Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.

Advancing nursing practice: redefining the theoretical and practical integration of knowledge.

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Christensen, Martin

2011-03-01

The aim of this paper is to offer an alternative knowing-how knowing-that framework of nursing knowledge, which in the past has been accepted as the provenance of advanced practice. The concept of advancing practice is central to the development of nursing practice and has been seen to take on many different forms depending on its use in context. To many it has become synonymous with the work of the advanced or expert practitioner; others have viewed it as a process of continuing professional development and skills acquisition. Moreover, it is becoming closely linked with practice development. However, there is much discussion as to what constitutes the knowledge necessary for advancing and advanced practice, and it has been suggested that theoretical and practical knowledge form the cornerstone of advanced knowledge. The design of this article takes a discursive approach as to the meaning and integration of knowledge within the context of advancing nursing practice. A thematic analysis of the current discourse relating to knowledge integration models in an advancing and advanced practice arena was used to identify concurrent themes relating to the knowing-how knowing-that framework which commonly used to classify the knowledge necessary for advanced nursing practice. There is a dichotomy as to what constitutes knowledge for advanced and advancing practice. Several authors have offered a variety of differing models, yet it is the application and integration of theoretical and practical knowledge that defines and develops the advancement of nursing practice. An alternative framework offered here may allow differences in the way that nursing knowledge important for advancing practice is perceived, developed and coordinated. What has inevitably been neglected is that there are various other variables which when transposed into the existing knowing-how knowing-that framework allows for advanced knowledge to be better defined. One of the more notable variables is

Coping with expanding nursing practice, knowledge, and technology.

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Gaudinski, M A

1979-10-01

Nurses utilize transcultural, transactional, systems, primary, and interdisciplinary approaches to physiological and psychosocial components of patient care. Expanded roles, as well as advances in knowledge and technology have prepared nurses for critical, specialized, primary, aerospace, and independent nursing practice. Exciting as they are, nursing's expanded roles and practices frequently contribute to the burnout and distress phenomena increasingly observed in practicing health care professionals. Causes and symptoms of the burnout distress phenomena are many and varied. Selye, Shubin, Maslach, and others adeptly identified and wrote on the phenomena as it specifically relates to nurses and the many facets of nursing practice. Rather than utilizing crisis intervention coping techniques, preventive strategies and adaptations are suggested. This paper reviews and discusses: 1. Factors associated with burnout-distress phenomena identified in professional literature; 2. Identification of factors associated with expanded roles and practice which contribute to burnout stress; 3. Identification of factors in military and civilian air ambulance and aeromedical evacuation systems which contribute to burnout stress; 4. Recommendations for strategies to prevent and cope with burnout distress factors.

The significance of routines in nursing practice.

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Rytterström, Patrik; Unosson, Mitra; Arman, Maria

2011-12-01

The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

Scoping the role and education needs of practice nurses in London.

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Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P

2017-07-01

Aims To identify education priorities for practice nursing across eight London Clinical Commissioning Groups (CCGs); to identify the education, training, development and support needs of practice nurses in undertaking current and future roles. The education needs of practice nurses have long been recognised but their employment status means that accessing education requires the support of their GP employer. This study scopes the educational requirements of the practice nurse workforce and working with educational providers and commissioners describes a coherent educational pathway for practice nurses. A survey of practice nurses to scope their educational attainment needs was undertaken. Focus groups were carried out which identified the education, training, development and support needs of practice nurses to fulfil current and future roles. Findings A total of 272 respondents completed the survey. Practice nurses took part in three focus groups (n=34) and one workshop (n=39). Findings from this research indicate a practice nurse workforce which lacked career progression, role autonomy or a coherent educational framework. Practice nurses recognised the strength of their role in building relationship-centred care with patients over an extended period of time. They valued this aspect of their role and would welcome opportunities to develop this to benefit patients. This paper demonstrates an appetite for more advanced education among practice nurses, a leadership role by the CCGs in working across the whole system to address the education needs of practice nurses, and a willingness on the part of National Health Service education commissioners to commission education which meets the education needs of the practice nurse workforce. Evidence is still required, however, to inform the scope of the practice nurse role within an integrated system of care and to identify the impact of practice nursing on improving health outcomes and care of local populations.

Public Health Interventions for School Nursing Practice

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Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

2016-01-01

School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

Clinical librarians as facilitators of nurses' evidence-based practice.

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Määttä, Sylvia; Wallmyr, Gudrun

2010-12-01

The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.

A multi-disciplinary approach to medication safety and the implication for nursing education and practice.

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Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet

2014-02-01

Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in

Evaluation of nurse engagement in evidence-based practice.

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Davidson, Judy E; Brown, Caroline

2014-01-01

The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

Beyond the classroom: nurse leader preparation and practices.

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O'Connor, Mary

2011-01-01

Formal academic education and experience as a nurse are established preparation for the chief nurse executive (CNE) or upcoming nurse leaders. This article proposes that the nurse leader must build on these fundamentals through self-discipline, lifelong learning, and practice. Three critical ingredients are discussed to guide the nurse leader on a life/career for the CNE and the nurse leader at every level. These include fostering relationships, feeding intellectual curiosity, and engaging in self-care practices. These indispensable ingredients of the successful nurse leader serve as an augmentation to formal education and experience for the nurse aspiring to reach the CNE level and beyond as well as for the current CNE mentoring future leaders.

Simulation and Advanced Practice Nursing Education

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Blue, Dawn I.

2016-01-01

This quantitative study compared changes in level of confidence resulting from participation in simulation or traditional instructional methods for BSN (Bachelor of Science in Nursing) to DNP (Doctor of Nursing Practice) students in a nurse practitioner course when they entered the clinical practicum. Simulation has been used in many disciplines…

A qualitative study of collaboration in general practice: understanding the general practice nurse's role.

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McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2017-07-01

To explore the nature of collaboration between registered nurses and general practitioners in Australian general practice. There is international recognition that collaboration between health professionals can improve care coordination, enhance health outcomes, optimise the work environment and reduce healthcare costs. However, effective collaboration requires a clear understanding of each team member's role. A qualitative approach guided by Naturalistic Inquiry was used to elicit and interpret participant narratives. Eight general practitioners and fourteen registered nurses working in general practice were purposefully recruited. Data were collected via individual, semi-structured face-to-face interviews during February to May 2015. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Data revealed three overarching themes. This study presents the data for the overarching theme 'Understanding the general practice registered nurse's role'. Many general practitioner participants lacked clarity around the role and scope of practice of the registered nurse. At the same time, nursing participants often articulated their role as an assistant rather than as an independent health professional. This limited collaboration and the nurses' role within the team. Collaboration was enhanced when general practitioners actively sought an understanding of the registered nurses scope of practice. Clarifying the nurses' role promotes collaboration and supports nurses to work to the full extent of their practice. This is important in terms of optimising the nurses' role within the team and reinforcing their professional identity. Identification of key issues around understanding the nurses' role may help inform strategies that improve collaboration and workplace relations. © 2016 John Wiley & Sons Ltd.

The scope of private practice nursing in an Australian sample.

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Wilson, Anne; Averis, Andrea; Walsh, Ken

2004-01-01

The changing Australian health care system is creating new opportunities for nurses who work directly with clients in private practice settings. This study examines the scope of practice of a cohort of nurses in private practice. In a questionnaire sent to 106 self-employed nurse entrepreneurs, questions were asked pertaining to the participants' scope of practice, their clients, the types of services offered, and their fee structures. Questions about scope of practice were divided into domains of clinical practice, business consultancy, education, and research. Quantitative and qualitative data were collected for a final sample 54 eligible responses. Participants had been in private practice for an average of 7.6 years (range: 1-20) and reported a mean of 21 years of nursing experience (range: 4-42) before entering private practice. Over half held diplomas in specialty areas. Most participants reported clinical practice, consultancy, or education as the primary work domain; research was much less important as a work activity. Nurses reported difficulties with building client base and receiving adequate fees for service, particularly in clinical practice. Increasing awareness within the nursing profession and health sector about various aspects of private practice nursing could improve service quality for their clients.

Nurses' but not supervisors' safety practices are linked with job satisfaction.

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Hurtado, David A; Kim, Seung-Sup; Subramanian, S V; Dennerlein, Jack T; Christiani, David C; Hashimoto, Dean M; Sorensen, Glorian

2017-10-01

To test the associations of safety practices as reported by nurses and their respective unit supervisors with job satisfaction. Psychosocial workplace factors are associated with job satisfaction; however, it is unknown whether nurses and supervisors accounts of safety practices are differentially linked to this outcome. Cross-sectional study design including nurses (n = 1052) nested in 94 units in two hospitals in Boston (MA, USA). Safety practices refer to the identification and control of occupational hazards at the unit. Safety practices were measured aggregating nurses' responses per unit, and supervisory levels. Individual's job satisfaction for each nurse was the response variable. Supervisors assessed safety practices more favourably than their unit nursing staff. Adjusted random intercept logistic regressions showed that the odds of higher job satisfaction were higher for nurses at units with better safety practices (OR: 1.67, 95% CI: 1.04, 2.68) compared with nurses at units that averaged lower safety practices. Supervisors' reports of safety practices were not correlated with the job satisfaction of their staff. Adequate safety practices might be a relevant managerial role that enhances job satisfaction among nurses. Nursing supervisors should calibrate their safety assessments with their nursing staff to improve nurses' job satisfaction. © 2017 John Wiley & Sons Ltd.

Nurse Work Engagement Impacts Job Outcome and Nurse-Assessed Quality of Care: Model Testing with Nurse Practice Environment and Nurse Work Characteristics as Predictors

Directory of Open Access Journals (Sweden)

Peter Mathieu Van Bogaert

2014-11-01

Full Text Available Key words: burnout,job satisfaction, nurse retention, nurse practice environment,quality of care, acute health care,structural equation modelling. Aim:To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Understanding to support and guide the practice community in their daily effort to answer most accurate complex care demands along with a stable nurse workforce are challenging.Design: Cross-sectional survey.Method:Based on previous empirical findings,a structural equation model designed with valid measurement instruments was tested.The study population was registered acute care hospital nurses(N = 1201 in twoindependent hospitals and one hospital group with six hospitals in Belgium.Results: Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care.Analyses were consistent with features of nurses’ work characteristics including perceived workload,decision latitude,and social capital,as well as three dimension of work engagement playing mediating roles between nurse practice environment and outcomes.A revised model adjusted using various fit measures explained 60 % and 47 % of job outcomes and nurse - assessed quality of care,respectively.Conclusion: Study findings show that aspects of nurse work characteristics such as workload,decision latitude and social capital along with nurse work engagement(e.g.vigor, dedication and absorption play a role between how various stakeholders such as executives,nurse managers and physicians will organize care and how nurses perceive job outcomes and quality of care.

Nurse competence: a concept analysis.

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Smith, Sarah A

2012-10-01

  The purpose of this analysis was to explore the concept of nurse competence.   Data sources include EBSCOhost, Gale PowerSearch, ProQuest, PubMed Medline, Google Scholar, and Online Journal of Issues in Nursing.   This paper utilizes Rodgers' evolutionary method to analyze the concept of nurse competence.   Antecedents to nurse competence include personal and external motivations. Attributes include integrating knowledge into practice, experience, critical thinking, proficient skills, caring, communication, environment, motivation, and professionalism. Consequences include confidence, safe practice, and holistic care. Implications for nursing responsibility regarding defining nurse competence and ensuring nurse competence need to be identified. More research is needed to determine the best evaluation methods for the different facets of nurse competence. © 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

The Effect of Nursing Quality Improvement and Mobile Health Interventions on Infant Sleep Practices: A Randomized Clinical Trial.

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Moon, Rachel Y; Hauck, Fern R; Colson, Eve R; Kellams, Ann L; Geller, Nicole L; Heeren, Timothy; Kerr, Stephen M; Drake, Emily E; Tanabe, Kawai; McClain, Mary; Corwin, Michael J

2017-07-25

Inadequate adherence to recommendations known to reduce the risk of sudden unexpected infant death has contributed to a slowing in the decline of these deaths. To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions. Four-group cluster randomized clinical trial of mothers of healthy term newborns who were recruited between March 2015 and May 2016 at 16 US hospitals with more than 100 births annually. Data collection ended in October 2016. All participants were beneficiaries of a nursing quality improvement campaign in infant safe sleep practices (intervention) or breastfeeding (control), and then received a 60-day mobile health program, in which mothers received frequent emails or text messages containing short videos with educational content about infant safe sleep practices (intervention) or breastfeeding (control) and queries about infant care practices. The primary outcome was maternal self-reported adherence to 4 infant safe sleep practices of sleep position (supine), sleep location (room sharing without bed sharing), soft bedding use (none), and pacifier use (any); data were collected by maternal survey when the infant was aged 60 to 240 days. Of the 1600 mothers who were randomized to 1 of 4 groups (400 per group), 1263 completed the survey (78.9%). The mean (SD) maternal age was 28.1 years (5.8 years) and 32.8% of respondents were non-Hispanic white, 32.3% Hispanic, 27.2% non-Hispanic black, and 7.7% other race/ethnicity. The mean (SD) infant age was 11.2 weeks (4.4 weeks) and 51.2% were female. In the adjusted analyses, mothers receiving the safe sleep mobile health intervention had higher prevalence of placing their infants supine compared with mothers receiving the control mobile health intervention (89.1% vs 80.2%, respectively; adjusted risk difference, 8.9% [95% CI, 5.3%-11.7%]), room sharing without bed sharing (82.8% vs 70.4%; adjusted risk difference, 12

How can the practice nurse be more involved in the care of the chronically ill? The perspectives of GPs, patients and practice nurses

Directory of Open Access Journals (Sweden)

Heiderhoff Marc

2006-03-01

Full Text Available Background A well established "midlevel" of patient care, such as nurse practitioners and/or physician assistants, exits in many countries like the US, Canada, and Australia. In Germany, however there is only one kind of profession assisting the physician in practices, the practice nurse. Little is known about the present involvement of practice nurses in patients' care in Germany and about the attitudes of GPs, assistants and patients concerning an increased involvement. The aim of our study was to get qualitative information on the extent to which practice nurses are currently involved in the treatment of patients and about possibilities of increased involvement as well as on barriers of increased involvement. Methods We performed qualitative, semi-structured interviews with 20 GPs, 20 practice nurses and 20 patients in the Heidelberg area. The interviews were digitally recorded, transcribed and content-analysed with ATLAS.ti. Results Practice nurses are only marginally involved in the treatment of patients. GPs as well as patients were very sceptical about increased involvement in care. Patients were sceptical about nurses' professional background and feared a worsening of the patient doctor relationship. GPs also complained about the nurses' deficient education concerning medical knowledge. They feared a lack of time as well as a missing reimbursement for the efforts of an increased involvement. Practice nurses were mostly willing to be more involved, regarding it as an appreciation of their role. Important barriers were lack of time, overload with administrative work, and a lack of professional knowledge. Conclusion Practice nurses were only little involved in patient care. GPs were more sceptical than patients regarding an increased involvement. One possible area, accepted by all interviewed groups, was patient education as for instance dietary counselling. New treatment approaches as the chronic care model will require a team approach

Marketing the nursing practice of obstetrics.

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Dill, P Z

1991-01-01

This article offers nurses a conceptual framework for marketing their skills and discusses how that framework can be applied to obstetric nursing practice. A thorough understanding of the framework presented will provide maternity nurses with the foundation they need to participate effectively in a marketing plan. Examples of the application of the framework to specific clinical situations are examined.

Two management systems in a nursing private practice group.

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Zahourek, R P

1979-09-01

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Model documentation of assessment and nursing diagnosis in the practice of nursing care management for nursing students

OpenAIRE

A. Aziz Alimul Hidayat; M. Kes

2015-01-01

Model documentation of assessment and nursing diagnosis in the practice of nursing care management is an integration model in nursing care records, especially records nursing assessment and diagnosis in one format. This model can reduce the duration of the recording in nursing care, and make it easier for students to understand the nursing diagnosis, so that nursing interventions more effective. The purpose of this paper was to describes the form integration documentation of nursing assessmen...

Nursing home work practices and nursing assistants' job satisfaction.

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Bishop, Christine E; Squillace, Marie R; Meagher, Jennifer; Anderson, Wayne L; Wiener, Joshua M

2009-10-01

To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey, and county-level data from the Area Resource File. Multinomial logistic regression was used to estimate effects of compensation and working conditions on nursing assistants' overall job satisfaction, controlling for personal characteristics and local labor market characteristics. Wages, benefits, and job demands, measured by the ratio of nursing assistant hours per resident day, were associated with job satisfaction. Consistent with previous studies, job satisfaction was greater when nursing assistants felt respected and valued by their employers and had good relationships with supervisors. Nursing assistants were more satisfied when they had enough time to complete their work, when their work was challenging, when they were not subject to mandatory overtime, and where food was not delivered to residents on trays. This is the first investigation of nursing assistant job satisfaction using a nationally representative sample of nursing assistants matched to information about their employing nursing homes. The findings corroborate results of previous studies in showing that compensation and working conditions that provide respect, good relationships with supervisors, and better staffing levels are important to nursing assistant job satisfaction.

Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice Environment

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Dyess, Susan M; Sherman, Rose O; Pratt, Beth A; Chiang-Hanisko, Lenny

2016-01-14

With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master’s Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership. Conventional content analysis was used to analyze and code the data into categories. We discuss the three major categories identified, including: idealistic expectations of leaders, leading in a challenging practice environment, and cautious but optimistic outlook about their own leadership and future, and study limitations. The conclusion offers implications for future nurse leader development. The findings provide important insight into the viewpoints of nurses today about leaders and leadership.

Israeli nurse practice environment characteristics, retention, and job satisfaction.

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Dekeyser Ganz, Freda; Toren, Orly

2014-02-24

There is an international nursing shortage. Improving the practice environment has been shown to be a successful strategy against this phenomenon, as the practice environment is associated with retention and job satisfaction. The Israeli nurse practice environment has not been measured. The purpose of this study was to measure practice environment characteristics, retention and job satisfaction and to evaluate the association between these variables. A demographic questionnaire, the Practice Environment Scale, and a Job Satisfaction Questionnaire were administered to Israeli acute and intensive care nurses working in 7 hospitals across the country. Retention was measured by intent to leave the organization and work experience. A convenience sample of registered nurses was obtained using a bi-phasic, stratified, cluster design. Data were collected based on the preferences of each unit, either distribution during various shifts or at staff meetings; or via staff mailboxes. Descriptive statistics were used to describe the sample and results of the questionnaires. Pearson Product Moment Correlations were used to determine significant associations among the variables. A multiple regression model was designed where the criterion variable was the practice environment. Analyses of variance determined differences between groups on nurse practice environment characteristics. 610 nurses reported moderate levels of practice environment characteristics, where the lowest scoring characteristic was 'appropriate staffing and resources'. Approximately 9% of the sample reported their intention to leave and the level of job satisfaction was high. A statistically significant, negative, weak correlation was found between intention to leave and practice environment characteristics, with a moderate correlation between job satisfaction and practice environment characteristics. 'Appropriate staffing and resources' was the only characteristic found to be statistically different based on

Exchange students crossing language boundaries in clinical nursing practice.

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Myhre, K

2011-12-01

This article examines challenges and learning outcomes for nursing students from a Central European university of applied sciences who completed 3 months of clinical practice in Norway. The clinical practice was supervised in English by Norwegian nurses and nursing teachers. English is not the primary language in any of the countries. Increases in global migration have contributed to the need for an international dimension in nursing education. Personal mobility is a crucial part of the European Union's goal of becoming a knowledge society. Clinically based experiences pose challenges that are additional to and often more complex than traditional course-based experiences. Students who come from a non-English-speaking country for clinical practice in Norway face challenges regarding language. Accepting incoming students is a way of achieving higher quality and more relevant education in nursing. The study shows that clinical practice in a foreign country gives added value compared with clinical practice at home. Greater self-confidence and understanding of core concepts in nursing is described by the participants. Language differences are not regarded as a problem but as a way of developing personal and professional competence. The ability to compare healthcare systems in the two counties is important in developing competencies in nursing. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.

Current nursing practice by hospital-based stoma specialist nurses.

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Burch, Jennie

Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

Safe waste management practices in beryllium facilities

International Nuclear Information System (INIS)

Bhat, P.N.; Soundararajan, S.; Sharma, D.N.

2012-01-01

Beryllium, an element with the atomic symbol Be, atomic number 4, has very high stiffness to weight ratio and low density. It has good electrical conductive properties with low coefficient of thermal expansion. These properties make the metal beryllium very useful in varied technological endeavours, However, beryllium is recognised as one of the most toxic metals. Revelation of toxic effects of beryllium resulted in institution of stringent health and safety practices in beryllium handling facilities. The waste generated in such facilities may contain traces of beryllium. Any such waste should be treated as toxic waste and suitable safe waste management practices should be adopted. By instituting appropriate waste management practice and through a meticulously incorporated safety measures and continuous surveillance exercised in such facilities, total safety can be ensured. This paper broadly discusses health hazards posed by beryllium and safe methods of management of beryllium bearing wastes. (author)

Keeping nurse researchers safe: workplace health and safety issues.

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Barr, Jennieffer; Welch, Anthony

2012-07-01

This article is a report of a qualitative study of workplace health and safety issues in nursing research. Researcher health and safety have become increasing concerns as there is an increased amount of research undertaken in the community and yet there is a lack of appropriate guidelines on how to keep researchers safe when undertaking fieldwork. This study employed a descriptive qualitative approach, using different sources of data to find any references to researcher health and safety issues. A simple descriptive approach to inquiry was used for this study. Three approaches to data collection were used: interviews with 15 researchers, audits of 18 ethics applications, and exploration of the literature between 1992 and 2010 for examples of researcher safety issues. Data analysis from the three approaches identified participant comments, narrative descriptions or statements focused on researcher health and safety. Nurse researchers' health and safety may be at risk when conducting research in the community. Particular concern involves conducting sensitive research where researchers are physically at risk of being harmed, or being exposed to the development of somatic symptoms. Nurse researchers may perceive the level of risk of harm as lower than the actual or potential harm present in research. Nurse researchers do not consistently implement risk assessment before and during research. Researcher health and safety should be carefully considered at all stages of the research process. Research focusing on sensitive data and vulnerable populations need to consider risk minimization through strategies such as appropriate researcher preparation, safety during data collection, and debriefing if required. © 2012 Blackwell Publishing Ltd.

Survey of advanced practice registered nurses disciplinary action.

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Hudspeth, Randall

2007-04-02

The nursing profession continues to struggle to find the most appropriate approach to credentialing Advanced Practice Registered Nurses (APRNs). One early step in addressing this struggle is determining the incidence of APRN disciplinary actions by boards of nursing. This article presents data from 2003 and 2004 describing the incidence of APRN disciplinary actions by United States boards of nursing. Fifty-one boards of nursing, all members of the National Council of State Boards of Nursing, were asked to report the numbers of APRN discipline cases for 2003 and 2004 which had been resolved, using a tool that differentiated disciplinary cases into four data categories: chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients. Thirty-eight (74.5%) of 51 boards of nursing reported discipline data for a total of 125,882 APRNs showing 688 disciplinary actions were taken during 2003 and 2004. This indicates that APRNs experience a low incidence of discipline related to chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients.

Connecting congregations: technology resources influence parish nurse practice.

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Zerull, Lisa M; Near, Kelly K; Ragon, Bart; Farrell, Sarah P

2009-01-01

This descriptive pilot study evaluated the influence of health resource information education and the use of Web-based communication technology on the professional practice of the parish nurse in the congregational setting. Five parish nurse participants from varied denominations in rural and nonrural Virginia received a laptop computer, printer, video projector, and webcam along with high-speed Internet access in each congregational setting. The nurses attended two group education sessions that incorporated computer applications and training in accessing and using quality health information resources and communication applications such as a group "chat" software and webcam to communicate with others through high-speed Internet access. Qualitative analysis from semistructured interviews of nurses confirmed that participants found the project to be beneficial in terms of awareness, education, and applicability of technology use in parish nurse practice. Quantitative data from preproject and postproject surveys found significant differences in nurses' abilities and confidence with technology use and application. Findings showed that the knowledge and experience gained from this study enhanced parish nurse practice and confidence in using technology for communication, health education, and counseling.

Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

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Mick, D J; Ackerman, M H

2000-01-01

This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical

Profile of advanced nursing practice in Spain: A cross-sectional study.

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Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

2018-03-01

In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

Orientation based on nursing diagnoses. Old concepts in today's practice.

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Anderson, L K; Vincent, N

1991-10-01

Although many operating room orientation programs contain content necessary to meet accrediting guidelines, very few tie the nursing process to the content. Our orientation is structured within a nursing framework (ie, Dr Gordon's "Eleven Functional Health Patterns") and emphasizes nursing diagnoses, theory, and clinical competencies. Although the new orientation program has been in effect for only two years, we feel the following list reflects the positive outcomes so far: decreased staff turnover (ie, one nurse out of 26 full-time equivalents in 18 months), increased success in recruiting nurses into the operating room (ie, multiple applicants as positions open), new nurses demonstrate comfort with basic perioperative nursing practice with-in six months, and nurses who did not complete new orientation program are requesting all or portions of the content. By using this plan, essential aspects of perioperative practice are consistent with hospital-wide nursing practice, practice standards for the operating room, and accrediting standards.

Analysis instruments for the performance of Advanced Practice Nursing.

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Sevilla-Guerra, Sonia; Zabalegui, Adelaida

2017-11-29

Advanced Practice Nursing has been a reality in the international context for several decades and recently new nursing profiles have been developed in Spain as well that follow this model. The consolidation of these advanced practice roles has also led to of the creation of tools that attempt to define and evaluate their functions. This study aims to identify and explore the existing instruments that enable the domains of Advanced Practice Nursing to be defined. A review of existing international questionnaires and instruments was undertaken, including an analysis of the design process, the domains/dimensions defined, the main results and an exploration of clinimetric properties. Seven studies were analysed but not all proved to be valid, stable or reliable tools. One included tool was able to differentiate between the functions of the general nurse and the advanced practice nurse by the level of activities undertaken within the five domains described. These tools are necessary to evaluate the scope of advanced practice in new nursing roles that correspond to other international models of competencies and practice domains. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Nurse leaders' experiences of implementing regulatory changes in sexual health nursing practice in British Columbia, Canada.

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Bungay, Vicky; Stevenson, Janine

2013-05-01

Most research about regulatory policy change concerning expanded nursing activities has emphasized advanced practice roles and acute care settings. This study is a contribution to the small pool of research concerned with regulatory policy implementation for nurses undertaking expanded nursing practice activities in a public health context. Using the regulatory changes in certified nursing practice in one Canadian province as our starting point, we investigated the experiences of nurse leaders in implementing this change. Using a qualitative interpretive descriptive approach informed by tenets of complexity theory, we examined the experiences of 16 nurse leaders as situated within the larger public health care system in which nurses practice. Two interrelated themes, (a) preparing for certification and (b) the certification process, were identified to illustrate how competing and contrasting demands between health care and regulatory organizations created substantial barriers to policy change. Implications for health service delivery and future research are discussed.

Contributions of Public Health to nursing practice

Directory of Open Access Journals (Sweden)

Káren Mendes Jorge de Souza

Full Text Available ABSTRACT Objective: Analyze the perceptions of undergraduate nursing students about the contributions of public health to nursing practice in the Unified Health System. Method: Qualitative Descriptive Study. Data collection was carried out through semi-directed interviews with 15 students. The language material was analyzed according to content and thematic analysis. Results: Thematic categories were established, namely: "Perceptions about Public Health" and "Contribution of Public Health to nursing practice in the Unified Health System". Final considerations: Perceptions about Public Health are diversified, but converge to the recognition of this field as the basis for training nurses qualified to work in the SUS with technical competence, autonomy and focusing on the integrality in health care.

Delegation practices between registered nurses and nursing assistive personnel.

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Potter, Patricia; Deshields, Teresa; Kuhrik, Marilee

2010-03-01

To understand registered nurses' (RNs) and nursing assistive personnel's (NAP) perceptions of delegation practices in delivery of oncology patient care. No research to date describes how RNs and NAP communicate and interact during the delegation process. An understanding of the nature of communication during delegation offers direction for how RNs and NAP can improve collaboration. Qualitative descriptive study. Participants described conflict as a central theme during delegation. Sources of conflict varied between RNs and NAP. Successful delegation is characterised by effective communication, teamwork and initiative. Successful delegation depends on the quality of RN and NAP working relationships, timely ongoing communication, initiative and a willingness to collaborate. Nurse managers play a key role in the facilitation of delegation practices. Developing clear guidelines for RN and NAP patient reporting and providing opportunities to discuss conflict-related issues is essential. RNs would benefit from acquiring competency in how to conduct reports, resolve conflicts, and how to convey their role in patient care management. Nursing assistive personnel would benefit from developing competency in using effective communication skills for giving feedback, clarifying tasks and patient status and resolving conflict.

[Necessary changes for advancing nursing as caring science].

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de Pires, Denise Elvira Pires

2013-09-01

The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care.

Strategies and challenges for safe injection practice in developing countries

OpenAIRE

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the earl...

Promoting a Strategic Approach to Clinical Nurse Leader Practice Integration.

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Williams, Marjory; Avolio, Alice E; Ott, Karen M; Miltner, Rebecca S

2016-01-01

The Office of Nursing Services of the Department of Veterans Affairs (VA) piloted implementation of the clinical nurse leader (CNL) into the care delivery model and established a strategic goal in 2011 to implement the CNL role across the VA health care system. The VA Office of Nursing Services CNL Implementation and Evaluation (CNL I&E) Service was created as one mechanism to facilitate that goal in response to a need identified by facility nurse executives for consultative support for CNL practice integration. This article discusses strategies employed by the CNL I&E consultative team to help facility-level nursing leadership integrate CNLs into practice. Measures of success include steady growth in CNL practice capacity as well as positive feedback from nurse executives about the value of consultative engagement. Future steps to better integrate CNL practice into the VA include consolidation of lessons learned, collaboration to strengthen the evidence base for CNL practice, and further exploration of the transformational potential of CNL practice across the care continuum.

The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey.

Science.gov (United States)

Van Bogaert, Peter; Kowalski, Christoph; Weeks, Susan Mace; Van Heusden, Danny; Clarke, Sean P

2013-12-01

To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. Cross-sectional survey. Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses' work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with

The role of safe practices in hospitals’ total factor productivity

Directory of Open Access Journals (Sweden)

Timothy R Huerta

2011-01-01

Full Text Available Timothy R Huerta1, Mark A Thompson2, Eric W Ford31Center for Health Innovation, Education, and Research, 2Rawls College of Business, Texas Tech University, Lubbock, TX, USA; 3Forsyth Medical Center Distinguished Professor of Health Care, The University of North Carolina Greensboro, Greensboro, NC, USAAbstract: The dual aims of improving safety and productivity are a major part of the health care reform movement hospital leaders must manage. Studies exploring the two phenomena conjointly and over time are critical to understanding how change in one dimension influences the other over time. A Malmquist approach is used to assess hospitals’ relative productivity levels over time. Analysis of variance (ANOVA algorithms were executed to assess whether or not the Malmquist Indices (MIs correlate with the safe practices measure. The American Hospital Association’s annual survey and the Centers for Medicare and Medicaid Services’ Case Mix Index for fiscal years 2002–2006, along with Leapfrog Group’s annual survey for 2006 were used for this study. Leapfrog Group respondents have significantly higher technological change (TC and total factor productivity (TFP than nonrespondents without sacrificing technical efficiency changes. Of the three MIs, TC (P < 0.10 and TFP (P < 0.05 had significant relationships with the National Quality Forum’s Safe Practices score. The ANOVA also indicates that the mean differences of TFP measures progressed in a monotonic fashion up the Safe Practices scale. Adherence to the National Quality Forum’s Safe Practices recommendations had a major impact on hospitals’ operating processes and productivity. Specifically, there is evidence that hospitals reporting higher Safe Practices scores had above average levels of TC and TFP gains over the period assessed. Leaders should strive for increased transparency to promote both quality improvement and increased productivity.Keywords: safety, productivity, quality, safe

Impact of Healthcare Information Technology on Nursing Practice.

Science.gov (United States)

Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel

2015-07-01

To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care. The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables. Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage. Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes. © 2015 Sigma Theta Tau International.

Nursing students' responses to ethical dilemmas in nursing practice.

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Dierckx de Casterlé, B; Grypdonck, M; Vuylsteke-Wauters, M; Janssen, P J

1997-01-01

In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.

Information management competencies for practicing nurses and new graduates

Directory of Open Access Journals (Sweden)

Corina Saratan

2015-09-01

Full Text Available Nursing informatics skills are required at all levels of nursing practice. Of those basic skills, management of information through the electronic health record (EHR is paramount. Previous research has explored computer literacy of nurses but has not investigated the competencies that relate specifically to information management. The purpose of this research study was to gather practicing nurses’ views of current information management competencies published by the Technology Informatics Guiding Education Reform (TIGER initiative, as they pertain to new graduates. A convenience sample of members from the InspireNet online user group was surveyed. The results suggest that overall, nurses tend to agree with the information management competencies; however, informatics education is most needed for those who have been practicing nursing for longer, rather than for novice nurses.

Nurses who work in general medical practices: a Victorian survey.

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Bonawit, V; Watson, L

1996-01-01

A questionnaire survey of 452 general medical practices in Victoria attracted responses from 277 practices, many of which did not employ nurses. The 93 respondents from 85 practices who were nurses reported that they enjoyed flexible working hours and stable employment. While their main reason for working in GPs' rooms was convenience, the most important aspect of their work was interaction with patients and fellow workers. Sixtyseven percent of nurses thought continuing education in specific skills was necessary for their work, 43% thought a post-registration qualification in community health nursing would be desirable and 47% thought a special interest group of nurses working in medical practices would be useful.

Nursing history: from conformity to challenging practice.

OpenAIRE

Rosser, Elizabeth

2016-01-01

Elizabeth Rosser, Deputy Dean (Education and Professional Practice) and Professor of Nursing at Bournemouth University, considers the lessons that the nursing profession has learned since its early days.

Advanced practice nurses core competencies: a framework for developing and testing an advanced practice nurse discharge intervention.

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Cooke, Liz; Gemmill, Robin; Grant, Marcia

2008-01-01

The purpose of this paper was to describe evidenced-based interventions as implemented by advanced practice nurses (APNs) conducting intervention research with a vulnerable population of blood and marrow transplant patients. In addition, each of the 6 core competencies of the APN role identified by Hamric are outlined and applied using a patient case study. These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision making. This article chronicles a typical patient's journey through a post-hospital discharge nursing research study involving APNs as "intervention nurses" and discusses the various aspects of the APN core competencies throughout the process.

Reconceptualizing the core of nurse practitioner education and practice.

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Burman, Mary E; Hart, Ann Marie; Conley, Virginia; Brown, Julie; Sherard, Pat; Clarke, Pamela N

2009-01-01

The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice. Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education. The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of nursing is in health promotion, both in healthy persons and in those dealing with chronic illness. Current master's programs do not prepare NPs to assume high-level practice focused on health promotion and disease management using the latest theoretical developments in health behavior change, behavioral sciences, exercise physiology, nutrition, and medical anthropology. Although these are touched upon in most NP programs, they do not represent the core science of NP education and need to be a critical part of any DNP program. Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.

Development of advanced nursing practice in China: Act local and think global

Directory of Open Access Journals (Sweden)

Frances Kam Yuet Wong

2018-04-01

Full Text Available This paper discusses the development of advanced nursing practice in China in the context of global development. The scope of nursing is evolving over time, with increasing demands for the management of complex healthcare situations at individual, community and system levels. These demands are aggravated by the specialization of medical practice, with advanced treatment plans and patients requiring care in focused areas. The qualifications and competencies of the initial entrants into nursing practice are not adequate to deal with these demands. Advanced nursing practice (ANP developed first in response to service demands, and education programs were introduced to prepare nurses for practicing at a higher level. This paper will first review the historical development of ANP in China, followed by a discussion of the differentiation of competence levels in nursing practice and the classification of specializations. It concludes by exploring how education in combination with experience protected by regulation of practice can support nurses to gradually evolve from registered nurse, specialty nurse to advanced practiced nurse.

Nurse uniform wearing practices and associated factors among nurses working in Northwest Ethiopia: a cross-sectional institution based study.

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Desta, Etaferahu Alamaw; Gebrie, Mignote Hailu; Dachew, Berihun Assefa

2015-01-01

Wearing uniforms help in the formation of professional identity in healthcare. It fosters a strong self image and professional identity which can lead to good confidence and better performance in nursing practice. However, most nurses in Ethiopia are not wearing nursing uniforms and the reasons remain unclear. Therefore, the aim of this research is to assess nurse uniform wearing practices among nurses and factors associated with such practice in hospitals in Northwest Ethiopia. A hospital based cross-sectional study was conducted from March to April, 2014 in five hospitals located in Northwest Ethiopia. A total 459 nurses participated in the study. Data was collected using a pre-tested self-administered questionnaire. Descriptive statistics were analyzed in order to characterize the study population. Bivariate and multiple logistic regression models were fitted. Odds ratios with 95 % confidence intervals were computed to identify factors associated with nursing uniform practice. Nurse uniform wearing practice was found to be 49.2 % of the total sample size. Around 35 % of the respondents that did not implement nurse uniform wearing practices stated that there was no specific uniform for nurses recommended by hospital management. In addition to this, nurse uniform wearing practices were positively associated with being female [AOR = 1.58, 95 % CI (1.02, 2.44)], studying nursing by choice [AOR =3.16, 95 % CI (2.03, 4.92)], and the appeal of nursing uniforms to nurses [AOR = 3.43 95 % CI (1.96, 5.98)]. Nurse uniform wearing practices were not exceptionally prevalent in Northwest Ethiopian hospitals. However, encouraging students to pursue interest-based careers and implementing a nurse uniform wearing policy may have the potential to improve such practices.

Assessing the Information and Communication Technology (ICT)-Educational Needs of Nursing Students at Millikin University

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Folami, Florence; Adeoye, Blessing F.

2012-01-01

While the leading edge between nursing and information provides an opportunity to expand the limitations of nursing knowledge and practice and creates new leadership roles for nurses, it also requires special competencies for safe and effective nursing practice. This study, therefore, assesses informatics competencies and examines the pedagogic…

Effects of nursing position on transformational leadership practices.

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Herman, Susan; Gish, Mary; Rosenblum, Ruth

2015-02-01

This study sought to identify significant differences in nursing leadership strengths by position title. Recent reports show aspects of transformational leadership (TL) related to position, age, and educational level. This study focuses on differentiating the strength of leadership practices across the range of nursing management positions. The Leadership Practices Inventory-Self-assessment survey, and a variety of demographic questions, were used to anonymously poll voluntary members of the Association of California Nurse Leaders. Nursing positions of director level and above were strongest in leadership practices. Those at manager and below were identified as needing additional leadership development. LPI-S subscales Enable Others to Act and Model the Way were strongest. Those at the manager level and below will benefit most from additional education and training. Even upper levels of management would gain from enhancing the LPI practices of Challenge the Process and Inspire a Shared Vision.

Iatrogenic Hepatitis C Virus Transmission and Safe Injection Practices.

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Defendorf, Charles M; Paul, Sindy; Scott, George J

2018-05-01

Hepatitis C virus (HCV) infection poses significant adverse health effects. Improper use of vials, needles, syringes, intravenous bags, tubing, and connectors for injections and infusions is a current preventable cause of iatrogenic HCV transmission. Numerous cases have demonstrated the need for continued vigilance and the widespread nature of this iatrogenic infection risk across a variety of medical practice settings in the United States. Failure to implement the evidence-based Centers for Disease Control and Prevention (CDC) infection prevention guidelines exposes patients to preventable harm. The guidelines establish the requirement to notify patients in cases of suspected virus transmission, as well as to screen those patients who would not otherwise have been at risk for HCV seroconversion and other bloodborne pathogens. Legal and regulatory ramifications, including state, criminal, and tort laws, hold physicians and other health care professionals accountable to use safe injection practices. This article reviews the major health risks of HCV infection, significant effects of iatrogenic infection transmission, CDC guidelines for safe injection practices, and legal regulations and ramifications designed to promote safe injection practices.

Effects of a sexual health care nursing record on the attitudes and practice of oncology nurses.

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Jung, Dukyoo; Kim, Jung-Hee

2016-10-01

A nursing record focused on sexual health care for patients with cancer could encourage oncology nurses to provide sexual health care for oncology patients in a simple and effective manner. However, existing electronic information systems focus on professional use and not sexual health care, which could lead to inefficiencies in clinical practice. To examine the effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Twenty-four full-time registered nurses caring for oncology patients were randomly assigned to the intervention and control groups in Korea. The researchers developed a sexual health care record and applied it to the intervention group for one month. Data were analyzed by Mann-Whitney U test and chi-square test. Content analysis was used to analyze interviews. Oncology nurses using the sexual health care record had significantly higher levels of sexual health care practice at 4 weeks post-intervention as compared to those who provided usual care to patients with cancer. A sexual health care record may have the potential to facilitate oncology nurses' practice of sexual health care. This study highlighted the importance of using SHC records with oncology patients to improve nursing practice related to sexuality issues. A nursing record focused on SHC for patients with cancer could make it easier and more effective for oncology nurses to provide such care to their patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Decision Making in Nursing Practice: A Concept Analysis.

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Johansen, Mary L; O'Brien, Janice L

2016-01-01

The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.

Strategic directions and actions for advanced practice nursing in China

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Martha N. Hill

2017-01-01

Full Text Available There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs improve health care and outcomes. The China Medical Board (CMB China Nursing Network (CCNN began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system.

Team work and collaborative practice agreements among pharmacists and nurse practitioners.

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Funk, Kylee A; Weaver, Krystalyn K

The authors share their knowledge about partnering and establishing collaborative practice agreements with nurse practitioners. State laws and regulations were reviewed that affect pharmacists' ability to fully partner with nurse practitioners. Nurse practitioners' role in primary care is growing, and, in many states, nurse practitioners practice independently. Collaborative practice agreements (CPAs) enable pharmacists to work with prescribers more efficiently. Pharmacists' and nurse practitioners' scope-of-practice laws and regulations may prevent CPAs between pharmacists and nurse practitioners. State pharmacy practice acts were reviewed to demonstrate which states allow for partnership under a CPA. Pharmacists should consider opportunities to partner more closely with nurse practitioners to provide care, sometimes under a CPA. In states where laws or regulations prevent CPAs between pharmacists and nurse practitioners, pharmacists should advocate for policy change. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.

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Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline

2018-02-05

To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.

Assessing undergraduate nursing students in clinical practice: do preceptors use assessment strategies?

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McCarthy, Bridie; Murphy, Siobhan

2008-04-01

Health care organisations such as the World Health Organisation (WHO) and An Bord Altranais (ABA, The Irish Nursing Registration Board) demand higher standards of new graduate nurses than heretofore. This is in conjunction with the implementation of degree programmes for undergraduate nurse education. These organisations stipulate that graduates must be well-educated, accountable, and can demonstrate the skills of a safe, caring and competent decision-making practitioner. The Bachelor of Science (BSc) four-year degree programme for undergraduate nurse education was introduced in Ireland in 2002, and is provided in universities and colleges of higher education throughout The Republic of Ireland. During the implementation process, each university and college of higher education developed a range of assessment strategies to clinically assess students. Preceptor nurses were subsequently assigned the responsibility of clinically assessing students, a remit previously undertaken by Clinical Ward/Unit Nurse Managers. Preceptors are qualified nurses, working in clinical units who are specially prepared to support BSc students during clinical placements. The purpose of this study was to explore to what extent preceptor nurses use the devised assessment strategies to clinically assess BSc students in one university in The Republic of Ireland. Data were collected by using a questionnaire distributed to all known preceptors in General, Psychiatric and Intellectual Disability nursing, during year four of the first cycle of the BSc programme. Findings from this descriptive study revealed that many preceptors were inexperienced, did not fully comprehend the assessment process and were not applying all of the recommended assessment strategies when assessing students in clinical practice. In light of these findings suggestions are made in the context of further research, management and education.

Practical strategies for nursing education program evaluation.

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Lewallen, Lynne Porter

2015-01-01

Self-evaluation is required for institutions of higher learning and the nursing programs within them. The literature provides information on evaluation models and instruments, and descriptions of how specific nursing education programs are evaluated. However, there are few discussions in the nursing education literature of the practical aspects of nursing education program evaluation: how to get started, how to keep track of data, who to involve in data collection, and how to manage challenging criteria. This article discusses the importance of program evaluation in the academic setting and provides information on practical ways to organize the evaluation process and aggregate data, and strategies for gathering data from students, graduates, alumni, and employers of graduates. Copyright © 2015 Elsevier Inc. All rights reserved.

Authentic leaders creating healthy work environments for nursing practice.

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Shirey, Maria R

2006-05-01

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

The context of oncology nursing practice: an integrative review.

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Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta

2013-01-01

In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.

What interventions can improve the mental health nursing practice environment?

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Redknap, Robina; Twigg, Di; Towell, Amanda

2016-02-01

The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia. © 2016 Australian College of Mental Health Nurses Inc.

Introduction of assistive devices: home nurses' practices and beliefs.

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Roelands, Marc; Van Oost, Paulette; Depoorter, Anne Marie; Buysse, Ann; Stevens, Veerle

2006-04-01

This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.

Queensland nursing staffs' perceptions of the preparation for practice of registered and enrolled nurses.

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Hegney, Desley; Eley, Robert; Francis, Karen

2013-10-01

In Australia, unlike other countries, programmes which lead to registration as a registered or enrolled nurse (called "entry to practice" programmes) are carried out solely in the tertiary sector. In Australian nursing and the wider community, there continues to be a debate over the place of preparation and the "work readiness" of graduates. Despite several opinion papers on the preparation of registered nurses, there is a dearth of published research on the perceptions of the clinical nursing workforce on the suitability of the current preparation for practice models. Data were collected from approximately 3000 nurses in Queensland, Australia in 2007 and 2010. The aim of these studies was to ascertain issues around nursing work. This paper reports on qualitative data that were collected as part of that larger survey. Specifically this paper provides the thematic analysis of one open-ended question: "what are the five key issues and strategies that you see could improve nursing and nursing work?" as it was apparent when we undertook thematic analysis of this question that there was a major theme around the preparation of nurses for the nursing workforce. We therefore carried out a more detailed thematic analysis around this major theme. The major sub-themes that we identified from comments on the preparation of the nursing workforce were: perceptions of lack of clinical exposure and the need to increase the amount of clinical hours; the design of the curriculum, the place of preparation (solely within industry or a great focus on industry), financial consideration (students to be paid for their work); and in 2007 only, the need for students to have better time management. The findings suggest that a majority of respondents believed there should be changes to the entry to practice preparation for nurses. The major focus of these comments was the perception of insufficient clinical experience and inappropriate curriculum content. Thus, graduates are not "work ready

Developing a general ward nursing dashboard.

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Russell, Margot; Hogg, Maggie; Leach, Stuart; Penman, Mags; Friel, Susan

2014-12-15

The seventh and final article in the series on Leading Better Care explores some of the challenges in clinical practice relating to the use of data and making information meaningful to senior charge nurses and ward sisters. It describes the collaborative approach taken by NHS Lanarkshire, which involved nursing staff, programme leads and the eHealth team in the development of a general ward nursing dashboard as a means of ensuring safe, effective person-centred care. The article also illustrates how this web-based data-reporting programme is used to support clinical practice.

Leadership practices and staff nurses' intent to stay: a systematic review.

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Cowden, Tracy; Cummings, Greta; Profetto-McGrath, Joanne

2011-05-01

The aim of the present study was to describe the findings of a systematic review of the literature that examined the relationship between managers' leadership practices and staff nurses' intent to stay in their current position. The nursing shortage demands that managers focus on the retention of staff nurses. Understanding the relationship between leadership practices and nurses' intent to stay is fundamental to retaining nurses in the workforce. Published English language articles on leadership practices and staff nurses' intent to stay were retrieved from computerized databases and a manual search. Data extraction and quality assessments were completed for the final 23 research articles. Relational leadership practices influence staff nurses' intentions to remain in their current position. This study supports a positive relationship between transformational leadership, supportive work environments and staff nurses' intentions to remain in their current positions. Incorporating relational leadership theory into management practices will influence nurse retention. Advancing current conceptual models will increase knowledge of intent to stay. Clarifying the distinction between the concepts intent to stay and intent to leave is needed to establish a clear theoretical foundation for further intent to stay research. Nurse managers and leaders who practice relational leadership and ensure quality workplace environments are more likely to retain their staff. The findings of the present study support the claim that leadership practices influence staff nurse retention and builds on intent to stay knowledge. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

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Brooke, Joanne Mary; Mallion, Jaimee

2016-08-01

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses. © 2016 John Wiley & Sons Australia, Ltd.

Organizational climate and hospital nurses' caring practices: a mixed-methods study.

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Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P

2014-06-01

Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices. © 2014 Wiley Periodicals, Inc.

Distraction by smartphone use during clinical practice and opinions about smartphone restriction policies: A cross-sectional descriptive study of nursing students.

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Cho, Sumi; Lee, Eunjoo

2016-05-01

Smartphone use in healthcare settings may distract healthcare providers and disrupt patient care. Moreover, it may lead to adverse events, thereby threatening patient safety. This study assessed nursing students' smartphone use as a source of distraction in clinical practice and identified their opinions about policies restricting smartphone use during patient care. A cross-sectional descriptive design was used with convenience sampling. Third-year nursing students (n=312) from two nursing schools in the Republic of Korea completed the survey in 2012. A self-report questionnaire-based on addiction theories for problem behaviors and literature on the distraction caused by cellular phone use-was used to assess smartphone use, experiences of distraction caused by smartphone use, and opinions about restriction policies on smartphone use during clinical practice. Nearly half (46.2%) of the nursing students used smartphones at least sometimes during clinical practice and about a quarter of the respondents (24.7%) were at least sometimes distracted by smartphones during clinical practice. The majority of the respondents (83.7%) had witnessed nurses using smartphones at least sometimes during their work. A few respondents (15.7%) agreed or strongly agreed with the policy for restricting smartphone use in hospitals. Students who used smartphones more often tended to disagree with restriction policies for smartphone use in hospitals. Awareness about the risks of smartphone use, especially regarding patient safety, is necessary for nursing students in school and hospital settings. Educators and faculty of nursing schools need to develop policies that encourage intelligent and safe use of smartphones during clinical practice. Copyright © 2016. Published by Elsevier Ltd.

Person-centredness in graduate nursing education: practice development in action

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Karen LeGrow

2016-05-01

Full Text Available Background: Person-centredness is an approach that views each individual as a unique being, and is supported by the values of mutual respect and individual right to self-determination. This approach is currently a prevailing principle in policy, education and practice settings globally. The relevance of person-centredness to postgraduate student learning is immense, as new graduate nurses are expected to assume leadership and advocacy roles in healthcare environments and engage with key stakeholders in the exchange of knowledge to inform practice. The application of person-centred practices by faculty within postgraduate nursing programmes is therefore instrumental in providing students with the necessary supportive environments to acquire the skills for person-centred care. Method: Practice development was used as a foundation for implementing innovative teaching methods for postgraduate nursing students. Nurses enrolled in the advancement of professional nursing practice seminars and practicum, participating in various active learning and critical reflection activities throughout the semester. Implications for practice: Practice development provides an innovative foundation for postgraduate nursing education Educators should consider this unique and person-centred approach as an alternative to the typical pedagogical approach

Using Concept Maps with Simulation: Learning Experiences of Associate Degree in Nursing Students

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O'Halloran, Bernadette D.

2017-01-01

Graduate nurses have experienced a difficult transition to clinical practice. With the continuing gap in educational preparation and clinical nursing practice leading to errors in health care delivery, the nurse faculty remains challenged in performing innovative changes to the curriculum to improve and maintain quality and safe patient care. The…

Research supporting the congruence between rehabilitation principles and home health nursing practice.

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Neal, L J

1999-01-01

A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.

Analysing the role of the PICU nurse to guide education of new graduate nurses.

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Long, Debbie A; Young, Jeanine; Rickard, Claire M; Mitchell, Marion L

2013-04-01

One strategy to address the current nursing shortage in specialty areas has been to introduce graduate nurse programs. However introducing novice nurses to specialty areas raises concerns around education and competency which, in turn, highlights the need to identify and prioritise the elements of competent paediatric intensive care unit (PICU) nursing care considered essential to safe practice. To determine the key knowledge, skills and attributes of competent level PICU nurses. A practice analysis survey of 15 nurse educators was conducted in all eight Australian and New Zealand PICUs during 2008. Three areas of practice essential to PICU nursing competence were explored: patients most commonly cared for; frequency and criticality of activities performed; and level of independence against critical care nursing competency standards. Data were analysed using descriptive statistics. Cardiac and respiratory problems accounted for over 50% of patients cared for by competent level nurses. Cardiac and respiratory activities were therefore also ranked as the most important activities. Respondents identified that competency domains of teamwork and professional practice are performed with minimal supervision, whereas clinical problem solving requires supervision and assistance. PICU nurses are performing activities and caring for a breadth of complex patients within a year of entering the workforce. Using a practice analysis to define actual practice and expectations can assist in the identification and prioritisation of content for graduate and other educational programs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Nurses' Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People's Care in Ontario Acute Care Hospitals.

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Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah

2017-06-01

Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

Using mobile technology to promote safe sex and sexual health in adolescents: current practices and future recommendations

Directory of Open Access Journals (Sweden)

Cornelius JB

2016-04-01

Full Text Available Judith B Cornelius,1 Josephine A Appiah2 1School of Nursing, 2Health Services Research Doctoral Program, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA Abstract: Youth and young adults (19–24 years of age shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans. Keywords: mobile, safe sex, sexual health, practices, recommendations

Articulation Matrix for Home Health Aide, Nursing Assistant, Patient Care Assistant, Practical Nursing.

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Florida State Univ., Tallahassee. Center for Instructional Development and Services.

This document demonstrates the relationships among four Florida nursing education programs (home health aide, nursing assistant, patient care assistant, and practical nursing) by listing student performance standards and indicating which ones are required in each program. The 268 student performance standards are arranged in 23 areas of…

Learning Opportunities in Case Studies for Becoming a Reflective Nurse Practitioner

NARCIS (Netherlands)

Dr. A.J. ter Maten - Speksnijder; A. Pool; J.N. Streumer; M.H.F. Grypdonck

2012-01-01

The transition from RN to nurse practitioner presents challenges. Because nurse practitioners require deeper critical decision-making abilities to provide safe and quality health care, the Master in Advanced Nursing Practice curriculum implemented reflective case studies to facilitate active and

Nursing in an imperfect world: Storytelling as preparation for mental health nursing practice.

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Treloar, Anna; McMillan, Margaret; Stone, Teresa

2017-06-01

Storytelling is a valuable adjunctive method of preparing undergraduate mental health nursing students for practice. To explore the possibilities of this method of teaching, 100 stories were collected from experienced nurses working in mental health and analysed using a case study methodology. The aim was to explore the purpose of clinical anecdotes told by experienced nurses working in mental health settings to undergraduates and new recruits, with an ancillary purpose of looking at the implications of these anecdotes for the exploration of contemporary mental health practice and education. A framework for student discussion of stories is provided. The insights gained illuminate not only the history of mental health nursing and the daily activities of nurses working in mental health, but also some of the deep-level skills developed and used by these nurses as they work in the complexity and ambiguity of an imperfect world where the job requires managing the unexpected every shift, and where there might not always be a textbook-perfect solution to clinical situations. © 2016 Australian College of Mental Health Nurses Inc.

Priority setting in clinical nursing practice: literature review.

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Hendry, Charles; Walker, Anne

2004-08-01

Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.

e-Learning competency for practice nurses: an evaluation report.

Science.gov (United States)

Heartfield, Marie; Morello, Andrea; Harris, Melanie; Lawn, Sharon; Pols, Vincenza; Stapleton, Carolyn; Battersby, Malcolm

2013-01-01

Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals' is determined by several organisational, economic, pedagogical and individual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses' expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.

Registered nurse job satisfaction and satisfaction with the professional practice model.

Science.gov (United States)

McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J

2012-03-01

This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.

The art of noticing: essential to nursing practice.

OpenAIRE

Watson, Fiona; Rebair, Annessa

2014-01-01

Noticing is integral to the everyday practice of nurses; it is the pre-cursor for clinical reasoning, informing judgement and the basis of care. By noticing the nurse can pre-empt possible risks or support subtle changes towards recovery. Noticing can be the activity that stimulates action before words are exchanged, pre-empting need. In this article, the art of noticing is explored in relation to nursing practice and how the failure to notice can have serious consequences for those in care.

Utilizing Ericksonian hypnosis in psychiatric-mental health nursing practice.

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Zahourek, Rothlyn P

2002-01-01

Ericksonian hypnosis conceptual framework. To acquaint psychiatric-mental health nurses with hypnotic principles and how these can be integrated into their practice. Published literature and author's clinical experience. Ericksonian hypnosis offers an array of potential interventions for psychiatric-mental health nurses to integrate into their practices in a framework familiar to nurses: holism, honoring and respecting individuality, and capitalizing on an individual's strengths.

Obesity Prevention Practices of Elementary School Nurses in Minnesota: Findings from Interviews with Licensed School Nurses

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Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.

2011-01-01

Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…

Ambiguity Within Nursing Practice: An Evolutionary Concept Analysis.

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McMahon, Michelle A; Dluhy, Nancy M

2017-02-01

To analyze the concept of ambiguity in a nursing context. Ambiguity is inherent within nursing practice. As health care becomes increasingly complex, nurses must continue to successfully deal with greater amounts of clinical ambiguity. Although ambiguity is discussed in nursing, minimal concept refinement exists to capture the contextual intricacies from a nursing lens. Nurse perception of an ambiguous clinical event, in combination with nurse tolerance level for ambiguity, can impact nurse response. Yet, little is known about what constitutes ambiguity within nursing practice (AWNP). Rodgers evolutionary method was used to explore AWNP, with emphasis on nurse thinking during ambiguous clinical situations. Literature searches across multiple databases yielded 38 articles for analysis. Attributes of AWNP include (a) variations in cues/available information, (b) multiple interpretations, (c) novel/nonroutine presentations, and (d) unpredictable. Antecedents include (a) a context-specific, clinical situation with ambiguous features needing evaluation and (b) an individual to sense a knowledge gap or perceive ambiguity. Consequences include ranges of (a) emotional, (b) behavioral, and (c) cognitive clinician responses. Preliminary findings support AWNP as a distinct concept in which ambiguity perceived by the nurse likely affects judgment, decision making, and clinical interventions. AWNP is a clinically relevant concept requiring continued development.

Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing.

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O'Connell, Jane; Gardner, Glenn; Coyer, Fiona

2014-12-01

This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. Data were sourced from electronic databases as described in the background section. As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education. © 2014 John Wiley & Sons Ltd.

Accountability in district nursing practice: key concepts.

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Griffith, Richard

2015-03-01

Public trust and confidence in district nurses is essential to the nurse-patient relationship that underpins effective care and treatment. That trust and confidence has even greater focus for district nurses who care for patients in their own homes. Those patients need to be able to count on the professionalism and probity of their district nurses. The professionalism and probity of district nurses is based on their accountability, which protects the public by imposing standards on district nurses and holds them answerable for their acts and omissions. This is the first of a series of articles on accountability in district nursing practice to mark the introduction of the revised Nursing and Midwifery Code on the 31 March 2015. This month's article considers the key concepts of accountability.

Irish psychiatric nurses' self-reported sources of knowledge for practice.

LENUS (Irish Health Repository)

Yadav, B L

2012-02-01

Evidence-based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence-Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.

Contributions of qualitative research to evidence-based practice in nursing

Directory of Open Access Journals (Sweden)

Ailinger Rita L.

2003-01-01

Full Text Available AIM: This article aims to identify the contributions of qualitative research to evidence-based practice in nursing. BACKGROUND: Qualitative research dates back to the 1920s and 1930s, when anthropologists and sociologists used qualitative research methods to study human phenomena in naturalistic settings and from a holistic viewpoint. Afterwards, other subject matters, including nursing, adopted qualitative methods to answer their research questions. The restructuring of health care over the past decade has brought about increased accountability in nursing research. One method for increasing this accountability is evidence-based practice. METHOD: The method used was a search in the Cumulative Index to Nursing and Allied Health Literature database from 1999-present. The search resulted in 61 citations for evidence-based practice in nursing research; however, only 5 citations focused on evidence-based practice and qualitative research. FINDINGS: The authors' findings revealed six contributions of qualitative research to evidence-based practice: generation of hypotheses; development and validation of instruments; provision of context for evaluation; development of nursing interventions; development of new research questions; and application of Qualitative Outcome Analysis. CONCLUSION: Qualitative research makes important contributions to the quality of evidence-based practice.

Work engagement in nursing practice: a relational ethics perspective.

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Keyko, Kacey

2014-12-01

The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments. © The Author(s) 2014.

My practice evolution: an appreciation of the discrepancies between the idealism of nursing education and the realities of hospital practice.

Science.gov (United States)

Perkins, Danielle E K

2010-01-01

Newly graduated registered nurses face a barrage of physical and mental challenges in their first few years of practice, especially in the hospital setting. This article explores discrepancies between student nurse practice and professional nursing practice and the challenges that new nurses face in bridging the gap between idealistic theory and realistic practice. The author's subsequent graduate nursing education and continued practice in the field resulted in a personal evolution of practice that elicited a profound sense of appreciation for the field and a desire to share these experiences with other practicing nurses and students.

An investigation of nurse educator's perceptions and experiences of undertaking clinical practice.

Science.gov (United States)

Williams, Angela; Taylor, Cathy

2008-11-01

Educational policy (DOH, 1999. Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare. Department of Health, London; UKCC, 1999. Fitness for Practice. United Kingdom Central Council for Nursing, Midwifery and Health Visiting, London; Nursing and Midwifery Council, 2006. Standards to support learning and assessment in practice. Nursing and Midwifery Council, London) and current nursing literature (Griscti, O., Jacono, B., Jacono, J., 2005. The nurse educator's clinical role. Journal of Advanced Nursing 50 (1), 84-92; Owen, S., Ferguson, K., Baguley, I., 2005. The clinical activity of mental health nurse lecturers. Journal of Psychiatric and Mental Health Nursing 12, 310-316), place increasing emphasis on nurse educators undertaking clinical practice to facilitate their clinical confidence and competence. This study investigated nurse educators' perceptions and experiences of undertaking clinical practice. A qualitative design and descriptive, exploratory approach were used. A purposive sample of 11 nurse educators in one nursing department, took part in two focus group interviews, one with 5 and the other with 6 respondents, to identify and discuss their perceptions and experiences of undertaking clinical practice. A process of thematic content analysis revealed three broad themes relating to the meaning and importance of clinical practice, perceived benefits and barriers which are examined and discussed. The paper concludes that despite policy recommendations, barriers highlighted in this study such as insufficient time, heavy workload and a lack of valuing of the clinical role have been raised over the past few decades. The effect of undertaking clinical practice, particularly on the quality of teaching is argued to be valuable armoury in the battle to secure sufficient resources to support engagement in clinical practice. Financial and organisational commitment; valuing of clinical practice and research

Northern nursing practice in a primary health care setting.

Science.gov (United States)

Vukic, Adele; Keddy, Barbara

2002-12-01

This paper explicates the nature of outpost nursing work, and/or the day-to-day realities of northern nursing practice in a primary health care setting in Canada. The study was carried out to systematically explore the work of nurses in an indigenous setting. Institutional ethnography, pioneered by Dorothy Smith was the methodology used to guide this research. The theoretical perspective of this methodology does not seek causes or links but intends to explicate visible practices. It is intended to explicate the social organization of specific discourses that inform work processes of nurses working in remote indigenous communities. The data originated from various sources including spending 2 weeks in a northern remote community shadowing experienced nurses, taking field notes and audio taping interviews with these nurses. One of the two researchers was a northern practice nurse for many years and has had taught in an outpost nursing programme. As part of the process, texts were obtained from the site as data to be incorporated in the analysis. The lived experiences have added to the analytical understanding of the work of nurses in remote areas. Data uncovered documentary practices inherent to the work setting which were then analysed along with the transcribed interviews and field notes derived from the on-site visit. Identifying disjuncture in the discourse of northern nursing and the lived experience of the nurses in this study was central to the research process. The results indicated that the social organization of northern community nursing work required a broad generalist knowledge base for decision making to work effectively within this primary health care setting. The nurse as 'other' and the invisibility of nurses' work of building a trusting relationship with the community is not reflected in the discourse of northern nursing. Trust cannot be quantified or measured yet it is fundamental to working effectively with the community. The nurses in this study

Clinical Experience in Advanced Practice Nursing: A Canadian Perspective.

Science.gov (United States)

Donnelly, Glenn

2003-01-01

The role of advanced practice (AP) nurses must be clearly articulated and defined and not overshadowed by medical functions. Consensus on their educational preparation and explication of the nature of expertise in advanced practice are needed if AP nurses are to realize the full scope of their practice. (Contains 35 references.) (SK)

Promoting leadership and management in Australian general practice nursing: what will it take?

Science.gov (United States)

Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth

2008-10-01

This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

The understanding of theory and practice in nursing education

DEFF Research Database (Denmark)

Dau, Susanne; Nielsen, Gitte

This project deals with the matter of nursing education on professional bachelor level in Denmark. It is a fact that opinions differ in the matter of what can and must be learned in respectively clinical practice and in theoretical practice in a professional nursing training. The aim...... of this project is to investigate the understandings of clinical as well as theoretical training in nursing education, and to discuss which implications and problems these opinions can have for the nursing students’ competences to develop the profession. The method of this project consists of three qualitative...... focus group interviews. The informants are nursing students, teachers from a university college and clinical instructors from a university hospital. The three focus group interviews are conducted from a theoretical frame of reference regarding the matter of theory and practice. The method of data...

International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-07-01

Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices.

International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

International Nuclear Information System (INIS)

2002-01-01

Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

Science.gov (United States)

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Practical Nursing Education: Criteria and Procedures for Accreditation.

Science.gov (United States)

National Association for Practical Nurse Education and Service, Inc., New York, NY.

The third in a series of pamphlets on practical nursing education, this document contains information on accreditation standards governing nursing programs. Included are announcements of: (1) available accreditation and consultation services, (2) policies regulating accreditation eligibility, (3) standards of ethics by which nursing programs are…

The Prevalence of Allergic Contact Sensitization of Practicing and Student Nurses

Directory of Open Access Journals (Sweden)

A Akan

2011-12-01

Full Text Available Background: Contact dermatitis (CD is a significant problem among nurses. Although there are reports about the prevalence of CD from different parts of the world, data about its frequency in Turkey and about allergic contact sensitization among nurses is insufficient. Objective: To define the frequency and patterns of allergic contact sensitization and related symptoms in practicing and student nurses. Methods: There were 123 nurses in our hospital practicing in the in-patient clinics. All were invited to participate in the study. 69 working-in nurses and 79 student nurses participated in the study. The main reason for refusal of nurses was that they were usually having a shower daily after a hard working day and they had to postpone having a bath for 3 days if they had a patch test on their back. A ready-to-use patch test system (TRUE test® with 29 standardized test substances was applied to all of the participants. History about symptoms of CD and allergic diseases was investigated by questionnaire. Results: While 34.8% (24/69 of practicing nurses had symptoms of CD, 19% (15/79 of student nurses reported the symptoms (p=0.039. The most prevalent positive reaction was to nickel sulfate followed by thimerosal. There was no difference for positive reaction rates between practicing and student nurses. Nurses who had symptoms of CD were older than those without symptoms (p=0.003. The participants with symptoms of CD were more frequently from practicing nurses (p=0.047. Conclusion: CD is more frequent in practicing nurses than student nurses; allergic contact sensitization is not. This may be attributed to the length of occupation that is also correlated well with the length of exposure to the occupational irritants.

Pain Management: Knowledge and Attitudes of Senior Nursing Students and Practicing Registered Nurses

Science.gov (United States)

Messmer, Sherry

2009-01-01

Despite scientific advances in pain management, inadequate pain relief in hospitalized patients continues to be an on-going phenomenon. Although nurses do not prescribe medication for pain, the decision to administer pharmacological or other interventions for pain relief is part of nursing practice. Nurses play a critical role in the relief of…

Work engagement in professional nursing practice: A systematic review.

Science.gov (United States)

Keyko, Kacey; Cummings, Greta G; Yonge, Olive; Wong, Carol A

2016-09-01

Work engagement in professional nursing practice is critically important to consider when addressing key challenges of health systems, including the global nursing shortage, pressures to reduce health care spending, and increasing demands for quality care and positive outcomes for patients. However, research on work engagement in professional nursing practice has not yet been synthesized and therefore, does not provide a sufficient foundation of knowledge to guide practice and further research. The overall aim of this systematic review is to determine what is currently known about the antecedents and outcomes of work engagement in professional nursing practice. Systematic review. The search strategy included eight electronic databases: CINAHL, MEDLINE, PsycINFO, PROQUEST, SCOPUS, Web of Science, EMBASE, and Business Source Complete. The search was conducted in October 2013. Quantitative and qualitative research that examined relationships between work engagement and antecedent or outcome factors was included. Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were synthesized through descriptive and narrative synthesis. Content analysis was used to categorize factors into themes and categories. 3621 titles and abstracts were screened and yielded 113 manuscripts for full text review. Full text review resulted in 18 included studies. All factors examined were grouped into either influences or outcomes of work engagement. A total of 77 influencing factors were categorized into 6 themes: organizational climate, job resources, professional resources, personal resources, job demands, and demographic variables. A total of 17 outcomes of work engagement were categorized into 3 themes: performance and care outcomes, professional outcomes, and personal outcomes. Based on the results, we adapted the Job Demands-Resources (JD-R) model and developed the Nursing Job Demands-Resources (NJD-R) model for

An Academic-Practice Partnership Model to Grow and Sustain Advanced Practice Nursing.

Science.gov (United States)

Williams, Tracy E; Howard, Patricia B

2017-12-01

The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study. The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing. An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program. Qualitative methods were used to explore pilot data at midpoint of cohort 1 student progression to determine learning outcomes and DNP projects with potential for impact on organization goals. Partnership implementation experiences indicate that contractual agreements and an established evaluation plan are keys to academic-practice partnership success. Pilot study findings suggest that curriculum core courses provide a foundation for designing DNP projects congruent with acute and primary care health system goals. Implementing an academic-practice partnership is a strategy for workforce development to increase retention of advanced practice nurses. Academic-practice partnerships can serve as a catalyst for a paradigm shift for changing models of care, thus enhancing workforce development succession planning for sustainable growth in healthcare systems.

The impact of [corrected] expanded nursing practice on professional identify in Denmark.

Science.gov (United States)

Piil, Karin; Kolbæk, Raymond; Ottmann, Goetz; Rasmussen, Bodil

2012-01-01

This article explores the concept of professional identity of Danish nurses working in an expanded practice. The case study explores the experiences of a small group of Danish nurses with a new professional category that reaches into a domain that customarily belonged to physicians. The aim of this case study was to explore the impact of "nurse consultations," representing an expanded nursing role, of 5 nurses focusing on their perception of autonomy, self-esteem, and confidence. The case study used semistructured interviews with 5 participants triangulated and validated with participant observations, a focus group interview, and theoretically derived insights. This study indicates that nurses working within a new expanded professional practice see themselves as still engaged in nursing and not as substitute physicians. The study also suggests that the involved nurses gained a higher sense of autonomy, self-esteem, and confidence in their practice. These elements have a positive impact on their professional identity. The research demonstrates that for the nurses involved in expanded professional practice, the boundaries of professional practice have shifted significantly. The research indicates that an expanded practice generates a new domain within the professional identity of nurses.

Impact of professional nursing practice environment and psychological empowerment on nurses' work engagement: test of structural equation modelling.

Science.gov (United States)

Wang, Shanshan; Liu, Yanhui

2015-04-01

This study aimed to investigate the influence of professional nursing practice environment and psychological empowerment on nurses' work engagement. Previous researchers have acknowledged the positive influence that nurse work environment and psychological empowerment have on engagement. However, less is known about the mechanisms that explain the links between them. A predictive, non-experimental design was used to test the model in a random sample of 300 clinical nurses from two tertiary first class hospitals of Tianjin, China. The Utrecht Work Engagement Scale, the Practice Environment Scale of the Nursing Work Index and the Psychological Empowerment Scale were used to measure the study variables. Structural equation modelling revealed a good fit of the model to the data based on various fit indices (P = 0.371, χ(2) /df = 1.056, goodness of fit index = 0.967), which indicated that both professional practice environment and psychological empowerment could positively influence work engagement directly, and professional practice environment could also indirectly influence work engagement through the mediation of psychological empowerment. The study hypotheses were supported. Psychological empowerment was found to mediate the relationship between practice environments and work engagement. Administrators should provide a professional nursing practice environment and empower nurses psychologically to increase nurse engagement. © 2013 John Wiley & Sons Ltd.

Practical ethical theory for nurses responding to complexity in care.

Science.gov (United States)

Fairchild, Roseanne Moody

2010-05-01

In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.

Effective communication skills in nursing practice.

Science.gov (United States)

Bramhall, Elaine

2014-12-09

This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.

The ethics curriculum for doctor of nursing practice programs.

Science.gov (United States)

Peirce, Anne Griswold; Smith, Jennifer A

2008-01-01

Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.

Maths for medications: an analytical exemplar of the social organization of nurses' knowledge.

Science.gov (United States)

Dyjur, Louise; Rankin, Janet; Lane, Annette

2011-07-01

Within the literature that circulates in the discourses organizing nursing education, there are embedded assumptions that link student performance on maths examinations to safe medication practices. These assumptions are rooted historically. They fundamentally shape educational approaches assumed to support safe practice and protect patients from nursing error. Here, we apply an institutional ethnographic lens to the body of literature that both supports and critiques the emphasis on numeracy skills and medication safety. We use this form of inquiry to open an alternate interrogation of these practices. Our main argument posits that numeracy skills serve as powerful distraction for both students and teachers. We suggest that they operate under specious claims of safety and objectivity. As nurse educators, we are captured by taken-for-granted understandings of practices intended to produce safety. We contend that some of these practices are not congruent with how competency actually unfolds in the everyday world of nursing practice. Ontologically grounded in the materiality of work processes, we suggest there is a serious disjuncture between educators' assessment and evaluation work where it links into broad nursing assumptions about medication work. These underlying assumptions and work processes produce contradictory tensions for students, teachers and nurses in direct practice. © 2011 Blackwell Publishing Ltd.

The International Classification for Nursing Practice (ICNP)

DEFF Research Database (Denmark)

Mortensen, Randi A.; Nielsen, Gunnar Haase

2001-01-01

This publication deals with the general field of health informatics and some issues particular to nursing. It starts with an introduction to health care, discussing the ‘classification and management in nursing information technology’ and the ‘nursing minimum data set’, health concepts......, an introduction to nursing science and the International Classification for Nursing Practice (ICNP). The textbook continues with an information technology aspects’ section. in this section important aspects of health informatics and hospital information systems are discussed, like data protection...... and confidentiality, telecare service for nurses, data analysis methods and classification methods. The last section of this book deals with the organizational impact of health informatics. Major topics are: impacts of communications, information and technology on organizations, impact in nursing environment, quality...

Upgrading Licensed Practical Nurse to Registered Nurse Program, September 1971 - June 1973. Report.

Science.gov (United States)

Holloway, Sally

Twenty Licensed Practical Nurses (LPN) became Registered Nurses (RN) in a pilot program giving partial academic credit for their LPN training and building on their existing skills. The program revolved around three needs: (1) trained nurses; (2) eliminating the notion that jobs were dead-end; and (3) achieving upward mobility for hospital staff.…

Impact of postgraduate education on advanced practice nurse activity - a national survey.

Science.gov (United States)

Wilkinson, J; Carryer, J; Budge, C

2018-03-22

There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.

Safe Patient Handling and Mobility: Development and Implementation of a Large-Scale Education Program.

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Lee, Corinne; Knight, Suzanne W; Smith, Sharon L; Nagle, Dorothy J; DeVries, Lori

This article addresses the development, implementation, and evaluation of an education program for safe patient handling and mobility at a large academic medical center. The ultimate goal of the program was to increase safety during patient mobility/transfer and reduce nursing staff injury from lifting/pulling. This comprehensive program was designed on the basis of the principles of prework, application, and support at the point of care. A combination of online learning, demonstration, skill evaluation, and coaching at the point of care was used to achieve the goal. Specific roles and responsibilities were developed to facilitate implementation. It took 17 master trainers, 88 certified trainers, 176 unit-based trainers, and 98 coaches to put 3706 nurses and nursing assistants through the program. Evaluations indicated both an increase in knowledge about safe patient handling and an increased ability to safely mobilize patients. The challenge now is sustainability of safe patient-handling practices and the growth and development of trainers and coaches.

An ethnographic study of nurses' experience with nursing research and its integration in practice.

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Dupin, Cécile Marie; Borglin, Gunilla; Debout, Christophe; Rothan-Tondeur, Monique

2014-09-01

To report from a study aimed at illuminating how French Registered Nurses experience and engage in nursing research in clinical practice. Nursing research in France is mainly conducted by nurses working at clinical research units rather than by dedicated nurse researchers. Education, i.e. advanced degrees, in the field of nursing research is still in its infancy and not yet consistent with the international context. Outside France, the general perception is that nursing research is a unified part of professional nursing. Consequently, in-depth knowledge about how nurses in a French clinical context might experience and engage in nursing research is still lacking. The design of this study was influenced by an ethnographic approach as described by the French anthropologists Beaud and Weber. Data, participatory observations, field notes and interviews (n = 6) were collected in a teaching hospital between April-August 2012. The field consisted of a wound-care unit and clinical research units. Collected data were analysed based on Beaud and Weber's description of analysis. Three beliefs were identified: being a unified part of a research team, being an integral part of 'crosswise - across' activities and being part of research activities. Commitment to nursing research was strengthened by patient-related issues. Based on this context, nursing research would likely benefit from the support of a naturalized reciprocity between clinical practice and research. © 2014 John Wiley & Sons Ltd.

ICU nurses' oral-care practices and the current best evidence.

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DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie

2009-01-01

The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all

[Job retention and nursing practice environment of hospital nurses in Japan applying the Japanese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI)].

Science.gov (United States)

Ogata, Yasuko; Nagano, Midori; Fukuda, Takashi; Hashimoto, Michio

2011-06-01

The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments. A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

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Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Effects of incivility in clinical practice settings on nursing student burnout.

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Babenko-Mould, Yolanda; Laschinger, Heather K S

2014-10-31

To examine the relationship between nursing students' exposure to various forms of incivility in acute care practice settings and their experience of burnout. Given that staff nurses and new nurse graduates are experiencing incivility and burnout in the workplace, it is plausible that nursing students share similar experiences in professional practice settings. A cross-sectional survey design was used to assess Year 4 nursing students' (n=126) perceptions of their experiences of incivility and burnout in the clinical learning environment. Students completed instruments to assess frequency of uncivil behaviors experienced during the past six months from nursing staff, clinical instructors, and other health professionals in the acute care practice setting and to measure student burnout. Reported incidences of incivility in the practice setting were related to burnout. Higher rates of incivility, particularly from staff nurses, were associated with higher levels of both components of burnout (emotional exhaustion and cynicism).

Role modeling excellence in clinical nursing practice.

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Perry, R N Beth

2009-01-01

Role modeling excellence in clinical nursing practice is the focus of this paper. The phenomenological research study reported involved a group of 8 nurses identified by their colleagues as exemplary. The major theme revealed in this study was that these exemplary nurses were also excellent role models in the clinical setting. This paper details approaches used by these nurses that made them excellent role models. Specifically, the themes of attending to the little things, making connections, maintaining a light-hearted attitude, modeling, and affirming others are presented. These themes are discussed within the framework of Watson [Watson, J., 1989. Human caring and suffering: a subjective model for health services. In: Watson, J., Taylor, R. (Eds.), They Shall Not Hurt: Human Suffering and Human Caring. Colorado University, Boulder, CO] "transpersonal caring" and [Bandura, A., 1997. Social Learning Theory. Prentice Hall, Englewood Cliffs, NJ] "Social Learning Theory." Particular emphasis in the discussion is on how positive role modeling by exemplary practitioners can contribute to the education of clinical nurses in the practice setting.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Nermine Mohamed Tawfik Foda

2017-01-10

Jan 10, 2017 ... Background: Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms.

Everyday ethics: ethical issues and stress in nursing practice.

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Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

[Competencies and professional profile of the advanced practice nurse].

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del Barrio-Linares, M

2014-01-01

The advanced practice nurse can foster the development of innovative approaches in the design of patient, families and community care. This study has aimed to explain the importance of the advanced practice nurse, especially that of the clinical nurse specialist (CNS), within the care setting and to go deeper into the knowledge of this nursing profile. A review of the literature. The following databases were used: CINAHL, PubMed and Medline. Search terms were 'clinical nurse specialist,' 'implementation,' and 'advanced practice nursing.' The sample included 24 publications. A synthesis of the findings generated a summary of the competencies of CNS and their definitions, with some examples in their daily practice and the outcome on its 3 spheres of influences: patients and families, staff and organization. CNS emerges in the health systems in order to improve the outcomes in the patients, staff and the organization per se because of its competence as an agent of change and transformational leader National policies and national strategies are needed to implement CNS on the Master's level in the Spanish National Health System given the evidence-based improvement in the care standards. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.

Weathering the storm: nurses' satisfaction with a mobile admission nurse service.

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Kirkbride, Geri; Floyd, Valerie; Tate, Cheryl; Wendler, M Cecilia

2012-04-01

To evaluate nurses' satisfaction with, and perceptions of, a practice innovation introducing a Mobile Admission Nurse service. Staff nurses identified that the admission process, while crucial to initiating safe and appropriate acute care, can be disruptive and interfere with care in progress. A pilot project implementing the role of a Mobile Admission Nurse was introduced to address this need. A self-developed web-based survey was administered to a convenience sample of 104 RNs who had used the services during the pilot project. Staff nurses (n = 78) reported a chaotic, demanding work environment within which the admission process disrupts the flow of care. The Mobile Admission Nurse helped them in 'weathering the storm', which was the overarching theme that emerged during data analysis. Having an admission nurse complete the admission process steadied workflow processes for nurses. Improved patient safety and increased staff and family satisfaction were also reported. The strongly positive feedback led to expansion of the service. Proactively redesigning work processes, using a structured theoretical model such as the (Plan-Do-Study-Act) PDSA approach, may improve outcomes in a chaotic practice environment. © 2011 Blackwell Publishing Ltd.

Nursing practice implications of the year of ethics.

Science.gov (United States)

Harris, Karen T

2015-01-01

e 2015 ANA Code of Ethics is foundational to professional nursing practice and is aligned with AWHONN’s core values, standards of care and position statement on ethical decision-making in the clinical setting. Understanding the roles and responsibilities of nurses to ensure an ethical practice environment is critical to perinatal health outcomes and sta engagement and to the prevention of moral distress.

Time to talk, time to see: changing microeconomies of professional practice among nurses and doctors in Australian general practice.

Science.gov (United States)

Phillips, Christine; Dwan, Kathryn; Pearce, Christopher; Hall, Sally; Porritt, Julie; Yates, Rachel; Sibbald, Bonnie

2007-08-01

In Australia, more nurses are entering general practice, and nurses' work is being funded in increasingly complex ways through Medicare. Little research has explored the ways doctors and nurses realign their priorities and activities when working together in general practice. We undertook rapid, intensive multimethod studies of 25 general practices to explore the ways in which the labour of nurses and doctors was structured, and the implicit decisions made by both professions about the values placed on different ways of working and on their time. Data collected included photographs, floor-plans, interviews with 37 nurses, 24 doctors and 22 practice managers, and 50 hours of structured observation. Nursing time was constructed by both nurses and doctors as being fluid and non-contingent; they were regarded as being 'available' to patients in a way that doctors were not. Compared to medical time, nursing time could be disposed more flexibly, underpinning a valorized attribute of nursing: deep clinical and personal contact with patients. The location of practice nurses' desks in areas of traffic, such as administrative stations, or in the treatment room, underpinned this valuable unstructured contact with patients. Changes to the practice nurse role through direct fee-for-service items for nurses may lead to greater congruence between the microeconomies of nursing and medicine in general practice. In a time of pressure upon a primary care workforce, this is likely to lead to more independent clinical work by nurses, but may also lead to a decrease in flexible contact with patients.

Evidence-based care: an innovation to improve nursing practice ...

African Journals Online (AJOL)

Evidence-based care: an innovation to improve nursing practice globally. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... best available evidence from research findings, expert ideas from specialists in the various health ... need to be addressed to enhance utilization of the best available evidence in nursing practice.

Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention

Science.gov (United States)

Lee, Sang-Yi; Kim, Chul-Woung; Kang, Jeong-Hee; Yoon, Tae-Ho; Kim, Cheoul Sin

2014-01-01

Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; pturnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention. PMID:25284197

An exploration of undergraduate nursing and physiotherapy students' views regarding education for patient handling.

Science.gov (United States)

Kneafsey, Rosie; Ramsay, Jill; Edwards, Helen; Callaghan, Helen

2012-12-01

To ascertain the views of undergraduate student nurses and physiotherapists regarding their education in patient handling. Musculo-skeletal injuries are an important cause of staff sickness absence and attrition from the nursing profession and are a recognised problem within the physiotherapy profession. Nurses and physiotherapists are at risk of musculo-skeletal injuries as a result of their role in assisting patients with movement. A questionnaire survey was undertaken of undergraduate nursing and physiotherapy students (n = 371) at one university. Most students agreed that university teaching about moving and handling prepared them for clinical practice (64%). Over a third reported that they had never undertaken a written moving and handling risk assessment in clinical practice (38%). Almost half of the sample (40%) admitted undertaking unsafe moving and handling activities. Half (50%) also stated that they would rather 'fit' into the team than challenge unsafe practice. Almost a third (29%) stated that they had begun to experience pain since becoming a student. There were significant differences between nursing and physiotherapy students. Physiotherapy students were more likely to report being supervised when moving and handling and reported being more assertive about adhering to safe practice. The well-being of both nursing and physiotherapy undergraduate students is threatened when students undertake work placements in clinical settings. University-based education in safe patient handling, though important, can be undermined by workplace settings where unsafe practices occur. Collaboration is needed between university educators, managers and practice-based mentors to support students to maintain safe approaches to moving and handling patients. A third of students reported developing pain since becoming a healthcare student. Students entering their professions already injured may leave the workforce owing to poor physical well-being. It is vital that the

Differences in nursing practice environment among US acute care unit types: a descriptive study.

Science.gov (United States)

Choi, JiSun; Boyle, Diane K

2014-11-01

The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered

Exploring whether student nurses report poor practice they have witnessed on placements.

Science.gov (United States)

Bellefontaine, Nerys

While literature suggests that nurses report incidents or potentially unsafe care delivery, there is little evidence on student nurses' practice in this area. To explore the factors that influence student in reporting concerns about practice. A qualitative study was carried out using a phenomenological approach, based on semi-structured interviews with six student nurses. Student nurses said they do not always report potentially unsafe practice they have witnessed. Four main themes were identified: the student-mentor relationship in clinical placement; actual or potential support provided by both the practice area and university; students' own personal confidence and professional knowledge base; and fear of failing clinical placements. The nursing profession needs to take stock of current organisational culture and practice, and address issues around reporting in practice. Recommendations are made to improve mentorship, nurse training and for further research.

Supporting nurse mentor development: An exploration of developmental constellations in nursing mentorship practice.

Science.gov (United States)

MacLaren, Julie-Ann

2018-01-01

Supervised practice as a mentor is currently an integral component of nurse mentor education. However, workplace education literature tends to focus on dyadic mentor-student relationships rather than developmental relationships between colleagues. This paper explores the supportive relationships of nurses undertaking a mentorship qualification, using the novel technique of constellation development to determine the nature of workplace support for this group. Semi-structured interviews were conducted with three recently qualified nurse mentors. All participants developed a mentorship constellation identifying colleagues significant to their own learning in practice. These significant others were also interviewed alongside practice education, and nurse education leads. Constellations were analysed in relation to network size, breadth, strength of relationships, and attributes of individuals. Findings suggest that dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. Redundancy of mentorship attributes within the constellation (overlapping attributes between members) may counteract problems caused when one mentor attempts to fulfil all mentorship roles. Wider nursing teams are well placed to provide the support and supervision required by mentors in training. Where wider and stronger networks were not available to mentorship students, mentorship learning was at risk. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Feminine hygiene practices among female patients and nurses in Lebanon.

Science.gov (United States)

Attieh, Elie; Maalouf, Samer; Roumieh, Dina; Abdayem, Pamela; AbiTayeh, Georges; Kesrouani, Assaad

2016-05-23

Inappropriate feminine hygiene practices are related to vulvovaginitis. We investigated the prevalence of personal hygiene habits among Lebanese women as well as their awareness of adequate practices. Consists of a cross-sectional observational study. Female patients and nurses at Hotel-Dieu de France University Hospital in Beirut- Lebanon filled a questionnaire about their intimate hygiene habits and knowledge of proper practices. The study included 249 women. 21.3 % of the 136 nurses and 38.9 % of the 113 patients reported a history of vulvovaginitis. The majority of women took an intimate bath at least twice daily. 14 % of nurses and 17 % of patients douched.20. Seven percent of the nurses and 43.4 % of the patients used wet wipes. 1.5 % of nurses and 4.4 % of patients used feminine deodorant sprays. There was a significant lack of awareness mainly among patients about suitable hygiene practices as well for their adverse effects. Education provided by nurses, and other healthcare providers is essential to promote reproductive health among Lebanese women.

Fieldwork in nursing research: positionality, practicalities and predicaments.

Science.gov (United States)

Borbasi, Sally; Jackson, Debra; Wilkes, Lesley

2005-09-01

This paper draws on the literature to explore some of the issues of concern to nurses undertaking fieldwork in contemporary healthcare settings. The emergence of poststructuralist and postmodern perspectives has raised questions about ethnographic approaches, and problematized the role of researchers in the construction of plausible and credible ethnographic accounts. As a practice discipline, nursing needs to negotiate a thorny path between methodological purity and practical application, with nurse researchers required to take account of both philosophical and pragmatic concerns. There is general agreement that researching with an individual or group rather than researching on an individual or group is the more effective way to approach fieldwork. Feminist writers appear to have dealt with this issue best, advocating intimacy, self-disclosure, and reciprocity in encounters with research participants. The duality of the nurse researcher role; power and politics and the moral implications of fieldwork are acknowledged as factors influencing nurses in the planning and conduct of fieldwork. Nurses as researchers may be better equipped than other social researchers to deal with contingencies in the field. Laying the epistemological ground for the participant observer role during fieldwork and understanding its impact on the resultant ethnographic account is essential to methodological rigour in field research. Consideration of some of the practicalities and predicaments experienced by nurses as researchers when conducting fieldwork prior to going out into the field is an important research strategy and will facilitate methodological potency.

Framework for 21st Century School Nursing Practice: Framing Professional Development.

Science.gov (United States)

Allen-Johnson, Ann

2017-05-01

The NASN Code of Ethics upholds that it is the responsibility of the school nurse to maintain competency and pursue personal and professional growth. Designing professional development activities that are relevant and support the needs of the school nurse can be a challenge. The Framework for 21st Century School Nursing Practice provides a model rooted in evidence-based standards of practice that can be utilized to assess an existing professional development program and identify gaps in learning opportunities. Nurse leaders can use the Framework for 21st Century Nursing Practice to provide a roadmap toward a professional development program that will be meaningful to school nurse staff, help restore or maintain joy in their practice, and allow them to achieve the goal of advancing the well-being, academic success, and lifelong achievement and health of students.

Leadership and management skills of general practice nurses: experience or education?

Science.gov (United States)

Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

2014-12-01

A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

Implementing differentiated practice: personal values and work satisfaction among hospital staff nurses.

Science.gov (United States)

Prothero, M M; Marshall, E S; Fosbinder, D M

1999-01-01

This project was part of a collaborative model for nursing staff development and student education. Personal values and work satisfaction of 49 staff nurses working on three hospital units were compared. One of the units employed differentiated practice. Results revealed high similarity in personal values among all nurses. Work satisfaction was significantly higher among nurses working on the unit employing differentiated practice. The importance of assessing personal values of nurses emerged as an important aspect of staff development, and differentiated practice appeared to be related to staff nurse satisfaction.

Decision-making in nursing practice: An integrative literature review.

Science.gov (United States)

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient

Information literacy during entry to practice: information-seeking behaviors in student nurses and recent nurse graduates.

Science.gov (United States)

Wahoush, Olive; Banfield, Laura

2014-02-01

The ability to locate information pertinent to guide clinical practice is important for quality nursing care and patient safety. To date, little is known about the transfer of information literacy skills as student nurses transition to clinical practice as new graduates. This study begins to address this gap from the perspective of student nurses, recent nurse graduates (RNs), nurse leaders and library staff. To describe the information-seeking behaviors of student nurses and RNs within their clinical settings. This is a descriptive study that included both cross-sectional surveys and key informant interviews. Participants were senior-level undergraduate students and recently graduated RNs (graduated since 2008), and nurse leaders and library staff employed in one of the clinical sites accepting undergraduate students from the McMaster Mohawk and Conestoga BScN program. The study was completed in two large hospital corporations in Hamilton, Ontario, Canada. Student nurses and RNs were invited to complete online surveys to assess their access to and use of information sources and resources within clinical practice. Students completed a survey comprised of five open-ended questions, while RNs completed a survey comprised of 13 fixed choice and open-ended questions. Nurse leaders and library staff participated in qualitative interviews to verify the extent and availability of information resources. Eighteen RNs and 62 students completed their respective surveys. Three categories of information sources and resources were identified: electronic, print and interpersonal. Electronic sources of information were the most used resource by both students and RNs. More RNs reported using interpersonal sources, while students reported using more print sources of information. Recent RN graduates meet the Canadian Association of Schools of Nursing performance indicators related to information access for the entry to practice Nursing Informatics competencies. Crown Copyright �

Effects of holistic nursing course: a paradigm shift for holistic health practices.

Science.gov (United States)

Downey, Marty

2007-06-01

A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

Lifestyle practices and the health promoting environment of hospital nurses.

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Hope, A; Kelleher, C C; O'Connor, M

1998-08-01

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

Lifestyle practices and the health promoting environment of hospital nurses.

LENUS (Irish Health Repository)

Hope, A

1998-08-01

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends\\/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern\\/worry in caring for AIDS patients than qualified nurses.

Colostomy irrigation: current knowledge and practice of WOC nurses.

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Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S

2015-01-01

This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for

Epigenetics: An Emerging Framework for Advanced Practice Psychiatric Nursing.

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DeSocio, Janiece E

2016-07-01

The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.

Leadership styles in nursing.

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Cope, Vicki; Murray, Melanie

2017-06-21

Nurses are often asked to think about leadership, particularly in times of rapid change in healthcare, and where questions have been raised about whether leaders and managers have adequate insight into the requirements of care. This article discusses several leadership styles relevant to contemporary healthcare and nursing practice. Nurses who are aware of leadership styles may find this knowledge useful in maintaining a cohesive working environment. Leadership knowledge and skills can be improved through training, where, rather than having to undertake formal leadership roles without adequate preparation, nurses are able to learn, nurture, model and develop effective leadership behaviours, ultimately improving nursing staff retention and enhancing the delivery of safe and effective care.

Desperately seeking sociology: nursing student perceptions of sociology on nursing courses.

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Edgley, Alison; Timmons, Stephen; Crosbie, Brian

2009-01-01

This paper will present the findings of a qualitative study exploring the perceptions of students confronted by a requirement to learn sociology within a nursing curriculum. Those teaching sociology have a variety of explanations (more or less desperate), seeking to justify its place on the nursing curriculum. While there may be no resolution to the debate, the dispute thus far, has largely been between sociology and nursing academics. Absent from this debate are the voices of students 'required' to learn both nursing and sociology. What do students make of this contested territory? When students are trying to learn their trade, and know how to practice safely and efficaciously what do they make of the sociological imagination? How realistic is it to expect students to grasp both the concrete and practical with the imaginative and critical? Findings from this qualitative, focus group study suggest that students do indeed find learning sociology within a nursing curriculum "unsettling". It would seem that students cope in a number of ways. They fragment and compartmentalise knowledge(s); they privilege the interception of experiential learning on the path between theory and practice; and yet they appear to employ sociological understanding to account for nursing's gendered and developing professional status.

Hallmarks of the Professional Nursing Practice Environment. AACN White Paper.

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Journal of Professional Nursing, 2002

2002-01-01

This white paper from the American Association of Colleges of Nursing depicts the current environment of nursing practice, including supply and demand. It describes work environments that support professional practice and outlines eight indicators for the practice environment. Contains 48 references and an appendix with suggested questions for…

Financial literacy as an essential element in nursing management practice.

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Talley, Linda B; Thorgrimson, Diane H; Robinson, Nellie C

2013-01-01

Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.

The evolution and development of an instrument to measure essential professional nursing practices.

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Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia

2014-11-01

Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

Translating Nursing Philosophy for Practice and Healthcare Policy.

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Reed, Pamela G

2017-07-01

This article introduces the feature article on policy implications of integrative nursing. It describes unitary ontology in nursing, highlighting the Rogerian view of holism. The importance of linking philosophy to practice policy is emphasized.

Cultural relativism and cultural diversity: implications for nursing practice.

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Baker, C

1997-09-01

This article examines the doctrine of cultural relativism in nursing practice. To introduce the issue, an overview of the intellectual history of cultural relativism is presented. The academic themes of the debate surrounding cultural relativism are illustrated with an example of the social controversy in France involving cultural relativism as used to defend the practice of female genital excision among immigrant communities. The dilemma faced by nursing in making cross-cultural judgments is then examined in the light of the academic and social debates. The article concludes with a theoretical resolution of the issue of cultural relativism for nursing practice that is based on hermeneutic philosophy.

Effects of an Interdisciplinary Practice Bundle for Second-Stage Labor on Clinical Outcomes.

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Garpiel, Susan J

2018-04-09

There is renewed interest in second-stage labor practices as recent evidence has challenged historical perspectives on safe duration of secondstage labor. Traditional practices and routine interventions during second-stage have uncertain benefit for low-risk women and may result in cesarean birth. The purpose of this quality improvement project was to implement an interdisciplinary second-stage practice bundle to promote safe outcomes including method of birth and women's birth experience. Standardized second-stage labor evidence-based practice recommendations structured into a 5 Ps practice bundle (patience, positioning, physiologic resuscitation, progress, preventing urinary harm) were implemented across 34 birthing hospitals in Trinity Health system. Significant improvements were observed in second-stage practices. Association of Women's Health, Obstetric and Neonatal Nurses' perinatal nursing care quality measure Second-Stage of Labor: Mother-Initiated Spontaneous Pushing significantly improved [pre-implementation 43% (510/1,195), post-implementation 76% (1,541/2,028), p labor practices derived from the Association of Women's Health, Obstetric and Neonatal Nurses and American College of Nurse-Midwives professional guidelines achieved our goals of safely reducing primary cesarean birth among low-risk nulliparous women, and optimizing maternal and fetal outcomes associated with labor and birth. By minimizing routine interventions, nurses support physiologic birth and improve women's birth satisfaction.

Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

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Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

2018-02-01

Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

Science.gov (United States)

Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

2007-08-01

Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

Science.gov (United States)

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

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Canada, Amanda N

2016-04-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

Science.gov (United States)

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge and Food Handling Practices of Nurses in a Tertiary Health Care Hospital in Nigeria.

Science.gov (United States)

Oludare, Aluko Olufemi; Ogundipe, Abiodun; Odunjo, Abimbola; Komolafe, Janet; Olatunji, Ibukun

2016-01-01

Food safety in hospitals is important to protect patients whose immunity may be compromised by their illness. The safety of food served to patients is dependent on its handling acquisition of raw food items, to preparation, packaging, and distribution. The study described in this article assessed the knowledge and food handling practices of nurses in the food chain to patients in the hospital wards. The mean age of respondents was 33.7 ± 9.3 years and 180 (56.6%) had worked in the hospital for 1-5 years. While respondents had good knowledge scores overall, only 22 (6.5%) knew the correct temperature for maintaining hot, ready-to-eat food. Also, 332 (97.6%) respondents knew the importance of hand washing before handling food while 279 (84.1%) always wash hands before handling food. The study revealed a decline in performance over time, from knowledge and attitudes to practice in food handling. Therefore, regular training on safe food handling procedures should be mainstreamed into the training curriculum of staff nurses in health care institutions.

Technical attainment, practical success and practical knowledge: hermeneutical bases for child nursing care.

Science.gov (United States)

de Mello, Débora Falleiros; de Lima, Regina Aparecida Garcia

2009-01-01

This reflective study aimed to present some aspects of the concepts technical attainment, practical success and practical knowledge, with a view to a broader understanding of child nursing care. Health care is considered in the perspective of reconstructive practices, characterized as contingencies, highlighting the importance of the connection between technical attainment and practical success and the valuation of practical knowledge, based on philosophical hermeneutics, in the context of practical philosophy. Child health nursing can deal with technical attainment and practical success jointly, and also understand practical knowledge in the longitudinality of care. Health promotion, disease prevention, recovery and rehabilitation of child health should be indissociably associated with contextualized realities, shared between professionals and families, aiming to follow the child's growth and development, produce narratives, identify experiences, choices and decision making to broaden health care.

Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

Science.gov (United States)

Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-10-01

This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

Final assessment of nursing students in clinical practice: Perspectives of nursing teachers, students and mentors.

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Helminen, Kristiina; Johnson, Martin; Isoaho, Hannu; Turunen, Hannele; Tossavainen, Kerttu

2017-12-01

To describe the phenomenon of final assessment of the clinical practice of nursing students and to examine whether there were differences in assessments by the students and their teachers and mentors. Final assessment of students in clinical practice during their education has great importance for ensuring that enough high-quality nursing students are trained, as assessment tasks affect what the nursing student learns during the clinical practice. This study used descriptive, cross-sectional design. The population of this study comprised nursing students (n = 276) and their teachers (n = 108) in five universities of applied sciences in Finland as well as mentors (n = 225) who came from five partner hospitals. A questionnaire developed for this study contained questions about background variables as well as structured questions scored on a four-point scale, which also allowed the respondents to provide additional comments. When comparing the results related to nursing teachers' presence in the final assessment situation, it was found that teachers and mentors evaluated this as being carried out more often than nursing students suggested. Nursing students noted that fair and consistent assessment is carried out more often than nursing teachers thought. Mentors and teachers said that honest and direct criteria-based final assessment was carried out more often than nursing students evaluated. Nursing students and mentors need support from educational institutions and from nursing teachers in order to ensure the completion of a relevant assessment process. The findings of this study highlight an awareness of final assessment process. It is desirable to have a common understanding, for example, of how the assessment should be managed and what the assessment criteria are, as this will ensure a good quality process. © 2017 John Wiley & Sons Ltd.

Improving safety-related knowledge, attitude and practices of nurses handling cytotoxic anticancer drug: pharmacists' experience in a general hospital, Malaysia.

Science.gov (United States)

Keat, Chan Huan; Sooaid, Nor Suhada; Yun, Cheng Yi; Sriraman, Malathi

2013-01-01

An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. The mean age of nurses was 32.2∓6.19 years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from 45.5∓10.52 to 73.4∓8.88 out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from 7.6∓5.51 to 15.3∓2.55 out of 20 (p<0.001). The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.