Genomic-based nursing care for women with Turner Syndrome: genomic-based nursing care Atención de enfermería basada en genómica para las mujeres con Síndrome de Turner Cuidado de enfermagem baseado em genômica para mulheres com Síndrome de Turner
Full Text Available Biologic and technologic advances generated from The Human Genome Project are having a dramatic impact on the expanding role of nurses in current health care practice. New genetic research needs to be transformed rapidly into clinical protocols with recommendations for delivering care to targeted populations. Nurses can contribute significantly, as part of an interdisciplinary approach, to translate genome-based knowledge into benefits for health care and society. In this context, we describe a clinical-genetic investigation protocol, as well nursing diagnosis, interventions and outcomes for clients with Turner Syndrome (TS at risk for develop gonadal tumors, due the presence of a normal or abnormal Y chromosome.Los avances biológicos y tecnológicos generados a partir del Proyecto Genoma Humano están teniendo un impacto dramático en el extenso papel de las enfermeras en la práctica actual del cuidado de la salud. Nuevas investigaciones genéticas necesitan ser transformadas rápidamente en protocolos clínicos con recomendaciones para suministrar cuidados a las poblaciones necesitadas. Las enfermeras pueden contribuir significantemente, como parte de un acercamiento interdisciplinario, traduciendo conocimientos basados en el genoma en ventajas para el cuidado de la salud y la sociedad. En este contexto, describimos un protocolo de investigación clínico-genético e también diagnósticos de enfermería, intervenciones y resultados para clientes con Síndrome de Turner (TS y riesgo de desarrollar tumores gonadales, debido a la presencia de un cromosoma Y normal o anormal.Os avanços biológicos e tecnológicos gerados a partir do Projeto Genoma Humano estão tendo um impacto dramático na expansão do papel dos enfermeiros na prática atual do cuidado em saúde. As novas pesquisas genéticas necessitam ser rapidamente transformadas em protocolos clínicos, com recomendações para ministrar cuidados a populações alvo. Enfermeiros podem
Nurses care, help and support patients before they are born, when they are alive and after they die. The starting points of this study were how nurses provide physical care for the dead patients and psychological care for the bereaved families. The purpose of this study was to describe the role of a nurse when patients die. The aims of this study were that the results of the study could help the nurses’ clinical work and could be used as part of teaching material in post-mortem care or nu...
Full Text Available Aim: The aim of this literature review was to search for qualitative studies focusing on the concept of caring in nursing, to analyse them and to synthesize knowledge that concerns the definition of the concept of caring in nursing from the point of view of nurses and patients. Design: Review. Methods: Qualitative studies were searched for systematically in the electronic databases Academic Search Complete (EBSCO, CINAHL, Medline, Science Direct, and the Wiley Library Online, according to set criteria and defined key words for the period 1970-2015. Seven selected articles were analysed after selection of documents with the aid of a sorting chart. Results: Nurses understand caring in nursing as a relationship with patients which is characterised on the nurses' part by an individual and empathetic approach, attentiveness, experience and sensitivity. Through caring, active communication takes place, providing information which reduces anxiety and leads to the breaking down of barriers. This relationship helps protect patients' autonomy, dignity and comfort. It requires experience on the part of nurses, and it is influenced by the environment. The nurses' personal qualities (what professional knowledge, attitudes and skills they have and their availability, reliability, and emotional and physical support are important to patients. Conclusion: The concept of caring is a content specific interpersonal process which is characterized by the professional knowledge, skills, personal maturity, and interpersonal sensitivity of nurses, which result in the protection, emotional support, and the meeting of bio-psycho-social needs of patients. The results of the overview study could contribute to an explanation and understanding of the nature of caring as a fundamental feature of the discipline of nursing.
Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.
Lima-Rodríguez, Joaquin Salvador; Lima-Serrano, Marta; Sáez-Bueno, Africa
Nursing has experienced an important methodological development, in which it gives priority to the individual, although at a socioeconomic level a marked interest is seen in the health care of the family unit and the NANDA (North American Nursing Diagnosis Association), NIC (Nursing Interventions Classification) and NOC (Nursing Outcomes Classification) nursing guidelines, using diagnoses, criteria of results and interventions orientated towards this aim. We consider to the family as an opened system consisted of human elements, with a common history, which they form a functional unit been ruled by own procedure. In this paper we look at those aspects that must be taken into account in nursing assessment of families from a systemic perspective, including some tools for data collection and analysis of information. In addition, we identify specific areas of intervention. We believe that the family must be studied from a nursing care point of view with its own characteristics as opposed to those possessed individually by each of its members. We also believe that, when assessment is centred on the Henderson unaided activities study or the Gordon functional health patterns, they are not useful in assessing the family unit. This work offers an assessment method centred on the family unit, which helps to identify the nursing diagnoses applicable to it. Our proposal, which has been successfully used by nursing students over the last few years, hopes to contribute to quality clinical practice with a tool orientated towards the family.
Lake, Eileen T; de Cordova, Pamela B; Barton, Sharon; Singh, Shweta; Agosto, Paula D; Ely, Beth; Roberts, Kathryn E; Aiken, Linda H
A growing literature suggests that missed nursing care is common in hospitals and may contribute to poor patient outcomes. There has been scant empirical evidence in pediatric populations. Our objectives were to describe the frequency and patterns of missed nursing care in inpatient pediatric settings and to determine whether missed nursing care is associated with unfavorable work environments and high nurse workloads. A cross-sectional study using registered nurse survey data from 2006 to 2008 was conducted. Data from 2187 NICU, PICU, and general pediatric nurses in 223 hospitals in 4 US states were analyzed. For 12 nursing activities, nurses reported about necessary activities that were not done on their last shift because of time constraints. Nurses reported their patient assignment and rated their work environment. More than half of pediatric nurses had missed care on their previous shift. On average, pediatric nurses missed 1.5 necessary care activities. Missed care was more common in poor versus better work environments (1.9 vs 1.2; P < .01). For 9 of 12 nursing activities, the prevalence of missed care was significantly higher in the poor environments (P < .05). In regression models that controlled for nurse, nursing unit, and hospital characteristics, the odds that a nurse missed care were 40% lower in better environments and increased by 70% for each additional patient. Nurses in inpatient pediatric care settings that care for fewer patients each and practice in a professionally supportive work environment miss care less often, increasing quality of patient care. Copyright © 2017 by the American Academy of Pediatrics.
Donik Barbara; Pajnkihar Majda; Bernik Mojca
Starting points: In Slovenia, the higher education institution for nursing started exploring employability opportunities in nursing care in connection with the achievement of competencies from students and employers point of view. This article highlights the importance of monitoring nursing graduates employability. Its aim is to examine the employability of nursing care graduates based on the self-evaluation of competences obtained during the last study year and to establish a link between th...
Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin
AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...
Aurora Miguel García
Full Text Available Tobacco dependence is a major risk factor for health that requires a correct approach by all health workers. Nursing plays a key role both in identifying smokers, as in the systematic advice to quit smoking, or assist in smoking quit. This work presents three standardized care plans that enable the nursing work in accordance with a methodology and using a standardized language that allows both continuity of care such as research and development of knowledge nurse: Care plan to smoker in precontemplation stage; Care plan to smoker in contemplation stage; Care plan to smoker in preparation/action stage.
Full Text Available Starting points: In Slovenia, the higher education institution for nursing started exploring employability opportunities in nursing care in connection with the achievement of competencies from students’ and employers’ point of view. This article highlights the importance of monitoring nursing graduates’ employability. Its aim is to examine the employability of nursing care graduates based on the self-evaluation of competences obtained during the last study year and to establish a link between the self-evaluation of competences and students’ academic performance.
for people to benefit from widespread genetic/genomic discoveries, nurses must be competent to obtain .... specific diseases, or the thousands of basic biochemical processes that .... all nursing courses; Create a curriculum thread focused on ...
Marco Antonio Zapata Sampedro
Full Text Available The standardized nursing care plan can be used as a means through which the nurse will assess and identify the particular needs of the blood donor.To draw up the care plan, we have conducted the evaluation on the basis of the Marjory Gordon’s functional health patterns.The more prevailing diagnosis according to the NANDA taxonomy have been identified, results have been established according to the NOC (Nursing Outcomes Classification taxonomy, and nursing interventions have been suggested according to the NIC (Nursing Interventions Classification taxonomy. Also, certain potential complications, which are infrequent, must be observed and controlled in the blood donation process. Our main aim with this article has been to offer to professionals resources that grant to the caring activity scientific rigor, professional recognition and an unique and valid tool to evaluate the assistance with the best levels of quality for the blood donor.
Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel; Yarandi, Hossein
The aim of this study is to report the results of a replication study of the relationship between self-reported nursing care reminder (NCR) use and missed nursing care. A descriptive cross-sectional correlational design was used. The sample (N = 124) was composed of medical/surgical and ICU RNs working on acute care hospital units in a large Midwestern teaching hospital. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Health Care Information Technology Survey were used to collect data. Adjusted hierarchical multiple regression was used to determine study outcomes. Nurses who use NCRs more frequently have decreased reports of missed nursing care. Nurses who perceive the impact of healthcare technology as positive on their practice also have decreased missed nursing care. The results of this study suggest that NCRs are an effective intervention to decrease missed nursing care in acute care hospitals.
... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing care. 409.21 Section 409.21 Public Health... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.21 Nursing care. (a) Basic rule. Medicare pays for nursing care as posthospital SNF care when provided by or under the supervision of a...
Full Text Available BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA may cause prolonged outbreaks of infections in neonatal intensive care units (NICUs. While the specific factors favouring MRSA spread on neonatal wards are not well understood, colonized infants, their relatives, or health-care workers may all be sources for MRSA transmission. Whole-genome sequencing may provide a new tool for elucidating transmission pathways of MRSA at a local scale. METHODS AND FINDINGS: We applied whole-genome sequencing to trace MRSA spread in a NICU and performed a case-control study to identify risk factors for MRSA transmission. MRSA genomes had accumulated sequence variation sufficiently fast to reflect epidemiological linkage among individual patients, between infants and their mothers, and between infants and staff members, such that the relevance of individual nurses' nasal MRSA colonization for prolonged transmission could be evaluated. In addition to confirming previously reported risk factors, we identified an increased risk of transmission from infants with as yet unknown MRSA colonisation, in contrast to known MRSA-positive infants. CONCLUSIONS: The integration of epidemiological (temporal, spatial and genomic data enabled the phylogenetic testing of several hypotheses on specific MRSA transmission routes within a neonatal intensive-care unit. The pronounced risk of transmission emanating from undetected MRSA carriers suggested that increasing the frequency or speed of microbiological diagnostics could help to reduce transmission of MRSA.
... your healthcare provider about your medications, symptoms, and health problems. May 2013 Ensuring Quality Nursing Home Care Expert information from Healthcare Professionals Who Specialize in the Care of Older Adults After you’ve placed your family member in a facility KEEP VISITING! Seeing family ...
Backes, Dirce Stein; Backes, Marli Stein; Erdmann, Alacoque Lorenzini
This study is the result of the project: networks care and social entrepreneurship: the autonomy and social commitment of nurses. The purpose of this qualitative study is to comprehend the meaning of nursing care as a social enterprising practice. The Grounded Theory was used as a methodological reference and the interview, conducted with 35 participants as technique of data collection. Data codification led to the central theme: Viewing Nursing Care as a Social Enterprising Practice. This theme is complemented by the category, characterized the cause condition: the social integration through the creation a political identity that expresses your involvement. The results showed that is necessary to learn and have a deep dialogic knowledge. In order to consolidate popular participation as a citizenship ideal, a critical professional attitude, base don the combination of care with liberty, participation end autonomy.
Knowledge of intensive care nurses in selected care areas commonly ... To assess the knowledge of nurses working in intensive care units (ICUs) in respect of pain management, ... An analytical, cross-sectional survey design was used.
Piscotty, Ronald J; Kalisch, Beatrice
The purpose of the study was to explore relationships between nurses' perceptions of the impact of health information technology on their clinical practice in the acute care setting, their use of electronic nursing care reminders, and episodes of missed nursing care. The study aims were accomplished with a descriptive design using adjusted correlations. A convenience sample (N = 165) of medical and/or surgical, intensive care, and intermediate care RNs working on acute care hospital units participated in the study. Nurses from 19 eligible nursing units were invited to participate. Adjusted relationships using hierarchical multiple regression analyses indicated significant negative relationships between missed nursing care and nursing care reminders and perceptions of health information technology. The adjusted correlations support the hypotheses that there is a relationship between nursing care reminder usage and missed nursing care and a relationship between health information technology and missed nursing care. The relationships are negative, indicating that nurses who rate higher levels of reminder usage and health information technology have decreased reports of missed nursing care. The study found a significant relationship between nursing care reminders usage and decreased amounts of missed nursing care. The findings can be used in a variety of improvement endeavors, such as encouraging nurses to utilize nursing care reminders, aid information system designers when designing nursing care reminders, and assist healthcare organizations in assessing the impact of technology on nursing practice.
Burtson, Paige L; Stichler, Jaynelle F
This paper is a report of a study of the relationships among compassion satisfaction, nurse job satisfaction, stress, burnout and compassion fatigue to nurse caring. Nurse caring is the most influential dimension of patient advocation and is predictive of patient satisfaction. Qualitative studies have indicated that nurse caring is a key motivational factor impacting recruitment and retention. A correlational study of nurses (N = 126) was conducted in 2008 at a single, academic medical center. The six variables of interest were operationalized using four valid and reliable research instruments: (1) the Mueller McCloskey Satisfaction Scale, (2) the Professional Quality of Life Scale, (3) the Stress in General Scale and (4) the Caring Behaviors Inventory. Pearson Product-moment correlations showed statistically significant relationships between nurse caring and compassion satisfaction (r = 0.51, P nurse job satisfaction subscales (r = 0.16-0.28, P burnout (r = -0.22, P nurse caring subscale of knowledge and skill and compassion fatigue (r = -0.22, P nurse satisfaction with social interaction opportunities related to work (beta = 0.223, P = 0.032) explained variability in nurse caring. Fostering compassion satisfaction and social interaction opportunities among nurses may improve nurse caring, potentially sustaining long-term improvements in patient.
van Leeuwen, Rene; Tiesinga, Lucas J.; Post, Doeke; Jochemsen, Henk
Aim. This paper aimed to gain insight into the spiritual aspects of nursing care within the context of health care in the Netherlands and to provide recommendations for the development of care in this area and the promotion of the professional expertise of nurses. Background. International nursing l
van Leeuwen, Rene; Tiesinga, Lucas J.; Post, Doeke; Jochemsen, Henk
Aim. This paper aimed to gain insight into the spiritual aspects of nursing care within the context of health care in the Netherlands and to provide recommendations for the development of care in this area and the promotion of the professional expertise of nurses. Background. International nursing
Jiao He; De-Ying Hu; Yi-Lan Liu; Li-Fen Wu; Lian Liu
Objective: To understand the effect of humanistic nursing care model wards in Children Caring Ward School (CCWS) on the nurses' caring ability. Methods: Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory (CAI) before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses' caring ability. Results: The nurses' caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered (p Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.
Marília Silveira Faeda
Full Text Available ABSTRACT Objective: investigate the understanding of nurses on nurse prescribing conformity to the care needs of hospitalized patients and factors associated with that conformity. Method: a descriptive study, with a quantitative approach, was conducted at 20 in-patient units of a teaching hospital in the state of São Paulo. The participants (N=139 answered a semi-structured questionnaire. Results: For 43 (30.9% nurses, nurse prescribing is always in line with patients' care needs. The fields of body care and elimination, skin and mucosa care and investigation and monitoring were the most frequently addressed. Conclusion: in the perception of most nurses, nurse prescribing does not conform with patients' health heeds. The establishment of strategies to improve prescribing quality is recommended, as well as the development of permanent qualification programs and the systematic use of instruments for assessment of patients' care demands regarding nursing.
Faeda, Marília Silveira; Perroca, Márcia Galan
investigate the understanding of nurses on nurse prescribing conformity to the care needs of hospitalized patients and factors associated with that conformity. a descriptive study, with a quantitative approach, was conducted at 20 in-patient units of a teaching hospital in the state of São Paulo. The participants (N=139) answered a semi-structured questionnaire. For 43 (30.9%) nurses, nurse prescribing is always in line with patients' care needs. The fields of body care and elimination, skin and mucosa care and investigation and monitoring were the most frequently addressed. in the perception of most nurses, nurse prescribing does not conform with patients' health heeds. The establishment of strategies to improve prescribing quality is recommended, as well as the development of permanent qualification programs and the systematic use of instruments for assessment of patients' care demands regarding nursing.
Castro, Emily; Click, Elizabeth; Douglas, Sara; Friedman, Isabel
Professionalism is paramount to the formation and functioning of new graduate critical care nurses. In this project, a sample of 110 new graduate nurses used a descriptive self-report electronic survey with Hall's Professionalism Inventory Scale. A great percentage of these new graduate critical care nurse fellows with high professionalism scores may be related to their participation in the Critical Care Nurse Fellowship orientation program. Perhaps, Nursing Professional Development specialists should incorporate classes on professional advancement planning for new graduate nurses.
Learning to care and first encounter to care patients for male nursing students introduce a unique set of dilemmas to the predominantly female nursing educational process. The purpose of this study was to describe the experience male nursing students learning to care and first encounter care patients in their first nursing practice. A purposive sampling of seven male nursing students were interviewed by internet interview and analyzed by Qualitative content analysis. The results show that the...
The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.
Lecordier, Didier; Jovic, Ljiljana
As a continuation of its work and of the seminar on nursing sciences education in 2014, the “Association de recherche en soins infirmiers” (Arsi) organized a seminar on the 3rd and-4th of June 2016 in Nantes entitled : “nursing : perspectives and foresights”. More than fifty participants from the francophone area representing various sectors of practice : clinical, teaching, management and students gathered to debate and produce benchmarks to support the development of nursing sciences in France and to draw future directions for clinical practice and training. The successive sessions made it possible to reflect, to confront opinions, to make proposals and to identify the terms of the problematic of care and nursing knowledge today and the methodological elements relating to foresight. At the end of this very creative seminar, new avenues of reflection emerged shifting our usual look at the nurse profession. Orientations for training and practice have been defined with different stakes depending on the level of training and professional commitment. The strong links between professional, scientific and academic discipline have also been clarified, highlighting the importance to hold a high theoretical and scientific requirement, rigorous clinical practice, strong professional commitment and effective leadership.
Full Text Available The purpose of this literature review is to explore the relationship between nurse staffing, nurse job satisfaction, nurse practice environment, burnout, and nursing care quality through a consideration of what is meant by perceptions of nursing care quality. Different people define nursing care quality in many ways. It is complex, multi-faceted and multi-dimensional, and attempts to assess, monitor, evaluate and improve nursing care quality have evolved over a number of years. Of particular interest is the way in which changes in nurse staffing, nurse job satisfaction, nurse practice environment, and burnout may affect the quality of nursing care delivery. A search was conducted using the CINAHL, Medline and Embase databases, HINARI, Science Direct, Google, and PubMed. The terms searched included quality of health care; nursing care quality; nurse job satisfaction; nurse practice environment; burnout; and nurse staffing. Papers were included for their relevance to the field of enquiry. The original search was conducted in 2003 and updated in 2004. Quality of care is a complex, multi-dimensional concept, which presents researchers with a challenge when attempting to evaluate it. Many different tools have assessed nursing care quality. In addition, the review found that there were relationships between nurse staffing, nurse job satisfaction, nurse practice environment, burnout, and nursing care quality. [Int J Res Med Sci 2015; 3(8.000: 1825-1831
Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.
Anderson, Jane A; Willson, Pamela
Almost everything we do in nursing is based on our knowledge. In 1984, Benner (From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984) described nursing knowledge as the culmination of practical experience and evidence from research, which over time becomes the "know-how" of clinical experience. This "know-how" knowledge asset is dynamic and initially develops in the novice critical care nurse, expands within competent and proficient nurses, and is actualized in the expert intensive care nurse. Collectively, practical "know-how" and investigational (evidence-based) knowledge culminate into the "knowledge of caring" that defines the profession of nursing. The purpose of this article is to examine the concept of knowledge management as a framework for identifying, organizing, analyzing, and translating nursing knowledge into daily practice. Knowledge management is described in a model case and implemented in a nursing research project.
Chaves, Lucieli Dias Pedreschi; Mininel, Vivian Aline; Silva, Jaqueline Alcântara Marcelino da; Alves, Larissa Roberta; Silva, Maria Ferreira da; Camelo, Silvia Helena Henriques
To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks. refletir a supervisão de enfermagem como instrumento gerencial do enfermeiro para integralidade do cuidado, considerando suas potencialidades e limitações no cenário atual. estudo reflexivo baseado na formulação discursiva sobre a supervisão de enfermagem, apresentando conceitos e enfoques teóricos e/ou práticos. limitações no exercício da supervisão estão relacionadas à organização dos serviços de saúde embasada no modelo funcional e clínico de atenção, assim como possíveis lacunas no processo de formação do enfermeiro e sobrecarga de trabalho. Quanto às potencialidades, destaca-se a supervisão como instrumento de articulação de ações assistenciais e gerenciais, que pode favorecer integralidade da atenção, estimular atitudes de cooperação e colaboração em equipe, além da corresponsabilização e promoção da educação no trabalho. supervisão de enfermagem pode contribuir para fortalecimento da integralidade do cuidado, pressupondo reflexão cont
Labrague, Leodoro J; McEnroe-Petitte, Denise M; Achaso, Romeo H; Cachero, Geifsonne S; Mohammad, Mary Rose A
This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment.
Broderick, Margaret C
BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation
Carroll, M; Maichele, J
Since the inception of the Social Security Amendments of 1983, nurses have assumed expanded roles in ensuring the monitoring of the quality of care received by Medicare beneficiaries. This unique area of nursing practice offers new challenges and employment opportunities for the nurse as a patient advocate. Nurses who are interested in this role may contact state PRO directors or watch for specific recruitment advertisements in nursing magazines.
Richardson, Cliff; Percy, Marcus; Hughes, Jane
Debate continues regarding whether humanitarian values such as care and compassion can be taught or are innate in individuals who wish to become nurses. To undertake a discursive review of the literature on caring, compassion and empathy. To understand the teaching and learning issues associated with these concepts. To design and implement an Undergraduate Unit of study which addresses the development of caring, compassion and empathy in student nurses. MEDLINE, CINAHL, and a wide range of literature including books and governmental reports were used for a discursive narrative review. Caring, compassion and empathy are ill-defined; however healthcare users are clear that they know when nurses use skills and attitudes associated with these concepts. Evidence is available to show that caring, compassion and empathy can be taught and there are tools available to measure them in neophytes through their training. Central to the androgogical embedding of these concepts into nursing curricula is the development of therapeutic relationships. It is possible to develop materials to enable student nurses to learn how to care using compassion and empathy. Nursing therapeutics is a term devised to describe how student nurses can exploit the therapeutic potential of any patient contact especially when related to specific and routine nursing interventions. Muetzel's model for understanding therapeutic relationships is one framework that can be adopted to help student nurses to appreciate how to build patient relationships and encourage them to move towards therapeutic advantage using care, compassion and empathy. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gustafsson, Christine; Fagerberg, Ingegerd; Asp, Margareta
Few research studies have focused on nurses' working conditions for caring provided at night, and these studies have mainly described nurses' work in hospital settings, not in a municipal, social-care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses' caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses' experiences of their working conditions for caring in nursing. All municipal night-duty nurses (n = 7) in a medium-sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses' role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed-side caring, which makes it easier for them to find time for caring in situations that arise when nurses' skills, expertise and authority are called upon. Conversely the consultancy function entails short-term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses' possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.
of nursing. The findings of the research indicate that values in nursing and the perception of care are closely linked to the Islamic values of the informants. However, one of the most challenging aspects emerging from this study is related to these nurses’ experiences related to the public’s negative......‘Values are principles and standards that have meaning and worth to an individual, family, group, or community’ (Purnell & Paulanka 1998: 3). Values are central to the care provided by nurses. The provision of nursing care within the context of value clarification, has been explored from various...... perspectives, however, as values vary within cultures, there is a limited range of studies reflecting on Saudi Arabian nurses’ perspectives of nursing care. Through a Heideggerian phenomenological research design, six nurses were enrolled through purposive sampling. Semi-structured, in-depth interviews, which...
Chuang, Shu-Ting; Liu, Yi-Fang; Fu, Zi-Xuan; Liu, Kuang-Chung; Chien, Sou-Hsin; Lin, Chin-Lon; Lin, Pi-Yu
Traditionally, a patient presses the nurse call button and alerts the central nursing station. This system cannot reach the primary care nurse directly. The aim of this study was to apply a new smartphone system through the cloud system and information technology that linked a smartphone and a mobile nursing station for nursing care service. A smartphone and mobile nursing station were integrated into a smartphone nurse call system through the cloud and information technology for better nursing care. Waiting time for a patient to contact the most responsible nurse was reduced from 3.8 min to 6 s. The average time for pharmacists to locate the nurse for medication problem was reduced from 4.2 min to 1.8 min by the new system. After implementation of the smartphone nurse call system, patients received a more rapid response. This improved patients' satisfaction and reduced the number of complaints about longer waiting time due to the shortage of nurses.
Sibbald, B.; Laurant, M.G.H.; Reeves, D.
Nurses increasingly work as substitutes for, or to complement, general practitioners in the care of minor illness and the management of chronic diseases. Available research suggests that nurses can provide as high quality care as GPs in the provision of first contact and ongoing care for unselected
Sibbald, B.; Laurant, M.G.H.; Reeves, D.
Nurses increasingly work as substitutes for, or to complement, general practitioners in the care of minor illness and the management of chronic diseases. Available research suggests that nurses can provide as high quality care as GPs in the provision of first contact and ongoing care for unselected
In June 2008 the UK government, supported by the Royal College of Nursing, stated that nursing care would be measured for compassion. This paper considers the implications of this statement by critically examining the relationship of compassion to care from a variety of perspectives. It is argued that the current market-driven approaches to healthcare involve redefining care as a pale imitation, even parody, of the traditional approach of the nurse as "my brother's keeper". Attempts to measure such parody can only measure artificial techniques and give rise to a McDonald's-type nursing care rather than heartfelt care. The arguments of this paper, although applied to nursing, also apply to medicine and healthcare generally.
The transition from hospital to home can be a worrying period of time for a patient with a newly formed stoma. It is well documented that community care is important, however this transition has been seen as a weak link in the care for a patient with a stoma (Allison 1996). In most cases following discharge from hospital, the nurse specialist in stoma care will visit the patient at home as a means of maintaining continuity of care. It is also important that the patient's GP, district nurse and other relevant community services are introduced to ensure a cohesive approach to the patients care at home (Taylor, 2003). This article therefore aims to offer the community nurse an overview of stoma care nursing in order to provide the continuity of care much needed by this group of patients.
Bruyneel, Luk; Li, Baoyue; Ausserhofer, Dietmar; Lesaffre, Emmanuel; Dumitrescu, Irina; Smith, Herbert L; Sloane, Douglas M; Aiken, Linda H; Sermeus, Walter
This study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals in eight European countries shows that patient care experience is better in hospitals with better nurse staffing and a more favorable work environment in which less clinical care is left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left undone less frequently in hospitals with better nurse staffing and more favorable nurse work environments, and in which nurses work less overtime and are more experienced. Higher proportions of nurses with a bachelor's degree reduce the effect of worse nurse staffing on more clinical care left undone. © The Author(s) 2015.
Wälivaara, Britt-Marie; Sävenstedt, Stefan; Axelsson, Karin
The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person's genuine needs. The aim of this study was to explore registered nurses' experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person's position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology.
Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided.
Lentz, Shaynie; Luther, Brenda
Fragmented and uncoordinated care is the third highest driver of U.S. healthcare costs. Although less than 10% of patients experience uncoordinated care, these patients represent 36% of total healthcare costs; care management interaction makes a significant impact on the utilization of healthcare dollars. A literature search was conducted to construct a model of care coordination for elective surgical procedures by collecting best practices for acute, transitions, and post-acute care periods. A case study was used to demonstrate the model developed. Care management defines care coordination as a model of care to address improving patient and caregiver engagement, communication across settings of care, and ultimately improved patient outcomes of care. Nurse-led care coordination in the presurgical, inpatient, and post-acute care settings requires systems change and administrative support to effectively meet the goals of the Affordable Care Act of reducing redundancy and costs while improving the patient experience. Nursing is the lynchpin of care management processes in all settings of care; thus, this model of care coordination for elective surgical admissions can provide nursing care management leaders a comprehensive view of coordinating care for these patient across settings of care during the predetermined time period of care. As bundled payment structures increasingly affect hospital systems, nursing leaders need to be ready to create or improve their care management processes; care coordination is one such process requiring immediate attention.
Monareng, Lydia V
Although the concept 'spiritual nursing care' has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech's eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result 'caring presence' was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.
Modified electroconvulsive therapy (ECT) is a controlled medical procedure in which a seizure is induced in an anaesthetized patient to produce a therapeutic effect. ECT is the most acutely effective treatment available for affective disorders and is more effective than antidepressant drugs. Although in use for 70 years, ECT continues to attract controversy and there is considerable stigma associated with its use that often overshadows the empirical evidence for its effectiveness. One way to overcome this is for health professionals to be educated about contemporary ECT practice. Patients need to make informed decisions when consenting to ECT and this process can be influenced by preconceived ideas and scientific fact. It is, therefore, essential that nurses possess sufficient information to help patients make rational and informed treatment decisions and be able to care for both the clinical and psychological needs of patients treated with ECT. This review outlines the nursing role in ECT and summarizes the main aspects of contemporary ECT practice relevant to general and psychiatric nursing practice.
OʼConnor, Melissa; Arcamone, Angelina; Amorim, Frances; Hoban, Mary Beth; Boyd, Regina M; Fowler, Lauren; Marcelli, Theresa; Smith, Jacalyn; Nassar, Kathleen; Fitzpatrick, M Louise
Management and facilitation of care transitions from hospital to alternative settings requires skill and attention to avoid adverse events. Several interprofessional organizations and nurse leaders have called for the expansion and redesign of undergraduate nursing curricula to include care transitions. Yet there is little evidence describing how undergraduate baccalaureate nursing students are educated on this critical topic or how successful they are in improving student knowledge about care transitions. To address this gap, an in-classroom and clinical experience was implemented to prepare students to manage and facilitate care transitions from the hospital to alternative settings-including the home. Perceptions of undergraduate nursing students and home healthcare nurse preceptors were assessed via an electronic survey that was emailed to participants. Forty-eight responses to the survey were received. Students agreed this experience contributed to their understanding of caring for adults and older adults who are experiencing a care transition and they had a good understanding of care transitions to apply to their future nursing courses. Home healthcare nurse preceptors agreed they were able to demonstrate transitional care and that students were engaged. Future work should include expanding transitional care immersion to other care settings as well as the inclusion of additional healthcare disciplines in care transition education.
Roberta Juliane Tono de Oliveira
Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.
Bakir, Ercan; Samancioglu, Sevgin; Kilic, Serap Parlar
The purpose of this study was to determine the experiences and perceptions of intensive care nurses (ICNs) about spirituality and spiritual care, as well as the effective factors, and increase the sensitivity to the subject. In this study, we examined spiritual experiences, using McSherry et al. (Int J Nurs Stud 39:723-734, 2002) Spirituality and spiritual care rating scale (SSCRS), among 145 ICNs. 44.8% of the nurses stated that they received spiritual care training and 64.1% provided spiritual care to their patients. ICNs had a total score average of 57.62 ± 12.00 in SSCRS. As a consequence, it was determined that intensive care nurses participating in the study had insufficient knowledge about spirituality and spiritual care, but only the nurses with sufficient knowledge provided the spiritual care to their patients.
Eliason, Michele J.
Argues that nursing practice and theory cannot be ethical unless cultural factors are taken into consideration and that ethical/transcultural nursing is central to the philosophy and practice of nursing. (Author)
Stombaugh, Angie; Judd, Andrea
The purpose of this study was to explore nursing student's confidence level with basic nursing care when entering the nursing program after implementation of required nursing assistant certification for program admission. In addition, the relationship between being employed as a nursing assistant and confidence level with basic nursing care when entering the nursing program was explored. A Likert-scale survey assessing confidence levels of basic nursing care was sent to 156 nursing students admitted to a nursing program prior to their first nursing course. Confidence level with nursing skills, nursing assistant employment, and length of nursing assistant employment were assessed. Students were most confident in hand washing (M = 5.87, SD = 0.36), gloving and gowning (M =5.46, SD = 0.75), making an unoccupied bed (M = 5.38, SD = 0.88), and oral temperature (M = 5.30, SD = 0.87). Students were least confident in the fitting for cane (M = 1.74, SD = 1.16) and ambulation with crutches on steps (M =1.81, SD = 1.27). Nursing assistant employment increased student confidence with basic nursing care. Nursing programs cannot assume that students are prepared in basic nursing care based on a nursing assistant certification. © 2014.
Nouwens, Elvira; van Lieshout, Jan; van den Hombergh, Pieter; Laurant, Miranda; Wensing, Michel
To explore nurse involvement in cardiovascular risk management (CVRM) in primary care and how this involvement was associated with the degree of structured chronic illness care. A cross-sectional observational study in 7 European countries. Five aspects of nurse involvement in CVRM and 35 specific components of structured chronic illness care were documented in 202 primary care practices in Austria, Belgium, Germany, the Netherlands, Slovenia, Spain, and Switzerland. An overall measure for chronic care management, range 0 to 5, was constructed, derived from elements of the Chronic Care Model (CCM). Random coefficient regression modeling was used to explore associations. A majority of practices involved nurses for organization of CVRM in administrative tasks (82.2 %), risk factor monitoring (78.5%) and patient education (57.1%). Fewer practices involved nurses in defining protocol and the organization for CVRM (45%) or diagnosis and treatment (34.6%). With an increasing number of tasks handled by nurses, overall median adoption of CCM increased from 2.7 (95% CI, 1.5-3.6) to 4.2 (95% CI, 3.8-4.1). When the number of nurse tasks increased by 1, the adoption of CCM increased by 0.13 (P nurse involvement had high adoption of CCM, while variation of adoption of CCM across practices reduced substantially with an increasing level of nurse involvement. Nurses were involved in the delivery of CVRM in varying degrees. Higher involvement of nurses was associated with higher degree of structured chronic illness care, with less variation.
Caine, R M
Mentoring is an active process that is currently receiving widespread attention in education, in the corporate world, and increasingly in health care. Job satisfaction of the critical care nurse may be related to the fulfillment of personal needs and goals. The attainment of these needs and goals ultimately will lead to increased job productivity, which in turn will promote cost-effectiveness, an outcome cherished by management. Therefore, recognizing the worth of job satisfaction to the institution and the possibility that mentoring may have an effect on it among the professional staff may be a key to the future of improved health care and cost reduction in an increasingly specialized and technologic health care environment. Certainly, the nursing shortage is no longer news to the lay public or those of us engaged in the practice of nursing. In critical care that shortage is acutely apparent. Attrition of qualified critical care nurses is increasing and various solutions to the shortage have been proposed, some being met with more enthusiasm than others. A more basic solution might be to answer the question, "How can we maintain a high quality of patient care while promoting job satisfaction and instilling a sense of self-worth within the critical care nurse?" Critical care nurses need to play a pivotal role in nurturing and developing other critical care nurses as a means to retain those individuals. How can they do that effectively? Mentoring is one answer.
The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment.
The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment. How
Silva, Elisama Gomes Correia; de Oliveira, Viviane Carla; Neves, Giselda Bezerra Correia; Guimarães, Tânia Maria Rocha
The objective of this study is to analyze the knowledge that nurses from a large hospital in Recife, Pernambuco, have about Nursing Care Systematization (NCS). This is a descriptive, exploratory, quantitative study. The study population consisted of 107 clinical nurses, with a sample of 73 (68%). Data collection was performed in June 2008, using a semi-structured questionnaire that was filled out by the subjects. We found that 50 (69%) nurses had no knowledge about NCS, especially about nursing diagnoses. We identified the absence of forms in most hospitalization units. The nurses gave several justifications for their not working with NCS, including work overload and the scarcity of forms. We concluded that there is a need for more incentives by the institution and through policies, so as to permit nurses a greater autonomy in their practice.
In the extremely aged society, rehabilitation staff will be required to provide ample rehabilitation training for more stroke patients and more aged people with disabilities despite limitations in human resources. A nursing-care robot is one potential solution from the standpoint of rehabilitation. The nursing-care robot is defined as a robot which assists aged people and persons with disabilities in daily life and social life activities. The nursing-care robot consists of an independent support robot, caregiver support robot, and life support robot. Although many nursing-care robots have been developed, the most appropriate robot must be selected according to its features and the needs of patients and caregivers in the field of nursing-care.
Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin
Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values. © 2016 Australian College of Mental Health Nurses Inc.
Claxton-Oldfield, Stephen; Hastings, Emily; Claxton-Oldfield, Jane
A total of 50 nurses (hospital and home care) responded to a survey designed to measure: (1) their attitudes toward, and knowledge of, hospice palliative care volunteers; (2) the types of tasks they felt it was appropriate for volunteers to perform; and (3) how valuable they felt different members of the hospice palliative care team are. In addition, they were asked to respond to some open-ended questions (eg, "Do you feel that it is appropriate for hospice palliative care volunteers to know patient medical information?"). The nurses' responses to the "Attitude/Knowledge" part of the survey revealed that they generally held positive attitudes toward volunteers. The majority of the nurses felt that it was appropriate for volunteers to perform most of the tasks listed, except for hands-on patient care. Nurses rated the value of nurses, family members, doctors, and pharmacists significantly higher than volunteers. Fifty-three percent of the nurses felt that volunteers should know patient medical information, and 77% thought that volunteers should have the opportunity to provide input regarding patient care. Also, 75% of the nurses felt that volunteers made their jobs easier, and 56% felt that volunteers should be included in team meetings. When asked to list the topics covered in a hospice palliative care volunteer training program, 73% of the nurses indicated that they were not sure or did not know what topics were covered, indicating a lack of knowledge regarding volunteer training.
Zibrik, Kelly J; MacLeod, Martha L P; Zimmer, Lela V
Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice.This study examines rural nurses experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach.The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts.To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources ofjob satisfaction among rural nurses and creating professional practice environments in rural areas.
Bagherian, Behnaz; Sabzevari, Sakineh; Mirzaei, Tayebeh; Ravari, Ali
To examine the association between attitudes of critical care nurses about influences of technology and their caring attributes. In a cross-sectional study, firstly the psychometric properties of caring attributes questionnaire, which was developed to examine caring attributes of a sample of international nurses, was refined in a sample of 200 critical care nurses working in educational hospitals of a city in the southwest of Iran. Results of factor analysis with Varimax rotation decreased 60 items of caring attributes to 47 items which loaded under five subscales of caring negation, caring compassionate, caring advocacy, caring essence and caring communication. Secondly, attitudes of these nurses toward influences of technology on nursing care were assessed using a 22-item questionnaire, developed by the study researchers. Finally, the association between scores of caring attributes and attitudes toward influences of technology of this sample was determined. There was a positive association between caring attributes and influences of technology among our study nurses. Caring attributes scores were higher in female single nurses. Although caring attributes' scores had decreased along with age and work experience, caring commitment was higher in older more experienced nurses. Furthermore, female nurses had a better attitude toward influences of technology on their care. In contrast, younger and less experienced nurses had negative views on the effects of technology on nursing care. Continuing education and life-long learning on application of new technological equipment in nursing care and harmonising their use with caring values are necessary for nursing students and registered nurses to ensure delivering a patient-centred care, in a technologically driven environment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available The purpose of this paper is to provide a clear definition of nursing care quality that contributes to the formulation, application, and measurement of quality nursing outcomes for patients, organisations, and nursing staff. It also indicates the manner in which, by using the definition, empirically based operational definitions can be developed for different operational environments and settings. The study employed a concept analysis methodology to extract terms, attributes, antecedents, and consequences (outcomes from relevant literature databases. The analysis identified nine attributes: nurse competency performance, met nursing care needs, good experiences for patients, good leadership, staff characteristics, preconditions of care, physical environment, progress of nursing process, and cooperation with relatives. Antecedences include nurse-staffing levels, positive practice environment, and nursing turnover. Consequences include patient safety, patient satisfaction, nursing outcomes, nurse satisfaction, and budget management. Because of the breadth and depth of modern nursing practice, further research and development of the concept is required. [Int J Res Med Sci 2015; 3(8.000: 1832-1838
A. Aziz Alimul Hidayat; M. Kes
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...
Rafael Celestino da Silva
Full Text Available Objective: to propose a conceptual framework for clinical nursing care in intensive care.Method: descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software.Results: the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks.Conclusion: the conceptual framework of the clinic's intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.
da Silva, Rafael Celestino; Ferreira, Márcia de Assunção; Apostolidis, Thémistoklis; Brandão, Marcos Antônio Gomes
to propose a conceptual framework for clinical nursing care in intensive care. descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. the conceptual framework of the clinic's intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.
Blum, Cynthia A
Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. This article briefly reviews stressors common to students and nurses and the importance of practicing self-care to combat stress and promote health in practice. Florida Atlantic University offers a course for all levels of undergraduate nursing students called Caring for Self. The course, supported by principles of Adult Learning Theory, focuses on guiding the nurse to practice and model self-care. The author describes the evolution of this self-care initiative by discussing the needs assessment, course description and strategies, examples of course activities, and an exemplar of student impact. The conclusion offers discussion of challenges and lessons noted by faculty and students.
Trinier, Ruth; Liske, Lori; Nenadovic, Vera
Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events.
Nouwens, E.; Lieshout, J. van; Hombergh, P. van den; Laurant, M.; Wensing, M.
OBJECTIVES: To explore nurse involvement in cardiovascular risk management (CVRM) in primary care and how this involvement was associated with the degree of structured chronic illness care. STUDY DESIGN: A cross-sectional observational study in 7 European countries. METHODS: Five aspects of nurse
Sullivan, Debra Henline
Technology is rapidly changing the way nurses deliver patient care. The Health Information Technology for Economic and Clinical Health Act of 2009 encourages health care providers to implement electronic health records for meaningful use of patient information. This development has opened the door to many technologies that use this information to streamline patient care. This article explores current and new technologies that nurses will be working with either now or in the near future.
‘Values are principles and standards that have meaning and worth to an individual, family, group, or community’ (Purnell & Paulanka 1998: 3). Values are central to the care provided by nurses. The provision of nursing care within the context of value clarification, has been explored from various...... were audio tape-recorded, were chosen as the methods of data collection. A seven stage framework approach was applied to analyse and organise the research findings in three conceptual themes: values in context of Islam, the nurse-patient relationship, and identity’s influence on being in the world...
Cope, Vicki Catherine; Jones, Bronwyn; Hendricks, Joyce
To explore residential aged care nurses working in interim, rehabilitation and residential aged care perceptions of resilience. Qualitative Portraiture methodology. Inclusion criteria were that all participants were English speaking, registered with the Australian Health Practitioners Registration Authority and had more than five years' experience working in an aged care environment. Three participants were interviewed and employed within a metropolitan interim, rehabilitation and aged care setting. Eight themes were identified: valuing social support; leadership, managing 'self'; 'paying it forward'; passion for the profession; focusing on the positive and the taking on of challenge. This paper focuses on the impact of aged care nursing work on nurses and in particular how the nurses remain resilient in their work environment. Resilience can be developed through education and can sustain professional longevity. Workload stress can be alleviated through the provision of resilience training.
Tirgari, Batool; Iranmanesh, Sedigheh; Ali Cheraghi, Mohammad; Arefi, Ali
Spiritual care is an essential component in nursing practice and strongly influenced by the sociocultural context. This article aimed to elucidate the meaning of nurses' experiences of giving spiritual care in southeast of Iran. A phenomenological hermeneutic approach influenced by Ricoeur was used. Eleven staff nurses who were currently working in the 3 major hospitals under the umbrella of the Kerman University of Medical Sciences were interviewed. The meaning of spiritual care was comprehensively understood as meeting patient as a unique being. This can be divided into 3 themes: meeting patient as a being in relationship, meeting patient as a cultural being, and meeting patient as a religious being. The results in this study suggest that education about spirituality and spiritual care should be included in the continuous and in-service education of registered nurses. Spiritual and cultural assessment criteria should be included in this education to improve the provision of holistic care.
Susana de la Flor Picado
Full Text Available The superiority of human milk in feeding the human infant is incontestable. Breastmilk is a living food can´t be copied and is supported by numerous arguments in support of excellence, both biological and anthropometric or economic. Despite it, has been a significant decline in this practice. Scientific advances, sociological changes and the lack f health personnel have contributed to this expense. Currently, both the WHO and UNICEF cone try relaunching excusive breastfeeding as feeding the infant until 6 months of life. Initiatives whit the Baby Friendly Hospital or the Strategic Plan for the Protection, Promotion and Support of Breastfeeding trying to promote the recognition of breastfeeding as irrefutable cornerstone for optimal growth and development of our children.Goal: Unify care criteria and actions to promote breastfeeding initiation and maintenance of the same, improving communication between professionals and between them and patients.Methodology: Care Development Plan following the NANDA taxonomies, NOC, NIC.Conclusions: Standardized work promotes decision making and performance of nursing staff to develop a happy breastfeeding.
Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Buller, Haley; Neiman, Tammy
Conversations about goals of care with the patient and family are a critical component of advanced practice in oncology. However, there are often inadequate team structures, training, or resources available to assist advanced practitioners in initiating these conversations. We conducted a study to assess nurses' perceived role and communication tasks in such conversations about goals of care. In a cross-sectional survey of 109 nurses attending a comprehensive 2-day end-of-life nursing education course, nurses were asked to describe how they would participate in a "goals of care" meeting in three different scenarios. They were also asked what changes they desired in their clinical settings. Nurses overwhelmingly described that their primary task and communication role was to assess patient/family understanding. Nurses referenced their team members and team support with the least frequency across scenarios. Team roles, structure, and process were reported as areas in greatest need of change in patient/family goals of care meetings. These findings demonstrate that lack of preparation to function as a team is a barrier for nurses in communicating about goals of care, and there is a demand to move such conversations upstream in oncology care.
Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de
BACKGROUND: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with t
Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de
Background: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with t
Christensen, Kirsten Haugaard; Turner, de Sales
respects patients’ values, religion, customs, and spiritual beliefs. Literature however revealed that the phenomenon of spiritual care is complex and variously interpreted, and that there seems to be a lack of conceptual clarity regarding what constitutes spiritual care. A phenomenological and hermeneutic......Spiritual care perspectives of Danish Nurses The purpose of this study was to explore how Danish registered nurses understand the phenomenon of spiritual care and how their understanding impacts on their interventions with their patients. Nurses are responsible for the provision of care which...... would engage in provision of spiritual care. The participants acknowledged that their understanding of spirituality influenced their provision of spiritual care, which was recognized as a challenge requiring the nurse’s initiative and courage. Spirituality was primarily understood as a patient’s private...
Kumaş, Gülşah; Oztunç, Gürsel; Nazan Alparslan, Z
This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011).
Lydia V. Monareng
Full Text Available Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
Ingrid Schivre's nursing practice in an emergency department has evolved towards more relaxing approaches which allow for a greater focus on the notion of caring. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
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Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.
L. Bruyneel (Luk); B. Li (Baoyue); D. Ausserhofer (Dietmar); E.M.E.H. Lesaffre (Emmanuel); I. Dumitrescu (Irina); H.L. Smith (Herbert L.); D.M. Sloane (Douglas M.); L.H. Aiken (Linda); W. Sermeus (Walter)
textabstractThis study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals
L. Bruyneel (Luk); B. Li (Baoyue); D. Ausserhofer (Dietmar); E.M.E.H. Lesaffre (Emmanuel); I. Dumitrescu (Irina); H.L. Smith (Herbert L.); D.M. Sloane (Douglas M.); L.H. Aiken (Linda); W. Sermeus (Walter)
textabstractThis study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals
Kisorio, Leah C; Langley, Gayle C
To explore intensive care nurses' experiences of end-of-life care in adult intensive care units. An exploratory, descriptive qualitative approach was utilised. Purposive sampling method was used to select nurse participants (n=24) working at the selected intensive care units in the three academic affiliated, tertiary specialist hospitals in the Johannesburg and Pretoria regions, South Africa. Using a focus group guide, three focus group discussions were conducted. Data were analysed using the long-table approach (Krueger and Casey, 2000). Trustworthiness of the study was ensured by following the criteria set out by Lincoln and Guba (1985). Five major themes related to nurses' experiences of end-of-life care emerged. These included: "difficulties we experience", "discussion and decision making", "support for patients", "support for families" and "support for nurses". End-of-life care can be difficult and a challenging process. Nevertheless, this study has highlighted some of the interventions and support systems that could be incorporated for improved caring process. Whereas the dying patients and their families need to be continuously supported, critical care nurses too need to be taken care of for them to continue providing the best possible end-of-life care. Copyright © 2015 Elsevier Ltd. All rights reserved.
Cheung, Robyn B.; Aiken, Linda H.; Clarke, Sean P.; Sloane, Douglas M.
Countries across the globe are experiencing nursing shortages. In hospitals, supportive practice environments have positive effects on both nurse and patient outcomes. However, these relationships have been established primarily in the US. International studies of the effects of nurse staffing levels and the practice environment on nurse outcomes and the quality of care mirror the findings from the US, thus raising these issues to the international level. The solutions that have been successful in the US for improving practice environment and patient outcomes are solutions that should be successful in any country, thus putting them on a global scale. The Magnet hospital program is one model that has been shown to improve nurse and patient outcomes and is one solution to the shortage of hospital nurses. PMID:18218265
Full Text Available Aim: The aim of this study was to determine and evaluate appropriateness of nursing diagnoses with NANDA taxonomy used by second year nursing students in their nursing care plans.Methods: Retrospective design.Findings: While care plans included 42 nursing diagnoses appropriate to NANDA II taxonomy, some phrases (n=30were used as nursing diagnoses. Risks for infection, pain, activity intolerance, anxiety were the most frequently used diagnoses while nursing diagnoses in domains of cognitive-perceptive, self perception and role relations are very few.Conclusio: Performing case studies in clinical settings by using NANDA diagnoses, specifying difficulties experienced by nursing students’ and determining levels of discomfort while assessing the patients and determining the perceptions of nursing students by doing qualitative studies are recommended.
Simpson, Roy L
Although America spends more per capita on health care than any other nation in the world, care is neither consistent nor effective. The rising prominence of value-based care initiatives gives nurse executives an opportunity to lead clinical practice into a new evidence-fueled decision-making era. Technology holds the key to making emerging better practices and the latest clinical breakthroughs available at the point of care.
Truppel, Thiago Christel; Meier, Marineli Joaquim; Calixto, Riciana do Carmo; Peruzzo, Simone Aparecida; Crozeta, Karla
This is a methodological research, which aimed at organizing the systematization of nursing assistance in a critical care unit. The following steps were carried out: description of the nursing practice; transcription of nursing diagnoses; elaboration of a protocol for nursing diagnosis based in International Classification for Nursing Practice (ICNP); determination of nursing prescriptions and the elaboration of guidelines for care and procedures. The nursing practice and care complexity in ICU were characterized. Thus, systematization of nursing assistance is understood as a valuable tool for nursing practice.
D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )
textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-s
D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )
textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-s
Grøndahl, Vigdis Abrahamsen; Fagerli, Liv Berit
Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ(2) tests and one-way between-groups ANOVA were performed to characterise the clusters ( pclusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents' care quality perceptions.
Full Text Available The quality of palliative care given to terminally ill patients and their family members can be directly impacted by the attitudes that nurses hold towards palliative care. This study aimed to investigate the attitudes of nonpalliative care nurses towards death and dying in the context of palliative care. Nurses working within the medical aged care, cardiology and respiratory wards at two metropolitan teaching hospitals in Sydney completed the Frommelt Attitudes Towards Care of the Dying (FATCOD scale, an anonymous self-administered questionnaire, and a twelve-item demographic questionnaire. A total of 95 completed surveys were used in the final analysis. The total FATCOD score was 119.8±11.1, patient FATCOD was 79.6±8.6, and family FATCOD was 40.2±4.4. Of significance, the professional variables designation and role were associated with attitudes in the total FATCOD and country of birth, designation, highest level of education, and role were associated with attitudes towards the patient FATCOD. Scores for communication between the nurse and the terminally ill patient were poor. Health care facilities should focus on developing strategies to improve the communication skills among nonpalliative care nurses in order to optimize patient outcomes.
Debbie Verbeek-Oudijk; Cretien van Campen
Original title: Ouderen in verpleeghuizen en verzorgingshuizen For centuries, there have been institutions where the most vulnerable and oldest members of society could go for shelter, food and care. In modern Dutch society, these institutions take the form of nursing and residential care homes.
McNamara, S A
This study was designed to determine how caring is practiced in perioperative nursing. The theory of nursing by M. Jean Watson, RN, PhD, FAAN, provided the conceptual framework for the study. The researcher used a qualitative, descriptive methodology to analyze data collected in audiotaped interviews with five perioperative nurses and used standard qualitative research procedures for transcribing and analyzing the interview data. The five study participants identified their perceptions of caring behaviors with conscious and unconscious patients in the preoperative, intraoperative, and postoperative periods. They described the essential structure of caring as the establishment of a human care relationship and provision of a supportive, protective, and/or corrective psychological, physical, and spiritual environment.
da Silva, Karen Schein; Kruse, Maria Henriqueta Luce
Palliative care is becoming a professional knowledge and performance field by means of the proposal of another "regimen of truths". Such fact can be observed in the broadening of palliative care services and in the increase of publications on the subject. This study aims at learning the discourses on palliative care that the nurses have conveyed in the nursing publications. For such purpose we approached the Cultural Studies, especially those inspired on Michel Foucault in order to analyze articles published in two national nursing periodicals from 1999 to 2007. Among the statements, we point out those that see the hospital as a site where the patient is divested of his individuality and identity and those that mention such care as capable of providing the family and the patient with the best quality of life possible during the death process.
Vaismoradi, Mojtaba; Bondas, Terese; Salsali, Mahvash; Jasper, Melanie; Turunen, Hannele
Aim The purpose of this study was to explore and describe how nurse leaders facilitate safe care from the perspectives of both nurses and nurse leaders. Background The health-care system's success in improving patient safety pivots on nursing leadership. However, there is a lack of knowledge in the international literature about how nurse leaders facilitate provision of safe care and reaching the goal of a safe health-care system. Method A qualitative design using a content analysis approach was applied for data gathering and analysis. In this study, 20 nurses (16 nurses and four head nurses) working in a referral teaching hospital in Tehran, Iran, were recruited through purposive sampling. Semi-structured interviews and 10 hours of structured observations were conducted to collect data. Results The data analysis resulted in three main themes: 'providing environmental prerequisites for safe nursing practice', 'uniting and integrating health-care providers', and 'creating an atmosphere of safe care'. Conclusion The results indicate that to facilitate providing safe care, nurse leaders should improve nurses' working conditions, develop the nurses' practical competencies, assign duties to nurses according to their skills and capabilities, administer appropriate supervision, improve health-care providers' professional relationships and encourage their collaboration, empower nurses and reward their safe practice. Implications for nursing management Approaching the challenge of patient safety requires the health-care system to combine its efforts and strategies with nursing leadership in its vital role of facilitating safe care and improving patient safety. © 2012 John Wiley & Sons Ltd.
Maeve, M K; Vaughn, M S
The number of incarcerated persons in the United States has been increasing dramatically over the last two decades. Incarcerated men and women have increased rates of serious and chronic physical and mental illnesses and therefore require substantial health care efforts. Caring for prisoners is a difficult and often unrewarding experience for health care providers, particularly within a social climate that encourages noncaring behaviors. This article critically analyzes three philosophic stances toward nursing care with prisoners and suggests their philosophic commensurability within traditional nursing practice. Implications for nursing practice, research, and education are discussed.
Negrisolo, Adriana; Brugnaro, Luca
In nursing practice, the ability to make decisions regarding patients and to act on them is considered to be an expression of the professional nursing role. Problems may arise when a nurses would like to perform an action they believe morally correct but which are conflictual with the habits, organization or politics of the health structure in which they work. This inevitably produces moral distress in nurses who feel impotent to act as they feel they should. Although a certain amount of moral distress is part and parcel of the nursing profession , when it is excessive or prolonged it may become unacceptable and culminate in burn-out and the relative consequences. The aim of the study was to compare the level of moral stress in 111 Italian nurses working in different Operative Units to identify those clinical situations significantly associated with moral stress using the MDS scale. Similarly to studies performed in the USA, the level of moral stress in the 3 different work contexts was moderate, although some clinical situations were related to significant stress levels.
Team work is required in the treatment of the thermally injured patient--nursing staff being part of the team. The nurses are with the patient for 24 hours a day and they have to understand the objectives of all other members of the team involved in the treatment as well as thoroughly mastering their own work. For the nursing staff the care of the thermally injured patient is a challenge. The work demands strong motivation and interest--it includes at times painful treatment, isolation and also constant alertness. It is important that the nursing staff is given continuous training so that they are able to give the required care efficiently and to keep up active interest. Practical work is the best way of getting aquainted with the complex forms of treatment of the thermally injured patient. It also lessens the fear of a badly burned patient. Nursing care of the thermally injured patient consists of good basic care, local attention and active observation. The basic care consists of basic hygiene, diet, observation of the patient's psychological condition, giving emotional support, encouraging initiative physiotherapy and postural treatment.
The question of secularism, long-time confined to schools and the relationships between the Church and State, is today being raised in the field of public health. Nurses are directly affected and are integrating this dimension of secularism into their care practices. A private practice nurse describes the effect these changes are having on her practice in patients' homes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Schmitz, Eudinéia Luz; Gelbcke, Francine Lima; Bruggmann, Mario Sérgio; Luz, Susian Cássia Liz
To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.
Murphy, Lyn S; Walker, Mark S
Healthcare today is challenged to provide care that goes beyond the medical model of meeting physical needs. Despite a strong historical foundation in spiritual whole person care, nurses struggle with holistic caring. We propose that for the Christian nurse, holistic nursing can be described as Spirit-guided care--removing oneself as the moiatiating force and allowing Christ, in the furm of the Holy Spirit, to flow through and guide the nurse in care of patients and families.
Suhonen, Riitta; Välimäki, Maritta; Leino-Kilpi, Helena
This paper reports a study of the maintenance of individualized care from surgical patients' point of view and examines associations between individualized care, patient satisfaction with nursing care, and health-related quality of life. Rationale. There is preliminary evidence that individualized care is effective from patients' point of view, and is associated with improved patient outcomes, such as patient satisfaction and quality of life. However, individualized care has mainly been studied from the vantage-point of nurses' experiences. In this cross-sectional, descriptive, correlational study the data were collected with surgical adult patients (n = 279, response rate 93%) in surgical wards in Finland using self-administered questionnaires including the Individualized Care Scales, Patient-Satisfaction Scale, and Finnish versions of the Nottingham Health Profile and EuroQol 5D. Associations between individualized care, satisfaction with care and health-related quality of life were examined. Cronbach's alpha values and item analysis were used to evaluate the psychometric properties of the instruments, especially the Individualized Care Scales. The more often patients felt they received support for individuality through specific nursing interventions, the higher the individuality of care received. Secondly, the more individualized patients regarded their care, the higher the level of reported patient satisfaction with nursing care. However, the correlation between individualized care and health-related quality of life was fairly low, albeit statistically significant. Individualized care may produce positive outcomes, such as patient satisfaction. Further research is needed to explore individualized care in relation to health-related quality of life.
Full Text Available Introduction. The TISS-28 scale, which may be used for nursing staff scheduling in ICU, does not reflect the complete scope of nursing resulting from varied cultural and organizational conditions of individual systems of health care. Aim. The objective of the study was an attempt to provide an answer to the question what scope of nursing care provided by Polish nurses in ICU does the TISS-28 scale reflect? Material and Methods. The methods of working time measurement were used in the study. For the needs of the study, 252 hours of continuous observation (day-long observation and 3.697 time-schedule measurements were carried out. Results. The total nursing time was 4125.79 min. (68.76 hours, that is, 60.15% of the total working time of Polish nurses during the period analyzed. Based on the median test, the difference was observed on the level of χ2=16945.8, P<0.001 between the nurses’ workload resulting from performance of activities qualified into the TISS-28 scale and load resulting from performance of interventions within the scopes of care not considered in this scale in Polish ICUs. Conclusions. The original version of the TISS-28 scale does not fully reflect the workload among Polish nurses employed in ICUs.
Wound care is an important step in promoting wound healing, but it may cause wound care pain. This article aims to explore factors influencing wound care pain and the effectiveness of various interventions to alleviate it. Five major factors that influence wound care pain include inappropriate dressing change techniques, inflammation response, emotion, cognition, and social-cultural factors. Nurses should apply appropriate dressings and dressing change techniques to relieve wound care pain. Music therapy and aromatherapy can alleviate wound pain after dressing change. But distraction techniques should be used in conjunction with consideration of the needs of the individual subject.
Moss, Jacqueline; Saba, Virginia
The purpose of this study was to combine an established methodology for coding nursing interventions and action types using the Clinical Care Classification System with a reliable formula (relative value units) to cost nursing services. Using a flat per-diem rate to cost nursing care greatly understates the actual costs and fails to address the high levels of variability within and across units. We observed nurses performing commonly executed nursing interventions and recorded these into an electronic database with corresponding Clinical Care Classification System codes. The duration of these observations was used to calculate intervention costs using relative value unit calculation formulas. The costs of the five most commonly executed interventions were nursing care coordination/manage-refer ($2.43), nursing status report/assess-monitor ($4.22), medication treatment/perform-direct ($6.33), physical examination/assess-monitor ($3.20), and universal precautions/perform-direct ($1.96). Future studies across a variety of nursing specialties and units are needed to validate the relative value unit for Clinical Care Classification System action types developed for use with the Clinical Care Classification System nursing interventions as a method to cost nursing care.
Srulovici, Einav; Drach-Zahavy, Anat
Missed nursing care is considered an act of omission with potentially detrimental consequences for patients, nurses, and organizations. Although the theoretical conceptualization of missed nursing care specifies nurses' values, attitudes, and perceptions of their work environment as its core antecedents, empirical studies have mainly focused on nurses' socio-demographic and professional attributes. Furthermore, assessment of missed nursing care has been mainly based on same-source methods. This study aimed to test the joint effects of personal and ward accountability on missed nursing care, by using both focal (the nurse whose missed nursing care is examined) and incoming (the nurse responsible for the same patients at the subsequent shift) nurses' assessments of missed nursing care. A cross-sectional design, where nurses were nested in wards. A total of 172 focal and 123 incoming nurses from 32 nursing wards in eight hospitals. Missed nursing care was assessed with the 22-item MISSCARE survey using two sources: focal and incoming nurses. Personal and ward accountability were assessed by the focal nurse with two 19-item scales. Nurses' socio-demographics and ward and shift characteristics were also collected. Mixed linear models were used as the analysis strategy. Focal and incoming nurses reported occasional missed nursing care of the focal nurse (Mean=1.87, SD=0.71 and Mean=2.09, SD=0.84, respectively; r=0.55, ppersonal socio-demographic characteristics, higher personal accountability was significantly associated with decreased missed care (β=-0.29, p0.05). The interaction effect was significant (β=-0.31, ppersonal accountability and missed nursing care. Similar patterns were obtained for the incoming nurses' assessment of focal nurse's missed care. Use of focal and incoming nurses' missed nursing care assessments limited the common source bias and strengthened our findings. Personal and ward accountability are significant values, which are associated with
Josueida de Carvalho Sousa
Full Text Available The aim of this study was to analyze national and international scientific literature on nursing care for lesbian women. An integrative approach was adopted to review studies from MEDLINE, LILACS, BDENF and SCOPUS databases and SciELO and Cochrane libraries using the keywords: female homosexuality, nursing care, health promotion and women's health. Studies published between 1990 and 2013 in English, Portuguese or Spanish were considered for analysis. After analyzing data, four international studies were selected, being that three were from the United States and one was from Canada. This study revealed a scarcity of Brazilian and international studies and the importance of increasing scientific literature on this topic.
Nielsen, Ben; Martinsen, Bente
to improve quality of life after being diagnosed with HIV, a sharp distinction between HIV and AIDS and a religious and spiritually coping. Identifying the emotional challenges women living with HIV face in their daily lives may help nurses obtain a clearer understanding and greater knowledge of how...... to provide HIV-positive women with effective care that empower and support these women in managing their chronic disease. However to ensure that nurses have the proper tools for effective care for women living with HIV European studies are essentials in relation to what emotional challenges these women...
Angelo, Margareth; Cruz, Andréia Cascaes; Mekitarian, Francine Fernandes Pires; Santos, Carolina Cavalcante da Silva Dos; Martinho, Maria Júlia Costa Marques; Martins, Maria Manuela Ferreira Pereira da Silva
Affective, cognitive and behavioral components affect nurses´ attitudes to include families in the care processes. The purpose of this study was to investigate the attitudes of nurses about the importance of including families in nursing care. Data collection was performed in pediatric and maternal-child unit of a Brazilian university hospital. A sample of 50 nurses completed the Portuguese version of the instrument Families'Importance in Nursing Care-Nurses' Attitudes (FINC-NA). The results indicated that nurses have supportive attitudes regarding families participation in nursing care. Attitudes of lower support for involving families in nursing care were found among nurses with older age, more time in the profession and who had no previous contact with contents related to Family Nursing. The application of the instrument in other contexts of assistance may help to illuminate important aspects of the challenges to implementing a family-centered approach in clinical practice.
Fairbrother, Greg; Chiarella, Mary; Braithwaite, Jeffrey
This paper provides an overview of the developmental history of models of care (MOC) in nursing since Florence Nightingale introduced nurse training programs in a drive to make nursing a discipline-based career option. The four principal choices of models of nursing care delivery (primary nursing, individual patient allocation, team nursing and functional nursing) are outlined and discussed, and recent MOC literature reviewed. The paper suggests that, given the ways work is being rapidly reconfigured in healthcare services and the pressures on the nursing workforce projected into the future, team nursing seems to offer the best solutions.
Stalpers, Dewi; Kieft, Renate A. M. M.; Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke
textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. Methods: To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores...
Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.
Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive
Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.
Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive scr
Fowler, Jim; Chevannes, Mel
Nursing is a growing area of higher education, in which an introduction to statistics is an essential component. There is currently a gap in the market for a 'user-friendly' book which is contextulised and targeted for nursing. Practical Statistics for Nursing and Health Care introduces statistical techniques in such a way that readers will easily grasp the fundamentals to enable them to gain the confidence and understanding to perform their own analysis. It also provides sufficient advice in areas such as clinical trials and epidemiology to enable the reader to critically appraise work published in journals such as the Lancet and British Medical Journal. * Covers all basic statistical concepts and tests * Is user-friendly - avoids excessive jargon * Includes relevant examples for nurses, including case studies and data sets * Provides information on further reading * Starts from first principles and progresses step by step * Includes 'advice on' sections for all of the tests described.
Full Text Available Context: The total time spent in nursing care depends on the type of patient and the patient′s condition. We analysed factors that influenced the time spent in nursing a patient. Aims : To analyse the factors in a patient′s condition that influenced time spent in nursing a patient. Materials and Methods: This study was performed in the Surgical Intensive Care Unit of a tertiary referral centre, over a period of one month. The total time spent on a patient in nursing care for the first 24 hours of admission, was recorded. This time was divided into time for routine nursing care, time for interventions, time for monitoring and time for administering medications. Statistical analysis used: A backward stepwise linear regression analysis using the age, sex, diagnosis, type of admission and ventilatory status as variables, was done. Results: Patients admitted after elective surgery required less time (852.4 ± 234.1 minutes, than those admitted after either emergency surgery (1069.5 ± 187.3 minutes, or directly from the ward or the emergency room (1253.7 ± 42.1 minutes. Patients who were ventilated required more time (1111.5 ± 132.5 minutes, than those brought on a T-piece (732.2 ± 134.8 minutes or extubated (639.5 ± 155.6 minutes. The regression analysis showed that only the type of admission and the ventilatory status significantly affected the time. Conclusions : This study showed that the type of admission and ventilatory status significantly influenced the time spent in nursing care. This will help optimal utilization of nursing resources.
Full Text Available Background: Critical care is described as complex, detailed healthcare in a unique, technologically rich environment. Critical care nursing requires a strong knowledge base and exceptional clinical and technological skills to cope in this demanding environment. Many registered nurses (RNs commencing work in these areas may lack resilience, and because of the stress of the critical care environment, coping mechanisms need to be developed. To prevent burnout and to enable critical care nurses to function holistically, emotional intelligence (EI is essential in the development of such coping mechanisms.Objective: The aim of this study was to describe the EI of RNs commencing work in critical care units in a private hospital group in Gauteng, South Africa.Method: The design used for this study was a quantitative descriptive survey. The target population were RNs commencing work in critical care units. Data were collected from RNs using the Trait Emotional Intelligence Questionnaire – Short Form and analysed using the Statistical Package for the Social Sciences software.Results: The sample (n = 30 had a mean age of 32 years. Most of the participants (63% qualified through the completion of a bridging course between 2010 and 2012. The majority (62% of the sample had less than 2 years’ experience as RNs.Conclusion: The EI of RNs commencing work in a critical care environment was indicative of a higher range of Global EI, with the well-being factor scoring the highest, followed by the emotionality factor, then self-control, with the sociability factor scoring the lowest.
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing home care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.140 Nursing home care... equipped for adequate nursing care, comfort, and privacy of residents. Resident rooms must: (1)...
Sabrina da Costa Machado Duarte
Full Text Available Objectives: to identify the errors in daily intensive nursing care and analyze them according to the theory of human error. Method: quantitative, descriptive and exploratory study, undertaken at the Intensive Care Center of a hospital in the Brazilian Sentinel Hospital Network. The participants were 36 professionals from the nursing team. The data were collected through semistructured interviews, observation and lexical analysis in the software ALCESTE(r. Results: human error in nursing care can be related to the approach of the system, through active faults and latent conditions. The active faults are represented by the errors in medication administration and not raising the bedside rails. The latent conditions can be related to the communication difficulties in the multiprofessional team, lack of standards and institutional routines and absence of material resources. Conclusion: the errors identified interfere in nursing care and the clients' recovery and can cause damage. Nevertheless, they are treated as common events inherent in daily practice. The need to acknowledge these events is emphasized, stimulating the safety culture at the institution.
Golden, Julia Rose
The role of the pediatric advanced practice registered nurse continues to evolve within the ever-changing field of health care. In response to increased demand for health care services and because of a variety of changes in the health care delivery system, nurse practitioner patient care teams are an emerging trend in acute care settings. Care provided by nurse practitioner teams has been shown to be effective, efficient, and comprehensive. In addition to shorter hospital stays and reduced costs, nurse practitioner teams offer increased quality and continuity of care, and improved patient satisfaction. Nurse practitioner patient care teams are well suited to the field of pediatric oncology, as patients would benefit from care provided by specialized clinicians with a holistic focus. This article provides health care professionals with information about the use of nurse practitioner patient care teams and implications for use in pediatric oncology.
Currently, much nursing care adheres to a specific biomedical paradigm within the positivist framework. However, sometimes nursing care cannot be adapted to numerous human or vital conditions affecting our patients, their families or the environment in which nurses work. An specific example of these nursing interventions are those applied in intensive care units (ICU) where there is a large amount of technology and nursing care is specialized. Several questions that arise are whether the above-mentioned specialization is inherent to nurse care, whether technology management forms part of nursing care, whether this care has a non-nursing origin, and what is the source of nursing knowledge. The present article aims to provide basic knowledge to distinguish the nursing care performed in the ICU within the 2 predominant paradigms in current nursing: the biomedical and the holistic paradigms. The characteristics of nursing care in both paradigms are described and an integrated vision of these 2 paradigms and of nursing care with and without the use of technology is provided.
Riklikiene, Olga; Vozgirdiene, Inga; Karosas, Laima M; Lazenby, Mark
Political restrictions during 50years of Soviet occupation discouraged expressions of spirituality among Lithuanians. The aim of this paper is to describe Lithuanian nursing educators' and students' perception of spiritual care in a post-Soviet context. This cross-sectional study was carried out among student nurses and nursing educators at three universities and six colleges in Lithuania. The questionnaire developed by Scott (1959) and supplemented by Martin Johnson (1983) was distributed to 316 nursing students in the 3rd and 4th years of studies and 92 nurse educators (N=408). Student nurses and their educators rated general and professional values of religiousness equally; although students tended to dislike atheistic behavior more than educators. Four main categories associated with perceptions of spirituality in nursing care emerged from the student nurses: attributes of spiritual care, advantages of spiritual care, religiousness in spiritual care, and nurse-patient collaboration and communication. Themes from nurse educators paralleled the same first three themes but not the last one. Student nurses and nurse educators acknowledged the importance of spiritual care for patients as well as for care providers - nurses. In many cases spiritual care was defined by nursing students and nurse educators as faith and religiousness. Being a religious person, both for students and educators, or having spiritual aspects in students' personal lives influenced the perception of religious reflection. Copyright © 2015 Elsevier Ltd. All rights reserved.
Eric Benchimol Ferreira; Milca Severino Pereira; Adenicia Custódio Silva e Souza; Carlos Cristiano Oliveira de Faria Almeida; Alexandre Chater Taleb
Objective: to analyze the perception of nurses about the systematization of nursing care in the perspective of professional autonomy. Methods: a descriptive and exploratory research, carried out with 24 nurses at five inpatient clinics of a large-scale public teaching hospital, through a structured questionnaire evaluated by experts. Data were analyzed using descriptive statistics. Results: nurses claimed that the systematization of nursing care promotes autonomy, emphasizing that the pursuit...
Watters, Carol L; Harvey, Carol V; Meehan, Anita J; Schoenly, Lorry
Patients who face chronic, incurable, or life-ending musculoskeletal conditions often receive inadequate care either due to a lack of caregiver awareness or inattention to maintaining the highest quality at the end of life. Palliative care focuses on the comprehensive physical, psychological, social, spiritual, and existential needs of patients with life-threatening or debilitating illness. Orthopaedic nurses and all nurses in general are challenged to incorporate palliative care principles into care planned with patients and families facing end-of-life issues. This article addresses the leadership role the National Association of Orthopaedic Nurses (NAON) has taken to develop a consensus document which endorses the Last Acts Precepts of Palliative Care and affirms the need for palliative care with patients who experience life-threatening illness. A case study is used to illustrate the opportunity a multidisciplinary team has to center care on the individual, while remaining sensitive to the holistic needs of the patient for self-determination at the end of life.
Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H
To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
Aims. To critically examine the nursing care offered to older people who have been delirious. Background. Delirium occurs as a result of physiological imbalances resulting in an alteration in consciousness and cognitive impairment. Delirium is a prevalent and serious cognitive disorder experienced by older people. While there is a vast number of studies published utilizing quantitative methods, there remains a dearth of research relating to delirium in older people from a qualitative perspective. Design. A qualitative research design that utilized a critical gerontological framework underpinned this study. This framework drew on aspects of postmodernism and Foucault's understanding of discourse. Methods. Data sources included published documents on delirium, semi-structured taped interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, Registered Nurses and a hospital doctor. A postmodern discourse analytic approach was used to interrogate the 20 sets of data collected. Findings. Textual analysis revealed the presence of two major discourses impacting on being an older person with delirium. These were identified as a nursing discourse of delirium and a personal discourse of delirium. A nursing discourse of delirium was largely focussed on the biomedical processes that resulted in a delirious episode. Conversely, a personal discourse of delirium highlights that there are other ways of 'knowing' about delirium through considering the narratives of older adults, and their families, when offering a nursing service to this group of people. Relevance to clinical practice. Nursing needs to critically examine all aspects of nursing care as it applies to older people who have delirium to ensure the rhetorical claims of the profession become the reality for consumers of health services. The use of critical gerontology provides nurses with the tools to challenge the status quo and uncover the
MARIUTTI, Mariana Gondim; Almeida, Ana Maria; PANOBIANCO, Marislei Sanches
This qualitative study aimed to understand how women having an abortion experience the nursing care they receive. The statements of 13 hospitalized women were analyzed through content analysis. The central category "Nursing care experienced in situations of abortion" was constituted from 4 subcategories: care centered in physical needs; fear of judgment in abortion situations; legal aspects defining care; the need for support in abortion situations. These women identified nursing care as base...
Wu, Hung-Lan; Volker, Deborah L
This article presents a discussion of the relevance of Humanistic Nursing Theory to hospice and palliative care nursing. The World Health Organization has characterized the need for expert, palliative and end-of-life care as a top priority for global health care. The specialty of hospice and palliative care nursing embraces a humanistic caring and holistic approach to patient care. As this resonates with Paterson and Zderad's Humanistic Nursing Theory, an understanding of hospice nurses' experiences can be investigated by application of relevant constructs in the theory. This article is based on Paterson and Zderad's publications and other theoretical and research articles and books focused on Humanistic Nursing Theory (1976-2009), and data from a phenomenological study of the lived experience of Taiwanese hospice nurses conducted in 2007. Theoretical concepts relevant to hospice and palliative nursing included moreness-choice, call-and-response, intersubjective transaction, uniqueness-otherness, being and doing and community. The philosophical perspectives of Humanistic Nursing Theory are relevant to the practice of hospice and palliative care nursing. By 'being with and doing with', hospice and palliative nurses can work with patients to achieve their final goals in the last phase of life. Use of core concepts from Humanistic Nursing Theory can provide a unifying language for planning care and describing interventions. Future research efforts in hospice and palliative nursing should define and evaluate these concepts for efficacy in practice settings. © 2011 Blackwell Publishing Ltd.
Standards for nurse staffing in critical care units determined by: The British Association of Critical Care Nurses, The Critical Care Networks National Nurse Leads, Royal College of Nursing Critical Care and In-flight Forum.
Bray, Kate; Wren, Ian; Baldwin, Andrea; St Ledger, Una; Gibson, Vanessa; Goodman, Sheila; Walsh, Dominic
Since 1967 the gold standard for nurse staffing levels in intensive care and subsequently critical care units has been one nurse for each patient. However, critical care has changed substantially since that time and in recent years this standard has been challenged. Previously individual nursing organisations such as the British Association of Critical Care Nurses (BACCN) and the Royal College of Nursing have produced guidance on staffing levels for critical care units. This paper represents the first time all three UK Professional Critical Care Associations have collaborated to produce standards for nurse staffing in critical care units. These standards have evolved from previous works and are endorsed by BACCN, Critical Care Networks National Nurse Leads Group (CC3N) and the Royal College of Nursing Critical Care and In-flight Forum. The aim of this paper is to provide an overview of the much more detailed document 'Standards for Nurse Staffing in Critical Care', which can be found on the BACCN web site at www.baccn.org.uk. The full paper has extensively reviewed the evidence, whereas this short paper provides essential detail and the 12 standard statements. Representation was sort from each of the critical care associations. The authors extensively reviewed the literature using the terms: (1) critical care nursing, (2) nursing, (3) nurse staffing, (4) skill mix, (5) adverse events, (6) health care assistants and critical care, (7) length of stay, (8) critical care, (9) intensive care, (10) technology, (11) infection control. Comprehensive review of the evidence has culminated in 12 standard statements endorsed by BACCN, CC3N and the Royal College of Nursing Critical Care and In-flight Forum. The standards act as a reference for nursing staff, managers and commissioners associated with critical care to provide and support safe patient care. The review of the evidence has shown that the contribution of nursing can be difficult to measure and consequently support
This survey describes caring in the workplace in selected health services and is part of a greater study conducted in KwaZulu-Natal, South Africa. This study describes the views of nurse managers and nurses regarding caring in the workplace. Human competence, recovery and healing are central to caring. To ensure caring and healing of patients in health services it is of the utmost importance for nurse managers to ensure a healthy and caring environment in the management of nurses. When caring is present in the workplace, nurses are more able to render caring nursing practices in the patient care environment. It is clear that to become a caring person, one must be treated in a caring way and that caring may be impaired or reinforced by the environment. The environment of interest to this study was the environment in which nurses practise. A descriptive survey with a convenience sampling explored caring in the workplace of nurses. The questionnaire was divided into two sections. Section A comprised demographic information and in section B the questionnaire consisted of Likert type questions, open-ended questions and yes/no questions. Analysis included descriptive statistics. It was found that caring was not experienced in the hospitals by nurses in the major management tasks such as respect for human dignity, two-way communication, trust between nurses and nurse managers, wellness, cultural sensitivity, support and the recognition and handling of the concerns of nurses. It was clear that although nurse managers and nurses have the knowledge and structures for the implementation of caring in the hospitals, the everyday practical application of caring needs attention. Nurse managers were aware of caring practices but nurses did not always experience caring in their places of work in the hospitals. Nurse managers and nurses should all accept responsibility for finding means to improve communication and, in particular, participative leadership strategies in the hospitals
Giacon, Bianca Cristina Ciccone; Galera, Sueli Aparecida Frari
Schizophrenia is one of the main health problems in current days, requiring considerable investment from the health system. Intervening in the first episode offers a unique opportunity in the treatment of schizophrenia and influences the course of the illness. This article consists of a critical literature review aimed at examining knowledge on first episode schizophrenia and discussing the contribution of nursing care. A research was carried out in bibliographical databases. The data collected made possible the organization of information on the general concept of schizophrenia, its first episode, types of intervention and nursing performance. We found out that in Brazil there are few studies related to first episode schizophrenia in Nursing, few available specialized services, and few social resources. This situation reveals the need for more studies on first episode schizophrenia.
Manley, Kim; Hills, Val; Marriot, Sheila
This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.
Argues for moral context in nursing education. Discusses steps taken at the University of Colorado School of Nursing to emphasize human caregiving in the curriculum. Also argues that the preferred future for nursing education is a postbaccalaureate program in human caring, health, and healing that leads to the nursing doctorate. (CH)
Furtado, Angelina Monteiro; Pennafort, Viviane Peixoto dos Santos; da Silva, Lúcia de Fátima; Silveira, Lia Carneiro; de Freitas, Maria Célia; Queiroz, Maria Veraci Oliveira
Theoretical-reflexive study motivated by the epistemology of Gaston Bachelard and by the project "Thousand and one ways to take care in Nursing" by Maria José Coelho. We had as objective to trace new ways to take care in dialysis nursing, creating a system of cares offered to chronic kidney patients. Seven nursing cares that involve care of people in dialysis treatment were described: reception; bonding; specialized techniques; support to self-care; assessment of the treatment, facing the unstimulating routine; and citizenship rescue. Permanent care emerged, understood as an articulate and complementary relation between the scientific knowledge present in nursing care and the valorization of the other's essence, as a complex being in its whole.
Nursing has always regarded caring as its core business. The historical record about caring in nursing is non-specific, and little direct evidence exists about caring as part of nursing. Caring is not restricted to nursing, is possibly influenced by public perceptions of nursing, and can be subverted for maleficent ends. This paper discusses these points, and then moves to explain how caring fares in the Australian health care system. Australia has been blighted by a "cultural cringe" which sees anything from overseas as more valuable than anything Australian. This is as true for nursing, and caring within that, as for any other aspect of Australian life. However, Australia has one of the best health care systems in the world, and nursing as a profession is a world leader. The argument of this paper is that the core business of caring could be under threat in Australia unless nurses recognize their particularly good contribution to the profession and subsequent patient/client care, and celebrate that. Examples are taken from the United Kingdom where there is a crisis of caring within nursing and health. These are used to explain how Australian nursing can avoid the pitfalls and retain caring as its core business.
Helvie, C O
Nursing opportunities have expanded beyond the traditional bedside role. Nurses serve in a variety of roles such as administrators, teachers, or primary care givers in a variety of settings. The role of primary care giver is a more recent role; it involves relatively independent nursing practice with clients who have acute or chronic illnesses. Client groups may include the elderly in high rise buildings, mothers and children at schools, or homeless and low-income populations at homeless shelters. This care is often provided in a nursing center. Nursing centers are nurse-managed centers in which nurses are accountable and responsible for care of clients; they are the primary provider of care and the one most seen by clients. Case managers may be in a position to refer patients to nursing centers or to work directly with nurse practitioners in nursing centers. However, questions about the primary care provided in nursing centers must be addressed for healthcare providers, insurance companies, and patients to be confident in the efficacy of this delivery system. Is the primary care comprehensive? Is it of high quality? Is it cost effective? Is it satisfactory to clients? These and other questions about the primary care provided in nursing centers must be answered to effect political and other changes needed to fulfill the role of nursing centers envisioned by early leaders of the movement. This article addresses questions related to the efficacy of primary care provided in nursing centers by family nurse practitioners. After defining efficacy, the discussion focuses on the components identified and studied in one nursing center and includes information on opportunities for case managers to utilize nursing centers for referral and appropriate follow-up of their patients.
Tan, Yung-Ming; Hii, Joshua; Chan, Katherine; Sardual, Robert; Mah, Benjamin
With the introduction of CPOE systems, nurses in a Singapore hospital were facing difficulties monitoring key patient information such as critical tasks and alerts. Issues include unfriendly user interfaces of clinical systems, information overload, and the loss of visual cues for action due to paperless workflows. The hospital decided to implement an interactive electronic dashboard on top of their CPOE system to improve visibility of vital patient data. A post-implementation survey was performed to gather end-user feedback and evaluate factors that influence user satisfaction of the dashboard. Questionnaires were sent to all nurses of five pilot wards. 106 valid responses were received. User adoption was good with 86% of nurses using the dashboard every shift. Mean satisfaction score was 3.6 out of 5. User satisfaction was strongly and positively correlated to the system's perceived impact on work efficiency and care quality. From qualitative feedback, nurses generally agreed that the dashboard had improved their awareness of critical patient issues without the hassle of navigating a CPOE system. This study shows that an interactive clinical dashboard when properly integrated with a CPOE system could be a useful tool to improve daily patient care.
Dykes, Patricia C; Rothschild, Jeffrey M; Hurley, Ann C
: The frequency and types of medical errors are well documented, but less is known about potential errors that were intercepted by nurses. We studied the type, frequency, and potential harm of recovered medical errors reported by critical care registered nurses (CCRNs) during the previous year. : Nurses are known to protect patients from harm. Several studies on medical errors found that there would have been more medical errors reaching the patient had not potential errors been caught earlier by nurses. : The Recovered Medical Error Inventory, a 25-item empirically derived and internally consistent (alpha =.90) list of medical errors, was posted on the Internet. Participants were recruited via e-mail and healthcare-related listservs using a nonprobability snowball sampling technique. Investigators e-mailed contacts working in hospitals or who managed healthcare-related listservs and asked the contacts to pass the link on to others with contacts in acute care settings. : During 1 year, 345 CCRNs reported that they recovered 18,578 medical errors, of which they rated 4,183 as potentially lethal. : Surveillance, clinical judgment, and interventions by CCRNs to identify, interrupt, and correct medical errors protected seriously ill patients from harm.
Nursing documentation is crucial to high quality, good and safe nursing care. According to earlier studies nursing documentation varies and the nursing classifications used in electronic patient records (EPR) is not yet stable internationally nor nationally. Legislation on patient records varies between countries, but they should contain accurate, high quality information for assessing, planning and delivering care. A unified national model for documenting patient care would improve informati...
de Guzman, Allan B.; Cruz, Andrei Angelo R.; Cruz, Angela Laurice G.; Cruz, Robert Edward D.; Cuarto, Jose Mari Nino L.
The continually rising percentage of the elderly population and the demand for geriatric nursing care are dramatically related. While it is true that most undergraduate programs prepare nurses for the care of geriatric patients, most receive limited academic preparation in the nursing curriculum (Williams & Mezey, 2000). This is particularly…
Seferdjeli, Laurence; Terraneo, Fabienne
In a context in which sanitary institutions have transparency obligations toward authorities and patients, quality management and best practices--defined according to scientific standards--have become major concerns with respect to in-house management. While protocols and prescriptions are necessary for orienting work, they don't apply by themselves. Given that these various documents provide standardized and stabilized work descriptions, they contribute to hide what workers effectively do in unstable and variable situations in which numerous, sometimes contradictory, elements need to be simultaneously considered. In the present work, we follow this claim held by the French ergonomics stream and we consider the serious and irreducible gap between "prescribed work" and "real effective work". Such an understanding based on research evidence appears more adapted to professional realities and provides (valued) resources in nursing education. Based on information collected in three work analysis studies conducted by our team in hospital settings, we deepen these notions and their implication for practice and education.
Brown, Loraine P
It is widely accepted that a caring curriculum is integral to nursing education. Caring as a concept is extensively cited in the literature as a core value in nursing education and nursing practice. What is not evident is the curricular designs used by nurse educators to enable students to internalize caring behaviors. The literature supports the internalization of affective learning through hierarchically structured learning objectives, and the movement from emotional to reflexive responses through critical reflection. Krathwohl, Bloom, and Masia's (1964) taxonomy of affective objectives and concepts from Mezirow's (2000) transformational learning theory were used to synthesize the integration of caring affective objectives into the design of the nursing curricula. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students' caring behaviors that are consistent with the ideals of the profession. Examples of hierarchically leveled caring objectives are provided.
Noel, Dianne L
Many health care and academic centers have adopted Watson's Theory of Human Caring as their guiding principle; the theory is also used in other disciplines, such as library science. Human caring theory offers occupational health nurses as structure that not only defines a focus for practice, but also provides a basis for moral and philosophical practice analyses. In particular, nurses may find this theory useful in confirming the definition of "caring" and reconsidering what nursing is all about. More importantly, consideration and application of this theory may lead to research on its applicability to the field of occupational health nursing. This article presents the science and philosophy of human caring, specifically Watson's Theory of Human Caring. Two case studies are presented that demonstrate how the theory could be used to evaluate occupational health nursing practice. To demonstrate its possible relevance as an occupational health nursing framework, an analysis of and comparison to existing occupational health nursing guidelines are detailed and discussed.
Mykkänen, Minna; Saranto, Kaija; Miettinen, Merja
Nursing documentation is crucial to high quality, good and safe nursing care. According to earlier studies nursing documentation varies and the nursing classifications used in electronic patient records (EPR) is not yet stable internationally nor nationally. Legislation on patient records varies between countries, but they should contain accurate, high quality information for assessing, planning and delivering care. A unified national model for documenting patient care would improve information flow, management between multidisciplinary care teams and patient safety. Nursing documentation quality, accuracy and development needs can be monitored through an auditing instrument developed for the national documentation model. The results of the auditing process in one university hospital suggest that the national nursing documentation model fulfills nurses' expectations of electronic tools, facilitating their important documentation duty. This paper discusses the importance of auditing nursing documentation and especially of giving feedback after the implementation of a new means of documentation, to monitor the progress of documentation and further improve nursing documentation.
Internal radiation therapy has been used in treating gynecological cancers for over 100 years. A variety of radioactive sources are currently used alone and in combination with other cancer treatments. Nurses need to be able to provide safe, comprehensive care to patients receiving internal radiation therapy while using precautions to keep the risks of exposure to a minimum. This article discusses current trends and issues related to such treatment for gynecological cancers.20 references.
Ball, Jane E.; Murrells, Trevor; Rafferty, Anne Marie; Morrow, Elizabeth; Griffiths, Peter
Background There is strong evidence to show that lower nurse staffing levels in hospitals are associated with worse patient outcomes. One hypothesised mechanism is the omission of necessary nursing care caused by time pressure—‘missed care’. Aim To examine the nature and prevalence of care left undone by nurses in English National Health Service hospitals and to assess whether the number of missed care episodes is associated with nurse staffing levels and nurse ratings of the quality of nursi...
Kim, Hongsoo; Harrington, Charlene; Greene, William H.
Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…
Kim, Mi So; Kim, Hyun Ju; Choi, Jung Eun; Kim, Su Jin; Chang, Sung Ok
With ageing, older people face cardiovascular problems as the major cause of disability and death. Although immediate medical attention is a major factor in determining outcomes of cardiac problems, lack of personnel (i.e. registered nurse, certified nursing assistant and home care aide) in nursing homes without residing doctor limits the awareness of such problems, thus making it difficult to initiate timely and appropriate intervention. The aim of this study was to conceptualize critical care for nursing home residents with cardiac vulnerability and develop practical knowledge in nursing practice. Conventional content analysis was performed on date from interviews with 30 nurses from 10 nursing homes in South Korea between July and November 2010. The analysis revealed three major cardiac problems resulting from residents' cardiac vulnerability: angina, myocardial infarction (MI) and cardiogenic shock. Through content analysis, we extracted 6 themes and 21 subthemes for nurses' conceptualization of critical care for nursing home residents with cardiac vulnerability. In nursing homes without a residing doctor, nurses assessed the physical, functional and cognitive conditions along with the responses and symptoms of residents when emergency situations related to the cardiac problems occurred. Moreover, with a lack of infrastructures of a hospital, nurses provided critical care to the elderly by using personal practice strategies based on their personal experience in facilities along with practical knowledge of nurses while following the management principles of emergencies. We found that nurses conceptualized critical nursing care for cardiac problems at nursing homes, which are different from those of general hospitals. The results of this study will provide basis for the development of care guidelines and educational materials that can be used by novice nurses or nursing students. © 2015 British Association of Critical Care Nurses.
Eric Benchimol Ferreira
Full Text Available Objective: to analyze the perception of nurses about the systematization of nursing care in the perspective of professional autonomy. Methods: a descriptive and exploratory research, carried out with 24 nurses at five inpatient clinics of a large-scale public teaching hospital, through a structured questionnaire evaluated by experts. Data were analyzed using descriptive statistics. Results: nurses claimed that the systematization of nursing care promotes autonomy, emphasizing that the pursuit of knowledge for the development of systematization of nursing care is supported by an exchange of experiences among colleagues. Conclusion: applying the systematization of nursing care generates autonomy, demonstrating that nurses become more apt in developing it, thereby resulting in increased professional autonomy.
Byung-Hye Kong, RN, PhD
Full Text Available Nursing scholars consider caring a key concept in understanding what is involved in nursing and believe that it is a major issue in nursing ethics. In this paper, the moral characteristics required for nursing care are described and these characteristics are discussed on the basis of taking responsibility for the Other, as described in Levinas' ethics. First of all, the altruistic aspect of care in terms of Levinas' ethics is examined. That is, a nurse should meet the needs of a person who is suffering, respond to them morally, and take responsibility. Levinas puts an emphasis on passive sensibilities that lead a nurse to respond to the needs of someone who is suffering, and also on the moral responsibility that encourages a nurse to empathize with others. However, his ethics cannot explain clearly how a nurse, as a moral subject with autonomy, forms a caring relationship with others.
Nursing scholars consider caring a key concept in understanding what is involved in nursing and believe that it is a major issue in nursing ethics. In this paper, the moral characteristics required for nursing care are described and these characteristics are discussed on the basis of taking responsibility for the Other, as described in Levinas' ethics. First of all, the altruistic aspect of care in terms of Levinas' ethics is examined. That is, a nurse should meet the needs of a person who is suffering, respond to them morally, and take responsibility. Levinas puts an emphasis on passive sensibilities that lead a nurse to respond to the needs of someone who is suffering, and also on the moral responsibility that encourages a nurse to empathize with others. However, his ethics cannot explain clearly how a nurse, as a moral subject with autonomy, forms a caring relationship with others.
Dimitri van der Linden; Prof. Dr. Marieke J. Schuurmans; Dewi Stalpers; Marian J. Kaljouw; Renate A.M.M. Kieft
Background: Nurse-sensitive indicators and nurses’ satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive
D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )
textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between
Vardell, Emily; Paulaitis, Gediminas Geddy
Nursing Reference Center is a point-of-care resource designed for the practicing nurse, as well as nursing administrators, nursing faculty, and librarians. Users can search across multiple resources, including topical Quick Lessons, evidence-based care sheets, patient education materials, practice guidelines, and more. Additional features include continuing education modules, e-books, and a new iPhone application. A sample search and comparison with similar databases were conducted.
Kerfoot, Karlene M
Much information and clinical data are available in health care. Unfortunately, much of it is not available for clinical decision making and management support. Analytics within the context of health information technology (HIT) will provide a framework to bring better reasoning and intelligence to HIT and nursing care. The missing link is the people who will bring this forward into the everyday lives of clinical nurses and nurse executives. With better competencies among staff and leaders in nursing and more credentialed nursing informatics leaders in influential positions, nursing will be a full participant in the digital revolution which, along with analytics, will lead to intelligent and effective systems.
Tagie Azarsa; Arefeh Davoodi; Abdolah Khorami Markani; Akram Gahramanian; Afkham Vargaeei
Introduction: Nurses’ spiritual wellbeing and their attitude toward spirituality and competence of nurses in providing of spiritual care can affect the quality of care in nursing. The aim of this study was to evaluate spiritual wellbeing, attitude toward spiritual care and its relationship with the spiritual care competence among nurses. Methods: This was a correlational descriptive study conducted on 109 nurses working in the Intensive Care Units of Imam Reza and Madani hospitals in 2015, Ta...
de Medeiros, Ana Lúcia; dos Santos, Sérgio Ribeiro; de Cabral, Rômulo Wanderley Lima
This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of nursing care (SNC) in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon. "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff" The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as well as considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.
Sarikonda-Woitas, Candace; Robinson, Janet Hoey
Nurse administrators must become more involved in the policy debates concerning universal access to care and allocation of health care resources. In order to promote nursing's agenda in the policy debates, nurses must be familiar with the numerous ethical issues that impact macroallocation decisions. This article explores the ethical viewpoint of the nursing profession as it relates to allocation decisions and examines how the ethical principles of the nursing profession, along with the ethical theories of egalitarianism and utilitarianism, can be used throughout the policy process to guide the development of a plan for universal access to care.
Passarella, P M; Lewis, N
The nursing approach in the care of stroke patients has a direct impact on functional outcome. Nursing application of Bobath principles in stroke care offers a nursing focus on involvement of the affected side; facilitation of normal tone, posture, and movement; and development of more normal function. A research study evaluating the functional gains of stroke patients demonstrated a significant level of functional improvement in those treated with Bobath principles over stroke patients treated with the traditional nursing approach. Practical methods for applying Bobath principles in patient care activities are described. These therapeutic methods provide nurses with the means to maximize stroke patients' potential and further influence their functional recovery.
Sawatzky, Jo-Ann V; Enns, Carol L; Ashcroft, Terri J; Davis, Penny L; Harder, B Nicole
Nursing education plays a central role in the ability to practice effectively. It follows that an optimally educated nursing workforce begets optimal patient care. A framework for excellence in nursing education could guide the development of novice educators, establish the basis for evaluating teaching excellence, and provide the impetus for research in this area. However, a review of the social sciences and nursing literature as well as a search for existing models for teaching excellence revealed an apparent dearth of evidence specific to excellence in nursing education. Therefore, we developed the Caring Framework for Excellence in Nursing Education. This framework evolved from a review of the generic constructs that exemplify teaching excellence: excellence in teaching practice, teaching scholarship, and teaching leadership. Nursing is grounded in the ethic of caring. Hence, caring establishes the foundation for this uniquely nursing framework. Because a teaching philosophy is intimately intertwined with one's nursing philosophy and the ethic of caring, it is also fundamental to the caring framework. Ideally, this framework will contribute to excellence in nursing education and as a consequence excellence in nursing practice and optimal patient care.
Dhaliwal, Kirnvir; Hirst, Sandra
Registered nurses are the primary healthcare providers for offenders in correctional facilities. The way in which correctional nurses care for offenders can be difficult in this context. Following a systematic review and narrative synthesis of literature regarding how correctional nurses show caring for offenders three themes emerged: the struggle of custody and caring (conflicting ethical and philosophical ideologies, correctional priorities that override nursing priorities, safety and security), the need to be nonjudgmental (judgmental attitudes can impact care; focus on health not the crime), and the importance of boundaries. Implications for practice focus on recommendations to promote caring in correctional nursing; the outcome of which will potentially enhance quality of care for offenders and improve working environments for nurses.
Burnout and its development in critical care nurses is a concept that has received extensive study, yet remains a problem in Canada and around the world. Critical care nurses are particularly vulnerable to developing burnout due to the chronic occupational stressors they are exposed to, including high patient acuity, high levels of responsibility, working with advanced technology, caring for families in crisis, and involved in morally distressing situations, particularly prolonging life unnecessarily. The purpose of this article is to explore how the chronic stressors that critical care nurses are exposed to contribute to the development of burnout, and strategies for burnout prevention. A review of the literature between the years 2007 and 2012 was conducted and included the search terms burnout, moral distress, compassion fatigue, intensive care, critical care, and nursing. The search was limited to the adult population, English language, and Western cultures. The results revealed that nurse managers play a crucial role in preventing burnout by creating a supportive work environment for critical care nurses. Strategies for nurse managers to accomplish this include being accessible to critical care nurses, fostering collegial relationships among the different disciplines, and making a counsellor or grief team available to facilitate debriefing after stressful situations, such as a death. In addition, critical care nurses can help prevent burnout by being a support system for each other and implementing self-care strategies.
Ferrell, Betty R.; Virani, Rose; Grant, Marcia
As the members of the health care team who spend the most time with patients who are facing death, nurses are aware of the need for improved end-of-life (EOL) care and have identified resources to achieve that goal by improving education. A survey of 725 nursing faculty and state boards indicates an awareness of the need for improved EOL care and…
Full Text Available This survey describes caring in the workplace in selected health services and is part of a greater study conducted in KwaZulu-Natal, South Africa. This study describes the views of nurse managers and nurses regarding caring in the workplace. Human competence, recovery and healing are central to caring. To ensure caring and healing of patients in health services it is of the utmost importance for nurse managers to ensure a healthy and caring environment in the management of nurses. When caring is present in the workplace, nurses are more able to render caring nursing practices in the patient care environment. It is clear that to become a caring person, one must be treated in a caring way and that caring may be impaired or reinforced by the environment. The environment of interest to this study was the environment in which nurses practise. A descriptive survey with a convenience sampling explored caring in the workplace of nurses. The questionnaire was divided into two sections. Section A comprised demographic information and in section B the questionnaire consisted of Likert type questions, open-ended questions and yes/no questions. Analysis included descriptive statistics.
Bambi, Stefano; Lucchini, Alberto; Solaro, Massimo; Lumini, Enrico; Rasero, Laura
Interventional Patient Hygiene Model. A critical reflection on basic nursing care in intensive care units. Over the past 15 years, the model of medical and nursing care changed from being exclusively oriented to the diagnosis and treatment of acute illness, to the achievement of outcomes by preventing iatrogenic complications (Hospital Acquired Conditions). Nursing Sensitive Outcomes show as nursing is directly involved in the development and prevention of these complications. Many of these complications, including falls from the bed, use of restraints, urinary catheter associated urinary infections and intravascular catheter related sepsis, are related to basic nursing care. Ten years ago in critical care, a school of thought called get back to the basics, was started for the prevention of errors and risks associated with nursing. Most of these nursing practices involve hygiene and mobilization. On the basis of these reflections, Kathleen Vollman developed a model of nursing care in critical care area, defined Interventional Patient Hygiene (IPH). The IPH model provides a proactive plan of nursing interventions to strengthen the patients' through the Evidence-Based Nursing Care. The components of the model include interventions of oral hygiene, mobilization, dressing changes, urinary catheter care, management of incontinence and bed bath, hand hygiene and skin antisepsis. The implementation of IPH model follows the steps of Deming cycle, and requires a deep reflection on the priorities of nursing care in ICU, as well as the effective teaching of the importance of the basic nursing to new generations of nurses.
Beatriz Francisco Farah
Full Text Available Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods: this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results: two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.
Vázquez-Calatayud, Mónica; Oroviogoicoechea, Cristina; Saracibar, Maribel; Pumar-Méndez, María J
Although the concept of 'Transforming care' is promising for improving health care, there is no consensus in the field as to its definition. The aim of this concept analysis is to develop a deeper understanding of the term 'Transforming care' within the nursing discipline, in order to facilitate its comprehension, implementation, and evaluation. We performed a comprehensive literature review on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Web of Science, Wiley-Blackwell, ScienceDirect, and SpringerLink and used Walker and Avant's approach to analyse the concept. From the 20 studies selected for this analysis, 3 main attributes of 'Transforming care' were identified: patient-centredness, evidence-based change, and transformational leadership driven. We suggest an operational definition to facilitate the implementation of the concept in practice. Furthermore, we propose that implementation is guided by the following key ideas: (1) fostering a culture of continuous improvement; (2) encouraging bottom-up initiatives; (3) promoting patient-centred care; and (4) using transformational leadership. Lastly, the evaluation of 'Transforming care' initiatives should assess care processes and professionals' and patients' outcomes.
Juvé-Udina, Maria-Eulàlia; Pérez, Esperanza Zuriguel; Padrés, Núria Fabrellas; Samartino, Maribel Gonzalez; García, Marta Romero; Creus, Mònica Castellà; Batllori, Núria Vila; Calvo, Cristina Matud
This study aimed to evaluate the frequency of psychosocial aspects of basic nursing care, as e-charted by nurses, when using an interface terminology. An observational, multicentre study was conducted in acute wards. The main outcome measure was the frequency of use of the psychosocial interventions in the electronic nursing care plans, analysed over a 12 month retrospective review. Overall, 150,494 electronic care plans were studied. Most of the intervention concepts from the interface terminology were used by registered nurses to illustrate the psychosocial aspects of fundamentals of care in the electronic care plans. The results presented help to demonstrate that the interventions of this interface terminology may be useful to inform psychosocial aspects of basic and advanced nursing care. The identification of psychosocial elements of basic nursing care in the nursing documentation may lead to obtain a deeper understanding of those caring interventions nurses consider essential to represent nurse-patient interactions. The frequency of psychosocial interventions may contribute to delineate basic and advanced nursing care. © 2013 Sigma Theta Tau International.
End-of-life care and the dying patient have been an area lightly covered in my nursing school experience. While I expected the topics to surface in more detail in conjunction with the critical care nursing unit, this was not the case. This article is a personal reflection on my experience in critical care nursing and the deficits involving death and dying education in both institutional and professional settings.
Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro
The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.
Pearson, A; Baker, H
The quality of nursing care delivered to two groups of patients suffering from diabetes mellitus was examined. Using Phaneuf's Nursing Audit, a retrospective audit of the nursing documentation regarding the care of all patients was carried out, and a comparison made of the numeric scores obtained. The nursing care of the group of patients from the Professional Nursing Unit (PNU) obtained mean scores which were 26.4% higher than those obtained by the group from the general hospital wards. There are major variations in scores in specific areas. These give rise to some questions regarding the value to nurses of the caring and nurturing component of nursing work, and how this is affected by differing philosophies and environments.
Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee
The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.
Stalpers, Dewi; Kieft, Renate A M M; van der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J
Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores of the publicly reported nurse-sensitive indicators: screening of delirium, screening of malnutrition, and pain assessments, were averaged (2011). Nurse-perceived quality ratings were obtained from staff nurses working in the same hospitals by the Dutch Essentials of Magnetism II survey (2010). Concordance between the quality measures was analyzed using Spearman's rank correlation. The mean screening performances ranged from 63% to 93% across the six hospitals. Nurse-perceived quality of care differed significantly between the hospitals, also after adjusting for nursing experience, educational level, and regularity of shifts. The hospitals with high-levels of nurse-perceived quality were also high-performing hospitals according to nurse-sensitive indicators. The relationship was true for high-performing as well as lower-performing hospitals, with strong correlations between the two quality measures (rS = 0.943, p = 0.005). Our findings showed that there is a significant positive association between objectively measured nurse-sensitive screening indicators and subjectively measured perception of quality. Moreover, the two indicators of quality of nursing care provide corresponding quality rankings. This implies that improving factors that are associated with nurses' perception of what they believe to be quality of care may also lead to better screening processes. Although convergent validity seems to be established, we emphasize that different kinds of quality measures could be used to complement each other
Zinn, J S
This study examines the extent to which nursing homes adjust staffing and care practices relative to local market conditions. Weighted two-stage least squares regression results suggest that facilities employ more nonprofessional nursing staff in markets in which professional nurse wages are higher. RN staffing levels are higher in markets with a higher percentage of self-pay nursing home residents and a lower percentage of for-profit nursing homes. Controlling for resident characteristics, the use of labor-saving practices is higher in markets with higher average nursing home wages, suggesting that there are economic incentives to hire fewer nursing personnel.
Eggenberger, Sandra K; Sanders, Marita
The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in
L'Ecuyer, Kristine M; Shatto, Bobbi J; Hoffmann, Rosemary L; Crecelius, Matthew L
Challenges of the current health system in the United States call for collaboration of health care professionals, careful utilization of resources, and greater efficiency of system processes. Innovations to the delivery of care include the introduction of the clinical nurse leader role to provide leadership at the point of care, where it is needed most. Clinical nurse leaders have demonstrated their ability to address needed changes and implement improvements in processes that impact the efficiency and quality of patient care across the continuum and in a variety of settings, including critical care. This article describes the role of the certified clinical nurse leader, their education and skill set, and outlines outcomes that have been realized by their efforts. Specific examples of how clinical nurse leaders impact critical care nursing are discussed.
Pipe, Teri Britt; Connolly, Teresa; Spahr, Nancy; Lendzion, Nadine; Buchda, Vicki; Jury, Rita; Cisar, Nancy
Nursing leadership involves creating and sustaining a professional environment where nurses can perform at the highest levels of their preparation and expertise. As the work of nursing becomes increasingly more complex and significantly more technical in nature, nurses are beginning to find that the basic nursing interventions that were once the hallmark of good nursing care are being left behind. The purpose of this article is to describe an initiative to develop a clearly defined set of consensus-driven expectations about those essential, foundational elements of nursing care that nurses strive for and which we wanted to be universal within our organization, no matter where the patient receives care. The leadership challenge was to convey expectations that encompass both the tasks of nursing care and the compassionate environment in which the care is delivered. Adding to the complexity of this goal was the recognition that we would be much more successful in meeting these standards consistently if the expectations were grounded in the experience of direct care nurses, explicitly described and intentionally specified. This article describes the various phases of this initiative and includes the resulting "Patient Care Essentials" document.
Alharbi, Jalal; Wilson, Rhonda; Woods, Cindy; Usher, Kim
The aim of the study was to explore the prevalence of burnout and job satisfaction among Saudi national critical care nurses. Burnout is caused by a number of factors, including personal, organisational and professional issues. Previous literature reports a strong relationship between burnout and job satisfaction among critical care nurses. Little is known about this phenomenon among Saudi national critical care nurses. A convenience sample of 150 Saudi national critical care nurses from three hospitals in Hail, Saudi Arabia were included in a cross-sectional survey. Saudi national critical care registered nurses reported moderate to high levels of burnout in the areas of emotional exhaustion and depersonalisation. Participants also reported a feeling of ambivalence and dissatisfaction with their jobs but were satisfied with the nature of their work. Saudi national critical care nurses experience moderate to high levels of burnout and low levels of job satisfaction. Burnout is a predictor of job satisfaction for Saudi national critical care nurses. These results provide clear evidence of the need for nurse managers and policy makers to devise strategies to help nurses better cope with a stressful work environment, thereby also improving job satisfaction among Saudi national critical care nurses. © 2016 John Wiley & Sons Ltd.
Isaksen, Lise Widding
This article argues that international nurse recruitment from Latvia to Norway is not a win–win situation. The gains and losses of nurse migration are unevenly distributed between sender and receiver countries. On the basis of empirical research and interviews with Latvian nurses and families they left behind, this article argues that nurse migration transforms families and communities and that national health services now become global workplaces. Some decades ago feminist research pointed to the fact that the welfare state was based on a male breadwinner family and women’s unpaid production of care work at home. Today this production of unpaid care is “outsourced” from richer to poorer countries and is related to an emergence of transnational spaces of care. International nurse recruitment and global nurse care chains in Norway increasingly provide the labor that prevents the new adult worker model and gender equality politics from being disrupted in times where families are overloaded with elder care loads.
Lakanmaa, Riitta-Liisa; Suominen, Tarja; Perttilä, Juha; Ritmala-Castrèn, Marita; Vahlberg, Tero; Leino-Kilpi, Helena
To describe and evaluate the basic competence of graduating nursing students in intensive and critical care nursing. Intensive and critical care nursing is focused on severely ill patients who benefit from the attention of skilled personnel. More intensive and critical care nurses are needed in Europe. Critical care nursing education is generally postqualification education that builds upon initial generalist nursing education. However, in Europe, new graduates practise in intensive care units. Empirical research on nursing students' competence in intensive and critical care nursing is scarce. A cross-sectional survey design. A basic competence scale (Intensive and Critical Care Nursing Competence Scale, version 1) and a knowledge test (Basic Knowledge Assessment Tool, version 7) were employed among graduating nursing students (n = 139). Sixty-nine per cent of the students self-rated their basic competence as good. No association between self-assessed Intensive and Critical Care Nursing-1 and the results of the Basic Knowledge Assessment Tool-7 was found. The strongest factor explaining the students' conception of their competence was their experience of autonomy in nursing after graduation. The students seem to trust their basic competence as they approach graduation. However, a knowledge test or other objective method of evaluation should be used together with a competence scale based on self-evaluation. In nursing education and in clinical practice, for example, during orientation programmes, it is important not only to teach broad basic skills and knowledge of intensive and critical care nursing, but also to develop self-evaluation skills through the use of special instruments constructed for this purpose. © 2013 John Wiley & Sons Ltd.
AIMS AND OBJECTIVES: The aim of this phenomenological study was to explore the emotions experienced by children\\'s nurses when caring for children with burns, in addition to ascertaining how the nurses dealt with these emotions. BACKGROUND: The nature of nursing practice is such that it inevitably generates some form of emotional response in nurses. The literature reveals that the manner nurses deal with their emotional experiences can impact on their nursing care. DESIGN: The study used Husserlian phenomenology to explore the emotional experiences of eight purposively selected children\\'s nurses who have worked on the burns unit of an Irish paediatric hospital. METHODS: Data were collected using in-depth, unstructured interviews and analysed using Colaizzi\\'s seven stage framework. RESULTS: The phenomenon of participants\\' emotional experiences is captured in four themes: (1) caring for children with burns, (2) supporting parents, (3) sustaining nurses\\' emotional well-being, and (4) learning to be a burns nurse. Nursing children with burns generated a myriad of emotions for participants. Burns dressing-changes, managing burn-related pain, supporting parents and the impact of busy workloads on the emotional care of children and their parents emerged as the most emotionally challenging aspects of participants\\' role. Participants recognised the need to manage their emotional responses and spoke of the benefits of a supportive nursing team. CONCLUSIONS: The findings offer insights into both the rewarding and challenging aspects of nursing children with burns. Nurses in this environment must be supported to recognise and manage their emotional responses to their work. RELEVANCE TO CLINICAL PRACTICE: Helping nurses to manage the emotional consequences of their work will help to sustain their emotional well-being, enhance the care received by children and also enable nurses to support parents in their role as partners in care.
Temkin-Greener, Helena; Zheng, Nan; Norton, Sally A.; Quill, Timothy; Ladwig, Susan; Veazie, Peter
Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities.…
Temkin-Greener, Helena; Zheng, Nan; Norton, Sally A.; Quill, Timothy; Ladwig, Susan; Veazie, Peter
Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities.…
Laura Johanson da Silva
Full Text Available OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management.METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed.RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (demotivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method.CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (discontinuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model.
Gielen, Joris; van den Branden, Stef; van Iersel, Trudie; Broeckaert, Bert
To adequately measure the attitudes of Flemish palliative care nurses toward euthanasia, and assess the relationship between these attitudes and demographic factors and the (perceived) influence of experience in palliative care on death anxiety. An anonymous questionnaire was sent to all nurses (n=589) employed in palliative care in Flanders, Belgium: 70.5% of the nurses (n=415) responded. A majority of the nurses supported the Belgian law regulating euthanasia but also believed that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care. Three clusters were discovered: staunch advocates of euthanasia (150 nurses, 41.1%); moderate advocates of euthanasia (135 nurses, 37%); and (moderate) opponents of euthanasia (80 nurses, 21.9%). An absolute opposition between advocates and opponents of euthanasia was not observed. A statistically significant relationship was found between the euthanasia clusters and years of experience in palliative care, and (perceived) influence of experience in palliative care on anxiety when a patient dies. Flemish palliative care nurses' attitudes toward euthanasia are nuanced and contextual. By indicating that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care, the nurses applied a 'palliative filter' a standard procedure in the case of a euthanasia request.
Ozbasaran, Ferda; Ergul, Safak; Temel, Ayla Bayik; Aslan, Gulsah Gurol; Coban, Ayden
To explore Turkish nurses' perceptions of spirituality and spiritual care and to investigate the relationship between their perceptions and their demographic/independent variables. Nurses' perception of spirituality can directly affect how they behave, deal with their patients and communicate with them in regard to the provision of spiritual care. Survey. This study employed a convenience sample of 348 staff nurses from the public hospitals in the west of Turkey. The data were collected with two tools; a 'sociodemographic data form' and the 'Spirituality and Spiritual Care Rating Scale' (SSCRS). The response rate was 92% (n = 319). The mean age of the nurses was 31·70 (SD 6·34) years and 22·9% of them had a Bachelor's degree. Among the nurses, 54·98% had ≥ 11 years of clinical experience. The mean score for the SSCRS was 3·21 (SD 0·63) which indicated that nurses' perceptions concerning spirituality and spiritual care were 'uncertain' or 'less clearly' defined. Significant differences were found between nurses' perceptions of spirituality and spiritual care and their ages (p evil eye and department of employment appeared to have a positive impact on their perception of spirituality and spiritual care. These findings will enable nurses to consider the importance of spirituality and spiritual care. Grasping these concepts will enable nurses to become more sensitive in their daily practices of spiritual care. © 2011 Blackwell Publishing Ltd.
Inga E. Larsson
Full Text Available Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT was employed. Interviews were performed with patients (=17, recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.
Solano Ruiz, Ma C; Hernández Vidal, P; Vizcaya Moreno, Ma F; Reig Ferrer, A
The concept of the "Burnout Syndrome" has come as a result of the chronic work-stress developed in workers involved in human services during their professional activity. The working conditions and the specific characteristics of the job developed at the Intensive Care Units by the nursing staff, involve a high risk for this group to acquire this syndrome. The main objective of this study is to assess the prevalence of the Burnout Syndrome in the nursing staff of the ICUs in different hospitals of the Alicante province, Spain, by means of the Malsach Burnout Inventory questionnaire. This questionnaire is self-administered and was handed to all the nursing staff at the ICUs in the University Hospitals of Alicante and Elche and in the Hospital Marina Baixa of Villajoyosa. form the total of 107 questionnaires, 83 proved to be valid. The average total of MBI was of 55.05, indicating low values of emotional tiredness, low depersonalisation, and an adequate level of personal accomplishment.
Habjanić, Ana; Elo, Satu; Micetić-Turk, Dusanka; Isola, Arja
The aim of this study was to explore nursing staffs' perceptions of the physical and psychological care needs of elderly residents, their views on the relative importance of these needs and their perceived ability to meet them. The literature reveals that the quality of elder care in nursing homes should comprise both physical and psychosocial care. Despite this, the nursing staffs' perceptions of the physical and psychosocial care provision have not often been researched. As a method cross-sectional research design was used, with structured questionnaires and unstructured interviews. Our sample consisted of members of the nursing staff from four nursing homes in Slovenia (survey: N = 148; interview: N = 16). The resulting data was processed by means of statistical analysis and conventional content analysis. The nursing staff reported more knowledge of, skills with and willingness to meet residents'physical needs than psychosocial needs. On the other hand, communication, conversation, self-care and a home-like environment were considered by nursing staff as marking quality elder care. Consequently, nursing home administrators should try to strengthen psychosocial care provision to improve the residents' quality of life. Conversation, as the most often recognised aspect of psychosocial care, should be promoted, since improvements in this area would not be costly, and each nursing staff member may decide individually how best to include more conversation in the daily routines of elder care provision.
dos Santos, Raquel Bezerra; Ramos, Karla da Silva
This is a descriptive and exploratory study with a quantitative approach, aiming to propose a protocol for the systematization of nursing care to women in the process of giving birth in the Obstetrical Center of a public hospital in Recife, Pernambuco, Brazil. A semi-structured instrument was applied to forty women in the process of giving birth, in order to obtaining the nursing history; from which the nursing diagnoses were identified, having as a basis the International Classification for Nursing Practice (ICNP®), version 1, and their respective results and nursing interventions were established. The protocol consists in two stages: the first one is the nursing consultation, which involves the anamnesis and physical examination; and the second, involves the judicious identification of the nursing diagnoses, which will guide the planning of the nursing care to provide the individualized attention to women in the process of giving birth, using a universal terminology.
Santos, Carla Cristina Viana; Shiratori, Kaneji
The present study is linked to the Center for Researching and Testing in Nursing at the Nursing School Alfredo Pinto - UNIRIO, and it started during the development of a monograph. The object of the study is the meaning of non-verbal communication under the optics of the nursing course undergraduates. The study presents the following objectives: to determine how non-verbal communication is comprehended among college students in nursing and to analyze in what way that comprehension influences nursing care. The methodological approach was qualitative, while the dynamics of sensitivity were applied as strategy for data collection. It was observed that undergraduate students identify the relevance and influence of non-verbal communication along nursing care, however there is a need in amplifying the knowledge of non-verbal communication process prior the implementation of nursing care.
McHugh, Matthew D; Stimpfel, Amy Witkoski
As the primary providers of round-the-clock bedside care, nurses are well positioned to report on hospital quality of care. Researchers have not examined how nurses' reports of quality correspond with standard process or outcomes measures of quality. We assess the validity of evaluating hospital quality by aggregating hospital nurses' responses to a single item that asks them to report on quality of care. We found that a 10% increment in the proportion of nurses reporting excellent quality of care was associated with lower odds of mortality and failure to rescue; greater patient satisfaction; and higher composite process of care scores for acute myocardial infarction, pneumonia, and surgical patients. Nurse reported quality of care is a useful indicator of hospital performance. Copyright © 2012 Wiley Periodicals, Inc.
Zirleide Carlos Felix
Full Text Available The aim of the study was to investigate the principles of bioethics reported by nurses when caring for terminally ill patients. Exploratory research with qualitative approach, developed with fifteen nurses from an intensive care unit of a university hospital, in northeastern Brazil. Data collection was conducted between March and July 2013, through a form. Data were analyzed using the technique of content analysis, emerging the following thematic category: respect to the principles of autonomy, beneficence, non-maleficence and justice to take care of the terminally ill patients. The participating nurses valued these principles when caring for terminally ill patients, which reflect the ethical commitment of these professionals in the practice of nursing care. It is noteworthy that bioethical principles should guide the nursing care of human beings throughout their life cycle.
Willey, Jeffrey Allan
Published research suggests that the future of health care will be dependent on new technologies that serve to decrease the need for increased numbers of critical-care nurses while also increasing the quality of patient care delivery. The eCare technology is one technology that provides this service in the intensive care unit (ICU) setting. The…
Willey, Jeffrey Allan
Published research suggests that the future of health care will be dependent on new technologies that serve to decrease the need for increased numbers of critical-care nurses while also increasing the quality of patient care delivery. The eCare technology is one technology that provides this service in the intensive care unit (ICU) setting. The…
Nagington, Maurice; Luker, Karen; Walshe, Catherine
Ethical care is beginning to be recognised as care that accounts for the views of those at the receiving end of care. However, in the context of palliative and supportive district nursing care, the patients' and their carers' views are seldom heard. This qualitative research study explores these views. Data were collected through semi-structured interviews with 26 patients with palliative and supportive care needs receiving district nursing care, and 13 of their carers. Participants were recruited via community nurses and hospices between September 2010 and October 2011. Post-structural discourse analysis is used to examine how discourses operate on a moral level. One discourse, 'busyness', is argued to preclude a moral form of nursing care. The discourse of friendship is presented to contrast this. Discussion explores Gallagher's 'slow ethics' and challenges the currently accepted ways of measuring to improve quality of care concluding that quality cannot be measured.
Hedman, Maria; Häggström, Elisabeth; Mamhidir, Anna-Greta; Pöder, Ulrika
Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care. The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation. A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed. The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people. Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents
de Oliveira, Marília de Fátima Vieira; Carraro, Telma Elisa
Given the dimensions involving human care, this study aimed at providing a reflection on nursing care as an ontological possibility. In Heidegger we consider the concepts that underlie the foundation of his thought. These reflections offer theoretical resource that allows the recognition that live in the everyday actions of nursing is a challenge that leads us to a new look at the magnitude of care. However, the actions of care should not target only the perspective of a philosopher, but live with that thought in search of reflection, and find, scrutinizing everything you contribute to a nursing care committed to the right, with ethics, and with respect for others.
Full Text Available Background & Objective: Patient satisfaction is the main indicator of the quality of healthcare systems. Usually in pediatric works parents are questioned due to lack of appropriate scale. Therefore, this study was done to assess the children’s satisfaction themselves by drawing which is an applicable scale for them.Patients & methods: This study was done with 20 hospitalized children aged 6-12 This study was done with 20 hospitalized children aged 6-12 years in medical and surgical wards of Dr. Sheikh pediatrics hospital in Mashhad who were hospitalized at least for 2 days In order to gathering data a blank A4 size paper and 12 color pencils was given to participants and asked them to draw what they’ve been thinking about nursing and their interventions. Each drawing was analyzed based on Plander et al scale (2007. The scale has content validity and reliability of α=0.89.Results: Most of participants were boys (65%, and hospitalized in medical wards (60%.In patient’s room no entertainment tools, toys or even readings were drawn. In all drawings the child was happy and in most was resting on a bed instead of playing or sitting (80%, 20%, and 0.0%, respectively. Conclusion: Drawing is a good and reliable source for assessing the quality of pediatric nursing care. So, suggested its usage in order of assessing children’s opinions in different matters relating to their care.
Eryl Zac Maunder
Full Text Available This article explores the emotional labor involved for nurses providing palliative care for children/young people living with life-limiting illnesses/conditions, and their families. It highlights the challenges nurses face in managing their emotion when caring for children/young people and their families, and explores strategies to enable nurses to cope with this aspect of their role without compromising their personal wellbeing. It suggests that emotional labor within nursing goes largely unrecorded, and remains undervalued by managers and health care services.
Full Text Available Introduction: A nurse who experience burnout feelings will influence their motivation, and quality performance. This situation is probably affecting a decline in work quality towards the caring behaviour demonstrated by nurses to their patiens, particularly for a nurse who are working in the long-stay installation room facing directly to patient's problems. The purpose of this research is to identify the work stress level of nurse towards the nurse's caring behaviour in the long-stay installation room (IRNA in general hospital in Malang. Method: This research used descriptive – correlational, the sampling was Non Probability Purposive Sampling with 93 nurses as the corresponds. The data was analyzed by operating Correlation Pearson, with a significance of p < 0.05. Result: The result found that there was a substantial correlation between the work stress level and the nurse's caring behaviour with p = 0.008 and r = -0.274, and it was a negative correlation. Discussion: It means that when the stress level of nurses will declined, the nurse's caring behavior automatically will beamplified. Conversely, if the stess level of nurses intensively increased, the nurse's caring behaviour become decreased. Thus, this research is needed to be analyzed further in order to asses the quality of caring behaviour by expanding the connected indicator and variable. It is aimed to improve the professionalism and quality of nurses in giving the best service to patients this research need to be continued further in order to asses the quality of nurse's caring behavior by expanding the variable, which is related to internal factors, such as knowledge, perception, emotion, ect and also connected to external factors, such as environment, both physically and non physically like: climate, human being, social economic, culture and ect.
Reza Zeighami; Mostafa Shokati Ahmadabad; Aref Mohammadian; Mahmoud Alipoor Heydari; Hossein Rafiei
Background and aims: In order to plan for preventing and decreasing the rate of nursing errors, understanding of nurse’s perception of nursing errors could be very helpful. This study was thus designed to examine the critical care nurses perception of nursing errors from view point of critical care nurses. Methods: This study was conducted in 9 hospitals in Qazvin province located in north of Iran. Using convenience sampling, all registered nurses who worked in critical care units were inv...
Rosa del Socorro Morales-Aguilar
Full Text Available Introduction: the theoretical and methodological components are the proper expertise in nursing, and it refers to models, theories, care process, taxonomy of nursing diagnoses, system of nursing intervention classification, and system of outcomes classification, which base nursing care into professional practice. Methodology: research was performed on Google Scholar, reviewing the databases of Scielo, Ciberindex, Index Enfermería, Dialnet, Redalyc, Medline, identifying 70 published articles between 2005-2015, and selecting 52 of them. The keywords used were: nurse care, nursing diagnostic, classification, nursing theory, in spanish and portuguese. Results: training students, receive knowledge in the nursing process, NANDA International, classification of the interventions, nurse results and theoretical components. The Dorothea Orem, Callista Roy, Nola Pender, Virginia Henderson, Florence Nightingale, and Betty Neuman theories are applied. The application of the nursing process is limited and low familiarity with the international taxonomy by nurse professionals in the assistance area is noticed. Conclusions: the challenge of nursing is to continue to solidify the scientific knowledge and to undo the gap between theory and practice.
Loke, Jennifer C F; Lee, Kah Wai; Lee, Bryant K; Mohd Noor, Asmah
In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care.
Goodman, Claire; Robb, Nadia; Drennan, Vari; Woolley, Rosemary
Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to
J. N. Gwala
Full Text Available The number of nurses entering the nursing profession is decreasing, but demands placed upon the Health Services are increasing primarily due to the increasing number of people in our society. People are living longer and it is apparent that some extra provision must be made to care effectively for the elderly members of our society. Various studies have shown that care of the elderly is an unpopular clinical field for nurses. (Shape, 1986. Notter, 1992. Vickels 1982.
J. N. Gwala; B. M. Zungu; B. B. Ntombela
The number of nurses entering the nursing profession is decreasing, but demands placed upon the Health Services are increasing primarily due to the increasing number of people in our society. People are living longer and it is apparent that some extra provision must be made to care effectively for the elderly members of our society. Various studies have shown that care of the elderly is an unpopular clinical field for nurses. (Shape, 1986. Notter, 1992. Vickels 1982).
Crocker, Cheryl; Timmons, Stephen
This paper is a report of a study to identify the meaning for critical care nurses of technology related to weaning from mechanical ventilation and to explore how that technology was used in practice. The literature concerned with the development of critical care (intensive care and high dependency units) focuses mainly on innovative medical technology. Although this use of technology in critical care is portrayed as new, it actually represents a transfer of technology from operating theatres. An ethnographic study was conducted and data were collected on one critical care unit in a large teaching hospital over a 6-month period in 2004. The methods included participant observation, interviews and the collection of field notes. The overall theme 'The nursing-technology relation' was identified. This comprised three sub-themes: definition of technology, technology transferred and technology transformed. Novice nurses took a task-focussed approach to weaning, treating it as a 'medical' technology transferred to them from doctors. Expert nurses used technology differently and saw its potential to become a 'nursing technology'. Nurses need to examine how they can adapt and to 'reconfigure' technology so that it can be transformed into a nursing technology. Those technologies that do not fit with nursing may have no place there. Rather than simply extending and expanding their roles through technology transfer, nurses should transform those technologies that preserve the essence of nursing and can contribute to a positive outcome for patients.
assess (a) any nursing imbalance and shortage and (b) the quality of nursing education ... future shortfalls, and develop strategies to recruit, educate .... workers, teachers and physicians, less than ..... learning materials are few and there is a.
Last month, Aysha Mendes discussed the impact on care of personal beliefs held by both nurses and patients. This month, she delves into the aspects of culture and religion, which form important pieces of this puzzle, as well as the importance of culturally appropriate care provision in nursing practice.
Using spiritual and religious resources gives patients and families strength to cope during a crisis, but nurses often do not offer spiritual care (Kloosterhouse & Ames, 2002). The purpose of this phenomenological study was to explore nurses" lived experience of giving spiritual care. A descriptive phenomenological approach was used to…
Thóra van der Hafsteinsdóttir; Cokky van der Venne; Yvonne van der Zalm; Nienke Kool; Willem Nugteren; prof Berno van Meijel
PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to
Corso, Nair Assunta Antônia; Gondim, Ana Paula Soares; Dalmeida, Patrícia Chagas Rocha; Albuquerque, Maria Girlene de Freitas
An experience report of nurses in the implementation of care systematization in ambulatory care in an interdisciplinary care center for patients with multiple sclerosis of a public hospital in Fortaleza, Ceará, Brazil. This implementation is based on the NANDA International, Inc., Nursing Interventions Classification, and Nursing Outcomes Classifications. One of the results concerns systemized nursing care, which has enabled the identification and understanding of the responses of MS patients to potential and current health problems. Systematization entails expanding knowledge through a practice based on approach and encourage further research scientific evidence, in addition to promoting the role of the nurse in acomprehensive approachand encourage further research.
Steyer, Nathalia Helene; Oliveira, Magáli Costa; Gouvêa, Mara Regina Ferreira; Echer, Isabel Cristina; Lucena, Amália de Fátima
Objective To analyze the clinical profile, nursing diagnoses, and nursing care established for postoperative bariatric surgery patients. Method Cross-sectional study carried out in a hospital in southern Brazil with a sample of 143 patients. Data were collected retrospectively from electronic medical records between 2011 and 2012 and analyzed statistically. Results We found a predominance of adult female patients (84%) with class III obesity (59.4%) and hypertension (72%). Thirty-five nursing diagnoses were reported, among which the most frequent were: Acute Pain (99.3%), Risk for perioperative positioning injury (98.6%), and Impaired tissue integrity (93%). The most frequently prescribed nursing care were: to use protection mechanisms in the surgical patient positioning, to record pain as 5th vital sign, and to take vital signs. There was an association between age and comorbidities. Conclusion The nursing diagnoses supported the nursing care prescription, which enables the qualification of nursing assistance.
Solvoll, Betty-Ann; Heggen, Kristin M
Care has always been a key element of nursing. This paper presents findings from research on the following issue: What opportunities and limitations do nursing students encounter when learning nursing care? The study has a qualitative design with field methodology and the study of documents. Six nursing students have been closely monitored during their clinical studies in hospitals, nursing homes and home-based nursing. The study shows that nursing students are likely to possess the potential to provide care for sick and unknown people. The motivation for their commitment to patients may contain an egoistical orientation and runs contrary to former ideals of the nurse's self-sacrificing altruism. Moreover the study shows that there is a potential in the clinical field and in the university college to reflective considerations on experience of care. While clinical practice often has focus on practical problem-solving and procedures, the college tends to focus on abstract theory. Both of these promote the privatisation and neglect of the students' experience of care. The paper concludes with a call for teaching and learning strategies targeting the use of nursing students' personal experience of care.
Andersson, Ewa K; Sjöström-Strand, Annica; Willman, Ania; Borglin, Gunilla
To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic--particularly in the context of coronary care--is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Qualitative descriptive study. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values. © 2015 John Wiley & Sons Ltd.
Scardina, S A
Rising health care costs and competition among hospital facilities have resulted in the need to recognize patient satisfaction as an important indicator of quality care. Nurses provide the primary service to patients; therefore, their role is influential in overall satisfaction. Several instruments have been developed to measure patient satisfaction with nursing care; however, most of them focus only on patient perceptions. One such approach to evaluating patient satisfaction with nursing care involves an instrument, SERVQUAL, derived from a marketing service perspective. Adapting SERVQUAL for use in evaluating nursing care is the focus of this article. SERVQUAL assesses both patient perceptions and expectations of quality service and permits managers and clinicians to view the gaps between the two; thus, the overall areas of improvement in nursing services can be determined.
Faeda, Marília Silveira; Perroca, Márcia Galan
analyze agreement between nursing prescriptions recorded in medical files and patients' care needs; investigate the correlation between the nurses' professional background and agreement of prescriptions. descriptive study with quantitative and documentary approach conducted in the medical clinic, surgical, and specialized units of a university hospital in the interior of São Paulo, Brazil. The new validated version of a Patient Classification Instrument was used and 380 nursing prescriptions written at the times of hospital admission and discharge were assessed. 75% of the nursing prescriptions items were compatible with the patients' care needs. Only low correlation between nursing prescription agreement and professional background was found. the nursing prescriptions did not fully meet the care needs of patients. The care context and work process should be analyzed to enable more effective prescriptions, while strategies to assess the care needs of patients are recommended. analisar a concordância entre prescrições de enfermagem, registradas nos prontuários, e as necessidades de cuidados dos pacientes; investigar a correlação entre o perfil profissional dos enfermeiros e a concordância das prescrições. estudo descritivo com abordagem quantitativa e documental, realizado em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino, no interior do Estado de São Paulo. Foi aplicada a nova versão validada do Instrumento de Classificação de Pacientes e, posteriormente, investigadas 380 prescrições de enfermagem no momento da admissão e alta hospitalar. foi identificado que 75% dos itens das prescrições de enfermagem estavam compatíveis com as necessidades cuidativas dos pacientes. Encontrou-se baixa correlação entre a concordância da prescrição de enfermagem e o perfil profissional. as prescrições de enfermagem não estão sendo realizadas, em sua totalidade, em consonância com as necessidades dos pacientes. Para
Bachrach-Lindström, Margareta; Jensen, Sara; Lundin, Rickard; Christensson, Lennart
The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care. Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long-term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs. A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five-point Lickert-type scale. It gives a total score and five subscales representing the dimensions 'Norms', 'Habits', 'Assessment', 'Intervention' and 'Individualization'. A higher score indicates a more positive attitude. Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The 'Intervention' dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The 'Norms' dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did. Nutritional issues comprise an important and time-consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further. Relevance to clinical practice. Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an
King, Phyllis Ann; Thomas, Sandra P
This existential phenomenological study explored caring for the dying based on the philosophical works of Merleau-Ponty. Fourteen critical care nurses were asked to describe lived experiences of caring for dying patients. An encompassing theme of Promises to Keep emerged, with five subthemes, including the following: (a) promise to be truthful: "Nurses are in the game of reality," (b) promise to provide comfort: "I'll make him comfortable," (c) promise to be an advocate: "Just one more day," (d) "Promise that couldn't be kept," and (e) "Promise to remain connected." The essence of intensive care nurses' lived experience of caring for dying patients is captured in the theme Promises to Keep. Nurses accept the reality of death and express strong commitment to making it as comfortable, peaceful, and dignified as possible, despite critical care unit environments that foster a "paradigm of curing" rather than a "paradigm of caring.".
Bratt, M M; Broome, M; Kelber, S; Lostocco, L
High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. To explore the influences of nurses' attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses' perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients' families was the most frequently cited job stressor. Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.
Rashvand, Farnoosh; Ebadi, Abbas; Vaismoradi, Mojtaba; Salsali, Mahvash; Yekaninejad, Mir Saeed; Griffiths, Pauline; Sieloff, Christina
To develop an instrument for the assessment of safe nursing care (ASNC) within the Iranian context and psychometrically evaluate its reliability and validity. There is a need for a valid and reliable instrument to assess how nurses employ the components of safe nursing care in clinical practice in non-Western countries. This methodological study was conducted in two phases: (1) a qualitative phase of instrument development, and (2) a quantitative phase of psychometric evaluation of the assessment of safe nursing care (ASNC). The instrument's content validity was assessed by experts in the field of safe nursing care. The reliability of this instrument was examined using internal consistency reliability and intra-rater reliability analysis. Exploratory factor analysis was then conducted to establish the instrument's initial construct validity. The instrument developed was a questionnaire with 32 items. The Cronbach's alpha of the scale was 0.92, and Intra-class Correlation Coefficient for intra-rater reliability was 0.78. Exploratory factor analysis resulted in a four-factor solution: (1) evaluation of nursing skills, (2) assessing the patient's psychological needs, (3) assessing the patient's physical need, and (4) Assessing nurses' teamwork. The four factors accounted for 63.54% of the observed variance. The ASNC can be applied to a wide variety of settings because of the broad range of methods utilised to generate items and domains, its comprehensive consideration of the principles of safe care, and its initial reliability and validity. The ASNC can help nurse managers assess whether clinical nurses are prepared to apply their safe care skills in clinical practice. It can also be used by clinical nurses to assess their own and peers' practice to detect potential areas for improvement in nursing care and help nurse managers with planning appropriate quality improvement programmes. © 2016 John Wiley & Sons Ltd.
Ahluwalia, Sangeeta C; Schreibeis-Baum, Hannah; Prendergast, Thomas J; Reinke, Lynn F; Lorenz, Karl A
Nurses' involvement in family meetings in the intensive care unit is central to supporting consistent communication and shared understanding within the care team and with patients and patients' family members...
Knapp, Caprice A; Madden, Vanessa; Wang, Hua; Kassing, Kristin; Curtis, Charlotte; Sloyer, Phyllis; Shenkman, Elizabeth A
Several studies have investigated nurses' attitudes toward hospice and palliative care for adults, yet little information exists about pediatrics. Assessing pediatric nurses' attitudes is especially important in Florida, where a publicly funded pediatric palliative care program operates in eight cities across the State. The aims of this study were 1) to assess the attitudes toward hospice and palliative care, and 2) to examine the associations between sociodemographic and nursing care factors and nurses' attitudes toward hospice and palliative care. A cross-sectional research design using online and mail-in survey data was used to address the study aims. Surveys were conducted with 279 pediatric nurses across Florida. Bivariate results showed there were significant differences between the attitudes of pediatric nurses employed in a city with a pediatric palliative care program versus those not employed in a program site (p = 0.05). Multivariate analyses also showed that being employed in a program site increased attitudinal scores toward hospice and pediatric palliative care by 0.6 points. Beyond being employed in an area city where a pediatric palliative care program operates, results also suggest that having prior training in palliative care could alter nurses' attitudes, which might subsequently lead to increased referrals and improved outcomes for children and families.
Dunn, Karen S; Otten, Cecilia; Stephens, Elizabeth
To examine relationships among demographic variables and nurses attitudes toward death and caring for dying patients. Descriptive and correlational. Two metropolitan hospitals in Detroit, MI. 58 RNs practicing in oncology and medical/surgical nursing. The majority was female and white, with a mean age of 41 years. Completed survey of three measurement tools: a demographic survey, Frommelt Attitudes Toward Care of the Dying (FATCOD) Scale, and Death Attitude Profile Revised (DAP-R) Scale. Of 60 surveys distributed, 58 were completed and returned. Past experiences (level of education and death training), personal experiences (age, race, religion, and attitudes toward death), professional experiences (months or years of nursing experience and the percentage of time spent in contact with terminally ill or dying patients), and attitudes toward caring for dying patients. Most respondents demonstrated a positive attitude about caring for dying patients. Nurses who reported spending a higher percentage of time in contact with terminally ill or dying patients reported more positive attitudes. No significant relationship was found between nurses attitudes toward death and nurses attitudes about caring for dying patients. Statistically significant relationships were found among certain demographic variables, DAP-R subscales, and FATCOD Scale. Regardless of how the nurses felt about death, providing professional and quality care to dying patients and their families was salient. Developing continuing education programs that teach effective coping strategies to prevent death anxiety and identifying barriers that can make caring for dying patients difficult may make the journey from novice to expert nurse a gratifying and rewarding experience.
Chen, Li-Wu; Shea, Dennis G
Using a modified hybrid short-term operating cost function and a national sample of nursing homes in 1994, the authors examined the scale economies of nursing home care. The results show that scale economies exist for Medicare postacute care, with an elasticity of -0.15 and an optimal scale of around 4,000 patient days annually. However, more than 68 percent of nursing homes in the analytic sample produced Medicare days at a level below the optimal scale. The financial pressures resulting from the implementation of a prospective payment system for Medicare skilled nursing facilities may further reduce the quantity of Medicare days served by nursing homes. In addition, the results show that chain-owned nursing homes do not have lower short-term operating costs than do independent facilities. This indicates that the rationale behind recent increasing horizontal integration among nursing homes may not be seeking greater cost efficiency but some other consideration.
Community palliative care nurses in Perth have joined the throng of healthcare workers relying on personal digital assistants (PDAs) to store, access and send client information in 'real time'. This paper is guided by Heidegger's approach to technologies and Habermas' insights into the role of law in administering social welfare programs to reveal how new ethical and legal understandings regarding patient information add to nursing's professional responsibilities. This qualitative research interprets data from interviews with twenty community palliative care nurses about clients' legal rights to informational privacy and confidentiality. It explores nurses' views of their nursing responsibilities regarding clients' legal rights, liability issues, bureaucratic monitoring and enforcement procedures. It concludes that nurses and clients are construed as legal subjects entrenched in legal relations that have magnified since these nurses began using PDAs in 2005/2006. © 2011 Blackwell Publishing Ltd.
Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty
Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.
Full Text Available Background Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. Objectives This study aimed to audit nursing care based on a nursing process model. Patients and Methods This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses’ compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. Results The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses’ age (r = 0.26, P = 0.001 and work experience (r = 0.273, P = 0.001. Conclusions Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools.
D.Cur. The goal of this research was to generate and describe a support approach for the advanced practitioner in psychiatric nursing to utilize for the neonatal intensive care nurse, working in a neonatal intensive care unit, in order to promote, to maintain and to restore mental health as integral part of health. Many changes occurred in the health care industry during the twentieth century. In South Africa, health care and social services that have developed, are grossly inefficient and...
Jeffers, Stephanie; Ferry, Dawn
An elective course titled "Nursing Care at the End of Life" was designed for fourth-year nursing students in a baccalaureate nursing program. This course, taught by the authors, was designed to teach students about caring for the dying patient. Students were required to complete service learning with patients in a hospice or hospital setting. Students reported having a positive learning experience and gaining new knowledge and a deeper understanding of the needs of dying patients and their families.
In an effort to clearly defi ne the constructive concepts of self-care among nursing students, in the present study a survey was conducted a survey of 655 individuals, comprised of 260 college nursing students and 395 vocational school nursing students. We found four factors of constructive concepts of self-care among nursing students, which included maintaining diet, coping with stress, maintaining habits and regulating lifestyle patterns, and maintaining interpersonal relationships.
Simmonds, Anne H
The Canadian Nurses' Association Code of Ethics (2008) and the College of Registered Nurses of Nova Scotia (CRNNS) Standards of Practice for Registered Nurses (CRNNS 2011) identify the provision of safe, compassionate, competent and ethical care as one of nursing's primary values and ethical responsibilities. While compassion has historically been viewed as the essence of nursing, there is concern that this has become an abstract ideal, rather than a true reflection of nursing practice. This paper describes a compassionate care initiative undertaken by the CRNNS and the initial outcomes of these educational workshops. This work is informed by an exploration of the multiplicity of factors that have brought this issue to the fore for nursing regulators, educators, administrators, the public as well as front-line staff. The two most significant areas of learning reported by workshop participants included understanding the connection between mindfulness, non-judgmental care and compassion/self-compassion and recognizing possibilities for action related to compassionate care, even in the face of personal and environmental constraints. Implications for nursing regulators and leaders include consideration of their roles and responsibilities in supporting nurses to meet professional practice standards, such as provision of compassionate care.
Ikegami, Naoki; Ikezaki, Sumie
To describe end-of-life care in Japanese nursing homes by comparing facility and characteristics of residents dying in nursing homes with those who had been transferred and had died in hospitals, and by comparing the quality of end-of-life care with hospitals and with their respective counterparts in the United States. National sample of 653 nursing homes with responses from 371 (57%) on their facility characteristics, 241 (37%) on their resident characteristics, and 92 (14%) on the residents' quality of life. All 5 hospitals in a city 80 miles from Tokyo cooperated. Nursing home staff answered questionnaires on facility and resident characteristics. Resident level data were obtained from 1158. The questionnaire on the quality of care was responded to by 256 (63%) of the decedents' families in nursing homes and 205 (48%) in hospitals. Facility characteristics included items on physicians, nurse staffing, and the facility's end-of-life care policy. Resident characteristics included basic demographics, level of dementia, and resident's and family's preference for the site of death. The Toolkit was used to measure the quality of end-of-life care. The proportion of those dying within the nursing home was related to the facility's policy on end-of-life care and the family's preference. The quality of end-of-life care in nursing homes was generally better than in hospitals, and than in their respective counterparts in the United States. Financial incentives by the Japanese government to promote end-of-life care in nursing homes may have contributed to increasing the proportion of deaths within the facility. The quality of care in nursing homes was evaluated as being better than hospitals. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
Feet are not necessarily the most attractive part of the body as it ages, and given the choice, most older adults would rather ignore them. In fact, many older adults cannot even see them, reach them, or care for them properly. And when they ache or look misshapen and oddly colored; well, that's just part of growing old, isn't it? The feet are important for weight bearing, balance, and mobility. Over an average life span, the feet are subject to considerable stress and trauma. Age-related changes of the foot predispose the older adult to discomfort if not pain, fungal infection, reduced range of motion, and itchy dry skin. More than three fourths of older adults (i.e., those age over 65 years) complain of foot pain that is associated with a significant foot problem and have evidence of arthritic changes on x-ray. Impaired ambulation can make the difference between independence versus dependency on others, engagement versus isolation. Assisted living is about choices. Being unable to get where one wants to go or do what one wants to do because of foot problems is a barrier to full enjoyment of the opportunities in assisted living communities. This article describes foot problems associated with aging, diabetes, nursing assessment of the feet, and nursing interventions in the service of accessing and optimizing choices for quality of life.
Full Text Available Terrah L Foster,1,2 Cynthia J Bell,1 Carey F McDonald,2 Joy S Harris,3 Mary Jo Gilmer,1,21Vanderbilt University School of Nursing, Nashville, 2Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, 3Vanderbilt University, Nashville, TN, USAAbstract: Pediatric palliative care aims to enhance life and decrease suffering of children and adolescents living with life-threatening conditions and their loved ones. Oncology nurses are instrumental in providing palliative care to pediatric oncology populations. This paper describes pediatric palliative care and provides an overview of literature related to the physical, psychological, social, and spiritual domains of palliative nursing care for children and adolescents with cancer. Nurses can provide optimal palliative care by accounting for children's understanding of death, encouraging early initiation of palliative care services, and improving utilization of pediatric palliative care in cancer settings. Specific roles of registered nurses and advanced practice nurses in pediatric palliative care will be addressed. Recommendations for future research are made to further advance the science of pediatric palliative care and decrease suffering for children and teens with cancer.Keywords: pediatric palliative care, pediatric cancer, oncology, child, suffering
Charles, Kerwin Kofi; Sevak, Purvi
Informal care should be a substitute for nursing homes but empirical evidence often suggests the opposite. This may be because informal care receipt is positively correlated with unobserved negative health characteristics. We exploit variation in children's characteristics as instruments for informal care to provide Two-Stage Least Squares (TSLS) estimates of nursing home use among a sample of 6855 individuals from the 1993-2000 waves of the AHEAD survey. While OLS results suggest informal care is associated with greater future nursing home risk, TSLS estimates show that receipt of informal care statistically and substantially reduces the risk of nursing home entry. This finding has implications for Medicaid and private long-term care insurance markets.
Rouleau, Geneviève; Gagnon, Marie-Pierre; Côté, José; Payne-Gagnon, Julie; Hudson, Emilie; Dubois, Carl-Ardy
Despite the well-known advantages of information and communication technologies (ICTs), their overall impact on nursing care has not been synthesized. The objective of this overview of systematic reviews is to summarize the best evidence regarding the effects of ICTs on nursing care. We considered quantitative, qualitative and mixed-method reviews published since January 1995. Two reviewers independently screened the title and abstract of 5515 papers to assess their eligibility. From these, 72 full-text papers were evaluated and 28 publications met the inclusion criteria. Three reviewers extracted and compared their data. Preliminary results show that the following dimensions of nursing care are the most frequently reported: assessment, care planning and evaluation, documentation time, quality of care and patient safety. This overview provides a starting point from which to compare and contrast findings of separate reviews regarding the positive, neutral and negative effects of ICTs on nursing care.
Issel, L Michele; Bekemeier, Betty
Patient safety, a cornerstone of quality nursing care in most healthcare organizations, has not received attention in the specialty of public health nursing, owing to the conceptual challenges of applying this individual level concept to populations. Public health nurses (PHNs), by definition, provide population-focused care. Safe practice of population-focused nursing care involves preventing errors that would affect the health of entire populations and communities. The purpose of this article is to conceptually develop the public health nursing concept of safe practice of population-focused care and calls for related research. Key literature on patient safety is reviewed. Concepts applying to population-focused care are organized based on Donabedian's Framework. Structural, operational and system failures and process errors of omission and commission can occur at the population level of practice and potentially influence outcomes for population-patients. Practice, research and policy implications are discussed. Safe PHN population-focused practice deserves attention.
Chou, Hsueh-Fen; Kao, Chien-Huei; Gau, Meei-Ling
Epigenetics is a field of biomedicine that expanded tremendously during the 1980s. Epigenetics is the study of heritable changes in gene expression independent of underlying DNA (DeoxyriboNucleic Acid) sequence, which not only affect this generation but will be passed to subsequent generations. Although conception is the critical moment for making decisions regarding gene mapping and fetal health, studies have shown that perinatal nursing care practices also affect the genetic remodeling processes and the subsequent health of the mother and her offspring. To optimize maternal-infant and the offspring health, it is important to ensure that the new mother get adequate nutrition, reduce stress levels, adopt gentle birth practices, facilitate exclusive breastfeeding, and avoid contacting toxic substances.
De Carlo, Paola; Guerra, Denise; Rega, Maria Luisa; Galletti, Caterina
Scopo. Nella letteratura infermieristica internazionale compassion e compassionate care hanno assunto una notevole importanza e si rivelano essere un fenomeno in divenire. Il concetto di compassionate nursing care risulta poco descritto ed oggettivato nella pratica infermieris-tica nel nostro Paese. Scopo di questo studio è stato di descrivere le esperienze di un campione di infermieri italiani circa il significato di cure infermieristiche compassionevoli. Metodo. È stato condotto uno studio qualitativo. Per la raccolta dei dati sono stati utilizzati i focus group, per analizzare i dati trascritti è stata utilizzata l’analisi di contenuto. Per lo studio è stato individuato un campione propositivo di 21 infermieri, di questi 15 hanno dato la disponibilità a partecipare. Risultati e discussione. Tutti i partecipanti hanno espresso liberamente le loro opinioni. Dall’analisi dei dati relativi alle quattro aree indagate con i focus group: definizione, la propria esperienza, tipologie di pazienti e formazione alle cure infermieristiche compassionevoli sono emersi aspetti contrastanti che variano da accezioni negative e negazione dei termini stessi a significati positivi di amore, carità, empatia, supporto, sostegno, relazione. Interessante ed innovativo è stato l’attribuire l’insegnamento delle cure compassionevoli ai parenti. Conclusioni. E’ risultato difficile per i partecipanti dare una definizione precisa sul significato di cure infermieristiche compassionevoli. E’ emersa la necessità e il desiderio di approfondire questo tema che risulta essere originale e un punto di forza per migliorare l’assistenza infermieristica. Infatti, puntare al recupero di questi valori educando gli infermieri ad erogare cure infermieristiche compassionevoli può sicuramente rappresentare un’implicazione futura per la professione.
Lamper-Linden, C; Goetz-Kulas, J; Lake, R
While hospitals evaluate ambulatory clinics as a revenue-generating service alternative, nursing executives develop new areas for nursing practice in nurse-managed clinics. The authors describe the five-year growth of a nurse-managed ambulatory clinic providing primary health care to those aged 55 and older. The discussion explains nurse practitioner leadership and practice, and accountability between professions. The concept and structure of services and marketing strategies are elated to the people served. Financial feasibility, cost containment, and other factors demonstrate the clinic's contribution to its sponsoring hospital.
Background: Risks assessments and subsequent assignment of interventions are important nursing tasks. Nurse-sensitive screening indicators, such as screening of delirium, screening of malnutrition, and pain assessments are therefore commonly used to benchmark nursing care quality. Previously,
Malucelli, Andreia; Otemaier, Kelly Rafaela; Bonnet, Marcel; Cubas, Marcia Regina; Garcia, Telma Ribeiro
It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional practice documentation. This paper describes the methodological steps and results of the information system development - requirements elicitation, modeling, object-relational mapping, implementation and system validation.
Moura, Denizielle de Jesus Moreira; Bezerra, Sara Taciana Firmino; Moreira, Thereza Maria Magalhães; Fialho, Ana Virgínia de Melo
This study aimed to identify the nursing care practices to the client with hypertension in the scientific production in the last ten years. It was carried out a bibliographic study, using in the BIREME, the LILACS, SciELO and BDENF's data basis, selecting thirty articles. The results were exposed in charts, tables and graphics, where prevails, in the literature analyzed, the nursing consultation as the more used practice, through the nursing attendance systematization and the Health Education with individual approaches, besides the realization of home visits with family approach. One believes that the systematization of nursing care will contribute in an expressive manner to the adhesion to the antihypertensive treatment.
Talbot, Rebecca; Brewer, Gayle
Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.
Galimany Masclans, Jordi; Garrido Aguilar, Eva; Roca Roger, Montse; Girbau García, M Rosa
To analyze the nurses make use of electronic health records (EHR) and assess their perception of it. A descriptive cross-sectional observational study was conducted in 2010 analyzing the nurses' perceptions of adult and pediatric consultations of primary health care teams in Baix Llobregat (Catalonia) in which the EHR is used. The study variables were: registration of care, continuity of care, training, usability and sociodemographic composition of the sample. The statistical analysis was descriptive. Nurses agree that EHR provides "continuity of care" in relation to nursing care (mean 2.03, Sd.0.83) and overall (mean 2.19, 5d.0.83). Show indifference to the "usability" of the EHR (mean 3.26, Sd.0.5), to facilitate the "record information" (mean 2.69, Sd.0.68) and the need for "training" in the use of EHR (mean 2.6, 5d.0.59). It has been found that with increasing age of the nurse, it shows more agreement that the EHR provides greater continuity of care overall. The average ratings of the continuum of care nurse, recording of information, continuity of care in general are greater the lead time using the EHR. The nurses' perceptions regarding the EHR are positive in that it provides continuity of care and to exchange information on patient health data.
Peter Mathieu Van Bogaert
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.
Song, Hyo-Suk; Choi, JiYeon; Son, Youn-Jung
Ineffective communication of critical care nurses can lead to higher levels of burnout and negatively affect quality of patient care and patient outcomes such as higher mortality. The purpose of this study is to describe the relationship between professional communication competences and nursing performance of critical care nurses in South Korea. This cross-sectional study collected data on 197 intensive care unit staff nurses in 3 tertiary academic medical centres in South Korea from July to November 2014. In the hierarchical regression analysis, the professional communication competences were the only significant predictors of nursing performance after adjusting for sociodemographic characteristics. In addition, the greater professional communication competences of nurses were associated with being older and having a higher education level, more years of overall clinical and intensive care unit experience, and a higher monthly salary. Our findings indicate that communication skills-related training should be included in the practical education to improve nursing performance for the quality of intensive care. Further research is needed to identify the comprehensive factors on professional communication competences of nurses in intensive care units. © 2017 John Wiley & Sons Australia, Ltd.
de Almeida Araújo, Iliana Maria; da Silva, Raimunda Magalhães; Bonfim, Isabela Melo; Fernandes, Ana Fátima Carvalho
The goal was to understand the nurse/patient communication process, emphasizing nursing care to mastectomized women. Symbolic Interactionism and Grounded Theory were used to interview eight nurses from a referral institution in cancer treatment, using the guiding question: how do nurses perceive their communication process with mastectomized women? Data analysis allowed for the creation of a central theory: the meaning of communication in nursing care to women, constituted by three distinct but inter-related phenomena: perceiving communication, the relationship nurse/mastectomized woman and rethinking the communication nurse/mastectomized woman. With a view to satisfactory communication, professionals need to get involved and believe that their presence is as important as the performance of technical procedures that relieve situations of stress.
Li-Ying, Jason; Paunova, Minna; Egerod, Ingrid
Aims This study investigates the influence of intensive care unit nurses’ knowledge sharing behaviour on nurse innovation, given different conditions of care quality control. Background Health-care organisations face an increasing pressure to innovate while controlling care quality. We have little...... nurses is encouraged to stimulate nurse innovations. Alternatively, managers may develop a climate where helping others, especially with younger colleagues, offsets the negative effects of strong process control....... insight on how the control of care quality interacts with the knowledge sharing behaviour of intensive care nurses to affect their innovative behaviours. Methods We developed a multi-source survey study of more than 200 intensive care nurses at 22 intensive care units of 17 Danish hospitals. Two versions...
Most hospitals are frantically planning recruitment strategies to attract new nurses for intensive care units. The direct cost associated with orientation of one of these nurses is estimated at greater than $2000, plus 6 months' to 1 year's salary per nurse. An interim strategy of using registered nurses to fill a full-time position for 1 year can cost upwards of $75,000 a year. Germane to the acclimatization of these nurses to the intensive care unit is the nurturing role of experienced nurses during the orientation and in assuring continuity of high-quality patient care. By virtue of their position, experienced nurses also model leadership behavior, and they are exposed to many day-to-day stresses that may leave them frustrated and feeling a lack of accomplishment. These factors, coupled with the scarcity of educational opportunities designed specifically for experienced nurses and a perceived absence of challenges, can lead to burnout. In this article I will describe an innovation in practice that uses the clinical nurse specialist role to stimulate and challenge experienced nurses. The program taught, supported, and nurtured unit-based change initiated by experienced nurses.
Fitzgerald, Ruth P
Doctor flight from rural areas is an international phenomenon that places great pressure on primary health care delivery. In New Zealand, the response to these empty doctors' surgeries has been the introduction of nurse-led rural health clinics that have attracted controversy both in the media and from urban-based doctors over whether such nurse-led care is a direct substitution of medical care. This article analyzes the reflections of nurses working in some of these clinics who suggest that their situation is more complex than a direct substitution of labor. Although the nurses indicate some significant pressures moving them closer to the work of doctoring, they actively police this cross-boundary work and labor simultaneously to shore up their nursing identities. My own conclusions support their assertions. I argue that it is the maintenance of a holistic professional habitus that best secures their professional identity as nurses while they undertake the cross-boundary tasks of primary rural health care. There are clear professional benefits and disadvantages for the nurses in these situations, which make the positions highly politicized. These recurring divisions of labor within medical care giving and the elaboration of new types of care worker form an appropriate although neglected topic of study for anthropologists. The study of the social organization of clinical medicine is much enriched by paying closer attention to its interaction with allied health professions and their associated understandings of "good" care.
Chu, Charlene H; Wodchis, Walter P; McGilton, Katherine S
To describe the relationship between nursing staff turnover in long-term care (LTC) homes and organisational factors consisting of leadership practices and behaviours, supervisory support, burnout, job satisfaction and work environment satisfaction. The turnover of regulated nursing staff [Registered Nurses (RNs) and Registered Practical Nurses (RPNs)] in LTC facilities is a pervasive problem, but there is a scarcity of research examining this issue in Canada. The study was conceptualized using a Stress Process model. Distinct surveys were distributed to administrators to measure organisational factors and to regulated nurses to measure personal and job-related sources of stress and workplace support. In total, 324 surveys were used in the linear regression analysis to examine factors associated with high turnover rates. Higher leadership practice scores were associated with lower nursing turnover; a one score increase in leadership correlated with a 49% decrease in nursing turnover. A significant inverse relationship between leadership turnover and nurse turnover was found: the higher the administrator turnover the lower the nurse turnover rate. Leadership practices and administrator turnover are significant in influencing regulated nurse turnover in LTC. Long-term care facilities may want to focus on building good leadership and communication as an upstream method to minimize nurse turnover. © 2013 John Wiley & Sons Ltd.
Ferrell, Betty; Malloy, Pam; Mazanec, Polly; Virani, Rose
Nurses spend the most time of any health care professional caring for patients and families dealing with the challenges of serious illness. The demand for nursing expertise in palliative care is growing as more people are living with chronic, life-limiting illnesses. Nursing faculty must prepare future nurses to meet this demand. The new American Association of Colleges of Nursing Palliative Competencies And Recommendations for Educating undergraduate nursing Students document, released February 2016, identifies the 17 competencies that all undergraduate nursing students should achieve by the time of graduation. This historic document is a revision of the 1998 American Association of Colleges of Nursing Peaceful Death document and is now the guiding framework for undergraduate nursing education. In an effort to support nursing faculty and prepare nursing students to deliver quality palliative care, an innovative, interactive on-line undergraduate End-of-Life Nursing Education Consortium (ELNEC) curriculum is under development and will be released in January 2017. This new curriculum will meet the competencies and recommendations for achieving those competencies outlined in the Competencies And Recommendations for Educating undergraduate nursing Students document.
Full Text Available This article will look at the theory of a Learning Organization as described by Senge and the Israeli Breast Care Nurses as an example. A description of the theory of a Learning Organization, the role of the Breast Care Nurses in Israel and the relation between the two will be described. Since 1996, the role of the Breast Care Nurse was founded in Israel. At that time, the role with its importance was very hard to be recognized by the health care team and other professionals of the multidisciplinary team for breast cancer patients. Since the role was initiated, it had been developing all over Israel through the support given by the Israel Cancer Association. As a learning organization, the Breast Care Nurses have a few goals: To learn to give patients the most updated and relevant information; to be a part and be seen as equal as the other members of the multidisciplinary team for breast cancer patients; to have knowledge which empowers them as a working group; to enable to teach students, mainly nursing students, in basic and further education and to help continually teach a new generation of nurses. This learning organization involves some formal and informal education. Although oncology nurses do much of the ideas we have described, we suggest using a strict model to help in implementing a Learning Organization. Future research can examine the outcomes of a Learning Organization on oncology nursing.
Monteiro, Estela Maria Leite Meirelles; da Nóbrega, Maria Miriam Lima; de Lima, Luciane Soares
This research aims at the systematization of nursing assistance under Orem's nursing theory of self-care deficit. In order to conduct this study, the convergent approach was used through the performance of the nursing processes in an adult with asthma. Interviews, physical examinations, observations, data record, observation of nursing assistance in policlinics along with home visits were the techniques used to gather data. After the observation of the nursing assistance, self-care deficits were identified and a new assistance plan and objectives were established, as well as a system and methods of support. The assistance plan was performed through the implementation of nursing assistance, prioritizing educational support. Based on the results, it was concluded that the application of the nursing processes through Orem's self-care referential is feasible and necessary for the engagement of clients and their family in self-care.
Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse\\'s experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse\\'s roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.
The aim of resuscitation is to sustain life with intact neurological functioning and the same quality of life previously experienced by the patient. Advanced cardiac life support (ACLS) was designed to achieve this aim. However the requirement for ACLS training for critical care nurses working in Canadian critical care units is inconsistent across the country. The purposes of this article are to explore the evidence surrounding ACLS training for critical care nurses and its impact on resuscitation outcomes, and to review the evidence surrounding ACLS knowledge and skill degradation with strategies to support code blue team efficiency for an effective resuscitation. Using the search terms ACLS training, resuscitation, critical care, and nursing, two databases, CINAHL and MEDLINE, were used. The evidence supports the need for ACLS training for critical care nurses. The evidence also supports organized ongoing refresher courses, multidisciplinary mock code blue practice using technologically advanced simulator mannequins, and videotaped reviews to prevent knowledge and skill degradation for effective resuscitation efforts.
Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret
Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.
Klever Souza Silva
Full Text Available The objective of this study was to identify the scientific article about the care of nursing to the family,published in periodic of Brazilian nursing, index-linked article survey to the LILACS, in the period of 1993 the 2003,and to analyze them how much to the concept and composition of the families, systematization and proposals ofaction of nursing and formation and qualification of the authors. In the results we find in 10 years (1993-2003, 9publications concerning nursing in family. Where we can find the predominance of works that focus thesystematization and proposals of action, evidencing of a general form, a lack of studies in the area of nursing infamily, where the Program of Health of the Family appears as principal source of promotion of care of nursing tothe family and motivation for studies that approach this thematic one. All research had had as authorship nursesdoctors, masters and specialists, which acted as professors.
This article explores mental health nurses' diabetes training needs. A survey of inpatient and community mental health nurses was undertaken using a 16-item self-reporting questionnaire. Two hundred and twenty questionnaires were sent out and 138 returned, providing a response rate of 63%. Analysis shows that mental health nurses are currently involved in a range of diabetes care activities, however, their knowledge and skills may not be up to date. Mental health nurses also report the growing impact of diabetes care on their workload. Areas of identified training needs include taking blood glucose readings, giving dietary advice, liaison with diabetes nurse specialists and weight management. Mental health services and education providers need to consider developing specific training courses for mental health nurses.
Nokes, Kathleen M; Aponte, Judith; Nickitas, Donna M; Mahon, Pamela Y; Rodgers, Betsy; Reyes, Nancy; Chaya, Joan; Dornbaum, Martin
Although there is general consensus that nursing students need knowledge and significant skill to document clinical findings electronically, nursing faculty face many barriers in ensuring that undergraduate students can practice on electronic health record systems (EHRS). External funding supported the development of an educational innovation through a partnership between a home care agency staff and nursing faculty. Modules were developed to teach EHRS skills using a case study of a homebound person requiring wound care and the Medicare-required OASIS documentation system. This article describes the development and implementation of the module for an upper-level baccalaureate nursing program located in New York City. Nursing faculty are being challenged to develop creative and economical solutions to expose nursing students to EHRSs in nonclinical settings.
Armero-Barranco, David; Ruiz-Mateos, María; Alcaraz-Baños, Miguel; Bernal-Páez, Fernando Luis
We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patient's hospital stay easier, more comfortable and less traumatic.
Otorhinolaryngologists began developing new operative techniques to minimize open surgical resections of the head and neck. While striving to reduce the morbidity and mortality associated with head and neck surgery and decrease the many psychosocial issues facing these patients, a new procedure defined as Transoral Robotic Surgery (TORS) was developed. With the development of new surgical techniques, nursing care must also change to meet the needs of the patient. As the TORS procedure becomes fully defined, so is nursing's role in the care of the patient. This paper aims to define TORS and discuss the nursing care of the patient undergoing this new surgical procedure.
Nordén, Charlotte; Hult, Karin; Engström, Åsa
Ambulance nurses work daily in both emergency and non-emergency situations that can be demanding. One emotionally demanding situation for ambulance nurses is to nurse children who are ill. The aim of this study was to describe ambulance nurses' experiences of nursing critically ill or injured children. Eight specialist ambulance nurses were interviewed and the interviews were analyzed using qualitative content analysis. The analysis resulted in one theme, a difficult aspect of ambulance nursing care, with five categories. The security of both child and parents was considered to be paramount. Ambulance nurses felt relieved when they handed over the responsibility and the child to the receiving unit. The ambulance nurses felt that more training, education and follow-up was desirable in order to increase their security when nursing children. Ambulance nurses are subject to stressful feelings while nursing children. As providing reassurance to the child and its parents is a cornerstone of the treatment, it is important for the ambulance nurses to take the time to build up a trusting relationship in such an encounter. Skill development in the area might lead to increased security and reduce the mental burden resulting from negative stress. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Introduction: Nurses' human traits and beliefs could help in better performance of their professional role. Care quality has been the most important priority of nursing whose promotion causes the patients satisfaction increase, efficiency increase and reduction of hospital costs. The present study was conducted for examining the relation between nurses' spiritual intelligence and nurses care quality in Estahban city. Study method: The study method used in this study is descriptive of correlation type and it was performed by accessible sampling method and participation of 80 nurses with bachelor and master's degree. 42- Question spiritual intelligence questionnaire of Badie et.al (2010 and Kioalpak nursing care quality (1975 was used that their reliability was confirmed by content method and their validity with Cronbach alpha method with coefficients 0.8 and 0.85 respectively. The relation between nurses' spiritual intelligence and nursing cares quality was examined by statistical test of Pearson correlation coefficient. Findings: There is a significant positive relation between spiritual intelligence and nursing cares quality ( p=0.00, r =0.502. There is a significant and positive relation between spiritual intelligence and communicational skills quality of nursing cares (p= 0.00, r = 0.398. There is a significant and positive relation between spiritual intelligence and mental and social quality of nursing cares (p=0.000, r = 0.366. Conclusion: Spiritual intelligence in reinforcing beliefs and personality of nurses could help in improving the quality of patients care. Therefore, benefiting from higher spiritual intelligence of nurses in workplace could be effective in promoting better performance and implementing of role which by itself leads to promotion of patients' health.
Eskes, Anne M; Maaskant, Jolanda M; Holloway, Samantha; van Dijk, Nynke; Alves, Paulo; Legemate, Dink A; Ubbink, Dirk T; Vermeulen, Hester
Health care professionals responsible for patients with complex wounds need a particular level of expertise and education to ensure optimum wound care. However, uniform education for those working as wound care nurses is lacking. We aimed to reach consensus among experts from six European countries as to the competencies for specialised wound care nurses that meet international professional expectations and educational systems. Wound care experts including doctors, wound care nurses, lecturers, managers and head nurses were invited to contribute to an e-Delphi study. They completed online questionnaires based on the Canadian Medical Education Directives for Specialists framework. Suggested competencies were rated on a 9-point Likert scale. Consensus was defined as an agreement of at least 75% for each competence. Response rates ranged from 62% (round 1) to 86% (rounds 2 and 3). The experts reached consensus on 77 (80%) competences. Most competencies chosen belonged to the domain 'scholar' (n = 19), whereas few addressed those associated with being a 'health advocate' (n = 7). Competencies related to professional knowledge and expertise, ethical integrity and patient commitment were considered most important. This consensus on core competencies for specialised wound care nurses may help achieve a more uniform definition and education for specialised wound care nurses.
Lavin, Mary Ann; Harper, Ellen; Barr, Nancy
The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made. In this article, we describe the experiential-reflective reasoning and action model used to understand staff nurses' perspectives, share committee reflections and recommendations for improving both documentation and documentation technology, and conclude by encouraging nurses to develop their documentation and informatics skills. Nursing issues include medication safety, documentation and standards of practice, and EHR efficiency. IT concerns include interoperability, vendors, innovation, nursing voice, education, and collaboration.
Laughlin, Candia Baker; Beisel, Marie
High-quality, accessible, and efficient primary care is needed as the U.S. health care system undergoes significant change. Advancing the role of registered nurses in the primary care setting is important to the solution. A large academic health center implemented five initiatives to improve the care of chronically ill patients through the expanded role of RNs in the context of the health care team. Role evolution of nurses in the pilots required some continuing education and some additional nursing support to release the pilot nurses from their usual duties. These strategies allowed the nurses to apply interventions that enhanced the coordination of care and promoted patient self-management skills. Some short-term improvements in health status were realized and barriers to self-care were identified and resolved.
Joosse LL; Palmer D; Lang NM
Laura L Joosse,1 Debra Palmer,1 Norma M Lang21University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, WI, USA; 2University of Wisconsin-Milwaukee, College of Nursing, Knowledge Based Nursing Research Initiative, Milwaukee, WI, USAAbstract: Elderly patients suffering from chronic cognitive decline/dementia are susceptible to poor quality of care which further erodes their quality of life. Seemingly benign events can create cascade iatrogenesis in those whose compensatory ability is c...
Prochnow, Adelina Giacomelli; Leite, Joséte Luzia; Erdmann, Alacoque Lorenzini
This paper presents a theoretical reflection on hospital nursing care management and Geertz' Interpretive Theory of Culture. We discuss some significant elements of culture in management, based on the theoretical reference frameworks of nursing, administration and anthropology. In these, the importance of cultural diversity is highlighted as an innovative resource to expand the vision of human integrity, valuing divergences, respect and sharing, which are important for nurses in the construction of their social practice.
Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi
and the nurses' reflections on GPNC: (1) GPNC provided in a treatment setting, (2) transition to loving care and the licence to perform palliative care (PC) and (3) potential for team improvement. Conclusions: GPNC as a culture in medical departments seemed to be embedded in a setting not suited for dying...... patients. Palliative care was still practised according to the transition model of care, sharply dividing curative from palliative care, and was inappropriately conducted in a fragmented and individual-based way. The term ‘loving care’ was used as a ‘gate-opener’ to provide palliative care for the dying......Background: In many countries, approximately half of the population dies in hospital, making general palliative nursing care (GPNC) a core nursing task. GPNC in the hospital setting is described as challenging, however little is known about its actual practice. Aim: To explore the GPNC culture...
Alanen, Seija; Ijäs, Jarja; Kaila, Minna;
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. METHOD: We assessed the style of implementation and adoption of the national...... Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as 'disseminators' (n = 13) or 'implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers...... were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. RESULTS: Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion...
de Andrade, Joseilze Santos; Vieira, Maria Jésia
Descriptive and qualitative study carried out to subsidize the implementation process of Nursing systematization in a University Hospital. It was used questionnaires approaching activities, perception on Nursing and customer, knowledge and application of the Nursing process and problems which are consequence of non systemized assistance. Results identified that the nurses activities are based on the technique and on the service administration; that nursing was related to the help of the human beings' basic needs and holism, being the customer defined as the one that needs care; that the majority of nurses knew, in theory, the Nursing process, but did not apply it in practice. The most mentioned problems which were consequence of the non systemized assistance were the following: the quality assistance detriment, the service disorganization and the conflict of roles.
Davies, William Richard
The nursing profession is experiencing a crisis in both manpower and the ability to fend off the deleterious effects of burnout. Nursing professionals face extraordinary stress in our present medical environment, and studies have frequently found moderate-to-high levels of burnout among nurses. Nurses experience burnout for a variety of reasons, some inherent to the profession and others related to our 21st-century values that have necessitated multiple breadwinners within the household. Mindful meditation represents a complementary therapy that has shown promise in the reduction of negative stress and those extraneous factors that lead to burnout. A mindful, meditative practice can be another tool with which critical care nurses can regain the control of their careers and personal lives. The purpose of this article is to describe nurse burnout, identify those factors that contribute to burnout, and offer a solution to a continuing problem for nurses.
Sockolow, Paulina; Bass, Ellen J; Eberle, Carl L; Bowles, Kathryn H
The re-hospitalization rate of homecare patients within 60 days of hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little is known about the homecare admission and care planning processes. The research team collected data during observations of three nursing visits to admit homecare patients in Camden NJ, and conducted thematic content analysis on these data. Human factors methods helped to identify nurse decision-making related to selection of the plan of care problems, non-nursing resources, and the nursing visit pattern. They identified how the electronic health record (EHR) assisted the nurse in visit pattern frequency decisions. Major themes that emerged included reduced efficiency due to use of redundant intra-team communication methods to augment EHR documentation, redundant documentation, and workarounds and reorganization of clinical workflow.
Ward-Griffin, C; McKeever, P
Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.
The purpose of this phenomenological study was to explore the lived experience of nurses who practice Reiki for self-care. In-person interviews were conducted with 11 nurses who met specific study criteria, using open-ended questions to examine the experience of nurses who are Reiki practitioners, to understand their perceptions of Reiki use in self-treatment, and to appreciate its meaning for them. The Colaizzi method was utilized in data analysis and independent decision trail audits were completed to promote study rigor and trustworthiness of results. Thematic categories and major and minor thematic clusters emerged around the topics of daily stress management, self-healing, spirituality, and interconnectedness of self, others, and beyond. Implications of the study findings for nursing practice and nursing education are discussed. Potential applications of study findings to Jean Watson's transpersonal caring theory located within a caring science framework are explored and recommendations for future research are offered.
Maria da Graça Oliveira Crossetti
Full Text Available The objective of this study was to analyze the structural elements of critical thinking (CT of nurses in the clinical decision-making process. This exploratory, qualitative study was conducted with 20 emergency care nurses in three hospitals in southern Brazil. Data were collected from April to June 2009, and a validated clinical case was applied from which nurses listed health problems, prescribed care and listed the structural elements of CT. Content analysis resulted in categories used to determine priority structural elements of CT, namely theoretical foundations and practical relationship to clinical decision making; technical and scientific knowledge and clinical experience, thought processes and clinical decision making: clinical reasoning and basis for clinical judgments of nurses: patient assessment and ethics. It was concluded that thinking critically is a skill that enables implementation of a secure and effective nursing care process.
This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.
Newman, Kristine M; Doran, Diane
Critical care nurses complete tasks during patient care to promote the recovery or maintain the health of their patients. These tasks can be routine or non-routine to the nurse. Non-routine tasks are characterized by unfamiliarity, requiring nurses to seek additional information from a variety of sources to effectively complete the tasks. Critical care units are dynamic environments where decisions are often made by nurses under stress and time pressure because patient status changes rapidly. A non-routine task (e.g., administration of an unfamiliar medication) to the critical care nurse can impact patient care outcomes (e.g., increased time to complete task has consequences for the patient). In this article, the authors discuss literature reviewed on nurses' information-seeking and explore an information-seeking conceptual model that will be used as a guide to examine the main concepts found through the empirical evidence.
Thorup, Charlotte Brun; Rundqvist, Ewa; Roberts, Christel
Scand J Caring Sci; 2011 Care as a matter of courage: vulnerability, suffering and ethical formation in nursing care The aim of the study was to explore nurses' experience of how their own vulnerability and suffering influence their ethical formation and their capacity to provide professional care......, it also demonstrates that the nurse's personal and professional life experiences of vulnerability and suffering influence ethical formation. Vulnerability and suffering have proven to be sensitive issues for nurses, like a sore point that either serve as an eye-opener or cause the development of blind......, resulting in the capacity to provide professional care. A nurse must have the sense of being a complete human being with own personal attributes and sensitivity in order to be able to relate to other people. The study is based on qualitative interviews with 23 experienced nurses from Sweden, Finland...
Khan, Ehsan Ullah
Hypertension is a prevalent chronic illness that is implicated in many cardiovascular diseases. Practice nurses and the district nursing team have a major role to play in its management. In this article, current British Hypertension Society guidelines are presented and discussed with regards to their evidence base. Implications for nursing practice are highlighted.
Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid
family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. DESIGN: Qualitative and quantitative...... and nonguided-family-centred-care-trained nurses. CONCLUSIONS: An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. RELEVANCE TO CLINICAL PRACTICE: Insights gained from our pioneering work might help nurses in a similar context...
Cho, Ok-Hee; Yoo, Yang-Sook; Yun, Sun-Hee; Hwang, Kyung-Hye
To develop and validate an eye care educational programme for intensive care unit nurses. Eye care guidelines and protocols have been developed for increasing eye care implementation in intensive care units. However, the guidelines lack consistency in assessment or intervention methodology. This was a one-sample pre/postprogramme evaluation study design for testing the effects of the eye care educational programme, developed for and applied to intensive care unit nurses, on their levels of knowledge and awareness. The eye care educational programme was developed based on literature review and survey of educational needs. Thirty intensive care unit nurses served as subjects for the study. The levels of eye care-related knowledge, awareness and practice were enhanced following the implementation of the educational programme. Moreover, satisfaction with the educational programme was high. It is necessary to intensify eye care education aimed at new nurses who are inexperienced in intensive care unit nursing and provide continuing education on the latest eye care methods and information to experienced nurses. The eye care educational programme developed in this study can be used as a strategy to periodically assess the eye status of patients and facilitate the appropriate eye care. © 2016 John Wiley & Sons Ltd.
BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.
Full Text Available Abstract Background Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. Methods A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30 efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. Results Across all nursing homes (n = 60, 18% (n = 570 of the residents had previously had a stroke. In homes (n = 30, where interviews with residents with stroke (n = 257, only 7% (n = 18 residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239 residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. Conclusions This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care for stroke survivors who reside in nursing homes in Ireland.
Result: A total of 131 nurses out of 150 completed the questioners, 100% were females, 86% of nurses are Baccalaureate degree, 93% with 7–9 years’ experience in critical care units, 80% of nurses have adequate time to provide oral care at least once a day, 20.4% only of the nurses are using a toothbrush with 2% Chlorhexidine Solution every 2–4 h for oral care at least Once a Day, 75.8% of nurses prefer to use oral swab with 2% Chlorhexidine Solution q 2–4 h, 98% has positive attitude toward mouth care practice.Conclusions The survey provided useful information on the oral care knowledge and practices of nurses caring for Mechanically Ventilated Patients. Almost all the nurses perceived oral care to be a high priority. Very low number of nurses are using the toothbrush with 2% Chlorhexidine Solution every 2–4 h, this figure must be studied for further action. The majority of nurses had some formal training in oral care, but would appreciate an opportunity to improve their knowledge and skills.
Piedrafita-Susín, A B; Yoldi-Arzoz, E; Sánchez-Fernández, M; Zuazua-Ros, E; Vázquez-Calatayud, M
Adequate provision of palliative care by nursing in intensive care units is essential to facilitate a "good death" to critically ill patients. To determine the perceptions, experiences and knowledge of intensive care nurses in caring for terminal patients. A literature review was conducted on the bases of Pubmed, Cinahl and PsicINFO data using as search terms: cuidados paliativos, UCI, percepciones, experiencias, conocimientos y enfermería and their alternatives in English (palliative care, ICU, perceptions, experiences, knowledge and nursing), and combined with AND and OR Boolean. Also, 3 journals in intensive care were reviewed. Twenty seven articles for review were selected, most of them qualitative studies (n=16). After analysis of the literature it has been identified that even though nurses perceive the need to respect the dignity of the patient, to provide care aimed to comfort and to encourage the inclusion of the family in patient care, there is a lack of knowledge of the end of life care in intensive care units' nurses. This review reveals that to achieve quality care at the end of life, is necessary to encourage the training of nurses in palliative care and foster their emotional support, to conduct an effective multidisciplinary work and the inclusion of nurses in decision making. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.
Rochefort, Christian M; Clarke, Sean P
This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.
Kalisch, Beatrice J; Xie, Boqin; Ronis, David L
Teamwork is essential for patient safety and results in less missed nursing care. The aim of this study was to test the impact of a train-the-trainer intervention on the level of satisfaction with nursing teamwork and the amount of missed nursing care. This study used a quasiexperimental design with repeated measures taken at pretest, posttest, and 2 months after completion of the intervention. The sample for this study was the nursing staff on three medical-surgical units in three separate acute care hospitals (one unit in each hospital). Three nurses from each unit underwent a training program and then taught the skills and knowledge they acquired to the staff members on their units in three-hour-long sessions. The training involved staff role-playing scenarios based on teamwork problems that occur regularly on inpatient units in acute care hospitals followed by debriefing, which focused on teamwork behaviors (e.g., leadership, team orientation, backup, performance monitoring) and missed nursing care. Four measures were used to test the efficacy of this intervention: The Nursing Teamwork Survey, the MISSCARE Survey, and questions about the knowledge of and satisfaction with teamwork. Return rates for the surveys ranged from 73% to 84%. Follow-up tests individually comparing pretest, posttest, and delayed posttest were conducted within the mixed model and used the Bonferroni correction for multiple comparisons. Teamwork increased (F = 6.91, df = 259.01, p = .001) and missed care decreased (F = 3.59, df = 251.29, p = .03) over time. Nursing staff also reported a higher level of satisfaction with teamwork and an increase of teamwork knowledge after the intervention. The intervention tested in this study shows promise of being an effective and efficient approach to increase nursing teamwork and decrease missed nursing care.
Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.
Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an
Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.
Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an
Stein, Shayna; And Others
Examined anticipation of stresses in 223 patients recently admitted to nursing homes, who completed the stresses in Institutional Care Scale (SIC). Factor analysis revealed five factors significantly related to psychological and physical variables. Suggests using SIC for admission screening in nursing homes. Appendix contains the SIC. (NRB)
among Primary Health Care (PHC) nurses could have a negative effect on the ... to acquire power in the workplace at mine clinic settings? ... The accessible population in this study was PHC nurses .... comprising elements of the population considered for actual ...... power effectively to manage diversity and job-related.
Law, Lesley; Akroyd, Karen; Burke, Linda
Evidence suggests that nurse documentation is often inconsistent and lacks a coherent and standardized approach. This article reports on research into the use of nurse documentation on a stoma care ward in a large London hospital, and explores the factors that may affect the process of record keeping by nursing staff. This study uses stoma care as a case study to explore the role of documentation on the ward, focusing on how this can be improved. It is based on quantitative and qualitative methods. The medical notes of 56 patients were analysed and in addition, focus groups with a number of nurses were undertaken. Quantitative findings indicate that although 80% of patients had a chart filed in their medical notes, only a small portion of the form was completed by nursing staff. Focus group findings indicate that this is because forms lacked standardization and because the language used was often ambiguous. Staff also felt that such documentation was not viewed by other nurses and so, was not effective in improving patient care. As a result of this study, significant improvements have been made to documentation used on the stoma care ward. This is an important exploration of record keeping within nursing in the context of the Nursing and Midwifery Council's emphasis on the importance of documentation in achieving effective patient outcomes.
Richie, Mary Fern; And Others
Psychiatric nursing faculty practice offers the academic nurse opportunity to generate salary support and integrate students into the real world of mental health care. It promotes scholarship and knowledge-building and has a direct impact on the lives of patients. (Author/JOW)
Braun, Kathryn L.; Rose, Charles L.
Relatives (N=62) of matched pairs of patients in geriatric foster homes and nursing homes rated care provided to their relatives. Significantly more foster family patients had positive pre-placement attitudes than did nursing home patients. Upon follow-up, relatives of foster patients reported seeing more patient improvement, satisfaction,…
The attitudes of hospice nurses towards psychosexual issues in palliative care were surveyed. Sexuality was acknowledged to be both important and relevant in hospice nursing. A high level of awareness of sexual and relationship issues was apparent, reflecting broadly liberal attitudes.
Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Moonaghi, Hossein Karimi; Mazloom, Seyed Reza
Introduction The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles. Methods A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software. Results The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as “caring pedagogy,” “value-based education,” and “teaching excellence,” caring in nursing education does not have exact and clear conceptual boundaries (logic principle). Conclusion Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development
van Eeden, Karin; Moeke, Dennis; Bekker, René
Nursing homes face ever-tightening healthcare budgets and are searching for ways to increase the efficiency of their healthcare processes without losing sight of the needs of their residents. Optimizing the allocation of care workers plays a key role in this search as care workers are responsible for the daily care of the residents and account for a significant proportion of the total labor expenses. In practice, the lack of reliable data makes it difficult for nursing home managers to make informed staffing decisions. The focus of this study lies on the 'care on demand' process in a Belgian nursing home. Based on the analysis of real-life 'call button' data, a queueing model is presented which can be used by nursing home managers to determine the number of care workers required to meet a specific service level. Based on numerical experiments an 80/10 service level is proposed for this nursing home, meaning that at least 80 percent of the clients should receive care within 10 minutes after a call button request. To the best of our knowledge, this is the first attempt to develop a quantitative model for the 'care on demand' process in a nursing home.
Yang, Cheng-Fang; Che, Hui-Lian; Hsieh, Hsin-Wan; Wu, Shu-Mei
To explore the experiences of nurses involved with induced abortion care in the delivery room in Taiwan. Induced abortion has emotional, ethical and legal facets. In Taiwan, several studies have addressed the ethical issues, abortion methods and women's experiences with abortion care. Although abortion rates have increased, there has been insufficient attention on the views and experiences of nurses working in the delivery room who are involved with induced abortion care. Qualitative, semistructured interviews. This study used a purposive sampling method. In total, 22 nurses involved with induced abortion care were selected. Semistructured interviews with guidelines were conducted, and the content analysis method was used to analyse the data. Our study identified one main theme and five associated subthemes: concealing emotions, which included the inability to refuse, contradictory emotions, mental unease, respect for life and self-protection. This is the first specific qualitative study performed in Taiwan to explore nurses' experiences, and this study also sought to address the concealing of emotions by nurses when they perform induced abortion care, which causes moral distress and creates ethical dilemmas. The findings of this study showed that social-cultural beliefs profoundly influence nurses' values and that the rights of nurses are neglected. The profession should promote small-group and case-study discussions, the clarification of values and reflective thinking among nurses. Continued professional education that provides stress relief will allow nurses to develop self-healing and self-care behaviours, which will enable them to overcome the fear of death while strengthening pregnancy termination counselling, leading to better quality professional care. © 2016 John Wiley & Sons Ltd.
Rodwell, John; Demir, Defne; Gulyas, Andre
Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers.
Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L
Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments.
Attitude and Practices of Sedation amongst Critical Care Nurses Working in a ... a standardized approach towards sedation management as very important. ... pharmacological agents (75%) had less than five years work experience in the ICU.
Despite the relational worldview that underpins nursing caring, the cultural value of individualism remains firmly embedded in nursing's conceptual systems. Individualism forms the basis of notions such as autonomy, self-reliance, personal rights and entitlement. When nurses concomitantly espouse the value of care, an orientation that stands in contrast to the predominant societal motif of the autonomous individual, they find themselves having to reconcile contrary ideals. The significance of the coexistence of the values of individualism and care rests upon the capability of each to contrast and sharpen our understanding of the other. The convergent outcome is the empowerment of nurses to refine their understanding of the human condition in illness and health, and to articulate a public practice of care that would temper the fundamental mark of nointerference in the traditional notion of individualism in American culture.
My first placement in my first year of nursing training was on a gastrointestinal/hepatology ward. Alongside my mentor, I was caring for a patient who had been withdrawing from alcohol since admission to hospital the previous evening.
Lumby, J; England, K
This paper describes one arm of a much larger, multi-site study whose hypothesis was that evidence-based nursing practice is more effective than routine nursing care in improving patient outcomes and health gain. This arm of the study investigated patient satisfaction as an outcome measure for those patients undergoing colorectal surgery. The study's relevance for nurses is in the potential feedback for reviewing nursing practice and health care delivery. Patient satisfaction with nursing care was measured through a validated questionnaire, the SERVQUAL, followed by interviews with a percentage of the study population. The results of this arm of the study confirm the importance of measuring patient satisfaction through a triangulated method which investigates thoroughly, providing feedback for continuous quality improvement. The in-depth interviews provided greater insight into the results of the questionnaire, enabling clear feedback to nursing staff at the different sites of the study. Results of the questionnaire revealed age, sex and education levels of patients as major influences on individual perceptions of nursing care. Patients whose surgery resulted in stomas were also less satisfied with health-care delivery.
Full Text Available Karen Jackson,1 Deborah E White,2 Jeanne Besner,1 Jill M Norris21Health Systems and Workforce Research Unit, Alberta Health Services, Calgary, Alberta, Canada; 2Faculty of Nursing, University of Calgary, Calgary, Alberta, CanadaBackground: Effective and efficient use of nursing human resources is critical. The Nursing Role Effectiveness Model conceptualizes nursing practice in terms of key clinical role accountabilities and has the potential to inform redesign efforts. The aims of this study were to develop, implement, and evaluate a job redesign intended to optimize the enactment of registered nurse (RN clinical role accountabilities.Methods: A job redesign was developed and implemented in a single medical patient care unit, the redesign unit. A mixed-methods design was used to evaluate the job redesign; a second medical patient care unit served as a control unit. Data from administrative databases, observations, interviews, and demographic surveys were collected pre-redesign (November 2005 and post-redesign (October 2007.Results: Several existing unit structures and processes (eg, model of care delivery influenced RNs' ability to optimally enact their role accountabilities. Redesign efforts were hampered by contextual issues, including organizational alignment, leadership, and timing. Overall, optimized enactment of RN role accountabilities and improvements to patient outcomes did not occur, yet this was predictable, given that the redesign was not successful. Although the results were disappointing, much was learned about job redesign.Conclusion: Potential exists to improve the utilization of nursing providers by situating nurses' work in a clinical role accountability framework and attending to a clear organizational vision and well-articulated strategic plan that is championed by leaders at all levels of the organization. Health care leaders require a clear understanding of nurses' role accountabilities, support in managing change, and
do Nascimento, Keyla Cristiane; Backes, Dirce Stein; Koerich, Magda Santos; Erdmann, Alacoque Lorenzini
This study is the result of an extended project, named: The systematization of nursing care in the perspective of complex thinking. The objective of this qualitative study is to better comprehend the meaning of the systematization of nursing care among healthcare professionals. The Data-Based Theory was used as a methodological reference. Data were collected by interviewing three sample groups, in a total of fifteen healthcare professionals. Data codification and analysis led us to the central theme: Viewing the Systematization of Nursing Care (SNC) as an Interactive and Complex Phenomenon. This theme is complemented by two phenomena. In this article, we discuss the phenomenon: Verifying the necessity of on interactive, complementary, and multi-professional process. The Systematization of Nursing Care is part of a process that has been developing over time by nurses committed to improve the care given to the patient, since they view the necessity for interactive, complementary, and multi-professional care.
Children living in foster care are a unique population with specialized healthcare needs. This article will assist forensic nurses and advanced practice forensic nurses, particularly those working in pediatrics, in understanding the needs of children in foster care and implementing a practice plan to better meet their healthcare needs. To that end, a basic understanding of the foster care system is crucial and involves an appreciation of the interface between the legal system and the child welfare system. Most important to providing care to children in foster care is a true understanding of trauma exposure and its potential effects on the lives of children: physically, developmentally, emotionally, and psychologically. This article will assist forensic nurses working with pediatric populations to more fully understand the needs of children in foster care and to develop innovative interventions to appropriately meet their unique needs.
Weslin, Anna T; Silva-Smith, Amy
Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care.
Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.
Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943
Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses
Bosek, Marcia Sue DeWolf; Ring, Marcia Ellen
Good documentation does not necessarily equate to good care. This article explores the potential underpinnings of poor documentation from an ethical decision-making lens. Nursing standards of care related to documentation are reviewed. The internal and external constraints of moral distress are considered, as is moral residue. Finally, the roles of the nurse administrator as well as specific remedial and restorative measures are suggested.
The arteriovenous fistula (AVF) is the most frequent form of vascular access for patients undergoing haemodialysis because it ensures good quality of dialysis and reduce haemodialysis mortality. For this reason, the nephrology nurse plays an important role in the appropriate care of fistula with a view to promoting the longevity and prevention of complications. Purpose: The purpose of this review was to investigate the role of Nephrology nurse in the appropriate care of fistula, promoting lon...
Patrícia Fátima Levandovski; Maria Alice Dias da Silva Lima; Aline Marques Acosta
To analyze patient satisfaction with nursing care received at a hospital emergency service. Methodology. This is a quantitative, descriptive, cross-sectional study. The sample was composed by 250 patients over 18 years old who used an emergency service in the south region of Brazil. Data were collected using an identification form and the Patient Satisfaction Instrument. Results. Results point to a good level of satisfaction of patients with the nursing care received, with the greatest mean f...
Oberlies, Amanda Stefancyk
The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.
Full Text Available Abstract Background Caring is the essence of nursing. Caring to be meaningful needs to be based on mutual agreement between nurses and patients as to what constitutes nurse caring behaviors. As a result, healthcare professional can enhance patients' satisfaction of care by providing appropriate caring behavior. However, previous research that combined multiple types of patients, nurses and institutions demonstrated disagreement in prioritizing important behaviors. This paper reports a study that aimed at determining the caring behaviors which oncology patients and oncology nurses perceive to be the most important. Methods This study is a comparative descriptive design that was conducted in an Iranian oncology centre. Convenience sampling was used to recruit 200 patients and 40 nurses to take part in the study. Data were collected over a period of 4 months in 2009 using the Caring Assessment Questionnaire, developed by Larson. Caring behaviors (n = 57 were ranked on a 5-point Likert-type scale and ordered in six subscales: "Being accessible", "Explains and facilitates", "Comforts", "Anticipates", "Trusting relationship", "Monitors and follows through". The data were analyzed using SPSS software version 13.0. The overall mean was calculated for each subscale to determine the rank distribution of the subscales. The nonparametric Mann-Whitney U test analysis of variables was used to compare patients' and nurses' scores on subscales. Results The results demonstrate that both groups considered the same order of importance of caring, the high ranking of "Monitors and Follows through and "Being Accessible" and the low ranking of "Comforts" and "Trusting Relationships". Also, Patients only ranked "Being accessible" (p = 0.04 and "Explains and facilitates" (p = 0.03 higher than nurses. Conclusions The oncology patients and nurses perceived highly physical aspects of caring and the results provide for nurses to be aware of the need, during their
da Silva, Rafael Celestino; Ferreira, Márcia de Assunção; Apostolidis, Thémistoklis; Brandão, Marcos Antônio Gomes
Objective: to propose a conceptual framework for clinical nursing care in intensive care. Method: descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. Results: the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. Conclusion: the conceptual framework of the clinic's intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization. PMID:26487133
Yam, B M; Rossiter, J C; Cheung, K Y
Ten registered nurses working in a neonatal intensive care unit in Hong Kong were interviewed to explore their experiences of caring for infants whose disease is not responsive to curative treatment, their perceptions of palliative care, and factors influencing their care. Eight categories emerged from the content analysis of the interviews: disbelieving; feeling ambivalent and helpless; protecting emotional self; providing optimal physical care to the infant; providing emotional support to the family; expressing empathy; lack of knowledge and counselling skills; and conflicting values in care. The subtle cultural upbringing and socialization in nurse training and workplace environment also contributed to their moral distress. Hospital and nurse administrators should consider different ways of facilitating palliative care in their acute care settings. For example, by culture-specific death education, peer support groups, bereavement teams, modification of departmental policies, and a supportive work environment. Future research could include the identification of family needs and coping as well as ethical decision-making among nurses.
Ray, Marilyn A; Turkel, Marian C
In the culture of health care, nurses are challenged to understand their values and beliefs as humanistic within complex technical and economically driven bureaucratic systems. This article outlines the language of social justice and human rights and the advance of a Theory of Relational Caring Complexity, which offers insights into caring as emancipatory nursing praxis. Recommendations provide knowledge of the struggle to balance economics, technology, and caring. As nurses practice from a value-driven, philosophical, and ethical social justice framework, they will find "their voice" and realize the full potential that the power of caring has on patient and organizational outcomes.
Paunova, Minna; Li-Ying, Jason; Egerod, Ingrid Eugenie
This study investigates the influence of nurse knowledge sharing behavior on nurse innovation, given different conditions of control of care quality within the intensive care unit (ICU). After conducting a number of interviews and a pilot study, we carried out a multi-source survey study of more...... than 200 nurses employed in 22 ICUs at 17 Danish hospitals. Overall, we find that knowledge sharing among individual ICU nurses has a positive impact on their innovation. Meanwhile, strong control of care quality makes this positive impact less effective. However, different aspects of knowledge sharing...
Borhani, Fariba; Abbaszadeh, Abbas; Mohamadi, Elham; Ghasemi, Erfan; Hoseinabad-Farahani, Mohammad Javad
Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. The present research was conducted to determine the relationship between moral sensitivity and moral distress of nurses in intensive care units. This study is a descriptive-correlation research. Lutzen's moral sensitivity questionnaire and Corley Moral Distress Questionnaire were used to gather data. Participants and research context: A total of 153 qualified nurses working in the hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected for this study. Subjects were selected by census method. Ethical considerations: After explaining the objectives of the study, all the participants completed and signed the written consent form. To conduct the study, permission was obtained from the selected hospitals. Nurses' average moral sensitivity grade was 68.6 ± 7.8, which shows a moderate level of moral sensitivity. On the other hand, nurses also experienced a moderate level of moral distress (44.8 ± 16.6). Moreover, there was no meaningful statistical relationship between moral sensitivity and moral distress (p = 0.26). Although the nurses' moral sensitivity and moral distress were expected to be high in the intensive care units, it was moderate. This finding is consistent with the results of some studies and contradicts with others. As moral sensitivity is a crucial factor in care, it is suggested that necessary training be provided to develop moral sensitivity in nurses in education and practical environments. Furthermore, removing factors that contribute to moral distress may help decrease it in nurses.
King, S J; de Sales Turner
This phenomenological study was undertaken to explore in depth the experiences of registered nurses caring for adolescent anorexic females within paediatric wards of general hospitals in Victoria, Australia. A qualitative design underpinned by the philosophy of Edmund Husserl was employed for this study. Audio taped in-depth interviews with five registered nurses working within the public health care system were conducted. Using Colaizzi's procedural steps of analysis, six themes of meaning were explicated. They were: (a) personal core values of nurses; (b) core values challenged; (c) emotional turmoil; (d) frustration; (e) turning points; and (f) resolution. These themes, when taken together, described the essence of the journey undertaken by registered nurses who cared for adolescent anorexic females. The findings of this study indicated that there is a need for extensive registered nurse preparation, on-going support, and development of education programmes to enable registered nurses to care for these patients with greater understanding. Further, the participants identified the need for new care regimes and protocols to be developed that incorporated new ways of thinking. They also expressed a desire to be have greater involvement in the planned care of their patients.
Sunde, Olivia Sissil; Øyen, Karianne Røssummoen; Ytrehus, Siri
Family caregivers are an important resource for providing care to elderly living at home. How nurses and other health professionals interact with family caregivers can have both a positive and a negative impact on the family caregivers' situation. We lack knowledge of Norwegian nurses' and other health professionals' participation in educational programmes about family caregivers' needs and situations. The purpose of this study was to investigate whether nurses and other health professionals working in home-care nursing had participated in educational programmes about family caregivers. Additionally, the study aimed to determine whether participation in educational programmes was associated with awareness of family caregivers' contributions to elder care. This is a quantitative study, and it was conducted as a cross-sectional study. The participants were required to be educated as nurses, nursing assistants or other health professionals with relevant health education and to be working with the elderly in home-care nursing settings. Descriptive statistics and trivariate table analysis using the Pearson Chi-square t-test were conducted using Statistical Package for the Social Sciences (SPSS). A total of 152 nurses and health professionals in home-care nursing in 23 municipalities have participated (in one county in Norway). The results showed that only half of the respondents had participated in educational programmes about family caregivers' needs and situations. The study did not provide a clear answer regarding the association between participation in educational programmes and awareness of family caregivers' contributions. The results indicate that nurses and other health professionals, to a small extent, have participated in educational programmes about family caregivers. Our findings indicate that participation in educational programmes may be particularly important for health professionals in leadership positions and for health professionals with vocational
Responses from 132 baccalaureate nursing programs indicated that the majority include spiritual dimensions in program philosophy and curriculum, but few had definitions of spirituality and nursing care. Content typically addressed patients' spiritual needs, dying, and holism. Respondents were uncertain about faculty preparation to teach about…
Tekindal, Benian; Tekindal, Mustafa Agah; Pinar, Gul; Ozturk, Filiz; Alan, Sumeyra
One of the biggest problems of work life today is burnout. With burnout, satisfaction of clients and service givers reduces. In this study, burnout levels of nurses working in the internal, surgical and intensive care units of a university hospital and the unmet needs of the patients' relatives related to nursing care were investigated. In the study, 225 nurses and 222 relatives of patients constituted the sample group of this study. Three separate forms were used in the study, namely, Nurse and Patient Relative Identification Form, the Maslach Burnout Inventory and the Nursing Services Satisfaction Inventory. In the study, burnout levels of the nurses were found to be high. Conditions like younger ages, scarcity of experience in the profession, lower levels of education, having chosen the profession and the unit they work in not willingly and working in environments like intensive care increase the burnout and as a result, expectations of the relatives of patients from nursing care are not fully met. Some suggestions have been made to make some regulations to prevent the burnout of nurses and to increase the satisfaction of relatives.
Hoekstra, Tialda; Lesman-Leegte, Ivonne; Van der Wal, Martje; Luttik, Marie Louise; Jaarsma, Tiny
Background Perspectives of nurses and patients on the intensity and content of disease management programmes (DMPs) in heart failure are seldom addressed but are important in optimizing these programmes Aim To describe the perspectives of patients and nurses on delivered care in two DMPs Methods In
Spigolon, Dandara Novakowski; Moro, Claudia Maria Cabral
This study aimed to develop an Essential Data Set for Nursing Care of Patients with Endometriosis (CDEEPE), represented by archetypes. An exploratory applied research with specialists' participation that was carried out at Heath Informatics Laboratory of PUCPR, between February and November of 2010. It was divided in two stages: CDEEPE construction and evaluation including Nursing Process phases and Basic Human Needs, and archetypes development based on this data set. CDEEPE was evaluated by doctors and nurses with 95.9% of consensus and containing 51 data items. The archetype "Perception of Organs and Senses" was created to represents this data set. This study allowed identifying important information for nursing practices contributing to computerization and application of nursing process during care. The CDEEPE was the basis for archetype creation, that will make possible structured, organized, efficient, interoperable, and semantics records.
Lohne, Vibeke; Høy, Bente; Lillestø, Britt
Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has...... personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach....
Gustafsson, Lena-Karin; Stenberg, Maja
It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee's aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager's role, which probably has different attributes and more focus on an organizational level. Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.
Nahm, Eun-Shim; Warren, Joan; Zhu, Shijun; An, Minjeong; Brown, Jeanine
Considerable research on preventive health care behaviors has been conducted in different segments of the population. Although nurses are the largest group of direct health care providers (3 million), little is known about their preventive health care behaviors. As the average age of nurses working in the United States (US) increases (mean age 47 years), maintaining their health to ensure they can continue to provide optimal health care to others becomes a greater priority. This descriptive online study examined registered nurses' dietary and exercise practices, weight status, stress levels, and preferred preventive health strategies using a sample of nurses recruited from a community-based, urban teaching hospital (n = 183; mean age 47 ± 11.3 years). The majority of participants (72.2%, n = 122) reported a lack of exercise, and more than half (53.8%, n = 91) had an irregular meal pattern. The average body mass index (BMI) was 28.3 ± 6.8, and 59.2% (n = 100) were either overweight (n = 47) or obese (n = 53). BMI had a significant inverse relationship with having a regular meal schedule and the amount of time spent exercising. Participants who reported greater stress had more irregular meal schedules. The most frequently used stress-release method was eating (n = 32), followed by exercise (n = 31). Nurses are fully aware of measures that should be taken for healthy living. Their knowledge, however, has not been well translated into their own self-care. As nursing shortages loom, maintaining the health of the aging nursing workforce is essential to retention. Further research is needed to identify factors that may motivate nurses to better care for themselves and measures that can be implemented by employers to initiate and sustain these preventive health care behaviors. Copyright © 2012 Elsevier Inc. All rights reserved.
Iman Taghizade Firoozjayi
Full Text Available Background: Hemodialysis is a critical treatment method, which depends on the vascular access route. Lack of care for the vascular access route could diminish its efficiency in a short time. Regarding this, the present study aimed to evaluate the frequency of nursing care for vascular access route in the hemodialysis patients. Methods: This cross-sectional study was conducted on 20 nurses and 120 hemodialysis patients, who referred to the Hemodialysis Department of Shahid Beheshti Hospital, Babol, Iran, in 2015. The method of nursing care for vascular access route was evaluated using a researcher-made checklist. The data analysis was performed using the descriptive statistics in the SPSS version 16. Results: In total, 14 cases of nursing care were evaluated, in 100% of which all the caring steps, including wearing gloves and a mask, early bolus injections of heparin, washing the catheter tubing, frequent monitoring of blood pressure, rinsing the catheter tubing, returning the blood to the body after hemodialysis, and sterile covering of the puncture site, were observed. However, some of the other techniques, such as the care related to appropriate pump speed when starting the dialysis machine (81.66%, observance of the needle distance from fistula (75.83%, appropriate placement of catheter (75%, pressing the injection site (54.17%, blood pressure monitoring at the end of dialysis (50%, and change of the needle site between two sessions (27.5%, were not adhered to by the nurses. Conclusion: According to the results of this study, some of the nursing care steps, which are necessary in the beginning and end of the hemodialysis, were not accurately followed by the nurses. It is recommended that constant training courses be held for the nurses in this regard.
Sacco, Tara L; Ciurzynski, Susan M; Harvey, Megan Elizabeth; Ingersoll, Gail L
Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. ©2015 American Association of Critical-Care Nurses.
Full Text Available Use of cultural models and guides is useful in accessing cultural data in a more systematical and standardized manner and in increasing information accumulated on inter-cultural nursing field. Thus, nurses know cultural factors underlying health- and disease-related attitudes of individual, whom they provide healthcare, and occurrence of any possible cultural shock between nurse and cared individual is avoided. As a consequence, quality of care provided by nurses to individuals is increased. Although it is not common in our country, models and guides are used in nursing care. However, these are not adequate for collecting cultural data from individuals. In our country, a model of guide is required to remove this deficiency in nursing care. For this purpose, “Guide for Identifying Cultural Features in Nursing Care” is developed. This guide is consisted of four fields identifying cultural features. These are as follows: personal features, communication features, familial and social roles as well as healthcare procedures. Use of this guide in clinics and in the field and also use and development of present guide by other healthcare professionals can be recommended.
Grabowski, David C; O'Malley, A James; Afendulis, Christopher C; Caudry, Daryl J; Elliot, Amy; Zimmerman, Sheryl
Culture change models are intended to improve the quality of life for nursing home residents, but the impact of these models on quality of care is unknown. We evaluated the impact of the implementation of nursing home culture change on the quality of care, as measured by staffing, health-related survey deficiencies, and Minimum Data Set (MDS) quality indicators. From the Pioneer Network, we have data on whether facilities were identified by experts as "culture change" providers in 2004 and 2009. Using administrative data, we employed a panel-based regression approach in which we compared pre-post quality outcomes in facilities adopting culture change between 2004 and 2009 against pre-post quality outcomes for a propensity score-matched comparison group of nonadopters. Nursing homes that were identified as culture change adopters exhibited a 14.6% decrease in health-related survey deficiency citations relative to comparable nonadopting homes, while experiencing no significant change in nurse staffing or various MDS quality indicators. This research represents the first large-scale longitudinal evaluation of the association of culture change and nursing home quality of care. Based on the survey deficiency results, nursing homes that were identified as culture change adopters were associated with better care although the surveyors were not blind to the nursing home's culture change efforts. This finding suggests culture change may have the potential to improve MDS-based quality outcomes, but this has not yet been observed.
Moghaddasian, Sima; Lak Dizaji, Sima; Mahmoudi, Mokhtar
The patients' families in intensive care units (ICUs) experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU. In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI) empathy scale and Critical Care Family Needs Intervention (CCFNI) inventories and were analyzed using descriptive and inferential statistical tests. Findings showed that most of the nurses had high level of empathy to the patients (38.8%). There was also statistically significant relationship between nurses' empathy and needs of patients' families (p < 0.001). In this study we found that by increasing the nurse's empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.
Brugués Brugués, Alba; Peris Grao, Antoni; Pavón Rodríguez, Francisca; Mateo Viladomat, Enric; Gascón Ferret, Jordi; Flores Mateo, Gemma
to evaluate the health outcomes of nurse demand management on unscheduled patients in a Primary Care Centre, following a clinical guide designed by the whole primary care team. Cross-sectional study. A primary care team from Castelldefels. Barcelona, Spain. A random sample of 558 patients requesting a consultation for the same day in a Primary Care setting, attended between May 1st, 2011 and January 31st, 2012. The guide includes 23 health problems that can be dealt by a nurse autonomously, 18 of them possibly requiring an emergency intervention, and shared decision with the physician. Each health problem is divided into three sections: a) a brief definition of the problem; b) an intervention algorithm; and c) nursing diagnoses of North American Nursing Diagnosis Association for each health problem and a description of the possible nursing interventions. We studied 558 patients with a mean age of 42.5 years old (SD 17.7). The most commonly consulted problems were upper respiratory tract symptoms (19.4%), followed by nausea/vomiting (16.5%), and burns/wounds (12.5%). 73.3% of the problems were resolved autonomously by a nurse. 65,8% of the patients attended received health advice. Nurse demand management has shown to be highly effective at handling the conditions attended, while it provides a high percentage of health advice and education during consultations. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Caffrey, Rosalie A
Few nurses have the experience of developing an independent practice. This ethnographic study explores the process and challenges of becoming an entrepreneur as described by nurses developing independent practices in community care gerontologic nursing. The process included developing a legal contract, marketing strategies, and reimbursement amounts and strategies. Major barriers to implementing this role identified by the nurses included ignorance and confusion by others about their role, financial issues related to an uncertain income, time management, and legal concerns especially around delegation. These were experienced and dedicated nurses who were also risk-takers and enjoyed the independence of practicing nursing because they believed it was meant to be practiced. Suggestions for research, education, and practice are included.
Archibald, Mandy M; Barnard, Alan
To explore the concept of futurism and the emergence of robotics in relation to the fundamentals of care, highlighting how nurses need a more anticipatory and contemporary position towards technology to maintain relevance in the future. The future of nursing in Western countries will soon be linked with the emergence of robotics for efficient and cost effective provision of fundamental care. Their emergence and roles with care of the body and more broadly assisting people with their daily living activities has enormous implications for the profession and health care. Despite this importance, how nursing understands and will respond to technological trends and developments is insufficiently reflected in the professions discourse. A discursive article METHODS: Literature from nursing fundamentals of care / fundamental care, information science, technology, humanities and philosophy informed the arguments in this paper. This paper examines the intersection of futurism and the fundamentals of care and how adopting an anticipatory and post-human perspective towards technological-care integration is necessary amidst a robot revolution in the techno-era. Nurses are currently challenged to understand, prioritize and deliver fundamental care. Health systems are challenged by a lack of care predicated by shortfalls in skilled staff and deficiencies in their mobilization. Both challenges can be compounded or alleviated by further integration of technology, but to maximize benefit requires forethought and understanding. This article can help open needed dialogue around planning for the future and is a call to action for the nursing profession to conceptualize their position on exponential technological growth and fundamental care provision. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Patient satisfaction is an important indicator of the quality of nursing care. However, it raises numerous dilemmas: lack of consistent conceptualization and a theoretical framework, lack of reliable measurement approaches, and inconsistency of instruments. (SK)
The purpose of this thesis was to study different aspects of nursing content in patient records with special reference to nursing home care. The thesis focused on the content, comprehensiveness, accuracy and auditing of records, as well as the practice and perceptions of nurses in relation to recording. A national sample of nurses was asked to complete a questionnaire. The effects on recording and nurses' practice and perceptions in nursing homes following educational intervention were studie...
As primary care delivery evolves in the United States with nurse practitioners (NPs) as key providers, exploring the patient's perception of the nature and quality of NPs' care is of critical importance to healthcare consumers, providers, educators, policy makers, and underwriters. The aim of this study was to describe the development and testing of the Nurse Practitioner Holistic Caring Instrument, a new, investigator-developed measure of the preservation of holistic nursing values in NP care. Results suggest that NPs provide patient-centered, comprehensive, and clinically competent care, rendering them ideally suited to leading primary health care delivery. However, further testing in more diverse populations and settings is needed to strengthen preliminary findings.
Field, John; Pearson, Alan
Beyond the initial 'shock-horror' reaction in the mass media, little attention is paid by nurses or the public to nurses who murder patients. This study used discursive inquiry to uncover social constructions of this phenomenon and their implications for the definition and treatment of such murders. The mass media and professional literature were searched for commentary on cases of nurses who had been convicted of murder between 1980 and 2006. The retrieved texts were subjected to discursive analysis. Discursive constructions included the profile of murderous nurses; types of murders; contexts in which murder occurs; factors that aid detection and apprehension; legal processes and punishment; and reactions of the public, profession, regulators and families. The findings imply that murder of a patient by a nurse might occur in any setting in which nurses care for vulnerable patients--the old, the young, the sick and the disabled. Trust in nurses assists a nurse to murder. Nurses have a responsibility to understand how their workplaces can form crucibles in which murder can take place. The profession needs to acknowledge the possibility of nurses who murder patients and to commence a discussion about what might be done to limit the harm they do.
Kuo, Chien-Lin; Turton, Michael A; Lee-Hsieh, Jane; Tseng, Hung-Fu; Hsu, Chin-Lung
Caring is one of the most important domains of nursing research, peer caring among student nurses, and its potential effects on nurse caring behaviors remains largely unexplored. Few tools in the literature target peer caring interactions, and which were either irrelevant to our research purpose or culturally inappropriate for nursing student population in Taiwan. The purpose of this study was to develop a culturally sensitive instrument to measure peer caring behavior from the student perspective and to offer a descriptive answer to "what is peer caring in Taiwan." The study uses both qualitative and quantitative methods in developing the "Peer Caring Measurement (PCM)" questionnaire. Students from a 5-year associate degree nursing program in a university of technology in southern Taiwan were recruited into this study. Thirteen first- through fourth-year student volunteers between the ages of 16 and 20 were interviewed to explore caring behavior in student peer-to-peer interactions. Two classes from each of the first, second, third, and fourth year students, a total of 360 students were randomly selected to assess the internal consistency of "PCM", and 47 first-year students were conveniently selected to examine the stability of the tool. Interviews were conducted in an unstructured manner. Qualitative data were analyzed by a constant comparative method. The questionnaire survey was used to assess the validity and reliability of "PCM". A 17-item "PCM" was developed; the content validity, construct validity, and reliability of the tool were ensured by expert review, factor analysis, and internal consistency. Three factors, labeled assistant caring, academic caring, and affective caring, accounted for 63.197% of the variance. The "PCM" addressed the multidimensional construct of peer caring. It was validated in a Chinese language version and can be used in college settings to evaluate student interactions and their peer caring behaviors.
Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha
The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.
Gea-Sánchez, Montserrat; Terés-Vidal, Lourdes; Briones-Vozmediano, Erica; Molina, Fidel; Gastaldo, Denise; Otero-García, Laura
To identify the ethical conflicts that may arise between the nursing codes of ethics and the Royal Decree-law 16/2012 modifying Spanish health regulations. We conducted a review and critical analysis of the discourse of five nursing codes of ethics from Barcelona, Catalonia, Spain, Europe and International, and of the discourse of the Spanish legislation in force in 2013. Language structures referring to five different concepts of the theoretical framework of care were identified in the texts: equity, human rights, right to healthcare, access to care, and continuity of care. Codes of ethics define the function of nursing according to equity, acknowledgement of human rights, right to healthcare, access to care and continuity of care, while legal discourse hinges on the concept of beneficiary or being insured. The divergence between the code of ethics and the legal discourse may produce ethical conflicts that negatively affect nursing practice. The application of RDL 16/2012 promotes a framework of action that prevents nursing professionals from providing care to uninsured collectives, which violates human rights and the principles of care ethics. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Hopkinson, Jane B
Cancer cachexia is a complex syndrome. Its defining feature is involuntary weight loss, which arises, in part, because of muscle atrophy and is accompanied by functional decline. International expert consensus recommends that nutritional support and counselling is a component of multimodal therapy for cancer cachexia, as poor nutritional intake can contribute to progression of the syndrome. The present paper focuses on what is presently known about the nursing contribution to nutritional care in cancer cachexia. There is potential for nurses to play an important role. However, obstacles to this include lack of a robust evidence base to support their nutritional care practices and unmet need for education about nutrition in cancer. The nursing role's boundaries and the outcomes of nurse-delivered nutritional care in cancer cachexia are both uncertain and should be investigated.
Hernández-Fabà, Eva; Sanfeliu-Julià, Cristina
Since 2008, the Institut Catala de la Salut (ICS) introduced the nurses management plan for acute pathology, in primary care centres. In the implementation of this system of organization, the ICS introduced various diseases protocols with performance algorithms. To raise awareness of the the practice of acute pathology, we present a clinical case. An urgent consultation of a 30 year-old male, with fever, sore throat and cough, which was managed and resolved by a nurse. The aim of this new management plan is that nursing is the first health professional to take care of patient coming to primary care centre without a scheduled visit, to avoid saturating the general clinic or hospital emergencies. This new organisational system involves an increase in the responsibilities of nursing in the diagnosis and treatment of patients.
Bekkema Nienke; Fleuren Margot AH; de Veer Anke JE; Francke Anneke L
Abstract Background A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. Methods The study population is a nationally representative resear...
The focus of neonatal nursing has shifted from a highly technical approach to one of supportive interventions and a more individualized developmental approach. Developmental care is described as a philosophy of care that requires rethinking the relationships between infants, families, and healthcare professionals. Various models of developmental care exist; however, they all include a variety of activities designed to manage the environment and individualize the care provided to premature and/or sick infants.
Lipp, Allyson; Fothergill, Anne
The psychological impact of abortion on the women undergoing the procedure is well researched, but little is known about the potential psychological impact on nurses working in abortion care. The proportion of medical abortions in the UK is rising compared to surgical abortions. A recent research study found that being more directly involved in the procedure places more emotional demands on the nurses. This emotional labour required by nurses working in abortion care may increase their stress levels. This paper examines the potential increase in stress in nurses caused by medical abortions. A model of stress comprising stressors, moderators and stress outcomes was used as a framework for this examination. Research on abortion and mental health nursing was applied to managing stress in abortion care; this included coping mechanisms, prevention and intervention strategies. This showed that stress, burnout and coping are important issues in abortion care. On this basis, recommendations for practice have been formulated to inform practice for nurses and managers in abortion care.
Full Text Available Context: Due to expansion of chronic diseases and increase of health care costs, there is a need for planning and delivering hospice care for patients in their final stages of life in Iran. The aim of the present study is to investigate the knowledge and attitudes of nurses about delivering hospice care for End of Life (EOL patients. Materials and Methods: This cross-sectional study was conducted in 2012 with a sample size of 200 nurses that were selected by convenient (available sampling. The data collection instrument was a self-administered questionnaire whose validity was approved by experts′ opinions and its reliability was approved by test-retest method. Results : Among all participants of this study, 87% were female. The mean age of nurses was 32.00 ± 6.72. From all respondents 62% stated that they have no knowledge about hospice care and 80% declared that need for hospice care is increasing. Most of the participants felt that, appropriate services are not presented to patients in the final stages of their lives. About 80% believed that hospice care leads to reduction of health care costs, improvement of physical, mental and social health of patients and finally improvement of the quality of health care services. There was a significant relationship between age, employment history and level of education of nurses and their attitude and knowledge about how this service is provided. Conclusion : In view of the increase in chronic illnesses and the costs of caring, the need for provision of hospice care is felt more and more every day. However the awareness level of nurses about these services is low. Therefore the need for including these issues in nursing curriculum and holding scientific courses and seminars in this field is needed.
The freelance nurse must be adaptable and reactive in order to meet the needs of a depressed or suicidal elderly person. In addition to her own particular relationship with the patient, the nurse must activate a network of other professionals who can carry out home visits.
Stolt, Minna; Suhonen, Riitta; Puukka, Pauli; Viitanen, Matti; Voutilainen, Päivi; Leino-Kilpi, Helena
This study aimed to explore nurses' knowledge of foot care and related factors in home care nursing. Nurses caring for older people are increasingly confronted with clients who have multiple foot problems and need support with their foot health. The role of nurses in promoting foot health, caring for existing foot problems and supporting older people in foot self-care is especially important in the home care context. However, this entails up-to-date foot care knowledge and practices. A cross-sectional correlational survey study design. Nurses' knowledge of foot care was evaluated using the Nurses' Foot Care Knowledge Test developed for this study. The data were analysed with descriptive and inferential statistics. Nurses (registered nurses, public health nurses and licensed practical nurses) from public home care (n = 322, response rate 50%) participated the study. Nurses' knowledge in foot care varied. The knowledge scores were highest for skin and nail care and lowest for the identification and care of foot structural deformities. Longer working experience in the current work place and participation in continuing education explained higher Nurses' Foot Care Knowledge Test scores. Nurses need more knowledge, and hence continuing education, in the foot care of older people to effectively prevent, recognise and care for foot problems and promote independent living in the community. Nurses' have clinically relevant knowledge gaps. Therefore, foot care knowledge of nurses needs to be improved by continuing education in clinical settings. Adequate foot care knowledge among nurses is important to identify, prevent and care foot problems especially in older people. © 2015 John Wiley & Sons Ltd.
Hahtela, Nina; Paavilainen, Eija; McCormack, Brendan; Slater, Paul; Helminen, Mika; Suominen, Tarja
To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave. © 2014 John Wiley & Sons Ltd.
Amante, Lúcia Nazareth; Rossetto, Annelise Paula; Schneider, Dulcinéia Ghizoni
The purpose of this study was to implement the Nursing Care Systematization--Sistematização da Assistência de Enfermagem (SAE)--with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA) Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.
Keddy, B A
Mental health professionals have the experience and skills necessary to provide care and support to colleagues and peers in these troubled and stressful times. Yet, traditionally nurses have not been supportive of one another. Not receiving much interest from the feminist movement and not willingly to embrace feminist social activism, the nursing profession has suffered as it continues to embrace racist, classist, sexist, and homophobic outdated theories and research practices. Without a collective voice which unites all nurses in a common struggle, issues related to mental health nursing will continue to be viewed in a fragmented way. Until feminist research, theory, and practice become central to the profession's ideology, nurses will continue to be divided among themselves, unable to provide the necessary caring for one another.
Karanikola, Maria N K; Albarran, John W; Drigo, Elio; Giannakopoulou, Margarita; Kalafati, Maria; Mpouzika, Meropi; Tsiaousis, George Z; Papathanassoglou, Elizabeth D E
To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession. © 2013 John Wiley & Sons Ltd.
da Cruz, Andrea de Mello Pereira; Almeida, Miriam de Abreu
This is a qualitative, exploratory and descriptive study whose general objective was to learn, considering the perspective of the nursing technician who works in school hospitals, the competencies developed during their educational process to implement the Nursing Care Systematization (NCS). Data collection and analysis were carried out through a focal group, with content analysis and nursing technicians. Two thematic categories emerged: The participation of the nursing technician in the NCS and The competencies in the education of the nursing technician. Each one received two subcategories: Conception of the NCS and (De)valuation of the NCS, Technical-scientific competency and Competency in the interpersonal relationship, respectively. It was observed that the NCS must be shared, discussed and made public among nursing professionals, so that they may acknowledge themselves as the leading actors of their methodology and be aware that their practices determine the results.
Sarah Nilkece Mesquita Araújo
Full Text Available OBJECTIVE: to analyze nursing care provided to cancer patients with oral mucositis based on the Nursing Process (NP. METHOD: this exploratory, descriptive, cross-sectional and quantitative study was conducted with 213 patients undergoing chemotherapy and/or radiotherapy in two cancer facilities: one philanthropic and one private service. RESULTS: the participants were mainly female, aged 45.8 years old on average, with up to 11 years of schooling and income of up to one times the minimum wage. Severe mucositis was related to chemotherapy associated with radiotherapy. Only 25.3% of the patients reported having received guidance from nurses during their treatment concerning self-care. The perceptions of patients regarding quality of care did not significantly differ between the private and public facilities. The basic human needs mainly affected were comfort, eating, and hygiene. Based on this finding, one NP was established listing the diagnoses, interventions and expected results to establish an ideal, though individualized, standard of nursing care to be provided to these patients. CONCLUSION: to understand oral mucositis is crucial to establish nursing care that includes prevention based on the implementation of an oral care plan.
Dellefield, Mary Ellen
Purpose: This article is a critical review of the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes. Design and Methods: We reviewed educational and empirical literature. Results: Interdisciplinary care planning and the written care plan are…
Helder, O.K.; Verweij, J.C.M.; Staa, A.L. van
To explore parents' and nurses' experiences with the transition of infants from the neonatal intensive care unit to a special care nursery. Qualitative explorative study in two phases. Level IIID neonatal intensive care unit in a university hospital and special care nurseries (level II) in five comm
Conclusion: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.
J.C.M. Verweij; O.K. Helder; Dr. A.L. van Staa
To explore parents' and nurses' experiences with the transition of infants from the neonatal intensive care unit to a special care nursery. Qualitative explorative study in two phases. Level IIID neonatal intensive care unit in a university hospital and special care nurseries (level II) in five comm
Davison, Ian; Cooke, Sandra
Patients with long-term conditions may benefit from involvement in decision-making and the management of their condition. This requires nurses to have a training role, which may conflict with their traditional identity as nurses. To explore the differences in attitudes and behaviours of 'carer' and 'trainer' nurses to patients taking increasing responsibility and control of their own care on long-term haemodialysis wards. Qualitative comparison of different nursing styles. Semi-structured interviews were undertaken with 30 patients and 44 nurses between September and November 2012. Participants were recruited from seven haemodialysis units in the UK. Data were analysed thematically using codes derived from theories associated with the research questions. 'Carer' nurses give bite-sized chunks of information to their patients about diet and medication. Treatment decisions are made with minimal patient discussion and all aspects of dialysis are performed by staff. Nurses who are most like trainers encourage patients to have a broader understanding of their condition and genuinely involve patients in decisions. Such nurses are happy to encourage appropriate patients to self-dialyse. Initiatives to enable patients with chronic illnesses to look after themselves have the potential to empower patients, aid recovery and save money. However, such initiatives can create tension between the carer identity of nurses and their role as trainers. To encourage haemodialysis patients to dialyse themselves, nurses need to: educate for broad understanding and empowerment; participate in patient-led decision-making about diet and lifestyle; and encourage shared decision-making for medication and dialysis. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Weber-Yaskevich, Olga; Reber, Alexandra; Gillabert, Cédric
In response to the ambulatorization of medical care, the panel of ambulatory nursing medical care is operating important changes. Since 2011, "acute and transitional medical care" is being prescribed by hospital practitioners, implying a new definition of the nurse's profession. The consequence is more complex and more autonomous nursing care: an academic formation has been created for nurses (bachelor and master) and their assistants (healthcare and community assistants). The futur will probably be made of ambulatory case management by nurses (advanced nurse practictioner). General practictioners will not only collaborate with the nurses but also assign them with tasks handled until then by themselves, prescribing, among other things, domiciliary "long-term" medical care.
Mayer, Deborah K
Nursing research and nurse researchers have been an integral and significant part of the Oncology Nursing Society's (ONS's) history, as evidenced by the development of the Nursing Research Committee within a few years of ONS's establishment. Ruth McCorkle, PhD, RN, FAAN, was the committee's first chairperson in 1979. This was followed by the creation of the Advanced Nursing Research Special Interest Group in 1989 under the leadership of Jean Brown, PhD, RN, FAAN. ONS also began to recognize nurse researchers in 1994 by creating the annual ONS Distinguished Researcher Award to recognize the contributions of a member who has conducted or promoted research that has enhanced the science and practice of oncology nursing. The list of recipients and of their work is impressive and reflects the wide range of our practice areas (see http://bit.ly/1MTC5cp for the recipient list). In addition, the ONS Foundation began funding research in 1981 and has distributed more than $24 million in research grants, research fellowships, and other scholarships, lectures, public education projects, and career development awards (ONS Foundation, 2015). And, in 2006, the Putting Evidence Into Practice resource was unveiled, which provides evidence-based intervention reviews for the 20 most common problems experienced by patients with cancer and their caregivers (www.ons .org/practice-resources/pep) .
Fringer, André; Huth, Martina; Hantikainen, Virpi
In geriatric care, movement support skills of nurses are often limited, resulting in unnecessary functional decline of older adult residents and physical strain of nurses. Kinaesthetics training aims to improve movement competences of nurses and residents. The aim of this qualitative descriptive study is to describe nursing teams' experience with…
Rahman, Anna N.; Simmons, Sandra F.; Applebaum, Robert; Lindabury, Kate; Schnelle, John F.
Purpose: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff…
This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were…
Mariani, E.; Chattat, R.; Vernooij-Dassen, M.; Koopmans, R.T.; Engels, Y.
BACKGROUND: Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents' con
Mariani, E.; Chattat, R.; Vernooij-Dassen, M.; Koopmans, R.T.; Engels, Y.
BACKGROUND: Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents'
The mobile palliative care and support team nurse works in different departments within the hospital. The clinical situation of a patient enables the team to identify in what ways she is declining and thereby participate in the care management in order to favour the patient's return home.
Kuehn, Mary Beth
The purpose of this qualitative, phenomenological study was to describe how nursing faculty are cared for in the workplace. Participants were interviewed individually or in a focus group to understand their experience. Following data analysis, the following themes were created: the process of being cared for included connecting, openly sharing,…
Full Text Available Abstract Background There is no comprehensive measure of dimensions describing the nursing relationship that is suitable for use with survey samples and that is focused on nursing particular types of patients. The objective of this study was to develop a measure to investigate significant dimensions of the nurse-patient relationship, the Nursing Relationship Scale (NRS. Methods Hypothetical cases (diabetes or mental illness in vignette format were presented to 132 psychiatric and 76 general nurses. Thirty-four questions about the nurse-patient interaction were asked. Principal component analyses (with oblique rotation were used to identify underlying dimensionality in the correlations of items, combining ratings from the two case vignettes. Scales were constructed from the final solution and Cronbach's alpha coefficients calculated. Subscale score variations were analysed across nurse type and patient type to examine the discriminant validity of the subscales. Results Principal components analysis revealed five dimensions accounting for 52 percent of the variation within items. Four 'conceptual' factors were derived. These were labeled Caring/Supportive Approach, Nursing Satisfaction, Authoritarian Stance, and Negativity. Developed as subscales, reliability analysis indicated high internal consistency with respective alpha coefficients for the diabetes case 0.91, 0.75, 0.65, and 0.78 and for the mental illness case of 0.91, 0.75, 0.73, and 0.85. There was significant variation in scale scores according to nurse type (psychiatric versus general and patient type (diabetes versus mental illness. Nurses endorsed more highly items from the subscales Caring/Supportive Approach and Nursing Satisfaction than items from Authoritarian Stance (with intermediate endorsement and Negativity (lowest endorsement subscales. Conclusions Psychometric evaluation of the NRS suggests it is a reliable instrument for measuring four key dimensions of the nurse
Happ, Mary Beth; Garrett, Kathryn; Thomas, Dana DiVirgilio; Tate, Judith; George, Elisabeth; Houze, Martin; Radtke, Jill; Sereika, Susan
Background The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. Objectives To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. Methods Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. Results Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). Conclusions Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials. PMID:21362711
Delicado Useros, M V; Candel Parra, E; Alfaro Espín, A; López Máñez, M; García Borge, C
To find the attitudes that primary care nurses in Albacete have towards family carers. Qualitative research using discussion groups. Primary care in Albacete: 5 health centres, 2 rural and 3 urban. Nurses following a primary care home visit programme, of both sexes, differing experience and training, and coming from both rural and urban areas took part. Exclusion criterion: nurses in management and administrative posts at time of recruitment. They were recruited by primary care nurses in line with the profiles of participants required. Information was collected through discussion in the groups, which was recorded and later transcribed for analysis. Those taking part in the 2 discussion groups had the following characteristics: 3 men and 8 women. 5 of them were from rural health centres (HC) and 6 from urban HC; 3 had under 2 years experience in the Home Visit Programme (HVP) and 8 had over 5 years experience in it; 5 completed their nursing studies before 1990, and 6 afterwards. In the chats it was clear that the broad experience of PC nurses made them aware of the health situation and quality of life of informal carers, of the loneliness of these and the inter-personal conflicts that occur in families when a situation of dependency arises. Nurses had their educational function towards the carers assumed despite the limitations. The view that the responsibility for the care of the dependent person is the family's was predominant, and a concern for lack of resources and support was appreciated. Nurses had a view of the carer as a resource and barely perceived her as a patient.
Full Text Available This study was conducted to determine the level of compassion fatigue which experienced by nurses who work in intensive care units and factors that affecting it. In a cross sectional design, critical nurses were surveyed by using questionnaire and compassion fatigue (CF subscale of the Professional Quality of Life Scale (ProQOL R-IV to measure levels of compassion fatigueat a large National Education and ResearchHospital located in northwestof Turkey. A total of 69 critical care nurses participated in the study, for a response rate of 78%.A series of cross tab analyses examined the relationship between nurses demographics and compassion fatigue (CF subscale. To analyze the data further, participants were recategorized into 2 groups for CF scores: (1 higher than 17: high risk and (2 lower than 17: low risk. Findings show that critical care nurses were at high risk (52.7% and low risk (47.3% for CF. Nurses informed significant differences in compassion fatigue on the basis of age, years of critical care experience, working hours (weekly.
Wietrich, Laurence; Regnier, Jean-Claude
This article presents some results stemming from university research work, in relation with nursing training and the construction of student nurses' professional identity. As a tool contributing in the process of this construction, Research in Nursing Care (RNS), the main subject of our research, is an element of the training program in nursing care. In a context of development of the profession, we tried to clarify the meaning of RNC as part of training but also in the fields where care is lavished as this is a work/study education program. The RNC object was discussed in historical, regulatory, and scientific contexts. Three hypotheses were raised and put to the test; the followed methodology was clarified some proposals followed the analysis of the various data corpus obtained and some reflection tracks were initiated for the trainers and assistants.
Yakusheva, Olga; Lindrooth, Richard; Weiss, Marianne
Objective The aims of the study were to (1) estimate the relative nurse effectiveness, or individual nurse value-added (NVA), to patients’ clinical condition change during hospitalization; (2) examine nurse characteristics contributing to NVA; and (3) estimate the contribution of value-added nursing care to patient outcomes. Data Sources/Study Setting Electronic data on 1,203 staff nurses matched with 7,318 adult medical–surgical patients discharged between July 1, 2011 and December 31, 2011 from an urban Magnet-designated, 854-bed teaching hospital. Study Design Retrospective observational longitudinal analysis using a covariate-adjustment value-added model with nurse fixed effects. Data Collection/Extraction Methods Data were extracted from the study hospital's electronic patient records and human resources databases. Principal Findings Nurse effects were jointly significant and explained 7.9 percent of variance in patient clinical condition change during hospitalization. NVA was positively associated with having a baccalaureate degree or higher (0.55, p = .04) and expertise level (0.66, p = .03). NVA contributed to patient outcomes of shorter length of stay and lower costs. Conclusions Nurses differ in their value-added to patient outcomes. The ability to measure individual nurse relative value-added opens the possibility for development of performance metrics, performance-based rankings, and merit-based salary schemes to improve patient outcomes and reduce costs. PMID:25256089
Vinicia de Holanda Cabral
Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.
Silva, Denise Conceição; Alvim, Neide Aparecida Titonelli
The purpose of this qualitative research was to characterize the elements that constitute the environment of the Surgical Center and to analyze its implications for dynamic of care and nursing care. Based on the Environmental Theory's principals. Participated twelve nurses from the Surgical Center of a College Hospital in Rio de Janeiro. Data were gathered through the creativity and sensitivity technique "Map-Speaker", semi-structered interviews and participant observation, and were analyzed by thematic categories. The results showed that care can happen directly and indirectly in favor of full client recovery, counting the environment that the integrate in purpose to maintain harmonic and balanced. The nurse interventions aim to maintain the environment in favorable conditions so that a higher standard of care can be promoted.
Alexander, Gina K; Rollins, Kari; Walker, Danielle; Wong, Lily; Pennings, Jacquelyn
The promotion of self-care and the prevention of burnout among nurses is a public health priority. Evidence supports the efficacy of yoga to improve physical and mental health outcomes, but few studies have examined the influence of yoga on nurse-specific outcomes. The purpose of this pilot-level randomized controlled trial was to examine the efficacy of yoga to improve self-care and reduce burnout among nurses. Compared with controls (n = 20), yoga participants (n = 20) reported significantly higher self-care as well as less emotional exhaustion and depersonalization upon completion of an 8-week yoga intervention. Although the control group demonstrated no change throughout the course of the study, the yoga group showed a significant improvement in scores from pre- to post-intervention for self-care (p < .001), mindfulness (p = .028), emotional exhaustion (p = .008), and depersonalization (p = .007) outcomes. Implications for practice are discussed. © 2015 The Author(s).
Farley, D O; Zellman, G; Ouslander, J G; Reuben, D B
To characterize the use of formal primary care programs by health maintenance organizations (HMOs) for their members who are long-stay residents of nursing homes. Using mail survey techniques, 34 Medicare risk-contracting HMOs with the largest Medicare beneficiary enrollments were asked to complete a written questionnaire. HMOs were asked how they evaluate care in nursing home settings and whether they operate a formal primary care program for members who are long-stay nursing home residents. Those reporting they had programs were asked about the program features, participation in the program, roles performed by clinical practitioners, and clinical caseloads. Surveys were completed by 21 (61.8%) of the HMOs. HMO management personnel who know the primary care programs the HMOs operate in affiliated nursing homes. Descriptive summaries of the HMOs' responses to the survey questions were generated. For HMOs with primary care programs, caseloads of physicians and nurse practitioners were estimated using survey data reported by the HMOs. Eight (38.1%) of the responding HMOs operate formal primary care programs in affiliated nursing homes. HMOs with programs consider more factors than non-program HMOs in evaluating care for nursing home residents. Reasons cited most frequently for not having a program are costs and too few nursing home residents. The most common primary care program features are designated physicians and use of physician extenders. Survey findings point to the potential importance of formal HMO primary care programs for long-term nursing home residents, which may expand with growth in the older population and Medicare-managed care. Program adoption, however, may depend on sufficient resident participation to be financially feasible.
Papastavrou, Evridiki; Andreou, Panayiota; Tsangari, Haritini; Merkouris, Anastasios
Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses' perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses' perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels. A descriptive, correlational design was employed. Participants in this study included 352 patients and 318 nurses from ten medical and surgical units of five general hospitals. Three measurement instruments were used: the BERNCA scale for rationing of care, the RPPE scale to explore nurses' perceptions of their work environment and the Patient Satisfaction scale to assess the level of patient satisfaction with nursing care. The statistical analysis included the use of Kendall's correlation coefficient to explore a possible relationship between the variables and multiple regression analysis to assess the effects of implicit rationing of nursing care together with organizational characteristics on patient satisfaction. The mean score of implicit rationing of nursing care was 0.83 (SD = 0.52, range = 0-3), the overall mean of RPPE was 2.76 (SD = 0.32, range = 1.28 - 3.69) and the two scales were significantly correlated (τ = -0.234, p < 0.001). The regression analysis showed that care rationing and work environment were related to patient satisfaction, even after controlling for nurse and patient characteristics. The results from the adjusted regression models showed that even at the lowest level of rationing (i.e. 0.5) patients indicated low satisfaction. The
Shirey, Maria R
This article provides a historical overview of nursing models of care for acute and critical care based on currently available literature. Models of care are defined and their advantages and disadvantages presented. The distinctive differences between care delivery models and professional practice models are explained. The historical overview of care delivery models provides a foundation for the introduction of best practice models that will shape the environment for acute and critical care in the future.
Hermida, Patricia Madalena Vieira
This study has reviewed the national literature regarding nursing assistance systematization (NAS), with the aim of identifying the difficulties implementing this practice and the factors that interfere with and harm its implementation. The MEDLINE, LILACS, and BDENF databases have been utilized and six studies published in nursing periodicals in the last five years have been surveyed. The results indicate several difficulties implementing the NAS and several factors that interfere negatively with its implementation. Considering the importance of this assistance methodology for valuing professional nursing, it is necessary to reflect on/discuss its practical difficulties so that we can overcome them, making it a pleasurable activity capable of providing nurses with autonomy and providing patients with quality assistance.
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Matney, Susan A; Dolin, Gay; Buhl, Lindy; Sheide, Amy
A care plan provides a patient, family, or community picture and outlines the care to be provided. The Health Level Seven Consolidated Clinical Document Architecture (C-CDA) Release 2 Care Plan Document is used to structure care plan data when sharing the care plan between systems and/or settings. The American Nurses Association has recommended the use of two terminologies, Logical Observation Identifiers Names and Codes (LOINC) for assessments and outcomes and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for problems, procedures (interventions), outcomes, and observation findings within the C-CDA. This article describes C-CDA, introduces LOINC and SNOMED CT, discusses how the C-CDA Care Plan aligns with the nursing process, and illustrates how nursing care data can be structured and encoded within a C-CDA Care Plan.
Ryan, Sheila A.
A knowledge base of nursing theory supports computerized consultation to nursing service administrators and staff about patient care. Three scenarios portray different nurses utilizing the system for inservice development, continuing education, and development of standards of care or protocols for practice. The advantages of the system including cost savings are discussed.
Bedells, Ella; Bevan, Ann
This article reviews the literature on nurses' and parents' self-perceived roles when caring for hospitalised children, focusing on research conducted since the Department of Health published the National Service Framework for Children: Standard for Hospital Services in 2003. Three main themes emerge from the review: nurses' perceptions, parents' perceptions, and negotiation. Clarification of what nurses and parents consider to be their respective roles when caring for hospitalised children is a prerequisite for negotiation of those roles. The family's background, life experiences and circumstances influence the effectiveness of negotiation between nurses and parents. The article explores potential barriers to negotiation, including poor communication and failure to provide information. Limitations of the research and the implications for practice are considered.
Silvia Helena Henriques Camelo
Full Text Available Objective. The aim in this study was to identify how Intensive Care Unit nurses perceive professional competences in thecare team. Methodology. Qualitative multiple case study with an exploratory focus. The sample consisted of 24 nurses from Intensive Care Units (ICU at two large hospitals. To collect the information, direct observation and - structured, non-structuredand participant - interviews were used. Results. Ninety-six percent of the participants were women, 79% were less than 40 years old, and 63% possessed less than five years of professional experience in ICU. Data analysis revealed three study categories: teamwork as a nursing management tool, improving teamwork, and interpersonal communication for teamwork. Conclusion. At the ICU where the nurses work, a teamwork strategy is observed, which demands cooperation and participation by other disciplines.
O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan
Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.
From the clinics of South Africa, where there are "No Gun" signs on the walls; to the rural island hospital in Micronesia, where there is no running water; to the urban hospitals of Los Angeles serving non-English speaking clients from around the globe; to the nurse-run clinics in the harsh Alaska frontier, nurses are focused on doing their best to give quality nursing care. This focus on providing quality care is commendable. However, nurses must also focus on taking care of themselves so they are able both to continue providing quality care for their patients and to maintain the profession's ability to recruit and retain new nurses. In nursing textbooks from the late 1980s and early 1990s, risks to health care workers were listed only as sub headings in sections such as infectious agents and musculoskeletal injuries, or in general chapters on "women's work." It is a remarkable sign of progress that there is now a discrete focus on the health and safety of health care workers. This article provides a general introduction to the topic of nurse safety. First the major areas of health and safety concerns and the Hierarchy of Controls framework for risk reduction will be outlined. Next, findings from American Nurses Association (ANA) surveys which helped to crystallize the issue of safety and challenged the profession to focus on nurse safety will be presented. Following this, the linkages between patient safety and nurse safety will be discussed. Finally national reports, environmental initiatives, and policy successes and opportunities related to nurse safety will be noted.
Ummu Yildiz Findik, BSN, MSc, PhD
Conclusions: The number of colonies of the microorganisms in the hand flora of the nurses increased postshift. The handwashing behavior of intensive care nurses must be improved as they nurse critical patients.
Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee
The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.
Full Text Available Introduction: Nursing students need to build their capacity to understand and learn the form of caring of a professional nurse from a different point of view and apply the acquired knowledge into nursing practice. The purpose of the present study was to develop a model of caring behavior improvement in students of professional nursing education program in order to achieve students’ nursing care competence. Method: The present study used the explanatory survey and pre-experimental research design. Samples were students practicing in the ICU. Independent variables were attitude, personality, motivation and job design. Dependent variables were students’ caring behaviors and competence. Instruments used were a questionnaire for the independent variables and an observation sheet for the dependent variables. Data were analyzed using the Partial Least Square method. Result: Results showed that the loading factor of attitudes, personality, motivation, and job design against students’ caring behavior was > 1.96. The loading factor of students’ caring behaviors against the achievement of students’ competence was > 1.96. There were effects of attitude, personality, motivation and job design on students’ caring behaviors. Additionally, there was a signifi cant effect of caring behaviors on the achievement of student competence. Discussion: students’ attitudes, personality, motivation and job design would affect the shaping of students’ caring behaviors. Students’ caring behaviors would affect the achievement of student competence. Keywords: Caring behaviors, competence, ICU
Jefferies, Diana; Johnson, Maree; Ravens, Jennifer
Researchers collaborated with clinicians, consumers and dietitians to develop a policy defining how nurses could support their patients' nutritional care. A high prevalence of hospital malnutrition has been reported in Australia, Europe and the UK. A patient's nutritional status can deteriorate during admission. Malnutrition can increase complications, length of stay, mortality rates and health care costs. As the nursing role has become increasingly complex, traditional nurturing activities such as serving the patients' meals have devolved to other categories of staff leaving the role of nurses in their patients' nutritional care ill-defined. The research team systematically reviewed relevant research literature using the principles of qualitative metasynthesis to identify appropriate nursing strategies that would assist in reducing the prevalence of hospital malnutrition. The policy was developed using a systematic review approach: devising a clinical question, searching the literature, appraising research evidence, analysing existing policy documents, synthesising evidence into dominant themes and once the policy was drafted, initiating a wide ranging consultation and ratification process. A literature search located 147 articles. Forty articles were identified as being within the scope of the clinical question. Most were reports of audits or observation studies. The dominant themes were developed into standards that assisted nurses in supporting the oral nutrition of their patients. These included the following: a focussed mealtime, management of mealtime environments, management of staff mealtimes and a designated nutrition support nurse in each clinical area to monitor and evaluate the implementation of the policy. There is a distinct role for nurses that will assist in reducing the prevalence of hospital malnutrition but successful implementation can only occur with the support of the multidisciplinary team. This policy provides a framework to define and
Cléton Salbego; Carla da Silveira Dornelles; Patrícia Bitencourt Toscani Greco; Vânia Marta Pradebon; Gabriela Fávero Alberti
Objective: to understand the meaning of care for nursing technicians who work in the Surgical Center of a general hospital in the western border of Rio Grande do Sul/Brazil. Methods: this is a qualitative research, with an exploratory and descriptive approach. The technique used for data collection was a semi-structured interview and notes from the field diary were available for support. The respondents were eight nursing technicians of the Surgical Center. Results: it can be emphasized that ...
Oliveira, Palmira da Conceição M; Fernandes, Henriqueta Ilda V; Vilar, Ana Isabel S P; Figueiredo, Maria Henriqueta de J S; Ferreira, Maria Margarida Silva R S; Martinho, Maria Júlia C M; Figueiredo, Maria do Céu A B; Andrade, Luísa Maria da C; de Carvalho, José Carlos M; Martins, Maria Manuela Ferreira P da S
The attitudes of nurses towards families determine the care process. With this study, we aimed to obtain an instrument that would allow us to learn about this variable. Hence, our purpose was to perform the cross-cultural adaptation and evaluate the psychometric features of the Portuguese version of the instrument Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), which aims to evaluate the attitudes of nurses towards the importance of involving the patient's family in the nursing care. The method recommended by the literature was followed. The sample consisted of 136 nurses working in primary health care. The results obtained in the reliability tests showed good internal consistency (Cronbach's Alpha=0.87). The psychometric study permits us to state that the Portuguese version of the FINC-NA, which in Portuguese is referred to as A importância das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), is a reliable and valid tool.
... nursing home care beyond six months. 17.60 Section 17.60 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.60 Extensions of community nursing home care beyond six months. Directors of health care facilities may authorize, for...
Milutinović, Dragana; Golubović, Boris; Brkić, Nina; Prokeš, Bela
The aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a cross-sectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.
Carpenter, Joan G
Although palliative care consultation teams are common in U.S. hospitals, follow up and outcomes of consultations for frail older adults discharged to nursing facilities are unclear. To summarize and critique research on the care of patients discharged to nursing facilities following a hospital-based palliative care consult, a systematic search of PubMed, CINAHL, Ageline, and PsycINFO was conducted in February 2016. Data from the articles (N = 12) were abstracted and analyzed. The results of 12 articles reflecting research conducted in five countries are presented in narrative form. Two studies focused on nurse perceptions only, three described patient/family/caregiver experiences and needs, and seven described patient-focused outcomes. Collectively, these articles demonstrate that disruption in palliative care service on hospital discharge and nursing facility admission may result in high symptom burden, poor communication, and inadequate coordination of care. High mortality was also noted. [Res Gerontol Nurs. 2017; 10(1):25-34.].
According to a contemporary school of thought there is a specific female approach to ethics which is based not on abstract "male" ethical principles or rules, but on "care". Nurses have taken a keen interest in these female approaches to ethics. Drawing on the views expounded by Carol Gilligan and Nel Noddings, nurses claim that a female "ethics of care" better captures their moral experiences than a traditional male "ethics of justice". This paper argues that "care" is best understood in a dispositional sense, that is, as sensitivity and responsiveness to the particularities of a situation and the needs of "concrete" others. While "care", in this sense, is necessary for ethics, it is not sufficient. Ethics needs "justice" as well as "care". If women and nurses excessively devalue principles and norms, they will be left without the theoretical tools to condemn some actions or practices, and to defend others. They will, like generations of nurses before them, be condemned to silence.
Paunova, Minna; Li-Ying, Jason; Egerod, Ingrid Eugenie
This study investigates the influence of nurse knowledge sharing behavior on nurse innovation, given different conditions of control of care quality within the intensive care unit (ICU). After conducting a number of interviews and a pilot study, we carried out a multi-source survey study of more...... than 200 nurses employed in 22 ICUs at 17 Danish hospitals. Overall, we find that knowledge sharing among individual ICU nurses has a positive impact on their innovation. Meanwhile, strong control of care quality makes this positive impact less effective. However, different aspects of knowledge sharing...... affect innovation differently, depending on the strength as well as type of control of care quality within the unit. Healthcare organizations face an increasing pressure to innovate while controlling and accounting for care quality. This study demonstrates that the increasing pressures to implement...
Veer, A.J.E. de; Fleuren, M.A.H.; Bekkema, N.; Francke, A.L.
Background: A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better un
Veer, A.J.E. de; Fleuren, M.A.H.; Bekkema, N.; Francke, A.L.
BACKGROUND: A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better un
Veer, A.J.E. de; Fleuren, M.A.H.; Bekkema, N.; Francke, A.L.
Background: A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better
Veer, A.J.E. de; Fleuren, M.A.H.; Bekkema, N.; Francke, A.L.
BACKGROUND: A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better
Fellona, M O; DeVore, L R
The basic oral health needs of more than 100 million Americans are not being met, which places them at an increased risk for serious oral and systemic health consequences. Primary care nursing centers, a comparatively new method of health care delivery, provide health care screening, education, and referral services to person typically underserved in the traditional health care delivery system. Primary care nursing centers were surveyed to determine to what extent they provide oral health screening, education, and referral services for clients, and to identify factors that discourage and encourage the integration of these services. Nurses from 158 primary care nursing centers in the United States made up the study population. Data were collected using a self-administered questionnaire. Data from 59 primary care nursing centers were analyzed using frequency distributions and measures of central tendency. Almost half of the responding nurses at primary care nursing centers "almost always" screen their clients for gum infections (49%) and oral lesions (48%). Fewer teach their clients how to perform oral cancer self-examinations (20%); or educate them regarding use of athletic mouth protectors (15%), the effects of xerostomia (19%), and the benefits of fluoride (38%). The majority do not always refer clients needing treatment for dental decay (55%), gum infections (61%), missing teeth (80%), oral lesions (67%), oral pain (64%), or oral trauma (65%). Lack of referral sources (64%) and unavailability of oral health professionals to provide on site basic oral health services (63%) were the leading factors that discourage the integration of oral health services in the centers. An appreciation for the benefits of oral health (73%) and a knowledgeable clinician to perform oral health services (68%) were the leading factors that encourage the integration of oral health services into primary care nursing centers. These data could be useful in planning, implementing, and
O'Brien, M E; Pheifer, W G
As suggested earlier we have chosen in this article to discuss only a small group of key physical and psychosocial concerns and needs associated with HIV and AIDS. These were the issues most frequently discussed by a study group of people living with HIV. We recognize, however, that holistic nursing intervention considers the totality of the individual living with HIV: body, mind, and spirit. It is to that end that the discussed nursing diagnoses and interventions are directed. Ultimately, the successful identification of and intervention in HIV related problems rests in the unique relationship between nurse and patient sharing as collaborators in the healing experience. The body of contemporary nursing and behavioral science research in the area of HIV/AIDS continues to grow. Presently the National Center for Nursing Research is supporting studies focusing on such areas as the use of designated versus general care settings for HIV patient care, quality of nursing care in HIV/AIDS, the effects of nurse-managed home care for AIDS patients, stress and coping in caregivers of AIDS children, the testing of interventions for black women with AIDS, and prevention studies (National Center for Nursing Research, personal communication, 1992). Nevertheless, as the HIV pandemic continues to grow and expand its demographic parameters, more research, particularly with such populations as women and children, is urgently needed. Studies exploring prevention issues and symptom management also are most important. Some suggestions for future study include examination of cultural variables associated with coping with HIV and AIDS; longitudinal research on surviving HIV over time; intervention studies to test specific nursing therapeutics in various settings such as hospital, home, and clinic; and finally, research describing the impact of HIV and AIDS on family functioning and adaptation. It is only through continued study of the impact of HIV, on both the individual living with HIV
Full Text Available Abstract Background A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. Methods The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel, of whom 685 (67% completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Results Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive. The factors most frequently mentioned as impeding actual use were related to the (kind of technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. Conclusions A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived characteristics of the technology itself.
de Veer, Anke J E; Fleuren, Margot A H; Bekkema, Nienke; Francke, Anneke L
A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive.The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself.
Lima, Ana Paula Souza; Chianca, Tânia Couto Machado; Tannure, Meire Chucre
OBJECTIVE: to analyze the efficacy of the Nursing Process in an Intensive Care Unit using indicators generated by software. METHOD: cross-sectional study using data collected for four months. RNs and students daily registered patients, took history (at admission), performed physical assessments, and established nursing diagnoses, nursing plans/prescriptions, and assessed care delivered to 17 patients using software. Indicators concerning the incidence and prevalence of nursing diagnoses, rate of effectiveness, risk diagnoses, and rate of effective prevention of complications were computed. RESULTS: the Risk for imbalanced body temperature was the most frequent diagnosis (23.53%), while the least frequent was Risk for constipation (0%). The Risk for Impaired skin integrity was prevalent in 100% of the patients, while Risk for acute confusion was the least prevalent (11.76%). Risk for constipation and Risk for impaired skin integrity obtained a rate of risk diagnostic effectiveness of 100%. The rate of effective prevention of acute confusion and falls was 100%. CONCLUSION: the efficacy of the Nursing Process using indicators was analyzed because these indicators reveal how nurses have identified patients' risks and conditions, and planned care in a systematized manner. PMID:26039293
Ana Paula Souza Lima
Full Text Available OBJECTIVE: to analyze the efficacy of the Nursing Process in an Intensive Care Unit using indicators generated by software. METHOD: cross-sectional study using data collected for four months. RNs and students daily registered patients, took history (at admission, performed physical assessments, and established nursing diagnoses, nursing plans/prescriptions, and assessed care delivered to 17 patients using software. Indicators concerning the incidence and prevalence of nursing diagnoses, rate of effectiveness, risk diagnoses, and rate of effective prevention of complications were computed. RESULTS: the Risk for imbalanced body temperature was the most frequent diagnosis (23.53%, while the least frequent was Risk for constipation (0%. The Risk for Impaired skin integrity was prevalent in 100% of the patients, while Risk for acute confusion was the least prevalent (11.76%. Risk for constipation and Risk for impaired skin integrity obtained a rate of risk diagnostic effectiveness of 100%. The rate of effective prevention of acute confusion and falls was 100%. CONCLUSION: the efficacy of the Nursing Process using indicators was analyzed because these indicators reveal how nurses have identified patients' risks and conditions, and planned care in a systematized manner.
Maria Valeria Jimenez-Baez
Full Text Available Objectives: Determine the domain of preventive dentistry in nursing personnel assigned to a primary care unit. Methods: Prospective descriptive study, questionnaire validation, and prevalence study. In the first stage, the questionnaire for the practice of preventive dentistry (CPEP, for the term in Spanish was validated; consistency and reliability were measured by Cronbach's alpha, Pearson's correlation, factor analysis with intra-class correlation coefficient (ICC. In the second stage, the domain in preventive dental nurses was explored. Results: The overall internal consistency of CPEP is α= 0.66, ICC= 0.64, CI95%: 0.29-0.87 (p >0.01. Twenty-one subjects in the study, average age 43, 81.0% female, average seniority of 12.5 were included. A total of 71.5% showed weak domain, 28.5% regular domain, and there was no questionnaire with good domain result. The older the subjects were, the smaller the domain; female nurses showed greater mastery of preventive dentistry (29%, CI95%: 0.1-15.1 than male nurses. Public health nurses showed greater mastery with respect to other categories (50%, CI95%: 0.56-2.8. Conclusions: The CDEP has enough consistency to explore the domain of preventive dentistry in health-care staff. The domain of preventive dentistry in primary care nursing is poor, required to strengthen to provide education in preventive dentistry to the insured population. Normal 0 false false false EN-US X-NONE X-NONE
Katz, Paul R.; Karuza, Jurgis; Intrator, Orna; Mor, Vincent
Marginalization of physicians in the nursing home threatens the overall care of increasingly frail nursing home residents who have medically complex illnesses. The authors propose that creating a nursing home medicine specialty, which recognizes the nursing home as a unique practice site, would go a long way toward remedying existing problems with care in skilled nursing facilities and would best serve the needs of the 1.6 million nursing home residents in the United States. Reviewing what is...
Full Text Available Childhood experiences of living in a world of sweeping changes and unpredictable extreme events can be very stressful and are often traumatic and children are not able to mobilize the defense mechanisms necessary for adaptation. Traumatic experiences for a child can include exposure to natural disasters, circumstances such as war and terrorism, situations of victimization (physical or sexual abuse, accidents resulting in serious injury and disability, loss of loved one, a life-threatening illness and hospitalizations, painful situations, as well as domestic and interfamily violence. The aim of this literature review was to explore the nursing care of children after a traumatic incident through a critical review of the existing literature. Material and Methods: A literature search was performed in Medline, Cinahl, BNI, PsycINFO, and Scopus databases with keywords relevant to the subject of this review. Results: From the literature review it was found that the published resources with respect to the nursing care of children after a traumatic event are very limited and they do not provide clear nursing care plans. Nursing care of children after a traumatic incident involves the prevention of trauma, the detection of early symptoms, the protection of the child from self-destructive and suicidal behavior, the restoration of confidence in self and others, the enhancement of the expressiveness, covering child's emotional needs, the family counseling and reconnection with their peers and childhood activities, as well as ensuring follow-up of their therapeutic progress. Conclusions: Traumatic experiences directly influence a child at physical, mental and emotional levels, making an impact on the smooth psycho-emotional development, the formation of his personality and the quality of childhood and future adult life. It is vital that nurses are aware of therapeutic techniques, in order to approach and nurse traumatized children in the community or in
Harden, Karen; Price, Deborah; Duffy, Elizabeth; Galunas, Laura; Rodgers, Cheryl
Oncology nurses affect patient care at every point along the cancer journey. This creates the perfect opportunity to educate patients and caregivers about palliative care early and often throughout treatment. However, healthcare providers frequently do not have the knowledge and confidence to engage in meaningful conversations about palliative care. . The specific aims were to improve oncology nurses' palliative care knowledge, attitudes, and behaviors by providing a palliative care nursing education program. An additional aim was to increase the number of conversations with patients and families about palliative care. . This project had a pre-/post-test design to assess knowledge, attitudes, and behaviors at baseline and one month after implementation of an established education curriculum. The teaching strategy included one four-hour class for oncology RNs with topics about the definition of palliative care, pain and symptom management, and how to have palliative care conversations. . Results showed a statistically significant difference after the educational intervention for knowledge, attitudes, and behaviors. The number of conversations with patients and caregivers about palliative and end-of-life care increased significantly.
Wlody, Ginger Schafer
This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.
Angelina Basilia Estela Díaz
Full Text Available Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care.
Haugstvedt, Anne; Aarflot, Morten; Igland, Jannicke; Landbakk, Tilla; Graue, Marit
Background Providing high-quality diabetes care in nursing homes and home-based care facilities requires suitable instruments to evaluate the level of diabetes knowledge among the health-care providers. Thus, the aim of this study was to examine the psychometric properties of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel. Methods The study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and...
Amorim, Thais Vasconselos; Arreguy-Sena, Cristina; Alves, Marcelo da Silva; Salimena, Anna Maria de Oliveira
This is a case study research that aimed to know, with the adoption of the Theory of Human Caring, the meanings of therapeutic interpersonal relationship between nurse and user on the preoperative nursing visit after the experience of the surgical process. The convenience sample was composed of three nurses and three users of an institution that has updated records to perform highly complex cardiovascular surgery, comprising nine combinations of therapeutic interactions. It was used instruments, structured according to the theory of Jean Watson and North American Nursing Diagnosis Association, Nursing Intervention Classification and Nursing Outcomes Classification taxonomies. The legal and ethical aspects of research involving human subjects were assured. The results revealed three clusters to grasp the significance of preoperative visits by users and five clusters to capture the perception of nurses when they experience this clinical experience.
Jordal, Kristin; Heggen, Kristin
Nursing education programmes and the nursing curriculum have been criticised for presenting an outdated and feminised description of care, which has had the effect of marginalising men, as well as hindering a more modern outlook for the profession. This article uses interview-based data from a qualitative study on Norwegian students' experiences in the first year of training. Using a narrative analysis method, the paper explores how male nursing students use stories to describe care and shows how their storytelling illustrates a way for men to negotiate their role in a feminised profession. The paper aims to deepen our understanding of the ways in which male students can challenge this historically female profession to broaden itself by including male-based caregiving as part of nursing care. In addition, the paper highlights the potential of stories and storytelling as a teaching and learning strategy in nursing education. Copyright © 2015 Elsevier Ltd. All rights reserved.
Medeiros, Renata Marien Knupp; Teixeira, Renata Cristina; Nicolini, Ana Beatriz; Alvares, Aline Spanevello; Corrêa, Áurea Christina de Paula; Martins, Débora Prado
to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses. transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software. the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results. inserting these nurses collaborated towards humanizing obstetric and neonatal care.
Fernanda Tiemi MIYAI
Full Text Available The University of Sao Paulo School of Nursing (EEUSP went through a period of transition from undergraduate syllabus between the years 2009 and 2010. This change was made to integrate basic and clinical cycles and to reduce fragmentation of the disciplines. The mental health nursing education was included in many modules including the primary care. This qualitative study aimed to identify how the service offered to people with mental illness was performed by 20 undergraduate students in the context of primary care and how they were prepared. Data collection was conducted through semi-structured interviews, in August 2012, in EEUSP. After thematic analysis, we separated in categories: Teaching-learning process, Basic Health Unit and Mental health-illness process. The socially constructed conception of madness added to the problems related to academic training may result in lack of preparation in nursing mental health care.
Soffer, Ann Katrine B.
of care are not explicated in the curriculum or textbooks; however, they surfaced once this crooked approach to studying care in a simulated practice was applied. The article starts from the assertion that detached engagements are not recognized within the ﬁeld of nursing education as an equal component...... to attachments. Yet empirical cases from the skills lab and hospitals illustrate how students sometimes felt emotionally attached to plastic dummies and how experienced nurses sometimes practised a degree of detachment in relation to human patients. Detached engagements will therefore be presented as part...... of care practices of nurses rendering the ability to detach in engagement with patients a professional skill that students also need to learn. In the analysis to follow, attached and detached engagements are located on an equal plane by integrating both in to the same conceptual framework, rather than...
Edwards, Marie Patricia; Throndson, Karen; Dyck, Felicia
Conflict over treatment plans is a cause of concern for those working in critical care environments. The purpose of this study was to explore and describe critical care nurses' perceptions of their roles in situations of conflict between family members and health-care providers in intensive care units. Using a qualitative descriptive design, 12 critical care nurses were interviewed individually and 4 experienced critical care nurses participated in focus group interviews. The roles described by the nurses were as follows: providing safe, competent, quality care to patients; building or restoring relationships of trust with families; and supporting other nurses. The nurses highlighted the level of stress when conflict arises, the need to be cautious in providing care and communicating with family members, and the need for support for nurses. More research related to working in situations of conflict is required, as is enhanced education for critical care nurses.
Smoleń, Ewa; Ksykiewicz-Dorota, Anna
Professionalism in nursing means the provision of medical and nursing services based on the best knowledge and skills, as well as on great responsibility for the undertaken actions. The opinions of patients and their families concerning professionalism, reflected in the level of satisfaction, contribute to the improvement of the quality of services offered. The study covered 120 parents/caregivers of children hospitalized in a pediatric ward. Diagnostic survey method was applied in the research. The standardized questionnaire for evaluation of the level of parents/caregivers satisfaction with nursing care (Latour et al.) adjusted to the conditions of Polish pediatric hospital services and subjected to validation was adopted as a research tool. Statistical analysis was performed using the Mann-Whitney U test and Kruskal-Wallis test. A value of p≤0.05 was considered to indicate statistical significance. The respondents were selected at random. The parents/caregivers received the questionnaire the day before the child's discharge. The parents/caregivers generally evaluated the professionalism of nursing care in positive terms (4.3). They expressed higher satisfaction with respect showed by nurses for patients (4.7), while lower satisfaction with nurses introducing themselves (3.2). A high level of satisfaction was obtained with respect to the parents/caregivers' opinions pertaining to cooperation within a therapeutic team (4.6), organization of nurses' work (4.6), and quality of nursing care (4.6). Parents/caregivers expressed their satisfaction with the professionalism of nursing care. Education of respondents, frequency and reasons for hospitalization among children proved to be the variables that significantly differed the opinions of parents/caregivers concerning the selected criteria for professionalism of nursing care. No correlation was found between the duration of hospitalization, children's age, place of parents/caregivers residence, and the level of
Thomas-Hawkins, Charlotte; Flynn, Linda; Clarke, Sean P
Little attention has been given to the effects of registered nurse (RN) staffing and processes of nursing care on patient outcomes in hemodialysis units. This research examined the effects of patient-to-RN ratios and necessary tasks left undone by RNs on the likelihood of nurse-reported frequent occurrences of adverse patient events in chronic hemodialysis units. Study findings revealed that high patient-to-RN ratios and increased numbers of tasks left undone by RNs were associated with an increased likelihood of frequent occurrences of dialysis hypotension, skipped dialysis treatments, shortened dialysis treatments, and patient complaints in hemodialysis units. These findings indicate that federal, state, and dialysis organization policies must foster staffing structures and processes of care in dialysis units that effectively utilize the invaluable skills and services of professional, registered nurses.
Rodwell, John; Demir, Defne
The objective of this study was to examine the social-situational (ie, Job Demands-Resource model) and individual (ie, negative affectivity) factors that might be associated with violence among nurses caring for the elderly (aged care nurses). Workplace violence is recognized as a serious issue among nurses. Effective intervention and prevention require an understanding of antecedent factors. Nurses working in elderly care facilities across an Australian healthcare organization participated in a cross-sectional survey. Job demands were associated with all of the externally sourced types of violence. Low job control was linked with external emotional abuse and physical assault. Outside work support was related to external physical assault and verbal sexual harassment. Finally, high negative affectivity was linked to internal and external emotional abuse and threat of assault. Both the Job Demands-Resource model and negative affectivity were useful in identifying relationships with violence, supporting suggestions that situational and individual factors are associated with violence among nurses who care for the elderly.
Full Text Available Introduction: The patients’ families in intensive care units (ICUs experience excessive stress which may disrupt their performance in daily life. Empathy is basic to the nursing role and has been found to be associated with improved patient outcomes and greater satisfaction with care in patient and his/her family. However, few studies have investigated the nursing empathy with ICU patients. This study aimed to assess nursing empathy and its relationship with the needs, from the perspective of families of patients in ICU.Methods: In this cross-sectional study, 418 subjects were selected among families of patients admitted to ICUs in Tabriz, Iran, by convenience sampling, from May to August 2012. Data were collected through Barrett-Lennard Relationship inventory (BLRI empathy scale and Critical Care Family Needs Intervention (CCFNI inventories and were analyzed using descriptive and inferential statistical tests. Results: Findings showed that most of the nurses had high level of empathy to the patients (38.8%. There was also statistically significant relationship between nurses’ empathy and needs of patients’ families (p < 0.001. Conclusion: In this study we found that by increasing the nurse’s empathy skills, we would be able to improve providing family needs. Through empathic communication, nurses can encourage family members to participate in planning for the care of their patients. However, further studies are necessary to confirm the results.
Sefer, Ellen Ben
Many European nurses were caught up in the horror of what happened to Jewish people during the Second World War, trapped in ghettoes and concentration camps. The advanced age of the nurses, however, decreases the number of firsthand accounts available. This paper reports on the experience of nurses in one camp, Westerbork, in the Netherlands, highlighting their work and relating their stories. Facing extreme suffering, they chose to care about others when it would have been easier to distance themselves. Until recently, historians' interest in medical practices in the transit and concentration camps has centered on medicine and sanitation. Utilisation of a nursing framework allows new material that has previously been overlooked to provide a broader understanding of the context of health care within the camps. Westerbork is an ideal camp to study since it had a genuine hospital with medicines and equipment available and a number of wards that provided care. Data collection was through oral interviews, archival documents and literature. The conclusion is that these nurses provide powerful role models of care that are as significant today as they were then.
da Silva, Josilaine Porfírio; Garanhani, Mara Lucia; Guariente, Maria Helena Dantas de Menezes
The aim of this study was to analyse the inclusion of the subject Nursing Care Systems (NCS) in nursing education. This study was based on qualitative desk research and it was conducted in a nursing programme in southern Brazil that offers an integrated curriculum with NCS as a cross-cutting theme. Data were collected from September to December 2012, by examining 15 planning and development workbooks on the cross-disciplinary modules of the programme. Analysis was divided into four stages: exploratory, selective, analytic and interpretive reading. The adopted theoretical framework was Complex Thought of Edgar Morin, according to the principles of relevant knowledge. Results were arranged into two categories: NCS as a crosscutting theme in nursing education: the context, the global and the multidimensional; and strategies for teaching, learning and assessment of NCS: the complex. The study contributes to the debate on the importance of teaching NCS as a crosscutting theme in nursing education.
Burke, Triona; O'Neill, Catherine
Primary care health services in the Irish Republic have undergone fundamental transformation with the establishment of multidisciplinary primary care teams nationwide. Primary care teams provide a community-based health service delivered through a range of health professionals in an integrated way. As part of this initiative ten pilot teams were established in 2003. This research was undertaken in order to gain an understanding of nurse's experiences of working in a piloted primary care team. The methodology used was a focus group approach. The findings from this study illustrated how community nurse's roles and responsibilities have expanded within the team. The findings also highlighted the benefits and challenges of working as a team with various other community-based health-care disciplines.
Changes in the health care environment have impacted nursing workload, quality of care, and patient safety. Traditional nursing workload measures do not guarantee efficiency, nor do they adequately capture the complexity of nursing workload. Review of the literature indicates nurses perceive the quality of their work has diminished. Research has…
American Association of Colleges of Nursing, Washington, DC.
A group of health care ethicists and palliative care experts convened by the American Association of Colleges of Nursing developed a set of competencies that should be achieved through nursing curricula. The purpose of the 15 competency statements is to assist nurse educators in incorporating end-of-life content into nursing curricula. Every…
Nydahl, Peter; Dewes, Michael; Dubb, Rolf; Hermes, Carsten; Kaltwasser, Arnold; Krotsetis, Susanne; von Haken, Rebecca
Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. The study used an open online survey with multiple-choice responses. An invitation for participation was spread via journals and electronic resources using a snowball system. Apart from recording socio-demographical characteristics, the survey collected data on delirium assessment, delirium-related processes, non-pharmacological prevention and treatment and barriers for implementation. Differences between nurses and physicians were tested by Fisher's exact test with sequential Bonferroni correction. The survey was conducted in autumn 2016, and 559 clinicians participated. More nurses than physicians reported screening for delirium. The majority of clinicians reported screening for delirium when this was suspected; more than 50% used validated instruments. Half of the clinicians had delirium-related structures implemented, such as two thirds reporting delirium-related processes. Most cited barriers were lack of time and missing knowledge about delirium and its assessment. With significant difference, physicians recommended more than nurses early removal of catheters and daily interprofessional goals for patients. In German-speaking countries, assessment of delirium needs further improvement, leading to accurate assessment. Delirium-related structures and processes appear to be implemented widely, with only a few differences between nurses and physicians. Nurses and physicians in this survey reported similar perceptions and attitudes towards management of delirium. Both professions need more knowledge and inter-professional training on when and how to use validated assessment instruments. © 2017 British
Rapin, Joachim; D'Amour, Danielle; Dubois, Carl-Ardy
The quality and safety of nursing care vary from one service to another. We have only very limited information on the quality and safety of nursing care in outpatient settings, an expanding area of practice. Our aim in this study was to make available, from the scientific literature, indicators potentially sensitive to nursing that can be used to evaluate the performance of nursing care in outpatient settings and to integrate those indicators into the theoretical framework of Dubois et al. (2013). We conducted a scoping review in three databases (CINAHL, MEDLINE, and EMBASE) and the bibliographies of selected articles. From a total of 116 articles, we selected 22. The results of our study not only enable that framework to be extended to ambulatory nursing care but also enhance it with the addition of five new indicators. Our work offers nurses and managers in ambulatory nursing units indicators potentially sensitive to nursing that can be used to evaluate performance. For researchers, it presents the current state of knowledge on this construct and a framework with theoretical foundations for future research in ambulatory settings. This work opens an unexplored field for further research.
Fuly, Patrícia Dos Santos Claro; Leite, Joséte Luzia; Lima, Suzinara Beatriz Soares
This study is a research that has as objective analyze the bibliographical production about the Systematization of Nursing Care in order to discuss concepts associated to the subject. Were analyzed books and national articles published in the database of the Virtual Library in Health, Medline, Lilacs and Scielo, in the period of January of 2000 to January of 2008. Were analyzed 11 articles, having been identified three distinct kind of thought to define concepts associated to Systematization of Nursing Care. Such fact aims for the difficulty of theoretical and pratical articulation, evidenced by the conflicts existing in the literature.
Backes, Dirce Stein; Koerich, Magda Santos; Nascimento, Keyla Cristiane do; Erdmann, Alacoque Lorenzini
This study aimed to understand the meaning of Nursing Care Systematization (NCS) for multiprofessional health team professionals based on the relationships, interactions and associations of Complex thought. This qualitative study uses Grounded Theory as a methodological reference framework. Data were obtained through interviews with three sample groups, totaling 15 professionals from different institutions. Simultaneous data codification and analysis identified the central theme: 'Glimpsing nursing care systematization as an interactive and multidimensional phenomenon' and the respective reference model. NCS appoints, in addition to interactivity and professional complementarity, the importance of dialog and connection between the academy, health practices and regulatory offices, based on new reference frameworks for the organization of health practices.
Johanson, Linda S
Much has been written about teaching students of the Millennial Generation (those born between the years 1980 and 2000) and about intergenerational dynamics in the healthcare workforce. However, little can be found in the literature regarding generation-specific nursing care of Millennial patients. This article presents six categories of considerations for nurses caring for patients of the Millennial Generation based on the characteristics, attitudes, and values that have influenced them as well as the healthcare issues confronting this group of young adults. © 2016 Wiley Periodicals, Inc.
Oeseburg, Barth; Hilberts, Rudi; Roodbol, Petrie F
BACKGROUND: The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of professionals required to meet this demand. However, a recent study showed that the curricula in vocational education for nursing assistants and care helpers remains inade
Li-Ying, Jason; Paunova, Minna; Egerod, Ingrid
quality within the unit. Conclusions The increasing pressures to implement the control of care quality and innovate may be conflicting, unless handled properly. Implications for nursing management Process control at intensive care units should be loosened, when personal interaction between intensive care...
Oeseburg, Barth; Hilberts, Rudi; Roodbol, Petrie F
BACKGROUND: The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of professionals required to meet this demand. However, a recent study showed that the curricula in vocational education for nursing assistants and care helpers remains inade
Rantz, Marilyn J; Grando, Victoria; Conn, Vicki; Zwygart-Staffacher, Mary; Hicks, Lanis; Flesner, Marcia; Scott, Jill; Manion, Pam; Minner, Donna; Porter, Rose; Maas, Meridean
In this study, the key exemplar processes of care in facilities with good resident outcomes were described. It follows that with description of these processes, it is feasible to teach facilities about the basics of care and the ways to systematically approach care so they can adopt these care processes and improve resident outcomes. However, for this to happen key organizational commitments must be in place for staff to consistently provide the basics of care. Nursing leadership must have a consistent presence over time, they must be champions of using team and group processes involving staff throughout the facility, and they must actively guide quality improvement processes. Administrative leadership must be present and express the expectation that high quality care is expected for residents, and that workers are expected to contribute to the quality improvement effort. If facilities are struggling with achieving average or poor resident outcomes, they must first make an effort to find nursing and administrative leaders who are willing to stay with the organization. These leaders must be skilled with team and group processes for decision-making and how to implement and use a quality improvement program to improve care. These leaders must be skilled at building employee relations and at retention strategies so residents are cared for by consistent staff who know them. The results of this study illustrate the simplicity of the basics of care that residents in nursing facilities need. The results also illustrate the complexity of the care processes and the organizational systems that must be in place to achieve good outcomes. Achieving these outcomes is the challenge facing those currently working in and leading nursing facilities.
Arthur, D; Pang, S; Wong, T
In an effort to place the international literature and research in nursing in a Chinese cultural context a study was commenced to examine the caring practices of nurses in Hong Kong. In view of a recent study (Wilkes & Wallis, 1993) which utilised Roach's 5Cs of caring (Roach, 1987, 1992), a pilot study was commenced on a sample of 77 Hong Kong Registered Nurses studying a Diploma of Nursing. An open ended questionnaire was designed which asked nurses to respond to questions about caring in general and the 5Cs: compassion, competence, confidence, conscience and commitment. The questions asked what each of the concepts meant to them as a nurse. Data was analysed into themes based on key words for each of the six areas revealing that the sample of Hong Kong nurses viewed caring in a similar light to those in overseas studies. The sample highlighted compassion and competence as their major features and it is suggested that methodological problems may have inhibited a deeper analysis of their caring attributes and behaviours. When asked to expand on the 5 Cs in terms of their own practice they were able to supply themes which were closely related to Roach's definitions but which may have been more 'textbook' in their origin and certainly lacked a richness of response. The paucity of responses in terms of clarity and richness of data, followed by discussions with the participants led to conclusions about the methodological issues of cross-cultural research and recommendations for future research are made. Highlighted are the problems with attempting to use concepts such as the 5 Cs across cultures and the problems encountered with translation of concepts related to caring from Chinese into English, and vice-versa. The study has provided some insights into the concepts of caring in Hong Kong Chinese nurses. In the light of advances in China and unification of previously separate countries these findings provide and offer insights into nursing in China and are encouraging
Engström, Asa; Lindberg, Inger
Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable. © 2013 British Association of Critical Care Nurses.
Reppetto, Maria Angela; de Souza, Mariana Fernandes
This descriptive study was carried out in a teaching hospital at São Paulo city and had as objective to identify the phases performance and registration of nursing care systematization and the most frequent nursing diagnoses. Data were collected retrospectively from 135 patients records of three units: Cardiology, Adult Infectious Diseases and Neurosurgery, from January to July, 2002. The phases: history, nursing diagnoses, prescription, evolution and assessment were performed and registered in the three units, however, it was verified systematization gaps performance related to nursing diagnoses registered without the realization of nursing history and nursing prescriptions without evolution. The most frequent nursing diagnosis in the three units was risk for infection.
Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa
Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations...
Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa
Objective: Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. Method...
Crampton, Ruth; Turner, de Sales
The purpose of this study was to unveil the complexity of registered nurse (RN) care for prisoner-patients in an acute care perioperative setting. The study design was based on phenomenology and the philosophy of Hans George Gadamer. This study used researcher journaling and two audio-taped in-depth interviews with each of the 12 nurse participants. Five key fused horizons or joint understandings emerged that resonated for all participants. They were the following: • RNs give prisoner-patients perfunctory care; • Prisoner-patient care is reactive; • Caring for prisoner-patients is emotionally draining; • Knowing or imagining a prisoner-patient's crime creates practice dilemmas; and • Expressions of care straddle ideal and real caring perspectives. In the caring literature, caring is altruistically presented as an ideal that (ought to) guide RN interactions with patients. However, the study findings call into question the assumptions that are made about what it means to care and how RNs enact their caring role, particularly in vexatious situations. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.
Bonalumi, N; Fisher, K
Nursing administrators facing reorganization understand the difficulties and resistance that accompany organizational change. This article discusses resilience, a critical character trait for successfully managing change. Understanding the change process can assist those charged with the challenge of leading organizational change to manage the journey more effectively.
Full Text Available Affective, cognitive and behavioral components affect nurses´ attitudes to include families in the care processes. The purpose of this study was to investigate the attitudes of nurses about the importance of including families in nursing care. Data collection was performed in pediatric and maternal-child unit of a Brazilian university hospital. A sample of 50 nurses completed the Portuguese version of the instrument Families’Importance in Nursing Care-Nurses’ Attitudes (FINC-NA. The results indicated that nurses have supportive attitudes regarding families participation in nursing care. Attitudes of lower support for involving families in nursing care were found among nurses with older age, more time in the profession and who had no previous contact with contents related to Family Nursing. The application of the instrument in other contexts of assistance may help to illuminate important aspects of the challenges to implementing a family-centered approach in clinical practice.
Conclusions: Ubuntu and Sisulu's approach to caring have much to offer for the nursing profession in terms of developing of new directions for nursing pedagogy, curriculum, practice patterns, and policies that emphasise caring constructs.
Full Text Available Limited adoption of mobile technology for informal learning and continuing professional development within Australian healthcare environments has been explained primarily as an issue of insufficient digital and ehealth literacy of healthcare professionals. This study explores nurse supervisors’ use of mobile technology for informal learning and continuing professional development both for their own professional practice, and in their role in modelling digital knowledge transfer, by facilitating the learning and teaching of nursing students in the workplace. A convenience sample of 27 nurse supervisors involved with guiding and supporting undergraduate nurses participated in one of six focus groups held in two states of Australia. Expanding knowledge emerged as the key theme of importance to this group of clinicians. Although nurse supervisors regularly browsed Internet sources for learning and teaching purposes, a mixed understanding of the mobile learning activities that could be included as informal learning or part of formal continuing professional development was detected. Participants need educational preparation and access to mobile learning opportunities to improve and maintain their digital and ehealth literacy to appropriately model digital professionalism with students. Implementation of mobile learning at point of care to enable digital knowledge transfer, augment informal learning for students and patients, and support continuing professional development opportunities is necessary. Embedding digital and ehealth literacy within nursing curricula will promote mobile learning as a legitimate nursing function and advance nursing practice.
Fumić, Nera; Marinović, Marin; Brajan, Dolores
Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and
Hravnak, Marilyn; Tuite, Patricia; Baldisseri, Marie
Programs educating advanced practice nurses (APNs), including acute care nurse practitioners (ACNPs) and clinical nurse specialists (CNSs) may struggle with the degree to which technical and cognitive skills necessary and unique to the care of critically ill patients should be incorporated within training programs, and the best ways these skills can be synthesized and retained for clinical practice. This article describes the critical care technical skills training mechanisms and use of a High-Fidelity Human Simulation (HFHS) Laboratory in the ACNP and CNS programs at the University of Pittsburgh School of Nursing. The mechanisms for teaching invasive procedures are reviewed including an abbreviated course syllabus and documentation tools. The use of HFHS is discussed as a measure to provide students with technical and cognitive preparation to manage critical incidents. The HFHS Laboratory, scenario development and implementation, and the debriefing process are discussed. Critical care technical skills training and the use of simulation in the curriculum have had a favorable response from students and preceptors at the University of Pittsburgh School of Nursing, and have enhanced faculty's ability to prepare APNs.
Malouf-Todaro, Nabia; Barker, James; Jupiter, Daniel; Tipton, Phyllis Hart; Peace, Jane
Ventilator-associated pneumonia is a hospital-acquired infection that may develop in patients 48 hours after mechanical ventilation. The project goal was to determine whether a ventilator-associated pneumonia care bundle checklist embedded into an existing electronic health record would increase completeness of nursing documentation in an intensive care unit setting. With the embedded checklist, there were significant improvements in nursing documentation and a decreased incidence of ventilator-associated pneumonia.
Holtkamp, C.C.M.; Kerkstra, A.; Ribbe, M.W.; Campen, C. van; Ooms, M.E.
Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client-tailored and effective nursing care for this population. Because of the permanency of their
Park, Yeonhwan; Oh, Seieun; Chang, Heekyung; Bang, Hwal Lan
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE 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 once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents" found on pages 30-39, 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 listed above 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 October 31, 2018. 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. ACTIVITY OBJECTIVES 1. Explain the development and testing of the Evidence-Based Nursing Care Algorithm of
Binkowska-Bury, Monika; Więch, Paweł; Bazaliński, Dariusz; Marć, Małgorzata; Bartosiewicz, Anna; Januszewicz, Paweł
The aim of this study was to identify and examine the differences in opinions held by health care professionals and the general public concerning the right to administer and prescribe medication which has been awarded to nurses and midwives in Poland.The study was conducted from December 1, 2014 to July 1, 2015, in randomly selected primary health care clinics, among 2227 individuals, including 849 subjects representing medical personnel of primary health care and 1378 patients receiving primary care services. The study used 2 versions of a questionnaire. The relationships were examined with χ test for independence and Kruskal-Wallis test.Health professionals do not believe the new rights awarded to nurses and midwives will reduce the waiting time for medical consultations (P Nurses' qualifications for the new tasks were most highly rated by patients, whereas the least favorable opinion was expressed by doctors (P nurse prescribing it is necessary to develop a suitable strategy enabling implementation of the government's initiative and facilitating the process of taking up the new task by nurses.
Objective: To share my knowledge, regarding the nursing care for the patients after femoral popliteal bypass grafting, with my Chinese colleagues who have never been abroad. Methods: From August 1998 to September 2002, five patients (including 1 female and 4 male) were summarized retrospectively on postoperative care by assessment, nursing implementation and evaluation. Results: All patients were followed up for 3 to 6 months. The results were evaluated as follows: patient's condition and the function of the operated leg were improved. The leg pain was released. The peripheral pulses were present and strong. The color, temperature and sensation of the skin were normal. None of further complications was noted. Conclusion: For Nursing the patient after femoral popliteal bypass grafting, the nurses should focus their attention on the circulatory status of the operated leg, anticoagulant therapy and signs of bleeding from the graft site. Meanwhile, provide a quiet、comfortable and safety environment for the patient. Asall of these are the main points of the postoperative care. A good nursing careoffer to a patient not only can ease the patient's physical suffering, but alsocan avoid some complications occurring.
Samarasinghe, K; Fridlund, B; Arvidsson, B
Involuntary migrant families in cultural transition face a number of challenges to their health and to family cohesion. Primary health care nurses (PHCNs) therefore play a vital role in the assessment and promotion of their health. The aim of this study was to describe the promotion of health in involuntary migrant families in cultural transition as conceptualized by Swedish PHCNs. Interviews were conducted with 34 strategically chosen PHCNs covering the entire range of the primary health care sector in two municipalities of Southern Sweden. A contextual approach with reference to phenomenography was used in interpreting the data. There are three qualitatively different descriptive categories epitomizing the characteristics of the PHCNs' promotion of health: (1) an ethnocentric approach promoting physical health of the individual, (2) an empathic approach promoting mental health of the individual in a family context, and (3) a holistic approach empowering the family to function well in everyday life. For nurses to promote involuntary migrant families'health in cultural transition, they need to adopt a holistic approach. Such an approach demands that nurses cooperate with other health care professionals and community authorities, and practise family-focused nursing; it also demands skills in intercultural communication paired with cultural self-awareness in interacting with these families. Adequate knowledge regarding these skills should therefore be included in the education of nurses, both at under- and at post-graduate level.
Southey, Dawn; Mishra, Pankaj Kumar; Nevill, Alan; Aktuerk, Dincer; Luckraz, Heyman
There have been recent reports on increased mortality in British National Health Service hospitals during weekends. This study aimed to assess the impact on patient care following the introduction of nurse practitioner cover for the cardiothoracic ward, including weekends. Prospectively collected and validated data of patients operated on from January 2005 to October 2011 were analyzed. The patients were grouped according to era: before (n = 2385) and after (n = 3910) the introduction of nurse practitioners in October 2007. There were no significant differences in preoperative patient characteristics such as age, logistic EuroSCORE, sex, smoking, and extracardiac vascular problems. There were more patients from an Asian background (p cardiac surgery (p nurse practitioner grade, there was a decrease in the rate of cardiac intensive care unit readmission from 2.6% to 1.9% (p = 0.05) and length of hospital stay from 10 to 8 days (p cardiac surgery from 96.5% to 98.0% (p nurse practitioners on the ward was the strongest predictor of survival with an odds ratio of 1.9 (95% confidence interval: 1.23-3.01). The introduction of the nurse practitioner grade to provide continuity in patient care including at weekends has been confirmed to improve patient outcomes including survival after cardiac surgery. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Smith, Veronica M
There has been little research that explores the interaction between community pharmacists and community nurses and how this interaction could benefit people affected by dementia. Using information taken from a larger study, this article presents the views of community pharmacists and one community nurse on how their communication, information sharing and team integration may improve care for this patient group. The community pharmacists reported positive attitudes to supporting people affected by dementia, but they highlighted barriers to integrated team working. In contrast, the community nurse conveyed the belief that the community pharmacist was an integrated member of the community health team. Community pharmacists and community nurses are keen to interact with each other to support people affected by dementia, but this interaction stops short of collaborative, integrated team working. Further research is needed to address this issue.
Karanikola, Maria N K; Papathanassoglou, Elizabeth D E; Mpouzika, Meropi; Lemonidou, Chrysoula
Burnout symptoms in Greek intensive care unit (ICU) nurses have not been explored adequately. The aim of this descriptive, correlational study was to investigate the prevalence and intensity of burnout symptoms in Greek ICU nursing personnel and any potential associations with professional satisfaction, as well as with demographic, educational, and vocational characteristics. Findings showed that the overall burnout level reported by Greek ICU nursing personnel was at a moderate to high degree. The most pronounced symptom of burnout was depersonalization, whereas emotional exhaustion was found to be a strong predictor of job satisfaction. This is a factor connected with the nurses' intention to quit the job. It appears that work factors have a more powerful influence over the development of burnout in comparison to personality traits.
The objective of the study is to identify nursing care and related problems involved in extending the daily life and supporting self-care of the elderly who underwent neurosurgical operation, and to determine the direction of nursing care. Subjects were six nurses who had been working in anacute-phase department for five years or longer. Collected data was analyzed by the qualitative synthesis method (KJ method). The results clarified [nursing care to enhance the treatment effect of neurosurg...
Chover-Sierra, Elena; Martínez-Sabater, Antonio; Lapeña-Moñux, Yolanda Raquel
Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in final stages of their life. Nurses need to acquire specific knowledge and abilities to provide quality palliative care. Palliative Care Quiz for Nurses is a questionnaire that evaluates their basic knowledge about palliative care. The Palliative Care Quiz for Nurses (PCQN) is useful to evaluate basic knowledge about palliative care, but its adaptation into the Spanish language and the analysis of its effectiveness and utility for Spanish culture is lacking. To report the adaptation into the Spanish language and the psychometric analysis of the Palliative Care Quiz for Nurses. The Palliative Care Quiz for Nurses-Spanish Version (PCQN-SV) was obtained from a process including translation, back-translation, comparison with versions in other languages, revision by experts, and pilot study. Content validity and reliability of questionnaire were analyzed. Difficulty and discrimination indexes of each item were also calculated according to Item Response Theory (IRT). Adequate internal consistency was found (S-CVI = 0.83); Cronbach's alpha coefficient of 0.67 and KR-20 test result of 0,72 reflected the reliability of PCQN-SV. The questionnaire had a global difficulty index of 0,55, with six items which could be considered as difficult or very difficult, and five items with could be considered easy or very easy. The discrimination indexes of the 20 items, show us that eight items are good or very good while six items are bad to discriminate between good and bad respondents. Although in shows internal consistency, reliability and difficulty indexes similar to those obtained by versions of PCQN in other languages, a reformulation of the items with lowest content validity or discrimination indexes and those showing difficulties with their comprehension is an aspect to take into account in order to improve the PCQN-SV. The PCQN-SV is a useful Spanish language
This paper reports a study examining how nursing home staff experienced working with residents' families. Working collaboratively with the family in residential aged care to provide care is consistent with nursing philosophy. The quality of the experience, however, is frequently fraught with problems for both the family and staff involved. Little research has focused on the nature of family involvement in nursing homes from the perspective of nursing home staff. The study adopted a naturalistic paradigm. Data were collected from 30 nursing home staff members drawn from a range of metropolitan and rural facilities in Victoria, Australia by means of conversational in-depth interviews. Issues concerned with how participants constructed the role of the family in the nursing home were explored. The data were collected in 2001-2002. Four key elements are presented in this paper: (1) Making the transition; (2) Forming ties; (3) Keeping them at a distance and (4) Unacceptable behaviour. Some nursing home staff have developed a substantive family orientation and had adopted practices which were inclusive of the family. Equally, many attitudes which cast the family into an adversarial and competitive role were noted, and many staff members outlined practices which were indicative of a need to control the family. A rhetoric of family partnerships is prevalent in some nursing homes. The activities of staff in these homes are still primarily geared towards provision of physical care, and families' needs become secondary to getting the work done. A new model of practice is needed that sees working collaboratively with families as a legitimate and necessary part of the staff role.
da Silva, Ana Lúcia; Ciampone, Maria Helena
The text addresses the Cartesian paradigms (modern) and the complexity paradigm (post-modern of Edgar Morin) aiming to deepen reflection on the theme and understanding to improve nursing. To this end, the authors discuss the model of care of methodical nursing in the Cartesian paradigm defining it as producer of an authoritarian, fragmented and linear care. They point the need to rethink that model because it restricts the autonomy of the people/patient moving in the direction of complex care that provides for customers/actors' participation in their health care planning.
Carmen Lúcia Mottin Duro
Full Text Available This study aimed to assess nurses’ perception regarding the risk classification in emergency care units. It is a descriptive study that used a qualitative approach and that was conducted with 55 nurses from emergency care units in the south of Brazil. Data were collected between July and October, 2011, through open questions, answered in writing. The data collected were submitted to the thematic analysis technique. Results indicate that the risk classification contributes to the organization of the service flow provided to patients, intervening in severe cases and preventing sequelae. Difficulties were described, such as: inadequate physical installations, overcrowding, disagreement in the definition of priorities among doctors and nurses and lack of articulation between the emergency care network and basic health care. It is highlighted the need to improve the physical structure, the quantity of human resources and the implementation of public policies to overcome these challenges.
Lucas Amaral Martins
Full Text Available The study aims to describe the experience of nursing care to person in mental suffering (PMS in the family context. Developed by nursing academic during home attendance, in the 2008.2 semester. The results showed that: is undeniable the family function of the PMS care, becoming the main partner of the heath teams, the care in the perspective of psychosocial rehabilitation influences the attitudes, patterns of response and participation in treatment, resulting in the empowerment of PMS and family. It’s concluded that home attendance contributes to the process of psychosocial rehabilitation of the PMS and assessment of mental health services, subsidizing the formulation of public policies for the sector, especially, in regard to care in perspective of the whole human life.
Boockvar, Kenneth S; Burack, Orah R
To identify organizational factors and hospital and nursing home organizational relationships associated with more-effective processes of care during hospital-nursing home patient transfer. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital-to-nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care. Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital-nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=-0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home. No management-level organizational relationship between nursing home and hospital was associated with better hospital-to-nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital-to-nursing home transfer processes.
Soffer, Ann Katrine B.
The implementation of skills labs in Danish nursing education can, in itself, be viewed as a complexity. The students are expected to eventually carry out their work in a situated hospital practice, but they learn their professional skills in a different space altogether, detached and removed from...... of care are not explicated in the curriculum or textbooks; however, they surfaced once this crooked approach to studying care in a simulated practice was applied. The article starts from the assertion that detached engagements are not recognized within the ﬁeld of nursing education as an equal component...... to attachments. Yet empirical cases from the skills lab and hospitals illustrate how students sometimes felt emotionally attached to plastic dummies and how experienced nurses sometimes practised a degree of detachment in relation to human patients. Detached engagements will therefore be presented as part...
The incidence of hypertension is increasing as the number of patients with obesity and diabetes mellitus increases. Hypertension results when the peripheral vascular resistance is increased, the blood viscosity is elevated and/or the flow of blood through the main arteries is impeded. Chronic hypertension results in an enlarged heart, myocardial damage and lung and renal abnormalities. While some causative factors, such as obesity, can be controlled, others, for example genetics, are more difficult to treat because often there is more than one factor involved. This article explores how essential and secondary factors contribute to the incidence of hypertension and the physiological changes resulting from raised blood pressure. It proposes that although traditional treatment has some success, nurse-led clinics are having better success not only in controlling raised blood pressure but also in reducing cardiac, pulmonary and renal morbidity. Nurse-led clinics are more cost-effective, staff are more productive and clients are more compliant with treatment.
This article reviews why nursing operations automation is important, reviews the impact of computer technology on nursing from a historical perspective, and considers the future of nursing operations automation and health care technology innovations in 2025 and beyond. The increasing automation in health care organizations will benefit patient care, staffing and scheduling systems and central staffing offices, census control, and measurement of patient acuity.
Mariani, Elena; Chattat, Rabih; Vernooij-Dassen, Myrra; Koopmans, Raymond; Engels, Yvonne
Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents' conditions occur. The aim of this review was to identify the core elements of the implementation of changes in nursing homes' care plans, by providing an overview of the type of stakeholders involved, describing the implementation strategies used, and exploring how care plans changed. An integrative literature review was used to evaluate intervention studies taking place in nursing homes. Data were collected from PubMed, CINHAL-EBSCO, and PsycINFO. English language articles published between 1995 and April 2015 were included. Data analysis followed the strategy of Knafl and Whittemore. Twenty-six articles were included. The stakeholders involved were professionals, family caregivers, and patients. Only a few studies directly involved residents and family caregivers in the quality improvement process. The implementation strategies used were technology implementation, audit, training, feedback, and supervision. The majority of interventions changed the residents' care plans in terms of developing a more standardized care documentation that primarily focuses on its quality. Only some interventions developed more tailored care plans that focus on individualized needs. Care plans generally failed in providing both standardized and personalized interventions. Efforts should be made to directly involve residents in care planning and provide professionals with efficient tools to report care goals and actions in care plans.
Introduction Competence of nurses is a complex combination of knowledge, function, skills, attitudes, and values. Delivering care for patients in the Intensive Cardiac Care Unit (ICCU) requires nurses’ competences. This study aimed to explain nurses’ competence in the ICCU. Methods This was a qualitative study in which purposive sampling with maximum variation was used. Data were collected through semi-structured interviews with 23 participants during 2012–2013. Interviews were recorded, tran...
Khosravan, Shahla; Mazlom, Behnam; Abdollahzade, Naiemeh; Jamali, Zeinab; Mansoorian, Mohammad Reza
Background: Few studies, especially in Iran, have assessed the status of family participation in the care of the hospitalized patients. Objectives: This study was conducted to assess why family members partake in caregiving of their patients in hospitals, the type of care that family provide, and the outcomes of the participation in the opinions of nurses and family members. Patients and Methods: In this comparative-descriptive study, data was collected by a two- version researcher-developed ...
Goodson, Justin; Jang, Wooseung; Rantz, Marilyn
Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…
Goodson, Justin; Jang, Wooseung; Rantz, Marilyn
Purpose: The purpose of this research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…
Rotegård, Ann Kristin; Fagermoen, May Solveig; Ruland, Cornelia M.
Patients’ experiences, knowledge and preferences, as well as more person-centered care need to be implemented in clinical support systems and are central values and outcomes of eHealth. Health assets represent such information. The concept of health assets was explored and described based on analysis of nursing documentation in cancer patients’ records.
Pryor, Claire; Clarke, Amanda
Nursing and healthcare is changing in response to an ageing population. There is a renewed need for holistic nursing to provide clinically competent, appropriate and timely care for patients who may present with inextricably linked mental and physical health requirements. This article explores the dichotomy in healthcare provision for 'physical' and 'mental' health, and the unique role nurses have when caring for people with delirium superimposed on dementia (DSD). Delirium is prevalent in older people and recognised as 'acute brain failure'. As an acute change in cognition, it presents a unique challenge when occurring in a person with dementia and poses a significant risk of mortality. In this article, dementia is contrasted with delirium and subtypes of delirium presentation are discussed. Nurses can recognise DSD through history gathering, implementation of appropriate care and effective communication with families and the multidisciplinary team. A simple mnemonic called PINCH ME (Pain, INfection, Constipation, deHydration, Medication, Environment) can help identify potential underlying causes of DSD and considerations for care planning. The mnemonic can easily be adapted to different clinical settings and a fictitious scenario is presented to show its application in practice.
Sherwin, Elisabeth D.; And Others
This study examined the effects of reality negotiation strategies on burnout among nurses (N=45) in chronic-care rehabilitation units. It was predicted that hope would be inversely related to three components of burnout. The factors of hope were described as: (1) "agency," defined as a sense of meaning and goal-directed energy; and (2)…
Williams, G; Chaboyer, W; Thornsteindóttir, R; Fulbrook, P; Shelton, C; Wojner, A; Chan, D
While critical care has been a specialty within nursing for almost 50 years, with many countries having professional organizations representing these nurses, it is only recently that the formation of an international society has been considered. A three-phased study was planned: the aim of the first phase was to identify critical care organizations worldwide; the aim of the second was to describe the characteristics of these organizations, including their issues and activities; and the aim of the third was to plan for an international society, if international support was evident. In the first phase, contacts in 44 countries were identified using a number of strategies. In the second phase, 24 (55%) countries responded to a survey about their organizations. Common issues for critical care nurses were identified, including concerns over staffing levels, working conditions, educational programme standards and wages. Critical care nursing organizations were generally favourable towards the notion of establishing a World Federation of their respective societies. Some of the important issues that will need to be addressed in the lead up to the formation of such a federation are now being considered.
Bowen, Mary; Lyons, Kevin J.; Young, Barbara E.
A survey of registered nurses who graduated in 1986 (n=50) and 1991 (n-58) revealed these opinions: insurance companies increasingly control patient care; workload and paperwork have increased; and there are fewer jobs and less job security. A significant number reported decreased job satisfaction. (SK)
Douguet, Florence; Vilbrod, Alain
Freelance nurses are in contact with an array of professionals working to help elderly people to continue living at home. In particular they form close ties with social service assistants and home care support workers. Between diverging perspectives and actual collaboration, these relationships seem atthe very least extremely contrasting.
Sherwin, Elisabeth D.; And Others
This study examined the effects of reality negotiation strategies on burnout among nurses (N=45) in chronic-care rehabilitation units. It was predicted that hope would be inversely related to three components of burnout. The factors of hope were described as: (1) "agency," defined as a sense of meaning and goal-directed energy; and (2) perceived…
Le Blanc, Pascale M.; Schaufeli, Wilmar B.; Salanova, Marisa; Llorens, Susana; Nap, Raoul E.
P>Aim. This paper is a report of an investigation of whether intensive care nurses' efficacy beliefs predict future collaborative practice, and to test the potential mediating role of team commitment in this relationship. Background. Recent empirical studies in the field of work and organizational p
Keenan, Gail; Yakel, Elizabeth
The provision of safe and effective interdisciplinary care requires making the unique and interdependent aspects of disciplinary care visible and understandable. Ideally, the electronic health record (EHR) should capture both disciplinary and interdisciplinary care. This paper reports on a “real time” pilot of a technology supported method of documenting, communicating, and tracking the nursing component of the patient’s plan of care for eventual integration into an EHR. An intensive care unit tested the intervention that included the adoption and use of the NANDA, NOC, and NIC terminologies. Multiple methods were used to evaluate the impact of the care planning method for a 12 month period. We found that the increased visibility of nursing care promoted greater awareness and understanding (collective mind) of care and in turn enhanced continuity. The results of the pilot were used to further refine our theoretical framework and method for the multi-site study currently underway. PMID:16779067