Are nurse-led chemotherapy clinics really nurse-led? : an ethnographic study

OpenAIRE

Farrell, Carole; Walshe, Catherine Elizabeth; Molassiotis, Alex

2017-01-01

Background: The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses’ roles in nurse-led clinics. Ob...

Developing an advanced practice nurse-led liver clinic.

Science.gov (United States)

McAfee, Jean L

2012-01-01

End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

Developing a nurse-led clinic using transformational leadership.

Science.gov (United States)

Gousy, Mamood; Green, Kim

2015-03-25

Nurses are at the forefront of implementing and managing change, given constantly changing healthcare services and the increase in demand for health care. Therefore, it is important to identify the best style of leadership to engage nurses in implementing service-led improvements. This article explores the effects of transformational leadership in bringing about service-led improvements in health care, using the example of setting up a nurse-led acupuncture clinic to optimise the care of patients with chronic pain. Transformational leadership was used throughout the project - from the initial local planning, training and development, through to liaising with the appropriate staff and deciding on an evaluation strategy. Transformational leadership proved to be an effective way to engage and empower nurses and other members of the chronic pain team to enable them to achieve the project aims.

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

Science.gov (United States)

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

2007-08-01

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

Specialized Nursing Practice for Chronic Disease Management in the Primary Care Setting

Science.gov (United States)

2013-01-01

Background In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. Objectives To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. Data Sources and Review Methods A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Results Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. Limitations There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Conclusions Specialized nurses with

Patient and Nurse Experiences in a Rural Chronic Disease Management Program: A Qualitative Evaluation.

Science.gov (United States)

Davisson, Erica A; Swanson, Elizabeth A

Rural status confounds chronic disease self-management. The purpose of this qualitative, descriptive study was to evaluate the nurse-led "Living Well" chronic disease management program reporting patient recruitment and retention issues since program initiation in 2013. The Chronic Care Model (CCM) was the guiding framework used to reinforce that interdisciplinary teams must have productive patient interactions for their program(s) to be sustainable. A rural, Midwest county clinic's chronic disease management program. Observations, interviews, and within- and across-case coding were used. Patients' responses were analyzed to identify (1) reasons for recruitment and retention problems and (2) program elements that were viewed as successful or needing improvement. A convenience sample of 6 rural, English-speaking adults (65 years or older, with no severe cognitive impairment) with at least one chronic condition was recruited and interviewed. Themes emerged related to nurse knowledge, availability, and value; peer support; overcoming barriers; adherence enhancement; and family/friends' involvement. Patients reported engagement in self-management activities because of program elements such as support groups and productive nurse-patient interactions. Interdisciplinary communication, commitment, and patient referral processes were identified as reasons for recruitment and retention issues. Findings substantiated that certain elements must be present and improved upon for future rural programs to be successful. Interdisciplinary communication may need to be improved to address recruitment and retention problems. It was clear from patient interviews that the nurse coordinators played a major role in patients' self-management adherence and overall satisfaction with the program. This is important to case management because results revealed the need for programs of this nature that incorporate the vital role of nurse coordinators and align with the CCM value of providing a

Nurse-led case management for ambulatory complex patients in general health care: A systematic review

NARCIS (Netherlands)

Latour-Delfgaauw, C.H.M.; van der Windt, D.A.W.M.; de Jonge, P.; Riphagen, II; Vos, R.; Huyse, F.J.; Stalman, W.A.B.

2007-01-01

Objective: The aim of this study was to summarize the available literature on the effectiveness of ambulatory nurse-led case management for complex patients in general health care. Method: We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and Cinahl. We included randomized

Engaging general practice nurses in chronic disease self-management support in Australia: insights from a controlled trial in chronic obstructive pulmonary disease.

Science.gov (United States)

Walters, Julia A E; Courtney-Pratt, Helen; Cameron-Tucker, Helen; Nelson, Mark; Robinson, Andrew; Scott, Jenn; Turner, Paul; Walters, E Haydn; Wood-Baker, Richard

2012-01-01

The growing burden of chronic disease will increase the role of primary care in supporting self-management and health behaviour change. This role could be undertaken to some extent by the increased practice nurse workforce that has occurred over recent years. Mixed methods were used to investigate the potential for general practice nurses to adopt this role during a 12-month randomised controlled study of telephone-delivered health mentoring in Tasmanian practices. Nurses (general practice and community health) were trained as health mentors to assist chronic obstructive pulmonary disease patients to identify and achieve personal health related goals through action plans. Of 21% of invited practices that responded, 19 were allocated to health mentoring; however, general practice nurses were unable to train as health mentors in 14 (74%), principally due to lack of financial compensation and/or workload pressure. For five general practice nurses trained as health mentors, their roles had previously included some chronic disease management, but training enhanced their understanding and skills of self-management approaches and increased the focus on patient partnership, prioritising patients' choices and achievability. Difficulties that led to early withdrawal of health mentors were competing demands, insufficient time availability, phone calls having lower priority than face-to-face interactions and changing employment. Skills gained were rated as valuable, applicable to all clinical practice and transferable to other health care settings. Although these results suggest that training can enhance general practice nurses' skills to deliver self-management support in chronic disease, there are significant system barriers that need to be addressed through funding models and organisational change.

Effectiveness of the Healthy Skin Clinic – a randomized clinical trial of nurse-led patient counselling in hand eczema

DEFF Research Database (Denmark)

Mollerup, Annette; Veien, Niels K; Johansen, Jeanne D

2014-01-01

BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse-led...... or burden of disease were found between the two groups. CONCLUSION: A tailored nurse-led programme of skin protection counselling may be recommended as an essential part of hand eczema treatment.......BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse......-led counselling programme, the Healthy Skin Clinic, emphasizing the patient's self-management, resources, and risks. PATIENTS AND METHODS: Patients (n = 306) referred for diagnostic work-up and treatment of hand eczema were randomized and allocated either to the programme or to usual care. The primary outcome...

The impact of nurse-led annual telephone follow-up of patients with inflammatory bowel disease

DEFF Research Database (Denmark)

Bager, Palle

2014-01-01

Inflammatory bowel diseases (IBD) are characterised by periods of disease activity and period with disease in remission. In Denmark all patients are seen in hospital settings. The aim of this study was to introduce a nurse-led phone service for stable patients replacing annual visits. The study....... In conclusion, changing the method of contact from routine annual visits to annual phone calls from a nurse was feasible and well accepted for stable patients with IBD. The benefits of the service were most marked for the patients........ Budget impact analysis (BIA) and cost-effectiveness analysis (CEA) were done. Furthermore, the staff evaluated the process. Almost 30% (n = 474) of the total cohort was enrolled in the service. Eighty-seven per cent of the patients welcomed the phone service beforehand. After implementation, 94...

[The organizational projects management led by head nurses: qualitative study from an educational device.

Science.gov (United States)

Dujardin, Pierre-Philippe; Reverdy, Thomas; Valette, Annick; François, Patrice

2017-09-01

The work of operational coordination led by head nurses (HN) is more known than their abilities to change work organization, as well as, care practices. In this article, we explore organizational projects led by HN. Depending on the situations, they may concern their health care team or involve institutional hierarchy or other teams. We rely on an intervention study, which enabled us to follow 17 organizational projects led by HN for one year. The results of this study highlight as the main condition for success, the HN' efforts to enable mutual understanding with other interested actors. Managers, who engage their health care team in the development of solutions, bring sustainable results. When problems involve the hierarchy, the managers focus on the development of personal relationships. When problems involve other departments, which they depend on, then they engage themselves into integrative negotiations. These results invite to open discussion about work organization and to formalize organizational projects. This intervention study also points out that work - training at operational audit is relevant for HN. Activé par Editorial Manager® et ProduXion.

Pitfalls when implementing nurse-led annual telephone calls to replace outpatient visits for Inflammatory Bowel Disease patients

DEFF Research Database (Denmark)

Jakobsen, Dorrit; Bager, Palle; Hentze, Runa

Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both for the patie......Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both...... for the patients and for the outpatient clinic. The purpose of this study was to identify potential barriers and pitfalls in the planning and implementation phase of a nurse-led telephone service. Methods: Preparations prior to introducing the annual telephone calls were done in 2010. From January 2011 all...... eligible IBD patients were shifted from regularly visits to annual telephone calls performed by an IBD nurse. As the intervention contained of several sub-elements and the elements were subject to adjustment during implementation, the intervention was regarded as a Complex Intervention. All the elements...

Effects of a Peer-Led Pain Management Program for Nursing Home Residents with Chronic Pain: A Pilot Study.

Science.gov (United States)

Tse, Mimi Mun Yee; Yeung, Suey Shuk Yu; Lee, Paul Hong; Ng, Shamay Sheung Mei

2016-09-01

OBJECTIVES : To examine the feasibility of a peer-led pain management program among nursing home residents. DESIGN : A quasi-experimental design. SETTING : Two nursing homes. SUBJECTS : Fifty nursing home residents. METHODS : The experimental group (n = 32) was given a 12-week group-based peer-led pain management program. There were two 1-hour sessions per week. Education in pain and demonstrations of nonpharmacological pain management strategies were provided. The research team and 12 trained peers led the sessions. The control group (n = 18) received one 1-hour session of pain management program each week over 12 weeks from the research team only. Outcome measures for the participants were collected at baseline (P1) and at week 12 (P2). Data from peer volunteers were collected prior to training (V1) and at week 12 (V2). T-tests were used to compare the differences in outcome measures collected at two time points. RESULTS : There was a significant reduction in pain intensity from 5.8 ± 2.6 (P1) to 3.4 ± 2.5 (P2) for the experimental group (p = 0.003) and from 6.3 ± 3.0 (P1) to 3.1 ± 2.4 (P2) for the control group (p = 0.001). Activities of daily living significantly improved for both the experimental group (p = 0.008) and the control group (p = 0.014). There was an enhancement in happiness level for the experimental group (p pain management knowledge (2.9 ± 2.6 to 8.1 ± 1.2, p pain management program was feasible and has potential in relieving chronic pain and enhancing the physical and psychological health of nursing home residents. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The impact and effectiveness of nurse-led care in the management of acute and chronic pain: a review of the literature.

Science.gov (United States)

Courtenay, Molly; Carey, Nicola

2008-08-01

To identify, summarise and critically appraise the current evidence regarding the impact and effectiveness of nurse-led care in acute and chronic pain. A diverse range of models of care exist within the services available for the management of acute and chronic pain. Primary studies have been conducted evaluating these models, but, review and synthesis of the findings from these studies has not been undertaken. Literature review. Searches of Pubmed (NLM) Medline, CINAHL, Web of Knowledge (Science Index, Social Science index), British Nursing Index from January 1996-March 2007 were conducted. The searches were supplemented by an extensive hand search of the literature through references identified from retrieved articles and by contact with experts in the field. Twenty-one relevant publications were identified and included findings from both primary and secondary care. The areas, in which nurses, caring for patients in pain are involved, include assessment, monitoring, evaluation of pain, interdisciplinary collaboration and medicines management. Education programmes delivered by specialist nurses can improve the assessment and documentation of acute and chronic pain. Educational interventions and the use of protocols by specialist nurses can improve patients understanding of their condition and improve pain control. Acute pain teams, led by nurses, can reduce pain intensity and are cost effective. Nurses play key roles in the diverse range of models of care that exist in acute and chronic pain. However, there are methodological weaknesses across this body of research evidence and under researched issues that point to a need for further rigorous evaluation. Nurse-led care is an integral element of the pain services offered to patients. This review highlights the effect of this care and the issues that require consideration by those responsible for the development of nurse-led models in acute and chronic pain.

The effect of nurse-led problem-solving therapy on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease: a randomised controlled trial.

Science.gov (United States)

Lee, Haejung; Yoon, Ju Young; Lim, Yeonjung; Jung, HeeYoung; Kim, Sungmin; Yoo, Younja; Kim, Yunseong; Ahn, Jong-Joon; Park, Hye-Kyung

2015-05-01

to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial. a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months. the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers. there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12). the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis.

Science.gov (United States)

2013-01-01

In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model

[Nurse-led in Primary Health Care setting: a well-timed and promising organizational innovation].

Science.gov (United States)

Torres-Ricarte, Marc; Crusat-Abelló, Ernest; Peñuelas-Rodríguez, Silvia; Zabaleta-del-Olmo, Edurne

2015-01-01

At present, the severe economic crisis along with the increasing prevalence of chronic diseases is leading to different countries to consider updating their Primary Health Care (PHC) services in order to make them more efficient and reduce health inequalities. To that end, various initiatives are being carried out, such as the provision of Nurse-led services and interventions. The purpose of this article is to present the available knowledge, controversies and opportunities for Nurse-led initiatives in the setting of PHC. Nurse- led interventions or health services in PHC have proven to be equal or more effective than usual care in disease prevention, the routine follow-up of patients with chronic conditions, and first contact care for people with minor illness. However, as there are only a few health economic evaluation studies published their efficiency is still potential. In conclusion, the Nurse-led care could be an innovative organizational initiative with the potential to provide an adequate response to the contemporary health needs of the population, as well as an opportunity for the nursing profession and for PHC and health systems in general. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The effect of nurse-led education on hospitalisation, readmission, quality of life and cost in adults with heart failure. A systematic review.

Science.gov (United States)

Rice, Helena; Say, Richard; Betihavas, Vasiliki

2018-03-01

The purpose of this systematic review was to highlight the effect of nurse-led 1:1 patient education sessions on Quality of Life (QoL), readmission rates and healthcare costs for adults with heart failure (HF) living independently in the community. A systematic review of randomised control trials was undertaken. Using the search terms nurse, education, heart failure, hospitalisation, readmission, rehospitalisation, economic burden, cost, expenditure and quality of life in PubMed, CINAHL and Google Scholar databases were searched. Papers pertaining to nurse-led 1:1 HF disease management of education of adults in the community with a history of HF were reviewed. The results of this review identified nurse-led education sessions for adults with HF contribute to reduction in hospital readmissions, reduction in hospitalisation and a cost benefit. Additionally, higher functioning and improved QoL were also identified. These results suggest that nurse-led patient education for adults with HF improves QoL and reduces hospital admissions and readmissions. Nurse-led education can be delivered utilising diverse methods and impact to reduce readmission as well as hospitalisation. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Azzurra Massimi

Full Text Available The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context. The aim of this systematic review and meta-analysis is to assess the efficacy of the nurse-led self-management support versus usual care evaluating patient outcomes in chronic care community programs. Systematic review was carried out in MEDLINE, CINAHL, Scopus and Web of Science including RCTs of nurse-led self-management support interventions performed to improve observer reported outcomes (OROs and patients reported outcomes (PROs, with any method of communication exchange or education in a community setting on patients >18 years of age with a diagnosis of chronic diseases or multi-morbidity. Of the 7,279 papers initially retrieved, 29 met the inclusion criteria. Meta-analyses on systolic (SBP and diastolic (DBP blood pressure reduction (10 studies-3,881 patients and HbA1c reduction (7 studies-2,669 patients were carried-out. The pooled MD were: SBP -3.04 (95% CI -5.01--1.06, DBP -1.42 (95% CI -1.42--0.49 and HbA1c -0.15 (95% CI -0.32-0.01 in favor of the experimental groups. Meta-analyses of subgroups showed, among others, a statistically significant effect if the interventions were delivered to patients with diabetes (SBP or CVD (DBP, if the nurses were specifically trained, if the studies had a sample size higher than 200 patients and if the allocation concealment was not clearly defined. Effects on other OROs and PROs as well as quality of life remain inconclusive.

Impact of disease management programs on hospital and community nursing practice.

Science.gov (United States)

Goldstein, Perry C

2006-01-01

The impact of disease management progrmms on the role of the nursing profession in the evolving U.S. health care system is reviewed. Needed changes in educational and training programs are discussed in relation to demands for changing clinical and administrative skills in nursing with an emphasis on increasing demand for advanced practice nurses.

Nurse-Led Intervention to Improve Knowledge of Medications in Survivors of Stroke or Transient Ischemic Attack: A Cluster Randomized Controlled Trial

OpenAIRE

Olaiya, Muideen T.; Cadilhac, Dominique A.; Kim, Joosup; Ung, David; Nelson, Mark R.; Srikanth, Velandai K.; Bladin, Christopher F.; Gerraty, Richard P.; Fitzgerald, Sharyn M.; Phan, Thanh G.; Frayne, Judith; Thrift, Amanda G.

2016-01-01

Introduction Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in patients with stroke or transient ischemic attack (TIA). Methods Prospective sub-study of the Shared Team Approach between Nurses and Doctors for Improved Risk Factor Management, a randomi...

Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial

OpenAIRE

Muideen Olaiya; Dominique Cadilhac; Dominique Cadilhac; Joosup Kim; Joosup Kim; David Ung; Mark Raymond Nelson; Mark Raymond Nelson; Velandai Srikanth; Velandai Srikanth; Christopher Bladin; Richard Gerraty; Sharyn Fitzgerald; THANH G PHAN; Judith Frayne

2016-01-01

Introduction: Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in patients with stroke or transient ischemic attack (TIA).Methods: Prospective sub-study of the Shared Team Approach between Nurses and Doctors For Improved Risk Factor Management (STAND FIRM), a rand...

Educational Outreach with an Integrated Clinical Tool for Nurse-Led Non-communicable Chronic Disease Management in Primary Care in South Africa: A Pragmatic Cluster Randomised Controlled Trial.

Science.gov (United States)

Fairall, Lara R; Folb, Naomi; Timmerman, Venessa; Lombard, Carl; Steyn, Krisela; Bachmann, Max O; Bateman, Eric D; Lund, Crick; Cornick, Ruth; Faris, Gill; Gaziano, Thomas; Georgeu-Pepper, Daniella; Zwarenstein, Merrick; Levitt, Naomi S

2016-11-01

In many low-income countries, care for patients with non-communicable diseases (NCDs) and mental health conditions is provided by nurses. The benefits of nurse substitution and supplementation in NCD care in high-income settings are well recognised, but evidence from low- and middle-income countries is limited. Primary Care 101 (PC101) is a programme designed to support and expand nurses' role in NCD care, comprising educational outreach to nurses and a clinical management tool with enhanced prescribing provisions. We evaluated the effect of the programme on primary care nurses' capacity to manage NCDs. In a cluster randomised controlled trial design, 38 public sector primary care clinics in the Western Cape Province, South Africa, were randomised. Nurses in the intervention clinics were trained to use the PC101 management tool during educational outreach sessions delivered by health department trainers and were authorised to prescribe an expanded range of drugs for several NCDs. Control clinics continued use of the Practical Approach to Lung Health and HIV/AIDS in South Africa (PALSA PLUS) management tool and usual training. Patients attending these clinics with one or more of hypertension (3,227), diabetes (1,842), chronic respiratory disease (1,157) or who screened positive for depression (2,466), totalling 4,393 patients, were enrolled between 28 March 2011 and 10 November 2011. Primary outcomes were treatment intensification in the hypertension, diabetes, and chronic respiratory disease cohorts, defined as the proportion of patients in whom treatment was escalated during follow-up over 14 mo, and case detection in the depression cohort. Primary outcome data were analysed for 2,110 (97%) intervention and 2,170 (97%) control group patients. Treatment intensification rates in intervention clinics were not superior to those in the control clinics (hypertension: 44% in the intervention group versus 40% in the control group, risk ratio [RR] 1.08 [95% CI 0.94 to 1

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

Science.gov (United States)

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

2015-01-01

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

A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

Science.gov (United States)

Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

2015-01-31

This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education

Reported challenges in nurse-led randomised controlled trials

DEFF Research Database (Denmark)

Wang Vedelø, Tina; Lomborg, Kirsten

2011-01-01

Aims: The purpose of this integrative literature review was to explore and discuss the methodological challenges nurse researchers report after conducting nurse-led randomised controlled trials in clinical hospital settings. Our research questions were (i) what are the most commonly experienced...... and the clinical nursing staff. Two lessons learned from this integrative review can be highlighted. First, we recommend researchers openly to share their experiences of barriers and challenges. They should describe factors that may have inhibited the desired outcome. Second, efforts to improve the collaboration...... between nurse researchers and clinicians, including education, training and support may increase the success rate and quality of nurse-led studies using the randomised controlled trial....

The nursing contribution to chronic disease management: a discussion paper.

Science.gov (United States)

Forbes, Angus; While, Alison

2009-01-01

This paper explores the nature of the nursing contribution to chronic disease management (CDM) and identifies a number of key nursing activities within CDM both at the individual patient and care system levels. The activities were identified following a detailed review of the literature (160 reports and studies of nursing practice) relating to three tracer disorders: diabetes, chronic obstructive pulmonary disease and multiple sclerosis. The paper examines these activities collectively to generate models expressing some of the core functions of nursing within CDM. The paper illustrates some of the changing characteristics of nursing roles within CDM. More fundamentally, the paper questions the position of nursing in relation to the technologies that define CDM systems and proposes four levels of contribution: the nurse as technology; the nurse as technologist; the nurse as system engineer; and the nurse as architect. These different levels reflect distinctions in the nature of the nursing gaze and power relations within the health care workforce. The paper also highlights how nurses are failing to develop the evidence for their practice in CDM. The paper concludes that there is a need for some clear principles to guide clinical practice and encourage innovation in CDM. It is argued that the principles should not be rule-bound but define a distinctive nursing gaze that will position the nursing profession within the health care system and in relation to other professions. The gaze should incorporate the needs of the individual patient and the care system that they inhabit.

Nurse health and lifestyle modification versus standard care in 40 to 70 year old regional adults: study protocol of the Management to Optimise Diabetes and mEtabolic syndrome Risk reduction via Nurse-led intervention (MODERN) randomized controlled trial.

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Carrington, Melinda J; Zimmet, Paul

2017-12-06

Metabolic syndrome (MetS), the clustering of multiple leading risk factors, predisposes individuals to increased risk for developing type 2 diabetes and/or cardiovascular disease (CVD). Cardio-metabolic disease risk increases with greater remoteness where specialist services are scarce. Nurse-led interventions are effective for the management of chronic disease. The aim of this clinical trial is to determine whether a nurse-implemented health and lifestyle modification program is more beneficial than standard care to reduce cardio-metabolic abnormalities and future risk of CVD and diabetes in individuals with MetS. MODERN is a multi-centre, open, parallel group randomized controlled trial in regional Victoria, Australia. Participants were self-selected and individuals aged 40 to 70 years with MetS who had no evidence of CVD or other chronic disease were recruited. Those attending a screening visit with any 3 or more risk factors of central obesity, dyslipidemia (high triglycerides or low high density lipoprotein cholesterol) elevated blood pressure and dysglycemia were randomized to either nurse-led health and lifestyle modification (intervention) or standard care (control). The intervention included risk factor management, health education, care planning and scheduled follow-up commensurate with level of risk. The primary cardio-metabolic end-point was achievement of risk factor thresholds to eliminate MetS or minimal clinically meaningful changes for at least 3 risk factors that characterise MetS over 2 year follow-up. Pre-specified secondary endpoints to evaluate between group variations in cardio-metabolic risk, general health and lifestyle behaviours and new onset CVD and type 2 diabetes will be evaluated. Key outcomes will be measured at baseline, 12 and 24 months via questionnaires, physical examinations, pathology and other diagnostic tests. Health economic analyses will be undertaken to establish the cost-effectiveness of the intervention. The MODERN

Self-management of type 2 diabetes mellitus: a qualitative investigation from the perspective of participants in a nurse-led, shared-care programme in the Netherlands.

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Moser, Albine; van der Bruggen, Harry; Widdershoven, Guy; Spreeuwenberg, Cor

2008-03-18

Diabetes mellitus is a major public health problem. Little is known about how people with type 2 diabetes experience self-management in a nurse-led, shared-care programme. The purpose of this article is to report an empirically grounded conceptualization of self-management in the context of autonomy of people with type 2 diabetes. This study has a qualitative descriptive, and exploratory design with an inductive approach. Data were collected by means of in-depth interviews. The sample consisted of older adults with type 2 diabetes in a nurse-led, shared-care setting. The data analysis was completed by applying the constant comparative analysis as recommended in grounded theory. People with type 2 diabetes use three kinds of self-management processes: daily, off-course, and preventive. The steps for daily self-management are adhering, adapting, and acting routinely. The steps for off-course self-management are becoming aware, reasoning, deciding, acting, and evaluating. The steps for preventive self-management are experiencing, learning, being cautious, and putting into practice. These processes are interwoven and recurring. Self-management consists of a complex and dynamic set of processes and it is deeply embedded in one's unique life situation. Support from diabetes specialist nurses and family caregivers is a necessity of self-managing diabetes.

Using nursing intervention classification in an advance practice registered nurse-led preventive model for adults aging with developmental disabilities.

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Hahn, Joan Earle

2014-09-01

To describe the most frequently reported and the most central nursing interventions in an advance practice registered nurse (APRN)-led in-home preventive intervention model for adults aging with developmental disabilities using the Nursing Intervention Classification (NIC) system. A descriptive data analysis and a market basket analysis were conducted on de-identified nominal nursing intervention data from two home visits conducted by nurse practitioners (NPs) from October 2010 to June 2012 for 80 community-dwelling adults with developmental disabilities, ages 29 to 68 years. The mean number of NIC interventions was 4.7 in the first visit and 6.0 in the second visit and last visit. NPs reported 45 different intervention types as classified using a standardized language, with 376 in Visit One and 470 in Visit Two. Approximately 85% of the sample received the Health education intervention. The market basket analysis revealed common pairs, triples, and quadruple sets of interventions in this preventive model. The NIC nursing interventions that occurred together repeatedly were: Health education, Weight management, Nutrition management, Health screening, and Behavior management. Five NIC interventions form the basis of an APRN-led preventive intervention model for individuals aging with lifelong disability, with health education as the most common intervention, combined with interventions to manage weight and nutrition, promote healthy behaviors, and encourage routine health screening. Less frequently reported NIC interventions suggest the need to tailor prevention to individual needs, whether acute or chronic. APRNs employing prevention among adults aging with developmental disabilities must anticipate the need to focus on health education strategies for health promotion and prevention as well as tailor and target a patient-centered approach to support self-management of health to promote healthy aging in place. These NIC interventions serve not only as a guide for

Adolescents' with congenital heart disease and their parents' experiences of a nurse-led transition program. An interpretive phenomenological

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Thomet, Corina; Lindenberg, Carina; Schwerzmann, Markus; Spichiger, Elisabeth

2018-02-01

Background: Up to 90 % of patients with congenital heart disease (CHD) now reach adulthood. To avoid lapses in care during the change from pediatric to adult care, a nurse-led transition program (TP) was implemented at a Swiss University Hospital. Aim: This study explored the experiences and expectations of adolescents with CHD and their parents regarding a nurse-led TP. Method: This qualitative study used an interpretive, phenomenological approach. Individual interviews were conducted with seven adolescent CHD patients in the transition period and their parents (six mothers, two fathers). Analysis followed an iterative process. Results: For most study participants, the transfer from pediatric to adult medicine as part of the TP went smoothly. They experienced the TP positively. Patients valued the provision of a constant contact person to provide CHD-related information; parents welcomed the support of an informed, neutral clinician for their children. To varying degrees, adolescents were willing to take over self-responsibility; conversely, parents found it difficult to turn their responsibility over to their children. Parents wished to give the adolescent as much time as needed to act responsibility on their own. Conclusions: A transition program is a key element for establishing a continuous care in adolescents with a chronic disease. It facilitates the parents' process of allowing their youths to assume increasing responsibility for their own health.

Multidisciplinary, Nurse-Led Psychiatric Consultation in Nursing Homes: A Pilot Study in Clinical Practice.

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Koekkoek, Bauke; van Baarsen, Carlijn; Steenbeek, Mirella

2016-07-01

To determine the effects of multidisciplinary, nurse-led psychiatric consultation on behavioral problems of nursing home residents. Residents often suffer from psychiatric symptoms, while staff psychiatric expertise varies. A pre-post study was conducted in seven homes using the Neuropsychiatric Inventory Nursing Home version (NPI-NH). In 71 consultations during 18 months, 56-75% of residents suffered from agitation/aggression, depression, anxiety, and disinhibition. Post-intervention (n = 54), frequency, and severity of psychiatric symptoms were significantly and clinically meaningfully reduced. Also, staff suffered from less work stress. Nurse-led psychiatric consultation is valuable to both nursing home residents and staff. © 2015 Wiley Periodicals, Inc.

Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer.

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Craven, Olive; Hughes, Carol Anne; Burton, Amy; Saunders, Mark P; Molassiotis, Alex

2013-05-01

Home care nursing has been shown to be a valuable service for patients receiving oral chemotherapy; however, associated costs can be high and telephone-based services may be more cost-effective options. This prospective audit explored the usefulness of a nurse-led telephone intervention for supporting cancer patients treated with Capecitabine, comparing historical findings from a randomised trial evaluating a home-based intervention over standard care with a modified nurse-led telephone follow-up intervention. Self-reported toxicity and service use were assessed in 298 patients who received nurse-led telephone follow-up, compared with historical data from 164 patients (81 receiving standard care and 83 home care intervention). Findings suggested that nurse-led telephone follow-up can potentially lead to reduced toxicity (chest pain, vomiting, oral mucositis, nausea, insomnia) when compared with standard care, and that it has a similar impact on the management of some symptoms when compared with home care (i.e. vomiting, oral mucositis), although it was not as effective as the home care intervention for other toxicities (diarrhoea and insomnia). These encouraging findings need to be explored further using a randomised trial design before we reach any conclusions. Further research should also include a health economics study to assess the cost-effectiveness of the telephone-based services for patients receiving oral chemotherapy. © 2013 Blackwell Publishing Ltd.

Nursing clinical practice changes to improve self-management in chronic obstructive pulmonary disease.

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Padilha, J M; Sousa, P A F; Pereira, F M S

2018-03-01

To propose nursing clinical practice changes to improve the development of patient self-management. Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self-management. A participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis. The main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision-making process. The specific guidelines, the provision of material to support decision-making and the optimization of information sharing between professionals positively influenced the change process. This change improved the development of self-management skills related to the awareness of the need for 'change', hope, involvement, knowledge and abilities. The implemented changes have improved health-related behaviours and clinical outcomes. To support self-management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours. The involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes. © 2017 International Council of Nurses.

Nurse-led action research project for expanding nurses' role in patient education in Iran: Process, structure, and outcomes.

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Khorasani, Parvaneh; Rassouli, Maryam; Parvizy, Soroor; Zagheri-Tafreshi, Mansoureh; Nasr-Esfahani, Mahmood

2015-01-01

Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses' role in patient education in Iran. This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses' educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.

Unravelling effectiveness of a nurse-led behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: study protocol for a cluster randomised controlled trial.

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Westland, Heleen; Bos-Touwen, Irene D; Trappenburg, Jaap C A; Schröder, Carin D; de Wit, Niek J; Schuurmans, Marieke J

2017-02-22

Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants' satisfaction. To increase physical activity in patients and to support nurses in delivering the intervention

Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review.

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Chiang, Chung-Yan; Choi, Kai-Chow; Ho, Ka-Ming; Yu, Sau-Fung

2018-04-22

Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. Twenty-three English and seven Chinese electronic databases were searched to identify the trials. The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of

Evaluation of a nurse-led haemophilia counselling service.

LENUS (Irish Health Repository)

O'Shea, Eadaoln

2012-01-01

Genetic counselling and testing for females with a family history of haemophilia has long been advocated. However, there is little research in regard to clients\\' satisfaction with the existing counselling models in haemophilia, and in particular with nurse-led clinics. The purpose of this study was to evaluate whether clients were satisfied with a nurse-led carrier testing clinic and counselling service. A retrospective quantitative study of clients\\' satisfaction and perceived knowledge was undertaken using an anonymous questionnaire. A sample of 42 women who had attended the clinic in the last 12 months was identified. The response rate for the study was 71% (n = 30).Two thirds of the respondents were 35 years of age or younger, 93% had a family history of haemophilia and 56% were diagnosed as carriers. Perceived understanding and knowledge increased significantly between the first and second appointments (p < 0.001). Overall, the study identified a high level of client satisfaction with the nurse-led carrier testing clinic and counselling service.

Nursing-led management of side effects of radiation: evidence-based recommendations for practice

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Poirier P

2013-03-01

Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management

Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

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Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S

2015-01-01

To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit

Dental Hygienist-Led Chronic Disease Management System to Control Early Childhood Caries.

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Ng, Man Wai; Fida, Zameera

2016-06-01

Management of the complex chronic disease of early childhood caries requires a system of coordinated health care interventions which can be led by a dental hygienist and where patient self-care efforts are paramount. Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries. In this article, we (1) introduce the concept of CDM of dental caries, (2) provide evidence that CDM improves oral health outcomes, and (3) propose a dental hygienist-led team-based oral health care approach to CDM. Although we will be describing the CDM approach for early childhood caries, CDM of caries is applicable in children, adolescents, and adults. Early childhood caries disease control requires meaningful engagement of patients and parents by the oral health care team to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in the rates of new caries, dental pain, and referral to the operating room compared with baseline rates. Dental hygienists are the appropriate team members to lead this approach because of their expertise in behavior change and prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of a nurse-led transitional care program on clinical outcomes, health-related knowledge, physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial.

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Zhang, Pan; Hu, Yu-Ding; Xing, Feng-Mei; Li, Chang-Zai; Lan, Wang-Feng; Zhang, Xiao-Li

2017-09-01

Coronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China. To examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease. Randomized controlled trial. The Omaha system and Pender's health promoting model were employed in planning and implementing this nurse-led transitional care program. The sample was comprised of 199 Chinese patients with coronary artery disease. The experimental group (n=100) received nurse-led transitional care intervention in addition to routine care. The nurse-led transitional care intervention included a structured assessment and health education, followed by 7 months of individual teaching and coaching (home visits, telephone follow-up and group activity). The control group (n=99) received a comparable length routine care and follow-up contacts. Evaluations were conducted at baseline and completion of the interventions using the perceived knowledge scale for coronary heart disease, the medical outcomes study 36-item short-form health survey and clinical measures (blood pressure, blood glucose, lipids, body mass index). Data were collected between March and October 2014. Compared with the control group, participants in the experimental group showed significant better clinical outcomes (systolic blood pressure, t=5.762, P=0.000; diastolic blood pressure, t=4.250, P=0.000; fasting blood glucose, t=2.249, P=0.027; total cholesterol, t=4.362, P=0.000; triglyceride, t=3.147, P=0.002; low density lipoprotein

A nurse-led clinic for patients consulting with osteoarthritis in general practice: development and impact of training in a cluster randomised controlled trial.

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Healey, Emma L; Main, Chris J; Ryan, Sarah; McHugh, Gretl A; Porcheret, Mark; Finney, Andrew G; Morden, Andrew; Dziedzic, Krysia S

2016-12-21

Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery. A training programme was developed and delivered to provide practice nurses with the knowledge and skill set needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA management was evaluated using case report forms and pre and post training questionnaires. The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they should be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to feel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical management patients received in the nurse-led OA clinics. A significant gap between what is recommended and what practice nurses feel they can currently provide in terms of OA management was evident. The development of a nurse training programme goes some way to develop a system in primary care for delivering the core recommendations by NICE. The cluster trial linked to this training was conducted from May 2012 through February 2014 by the Arthritis Research UK Primary Care Centre, Keele University, UK (Trial registration number ISRCTN06984617 ).

Building a Leadership Culture for Environmental Health in a Nurse-Led Clinic

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Shanda L Demorest

2017-10-01

Full Text Available Climate change is the biggest global health threat of the 21st century (Costello et al., 2009. Temperature shifts caused by greenhouse gases have negative health impacts such as worsening of chronic diseases and increases in vector-borne diseases (American Public Health Association, 2016, which nurses are ethically responsible to address (American Nurses Association, 2015. At an interdisciplinary nurse-led clinic, staff were not prepared to assist patients in building resiliency related to the health impacts of climate change or to implement environmental sustainability in their workplace. Based on principles of partnership-based healthcare (Eisler & Potter, 2014, this project included Climate Conversations - sharing stories, values, and knowledge about climate change – (Minnesota Interfaith Power & Light, 2010 and evidence-based transformational leadership. The Nurses’ Environmental Awareness Tool (Schenk et al., 2015 was used to survey staff before and after they participated in behavioral interventions to incorporate environmental sustainability at their workplace. Compared to baseline, staffs’ knowledge of environmental sustainability increased significantly (pp

Nurse manager engagement: what it means to nurse managers and staff nurses.

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Gray, Linda R; Shirey, Maria R

2013-01-01

To describe what nurse manager engagement means to nurse managers and staff nurses by incorporating an organizational dashboard to document engagement outcomes. Retaining engaged nurse managers is crucial for individual performance and organizational outcomes. However, nurse manager engagement is currently underreported in the literature. Existing data from the 2010 Employee Opinion Survey at the Baylor University Medical Center in Dallas, Texas, were used to measure staff engagement among 28 nurse managers and 1497 staff nurses. The data showed a 21% gap between manager and staff nurse engagement levels, with managers showing higher engagement levels than staff. No clear depiction of nurse manager engagement emerged. Consequently, an expanded definition of nurse manager engagement was developed alongside a beginning dashboard of engagement outcomes. The findings have implications for overcoming barriers that affect staff nurse engagement, improving outcomes, and creating definitions of nurse manager engagement.

The work of nurse case managers in a cancer and cardiovascular disease risk screening program.

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Fawcett, Jacqueline; Schutt, Russell K; Gall, Gail B; Cruz, Elizabeth Riley; Woodford, Mary Lou

2007-01-01

The purpose of this conceptual model of nursing and health policy-based study was to identify the frequency and correlates of activities performed by nurse case managers. Massachusetts Women's Health Network (WHN) contracting organization sites for breast and cervical cancer and cardiovascular disease risk screening. Twenty nurse case managers were interviewed. More time was spent performing client service activities than bureaucratic activities. Frequently performed client service activities were tracking test results, finding/connecting with clients, assessing client needs, and educating clients. The most frequently performed activity was documenting services; the least, discharging clients. Client service activity frequency was correlated with client caseload size, social barriers, overall workload, satisfaction with the way activities are carried out in the WHN, special training in WHN policies and procedures, and contracting organization service delivery arrangements. Bureaucratic activity frequency was correlated with caseload size, workload, months as a WHN case manager, system barriers, satisfaction with the way activities were carried out in the WHN, and special training. Documentation requires a great deal of WHN nurse case managers' time, which perhaps could be more productively spent with clients. Thus, more efficient ways to document services need to be identified. Additional research is needed to determine similarities and differences in activities performed by WHN nurse case managers and other case managers working in cancer and cardiovascular disease screening programs. Strategies need to be identified to remove all barriers that interfere with performance of case manager practice activities. Strategies are needed to reduce client fear of bills, overcome scheduling constraints, and improve translation services to lessen language barriers to effective communication.

A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers.

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Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela

2016-01-01

The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.

Best practice in nurse-led chemotherapy review: a position statement from the United Kingdom Oncology Nursing Society

OpenAIRE

Lennan, E; Vidall, C; Roe, H; Jones, P; Smith, J; Farrell, C

2012-01-01

This position statement has been formulated by nurses from the United Kingdom Oncology Nursing Society (UKONS) to provide guidance on the provision of nurse-led chemotherapy review clinics for adult patients. For the purposes of this statement, a nurse-led chemotherapy clinic is defined as one that conducts formal review (in a consultation room) before the decision to proceed and prescribe the next cycle of chemotherapy. This statement does not address the toxicity checks that take place imme...

Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

Directory of Open Access Journals (Sweden)

Mogale L. Mmamma

2015-12-01

Full Text Available Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9 and those working night duty (n = 3 who were at work on the anticipated days for data collection. Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers.

Science.gov (United States)

Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R

2015-12-17

Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group.

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Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

2016-01-01

Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses' areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not.

Thermal management for LED applications

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Poppe, András

2014-01-01

Thermal Management for LED Applications provides state-of-the-art information on recent developments in thermal management as it relates to LEDs and LED-based systems and their applications. Coverage begins with an overview of the basics of thermal management including thermal design for LEDs, thermal characterization and testing of LEDs, and issues related to failure mechanisms and reliability and performance in harsh environments. Advances and recent developments in thermal management round out the book with discussions on advances in TIMs (thermal interface materials) for LED applications, advances in forced convection cooling of LEDs, and advances in heat sinks for LED assemblies. This book also: Presents a comprehensive overview of the basics of thermal management as it relates to LEDs and LED-based systems Discusses both design and thermal management considerations when manufacturing LEDs and LED-based systems Covers reliability and performance of LEDs in harsh environments Has a hands-on applications a...

Nurse-led rehabilitation after gynaecological cancer surgery

DEFF Research Database (Denmark)

Seibæk, Lene

2009-01-01

  Abstract This article presents the preliminary results and experiences from an ongoing study aiming to: Develop and test a nurse-led multidisciplinary rehabilitation programme for women who undergo surgery for localised gynaecological cancers.Evaluate the effect of the programme prospectively o...

Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

Directory of Open Access Journals (Sweden)

Brownie S

2014-11-01

Full Text Available Sharon Brownie,1,2 Andrew P Hills,3,4 Rachel Rossiter51Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 2Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom; 3Allied Health Research, Mater Research Institute – The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia; 4Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia; 5MMHN and Nurse Practitioner Programs, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, AustraliaAbstract: Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.Keywords: primary health care planning, community health care, nurse-led clinics, allied health personnel

Effectiveness of nurse-led clinics on service delivery and clinical outcomes in adults with chronic ear, nose and throat complaints: a systematic review.

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Whiteford, Caroline; White, Sarahlouise; Stephenson, Matthew

2016-04-01

Ear, nose and throat complaints are very common and can cause significant disruption to patients' lives. Many conditions are of a chronic nature and are not currently managed in a timely manner by general practitioners in the community. This may be due to a lack of specialized knowledge, necessary diagnostic equipment or time for lengthy patient education on management of their condition. A nurse-led model of care may be an effective alternative. To examine the effectiveness of nurse-led clinics on adults with chronic ear, nose and throat complaints. Adult patients, aged 18 years and older, attending ear, nose and throat clinics, regardless of the complaint. Nurse-led care in general practice and acute care in which the nurse was identified as taking a lead role in the care of the patients with chronic ear, nose and throat complaints. General practitioner-led care, or ear, nose and throat consultant-led care, sometimes described as "standard care". Service delivery outcomes, clinical and health outcomes and financial outcomes. Any relevant quantitative studies published in English between 1980 and 2013 were considered. A standardized three-step search strategy aimed to find both published and unpublished studies. Databases searched include PubMed, CINAHL, Cochrane Library (CENTRAL), Scopus, Embase, MedNar and ProQuest Theses and Dissertations. Methodological validity was assessed independently by two reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute. Due to methodological heterogeneity of the included studies, no statistical pooling was possible and all results are presented narratively. The search identified 13,536 titles, of which 20 potentially relevant articles were retrieved. Of these 20, 17 were excluded following full-text review leaving three studies that were assessed for methodological quality and included in the review. Service delivery outcome findings were that patient satisfaction was equal or higher and

Management and leadership: a dual role in nursing education.

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Calpin-Davies, Philomena J

2003-01-01

The purpose of this paper is to review the dual concepts of leadership and management in nursing education. It provides a consideration of caring as the end purpose of nursing education and argues that empowered caring makes use of professional academic credentials to form collaborative alliances that influence health care delivery. Inspiring and empowering leadership also transform educational services. In particular the key issues of investing in technology, supporting life long learning and creating a community workplace are addressed. It concludes with the suggestion that the nurse education ought to be led and managed differently.

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

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Kyegombe Nambusi

2011-03-01

Full Text Available Abstract Background Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC Clinics. Methods A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Results Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. Conclusions This community-university HIV

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda.

Science.gov (United States)

Nankumbi, Joyce; Groves, Sara; Leontsini, Elli; Kyegombe, Nambusi; Coutinho, Alex; Manabe, Yuka

2011-03-09

Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. This community-university HIV innovative model was successful from the point of view of the nurses

Treatment and disease management of multiple sclerosis patients: A review for nurse practitioners.

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Roman, Cortnee; Menning, Kara

2017-10-01

This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts. NPs play an active role in the management of MS patients via effective monitoring and communication throughout the patient's treatment regimen and disease course. In the shared decision-making model of MS treatment, NPs ensure that patients understand the implications of their disease-modifying therapies (DMTs). As patients move through treatments during the course of their disease, the importance of this role increases, and it is critical that NPs follow the guidelines in each medication's product label and take into account any potential lingering effects of prior medications. It is critical for NPs to promote patient adherence, to ensure that patients understand treatment side effects and monitoring requirements, and to take sequencing and reversibility implications of DMTs into account when making clinical decisions. ©2017 American Association of Nurse Practitioners.

A review of factors affecting patient satisfaction with nurse led triage in emergency departments.

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Rehman, Salma Abdul; Ali, Parveen Azam

2016-11-01

To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patient knowledge of risk factors 18 months after a nurse-led vascular intervention

LENUS (Irish Health Repository)

Tone, J M

2011-01-01

Background and aims: Eighteen months after the completion of a vascular risk intervention study, the authors aimed to ascertain whether participants who attended the intensive, nurse-led group had better retention of knowledge of diabetes and heart disease compared with those who had undergone standard diabetes care. Method: A knowledge-based questionnaire was sent to participants who completed the vascular risk intervention study, 94 from the intensive, nurse-led group and 94 from the standard care group. Results: A response rate of 75% was achieved. Although more participants in the intensive group achieved recommended vascular risk targets, there was no increase in retained knowledge of vascular risks. A high proportion of the total cohort could not quantify targets for blood pressure (67.2%), cholesterol (65.1%) or HbA1c (68.1%). Conclusion: In this cohort of people with type 2 diabetes, knowledge retention regarding treatment targets was poor. Education programmes should stress awareness of vascular risk factors and diabetes.

Improving patient adherence to lifestyle advice (IMPALA: a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol

Directory of Open Access Journals (Sweden)

Grol Richard

2008-01-01

Full Text Available Abstract Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

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Hoch Jeffrey S

2011-08-01

Full Text Available Abstract Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention.

Science.gov (United States)

Markle-Reid, Maureen F; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Hoch, Jeffrey S; Browne, Gina; Peirce, Thomas; Busing, Barbara

2011-08-25

Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Data collection began in May 2010 and

Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care.

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Torrejón, Antonio; Oltra, Lorena; Hernández-Sampelayo, Paloma; Marín, Laura; García-Sánchez, Valle; Casellas, Francesc; Alfaro, Noelia; Lázaro, Pablo; Vera, María Isabel

2013-01-01

nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool "Nursing Care Quality in IBD Assessment" (NCQ-IBD) based on these standards. a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committee´s expert opinion. the final NCQ-IBD consists of 90 items, organized in13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations.

Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics

DEFF Research Database (Denmark)

Qvist, Ina; Hendriks, Jeroen M L; Møller, Dorthe S

2016-01-01

OBJECTIVE: A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse...

A formative evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic.

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Hansen, Kevin T; McDonald, Cheryl; O'Hara, Sue; Post, Leslie; Silcox, Susan; Gutmanis, Iris A

2017-07-01

The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic). A combination of semi-structured clinician interviews, post-clinic follow-up phone calls, satisfaction surveys, and information from the hospital workload management system served as data sources for this formative programme evaluation. Between January 2013 and December 2014, 293 patients were seen in the clinic with the majority being referred for either memory issues (49%) or functional decline (35%). The clinic assessment frequently uncovered other issues, which led to guidance around falls prevention, improved nutrition, medication management, and referrals to available community supports. Both patients and referring physicians were very satisfied with this model of care, which is likely transferable to other locations provided the needed clinical expertise and community support services are available.

Nurse managers' challenges in project management.

Science.gov (United States)

Suhonen, Marjo; Paasivaara, Leena

2011-11-01

To analyse the challenges that nurse managers meet in project management. Project management done by nurse managers has a significant role in the success of projects conducted in work units. The data were collected by open interviews (n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Nurse managers' challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects-ensuring patient care, (2) enthusiastic management-effective management of daily work and (3) supporting the work of a multiprofessional team-leadership of individual employees. It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers' ability to promote workplace spirituality, nurse managers' emotional intelligence and their enthusiasm in small projects. © 2011 Blackwell Publishing Ltd.

Nurse led, primary care based antiretroviral treatment versus hospital care: a controlled prospective study in Swaziland

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Bailey Kerry A

2010-08-01

Full Text Available Abstract Background Antiretroviral treatment services delivered in hospital settings in Africa increasingly lack capacity to meet demand and are difficult to access by patients. We evaluate the effectiveness of nurse led primary care based antiretroviral treatment by comparison with usual hospital care in a typical rural sub Saharan African setting. Methods We undertook a prospective, controlled evaluation of planned service change in Lubombo, Swaziland. Clinically stable adults with a CD4 count > 100 and on antiretroviral treatment for at least four weeks at the district hospital were assigned to either nurse led primary care based antiretroviral treatment care or usual hospital care. Assignment depended on the location of the nearest primary care clinic. The main outcome measures were clinic attendance and patient experience. Results Those receiving primary care based treatment were less likely to miss an appointment compared with those continuing to receive hospital care (RR 0·37, p p = 0·001. Those receiving primary care based, nurse led care were more likely to be satisfied in the ability of staff to manage their condition (RR 1·23, p = 0·003. There was no significant difference in loss to follow-up or other health related outcomes in modified intention to treat analysis. Multilevel, multivariable regression identified little inter-cluster variation. Conclusions Clinic attendance and patient experience are better with nurse led primary care based antiretroviral treatment care than with hospital care; health related outcomes appear equally good. This evidence supports efforts of the WHO to scale-up universal access to antiretroviral treatment in sub Saharan Africa.

Nurse led home-based care for people with HIV/AIDS.

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Wood, Elizabeth M; Zani, Babalwa; Esterhuizen, Tonya M; Young, Taryn

2018-03-27

. Nurse-led home-based interventions could help adherence to antiretroviral therapy and improve mental health. Further larger scale studies are needed, looking in more detail at improving medical care for HIV, especially related to screening and management of opportunistic infections and co-morbidities.

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

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

2015-08-01

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

Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial

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Muideen Olaiya

2016-11-01

Full Text Available Introduction: Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in patients with stroke or transient ischemic attack (TIA.Methods: Prospective sub-study of the Shared Team Approach between Nurses and Doctors For Improved Risk Factor Management (STAND FIRM, a randomized controlled trial of risk factor management. We recruited patients aged ≥18 years and hospitalized for stroke/TIA. The intervention comprised an individualized management program, involving nurse-led education, and management plan with medical specialist oversight. The outcome, participants’ knowledge of secondary prevention medications at 12 months, was assessed using questionnaires. A score of ≥5 was considered as good knowledge. Effectiveness of the intervention on knowledge of medications was determined using logistic regression. Results: Between May 2014 and January 2015, 142 consecutive participants from the main trial were included in this sub-study, 64 to usual care and 78 to the intervention (median age 68.9 years, 68% male, and 79% ischemic stroke. In multivariable analyses, we found no significant difference between intervention groups in knowledge of medications. Factors independently associated with good knowledge (score ≥5 at 12 months included higher socio-economic position (OR 4.79, 95% CI 1.76, 13.07, greater functional ability (OR 1.69, 95% CI 1.17, 2.45, being married/living with a partner (OR 3.12, 95% CI 1.10, 8.87, and using instructions on pill bottle/package as an administration aid (OR 4.82, 95% CI 1.76, 13.22. Being aged ≥65 years was associated with poorer knowledge of medications (OR 0.24, 95% CI 0.08, 0.71, while knowledge was worse among those taking three medications (OR 0.15, 95% CI 0.03, 0.66 or ≥4 medications

An intensive nurse-led, multi-interventional clinic is more successful in achieving vascular risk reduction targets than standard diabetes care.

LENUS (Irish Health Repository)

MacMahon Tone, J

2009-06-01

The aim of this research was to determine whether an intensive, nurse-led clinic could achieve recommended vascular risk reduction targets in patients with type 2 diabetes as compared to standard diabetes management.

The impact of peer-led simulations on student nurses.

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Valler-Jones, Tracey

Simulation within nurse education has been widely accepted as an educational approach. However, this is mainly led by the facilitator with the student maintaining a passive role in the learning. This paper describes a study that was undertaken to analyse the effectiveness of peer-led simulations in the undergraduate nursing programme. A mixed-method approach was used for this study design. This study took place in a simulation suite within a university in the Midlands. Twenty four second-year child branch students were purposively selected to take part. Students designed and facilitated a simulation based on the care of a critically ill child. Formal assessment of the learning was collected via the use of a structured clinical examination. Students completed an evaluation of their perceived confidence and competence levels. There was 100% pass rate in the assessment of students' clinical competence following the simulation. Thematic analysis of the evaluation highlighted the learning achieved by the students, not only of their clinical skills but also their personal development. The use of peer-led simulation promotes new learning and is a valuable educational approach.

A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit.

Science.gov (United States)

Perri, Giulia-Anna; Yeung, Herman; Green, Yoel; Bezant, Abby; Lee, Carman; Berall, Anna; Karuza, Jurgis; Khosravani, Houman

2018-01-01

Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKASRP) tool. Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.

Responsibility-Centered Management: A 10-Year Nursing Assessment.

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McBride, Angela Barron; Neiman, Sandra; Johnson, James

2000-01-01

Describes the implementation of responsibility-centered management, a decentralized model giving deans responsibility for expanding and using resources, at Indiana University's nursing school. Discusses how it led to creation of an information-rich environment, strategic decision making, and a performance-based reward structure. (SK)

Identification of nursing management diagnoses.

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Morrison, R S

1997-02-01

Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.

Nurse-led hypnotherapy: an innovative approach to Irritable Bowel Syndrome.

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Bremner, Helen

2013-08-01

Irritable Bowel Syndrome (IBS) is a common, chronic functional illness, which can greatly reduce patients' quality of life, and consumes healthcare resources. Standard treatments include dietary changes and medication, though these are often ineffective. Clinical studies of hypnotherapy demonstrate improvement in symptoms and quality of life in over 80% of subjects with intractable IBS. Our experience of a nurse-led hypnotherapy service for IBS in a community setting provides evidence of comparable efficacy for symptom control, improved quality of life, reduced dependence on medication and improved general health measures. We address the challenges of setting up and maintaining the service in a changing healthcare environment. This model of care could act as a template for providers of gastroenterology and functional disease services wishing to provide IBS care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effectiveness of a multidimensional home nurse led heart failure disease management program--a French nationwide time-series comparison.

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Agrinier, Nelly; Altieri, Christelle; Alla, François; Jay, Nicolas; Dobre, Daniela; Thilly, Nathalie; Zannad, Faiez

2013-10-09

The purpose of this study was to assess the effectiveness of a disease management program (DMP) in heart failure (HF) on the incidence of HF hospitalizations and related costs in a real-world population-based setting. Insuffisance CArdiaque en LORraine (ICALOR), a DMP for HF was established in 2006 in the French region of Lorraine. Patients were enrolled after an index HF hospitalization. They received educational and home-visit monitoring programs by HF-trained nurses. General physicians received automatic alerts about patients' significant clinical or biological changes. We used the ICALOR and the national diagnostic related group databases to conduct a comparison of time-series trends in HF hospitalizations in France. The economic impact was obtained using the national scale of costs in France. The median age of the 1222 patients recruited before 2010 was 76 years, and 65% were male. Upon enrollment, patients essentially presented with NYHA class II (n=537, 48%) or class III (n=359, 32%) symptoms. One-year mortality rate was 20.3%. The implementation of the ICALOR program was associated with a reduction in HF hospitalizations in Lorraine estimated by an absolute difference between the number of hospitalizations observed in the Lorraine region and that expected had it been similar to that observed in the whole country of -7.19% in 2010. The estimated annual hospital cost saved by ICALOR was €1,927,648 in 2010. Coordinated DMP of HF might improve outcome cost-effectively when implemented in a real-world population setting, and was associated in Lorraine with a substantial modification of the trend of HF hospitalizations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Validation of nursing management diagnoses.

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Morrison, R S

1995-01-01

Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

Enhancement on infectious diseases nursing plan information system.

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Yeh, Mei-Lin; Hao, Te-Hui; Hsu, Chien-Yeh

2009-01-01

Based on researches, the most time-consuming nursing activities, in teaching hospital, are: room patrols, the blood pressure survey, the body temperature pulse breath survey, the nursing record maintenance. The nursing record is one way to communicate data. It can allow the medical service team to understand what measures the nursing staff once did for sickness, as well as responses from sickness. Nevertheless, it is the key component to utilize the record with a clinical nursing plan, so as to provide a proficient health management. Since the maintenance of nursing plan is costly and time-consuming, therefore, it is essential to establish the nursing plan information system, which can effectively promote the nursing quality. This research main body comes from one infectious disease division nursing plan information system, which was developed in 1992, and its data base covers entire courtyard compatibility and various faculties characteristic nursing plan. The nursing staff often complained that this system is not user-friendly, its contents are not comprehensive, and sometimes it does not let staff choose the right diagnosis. Therefore this research is based on history analysis and the questionnaire survey procedure first, the infectious disease nursing plan use number of times, the frequency and the project content, then by the literature scientific theory and result of the improvement group discussion together. The original 38 infectious disease division nursing plan will be expanded to 45 nursing plans. Moreover, the common 38 infectious disease code (ICD-9), and its corresponding diagnosis items, shall automatically appear in the disease diagnose code field, so it would be better off for the nursing staff to set up the nursing plan efficiently. Infectious disease division nursing plan information system utilization ratio is promoted 9.6-folds, according to research outcome. Each task consumes 3.68 minutes beforehand-including computer program operation, the

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

Science.gov (United States)

Cathcart, Eloise Balasco; Greenspan, Miriam

2013-10-01

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

Evaluating a nurse-led model for providing neonatal care.

Science.gov (United States)

2004-07-01

The paper presents an overview of a multi-dimensional, prospective, comparative 5-year audit of the quality of the neonatal care provided by a maternity unit in the UK delivering 2000 babies a year, where all neonatal care after 1995 was provided by advanced neonatal nurse practitioners, in relation to that provided by a range of other medically staffed comparator units. The audit includes 11 separate comparative studies supervised by a panel of independent external advisors. Data on intrapartum and neonatal mortality is reported. A review of resuscitation at birth, and a two-tier confidential inquiry into sentinel events in six units were carried out. The reliability of the routine predischarge neonatal examination was studied and, in particular, the recognition of congenital heart disease. A review of the quality of postdischarge letters was undertaken alongside an interview survey to elicit parental views on care provision. An audit of all hospital readmissions within 28 days of birth is reported. Other areas of study include management of staff stress, perceived adequacy of the training of nurse practitioners coming into post, and an assessment of unit costs. Intrapartum and neonatal death among women with a singleton pregnancy originally booked for delivery in Ashington fell 39% between 1991-1995 and 1996-2000 (5.12 vs. 3.11 deaths per 1000 births); the decline for the whole region was 27% (4.10 vs. 2.99). By all other indicators the quality of care in the nurse-managed unit was as good as, or better than, that in the medically staffed comparator units. An appropriately trained, stable team with a store of experience can deliver cot-side care of a higher quality than staff rostered to this task for a few months to gain experience, and this is probably more important than their medical or nursing background. Factors limiting the on-site availability of medical staff with paediatric expertise do not need to dictate the future disposition of maternity services.

Nurse-led primary health care for homeless men: a multimethods descriptive study.

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Roche, M A; Duffield, C; Smith, J; Kelly, D; Cook, R; Bichel-Findlay, J; Saunders, C; Carter, D J

2017-12-21

To explore the primary healthcare needs and health service use of homeless men in inner Sydney. People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services. © 2017 International Council of Nurses.

Nurse versus physician-led care for the management of asthma

NARCIS (Netherlands)

Kuethe, Maarten C.; Vaessen-Verberne, Anja A. P. H.; Elbers, Roy G.; van Aalderen, Wim M. C.

2013-01-01

Background Asthma is the most common chronic disease in childhood and prevalence is also high in adulthood, thereby placing a considerable burden on healthcare resources. Therefore, effective asthma management is important to reduce morbidity and to optimise utilisation of healthcare facilities.

Feasibility of nurse-led antidepressant medication management of depression in an HIV clinic in Tanzania.

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Adams, Julie L; Almond, Maria L G; Ringo, Edward J; Shangali, Wahida H; Sikkema, Kathleen J

2012-01-01

Sub-Saharan Africa has the highest HIV prevalence worldwide and depression is highly prevalent among those infected. The negative impact of depression on HIV outcomes highlights the need to identify and treat it in this population. A model for doing this in lower-resourced settings involves task-shifting depression treatment to primary care; however, HIV-infected individuals are often treated in a parallel HIV specialty setting. We adapted a model of task-shifting, measurement-based care (MBC), for an HIV clinic setting and tested its feasibility in Tanzania. MBC involves measuring depressive symptoms at meaningful intervals and adjusting antidepressant medication treatment based on the measure of illness. Twenty adults presenting for care at an outpatient HIV clinic in Tanzania were enrolled and followed by a nurse care manager who measured depressive symptoms at baseline and every 4 weeks for 12 weeks. An algorithm-based decision-support tool was utilized by the care manager to recommend individualized antidepressant medication doses to participants' HIV providers at each visit. Retention was high and fidelity of the care manager to the MBC protocol was exceptional. Follow through of antidepressant prescription dosing recommendations by the prescriber was low. Limited availability of antidepressants was also noted. Despite challenges, baseline depression scores decreased over the 12-week period. Overall, the model of algorithm-based nursing support of prescription decisions was feasible. Future studies should address implementation issues of medication supply and dosing. Further task-shifting to relatively more abundant and lower-skilled health workers, such as nurses' aides, warrants examination.

A randomized trial of heart failure disease management in skilled nursing facilities (SNF Connect): Lessons learned.

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Daddato, Andrea; Wald, Heidi L; Horney, Carolyn; Fairclough, Diane L; Leister, Erin C; Coors, Marilyn; Capell, Warren H; Boxer, Rebecca S

2017-06-01

Conducting clinical trials in skilled nursing facilities is particularly challenging. This manuscript describes facility and patient recruitment challenges and solutions for clinical research in skilled nursing facilities. Lessons learned from the SNF Connect Trial, a randomized trial of a heart failure disease management versus usual care for patients with heart failure receiving post-acute care in skilled nursing facilities, are discussed. Description of the trial design and barriers to facility and patient recruitment along with regulatory issues are presented. The recruitment of Denver-metro skilled nursing facilities was facilitated by key stakeholders of the skilled nursing facilities community. However, there were still a number of barriers to facility recruitment including leadership turnover, varying policies regarding research, fear of litigation and of an increased workload. Engagement of facilities was facilitated by their strong interest in reducing hospital readmissions, marketing potential to hospitals, and heart failure management education for their staff. Recruitment of patients proved difficult and there were few facilitators. Identified patient recruitment challenges included patients being unaware of their heart failure diagnosis, patients overwhelmed with their illness and care, and frequently there was no available proxy for cognitively impaired patients. Flexibility in changing the recruitment approach and targeting skilled nursing facilities with higher rates of admissions helped to overcome some barriers. Recruitment of skilled nursing facilities and patients in skilled nursing facilities for clinical trials is challenging. Strategies to attract both facilities and patients are warranted. These include aligning study goals with facility incentives and flexible recruitment protocols to work with patients in "transition crisis."

Comparing nurse managers and nurses' perceptions of nurses' self-leadership during capacity building.

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Jooste, Karien; Cairns, Lindi

2014-05-01

This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. © 2014 John Wiley & Sons Ltd.

A review of critical care nursing and disease outbreak preparedness.

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Makamure, Miranda; Makamure, Muriel; Mendiola, Williane; Renteria, Daisy; Repp, Melissa; Willden, Azshwee

2013-01-01

The impact of disease outbreaks continues to increase globally. As frontline staff, critical care nurses (CCNs) are more likely to be confronted with the need to care for affected patients. With different pathological diseases emerging, CCNs play an integral role in disease outbreaks. The advanced skill set of CCNs is pivotal in the management and care of patients during an outbreak. Lack of planning and preparation before disease outbreaks leads to detrimental patient outcomes. Panic, chaos, and fear for personal safety cause stress and anxiety for unprepared nurses. However, this problem can be resolved. Comprehensive planning, training, and education can better prepare intensive care unit nurses for disease outbreaks. This article reviews some of the current literature on intensive care unit nurse preparedness for disease outbreaks in the United States. This article also offers strategies that may be used to better prepare CCNs for disease outbreaks.

A diabetes management mentor program: outcomes of a clinical nurse specialist initiative to empower staff nurses.

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Modic, Mary Beth; Canfield, Christina; Kaser, Nancy; Sauvey, Rebecca; Kukla, Aniko

2012-01-01

The purpose of this project was to enhance the knowledge of the bedside nurse in diabetes management. A forum for ongoing support and exploration of clinical problems, along with the distribution of educational tools were the components of this program. Diabetes accounts for 30% of patients admitted to the hospital. It has become more challenging to manage as the treatment choices have increased. There are a number of researchers who have identified nurse and physician knowledge of diabetes management principles as suboptimal. DESCRIPTION OF THE INNOVATION: Staff nurses are educated for a role as a Diabetes Management Mentor and are expected to educate/dialogue with peers monthly, model advocacy and diabetes patient education skills, facilitate referrals for diabetes education, and direct staff to resources for diabetes management. Diabetes Management Mentors feel more confident in their knowledge of diabetes and their ability to resolve clinical issues as they arise. The Diabetes Management Mentor role is another avenue for nurses to refine their clinical knowledge base and acquire skills to share with colleagues while remaining at the bedside. The clinical nurse specialist is expertly prepared to foster the professional development of bedside nurses while simultaneously making a positive impact on disease management. Opportunity for future investigation includes efficacy of teaching tools on diabetes mastery, the effect of clinical nurse specialist mentoring on a select group of bedside nurses, and the Diabetes Management Mentor's impact on prevention of near-miss events.

Management of diabetes by primary health care nurses in Auckland, New Zealand.

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Daly, Barbara; Arroll, Bruce; Kenealy, Timothy; Sheridan, Nicolette; Scragg, Robert

2015-03-01

The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (pmanagement on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes.

Conflict management style of Jordanian nurse managers and its relationship to staff nurses' intent to stay.

Science.gov (United States)

Al-Hamdan, Zaid; Nussera, Hayat; Masa'deh, Rami

2016-03-01

To explore the relationship between conflict management styles used by nurse managers and intent to stay of staff nurses. Nursing shortages require managers to focus on the retention of staff nurses. Understanding the relationship between conflict management styles of nurse managers and intent to stay of staff nurses is one strategy to retain nurses in the workforce. A cross-sectional descriptive quantitative study was carried out in Jordan. The Rahim organization conflict inventory II (ROCI II) was completed by 42 nurse managers and the intent to stay scale was completed by 320 staff nurses from four hospitals in Jordan. The anova analysis was carried out. An integrative style was the first choice for nurse managers and the last choice was a dominating style. The overall level of intent to stay for nurses was moderate. Nurses tend to keep their current job for 2-3 years. There was a negative relationship between the dominating style as a conflict management style and the intent to stay for nurses. The findings of the present study support the claim that leadership practices affect the staff nurses' intent to stay and the quality of care. Nurse managers can improve the intent to stay for staff nurses if they use the appropriate conflict management styles. © 2015 John Wiley & Sons Ltd.

The Effectiveness of Nurse-Led Preoperative Assessment Clinics for Patients Receiving Elective Orthopaedic Surgery: A Systematic Review.

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Sau-Man Conny, Chan; Wan-Yim, Ip

2016-12-01

Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care. The Joanna Briggs Institute (JBI) approach for conducting systematic review of quantitative research was used. Data bases searched included all published and unpublished studies in Chinese and English. All studies with adult patients who required elective orthopaedic surgery e.g. total knee replacement, total hip replacement, reduction of fracture or reconstruction surgery etc. in a hospital or day surgery center and attended a nurse-led POAC before surgery were included. Ten studies were critically appraised. Results showed that nurse-led POACs can reduce surgery cancellation rates. These studies suggested a reduction in the rate of postoperative mortality and length of hospital stay. In addition, the level of satisfaction towards services provided was significantly high. Although POACs are being increasingly implemented worldwide, the development of clinical guidelines, pathways and protocols was advocated. The best available evidence asserted that nurses in the POAC could serve as effective coordinators, assessors and educators. The nurse-led practice optimized patients' condition before surgery and hence minimized elective surgery cancellations. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Management and leadership: analysis of nurse manager's knowledge.

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Lourenço, Maria Regina; Shinyashiki, Gilberto Tadeu; Trevizan, Maria Auxiliadora

2005-01-01

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.

Characteristics that perinatal nurse managers desire in new nurse hires.

Science.gov (United States)

Falls, Emily; Hensel, Desiree

2012-04-01

Nursing leaders have proposed that nurses must have the Quality and Safety Education for Nurses (QSEN) competencies to work in complex health care systems. Using the QSEN framework, this study explored what characteristics perinatal nurse managers desired most in new nurses. This study used a survey design and a convenience sample of perinatal nurse managers working in Indiana hospitals (N = 46). Managers were more likely to hire nurses with experience, positive references, and excellent attendance. Of the QSEN competencies, managers looked most for teamwork and collaboration, followed by safety and patient-centered care. In addition to the traditional qualities desired in new nurses, the QSEN competencies are gaining importance among perinatal managers. Copyright 2012, SLACK Incorporated.

[Pain management nursing in hospitalized patients with non-oncological diseases].

Science.gov (United States)

Sepúlveda-Sánchez, Juana María; Canca-Sánchez, José Carlos; Rivas-Ruiz, Francisco; Martín-García, Mónica; Pérez-González, María Josefa; Timonet-Andreu, Eva María

2016-01-01

To assess pain management in patients hospitalized with a non-oncological disease and evaluate factors involved in pain assessment. A descriptive, cross-sectional study. We reviewed pain episodes documented in the medical records of 105 patients aged>18 years admitted to the medical units of a regional hospital between September and December 2014. Reports of pain episodes were evaluated by assessing 22 variables related to pain management quality criteria. A total of 184 reports were reviewed. Pain was measured using the visual analogue scale (VAS) in 70.1% of patients (n=129); pain was reassessed in 44.3% (n=54) of patients. Pain reassessment was significantly more frequent in patients agedPain was more frequently considered to be unrelated to the cause of admission in women as compared to men (50 vs. 25.7% p=0.027). Pain was identified in the patient care plan as a collaborative problem by the nurse for 21.1% of the patients. Some aspects of pain management should be improved, especially those regarding pain description and reassessment. The age and sex of patients significantly influence the approach of pain. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives

Directory of Open Access Journals (Sweden)

Wong Eliza LY

2011-05-01

Full Text Available Abstract Background Patient self-management is a key approach to manage non-communicable diseases. A pharmacist-led approach in patient self-management means collaborative care between pharmacists and patients. However, the development of both patient self-management and role of pharmacists is limited in Hong Kong. The objectives of this study are to understand the perspectives of physicians, pharmacists, traditional Chinese medicine (TCM practitioners, and dispensers on self-management of patients with chronic conditions, in addition to exploring the possibilities of developing pharmacist-led patient self-management in Hong Kong. Methods Participants were invited through the University as well as professional networks. Fifty-one participants comprised of physicians, pharmacists, TCM practitioners and dispensers participated in homogenous focus group discussions. Perspectives in patient self-management and pharmacist-led patient self-management were discussed. The discussions were audio recorded, transcribed and analysed accordingly. Results The majority of the participants were in support of patients with stable chronic diseases engaging in self-management. Medication compliance, monitoring of disease parameters and complications, lifestyle modification and identifying situations to seek help from health professionals were generally agreed to be covered in patient self-management. All pharmacists believed that they had extended roles in addition to drug management but the other three professionals believed that pharmacists were drug experts only and could only play an assisting role. Physicians, TCM practitioners, and dispensers were concerned that pharmacist-led patient self-management could be hindered, due to unfamiliarity with the pharmacy profession, the perception of insufficient training in disease management, and lack of trust of patients. Conclusions An effective chronic disease management model should involve patients in stable

Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

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Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

2015-07-26

Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

Caring behaviour perceptions from nurses of their first-line nurse managers.

Science.gov (United States)

Peng, Xiao; Liu, Yilan; Zeng, Qingsong

2015-12-01

Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.

Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument.

Science.gov (United States)

Bala, Sidona-Valentina; Forslind, Kristina; Fridlund, Bengt; Samuelson, Karin; Svensson, Björn; Hagell, Peter

2018-06-01

Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics. A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic. The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire. A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested. Copyright © 2018 John Wiley & Sons, Ltd.

Implementation of a School Nurse-led Intervention for Children With Severe Obesity in New York City Schools.

Science.gov (United States)

Schroeder, Krista; Jia, Haomiao; Wang, Y Claire; Smaldone, Arlene

The Healthy Options and Physical Activity Program (HOP) is a school nurse-led intervention for children with severe obesity. HOP was developed by experts at the New York City Department of Health and Mental Hygiene and implemented in New York City schools beginning in 2012. The purpose of this study was to evaluate HOP implementation with the goal of informing HOP refinement and potential future HOP dissemination. This study entailed a retrospective analysis of secondary data. Analytic methods included descriptive statistics, Wilcoxon rank sum and Chi square tests, and multivariate logistic regression. During the 2012-2013 school year, 20,518 children were eligible for HOP. Of these, 1054 (5.1%) were enrolled in the program. On average, enrolled children attended one HOP session during the school year. Parent participation was low (3.2% of HOP sessions). Low nurse workload, low school poverty, higher grade level, higher BMI percentile, and chronic illness diagnosis were associated with student enrollment in HOP. As currently delivered, HOP is not likely to be efficacious. Lessons learned from this evaluation are applicable to future nurse-led obesity interventions. Prior to implementing a school nurse-led obesity intervention, nursing workload and available support must be carefully considered. Interventions should be designed to facilitate (and possibly require) parent involvement. Nurses who deliver obesity interventions may require additional training in obesity treatment. With attention to these lessons learned, evidence-based school nurse-led obesity interventions can be developed. Copyright © 2017 Elsevier Inc. All rights reserved.

Value-based resource management: a model for best value nursing care.

Science.gov (United States)

Caspers, Barbara A; Pickard, Beth

2013-01-01

With the health care environment shifting to a value-based payment system, Catholic Health Initiatives nursing leadership spearheaded an initiative with 14 hospitals to establish best nursing care at a lower cost. The implementation of technology-enabled business processes at point of care led to a new model for best value nursing care: Value-Based Resource Management. The new model integrates clinical patient data from the electronic medical record and embeds the new information in care team workflows for actionable real-time decision support and predictive forecasting. The participating hospitals reported increased patient satisfaction and cost savings in the reduction of overtime and improvement in length of stay management. New data generated by the initiative on nursing hours and cost by patient and by population (Medicare severity diagnosis-related groups), and patient health status outcomes across the acute care continuum expanded business intelligence for a value-based population health system.

A comparative study on effect of e-learning and instructor-led methods on nurses' documentation competency.

Science.gov (United States)

Abbaszadeh, Abbas; Sabeghi, Hakimeh; Borhani, Fariba; Heydari, Abbas

2011-01-01

Accurate recording of the nursing care indicates the care performance and its quality, so that, any failure in documentation can be a reason for inadequate patient care. Therefore, improving nurses' skills in this field using effective educational methods is of high importance. Since traditional teaching methods are not suitable for communities with rapid knowledge expansion and constant changes, e-learning methods can be a viable alternative. To show the importance of e-learning methods on nurses' care reporting skills, this study was performed to compare the e-learning methods with the traditional instructor-led methods. This was a quasi-experimental study aimed to compare the effect of two teaching methods (e-learning and lecture) on nursing documentation and examine the differences in acquiring competency on documentation between nurses who participated in the e-learning (n = 30) and nurses in a lecture group (n = 31). The results of the present study indicated that statistically there was no significant difference between the two groups. The findings also revealed that statistically there was no significant correlation between the two groups toward demographic variables. However, we believe that due to benefits of e-learning against traditional instructor-led method, and according to their equal effect on nurses' documentation competency, it can be a qualified substitute for traditional instructor-led method. E-learning as a student-centered method as well as lecture method equally promote competency of the nurses on documentation. Therefore, e-learning can be used to facilitate the implementation of nursing educational programs.

Using e-learning to enhance nursing students' pain management education.

Science.gov (United States)

Keefe, Gemma; Wharrad, Heather J

2012-11-01

Absence of standardised pain curricula has led to wide diversity in the understanding and awareness of pain by healthcare students. Indeed pain management is frequently under-prioritised in nursing education, providing potential to negatively impact upon patient care. Yet the recent addition of Pain to the UK National Health Service's Essence of Care Benchmarks has highlighted the need to address this issue, and in response pain educators have called for the development of high quality, globally accessible e-learning resources in pain management. This study will determine the effectiveness of an e-learning intervention on pain management developed for nursing students. Two variants of an e-learning resource on pain management were developed, each containing the same core content but one with a section focusing on pain assessment and the other on pharmacological management. Nursing students (n=42) were randomly assigned to trial one resource, after which they undertook a questionnaire adapted (to ensure alignment with the content of the e-learning resources) from Ferrell and McCaffrey's Nurses Knowledge and Attitudes Towards Pain Survey. Scores were analysed for each resource and year of study, and compared with scores from a standard non-intervention group completing the questionnaire only (n=164). Scores averaged 19.2% higher for students undertaking the e-learning resources (pe-learning has substantial benefit to enhance pain education in nursing. Copyright © 2012 Elsevier Ltd. All rights reserved.

Peer-led prenatal breast-feeding education: a viable alternative to nurse-led education.

Science.gov (United States)

Rempel, Lynn A; Moore, Katrina C J

2012-02-01

To evaluate a prenatal breast-feeding class developed and facilitated by peer Breast-feeding Buddies. Non-equivalent control group quasi-experimental study comparing participants of the peer-led class (PLC) to those attending an established hospital-based breast-feeding nurse-led class (NLC). A brief questionnaire was completed immediately prior to the class, and telephone interviews were conducted approximately one week following the class, and one and six months post partum. 54 expectant mothers who registered for the community PLC and 55 expectant mothers who registered for the NLC. Breast-feeding intentions were measured at all time-points. Class evaluations, breast-feeding experiences, and breast-feeding support were measured at all post-class interviews. Both classes were considered worthwhile, but the PLC class was rated as more helpful and participants appreciated learning from the peers' personal experiences. Mothers taught by peers were more likely to access peer breast-feeding support. PLC participants initially decreased their prenatal breast-feeding duration intentions but had significantly stronger intentions to continue breast feeding at six months than did NLC mothers. A peer-led prenatal breast-feeding class is as effective as a traditional model of breast-feeding education and is a valuable tool to promote and support successful breast feeding. RECOMMENDATIONS FOR PRACTICE: Peer-led breast-feeding classes should be provided to enhance the accessibility of breast-feeding education and support for expectant mothers. Copyright © 2010 Elsevier Ltd. All rights reserved.

Nurse-led implementation of a ventilator-associated pneumonia care bundle in a children's critical care unit.

Science.gov (United States)

Hill, Charlotte

2016-05-09

Ventilator-associated pneumonia (VAP) is the leading cause of death with hospital-acquired infections, and preventing it is one of the Saving Lives initiatives ( Department of Health 2007 ). This article discusses the implementation of a purpose-designed VAP care bundle in a children's intensive care unit and examines the unique role of nurses in the management of the change process. A nurse-led VAP education, implementation and surveillance programme was set up. Nurse education was paramount, as nursing staff acceptance and involvement was a key feature. A multi-method training strategy was implemented, providing staff with multiple training opportunities and introducing VAP project education as a routine part of staff induction. Bundle compliance was monitored regularly and graphs of the results produced quarterly; feedback proved to be useful in keeping staff informed and engaged in VAP reduction. Comparison of VAP incidence before and after introduction of the care bundle showed a reduction after its implementation. With a co-ordinated, multidisciplinary approach, VAP care bundles can result in significant and sustained reductions in VAP rates in the paediatric intensive care unit. Effective co-ordination and leadership is crucial to successful implementation of the VAP bundle, and nurses are well placed to undertake this role.

Nursing safety management in onco-hematology pediatric wards

Directory of Open Access Journals (Sweden)

Marcelle Miranda da Silva

2015-02-01

Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement.

Science.gov (United States)

Manning, Jennifer

2016-09-01

Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses. The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement. Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form. Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement. Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.

Nurse-led action research project for expanding nurses′ role in patient education in Iran: Process, structure, and outcomes

Directory of Open Access Journals (Sweden)

Parvaneh Khorasani

2015-01-01

Full Text Available Background: Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses′ role in patient education in Iran. Materials and Methods: This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. Results: A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. Conclusions: A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses′ educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system

Nurse-led action research project for expanding nurses’ role in patient education in Iran: Process, structure, and outcomes

Science.gov (United States)

Khorasani, Parvaneh; Rassouli, Maryam; Parvizy, Soroor; Zagheri-Tafreshi, Mansoureh; Nasr-Esfahani, Mahmood

2015-01-01

Background: Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses’ role in patient education in Iran. Materials and Methods: This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. Results: A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a “core research support team,” “two steering committees,” and community representatives of clients and professionals as “feedback groups.” A seven-stage process, named the “Nurse Educators: Al-Zahra Role Expansion Action Research” (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. Conclusions: A nurse-led ad hoc structure with academic–clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses’ educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system

Nurses' knowledge of chronic disease management

African Journals Online (AJOL)

2014-11-21

Nov 21, 2014 ... Health Insurance, which is intended to improve care, requires capacity building for nurses at .... on-site training of nurses by nurse trainers was incorporated ... we focused on hypertension, diabetes, epilepsy, depression,.

Critical thinking in nurse managers.

Science.gov (United States)

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

[Reliability of nursing outcomes classification label "Knowledge: cardiac disease management (1830)" in outpatients with heart failure].

Science.gov (United States)

Cañón-Montañez, Wilson; Oróstegui-Arenas, Myriam

2015-01-01

To determine the reliability (internal consistency, inter-rater reproducibility and level of agreement) of nursing outcome: "Knowledge: cardiac disease management (1830)" of the version published in Spanish, in outpatients with heart failure. A reliability study was conducted on 116 outpatients with heart failure. Six indicators of nursing outcome were operationalized. All participants were assessed simultaneously by two evaluators. Three evaluation periods were defined: initial (at baseline), final (a month later), and follow-up (two months later). Internal consistency by Cronbach alpha coefficient, inter-rater reproducibility with intraclass correlation coefficient of reproducibility or agreement and level agreement using the 95% limits of Bland and Altman. Cronbach's alpha was 0.83 (95% CI: 0.77 - 0.89) in the final evaluation, and follow-up values of 0.85 (95% CI: 0.82-0.89) and 0.83 (95% CI: 0.78 - 0.88) were found for the first and second evaluator, respectively. The intraclass correlation coefficient showed values greater 0.9 in the three evaluation periods in both the random and mixed model. The Bland-Altman 95% limits of agreement were close to zero in the three evaluations performed. The questionnaire operationalized to assess the nursing outcome: "Knowledge: cardiac disease management (1830)" in its Spanish version, is a reliable method to measure skills and knowledge in outpatients with heart failure in the Colombian context. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Factors that facilitate registered nurses in their first-line nurse manager role.

Science.gov (United States)

Cziraki, Karen; McKey, Colleen; Peachey, Gladys; Baxter, Pamela; Flaherty, Brenda

2014-11-01

To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels. © 2013 John Wiley & Sons Ltd.

Magnetic Stent Removal in a Nurse-Led Clinic; a Nine-Month Experience.

LENUS (Irish Health Repository)

O’Connell, L

2018-02-01

Ureteric stents are frequently inserted post endourological procedures. However, subsequent endoscopic stent removal requires a second procedure for the patient and the availability of necessary resources. Longer duration of indwelling stents can lead to increased risk of symptoms and complications. The use of magnetic stents removed with a magnetic retrieval device (BlackStar©), offers an alternative which obviates the need for cystoscopy. We assessed the outcomes for this novel method of stent removal in our institution. A retrospective analysis was performed of all patients undergoing magnetic stent insertion and subsequent removal in a nurse-led clinic over a nine-month period. Patients were followed up with a prospective validated Ureteral Stent Symptoms Questionnaire (USSQ)3. A cost analysis was also performed. In total, 59 patients were treated using magnetic stents. The complication rate was low (6.7%). The median duration of indwelling stent was 5.8 days (range 1-11 days). Patients reported haematuria and lower urinary tract symptoms but >90% experienced no functional impairment with minimal days of employment lost (mean 0.75 days). All patients reported satisfaction with nurse-led stent removal and 97% were happy to have stents removed via this method in the future. The total financial savings were estimated at €47,790 over this period. Nurse-led removal of magnetic stents is safe and well tolerated by patients and enables expedient stent removal. It also provides a significant cost benefit and frees up valuable endoscopic resources.

Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control.

Science.gov (United States)

Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

2015-09-01

The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. © The Author(s) 2015.

Improving detection of familial hypercholesterolaemia in primary care using electronic audit and nurse-led clinics.

Science.gov (United States)

Green, Peter; Neely, Dermot; Humphries, Steve E

2016-06-01

In the UK fewer than 15% of familial hypercholesterolemia (FH) cases are diagnosed, representing a major gap in coronary heart disease prevention. We wished to support primary care doctors within the Medway Clinical Commissioning Group (CCG) to implement NICE guidance (CG71) and consider the possibility of FH in adults who have raised total cholesterol concentrations, thereby improving the detection of people with FH. Utilizing clinical decision support software (Audit+) we developed an FH Audit Tool and implemented a systematic audit of electronic medical records within GP practices, first identifying all patients diagnosed with FH or possible FH and next electronically flagging patients with a recorded total cholesterol of >7.5 mmol L(-1) or LDL-C > 4.9 mmol L(-1) (in adults), for further assessment. After a 2-year period, a nurse-led clinic was introduced to screen more intensely for new FH index cases. We evaluated if these interventions increased the prevalence of FH closer to the expected prevalence from epidemiological studies. The baseline prevalence of FH within Medway CCG was 0.13% (1 in 750 persons). After 2 years, the recorded prevalence of diagnosed FH increased by 0.09% to 0.22% (1 in 450 persons). The nurse advisor programme ran for 9 months (October 2013-July 2014) and during this time, the recorded prevalence of patients diagnosed with FH increased to 0.28% (1 in 357 persons) and the prevalence of patients 'at risk and unscreened' reduced from 0.58% to 0.14%. Our study shows that two simple interventions increased the detection of FH. This systematic yet simple electronic case-finding programme with nurse-led review allowed the identification of new index cases, more than doubling the recorded prevalence of detected disease to 1 in 357 (0.28%). This study shows that primary care has an important role in identifying patients with this condition. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley

A multi-faceted approach of a nursing led education in response to MERS-CoV infection

Directory of Open Access Journals (Sweden)

Jaffar A. Al-Tawfiq

2018-03-01

Full Text Available Background: The emergence of the Middle East respiratory syndrome-coronavirus (MERS-CoV resulted in multiple healthcare associated outbreaks. In response, we developed a nurse-led program to screen and triage patients with MERS-CoV infection. Methods: A formal educational program was implemented to ensure a standardized approach to care planning and delivery. The essential skills that were included were the use of Personal Protective Equipment (PPE including gown, gloves, head cover and N95 mask, hand hygiene, the practice of donning and doffing and the collection of MERS-CoV nasopharyngeal specimens. Results: A core group of nurses were identified from high-risk units. The education program consisted of four skill-days. Nurses were assigned a pre-course work from Mosby’s Nursing Skills, an online skill module, donning and doffing of PPE, and the process for obtaining a nasopharyngeal swab. The skill lab incorporated multiple methods such group discussion, watching an on-line video, and a simulated demonstration and practice on a mannequin. In total, 450 nurses attended the Nasopharyngeal Skills Day and 1000 nurses received training. Donning and doffing PPE and N95 mask fit testing has become an annual mandatory competency requirement for staff in nursing and clinical services. Conclusion: The application of specified protocols minimizes the risks of cross infection, placing emphasis on patient and staff safety as well as expediting the patient to definitive treatment. Nurse educators have an instrumental role in training nurses and other healthcare providers on the specifics needed to identify, contain and manage patient presenting with MERS-CoV. Keywords: Coronavirus, Education, MERS-CoV, Middle East respiratory syndrome, Saudi Arabia, Outbreak preparedness, Hospital care

Assessment of the amount of ability to manage transformation in nursing managers (Head Nurses

Directory of Open Access Journals (Sweden)

Asra Ramyad

2016-05-01

Full Text Available Quiescent leadership cannot last long time. When the environment is constant and unchanged, firms will have little mobility Human is subject to organizational changes and numerous factors. Removing the rust from the mirror of the soul of man enhances his development towards his capabilities. Purpose: This study aimed to examine change management capabilities of nurse managers (Head nurses. This research is a descriptive study, which examines the change management capabilities in 50 different supervisors from the perspective of 187 nurses in hospitals under the supervision of head nurses in Qazvin, and it is conducted by Census method. The tools of this research are Bass and Avolio's Transformational leadership questionnaire that its validity and reliability were confirmed. To analyze the data, the software ѕрѕѕ version 22 statistical tests of Pearson, T, Nava, KS, and Chi-square exact was used. The findings showed that, according to the results of t-test, a statistically significant difference was not seen between the scores on all subscales obtained from the questionnaire of management capabilities in change management from nurses, demographic characteristics of nurses. (All p>0/5. However, scores in terms of individual consideration was (p=0/44 and Mental stimulation was (p=0/035 and only statistically significant difference was observed in the education of nurses. Given that nursing managers (supervisors in the field of change management have a poor and average performance, it seems the higher the level of education is for nurse managers, their ability to apply change management is higher. Also supervisors' performance within individual consideration with an error probability equal to 0/012 is at an optimum level and hence was able to win the trust of staff. To advance the goals of excellence in medical care, training the managers towards change, establishing physical and mental health and confidence in them by their involvement, is

Outpatient management of childhood asthma by paediatrician or asthma nurse : randomised controlled study with one year follow up

NARCIS (Netherlands)

Kamps, Arvid W. A.; Brand, PLP; Kimpen, JLL; Maille, AR; Overgoor-van de Groes, AW; van Helsdingen-Peek, LCJAM

2003-01-01

Background: Until now, care provided by asthma nurses has been additional to care provided by paediatricians. A study was undertaken to compare nurse led outpatient management of childhood asthma with follow up by a paediatrician. Methods: Seventy four children referred because of insufficient

Pleural mesothelioma: management updates and nursing initiatives to improve patient care

Directory of Open Access Journals (Sweden)

Lehto RH

2014-05-01

Full Text Available Rebecca H LehtoCollege of Nursing, Michigan State University, East Lansing, MI, USAAbstract: Malignant pleural mesothelioma is a relatively rare but aggressive malignancy that is primarily associated with occupational asbestos exposure. While treatment options for mesothelioma have expanded, the disease carries a poor prognosis, with a median of 8 months to 1 year of survival postdiagnosis. This article synthesizes current disease-management practices, including the diagnostic workup, treatment modalities, emerging therapies, and symptom management, and identifies comprehensive nursing strategies that result in the best care based on updated evidence. Multidisciplinary coordination, palliative care initiation, survivorship, and end-of-life care are discussed. Findings may be applied in clinical environments as a resource to help nurses better understand treatment options and care for patients facing malignant pleural mesothelioma. Recommendations for future research are made to move nursing science forward and to improve patient well-being and health-related quality-of-life outcomes for patients and their family members.Keywords: pleural mesothelioma, cancer, symptom management, evidence-based care

Time management strategies in nursing practice.

Science.gov (United States)

Waterworth, Susan

2003-09-01

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

Advancing Nursing Practice: Management of Neuropathic Pain With Capsaicin 8% Without Physician Supervision.

Science.gov (United States)

O'Brien, Joanne; Keaveny, Joseph; Pollard, Valerie; Nugent, Linda Elizabeth

The purpose of this study was to examine the management of patient's neuropathic pain with capsaicin 8% in a nurse-led clinic when administered by 1 registered advanced nurse practitioner without physician supervision. A longitudinal, single-group, descriptive research design was used to assess pain scores and quality of life 3 times over 3 months after treatment. Patients with a diagnosis of neuropathic pain were assessed and treated with capsaicin 8% by 1 advanced nurse practitioner with prescriptive authority in a nurse-led clinic. Pain scores were collected at baseline, and self-assessed pain, activity level, and quality of life were assessed at 1 week, 4 weeks, and 3 months after treatment. Twenty-four patients were recruited, and data were analyzed using Friedman's test. In post hoc analysis, Wilcoxon signed-rank test was used with Bonferroni correction. Pain scores differed from pretreatment to posttreatment at each of the 3 time points, at rest (χ3 = 20.54, P = .001) and on movement (χ3 = 23.644, P = .001), and remained significant after Bonferroni correction. Overall, 62.5% (n = 15) of patients achieved at least a 30% reduction in self-reported pain at rest from pretreatment to 3 months, and 54% (n = 13) achieved the same reduction in pain on movement. Most improvements in patient's quality of life occurred between 1 and 4 weeks. Patient satisfaction was high, with 83% stating that they would be happy to have the treatment repeated. Single-dose capsaicin 8% decreased neuropathic pain after being administered in an outpatient setting by an experienced registered advanced nurse practitioner. Further multicenter research led by advanced nurse practitioners is needed to support high-quality, safe treatment of neuropathic pain with high-concentration capsaicin in nurse-led chronic pain clinics.

Ward-based, nurse-led, outpatient chest tube management: analysis of impact, cost-effectiveness and patient safety.

Science.gov (United States)

Tcherveniakov, Peter; De Siqueira, Jonathan; Milton, Richard; Papagiannopoulos, Kostas

2012-06-01

Prolonged drainage and air leaks are recognized complications of elective and acute thoracic surgery and carry significant burden on inpatient stay and outpatient resources. Since 2007, we have run a ward-based, nurse-led clinic for patients discharged with a chest drain in situ. The aim of this study is to assess its cost-effectiveness and safety. We present a retrospective review of the activity of the clinic for a period of 12 months (November 2009-10). An analysis of the gathered data is performed, focusing specifically on the duration of chest tube indwelling, the indications, complications and cost efficiency. The nurse-led clinic was housed in the thoracic ward with no additional fixed costs. Seventy-four patients were reviewed (53 males, 21 females, mean age of 59) and subsequently discharged from the clinic in this time period, accounting for 149 care episodes. Thirty-three (45%) of the patients underwent a video-assisted thoracoscopic surgery procedure, 35 (47%) of them a thoracotomy and 7 (9%) had a bedside chest tube insertion. Following hospital discharge, the chest tubes were removed after a median of 14 days (range 1-82 days). Fifty-eight percent of the patients were reviewed because of a prolonged air leak, 26% for persistent fluid drainage and 16% due to prolonged drainage following evacuation of empyemas. For the care episodes analysed, we estimate that the clinic has generated an income of €24,899 for the department. Hourly staffing costs for the service are significantly lower compared with those of the traditional outpatient clinic: €15 vs. €114. Our results show that a dedicated chest tube monitoring clinic is a safe and efficient alternative to formal outpatient clinic review. It can lead to shorter hospital stays and is cost effective.

Frontline nurse managers' confidence and self-efficacy.

Science.gov (United States)

Van Dyk, Jennifer; Siedlecki, Sandra L; Fitzpatrick, Joyce J

2016-05-01

This study was focused on determining relationships between confidence levels and self-efficacy among nurse managers. Frontline nurse managers have a pivotal role in delivering high-quality patient care while managing the associated costs and resources. The competency and skill of nurse managers affect every aspect of patient care and staff well-being as nurse managers are largely responsible for creating work environments in which clinical nurses are able to provide high-quality, patient-centred, holistic care. A descriptive, correlational survey design was used; 85 nurse managers participated. Years in a formal leadership role and confidence scores were found to be significant predictors of self-efficacy scores. Experience as a nurse manager is an important component of confidence and self-efficacy. There is a need to develop educational programmes for nurse managers to enhance their self-confidence and self-efficacy, and to maintain experienced nurse managers in the role. © 2016 John Wiley & Sons Ltd.

Job Satisfaction of Nursing Managers

OpenAIRE

Petrosova, Liana; Pokhilenko, Irina

2015-01-01

The aim of the study was to research levels of job satisfaction, factors affecting job satisfaction/dissatisfaction, and ways to improve job satisfaction among nursing managers. The purposes of the study were to extend knowledge in the field of healthcare management, to raise awareness about factors that affect job satisfaction in nursing management career, and to provide suggestions regarding how to increase job satisfaction among nursing managers. The method of this study is literature r...

Nurse specialists in adult congenital heart disease: The current status in Europe

NARCIS (Netherlands)

Moons, P.; Scholte op Reimer, W.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Martensson, J.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.

2006-01-01

Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the

Nurse managers: the ties that bind.

Science.gov (United States)

Simons, Sherri Lee

2003-01-01

The staff nurses' immediate manager directly influences an NICU's ability to attract and retain professional nurses. This makes it especially important that nurse executives and administrators identify opportunities to better meet the needs of their nurse managers and measure the impacts of their decisions. Data about front-line manager turnover need to be measured, reported, and examined. No longer can organizations afford to view managers as another expense; they are an asset on the balance sheet. Strategic planning for the recruitment and retention of nurse managers will be vital both to an organization's healthy bottom line and to the quality of its patient care.

Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa.

Science.gov (United States)

Maimela, Eric; Alberts, Marianne; Bastiaens, Hilde; Fraeyman, Jesicca; Meulemans, Herman; Wens, Johan; Van Geertruyden, Jeane Pierre

2018-05-04

Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa. A multifaceted intervention, called 'quality circles' (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS). These QCs used the findings from previous studies which formed part of the larger project in the study area, namely, the quantitative study using STEPwise survey and qualitative studies using focus group discussions and semi-structured interviews. The findings from previous studies in Dikgale HDSS revealed that an epidemiological transition is occurring. Again, the most widely reported barriers from previous studies in this rural area were: lack of knowledge of NCDs; shortages of medication and shortages of nurses in the clinics, which results in patients having long waiting-time at clinics. Lack of training of health care providers on the management of chronic diseases and the lack of supervision by the district and provincial health managers, together with poor dissemination of guidelines, were contributing factors to the lack of knowledge of non-communicable diseases (NCDs) management among nurses and community health care workers (CHWs). Consideration of all of these findings led to the development of model which focuses on integrating nursing services, CHWs and traditional health practitioners (THPs), including a well-established clinical information system for health care providers. A novel aspect of the model is the inclusion of community ambassadors who are on treatment for NCDs and are, thus, repositories of knowledge who can serve as a bridge between

The impact of advanced nurse practitioners on patient outcomes in chronic kidney disease: A systematic review.

Science.gov (United States)

McCrory, Geraldine; Patton, Declan; Moore, Zena; O'Connor, Tom; Nugent, Linda

2018-06-11

Management of individuals with chronic kidney disease (CKD) requires a collaborative approach. Nurses have diversified their skills to take on roles which have been traditionally physician-led. The impact of such roles, mainly that of the advanced nurse practitioner (ANP), has not been previously assessed using a systematic approach. The aim of this systematic review (SR) was to determine the impact of the addition of an ANP on patient outcomes in adults with CKD. A SR, following the guidance of PRISMA was undertaken. Population: adults with CKD. ANP. Databases searched included The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase and Medline. Outcome measures were blood pressure (BP), lipids, haemoglobin A1c (HbA1c), phosphate and parathormone (PTH) measures and recommended medication use. Four studies met the inclusion criteria. All possessed external validity and demonstrated low risk for random sequence generation and allocation concealment but were at high risk of performance bias and detection bias. The addition of an ANP resulted in the superior management of BP in all studies. Three studies reported improved control of low-density lipoprotein (LDL) and PTH. One study reported greater achievement of phosphate control. Glycaemic control was equal in both groups. All studies reported higher rates of recommended medication use. The addition of an ANP is superior or equal to the usual care models for the management of BP, LDL, PTH and glycaemic control in adults with CKD. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Managing Food Allergies at School: School Nurses

Centers for Disease Control (CDC) Podcasts

2015-01-20

This podcast highlights the leadership role of school nurses in the management of food allergies in schools. It also identifies CDC food allergy resources for schools.  Created: 1/20/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/20/2015.

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

Science.gov (United States)

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

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

Science.gov (United States)

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

2006-06-01

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

Psychological contracts and commitment amongst nurses and nurse managers: a discourse analysis.

Science.gov (United States)

McCabe, T J; Sambrook, Sally

2013-07-01

Few studies explore the link between the psychological contracts and the commitment of nursing professionals in the healthcare sector, and how perceived breaches of the psychological contract can impact on nurses' commitment levels. This study explores the connections between the psychological contracts and organisational and professional commitment of nurses and nurse managers. Semi-structured interviews were conducted with nurses and nurse managers, to explore the connections between their psychological contracts and organisational and professional commitment. Large acute and small community organisation within the British National Health Service. 28 nurses and 11 nurse managers working within an acute and a community sector organisation - 20 and 19 in each organisation. Participants were selected through a process of purposive sampling, reflecting variations in terms of age, grade, ward and tenure. A discourse analysis was conducted on the qualitative data from the thirty nine semi-structured interviews. Two overall themes emerged, professional and managerial values. Professional values included the sub-themes: professional recognition; immediate work environment - leadership and peer support; professional development and progression. Sub-themes under managerial values included: involvement; general management; resource management. The findings suggest that nurses and nurse managers are governed by relational psychological contracts, underpinned by an affective and to a lesser extent normative commitment towards the nursing profession. They emphasise 'professional values', and professional commitment, as the basis for positive psychological contracts amongst nursing professionals. There was anecdotal evidence of relational psychological contract breach, with decreasing job satisfaction as the outcome of perceived psychological contract breach. Positive psychological contracts and commitment levels amongst nursing professionals can be supported by managers been

Nurse-Led Telephone Follow-up: Improving Options for Women With Endometrial Cancer

NARCIS (Netherlands)

Smits, A.; Lopes, A.; Das, N.; Bekkers, R.L.M.; Kent, E.; McCullough, Z.; Galaal, K.

2015-01-01

BACKGROUND: Nurse-led follow-up (NLFU) has been identified as a suitable means of follow-up care in cancer patients, and its acceptability has already been demonstrated in other areas of cancer care. OBJECTIVES: The objectives of this study were to evaluate the effect of NLFU on quality of life and

Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers

Science.gov (United States)

Wise, Vanessa

2013-01-01

As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…

Transcultural nursing and a care management partnership project.

Science.gov (United States)

Lazure, G; Vissandjée, B; Pepin, J; Kérouac, S

1997-09-01

This paper aims to illustrate how Leininger's Theory of Culture Care Diversity and Universality has influenced the research process of a study that emerged from a care management partnership between Canadian nursing teachers and Tunisian nurses. The purpose of the study was to investigate the meanings of care as viewed by university hospital-based Tunisian nurses. The qualitative analysis of data gathered through observation-participation and interviews highlights recurrent patterns and reveals three major professional care themes. For Tunisian nurses care means to secure the patient's cooperation towards the medical regimen within established rules in the hospital; to contribute to curing the patient by using current technology as well as by maintaining their technical skills and improving their medical knowledge; to take charge of the patient to assist the physician in treating disease. This study showed that Tunisian nurses emphasize curing rather than widely shared community values such as interdependence, intercommunication, understanding, presence and responsibility for others. Discussion of the study's findings draws upon the perspective provided by Freire's Oppressed Group Theory. In order to promote cultural congruence within the Care Management Partnership Project in Tunisia, the three predicted modes of care within Leininger's theory guide the decisions and actions for future nursing research and partnership activities.

Conflict management styles of Asian and Asian American nurses: implications for the nurse manager.

Science.gov (United States)

Xu, Yu; Davidhizar, Ruth

2004-01-01

Foreign nurses and American nurses who are culturally diverse make up an increasing number of the US nursing workforce. Of foreign nurses, Asians constitute the largest number. Conflict is an inevitable aspect of human relations in health care settings. Nurses and other health team members with diverse cultural background bring to the workplace different conflict behaviors that directly impact the outcomes of conflicts. It is essential for health care team members and managers to be cognizant of different conflict behaviors as well as different conflict management styles so that strategies can be designed to build a culturally diverse health care team that is able to effectively achieve group and organizational objectives.

Leadership and management in mental health nursing.

Science.gov (United States)

Blegen, Nina Elisabeth; Severinsson, Elisabeth

2011-05-01

Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Efficacy of a brief nurse-led pilot psychosocial intervention for newly diagnosed Asian cancer patients.

Science.gov (United States)

Mahendran, Rathi; Lim, Haikel A; Tan, Joyce Y S; Chua, Joanne; Lim, Siew Eng; Ang, Emily N K; Kua, Ee Heok

2015-08-01

Cancer patients experience distress and high levels of psychosocial concerns. However, in Asian countries like Singapore, patients are often unwilling to seek support and help from mental healthcare professionals, but, instead, are more willing to confide in nurses. This quasi-experimental study developed and tested the efficacy of a brief nurse-led psychosocial intervention to alleviate these patients' distress, minor psychiatric morbidity, and psychosocial concerns. The semi-structured intervention comprised 20- to 30-minute face-to-face sessions with trained oncology nurses, monthly for 2 months and then bimonthly for 4 months. Patients received psycho-education on symptoms of stress, anxiety, and depression and counseling and were taught behavioral techniques such as deep breathing, progressive muscle relaxation, and positive self-talk. The results of this study found that patients who received the intervention had reduced distress, depression, and anxiety levels and improved quality of life (QOL) at 6 months. Although further research is necessary to explore the efficacy and viability of this intervention, findings support brief nurse-led psycho-educational interventions in Asian settings especially for cancer patients reluctant to seek help from mental health professionals.

Challenges of nurses' empowerment in the management of patient aggression: A qualitative study

Directory of Open Access Journals (Sweden)

Tahereh Ramezani

2017-01-01

Full Text Available Background: Patients' aggression in the mental care setting is a global health problem with major psychological, physical, and economic consequences; nurse empowerment to manage this aggressive behavior is an important step in psychiatric nursing. The aim of this study was to explore psychiatric nurses' experiences of the challenges of empowerment in the management of patients' aggression. Materials and Methods: This qualitative study was performed among 20 nurses working in a major referral psychiatric center in Iran during 2014–2016. The purposive sampling method was used for selecting the participants. Data were collected through semi-structured interviews, observations, and filed notes. Inductive content analysis was used for data analysis. Results: Three categories and ten subcategories were identified: inefficient organizational policy (limited human resources, mandatory shifts, shortage of protective equipment, lack of motivational sparks; insufficient job growth (failure to implement training programs, insufficient effort for job competence, lack of clinical guidelines; and deficiencies in the organizational culture (inadequate autonomy and authority, lack of the culture of prevention, culture of fault and blame after an incident. Conclusions: Psychiatric nurses were not satisfied with organizational empowering conditions for the management of patients' aggression and reported low levels of access to learning opportunity, receiving support and essential resources that led to unnecessary use of containment measures. Managers must make every effort to create organizational context that make it possible to empower nurses for optimal practice.

Primary immunodeficiency disease: a model for case management of chronic diseases.

Science.gov (United States)

Burton, Janet; Murphy, Elyse; Riley, Patty

2010-01-01

Patient-centered chronic care management is a new model for the management of rare chronic diseases such as primary immunodeficiency disease (PIDD). This approach emphasizes helping patients become experts on the management of their disease as informed, involved, and interactive partners in healthcare decisions with providers. Because only a few patients are affected by rare illnesses, these patients are forced to become knowledgeable about their disease and therapies and to seek treatment from a healthcare team, which includes physicians and nurse specialists who are equipped to manage the complexity of the disease and its comorbidities. Importantly, therapy for PIDD can be self-administered at home, which has encouraged the transition toward a proactive stance that is at the heart of patient-centered chronic care management. We discuss the evolution of therapy, the issues with the disease, and challenges with its management within the framework of other chronic disease management programs. Suggestions and rationale to move case management of PIDD forward are presented with the intent that sharing our experiences will improve process and better manage outcomes in this patient population. The patient-centered model for the management of PIDD is applicable to the primary care settings, where nurse case managers assist patients through education, support them and their families, and facilitate access to community resources in an approach, which has been described as "guided care." The model also applies specifically to immunology centers where patients receive treatment or instruction on its self-administration at home. Patient-centered management of PIDD, with its emphasis on full involvement of patients in their treatment, has the potential to improve compliance with treatment, and thus patient outcomes, as well as patients' quality of life. The patient-centered model expands the traditional model of chronic disease management, which relies on evidence

Time Management Skills of Nursing Students

Directory of Open Access Journals (Sweden)

Tulay Basak

2008-10-01

Full Text Available AIM: The purpose of this research was to determine time management skills of nursing students. METHOD: Time Management Inventory and the form that has been developed via screening the literatures by researcher were used gather data. The descriptive study was carried out between the 1st May 2007 and 31st May 2007. The research population of this study constituted nursing students in a Nursing School in Turkey. The sample was consisted of 323 students. Statistical analysis was made using Mann-Whithey U test, One-way ANOVA, Kruskal-Wallis variance analysis, Sperman’s correlation analysis. RESULTS: Nursing student’s total time management points were minimum 46 maximum 127 and median is 89.41±12.71. Total time management points were higher at older age group than the other group. There was a significant correlation between total time management points and academic achievement of nursing students. CONCLUSION: Nursing students needs progress about time planing. Students who are older age had better time management skills. As the total time management point increased also academic achievement point increased. [TAF Prev Med Bull 2008; 7(5.000: 429-434

Nurse manager job satisfaction and intent to leave

Science.gov (United States)

Warshawsky, Nora E.; Havens, Donna S.

2015-01-01

Background The nurse manager role is critical to staff nurse retention and often the portal to senior nursing leadership, yet little is known about nurse managers' job satisfaction and career plans. The purpose of this study was to describe nurse managers' job satisfaction and intent to leave. Methods An electronic survey was used to collect data from 291 nurse managers working in U.S. hospitals. Findings Seventy percent were satisfied or very satisfied with their jobs and 68% were either likely or very likely to recommend nursing management as a career choice. Seventy-two percent of these nurse managers were also planning to leave their positions in the next five years. The four most common reasons reported for intent to leave included burnout, career change, retirement, and promotion. Burnout was the most common reason cited by the entire sample but the fourth most common reason for leaving cited by those nurse managers who were planning to leave and also satisfied or very satisfied with their positions. Conclusions Recommendations for nursing leaders include evaluating the workload of nurse managers, providing career counseling, and developing succession plans. Additional research is needed to understand the determinants and consequences of nurse manager job satisfaction, intent to leave, and turnover. PMID:24689156

Refrigerating liquid prototype for LED's thermal management

International Nuclear Information System (INIS)

Faranda, Roberto; Guzzetti, Stefania; Lazaroiu, George Cristian; Leva, Sonia

2012-01-01

The heat management is the critical factor for high performance operation of LED. A new heat management application of refrigerating liquid integrated within a fabricated prototype is proposed and investigated. A series of experiments considering different heights of liquid level were performed to evaluate the heat dissipation performance and optical characteristics of the refrigerating liquid based prototype. The results reveal that the junction temperature decreases as the level of refrigerating liquid increases. The experimental results report that the refrigerating liquid reduces the junction temperature, and can positively influence the luminous radiation performances. An optimization investigation of the proposed solution was carried out to find an optimum thermal performance. The experiments indicated that refrigerating liquid cooling is a powerful way for heat dissipation of high power LEDs, and the fabrication of prototype was feasible and useful. - Highlights: ► New heat management application of refrigerating liquid on a fabricated LED prototype. ► Thermal models setup and comparison between the classical and the new solutions. ► The impact of refrigerating liquid level on LED thermal and luminous performances. ► The relationship between different levels of liquid with LED prototype performances.

University management nurse: a grounded theory

Directory of Open Access Journals (Sweden)

Kamylla Santos da Cunha

2018-03-01

Full Text Available ABSTRACT Objective: to understand the meaning of the university management performed by nurses managers of the nursing undergraduate course of a public university. Method: this is a qualitative research, based on the grounded theory. Data collection took place between May and September 2016, with open interviews, in the scenario of a federal public university. The technique of constant comparative analysis of the data was followed, obtaining a theoretical sample with 19 nurses, in two sample groups. Results: there were three categories emerged that shaped the phenomenon: Articulating complex collectives through university management for the qualified training of new nurses. The categories included: a conditions, defined by perceiving the commitment to the collective, previous experiences, and training for health management, as motivations to be a teacher manager; b actions/interactions, delimited by Knowing and recognizing, in practice, the university management process, limits and possibilities in the coordination of complex collective subjects; and, c consequences, such as Improving teaching work and taking responsibility for university education. Conclusion: the nurses teaching managers to explain university management as a set of individual and collective actions that, articulated in a complex social environment, promote conditions for the training of critical and reflexive nurses with the demands of society.

Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers.

Science.gov (United States)

Drennan, Vari M; Halter, Mary; Gale, Julia; Harris, Ruth

2016-11-01

To investigate the views of senior nurse and human resource managers of strategies to retain hospital nurses in a metropolitan area. Against a global shortage, retaining nurses is a management imperative for the quality of hospital services. Semi-structured interviews, thematically analysed. Metropolitan areas have many health organisations in geographical proximity, offering nurses choices in employer and employment. Senior nurse and human resource managers recognised the complexity of factors influencing nurse turnover, including those that 'pulled' nurses out of their jobs to other posts and factors that 'pushed' nurses to leave. Four themes emerged in retaining nurses: strategy and leadership, including analysis of workforce and leavers' data, remuneration, the type of nursing work and career development and the immediate work environment. In contexts where multiple organisations compete for nurses, addressing retention through strategic leadership is likely to be important in paying due attention and apportioning resources to effective strategies. Aside from good human resource management practices for all, strategies tailored to different segments of the nursing workforce are likely to be important. This metropolitan study suggests attention should be paid to strategies that address remuneration, progressing nursing careers and the immediate work environment. © 2016 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.

The nature of leadership style in nursing management.

Science.gov (United States)

Azaare, John; Gross, Janet

The purpose of this study was to explore the nature of leadership styles used by nurse managers, and describe staff nurses' perceptions of leadership styles. Effective leadership among nurse managers has been associated with staff nurse job satisfaction and retention. Twenty staff nurses from two hospitals in Ghana responded to tape-recorded interview questions. Four themes emerged from inductive analysis of the data. Findings suggest that nurse managers employed intimidation and minimal consultation to control their employees. The study further indicated that nurse managers were perceived as 'figure-heads', who are weak and inarticulate at the level of policy planning and implementation. It was therefore concluded that staff nurses in the study site hospitals lack confidence, trust and satisfaction with the current style of leadership. Staff nurses preferred a more proactive, articulate and independent nursing leadership at the top level. It is recommended that effective leadership training be instituted for prospective nurse managers before appointments are made into management and administrative positions.

Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

Science.gov (United States)

Kakyo, T A; Xiao, L D

2018-04-19

The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

Can job sharing work for nurse managers?

Science.gov (United States)

Dubourg, Laurence; Ahmling, Janette A; Bujas, Lenka

2006-02-01

Addressing employer reluctance to employ nurse managers in a job-sharing capacity, the aim of this paper is to explore job sharing among nurse managers. The literature highlighted potential fragmentation of leadership, breakdown of communication and higher costs as issues, with the retention of experienced highly motivated managers identified as an advantage. A staff survey explored whether the job-sharing arrangement trialled in a day surgery setting by two nurse managers was successful compared with similar roles held by full-time managers. This paper suggests that nurse managers can successfully job share. Overall, this paper recommends that employers consider a job-sharing arrangement when they wish to retain experienced nurse managers, and highlights aspects that can enhance a successful outcome.

A comparison of pediatric basic life support self-led and instructor-led training among nurses.

Science.gov (United States)

Vestergaard, Lone D; Løfgren, Bo; Jessen, Casper L; Petersen, Christina B; Wolff, Anne; Nielsen, Henrik V; Krarup, Niels H V

2017-02-01

Pediatric cardiac arrest carries a poor prognosis. Basic life support improves survival. Studies on pediatric basic life support (PBLS) training are sparse. The aim of our study was to investigate the effect of self-training in PBLS. We conducted a prospective controlled trial enrolling nurses from pediatric and maternity wards (n=29 in each group). Self-training, including a manikin and access to a web-based video on PBLS, was compared with a 2-h instructor-led course. Two weeks after training, all participants were tested in a mock scenario of pediatric cardiac arrest. Fifteen parameters equivalent to the steps in the PBLS algorithm - for example, effective ventilations, effective chest compressions, calling for help, and correct sequence of actions, were evaluated and rated dichotomously (1=approved or 0=not approved). No difference was observed in the baseline demographics between the self-training group and the instructor-led group. The participants in the self-training group accessed the website 2±1.5 times (mean±SD) and spent 41±25 min on the site. There was no significant difference between the two groups in the overall average score (10.5 in the self-training group vs. 10.0 in the instructor-led group, P=0.51) or in any of the 15 parameters. After the study, all participants felt that they had improved their skills and felt capable of performing PBLS. Self-training is not statistically different to instructor-led training in teaching PBLS. Self-evaluated confidence improved, but showed no difference between groups. PBLS may be disseminated through self-training.

Potential for Self-Management in Chronic Care: Nurses' Assessments of Patients.

Science.gov (United States)

Bos-Touwen, Irene; Dijkkamp, Evelien; Kars, Marijke; Trappenburg, Jaap; De Wit, Niek; Schuurmans, Marieke

2015-01-01

Although self-management interventions are, to some extent, individualized in clinical practice, the decision-making process is not fully understood. Exploring nurses' clinical reasoning about how and to what extent they currently tailor self-management support can provide new insights, enhancing process and outcome of chronic care. The aim of this study was to explore how nurses assess chronic patients concerning the potential of self-management and clinical reasoning with regard to tailoring care to the individual patient. A qualitative study was conducted using grounded theory. Semistructured interviews were held with 15 nurses working within chronic care. All interviews were carried out from February to July 2013. All nurses provided individualized care; however, a nurse's view of self-management influenced how tailoring was performed. Substantial differences were seen in patient assessments and how care was individualized. Patients' motivation, capacities, mindset, needs, and preferences were obtained through communication, experience, intuition, and trusting relationships. A typology with four patient types emerged: the unmotivated patient, the patient with limited capacities, the oblivious patient, and the ideal patient. Nurses elaborated on using different approaches for patients in each of these groups. A nurse's perception of self-management substantially impacted how care was individualized. Patient assessment was the key driver of tailoring, which was performed in various ways, and influenced how and the extent to which care was individualized. To enable responding to the unique wishes and needs of individual patients, both scientific and educational efforts need to be directed toward systematic assessments of patient capacity to self-manage their disease.

Strategic management of health care information systems: nurse managers' perceptions.

Science.gov (United States)

Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

2009-01-01

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.

A qualitative study of patients' experiences of a nurse-led memory clinic.

Science.gov (United States)

Stirling, Christine; Campbell, Briony; Bentley, Michael; Bucher, Hazel; Morrissey, Martin

2016-01-01

Little is known about patients' decision-making to attend a nurse-led memory clinic (NLMC) or of their experiences in the months following attendance. This paper reports qualitative follow-up data from 13 participants who attended a NLMC run by a Nurse Practitioner, and who were interviewed later in their own homes. Participants attended the NLMC seeking 'benchmarking' against the broader population or confirmation of diagnosis, with the Nurse Practitioner perceived as having more time to talk. Although we anticipated that participants would have changed some behaviours to incorporate 'brain health material', we found that the focus was on maintaining current capacity and lifestyle with most participants delaying planning and decisions about future lifestyle changes until 'necessary'. Understanding why people contact a NLMC and how their participation influences future planning can help us better target health care messages with the aim of improving health literacy. © The Author(s) 2013.

A ward without walls? District nurses' perceptions of their workload management priorities and job satisfaction.

Science.gov (United States)

Stuart, Elaine Haycock; Jarvis, Alison; Daniel, Katie

2008-11-01

To explore district nurses' workload management, job satisfaction and the challenges they face. This paper reports qualitative findings from a qualitative and quantitative study to identify a district nursing perspective on use of time, challenges and work satisfaction. District nursing is under increasing pressure because of the increasing shift to care in the community, early hospital discharge and changes in demography with an ageing population and more people with chronic illnesses. Qualitative. The study took place in one Scottish Health Board and data were collected in February and March 2005. The qualitative approach involved a total of 31 district nurses and senior managers in focus group discussions or individual interviews. Three main themes were identified: (1) the priorities of district nurses and their views on work unrelated to 'hands on' clinical care, (2) aspects of district nursing considered stressful and (3) district nurses' job satisfaction. District nurses and managers agree that caring work with patients is the priority for the service and provides job satisfaction. Many nurses feel overwhelmed by their workload and have little control over the admission of patients to their caseload; they are mainly demand led and therefore reactive care providers. A culture of long hours has developed as district nurses struggle to meet the needs of patients. Feeling devalued lowers satisfaction and Agenda for Change is perceived as de-valuing the skills of community nurses. More clerical support is required so district nurses can deliver care to patients. District nurses can better represent their workload and how it is managed through expressing the nature of assessing risk and caring for patients as opposed to defining patients care needs by medical diagnoses. Extending the hours of the full district nursing service would benefit patients and staff.

Retaining professional nurses in South Africa: Nurse managers ...

African Journals Online (AJOL)

Retaining professional nurses in South Africa: Nurse managers' perspectives. ... This implies that creating a favourable environment in the workplace situation ... Unsafe working environments and a lack of resources threaten the safety and ...

[From classical management to contemporary management: understanding new concepts to empower nursing management].

Science.gov (United States)

Spagnol, Carla Aparecida

2002-01-01

This theoretical work aimed to study Hospital Administration, focusing on Nursing Management. The author points out contemporary administration concepts, and leads us to think over how those new models of management (already in use in some institutions known as pioneers on this area) may have influence on the Nursing Management practice inserted on the context. The author concludes that Nursing is going through a transition moment, breaking paradigms, trying to get over Classical Administration beliefs and searching for flexible, humanized and shared ways to manage Nursing Care.

Preparing nurses for leadership roles in cardiovascular disease prevention.

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Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

2011-07-01

Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction. Copyright © 2011 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

LED lamp power management system and method

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Gaines, James; Clauberg, Bernd; Van Erp, Josephus A. M.

2013-03-19

An LED lamp power management system and method including an LED lamp having an LED controller 58; a plurality of LED channels 60 operably connected to the LED controller 58, each of the plurality of LED channels 60 having a channel switch 62 in series with at least one shunted LED circuit 83, the shunted LED circuit 83 having a shunt switch 68 in parallel with an LED source 80. The LED controller 58 reduces power loss in one of the channel switch 62 and the shunt switch 68 when LED lamp electronics power loss (P.sub.loss) exceeds an LED lamp electronics power loss limit (P.sub.lim); and each of the channel switches 62 receives a channel switch control signal 63 from the LED controller 58 and each of the shunt switches 68 receives a shunt switch control signal 69 from the LED controller 58.

A Critical Perspective on Relations between Staff Nurses and their Nurse Manager: Advancing Nurse Empowerment Theory.

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Udod, Sonia; Racine, Louise

2014-12-01

This study considers empowerment in nurse-manager relations by examining how conflict is handled on both sides and how the critical social perspective has influenced these relations. The authors use inductive analysis of empirical data to explain how (1) nursing work is organized, structured, and circumscribed by centrally determined policies and practices that downplay nurses' professional judgement about patient care; (2) power is held over nurses in their relationship with their manager; and (3) nurses' response to power is to engage in strategies of resistance. The authors illustrate how power influences relations between staff nurses and managers and provide a critical analysis of the strategies of resistance that result in personal, relational, and critical empowerment among staff nurses. Through resistance, staff nurses engage in alternative discourses to counteract the prevailing neoliberal organizational and managerial discourses of efficiency and cost-effectiveness. Copyright© by Ingram School of Nursing, McGill University.

Emotional intelligence (EI) and nursing leadership styles among nurse managers.

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Tyczkowski, Brenda; Vandenhouten, Christine; Reilly, Janet; Bansal, Gaurav; Kubsch, Sylvia M; Jakkola, Raelynn

2015-01-01

Less than 12.5% of nurses aspire to leadership roles, noting lack of support and stress as major factors in their decision not to pursue this area of practice. Psychological resiliency, described as the ability to properly adapt to stress and adversity, is key to successful nurse managers. Emotional intelligence (EI) is a related concept to resiliency and is another noteworthy predictor of leadership and management success. This study was undertaken to determine the level of and relationship between EI and leadership style of nurse managers employed in Wisconsin and Illinois facilities. A descriptive, exploratory study design was utilized, with a convenience sample of nurse managers working in 6 large Midwestern health systems. Nurse managers were invited to participate in the study by their employer, completing the online consent form and the demographic, Multifactor Leadership Questionnaire (MLQ) Form 5X and the Emotional Quotient Inventory (EQ-i 2.0) surveys. Statistically significant positive relationships were noted between EI and transformational leadership and the outcomes of leadership (extra effort, effectiveness, and satisfaction). No statistically significant relationships were noted between EI and transactional or laissez-faire leadership styles.

Nurse managers and budgeting: professional/bureaucratic conflict?

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Abernethy, M A; Stoelwinder, J U

1988-01-01

Professional/bureaucratic conflict theory suggests that the extent to which nurse managers use management control systems will depend on whether their goal orientation is to system rather than output or derived goals. This article examines the use of budgeting as a management control strategy, in relation to the goal orientation of nurse managers, in four large teaching hospitals. The goal orientations and use of budgeting by nurse managers is also compared with those of physician managers and other sub-unit managers. The results indicate that nurse managers appear to be developing their goals of professionalization without a diminution of their organizational focus or their orientation towards providing a high standard of patient care.

Nursing leadership and management effects work environments.

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Tomey, Ann Marriner

2009-01-01

The aim of this literature search was to identify recent research related to nursing leadership and management effects on work environment using the 14 forces of magnetism. This article gives some historical perspective from the original 1983 American Academy of Nursing study through to the 2002 McClure and Hinshaw update to 2009 publications. Research publications were given a priority for references. The 14 forces of magnetism as identified by Unden and Monarch were: '1. Quality of leadership..., 2. Organizational structure..., 3. Management style..., 4. Personnel policies and programs..., 5. Professional models of care..., 6. Quality of care..., 7 Quality improvement..., 8. Consultation and resources..., 9. Autonomy..., 10. Community and the hospital..., 11. Nurse as teacher..., 12. Image of nursing..., 13. Interdisciplinary relationships... and 14. Professional development....'. Correlations have been found among positive workplace management initiatives, style of transformational leadership and participative management; patient-to-nurse ratios; education levels of nurses; quality of patient care, patient satisfaction, employee health and well-being programmes; nurse satisfaction and retention of nurses; healthy workplace environments and healthy patients and personnel. This article identifies some of the research that provides evidence for evidence-based nursing management and leadership practice.

Succession planning for RNs: implementing a nurse management internship.

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Wendler, M Cecilia; Olson-Sitki, Kristi; Prater, Marsha

2009-01-01

The nursing shortage affects all levels, including the pivotal role of nurse managers, who may find themselves functioning in a complex, stressful work environment. In this increasingly difficult milieu, succession planning for nurse manager turnover is imperative. The authors describe an evidence-based, theoretically driven nurse management internship that allows staff nurses to explore the nurse manager role.

An integrative review on conflict management styles among nursing students: Implications for nurse education.

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Labrague, Leodoro J; McEnroe-Petitte, Denise M

2017-12-01

Nurse education plays a critical role in the achievement of conflict management skills in nursing students. However, a wider perspective on this concept has not been explored. This paper is a report of a review appraising and synthesizing existing empirical studies describing conflict management styles among nursing students. An integrative review method guided this review. Five (5) bibliographic databases (CINAHL, Medline, Psych Info, Embase and SCOPUS) were searched to locate relevant articles. An electronic database search was performed in December 2016 to locate studies published from 2007 onwards. The search words included: 'conflict', 'management resolution', 'management style', 'management strategy', 'nursing', 'student'. Thirteen (13) articles met the inclusion criteria. Nursing students preferred 'constructive/positive conflict management styles' when handling conflicts. However, more studies are needed to identify factors that may affect their choice of styles. Further, this review emphasizes the need for empirical studies to identify appropriate interventions that would effectively enhance nursing students' skills in managing conflicts using rigorous methods. Nursing faculty play a critical role in teaching, training, and modeling constructive conflict resolution styles in nursing students. Simulation scenarios, reflective exercises, and role playing may be useful to facilitate such learning in choosing constructive conflict management styles. Structured training programme on conflict management will assist nursing students develop positive conflict management styles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Utilizing a disease management approach to improve ESRD patient outcomes.

Science.gov (United States)

Anand, Shaan; Nissenson, Allen R

2002-01-01

In this era of processes and systems to improve quality, disease management is one methodology to improve care delivery and outcomes for patients with chronic kidney disease (CKD). In most disease management systems a senior renal nurse coordinates all aspects of the patient's care and ensures that the prescribed and necessary care is delivered for both CKD-related and comorbid conditions. The nurse also continually monitors outcomes on quality indicators and key performance measures. These outcome data are then aggregated and analyzed, are compared with local and national benchmarks, and drive the continuous quality improvement (CQI) process. Such a system attempts to centralize the currently fragmented care delivery system, continually improve patient outcomes, and conserve scarce economic resources. Early data suggest a disease management approach may improve both the morbidity and mortality of CKD patients.

Nurse middle manager ethical dilemmas and moral distress.

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Ganz, Freda D; Wagner, Nurit; Toren, Orly

2015-02-01

Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

Science.gov (United States)

2014-01-01

Background Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. Methods A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. Results Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. Conclusions Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion

A Learner-led, Discussion-based Elective on Emerging Infectious Disease.

Science.gov (United States)

Mathias, Clinton

2015-08-25

Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists.

What do cardiovascular nurses know about the hematological management of patients with Eisenmenger syndrome?

NARCIS (Netherlands)

Moons, Philip; Fleck, Desiree; Jaarsma, Tiny; Norekval, Tone M.; Smith, Karen; Stromberg, Anna; Thompson, David R.; Budts, Werner

2009-01-01

Aim: We investigated the level of knowledge of hematological management of patients with Eisenmenger syndrome among general cardiovascular nurses and nurses who specialize in congenital heart disease (CHD). Methods: We conducted a survey at two international conferences attended by cardiovascular

Use of electronic information systems in nursing management.

Science.gov (United States)

Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula

2010-05-01

The purpose of this study is to describe nurse managers' perceptions of the use of electronic information systems in their daily work. Several kinds of software are used for administrative and information management purposes in health care organizations, but the issue has been studied less from nurse managers' perspective. The material for this qualitative study was acquired according to the principles of focus group interview. Altogether eight focus groups were held with 48 nurse managers from both primary and specialized health care organizations. The nurse managers were asked in focus groups to describe the use of information systems in their daily work in addition to some other themes. The material was analyzed by inductive content analysis using ATLAS.ti computer program. The main category "pros and cons of using information systems in nursing management" summarized the nurse managers' perceptions of using electronic information systems. The main category consisted of three sub-categories: (1) nurse managers' perceptions of the use of information technology; (2) usability of management information systems; (3) development of personnel competencies and work processes. The nurse managers made several comments on the implementation of immature electronic information systems which caused inefficiencies in working processes. However, they considered electronic information systems to be essential elements of their daily work. Furthermore, the nurse managers' descriptions of the pros and cons of using information systems reflected partly the shortcomings of strategic management and lack of coordination in health care organizations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Patient Satisfaction, Empowerment, and Health and Disability Status Effects of a Disease Management-Health Promotion Nurse Intervention among Medicare Beneficiaries with Disabilities

Science.gov (United States)

Friedman, Bruce; Wamsley, Brenda R.; Liebel, Dianne V.; Saad, Zabedah B.; Eggert, Gerald M.

2009-01-01

Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

Conflict management styles used by nurse managers in the Sultanate of Oman.

Science.gov (United States)

Al-Hamdan, Zaid; Shukri, Raghda; Anthony, Denis

2011-02-01

The study aimed at investigating the conflict management styles used by nurse managers in the Sultanate of Oman. Conflict is inevitable in daily nursing work. Several styles are used to manage conflict situations. In previous studies conducted in Western countries, avoiding and compromising conflict management styles appear to be the first choices for the nurses. In Arab countries, no study to date has examined the conflict management styles used by nurse managers to compare with the results from studies conducted in Western countries. Survey. A questionnaire was distributed to all nurse managers working in the three-management levels from nine referral hospitals in Sultanate of Oman, 271 were returned, a response rate of 86%. The results were analysed using spss version 16. Nurse managers in Oman used all five conflict management styles, with integrating style as the first choice followed in order by compromising, obliging, dominating and avoiding. These results differ from the results of the studies conducted on nurses in other countries. The results of this study have implications for people who work in the hospitals, whether practitioners or policy makers. Recommendations are offered to improve nurse managers' work environment. Conflict can affect patient care if handled badly. Poorly handled conflict results in lower staff morale and poorer retention, both adversely affect patient care. © 2011 Blackwell Publishing Ltd.

Emergency nurses' knowledge of pain management principles.

Science.gov (United States)

Tanabe, P; Buschmann, M

2000-08-01

The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

The motivations to nurse: an exploration of factors amongst undergraduate students, registered nurses and nurse managers.

Science.gov (United States)

Newton, Jennifer M; Kelly, Cherene M; Kremser, Anne K; Jolly, Brian; Billett, Stephen

2009-04-01

To identify what motivates individuals to engage in a nursing career. Recruitment and retention of nurses is a worldwide concern that is associated with several compounding factors, primarily the high attrition of its new graduates and an ageing workforce. Given these factors, it is necessary to understand why individuals choose to nurse, what keeps them engaged in nursing, and in what ways healthcare systems can support career development and retention. This paper presents initial interview data from a longitudinal multi method study with 29 undergraduate student nurses, 25 registered nurses (RNs), six Nurse Unit Managers (NUMs) and four Directors of Nursing (DoNs) from four hospitals across a healthcare organization in Australia. Thematic analysis yielded four key themes that were common to all participants: (1) a desire to help, (2) caring, (3) sense of achievement and (4) self-validation. These themes represented individuals' motivation to enter nursing and sustain them in their careers as either nurses or managers. Managers need to be cognisant of nurses underlying values and motivators in addressing recruitment and retention issues. Strategies need to be considered at both unit and organizational levels to ensure that the 'desire to care' does not become lost.

Writing business communications. Are nurse managers prepared?

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Spears, L A

1997-12-01

Based on interviews, this study indicates that writing business communications is a key task for nurse managers, affecting their professional success and power. However, most of the nurse managers interviewed felt they needed more education in business communications. Several ways of bringing this training to nursing students and practicing managers are suggested.

Pilot Testing of the NURSE Stress Management Intervention.

Science.gov (United States)

Delaney, Colleen; Barrere, Cynthia; Robertson, Sue; Zahourek, Rothlyn; Diaz, Desiree; Lachapelle, Leeanne

2016-12-01

Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students. © The Author(s) 2015.

Using nurse managers' perceptions to guide new graduates toward positive nurse relationships.

Science.gov (United States)

Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy; Bradley, Jennifer M

One of the greatest challenges new graduates confront when transitioning to practice is establishing positive relationships with experienced nurses. Nursing faculty must prepare graduates for this challenge. However, nursing faculty are often removed from everyday practice and must rely on the perceptions of those entrenched in practice in order to ground teaching endeavors in authenticity. Nurse managers are well positioned to provide knowledgeable insights to nursing faculty regarding nurse relationships. The purpose of this qualitative, descriptive study was to explore nurse managers' perceptions regarding new graduates' relationships with more experienced nurses. Researcher-participant audiotaped interviews were conducted with 13 nurse managers. A content analysis revealed that all participants believed nurse relationships were significant, that factors such as perceived inequities and stressful occurrences triggered poor relationships, that new graduates were often targeted for negative relationships, and that reasons for targeting of new graduates included prolonged dependence on experienced nurses and either over or under confidence of the new graduate. Providing a supportive, protective environment and hiring practices that promote team unity were posed as strategies that could help to prevent targeting of new graduates. Findings provide real-life, practice based information that can underpin nurse educators' teaching regarding nurse relationships and relationship building. Copyright © 2017 Elsevier Inc. All rights reserved.

Leadership styles of nurse managers in a multinational environment.

Science.gov (United States)

Suliman, Wafika A

2009-01-01

This is a descriptive study conducted at a multinational working environment, where 1500 nurses representing 52 nationalities are employed. The study aimed at exploring the predominant leadership style of nurse managers through self-evaluation and staff nurses' evaluation and the impact of working in a multinational environment on their intention to stay or quit. The value lies in its focus on leadership styles in an environment where national diversity among managers, staff, and patients is very challenging. The study included 31 nurse managers and 118 staff nurses using Bass and Avolio's (1995) Multifactor Leadership Questionnaire. The results showed that nurse managers and staff nurses reported transformational leadership as predominant with significant difference in favor of nurse managers. Participants' nationality and intention to stay or quit affected their perception of transformational leadership as a predominant style. The implications highlight the need for senior nursing management to set effective retention strategies for transformational nurse managers who work at multinational environments.

Interdisciplinary approach to the management of medical supplies in the nursing home setting

Directory of Open Access Journals (Sweden)

Juan Francisco Peris Martí

2017-07-01

Full Text Available Introduction: Given the impact of pressure ulcers in institutionalized elderly people, an interdisciplinary approach to the care of ulcers and the management of medical supplies is essential. The aim of this study is to describe and evaluate the management of medical supplies by an interdisciplinary team in order to promote their rational use in the nursing home setting. Methods: An interdisciplinary team was set up, coordinated by a Pharmacy Unit including representatives of 18 elderly nursing homes (1,599 beds. Team interventions were assessed in terms of improvements in the management of wound care supplies. In addition, a retrospective descriptive study was carried out on those patients with pressure ulcers, in order to consider future interventions. Results: The team interventions led to a selection of 15% of the 180 wound care supplies from the public tender process. The monthly savings in wound dressing material purchases was at least 17%. Furthermore, a reduction in consumption greater than 50% was found in 7 centres. The prevalence of ulcers was 5.59%. A fourth of these ulcers were originated outside nursing homes. Conclusions: The creation of an interdisciplinary team, in which the pharmacist gets closer to patient needs, and where nurses share responsibility for the selection and management of medical supplies, leads to positive results and represents an opportunity for improvement in elderly care.

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

Science.gov (United States)

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

2008-10-01

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

Nurse managers' leadership styles in Finland.

Science.gov (United States)

Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena

2012-01-01

Nurse managers who can observe their own behaviour and its effects on employees can adjust to a better leadership style. The intention of this study was to explore nurses' and supervisors' perceptions of nurse managers' leadership styles. Open-ended interviews were conducted with 11 nurses and 10 superiors. The data were analysed by content analysis. In the study, six leadership styles were identified: visionary, coaching, affiliate, democratic, commanding, and isolating. Job satisfaction and commitment as well as operation and development work, cooperation, and organizational climate in the work unit were the factors, affected by leadership styles. The nurse managers should consider their leadership style from the point of view of employees, situation factors, and goals of the organization. Leadership styles where employees are seen in a participatory role have become more common.

Nurse Managers' Leadership Styles in Finland

Science.gov (United States)

Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena

2012-01-01

Nurse managers who can observe their own behaviour and its effects on employees can adjust to a better leadership style. The intention of this study was to explore nurses' and supervisors' perceptions of nurse managers' leadership styles. Open-ended interviews were conducted with 11 nurses and 10 superiors. The data were analysed by content analysis. In the study, six leadership styles were identified: visionary, coaching, affiliate, democratic, commanding, and isolating. Job satisfaction and commitment as well as operation and development work, cooperation, and organizational climate in the work unit were the factors, affected by leadership styles. The nurse managers should consider their leadership style from the point of view of employees, situation factors, and goals of the organization. Leadership styles where employees are seen in a participatory role have become more common. PMID:23008767

A new tool to adapt the treatment of Parkinson's disease patients in nursing homes.

Science.gov (United States)

Geny, Christian; Verna, Claudia; Arifi, Alexia; Ferreira, Ernestine; Boubakri, Choukri; Blain, Hubert

2018-03-01

Parkinson's disease (PD) is a common condition in nursing home (NH) residents. The primary treatment for Parkinson's disease is levodopa therapy to relieve motor symptoms and maximize physical function. Non-motor symptoms are highly prevalent in NH residents with Parkinson's disease and dramatically decrease quality of life. Choices in drug treatment need to take into account the complex interactions between aging, comorbidity and non-motor symptoms. Optimal management requires expertise and cooperative effort from prescribing neurologists and nursing home health professionals. The objective is to evaluate the pertinence of the CHEF, a new tool to screen daily life clinical data helpful for the management of neurologist consultants. NH nurses were asked to briefly report falls and gait problems, hallucinations, sleep disorders and motor fluctuations. Analysis of the results obtained in 26 patients showed that CHEF was perceived as a helpful complement to existing ressources. The use of this tool has the potential to enhance the quality of NH care of Parkinsonian patients.

Knowledge management: organizing nursing care knowledge.

Science.gov (United States)

Anderson, Jane A; Willson, Pamela

2009-01-01

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.

Putting conflict management into practice: a nursing case study.

Science.gov (United States)

Vivar, Cristina García

2006-04-01

This paper is intended to put knowledge in conflict management into practice through reflecting on a nursing case study. Nursing organizations are particularly vulnerable to conflict as the context of nurses' work may be difficult and stressful. Power conflict is argued to be an important source of tension within nursing units. Learning to manage conflict at an early stage is therefore crucial to the effective functioning of nursing organizations. A nursing case study that illustrates power conflict in an oncology nursing unit is displayed and reflection on conflict management from the case is provided. There is no appropriate or inappropriate strategy to deal with conflict. However, detecting initial symptoms of conflict and adopting the most effective behaviour to conflict resolution is essential in nursing units. Further nursing education in conflict management for staff nurses and nurse managers is greatly needed.

Generational diversity: what nurse managers need to know.

Science.gov (United States)

Hendricks, Joyce M; Cope, Vicki C

2013-03-01

This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion. © 2012 Blackwell Publishing Ltd.

Peer-led, transformative learning approaches increase classroom engagement in care self-management classes during inpatient rehabilitation of individuals with spinal cord injury.

Science.gov (United States)

Gassaway, Julie; Jones, Michael L; Sweatman, W Mark; Young, Tamara

2017-10-16

Evaluate effects of revised education classes on classroom engagement during inpatient rehabilitation for individuals with spinal cord injury/disease (SCI/D). Multiple-baseline, quasi-experimental design with video recorded engagement observations during conventional and revised education classes; visual and statistical analysis of difference in positive engagement responses observed in classes using each approach. 81 patients (72% male, 73% white, mean age 36 SD 15.6) admitted for SCI/D inpatient rehabilitation in a non-profit rehabilitation hospital, who attended one or more of 33 care self-management education classes that were video recorded. All study activities were approved by the host facility institutional review board. Conventional nurse-led self-management classes were replaced with revised peer-led classes incorporating approaches to promote transformative learning. Revised classes were introduced across three subject areas in a step-wise fashion over 15 weeks. Positive engagement responses (asking questions, participating in discussion, gesturing, raising hand, or otherwise noting approval) were documented from video recordings of 14 conventional and 19 revised education classes. Significantly higher average (per patient per class) positive engagement responses were observed in the revised compared to conventional classes (p=0.008). Redesigning SCI inpatient rehabilitation care self-management classes to promote transformative learning increased patient engagement. Additional research is needed to examine longer term outcomes and replicability in other settings.

Mobile phone technology in chronic disease management

OpenAIRE

Blake, Holly

2008-01-01

Mobile phones are being used to improve nurse-patient communication and monitor health outcomes in chronic disease. Innovative applications of mobile technology are expected to increase over time in community management of cancer, heart disease, asthma and diabetes. This article focuses on mobile phone technology and its contribution to health care.

The informed consent process in randomised controlled trials: a nurse-led process.

Science.gov (United States)

Cresswell, Pip; Gilmour, Jean

2014-03-01

Clinical trials are carried out with human participants to answer questions about the best way to diagnose, treat and prevent illness. Participants must give informed consent to take part in clinical trials that requires understanding of how clinical trials work and their purpose. Randomised controlled trials provide strong evidence but their complex design is difficult for both clinicians and participants to understand. Increasingly, ensuring informed consent in randomised controlled trials has become part of the clinical research nurse role. The aim of this study was to explore in depth the clinical research nurse role in the informed consent process using a qualitative descriptive approach. Three clinical research nurses were interviewed and data analysed using a thematic analysis approach. Three themes were identified to describe the process of ensuring informed consent. The first theme, Preparatory partnerships, canvassed the relationships required prior to initiation of the informed consent process. The second theme, Partnering the participant, emphasises the need for ensuring voluntariness and understanding, along with patient advocacy. The third theme, Partnership with the project, highlights the clinical research nurse contribution to the capacity of the trial to answer the research question through appropriate recruiting and follow up of participants. Gaining informed consent in randomised controlled trials was complex and required multiple partnerships. A wide variety of skills was used to protect the safety of trial participants and promote quality research. The information from this study contributes to a greater understanding of the clinical research nurse role, and suggests the informed consent process in trials can be a nurse-led one. In order to gain collegial, employer and industry recognition it is important this aspect of the nursing role is acknowledged.

Nurse manager succession planning: synthesis of the evidence.

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Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

2013-10-01

The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

Knowledge and attitudes of pain management among nursing faculty.

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Voshall, Barbara; Dunn, Karen S; Shelestak, Debra

2013-12-01

A descriptive correlational design was used in this study to examine nursing faculty knowledge and attitudes in pain management. Relationships between age, education level, pain management preparation, length of time practicing as a nurse, length of time teaching nursing, time teaching pain management in the classroom, taught pain guidelines in the classroom, and additional continuing education about pain management were explored. Ninety-six nursing faculty participated from 16 schools of nursing in one Midwestern U.S. region. Findings identified that most of the nursing faculty recalled being taught about pain management in their basic education, but less than one-half felt adequately prepared. Most respondents said that they taught pain management, yet fewer than one-half identified that they used specific pain management guidelines. Faculty demonstrated adequate knowledge of pain assessment, spiritual/cultural issues, and pathophysiology. Areas of weakness were found in medications, interventions, and addiction. Faculty that reported teaching pain management in the classroom and reported more continuing education missed fewer items. Older nursing faculty reported more years of practice, more years of teaching, and more continuing education in pain management than younger faculty. Younger nursing faculty remembered being taught pain management in nursing school and felt more adequately prepared than older nursing faculty. Faculty that reported practicing for longer periods of time felt less prepared in pain management than faculty who practiced for shorter periods of time. More continuing education in pain management may be needed for older nurses to meet the recommendations of the Institute of Medicines' report on relieving pain in the U.S. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

Science.gov (United States)

Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

2018-06-18

To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams

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Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney

2004-01-01

Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

Nurse manager residency program: an innovative leadership succession plan.

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Watkins, Amy; Wagner, Jennifer; Martin, Christina; Grant, Brandy; Maule, Katrina; Resh, Kimberly; King, Lisa; Eaton, Holly; Fetter, Katrina; King, Stacey L; Thompson, Elizabeth J

2014-01-01

To ensure succession planning within the ranks of nurse managers meet current and projected nursing management needs and organizational goals, we developed and implemented a nurse manager residency program at our hospital. By identifying, supporting, and mentoring clinical experts who express a desire and display an aptitude for nursing leadership, we are graduating individuals who can transition to a nurse manager position with greater ease and competence.

Does performance management affect nurses' well-being?

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Decramer, Adelien; Audenaert, Mieke; Van Waeyenberg, Thomas; Claeys, Tine; Claes, Claudia; Vandevelde, Stijn; van Loon, Jos; Crucke, Saskia

2015-04-01

This article focuses on employee performance-management practices in the healthcare sector. We specifically aim to contribute to a better understanding of the impact of employee performance-management practices on affective well-being of nurses in hospitals. Theory suggests that the features of employee-performance management (planning and evaluation of individual performances) predict affective well-being (in this study: job satisfaction and affective commitment). Performance-management planning and evaluation and affective well-being were drawn from a survey of nurses at a Flemish hospital. Separate estimations were performed for different aspects of affective well-being. Performance planning has a negative effect on job satisfaction of nurses. Both vertical alignment and satisfaction with the employee performance-management system increase the affective well-being of nurses; however, the impact of vertical alignment differs for different aspects of affective well-being (i.e. job satisfaction and affective commitment). Performance-management planning and evaluation of nurses are associated with attitudinal outcomes. The results indicate that employee performance-management features have different impacts on different aspects of well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

What do nurse managers say about nurses' sickness absenteeism? A new perspective.

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Baydoun, Mohamed; Dumit, Nuhad; Daouk-Öyry, Lina

2016-01-01

To explore nurses' sickness absenteeism from the perspective of nurse managers. Sickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation. A qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach. Data analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses' sickness absenteeism. This study conceptualised nurses' absenteeism from the nurse managers' perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature. The findings from this study can be utilised to design reform initiatives concerned with nurses' absenteeism and to decrease its negative consequences in terms of quality and cost. © 2015 John Wiley & Sons Ltd.

Nurse versus physician led-care for the management of paediatric asthma

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Küthe, M.C.

2014-01-01

This thesis discusses the role of a specialized nurse practitioner in the follow up of children with asthma in comparison with traditional care by a general practitioner or a paediatrician. In addition, we evaluated the suitability of an existing questionnaire to assess quality of care and we

Is nurse managers' leadership style related to Japanese staff nurses' affective commitment to their hospital?

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Kodama, Yoshimi; Fukahori, Hiroki; Sato, Kana; Nishida, Tomoko

2016-10-01

To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital. In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan. Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression. Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses. The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment. To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills. © 2016 John Wiley & Sons Ltd.

Paediatric fever management: continuing education for clinical nurses.

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Walsh, Anne M; Edwards, Helen E; Courtney, Mary D; Wilson, Jenny E; Monaghan, Sarah J

2006-01-01

This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.

Paediatric nurses' perception of the child-family dyad's autonomy in managing a chronic disease situation: the experience of an Italian paediatric department.

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Bagnasco, A; Petralia, P; Furnari, S; Ghio, S; Calza, S; Sasso, L

2013-06-01

Chronically ill patients have to take several medications and non-adherence to treatment can lead to severe and negative outcomes. Therefore, several interventions are suggested in literature to improve adherence rates in clinical practice. Adherence to treatment can be particularly troublesome in adolescents, who strive for autonomy and self-care independence. Literature suggests that improving adherence is useful to guarantee positive outcomes and reduce costs. To explore how nurses perceived autonomy in parents, adolescents, and children related to the management of chronic disease. A qualitative study including 1 focus group and 7 semi-structured interviews conducted between September 2011 and October 2011. The qualitative date were analysed with the thematic analysis method. The sample included 12 paediatric nurses working in a Children's Cystic Fibrosis Unit and Neuromuscular Disease Unit. The 5 main categories that emerged from this qualitative study after he process of categorization were: 'Changes in daily lifestyle', 'Nurses' attitude towards educating the dyad', 'Adolescence and transition', 'Parents' attitudes towards chronic disease', and 'Availability of information'. Correct information and education is crucial for families who have a chronically ill child. Internet can be a misleading source of information and provide wrong information also in relation to prevention.

Task Shifting the Management of Non-Communicable Diseases to Nurses in Kibera, Kenya: Does It Work?

Directory of Open Access Journals (Sweden)

David Some

Full Text Available In sub-Saharan Africa there is an increasing need to leverage available health care workers to provide care for non-communicable diseases (NCDs. This study was conducted to evaluate adherence to Médecins Sans Frontières clinical protocols when the care of five stable NCDs (hypertension, diabetes mellitus type 2, epilepsy, asthma, and sickle cell was shifted from clinical officers to nurses.Descriptive, retrospective review of routinely collected clinic data from two integrated primary health care facilities within an urban informal settlement, Kibera, Nairobi, Kenya (May to August 2014.There were 3,554 consultations (2025 patients; 733 (21% were by nurses out of which 725 met the inclusion criteria among 616 patients. Hypertension (64%, 397/616 was the most frequent NCD followed by asthma (17%, 106/616 and diabetes mellitus (15%, 95/616. Adherence to screening questions ranged from 65% to 86%, with an average of 69%. Weight and blood pressure measurements were completed in 89% and 96% of those required. Laboratory results were reviewed in 91% of indicated visits. Laboratory testing per NCD protocols was higher in those with hypertension (88% than diabetes mellitus (67% upon review. Only 17 (2% consultations were referred back to clinical officers.Nurses are able to adhere to protocols for managing stable NCD patients based on clear and standardized protocols and guidelines, thus paving the way towards task shifting of NCD care to nurses to help relieve the significant healthcare gap in developing countries.

Leadership styles in nursing management: preferred and perceived.

Science.gov (United States)

Sellgren, Stina; Ekvall, Göran; Tomson, Göran

2006-07-01

The aim was to explore nursing leadership regarding what nurse managers and subordinates see as important and to explore subordinates' opinions of their nurse manager's performance in reality. Background The manager's style can be fundamental for subordinates' acceptance of change and in motivating them to achieve stated visions and goals and high quality of care. Nurse managers (n=77) and 10 of each included nurse manager's subordinates received a questionnaire to assess 'preferred' leadership behaviour in three dimensions: change, production and employee/relation orientations. The same questionnaire was used to assess subordinates' opinions of their manager's leadership behaviour. There are statistically significant differences in opinions of preferred leadership between managers and subordinates, especially related to production and relation orientation. The subordinates' perception of real leadership behaviour has lower mean values than their preferred leadership behaviour in all three dimensions. Subordinates prefer managers with more clearly expressed leadership behaviour than managers themselves prefer and demonstrate.

The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

Science.gov (United States)

Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

2014-04-01

Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers.

Science.gov (United States)

Keys, Yolanda

2014-01-01

The present inquiry identifies elements of professional success, and personal and professional fulfilment as defined by Generation X Nurse Managers. Although work concerning Nurse Manager preparation has been documented, there is a paucity of research specific to the generation of nurses next in line to assume leadership roles. For the purposes of this study, a qualitative approach was used to develop insight regarding Generation X Nurse Managers and their perspectives on professional success, personal and professional fulfilment, and organisational environments that are conducive to loyalty and long-term professional commitment. Findings from this study reinforced those identified in the original study in that inflexible organisational cultures, a lack of opportunities for upward mobility, the need to be available at all times, feeling stereotyped or undervalued can all be barriers to members of Generation X perceptions of professional success and professional and personal fulfilment. Study findings suggest that Generation X Nurse Managers would benefit from initiatives focused on better preparation for the Nurse Manager role, openness to innovative scheduling alternatives and tailored support and feedback. © 2014 John Wiley & Sons Ltd.

ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

Science.gov (United States)

Steinman, Theodore I

2002-01-01

The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

Japanese management. Implications for nursing administration.

Science.gov (United States)

Smith, H L; Reinow, F D; Reid, R A

1984-09-01

Does Japanese management possess sufficient practical validity to warrant retraining of nursing administrators and their staffs? Can Japanese management really address the complexities of contemporary nursing administration? Before espousing the benefits of Theory Z and implementing quality circles in your hospital, read this analysis of the advantages and disadvantages of Japanese management--the benefits can be substantial but so can the costs!

Nurse manager engagement: a concept analysis.

Science.gov (United States)

Gray, Linda R

2012-01-01

This concept analysis examines the visibility of nurse manager engagement in the healthcare work environment. The term employee engagement was derived from studies of morale or the willingness of a group to accomplish objectives in the 1920s. "Following World War II group morale scores were used as predictors of speed, quality, and militancy by US Army researchers. The goal was to identify star, or high performers. A term was needed to describe emotional attachment of an individual to the organization, fellow associates, and the job" ("Employee engagement origins," 2010, p. 1). The CINAHL, MEDLINE, ABI INFORM, PsycINFO, and Ovid databases and the Internet were searched for the period of 2005-2010 for literature published in English with a focus on peer-reviewed journals from disciplines of health sciences, health administration, business, and psychology. The Walker and Avant method was used for this analysis. The experience of the author as a current and previous nurse manager was also used for this analysis. Nurse manager engagement was assumed to be present based indirectly on empirical referents and consequences, such as low or high vacancy rates for staff nurses. Further research is needed to explore the identity of the nurse serving in the role of manager/leader who is able to demonstrate the skills and talents necessary to visibly demonstrate engagement and facilitate a culture of engaged nurse managers. © 2012 Wiley Periodicals, Inc.

Multiple sclerosis care: an integrated disease-management model.

Science.gov (United States)

Burks, J

1998-04-01

A disease-management model must be integrated, comprehensive, individual patient focused and outcome driven. In addition to high quality care, the successful model must reduce variations in care and costs. MS specialists need to be intimately involved in the long-term care of MS patients, while not neglecting primary care issues. A nurse care manager is the "glue" between the managed care company, health care providers and the patient/family. Disease management focuses on education and prevention, and can be cost effective as well as patient specific. To implement a successful program, managed care companies and health care providers must work together.

Management development: a needs analysis for nurse executives and managers.

Science.gov (United States)

Kirk, R

1987-04-01

Clearly, both the nurse executive and nurse manager roles are becoming more complex. I feel an enthusiasm by the professionals in those positions to pursue development activities that will help them do their jobs better and with less discomfort. Nurse executives obviously know the power of combining knowledge with experience. How do the different leadership and management development needs identified by these NE fit with your organization's needs? What is the content in your leadership and management development programs? Are your programs meeting the real needs of your executive and management-level staff? One way to find out is to do a simple survey. Today, nurse executives are responsible and accountable for challenges we never considered possible, even a few years ago. But along with the new challenges came the flexibility and positive attitudes of NEs to respond to changes and acquire new skills such as cost accounting, computers, or marketing. It's this type of proactive thinking that helps nurse leaders turn problems into opportunities and their situations into success stories.

Therapeutic enhancement: nursing intervention category for patients diagnosed with Readiness for Therapeutic Regimen Management.

Science.gov (United States)

Kelly, Cynthia W

2008-04-01

To present a new nursing intervention category called therapeutic enhancement. Fewer than half of North Americans follow their physician's recommendations for diet and exercise, even when such are crucial to their health or recovery. It is imperative that nurses consider new ways to promote healthy behaviours. Therapeutic enhancement is intended to provide such a fresh approach. Traditional intervention techniques focusing on education, contracts, social support and more frequent interaction with physicians appear not to be effective when used alone. Successful strategies have been multidisciplinary; and have included interventions by professional nurses who assist patients to understand their disease and the disease process and that helps them to develop disease-management and self-management skills. Therapeutic enhancement incorporates The Stages of Change Theory, Commitment to Health Theory, Motivational Interviewing techniques and instrumentation specifically designed for process evaluation of health-promoting interventions. This is a critical review of approaches that, heretofore, have not been synthesised in a single published article. Based on the commonly used Stages of Change model, therapeutic enhancement is useful for patients who are at the action stage of change. Using therapeutic enhancement as well as therapeutic strategies identified in Stages of Change Theory, such as contingency management, helping relationships, counterconditioning, stimulus control and Motivational Interviewing techniques, nursing professionals can significantly increase the chances of patients moving from action to the maintenance stage of change for a specific health behaviour. Using the nursing intervention category, therapeutic enhancement can increase caregivers' success in helping patients maintain healthy behaviours.

Relationships between core factors of knowledge management in hospital nursing organisations and outcomes of nursing performance.

Science.gov (United States)

Lee, Eun Ju; Kim, Hong Soon; Kim, Hye Young

2014-12-01

The study was conducted to investigate the levels of implementation of knowledge management and outcomes of nursing performance, to examine the relationships between core knowledge management factors and nursing performance outcomes and to identify core knowledge management factors affecting these outcomes. Effective knowledge management is very important to achieve strong organisational performance. The success or failure of knowledge management depends on how effectively an organisation's members share and use their knowledge. Because knowledge management plays a key role in enhancing nursing performance, identifying the core factors and investigating the level of knowledge management in a given hospital are priorities to ensure a high quality of nursing for patients. The study employed a descriptive research procedure. The study sample consisted of 192 nurses registered in three large healthcare organisations in South Korea. The variables demographic characteristics, implementation of core knowledge management factors and outcomes of nursing performance were examined and analysed in this study. The relationships between the core knowledge management factors and outcomes of nursing performance as well as the factors affecting the performance outcomes were investigated. A knowledge-sharing culture and organisational learning were found to be core factors affecting nursing performance. The study results provide basic data that can be used to formulate effective knowledge management strategies for enhancing nursing performance in hospital nursing organisations. In particular, prioritising the adoption of a knowledge-sharing culture and organisational learning in knowledge management systems might be one method for organisations to more effectively manage their knowledge resources and thus to enhance the outcomes of nursing performance and achieve greater business competitiveness. The study results can contribute to the development of effective and efficient

Absence of Nursing Position in the new Health Policies in Iran: A Dialogue with Nursing Scholars and Nursing Managers

Directory of Open Access Journals (Sweden)

Ahmad Kalateh Sadati

2016-10-01

Full Text Available Family physician (FP is a suggested model for controlling Iran health system challenges such as non-communicable diseases (NCDs, mental illnesses, and HIV-AIDS besides urbanization, and elderly issues. Although FP is a legal commitment, it faces several obstacles such as lack of infrastructure, diversity of insurances, and unwillingness of senior health policy makers about it.1 As Shiraz University of Medical Sciences (SUMS is a pilot center for implementation of FP model, the First International Conference on Family Physician with participation of Health Policy Research Center (HPRC was conducted successfully on 27th and 28th of December 2015 in Shiraz, Iran. The main goal of this conference was developing the discourse of FP with these major subjects: ‘the philosophy of FP’, ‘FP and medical education’, ‘FP and universal health coverage’, ‘incentive and financial system in FP’, and ‘evaluation of the international, national and provincial experiences in FP’. Despite presenting interesting topics in the conference, the main missing issue was the role of nursing, specifically nursing practitioner (NP, in the conference. Experiences of other countries revealed that NP has an important role in primary health care (PHC,2,3 quality of care,3 diagnosis and treatment4 in healthcare system. Moreover, International Council of Nursing believed that nursing can be effective for universal health coverage and being cost-effective in health care delivery.5 However, none of the nursing scholars and nursing managers actively participated in this conference. With respect to recent great changes in health care system in Iran, problem is not limited to this conference. Absence of community based approaches in nursing is obvious in three major health policies recently approved in Iran; they include establishing FP project in two provinces (Fars and Mazandaran as pilot, making urban community health centers (UCHC or Comprehensive Health Center in

Improving heart failure disease management in skilled nursing facilities: lessons learned.

Science.gov (United States)

Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

2013-11-01

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Nurse manager cognitive decision-making amidst stress and work complexity.

Science.gov (United States)

Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

2013-01-01

  The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

Leadership styles of Finnish nurse managers and factors influencing it.

Science.gov (United States)

Vesterinen, Soili; Isola, Arja; Paasivaara, Leena

2009-05-01

The purpose of the present study was to explore nurse managers' perceptions of their leadership styles and factors influencing it. It is a challenge for nurse managers to retain nurses in hospitals and to ensure a high quality of care in nursing practice. Leadership style is an important part of leadership. Knowledge concerning nurse managers' resonant and non-resonant leadership styles provides nurse managers with tools to reflect on their own leadership style. Open-ended, tape-recorded interviews were conducted with 13 nurse managers from five Finnish hospitals and two long-term care facilities. The data were analysed using qualitative content analysis. Five categories of leadership style were discerned: visionary, coaching, affiliate, democratic, commanding. Factors that influence leadership style were identified: earlier superiors, values, information, cooperation, employees and education. The results of this study show that Finnish nurse managers use both resonant and non-resonant leadership styles. The findings of this study show that nurse managers use a variety of leadership styles. The study demonstrates the importance of knowledge about leadership styles and factors influencing it among nurse managers providing future leadership and management education.

Outcomes and provider perspectives on geriatric care by a nurse practitioner-led community paramedicine program.

Science.gov (United States)

Kant, Rebecca E; Vejar, Maria; Parnes, Bennett; Mulder, Joy; Daddato, Andrea; Matlock, Daniel D; Lum, Hillary D

2018-05-03

This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives. The most commonly treated diagnoses were respiratory conditions, urinary tract infections, and gastrointestinal concerns. Two patients required an immediate transfer to a higher level of care. Six patients had emergency department visits and five patients were hospitalized within two weeks. Geriatric providers identified three themes including: potential benefits to geriatric patients, importance of enhanced care coordination and communication, and considerations for the specific role of nurse practitioner-led community paramedicine programs for geriatric patient care. Published by Elsevier Inc.

Nurses leading the fight against Ebola virus disease.

Science.gov (United States)

Sagar, Priscilla L

2015-05-01

The current Ebola crisis has sparked worldwide reaction of panic and disbelief in its wake as it decimated communities in West Africa, particularly in Guinea, Liberia, and Sierra Leone, including its health care workers. This article affirms the crucial role nurses play in maintaining health and preventing diseases, connects the devastating havoc of the Ebola virus disease to another issue of nursing shortage in underdeveloped countries, and asserts the key leadership nurses play in protecting the communities they serve while maintaining their safety and those of other health care workers. Nurses must actively seek a place at the table, as echoed by the American Academy of Nursing and American Nurses Association and the American Nurses Association, when decisions are being made regarding Ebola virus disease: at care settings, in the board room, and at federal, state, and local levels. © The Author(s) 2015.

Predictors of transformational leadership of nurse managers.

Science.gov (United States)

Echevarria, Ilia M; Patterson, Barbara J; Krouse, Anne

2017-04-01

The aim of this study was to examine the relationships among education, leadership experience, emotional intelligence and transformational leadership of nurse managers. Nursing leadership research provides limited evidence of predictors of transformational leadership style in nurse managers. A predictive correlational design was used with a sample of nurse managers (n = 148) working in varied health care settings. Data were collected using the Genos Emotional Intelligence Inventory, the Multi-factor Leadership Questionnaire and a demographic questionnaire. Simple linear and multiple regression analyses were used to examine relationships. A statistically significant relationship was found between emotional intelligence and transformational leadership (r = 0.59, P transformational leadership. Nurse managers should be well informed of the predictors of transformational leadership in order to pursue continuing education and development opportunities related to those predictors. The results of this study emphasise the need for emotional intelligence continuing education, leadership development and leader assessment programmes. © 2016 John Wiley & Sons Ltd.

A review of passive thermal management of LED module

NARCIS (Netherlands)

Ye, H.; Sau, K.; Zeijl, H. van; Gielen, A.W.J.; Zhang, G.

2011-01-01

Recently, the high-brightness LEDs have begun to be designed for illumination application. The increased electrical currents used to drive LEDs lead to thermal issues. Thermal management for LED module is a key design parameter as high operation temperature directly affects their maximum light

Evaluation of a nurse-led social rehabilitation programme for neurological patients and carers: an action research study.

Science.gov (United States)

Portillo, Mari Carmen; Corchón, Silvia; López-Dicastillo, Olga; Cowley, Sarah

2009-02-01

Very few neurological rehabilitation programmes have successfully dealt with patients' and relatives' social needs. Furthermore, the nurses' contribution in those programmes is poor or unclear. To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers. In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home. Two neurological wards of a hospital in Spain. The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives). The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses. The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses' attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved. This rehabilitation programme was feasible and effective. Patients and

The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review.

Science.gov (United States)

Tappenden, P; Campbell, F; Rawdin, A; Wong, R; Kalita, N

2012-01-01

studies with respect to the nature of the intervention, the nurses delivering the programmes and the populations in which the interventions were assessed. Overall, the quality of the included studies was good: all but one of the included studies were judged to be at medium or low risk of bias. Meta-analysis of eight studies suggested a statistically significant mortality benefit for the home-based health promotion groups, whereas a meta-analysis of four studies suggested non-significant benefits in terms of fewer falls in the intervention groups than in the control groups. Positive outcomes for home-based, nurse-led health promotion interventions were also reported within individual studies across several other outcomes. Only three economic studies met the criteria for inclusion in the review of cost-effectiveness. This evidence base consists of one non-randomised cost minimisation analysis and two economic evaluations undertaken alongside randomised controlled trials. Two of these studies involved an intervention targeted specifically at patients with a known underlying incurable disease, whereas the third study examined the clinical effectiveness and cost-effectiveness of early discharge in patients with a range of conditions, including fractures, neurological conditions and cardiorespiratory conditions. Each study indicated some likelihood that home-based, nurse-led health promotion may offer cost savings to the NHS and associated sectors, such as social services. However, one study did not report any comparison of health outcomes and instead simply assumed equivalence between the intervention and comparator groups, whereas the other two studies suggested at best a negligible incremental benefit in terms of preference-based health-related quality-of-life measures. The evidence base for clinical effectiveness is subject to considerable heterogeneity. The UK economic evidence base is limited to three studies. On the basis of the evidence included in this systematic

Effective team management by district nurses.

Science.gov (United States)

Bliss, Julie

2004-12-01

This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.

Leadership styles of nurse managers and registered sickness absence among their nursing staff.

Science.gov (United States)

Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W

2011-01-01

Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.

Evaluation of Evidence-based Nursing Pain Management Practice.

Science.gov (United States)

Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

2015-08-01

It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Emotional intelligence in nurse management and nurse job satisfaction and retention: a scoping review protocol.

Science.gov (United States)

Phillips, Jacqueline; Harris, Janet

2017-11-01

The objective of this review is to map what is known about emotional intelligence (EI) in relation to staff job satisfaction and retention in nursing, and the tools that are used to measure EI in this context. The primary question of this review is: What is known about nurse managers' EI as it relates to staff job satisfaction and retention in nursing?Sub-question 1: What tools are being used to measure nurse managers' EI and what theoretical frameworks are they based on?Sub-question 2: What gaps exist in the research related to nurse managers' EI as it relates to staff job satisfaction and retention in nursing?

Treatment with beta-blockers in nurse-led heart failure clinics

DEFF Research Database (Denmark)

Gustafsson, Finn; Schou, Morten; Videbaek, Lars

2007-01-01

BACKGROUND: Beta-blockers (BBs) are a cornerstone in the treatment of chronic heart failure (HF), but several surveys have documented that many patients are not offered treatment or are not titrated to target doses. In part to address this problem, specialized, nurse-led HF clinics have been......% of the patients were being treated with a BB. Mean dose (relative to target dose) was 63 (+/-35)% in patients receiving a BB and target dose was reached by 21%. Patients who were not on BBs were more often female, elderly and in NYHA class III-IV. In a multivariable model only lower age predicted BB use at three...... months (PElderly patients appear to be less likely to receive treatment....

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

OpenAIRE

A. Aziz Alimul Hidayat; M. Kes

2015-01-01

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

Cost-effectiveness of cardiovascular risk management by practice nurses in primary care

NARCIS (Netherlands)

Tiessen, Ans H.; Vermeulen, Karin M.; Broer, Jan; Smit, Andries J.; van der Meer, Klaas

2013-01-01

Background: Cardiovascular disease (CVD) is largely preventable and prevention expenditures are relatively low. The randomised controlled SPRING-trial (SPRING-RCT) shows that cardiovascular risk management by practice nurses in general practice with and without self-monitoring both decreases

Time management behaviors of head nurses and staff nurses employed in Tehran Social Security Hospitals, Iran in 2011.

Science.gov (United States)

Ebrahimi, Hossein; Hosseinzadeh, Rahele; Tefreshi, Mansoreh Zaghari; Hosseinzadeh, Sadaf

2014-03-01

Effective time management is considered important for managers for achieving the goals in an organization. Head nurses can improve their efficiency and performance with effective use of time. There has always been a lot of disagreement in understanding time management behaviors of head nurses; therefore, the present study was conducted with an aim to compare the understanding of head nurses and staff nurses of the time management behaviors of head nurses employed in Social Security Hospitals in Tehran, Iran in 2011. This was a comparative descriptive study in which 85 head nurses were selected through census and 170 staff nurses were also selected through simple random sampling method from hospitals covered by the Social Security. Data collection was done through a standard inventory with high validity and reliability, which consisted of two parts: Socio-demographic characteristics and time management inventory. The obtained data were analyzed by descriptive and inferential statistics through SPSS software version 13. Mean score of time management in head nurses' viewpoint was 143.22 (±18.66) and in staff nurses' viewpoint was 136.04 (±21.45). There was a significant correlation between the mean scores of head nurses' time management and some of their socio-demographic characteristics such as gender, clinical experience, passing a time management course, and book reading (P < 0.05). There was a significant correlation between the mean scores of staff nurses' time management and their clinical working experience, education, using time management approach, and type of hospital (P < 0.05). The majority of head nurses (52.9%) believed that their time management was in a high level; besides, most of the staff nurses also (40%) believed that time management of their head nurses was high. However, there was a significant difference between the perceptions of both groups on using Mann-Whitney test (P < 0.05). With regard to the importance of time management and its vital

Part 2: Nurses' career aspirations to management roles: qualitative findings from a national study of Canadian nurses.

Science.gov (United States)

Wong, Carol A; Laschinger, Heather K Spence; MacDonald-Rencz, Sandra; Burkoski, Vanessa; Cummings, Greta; D'Amour, Danielle; Grinspun, Doris; Gurnham, Mary-Ellen; Huckstep, Sherri; Leiter, Michael; Perkin, Karen; MacPhee, Maura; Matthews, Sue; O'Brien-Pallas, Linda; Ritchie, Judith; Ruffolo, Maurio; Vincent, Leslie; Wilk, Piotr; Almost, Joan; Purdy, Nancy; Daniels, Frieda; Grau, Ashley

2013-03-01

Our aim was to investigate direct-care nurses' interests in formal management roles and factors that facilitate their decision-making. Based on a projected shortage of nurses by 2022, the profession could be short of 4200 nurse managers in Canada within the next decade. However, no data are currently available that identify nurses' interests in assuming manager roles. Using focus group methodology, we conducted 18 focus groups with 125 staff nurses and managers in four regions across Canada. Major themes and subthemes influencing nurses' decisions to pursue management roles included personal demographic (education, age, clinical experience and life circumstances), personal disposition (leadership skills, intrinsic rewards and professional commitment) and situation (leadership development opportunities, manager role perceptions and presence of mentors). Although nurses see management roles as positive opportunities, they did not perceive the rewards to be great enough to outweigh their concerns. Findings suggested that organizations need to provide support, leadership development and succession opportunities and to redesign manager roles for optimum success. Leaders need to ensure that they convey positive images of manager roles and actively identify and support staff nurses with leadership potential. © 2012 Blackwell Publishing Ltd.

Factors relating to professional self-concept among nurse managers.

Science.gov (United States)

Kantek, Filiz; Şimşek, Belkıs

2017-12-01

To investigate the self-concept in nurse managers in Turkey and the effects of certain variables on professional self-concept. Professional self-concept plays a significant role in improving certain professional behaviours. Nursing managers have the potential to influence other members of the profession with their attitudes and behaviours. The study was designed as a cross-sectional descriptive study. This study was conducted with 159 nurse managers in nine different hospitals. The study data were collected with a Personal Information Form and Professional Self-concept Nursing Inventory, and the data analysis was accomplished with descriptive statistics, Cronbach's alpha coefficients and Chi-squared Automatic Interaction Detector analyses. The professional self-concept score of nurse managers was 3·33 (SD = 0·308). Professional competence subdimension had the highest scores, while professional satisfaction subdimension had the lowest. The types of hospital were found to be influential on professional self-concept. The types of hospital were reported to influence the professional self-concept of nurses. Nursing managers are visionaries who can potentially influence nursing practices and decisions. Nursing leaders must monitor and administer strategies to improve their professional self-concept. © 2017 John Wiley & Sons Ltd.

Perception Of Nursing Middle Managers About The Evidence-Based Management

Directory of Open Access Journals (Sweden)

Wilza Carla Spiri

2017-02-01

Full Text Available Objective: to comprehend the experience of nursing middle managers of an accredited public hospital, from São Paulo state, about the evidence-based management. Method: case study and analysis of thematic content in the stages of unity of meaning, condensed meaning unity, interpretation of the underlying meaning, sub-theme and theme. Nine manager nurses participated. The data collection was done through a script with questions that, according to the convenience of the participants, were answered by electronic mail. The data were analyzed in the light of the theoretical reference of the managerial process in nursing and the evidence-based management. Results: six themes were revealed: Evidence-based management and management process; Evidence-based management strengths; Evidence-based management challenges; the leader and the Evidence-based management; Hospital accreditation and evidence-based management and Experiences with the evidence-based management. Conclusion: the scientific knowledge and the experiences in the work are sources of evidences that interfere, positively, in the quality and safety of the patient. Leadership training, planning, team empowerment and involvement are essential for the development of this practice. Strategies need to be discussed and implemented so that the management process is based on evidences.

Parkinson's Disease Videos

Medline Plus

Full Text Available ... Tips for Care Partners Nurse Webinars: Nursing Solutions: Innovations in PD Nurse Education CareMAP: Managing Advanced Parkinson's ... Progression of the Disease? OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis How Is Parkinson's Disease ...

The role of the charge nurse manager: a descriptive exploratory study.

Science.gov (United States)

McCallin, A M; Frankson, C

2010-04-01

To explore the charge nurse manager role. Management in nursing is increasingly challenging. Restructuring of organizations has had an impact on the scope of the charge nurse manager role that has expanded so that managers are now expected to be leaders. If role preparation is inadequate, potential for role confusion and role stress increases, undermining role effectiveness in this key senior nursing position. This descriptive exploratory study investigated the experiences of charge nurse managers. Twelve nurse managers from an acute care hospital in New Zealand were interviewed. Data were analysed thematically. Three themes, role ambiguity, business management deficit and role overload emerged. It was evident that charge nurse managers were appointed into a management role with clinical expertise but without management skills. Findings suggest that role preparation should include postgraduate education and business management training. Role induction requires a formal organizational management trainee programme and ongoing supportive clinical supervision. New approaches to charge nurse manager role development are needed. Organizations must provide formal structural support to facilitate management development. The profession needs to promote succession planning that would reduce these longstanding problems.

Applying talent management to nursing.

Science.gov (United States)

Haines, Sue

To deliver the chief nursing officer for England's vision for compassionate care and embed the 6Cs effectively, the NHS must attract, develop and retain talented nurses with a diverse range of skills. This is particularly important given the predicted shortage of nurses and evidence that NHS providers need to increase skill mix ratios to deliver safe patient care. "Talent management" is increasingly discussed within the health service; we recently asked nurses and student nurses to identify their priorities for talent development. They highlighted the importance of strong ward leadership, effective personal appraisal, clearer career pathways, increased staff engagement and involvement in decision making, as well as a need for greater emphasis on the recognition and reward of nursing achievements. We concluded that these factors are crucial to attracting, retaining and developing talent in nursing. Nurse leaders can learn approaches to developing talent from business and wider healthcare settings.

Nursing approaches in the postoperative pain management

OpenAIRE

Sevilay Yüceer

2011-01-01

Patients frequently experience moderate to severe pain inthe postoperative period. Although the pain managementis an integral and important part of the nursing care, studiessuggest that, nursing management of postoperativepain remains inadequate.Postoperative care nurses are responsible to assess thepatient’s pain, teach the patient strategies to deal with thepain, apply the analgesic treatment plan, monitor the resultsof treatment, educate the patient and the family onpain management and doc...

A nurse-led long-term pelvic floor muscle training program in the management of female patients with overactive bladder – A study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Tu-Zhen Xu

2015-06-01

Conclusion: A nurse-led long-term (6 months pelvic floor muscle training program may alleviate OAB symptoms effectively and improve the quality of life more than a short term (3 months pelvic floor muscle training program combined with solifenacin succinate tablets.

Pain management in Jordan: nursing students' knowledge and attitude.

Science.gov (United States)

Al Khalaileh, Murad; Al Qadire, Mohammad

Pain management requires knowledgeable and trained nurses. Because nursing students are the nurses of the future, it is important to ensure that students receive adequate education about pain management in nursing schools. The purpose of this study is to evaluate nursing students' knowledge and attitudes regarding pain management. A cross-sectional survey was used. The sample comprised 144 students from three nursing colleges in Jordan. Sixty-one percent were female and the average age was 21.6 years (SD 1.7). The students' Knowledge and Attitudes Survey Regarding Pain was used. The rate of correct answers ranged from 11.1% to 64%. Students showed a low level of knowledge regarding pain management-the average score was just 16 (SD 5.11) out of 40. Students were weak in their knowledge of pain medications pharmacology (actions and side effects). Less than half of students (47.9%) recognised that pain may be present, even when vital signs are normal and facial expressions relaxed. Finally, students showed negative attitudes towards pain management, believing that patients should tolerate pain as much as they can before receiving opioids; almost half (48%) of students agreed that patients' pain could be managed with placebo rather than medication. In conclusion, Jordanian nursing students showed lower levels of pain knowledge compared with other nursing students around the world. This study underlines the need to include pain-management courses throughout undergraduate nursing curricula in Jordan.

Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness.

Science.gov (United States)

Fraser, Sarah J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2018-04-01

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non-communicable disease. This repeated-measures, single-group intervention trial evaluated the effects of a 19-week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face-to-face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self-report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically-significant changes were demonstrated between baseline and post intervention for participants' waist circumference (P = 0.035) and waist-to-height ratio (P = 0.037). Non-significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse-led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an 'open door' policy to allow for attendance interruptions, such as hospitalization. © 2017 Australian College of Mental Health Nurses Inc.

Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences.

Science.gov (United States)

Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa

2018-02-15

A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.

Negative workplace behaviours: an ethical dilemma for nurse managers.

Science.gov (United States)

Lindy, Cheryl; Schaefer, Florence

2010-04-01

To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.

Relationship between Quality of Life and Nurse-led Bedside Symptom Evaluations in Patients with Chemotherapy-induced Peripheral Neuropathy

Directory of Open Access Journals (Sweden)

Yang-Sook Yoo, RN, PhD

2014-03-01

Conclusion: Collectively, our results indicate that nurse-led bedside evaluation is a noninvasive and useful method for detecting neurotoxicity and evaluating the patient’s QOL both during and after treatment.

LED deep UV source for charge management of gravitational reference sensors

International Nuclear Information System (INIS)

Sun Kexun; Allard, Brett; Buchman, Saps; Williams, Scott; Byer, Robert L

2006-01-01

Proof mass electrical charge management is an important functionality for the ST-7-LTP technology demonstration flight and for LISA. Photoemission for charge control is accomplished by using deep ultraviolet (UV) light to excite photoelectron emission from an Au alloy. The conventional UV source is a mercury vapour lamp. We propose and demonstrate charge management using a deep UV light emitting diode (LED) source. We have acquired selected AlGaN UV LEDs, characterized their performance and successfully used them to realize charge management. The UV LEDs emit at a 257 nm central wavelength with a bandwidth of ∼12 nm. The UV power for a free-space LED is ∼120 μW, and after fibre coupling is ∼16 μW, more than sufficient for LISA applications. We have directly observed the LED UV light-induced photocurrent response from an Au photocathode and an Au-coated GRS/ST-7 proof mass. We demonstrated fast switching of UV LEDs and associated fast changes in photocurrent. This allows modulation and continuous discharge to meet stringent LISA disturbance reduction requirements. We propose and demonstrate AC charge management outside the gravitational wave signal band. Further, the megahertz bandwidth for UV LED switching allows for up to six orders of magnitude dynamic power range and a number of novel modes of operations. The UV LED based charge management system offers the advantages of small-size, lightweight, fibre-coupled operation with very low power consumption

COMPETENCIES OF NURSE MANAGERS IN SLOVENIA: A QUALITATIVE AND QUANTITATIVE STUDY

Directory of Open Access Journals (Sweden)

Karmen Erjavec

2017-05-01

Full Text Available Aim: The aim of the study is to identify nurse managers’ competencies in Slovenia regarding various healthcare organisations, public and private healthcare sectors, and management levels, as well as the reasons for their differences. Design: The study was based on quantitative and qualitative research. Methods: An online survey was conducted among 297 nurse managers in Slovenia, and in-depth interviews with 12 nurse managers were carried out. Results: Managers who worked in nursing homes were significantly more likely to perceive themselves as being more competent in leadership (p = 0.001 and financial management (p = 0.004 than their colleagues. Managers who had higher management positions were significantly more likely to perceive themselves as being more competent in financial management than their colleagues in lower management positions (p = 0.002. Nurse managers in the private sector perceived themselves to be significantly more competent in financial management (p = 0.0001. The reasons for nurse managers’ differences in proficiency levels are the degree of job security, and degree of autonomy and support in the healthcare team. Conclusion: The study identified inadequate nurse manager competencies, and reflected the needs of nurse managers for designing and providing health management programmes aimed at enhancing management capacity in the health sector in Slovenia. Keywords: management, competencies, skills, nurse managers, Slovenia, in-depth interviews, healthcare organisations, management level.

Nurse manager succession planning: A cost-benefit analysis.

Science.gov (United States)

Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

2018-03-01

This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

Effect of interprofessional student-led beds on emergency department performance indicators.

Science.gov (United States)

Meek, Robert; Morphet, Julia; Hood, Kerry; Leech, Michelle; Sandry, Kate

2013-10-01

The study aims to compare ED performance indicators between patients managed by students in an inter-professional learning (IPL) programme and comparable patients receiving usual ED care. An IPL programme ran for five separate 2 week periods during 2012. Four student-led beds were managed by four final year students (two medical, two nursing). Four control beds were matched for patient acuity. Data were gathered electronically from the ED information system. Comparisons of baseline characteristics and a range of ED performance indicators were made between patients managed in the student-led and control beds. Patient satisfaction with student care was surveyed. Characteristics of the 369 study and 365 control patients were similar. Median times to being seen by a nurse and a doctor were not significantly different between student-led and control beds, at 50 (19-103) versus 45 (20-93) min, and 84 (28-162) versus 91 (41-165) min, respectively. Median time to inpatient referral for admitted patients was significantly longer in student-led compared with control beds, being 142 (65-249) versus 101.5 (48-200) min, respectively. Median lengths of stay were similar between the student-led and control groups, being 263 (201-343) versus 303.5 (204-384) min for discharged patients, and 866 (571-1238) versus 745.5 (487-1168) min for inpatient ward admissions. Patients reported high levels of satisfaction with student care. There was little difference in performance indicators between patients managed by student teams as part of an IPL programme and a similar group receiving usual ED care. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Mitigating the Impact of Nurse Manager Large Spans of Control.

Science.gov (United States)

Simpson, Brenda Baird; Dearmon, Valorie; Graves, Rebecca

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

[Case management process identified from experience of nurse case managers].

Science.gov (United States)

Park, Eun-Jun; Kim, Chunmi

2008-12-01

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Becoming nursing manager in the nested and complex border of caring and management dimensions

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Gabriela Marcellino de Melo Lanzoni

2015-06-01

Full Text Available The study aimed to understand the experience of managing medical-surgical inpatient units in a general hospital, highlighting the meaning of being a nursing manager, with the intention to qualify and instrument nurses for caring management practice in this scenario. This is a Grounded Theory research, conducted from August 2010 to August 2012, through interviews with 19 participants from the nursing team, distributed in 3 sampling groups. From the analysis emerged the phenomenon “Becoming a nursing manager in the nested and complex border of caring and management dimension”. To exercise caring management, nurses use management instruments as essential tools, they become capable theoretically and enhances, based on his experience, professional skills and personal characteristics.  We conclude that competency mobilization beyond the clinical aspect is needed; allowing the use of management instruments to make caring viable and to improve relational and interactive processes.

Leadership Practices in Hospital Nursing: A Self of Manager Nurses

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Vânea Lúcia dos Santos Silva

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

Information management competencies for practicing nurses and new graduates

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Corina Saratan

2015-09-01

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

Project Management: Essential Skill of Nurse Informaticists.

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Sipes, Carolyn

2016-01-01

With the evolution of nursing informatics (NI), the list of skills has advanced from the original definition that included 21 competencies to 168 basic competencies identified in the TIGER-based Assessment of Nursing Informatics Competencies (TANIC) and 178 advanced skills in the Nursing Informatics Competency Assessment (NICA) L3/L4 developed by Chamberlain College of Nursing, Nursing Informatics Research Team (NIRT). Of these competencies, project management is one of the most important essentials identified since it impacts all areas of NI skills and provides an organizing framework for processes and projects including skills such as design, planning, implementation, follow-up and evaluation. Examples of job roles that specifically require project management skills as an essential part of the NI functions include management, administration, leadership, faculty, graduate level master's and doctorate practicum courses. But first, better understanding of the NI essential skills is vital before adequate education and training programs can be developed.

Future preparation of occupational health nurse managers.

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Scalzi, C C; Wilson, D L; Ebert, R

1991-03-01

This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

Time management behaviors of head nurses and staff nurses employed in Tehran Social Security Hospitals, Iran in 2011

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Ebrahimi, Hossein; Hosseinzadeh, Rahele; Tefreshi, Mansoreh Zaghari; Hosseinzadeh, Sadaf

2014-01-01

Background: Effective time management is considered important for managers for achieving the goals in an organization. Head nurses can improve their efficiency and performance with effective use of time. There has always been a lot of disagreement in understanding time management behaviors of head nurses; therefore, the present study was conducted with an aim to compare the understanding of head nurses and staff nurses of the time management behaviors of head nurses employed in Social Security Hospitals in Tehran, Iran in 2011. Materials and Methods: This was a comparative descriptive study in which 85 head nurses were selected through census and 170 staff nurses were also selected through simple random sampling method from hospitals covered by the Social Security. Data collection was done through a standard inventory with high validity and reliability, which consisted of two parts: Socio-demographic characteristics and time management inventory. The obtained data were analyzed by descriptive and inferential statistics through SPSS software version 13. Results: Mean score of time management in head nurses’ viewpoint was 143.22 (±18.66) and in staff nurses’ viewpoint was 136.04 (±21.45). There was a significant correlation between the mean scores of head nurses’ time management and some of their socio-demographic characteristics such as gender, clinical experience, passing a time management course, and book reading (P nurses’ time management and their clinical working experience, education, using time management approach, and type of hospital (P nurses (52.9%) believed that their time management was in a high level; besides, most of the staff nurses also (40%) believed that time management of their head nurses was high. However, there was a significant difference between the perceptions of both groups on using Mann–Whitney test (P nursing care for clients, and also the fact that head nurses believed more in their time management behaviors, they are

Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators.

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Jones, Carolynn Thomas; Hastings, Clare; Wilson, Lynda Law

2015-01-01

There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse. Copyright © 2015 Elsevier Inc. All rights reserved.

Advanced practice nursing for enduring health needs management: a global perspective.

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Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

2012-07-01

Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Nurse entrepreneurs' attitudes to management, their adoption of the manager's role and managerial assertiveness.

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Sankelo, Merja; Akerblad, Leena

2008-10-01

This study explores the attitudes of Finnish nurse entrepreneurs to management, their adoption of the manager's role, managerial assertiveness, development and training needs in management and associated factors. The research was conducted as part of a questionnaire survey among 335 entrepreneurs with different educational backgrounds. The sample for the study reported here consisted of those respondents who had a registered nurse degree. The data were analysed using SPSS statistical software. Nurse entrepreneurs took a positive attitude towards management, but there were obvious shortcomings in their adoption of the manager's role. They also showed a lack of managerial assertiveness. Half of the respondents had development needs and one-third had training needs in relation to management. Nurses who are planning to start up in business should have earlier leadership experience and should attend some form of management training. The provision of care and nursing services is increasingly taking place in the private sector. This study contributes to our understanding of the managerial role of nurse entrepreneurs in this new environment.

Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population.

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Qvist, Ina; Hendriks, Jeroen M L; Møller, Dorthe S; Albertsen, Andi E; Mogensen, Helle M; Oddershede, Gitte D; Odgaard, Annette; Mortensen, Leif Spange; Johnsen, Søren Paaske; Frost, Lars

2016-01-01

A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse-led, structured hospital AF clinics with the outcomes of a randomised trial of the efficacy of a nurse-led AF clinic, with respect to a composite outcome of cardiovascular-related hospitalisation and death. All patients were referred to the AF nurse specialist by cardiologists. The AF nurse specialist provided patient education, risk-factor control and stimulated empowerment and compliance. During follow-up, treatment was adjusted according to clinical guidelines. Patient education was repeated, and compliance with medical treatment was controlled. The study size was powered as a non-inferiority study. Outcome measures were adjudicated by the same principles in both cohorts. A total of 596 patients from the real world and 356 patients from a clinical trial were included in this study. No significant difference between groups with respect to age, type of AF or CHA2DS2VASc score was found. The composite primary end point occurred with an incidence rate of 8.0 (95% CI 6.1 to 10.4) per 100 person-years in the real-world population and 8.3 (95% CI 6.3 to 10.9) per 100 person-years in the clinical trial, with a crude HR of 0.83 (95% CI 0.56 to 1.23). Structured, nurse-led, hospital-based AF care appears to be effective, and patient outcomes in an actual, hospital-based, structured AF care are as least as good as those in trial settings.

Nurse practitioners' perceptions of interprofessional team functioning with implications for nurse managers.

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Heale, Roberta; Dickieson, Patti; Carter, Lorraine; Wenghofer, Elizabeth F

2014-10-01

To determine the perceptions of nurse practitioners (NPs) about the level of functioning of their interprofessional teams. Interprofessional teams are a global trend, and nurses play leadership roles in their management. Little is known about the impact of specific barriers to team functioning and the role of the nurse manager on team functioning. Ninety-eight NPs at a conference completed the Interprofessional Team Functioning Survey (ITFS). The survey items with the lowest mean scores were related to organisational systems. These items included workplace policies that support interprofessional teamwork, in particular, orientation to the interprofessional team. Items that generated lower mean scores were adequate time to work as a member of the interprofessional team, team dynamics, collaboration among team members and the sharing of responsibility. Organisational and team relational issues can be addressed through organisational management strategies. Nurse managers have an important role in facilitating high functioning interprofessional teams. Strategies for managers to support interprofessional team functioning emerged. These strategies include ensuring that there are appropriate policies, orientation of new members, allocation of time to support interprofessional teamwork, leadership to enhance team collaboration and clear delineation of responsibilities of each member. © 2013 John Wiley & Sons Ltd.

Determinants of nurses' knowledge gap on pain management in Ghana.

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Aziato, Lydia; Adejumo, Oluyinka

2014-03-01

There are concerns about adequacy of nurses' knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses' inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses' inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Results of the Medicare Health Support disease-management pilot program.

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McCall, Nancy; Cromwell, Jerry

2011-11-03

In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

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Raup, Glenn H

2008-10-01

Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

Nurse-led ranibizumab intravitreal injections in wet age-related macular degeneration: a literature review.

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Gregg, Emma

2017-04-12

Aim The aim of this literature review was to explore the development of the role of specialist ophthalmic nurses in delivering ranibizumab intravitreal injections to patients with wet age-related macular degeneration (AMD), and to evaluate their contribution to reducing capacity pressures in medical retina services, while maintaining safe and effective standards of care. Method A systematic literature search was undertaken to identify relevant articles published between January 2000 and June 2015. A search of electronic databases was undertaken, and selected relevant journals were searched manually. A free text and subject heading search strategy was conducted, in which the abstracts of publications identified for review were assessed for relevance. Inclusion criteria were: nurses delivering ranibizumab intravitreal treatment; studies performed in the UK and other countries; and patients with AMD, diabetic macular oedema or central retinal vein occlusion receiving nurse-led ranibizumab (Lucentis) intravitreal treatment. Findings Five studies were identified from the literature search, which audited a total of 31,303 injections delivered by nurse practitioners between January 2007 and November 2013. The visual outcomes and the rate of complications from intravitreal injections delivered by trained ophthalmic nurse practitioners were comparable to intravitreal injections delivered by ophthalmologists. Four of the five studies reported increased patient satisfaction, patients consenting to nurse-delivered intravitreal injections, favourable pain experience, and absence of complaints. Conclusion Practice innovation is an example of a quality, innovation, productivity and prevention process. Role expansion, in which specialist ophthalmic nurses deliver intravitreal injections, has been shown to be economical, safe and effective. It enables timely delivery of the service, thereby preventing irreversible blindness for individuals with wet AMD.

Psychological recovery after intensive care: Outcomes of a long-term quasi-experimental study of structured nurse-led follow-up.

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Jónasdóttir, Rannveig J; Jónsdóttir, Helga; Gudmundsdottir, Berglind; Sigurdsson, Gisli H

2018-02-01

To compare psychological recovery of patients receiving structured nurse-led follow-up and patients receiving usual care after intensive care discharge. Quasi-experimental study. Single centre, university hospital, mixed intensive care patient population. Symptoms of post-traumatic stress disorder, anxiety and depression measured three and four times over 12 months after intensive care discharge. Disturbing memories of the intensive care stay and psychological reactions (that one's life was in danger, threat to physical integrity, intense fear, helplessness, horror) three months after intensive care. A mixed effect model tested differences between the groups over time and regression model predicted post-traumatic stress at three months. The experimental group had significantly more symptoms of post-traumatic stress and anxiety than the control group over the 12 months. Patients from both groups had severe symptoms of post-traumatic stress. Patients with post-traumatic stress at three months had disturbing memories and psychological reactions. The structured nurse-led follow-up did not improve patients' measured outcomes of psychological recovery after intensive care. Patients with severe symptoms of post-traumatic stress are of concern. Emphasis needs to be placed on disturbing memories of the intensive care stay and psychological reactions when constructing intensive care nurse-led follow-up. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between assertiveness and burnout among nurse managers.

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Suzuki, Eiko; Saito, Miyuki; Tagaya, Akira; Mihara, Rieko; Maruyama, Akiko; Azuma, Tomomi; Sato, Chifumi

2009-12-01

We aimed to clarify the relationship between assertiveness and burnout among nurse managers at university hospitals. The directors at three university hospitals agreed to cooperate with our study. During a one-month period from May to June 2007, a self-administered questionnaire was distributed to 203 nurse managers (head and sub-head nurses). The Japanese version of the Rathus Assertiveness Schedule (J-RAS) and the Japanese version of the Maslach Burnout Inventory (MBI) were used as scales. Burnout was operationally defined as a total MBI score in the highest tertile. Valid responses were obtained from 172 nurse managers. The mean J-RAS score of the burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). Responses about work experience and age showed no significant group difference. Total MBI score was inversely correlated with J-RAS score (R = -0.30, P assertiveness and satisfaction with own care provision contributes to preventing burnout among Japanese nurse managers.

Nurse managers' work life quality and their participation in knowledge management: a correlational study.

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Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba

2015-01-01

The association between quality of work life and participation in knowledge management is unknown. This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach's alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson's correlation coefficient and linear regression. Nurse managers' performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P The strongest correlations were found between implementation of knowledge management and participation of nurse managers in decision making (r = 0.82; P knowledge management.

Effect of nurse-led medication reviews in psychiatric patients - an interventional study

DEFF Research Database (Denmark)

Sørensen, Ann Lykkegaard; Mainz, Jan; Poulsen, Birgitte Klindt

will contribute with information regarding the effect of pharmacological training of nurses and possibly improve medication safety for psychiatric patients. Results from this study could serve as evidence, when hospital management makes decisions on how to accede the need for medication reviews as part...... nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... and conducting systematic medication reviews using computer based screening. The effect is evaluated in a controlled interventional study. METHODS: An interventional study including 2 acute psychiatric wards. In one ward nurses’ will receive pharmacological training and the other ward will function as a control...

Implications of online learning for nurse managers.

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McCarthy, Jillian

2014-10-30

Online learning for nurses is growing in popularity, with programmes ranging from mandatory update training to part-time master's degrees. E-learning, as it is known, offers flexibility in access to learning, study time and learning styles. In busy clinical areas, where guidance is provided on minimum nurse staffing levels, e-learning provides solutions for managers who wish to encourage professional development while maintaining adequate nursing cover. Caution must be taken, however, when choosing e-learning programmes, as quality and efficacy differ across the range. This article highlights the properties of good e-learning pedagogy to prepare nurse managers for successful assessment of these programmes.

Barriers to Asthma Management for School Nurses: An Integrative Review.

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Hanley Nadeau, Ellen; Toronto, Coleen E

2016-04-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

The teaching of nursing management in undergraduate: an integrative review

Directory of Open Access Journals (Sweden)

Mara Solange Gomes Dellaroza

2015-03-01

Full Text Available The study aims to identify the dynamics of teaching management in nursing degree. It is an integrative literature review with research conducted in the following online database platforms: SciELO, Medline, Lilacs and BDENF. The keywords used in the study were: competency-based education, professional competence, education, nursing, organization and administration, management, nursing, educational assessment, organization of management services, management of professional practice and education. All articles published in the last 10 years which answered the question presented to approach the teaching of nursing management in Brazil, published in any language were included. Those that were not presented in full text were excluded. Of the 1432 studies identified after matching the keywords, only 8 were selected for answering objective of this review. From these results, three related themes emerged: the teaching plans, workload and program content; methodologies of teaching and learning in nursing management; challenges faced in developing the teaching of nursing management.

The Milieu Manager: A Nursing Staffing Strategy to Reduce Observer Use in the Acute Psychiatric Inpatient Setting.

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Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith

Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.

Prospective Analysis of Nursing Management from the Students Voices

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Rafael Alejandro Camejo Giménez

2017-08-01

Full Text Available This scientific article was intended to study management in nursing from a prospective analysis, interpret the meanings and meanings that social actors grant to the future of nursing management and unveil the importance of nursing management from prospectivity. The paradigm was interpretative under a qualitative approach, where the phenomenological method based on hermeneutics was applied. We selected 05 students from the first semester of nursing and 05 from the eighth for a total of 10 social actors. As a technique for obtaining the information I used as resources the in-depth interview, notes, photographs and recordings. The following categories emerged from the findings: Service management: training, administration and functions; Prospectivity: profile and futuristic scenario. The emerging categories triangulated and I can say that every bachelor who enters the career must know the functions of nursing. The contribution of the theoretician Michel Godet, among others, was considered. Finally, as a main finding, it was known that most nursing students do not know the future of the career and UCLA in the Deanery under study does not apply prospective management to determine cognitive and mental indicators in future Nursing graduates.

[Job Satisfaction: a quality indicator in nursing human resource management].

Science.gov (United States)

Siqueira, Vera Thânia Alves; Kurcgant, Paulina

2012-02-01

This descriptive study addresses the job satisfaction of nurse managers and clinical nurses working at the Hematology and Hemotherapy Services of a public hospital in São Paulo. The study objectives were to identify the factors that caused job satisfaction among nurse managers and clinical nurses, and support the results in the development of indicators to evaluate the quality of nursing human resource management. The components of the study were: autonomy, interaction, professional status, job requirements, organizational norms and remuneration. Participants were 44 nurses. Data were collected using a Job Satisfaction Index (JSI) questionnaire. In conclusion, this study permitted the identification of the clinical nurse group, which was the most satisfied, with a JSI of 10.5; the managerial group scored 10.0. Regarding the satisfaction levels in regards to the current activity, 88.9% of the nurse managers reported feeling satisfied, as did 90.9% of clinical nurses. For both groups, autonomy was the component with the highest level of professional satisfaction.

How staff nurses perceive the impact of nurse managers' leadership style in terms of job satisfaction: a mixed method study.

Science.gov (United States)

Morsiani, Giuliana; Bagnasco, Annamaria; Sasso, Loredana

2017-03-01

To describe staff nurses' perceptions related to the leadership styles adopted by their nurse managers, identify which leadership style ensured job satisfaction in staff nurses and describe which behaviours nurse managers should change. Empirical literature suggests that leadership styles of nurse managers significantly influence staff satisfaction. However, few studies investigate how staff nurses perceive the leadership styles of their nurse managers, and how these impact upon the staff nurses' job satisfaction. This was a mixed method study, which included the administration of the Multi-factor Leadership Questionnaire and three focus groups. Ward nurse managers mostly adopted a transactional leadership style ('Management by exception active') aimed at monitoring errors and intervening to correct errors and punish, which had a negative impact on staff nurses' levels of job satisfaction. In contrast, the transformational leadership style, which is mostly correlated with satisfaction ('Idealized Influence Attributed', which staff nurses perceived as 'respect', 'caring for others', 'professional development' and 'appreciation'), was rarely practiced by nurse managers. The transformational leadership skills of Italian nurse managers need to be improved through behaviours based on greater respect, caring for others, professional development and appreciation. The present study could also serve as model to improve the leadership style of nurse managers in other countries. The themes of transformational leadership could serve as a guide for nurse managers to help them improve their leadership style, and improve the levels of job satisfaction in staff nurses. Owing to the complexity and the importance of this issue, classroom educational interventions would not be sufficient: it should be dealt as a strategic priority by nursing directors. © 2016 John Wiley & Sons Ltd.

Using a management perspective to define and measure changes in nursing technology.

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Alexander, J W; Kroposki, M

2001-09-01

The aims of this paper are to discuss the uses of the concept of technology from the medical science and the management perspectives; to propose a clear definition of nursing technology; and to present a study applying the use of the concept of nursing technology on nursing units. Nurse managers must use management terms correctly and the term technology may be misleading for some. A review of the nursing literature shows varied uses of the concept of technology. Thus a discussion of the dimensions, attributes, consequences, and definitions of nursing technology from the management perspective are given. A longitudinal study to measure the dimensions of nursing technology on nursing units 10 years apart. The findings suggest that the dimensions of nursing technology change over time and support the need for nurse managers to periodically assess nursing technology before making management changes at the level of the nursing unit. This study helps health care providers understand the unique role of nurses as healthcare professionals by identifying and measuring nursing technology on the nursing unit.

Developing a decision support system to meet nurse managers' information needs for effective resource management.

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Ruland, C M

2001-01-01

This article describes the development of a decision support system called CLASSICA, which assists nurse managers in financial management, resource allocation, activity planning, and quality control. CLASSICA integrates information about patient flow and activity, staffing, and the cost of nursing care at the nursing-unit level. The system provides assistance in planning activities, balancing the budget, and identifying barriers to unsatisfactory resource management. In addition, CLASSICA contains forecasting and simulation options to analyze the influence of factors that affect nursing costs. This article describes the system's development process steps to tailor it to the needs of nurse managers and their existing work practices. Nurse managers actively participated in defining their tasks and responsibilities; identified barriers and difficulties in managing these tasks; defined information needs, data input, and output and interface requirements; and identified expected benefits. Clear communication of project goals, strong user involvement, and purposeful benefit planning was used to achieve the goals for CLASSICA: (1) to provide essential information and decision support for effective financial management, resource allocation, activity planning, and staffing; (2) to improve nurse managers' competence in financial management and decision making; (3) to improve cost containment; and (4) to provide a helpful and easy to use tool for decision support.

Pain management in the nursing home.

Science.gov (United States)

Dumas, Linda G; Ramadurai, Murali

2009-06-01

This article is about pain management and some of the best practices to address the problem of pain in nursing home patients who have a serious illness and multiple comorbid conditions. Management of the emotional distress that accompanies chronic or acute pain is of foremost concern. In this article, the topics discussed include general pain management in a nursing home for a long-term care resident who has chronic pain, the relief of symptoms and suffering in a patient who is on palliative care and hospice, and the pain management of a postoperative patient with acute pain for a short transitional period (post-acute illness or surgery).

Knowledge of cardiovascular disease in Turkish undergraduate nursing students.

Science.gov (United States)

Badir, Aysel; Tekkas, Kader; Topcu, Serpil

2015-10-01

Cardiovascular disease is the number one cause of death worldwide. However, there is not enough data exploring student nurses' understanding, knowledge, and awareness of cardiovascular disease. To investigate knowledge of cardiovascular disease and its risk factors among undergraduate nursing students, with an emphasis on understanding of cardiovascular disease as the primary cause of mortality and morbidity, both in Turkey and worldwide. This cross-sectional survey assessed 1138 nursing students enrolled in nursing schools in Istanbul, Turkey. Data were collected using the Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale and questions from the Individual Characteristics Form about students' gender, age, level of education, and family cardiovascular health history, as well as smoking and exercise habits. Respondents demonstrated a high level of knowledge about cardiovascular disease, with years of education (p healthy, they could improve their practice of health-promoting behaviors. © The European Society of Cardiology 2014.

Emotion management in children′s palliative care nursing

Directory of Open Access Journals (Sweden)

Eryl Zac Maunder

2008-01-01

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.

Management capacity to promote nurse workplace health and safety.

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Fang, Yaxuan; McDonald, Tracey

2018-04-01

To investigate regarding workplace health and safety factors, and to identify strategies to preserve and promote a healthy nursing workplace. Data collected using the Delphi technique with input from 41 key informants across four participant categories drawn from a Chinese university and four hospitals were thematically analysed. Most respondents agreed on the importance of nurses' health and safety, and that nurse managers should act to protect nurses, but not enough on workplace safety. Hospital policies, staff disempowerment, workload and workplace conflicts are major obstacles. The reality of Chinese nurses' workplaces is that health and safety risks abound and relate to socio-cultural expectations of women. Self-management of risks is neccessary, gaps exist in understanding of workplace risks among different nursing groups and their perceptions of the professional status, and the value of nurses' contribution to ongoing risks in the hospital workplace. The Chinese hospital system must make these changes to produce a safer working environment for nurses. This research, based in China, presents an instructive tale for all countries that need support on the types and amounts of management for nurses working at the clinical interface, and on the consequences of management neglect of relevant policies and procedures. © 2017 John Wiley & Sons Ltd.

Nurses' knowledge and barriers regarding pain management in intensive care units.

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Wang, Hsiang-Ling; Tsai, Yun-Fang

2010-11-01

To explore nurses' knowledge and barriers regarding pain management in intensive care units. Pain is a common and treatable condition among intensive care patients. Quality care of these patients depends on the pain knowledge and pain management skills of critical care nurses. However, no single study has explored these nurses' knowledge of and perceived barriers to pain management in Taiwan. A cross-sectional study. Intensive care unit nurses (n = 370) were recruited from 16 hospitals chosen by stratified sampling across Taipei County in Taiwan. Data were collected on nurses' knowledge of pain management using the Nurses' Knowledge and Attitudes Survey-Taiwanese version, on perceived barriers to pain management using a researcher-developed scale and on background information. The overall average correct response rate for the knowledge scale was 53.4%, indicating poor knowledge of pain management. The top barrier to managing pain identified by these nurses was 'giving proper pain prescription needs doctor's approval; can't depend on me'. Knowledge of pain management was significantly and negatively related to perceived barriers to pain management. In addition, scores for knowledge and perceived barriers differed significantly by specific intensive care unit. Knowledge also differed significantly by nurses' education level, clinical competence level (nursing ladder) and hospital accreditation category. Our results indicate an urgent need to strengthen pain education by including case analysis for intensive care nurses in Taiwan. Pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese nurses in intensive care units. © 2010 Blackwell Publishing Ltd.

Leadership styles, roles, and relationships for the nurse manager.

Science.gov (United States)

Musholt, K S

1996-12-01

This article explores the nurse manager's relationships to physicians, staff, administration, patient and family, other department heads, and peers. Included in the discussion are the expectations of the nurse manager by these other disciplines and examples of some of the situations discussed. Throughout the article are descriptions of leadership styles that are necessary for a nurse manager to accomplish his or her pivotal role.

Nurse managers' perception of night-shift napping: A cross-sectional survey.

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Dalky, Heyam F; Raeda, AbuAlRub F; Esraa, Aldalqamouni A

2017-10-04

Night-shift work often results in sleep deprivation, and this in turn results in fatigue that jeopardizes both nurse and patient safety. Napping is considered a viable deterrent to fatigue, yet hospital administration has been slow to adopt napping. To identify nurse managers' knowledge and approval of napping practices for nurses on night shifts. Nurse managers at nine Jordanian hospitals (n = 129) were surveyed using an Arabic version of a questionnaire previously used in a Canadian study. Descriptive statistics were used to describe results, and a one-way ANOVA was used to determine if relationships existed among nurse manager's approval of napping and nurse demographic characteristics. The majority of nurse managers (61%) knew nurses were napping during breaks. However, the managers reported there was no written policy for napping. A majority thought there were more benefits to napping than drawbacks. Some 55% of nurse managers recognized fatigue as a cause of errors or incidents regarding patient safety, and 40% perceived fatigue to be a factor in staff injuries. This study supports an urgent need for shared responsibility among nursing administration, and bedside nurses to develop evidence-based programs to counteract the effects of nurse fatigue. © 2017 Wiley Periodicals, Inc.

[The state of quality management implementation in ambulatory care nursing and inpatient nursing].

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Farin, E; Hauer, J; Schmidt, E; Kottner, J; Jäckel, W H

2013-02-01

The demands being made on quality assurance and quality management in ambulatory care nursing and inpatient nursing facilities continue to grow. As opposed to health-care facilities such as hospitals and rehabilitation centres, we know of no other empirical studies addressing the current state of affairs in quality management in nursing institutions. The aim of this investigation was, by means of a questionnaire, to analyse the current (as of spring 2011) dissemination of quality management and certification in nursing facilities using a random sample as representative as possible of in- and outpatient institutions. To obtain our sample we compiled 800 inpatient and 800 outpatient facilities as a stratified random sample. Federal state, holder and, for inpatient facilities, the number of beds were used as stratification variables. 24% of the questionnaires were returned, giving us information on 188 outpatient and 220 inpatient institutions. While the distribution in the sample of outpatient institutions is equivalent to the population distribution, we observed discrepancies in the inpatient facilities sample. As they do not seem to be related to any demonstrable bias, we assume that our data are sufficiently representative. 4 of 5 of the responding facilities claim to employ their own quality management system, however the degree to which the quality management mechanisms are actually in use is an estimated 75%. Almost 90% of all the facilities have a quality management representative who often possesses specific additional qualifications. Many relevant quality management instruments (i. e., nursing standards of care, questionnaires, quality circles) are used in 75% of the responding institutions. Various factors in our data give the impression that quality management and certification efforts have made more progress in the inpatient facilities. Although 80% of the outpatient institutions claim to have a quality management system, only 32.1% of them admit to

Effects of Nurse-Led Multifactorial Care to Prevent Disability in Community-Living Older People : Cluster Randomized Trial

NARCIS (Netherlands)

Suijker, Jacqueline J.; van Rijn, Marjon; Buurman, Bianca M.; ter Riet, Gerben; van Charante, Eric P. Moll; de Rooij, Sophia E.

2016-01-01

Background To evaluate the effects of nurse-led multifactorial care to prevent disability in community-living older people. Methods In a cluster randomized trail, 11 practices (n = 1,209 participants) were randomized to the intervention group, and 13 practices (n = 1,074 participants) were

Collaborations in leadership: the nurse case management and nursing administration connection.

Science.gov (United States)

Carr, Dana Deravin

2009-01-01

With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. All settings, particularly acute care hospitals and integrated delivery systems. The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.

Development and Testing of the Nurse Manager EBP Competency Scale.

Science.gov (United States)

Shuman, Clayton J; Ploutz-Snyder, Robert J; Titler, Marita G

2018-02-01

The purpose of this study was to develop and evaluate the validity and reliability of an instrument to measure nurse manager competencies regarding evidence-based practice (EBP). The Nurse Manager EBP Competency Scale consists of 16 items for respondents to indicate their perceived level of competency on a 0 to 3 Likert-type scale. Content validity was demonstrated through expert panel review and pilot testing. Principal axis factoring and Cronbach's alpha evaluated construct validity and internal consistency reliability, respectively. Eighty-three nurse managers completed the scale. Exploratory factor analysis resulted in a 16-item scale with two subscales, EBP Knowledge ( n = 6 items, α = .90) and EBP Activity ( n = 10 items, α = .94). Cronbach's alpha for the entire scale was .95. The Nurse Manager EBP Competency Scale is a brief measure of nurse manager EBP competency with evidence of validity and reliability. The scale can enhance our understanding in future studies regarding how nurse manager EBP competency affects implementation.

Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

Science.gov (United States)

Caramanica, Laura; Spiva, LeeAnna

2018-05-01

The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

Mixed-method exploratory study of general practitioner and nurse perceptions of a new community based nurse-led heart failure service.

Science.gov (United States)

MacKenzie, Emma; Smith, Amanda; Angus, Neil; Menzies, Sue; Brulisauer, Franz; Leslie, Stephen J

2010-01-01

The treatment of patients with chronic heart failure (CHF) remains sub-optimal. Specialist CHF nurses are proven to improve care and reduce admission but developing such services, especially in remote areas, can be difficult. This study aimed: first, to assess the perceived acceptability and effectiveness of a new community based nurse-led heart failure service by general practitioners (GPs) in an area with a dispersed population; second, to assess the knowledge and learning needs of GPs; and third, to assess perceptions of the use of national guidelines and telehealth on heart failure management. The study was conducted in the Scottish Highlands, a large geographical area in the north of the UK which includes both rural and urban populations. The area has a total population of 240 000, approximately 60% of whom are within 1 hour travel time of the largest urban centre. A postal survey of all GPs (n = 260) and structured email survey of all CHF specialist nurses (n = 3) was performed. All responses were entered into a Microsoft Excel spreadsheet, summarised and subjected to thematic analysis. Differences between GPs in 'rural', 'urban' or both 'urban & rural' was investigated using an F-test for continuous variables and a three-sample test for equality of proportions for nominal data. Questionnaires were returned from 83 GPs (32%) and all three CHF specialist nurses. In this sample there were only a few differences between GPs from 'rural', 'urban' and 'urban & rural'. There also appeared to be little difference in responses between those who had the experience of the CHF nurse service and those who had not. Overall, 32 GPs (39%) wished better, local access to echocardiography, while 63 (76%) wished access to testing for brain natriuretic peptide (BNP). Only 27 GPs (33%) referred all patients with CHF to hospital. A number of GPs stated that this was dependant on individual circumstances and the patient's ability to travel. The GPs were confident to initiate

Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

Science.gov (United States)

Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don

2009-07-01

To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.

Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences.

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Zydziunaite, Vilma; Suominen, Tarja

2014-01-01

Abstract Background: Understanding the reasons and consequences of leadership styles in ethical dilemmas is fundamental to exploring nurse managers' abilities to influence outcomes for patients and nursing personnel. To explain the associations between different leadership styles, reasons for their application and its consequences when nurse managers make decisions in ethical dilemmas. The data were collected between 15 October 2011 and 30 April 2012 by statistically validated questionnaire. The respondents (N = 278) were nurse managers. The data were analysed using SPSS 20.0, calculating Spearman's correlations, the Stepwise Regression and ANOVA. The reasons for applying different leadership styles in ethical dilemmas include personal characteristics, years in work position, institutional factors, and the professional authority of nurse managers. The applied leadership styles in ethical dilemmas are associated with the consequences regarding the satisfaction of patients,' relatives' and nurse managers' needs. Nurse managers exhibited leadership styles oriented to maintenance, focussing more on the 'doing the job' than on managing the decision-making in ethical dilemmas.

Relationship between management styles and nurses' retention at ...

African Journals Online (AJOL)

Conclusion: Management style and nurses' retention were significantly interrelated in terms of exploitative/authoritative management style. Recommendation, the researcher recommended that hospital leaders should plan and implement effective strategies to promote nurse retention. This can be done through creating a ...

Educational nurse-led lifestyle intervention for persons with mental illness.

Science.gov (United States)

Rönngren, Ylva; Björk, Annette; Audulv, Åsa; Enmarker, Ingela; Kristiansen, Lisbeth; Haage, David

2018-06-01

Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention. © 2017 Australian College of Mental Health Nurses Inc.

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

Science.gov (United States)

Vincent, Leslie; Beduz, Mary Agnes

2010-05-01

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

Pain Assessment and Management in Nursing Education Using Computer-based Simulations.

Science.gov (United States)

Romero-Hall, Enilda

2015-08-01

It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. Nursing schools are in a unique position to address the gap in pain management knowledge by facilitating the acquisition and use of knowledge by the next generation of nurses. The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Strategic management: a new dimension of the nurse executive's role.

Science.gov (United States)

Johnson, L J

1990-09-01

The growth of corporate orientation for health care structures, with a focus on bottom-line management, has radically altered the role of nurse executives. With the organization's emphasis on performance, productivity, and results, successful nurse executives are now integrating the management of the delivery of nursing care with the management of complex corporate structures and relationships. The editor of Executive Development discusses the rapidly changing expectations and demands of the contemporary nurse executive's work. The nurse executive's role can be viewed from many perspectives: its scope, its value, its structure, its content. Content--"What does the nurse executive do that makes a real difference?"--is the focus here.

RESOURCE MANAGEMENT AMONG INTENSIVE CARE NURSES: AN ETHNOGRAPHIC STUDY.

Science.gov (United States)

Heydari, Abbas; Najar, Ali Vafaee; Bakhshi, Mahmoud

2015-12-01

Nurses are the main users of supplies and equipment applied in the Intensive Care Units (ICUs) which are high-priced and costly. Therefore, understanding ICU nurses' experiences about resource management contributes to the better control of the costs. This study aimed to investigate the culture of nurses' working environment regarding the resource management in the ICUs in Iran. In this study, a focused ethnographic method was used. Twenty-eight informants among ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations as a participant observer was used for data gathering. Data analysis was performed using the methods described by Miles and Huberman (1994). Two main themes describing the culture of ICU nurses regarding resource management included (a) consumption monitoring and auditing, and (b) prudent use. The results revealed that the efforts for resource management are conducted in the conditions of scarcity and uncertainty in supply. ICU nurses had a sense of futurism in the supply and use of resources in the unit and do the planning through taking the rules and guidelines as well as the available resources and their values into account. Improper storage of some supplies and equipment was a reaction to this uncertain condition among nurses. To manage the resources effectively, improvement of supply chain management in hospital seems essential. It is also necessary to hold educational classes in order to enhance the nurses' awareness on effective supply chain and storage of the items in the unit stock.

American Society for Pain Management Nursing position statement: pain management at the end of life.

Science.gov (United States)

Reynolds, Janice; Drew, Debra; Dunwoody, Colleen

2013-09-01

Pain at the end of life continues to be of great concern as it may be unrecognized or untreated. While nurses have an ethical obligation to reduce suffering at the end of life, barriers remain regarding appropriate and adequate pain management at the end of life. This position statement from the American Society for Pain Management Nursing contains recommendations for nurses, prescribers, and institutions that would improve pain management for this vulnerable population. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

"Hit the ground running": perspectives of new nurses and nurse managers on role transition and integration of new graduates.

Science.gov (United States)

Chernomas, Wanda M; Care, W Dean; McKenzie, Jo-Ann Lapointe; Guse, Lorna; Currie, Jan

2010-01-01

The workplace for new graduates must be a constructive learning environment to facilitate their development. Nurse managers need new graduates who can "hit the ground running." Conflict between the needs of new nurses and the realities of the workplace often creates role confusion and tension in new graduates and threatens employers' ability to retain them. As part of a larger study that examined the effectiveness of a new strategy on new nurse retention and workplace integration, we conducted focus groups with new nurses and nurse managers. This paper discusses the perspectives of new nurses on their role transition from graduates to practising professionals and the perspectives of nurse managers on the workplace integration of new nurses. The thematic findings integrate new nurses' perspectives on their needs during role transition with the perspectives of nurse managers in meeting those needs. The discussion includes strategies to facilitate successful transition and integration of new nurses into the workplace within the context of recruitment and retention.

Transformational leadership: the development of a model of nursing case management by the army nurse corps.

Science.gov (United States)

Hocker, Susan M; Trofino, Joan

2003-01-01

Management philosophy and culture of any organization must match the nursing professions' core value of caring. Organizational conflict symptomology includes communication barriers and widely differing values. Employment of accountability based systems and bringing nurses into governance prevents conflict and improves job satisfaction. This article identifies the barriers to case management program development and discusses strategies for its successful implementation. Today's most successful organizations will implement an institution-wide commitment to a culture within which excellence flourishes. Creative staffing models and professional practice partnerships such as nursing case management will be supported and encouraged by executive leadership; they work as a team and will be jointly accountable for positive outcomes The United States Army Nurse Corps has the framework necessary to develop a premiere nursing organization. Case management departments may adopt these techniques to improve working relationships and leadership capacity within their organizations.

Nurse Manager Behaviors That RNs Perceive to Affect Their Job Satisfaction.

Science.gov (United States)

Feather, Rebecca A; Ebright, Patricia; Bakas, Tamilyn

2015-01-01

Nurse manager behaviors and job satisfaction are commonly addressed in the literature; however, registered nurse (RN) perceptions of nurse manager behaviors provide a unique perspective that may inform future strategies designed to enhance RN job satisfaction. In this paper, the perceptions of RNs were explored through focus groups to learn the behaviors of nurse managers that most influence RNs' job satisfaction. Five focus groups were conducted through semi-structured interviews of a total of 28 RNs to provide data that were coded through qualitative content analysis for themes. The findings provide nurse managers with data related to the perceptions of RNs and the behaviors of managers that influence job satisfaction. The findings identified two conceptual categories of RN perceptions of nurse manager behaviors: manager behaviors supportive of RNs (communication, respect, and feeling cared for) plus the RNs' perceived disconnect of work issues from the manager's role. Findings support past research in relation to the perceptions of RNs wanting to be respected, included in communication, and the need to feel cared for by nurse managers to have higher levels of job satisfaction. © 2014 Wiley Periodicals, Inc.

Factors influencing nurse managers' intent to stay or leave: a quantitative analysis.

Science.gov (United States)

Hewko, Sarah J; Brown, Pamela; Fraser, Kimberly D; Wong, Carol A; Cummings, Greta G

2015-11-01

To identify and report on the relative importance of factors influencing nurse managers' intentions to stay in or leave their current position. Effective nurse managers play an important role in staff nurse retention and in the quality of patient care. The advancing age of nurse managers, multiple job opportunities within nursing and the generally negative perceptions of the manager role can contribute to difficulties in retaining nurse managers. Ninety-five Canadian nurse managers participated in a web survey. Respondents rated the importance of factors related to their intent to leave or stay in their current position for another 2 years. Descriptive, t-test and mancova statistics were used to assess differences between managers intending to stay or leave. For managers intending to leave (n = 28), the most important factors were work overload, inability to ensure quality patient care, insufficient resources, and lack of empowerment and recognition. Managers intending to leave reported significantly lower job satisfaction, perceptions of their supervisor's resonant leadership and higher burnout levels. Organisations wishing to retain existing nurse managers and to attract front-line staff into leadership positions must create and foster an environment that supports nurse managers. © 2014 John Wiley & Sons Ltd.

Leadership skills for nursing unit managers to decrease intention to leave

Directory of Open Access Journals (Sweden)

Roche MA

2015-05-01

Full Text Available Michael A Roche,1 Christine Duffield,1,2 Sofia Dimitrelis,1 Belinda Frew1 1Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, 2Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals. Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment. Methods: Data were collected from 62 medical, surgical, and mixed units across eleven public acute care hospitals in three Australian states (September 2008 to August 2010. A total of 1,673 nurses completed a nurse survey that included measures of intention to leave and leadership aspects of the practice environment. Analyses explored specific leadership characteristics that were associated with turnover intent. Results: The role of nursing unit managers was confirmed to be a major factor in nurses’ intention to remain or leave their current workplace. Nurses valued “human” skills more highly than other leadership characteristics, including their manager’s connection with nurses’ concerns, clarity, participation in decisions, and encouragement. Conclusion: Strong leadership qualities in the nursing unit manager have been associated with greater job satisfaction, reduced turnover intention among nursing staff, and improved patient outcomes. Nurse leaders need to be supported in an effort to retain nurses given ongoing workforce issues and to ensure high-quality patient care. Keywords: nurse

Comparison of an interactive CD-based and traditional instructor-led Basic Life Support skills training for nurses.

Science.gov (United States)

Mardegan, Karen J; Schofield, Margot J; Murphy, Gregory C

2015-08-01

Basic Life Support (BLS) is a life-saving and fundamental skill in resuscitation. However, studies have reported limitations in BLS training outcomes for both health professional and lay populations, and noted the resource and time-intensive nature of traditional training approaches. This exploratory study evaluated the effectiveness of an interactive CD-based BLS training programme that included unsupervised manikin practice compared with a traditional instructor-led BLS training programme involving demonstration and supervised practice. A quasi-experimental post-test with follow-up design was used. The sample was comprised of two cohorts: Novice second-year undergraduate Nursing students (n=187) and Practising Nurses (n=107) in their first year of hospital employment. BLS skill outcomes were assessed at one week and again at eight weeks post training. No statistically significant differences were found between the CD and traditional instructor-led BLS training methods in BLS skills of Novice and Practising Nurses at one week and eight weeks post training. However, there was a decrement in skill between one week and eight weeks post-training across both groups and an overall low level of competence. The failure to find a difference between the CD-based BLS programme with unsupervised manikin practice and a resource-intensive traditional instructor-led BLS training programme may indicate equivalence of the programmes or, even study design limitations. It is concerning that competence displayed by trainees from both groups was less than optimal and suggests the need for renewed efforts to develop and evaluate BLS training programmes which can achieve high rates of competence with acceptable skill retention over time. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Emergency nurses' knowledge of perceived barriers in pain management in Taiwan.

Science.gov (United States)

Tsai, Feng-Ching; Tsai, Yun-Fang; Chien, Chih-Cheng; Lin, Chia-Chin

2007-11-01

To explore knowledge of and perceived barriers to pain management among emergency nurses in Taiwan. Pain is the most common patient complaint in emergency departments. Quality care of these patients depends on the pain knowledge and pain management skills of emergency nurses. However, no studies have explored emergency nurses' knowledge of and perceived barriers to pain management in Taiwan. Nurse subjects (n = 249) were recruited from nine hospitals chosen by stratified sampling across Taiwan. Data were collected using the Nurses' Knowledge and Attitudes Survey-Taiwanese version, a scale to assess perceived barriers to pain management and a background information form. The overall average correct response rate for the knowledge scale was 49.2%, with a range of 4.8-89.2% for each survey question. The top barrier to managing pain was identified by these nurses as 'the responsibility of caring for other acutely ill patients in addition to a patient with pain. Knowledge of pain management had a significant, negative relationship with perceived barriers to pain management and a significant, positive relationship with extent of clinical care experience and total hours of prior pain management education. In addition, scores for knowledge and perceived barriers differed significantly by the nursing clinical ladder. Perceived barriers also differed significantly by hospital accreditation category. Our results indicate an urgent need to strengthen pain education for emergency nurses in Taiwan. The pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese emergency nurses.

Challenges for nurse managers in China.

Science.gov (United States)

Wong, Frances Kam Yuet

2010-07-01

To critically review the challenges facing nurse leaders in China during healthcare reform. China is now undergoing a major reform aimed at enhancing the accessibility and quality of its healthcare at a level that is affordable to the people. Nurses have a key role to play in this reform. Key documents produced by the government of China were critically reviewed using the strengths, weaknesses, opportunities and threats (SWOT) framework. A number of factors, including the insufficient number of nurses and the medical orientation of the health system, have hindered the development of nursing. However, healthcare reform has created new opportunities for nurses and nursing. This paper reviews the strengths, weaknesses, opportunities and threats faced by nurse managers in China. It identifies barriers but also possibilities for nurse leaders to advance nursing and make nurses visible in this era of transforming healthcare. Many of the issues identified in this review, such as the enhancement of quality and accessibility of care, are important to nurse leaders around the world. However, this article reveals the particular challenges faced by nurse leaders in China, with its unique social and historical background.

Relationship between leadership styles of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital.

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Negussie, Nebiat; Demissie, Asresash

2013-03-01

Leadership style of nurse managers plays a significant role in nurses' job satisfaction. However, there is limited literature in areas related to nurses' manager leadership style. The objective of this research was thus to investigate the relationship between leadership style of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital. The study was conducted at Jimma University Specialized Hospital from January to June 2012 and used a non-experimental correlation design. All full time, non-supervisory nurses with an experience of more than one year in nursing profession were participated in the study. The Multifactor Leadership Questionnaire and Minnesota Satisfaction Questionnaire were used to collect data. Data were entered and analyzed using SPSS version16.0 statistical software. The results were analyzed through descriptive statistics followed by the application of inferential statistics on the variables. Significance level was considered when pleadership style over transactional leadership style and had moderate-level intrinsic (M=2.72, SD=0.71) but low level of extrinsic job satisfaction (M=1.83, SD=0.68). Furthermore, from transactional leadership, only contingent reward was found to be statically significant and correlated with extrinsic (B=0.45, pleadership style were statistically significant and correlated with both intrinsic and extrinsic job satisfaction. Nurses tended to be more satisfied with the transformational leadership than transactional leadership style. Therefore, nurses' managers should use transformational leadership style in order to increase nurses' job satisfaction.

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

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Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

Self-management support for chronic pain in primary care: a cross-sectional study of patient experiences and nursing roles.

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Lukewich, Julia; Mann, Elizabeth; VanDenKerkhof, Elizabeth; Tranmer, Joan

2015-11-01

The aim of this study was to describe chronic pain self-management from the perspective of individuals living with chronic pain in the context of primary care nursing. Self-management is a key chronic pain treatment modality and support for self-managing chronic pain is mainly provided in the context of primary care. Although nurses are optimally suited to facilitate self-management in primary care, there is a need to explore opportunities for optimizing their roles. Two cross-sectional studies. The Chronic Pain Self-Management Survey was conducted in 2011-2012 to explore the epidemiology and self-management of chronic pain in Canadian adults. The questionnaire was distributed to 1504 individuals in Ontario. In 2011, the Primary Care Nursing Roles Survey was distributed to 1911 primary care nurses in Ontario to explore their roles and to determine the extent to which chronic disease management strategies, including support for self-management, were implemented in primary care. Few respondents to the pain survey identified nurses as being the 'most helpful' facilitator of self-management while physicians were most commonly cited. Seventy-six per cent of respondents used medication to manage their chronic pain. Few respondents to the nursing survey worked in practices with specific programmes for individuals with chronic pain. Individuals with chronic pain identified barriers and facilitators to self-managing their pain and nurses identified barriers and facilitators to optimizing their role in primary care. There are several opportunities for primary care practices to facilitate self-management of chronic pain, including the optimization of the primary care nursing role. © 2015 John Wiley & Sons Ltd.

The effectiveness of educational supervisors from the viewpoints of nurse managers and clinical nurses

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M Khodayarian

2012-09-01

Full Text Available Introduction: The educational supervisors should attempt to plan and implement nurses’ development programs according to the principles of educational process. The present study was conducted to assess the effectiveness of educational supervisors from the viewpoints of clinical nurses and nurse managers in 2007. Methods : 97 clinical nurses and 33 nurse managers in educational hospitals of Yazd participated in this cross sectional study. The questionnaire including 56 items related to expected professional competencies of educational supervisor was prepared and its validity and reliability was confirmed. Overall Cronbach’s alpha was 0.97 ranging from 0.77 to 0.96 for different dimensions which indicated internal consistency of the questionnaire. Results: The results showed 42.3% of nurses considered the function of their hospital as effective, 52.6% as ineffective, and 5.2% as relatively effective. One hundred percent of metrons considered the function of educational supervisors as effective. All the educational supervisors considered their function effective. The study samples reported that all the listed criteria were important in the effectiveness of educational supervisors’ function. Conclusion: In order to improve the effectiveness of educational supervisors’ function their management and leadership competencies should be developed. Competency-based approach is suggested in preparing educational supervisors for implementing the educational process from the problem solving skills. This will help nurse managers to make their work environments a learning and educational institute.

Experiences of peer support in self-management interventions among people with ischemic heart disease

DEFF Research Database (Denmark)

Enggaard, Helle; Uhrenfeldt, Lisbeth

2016-01-01

Review question/objective: The objective of this review is to identify, appraise and synthesize the best available evidence regarding people with ischemic heart disease and their experiences with peer support in self-management interventions. More specifically, the review question is: How do people...... with ischemic heart disease experience peer support in structured self-management interventions led or co-led by peers?...