Sample records for nursing assistant iii

  1. Assisted suicide: implications for nurses and nursing. (United States)

    Daly, B J; Berry, D; Fitzpatrick, J J; Drew, B; Montgomery, K


    Assisted suicide is an issue of great importance to nurses. This issue reflects our values and beliefs as a society, calls for a clear and precise response as a profession, and challenges individual nurses to think about their own moral views. The history of the debate and the compelling moral arguments on both sides attest to the complexity of the issue and also suggest that it will not soon be resolved. The current position of the profession, as expressed in the ANA Code for Nurses and a specific position statement, were reviewed. The dilemma faced by the individual nurse who perceives an obligation to adhere to the guidelines specified by his or her profession's code and yet whose conscience dictates an act in violation of this code has been discussed as an instance of conscientious objection. While this analysis has been necessarily brief, it was intended to illustrate the importance of being clear about one's personal moral views and equally clear about one's duty to fulfil the obligations stemming from the profession's public statements. It is essential that the profession continue to explore the moral issues involved in requests for assistance in dying and provide additional guidelines for practicing nurses, with sound rationale for the profession's position.

  2. Job satisfaction of nursing assistants. (United States)

    Lerner, Nancy; Resnick, Barbara; Galik, Elizabeth; Flynn, Linda


    This secondary data analysis explored factors influencing job satisfaction in a sample of nursing assistants employed in Maryland skilled nursing facilities. Multiple factors have been shown to affect job satisfaction and turnover in nursing assistants (NAs), but the problem of turnover persists in skilled nursing facility environments affecting quality of care. An existing data set of 556 nursing assistants from 12 Maryland skilled nursing facilities was used. To explore factors found to influence job satisfaction from other studies, a multiple regression analysis was performed. Nine dependent variables previously shown to affect job satisfaction were used. Of these variables, only years of experience (β = .230) and performance of restorative care (β = .095) were found to be positively associated with job satisfaction. Self-esteem (β = -.094) was found to be negatively associated with job satisfaction. Only length of experience and exemplary care as evidenced by the performance of restorative care were associated with job satisfaction. These results mirror results found in other studies. Self-esteem was negatively associated with job satisfaction in this population, a finding needing further study. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

  3. Nursing home work practices and nursing assistants' job satisfaction. (United States)

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


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

  4. Nurses' attitudes to assisted suicide: sociodemographic factors. (United States)

    Evans, Luke

    This literature review seeks to explore the factors that influence nurses' attitudes towards assisted suicide. A poll conducted by the Royal College of Nursing (RCN) showed that 49% of nurses supported assisted suicide while 40% were opposed to it. A literature review resulted in 16 articles being identified for data synthesis using a recognised critiquing framework. The articles revealed four key themes: nursing specialty, level of education, geographical location and religion. It was concluded that these four themes are key to understanding a nurse's attitude towards assisted suicide. Nursing staff need to be aware of their own influences on this topic, since they will inevitably be involved in the process in some way or another, in countries where assisted suicide has been legalised.

  5. Utilizing Computer Integration to Assist Nursing


    Hujcs, Marianne


    As the use of computers in health care continues to increase, methods of using these computers to assist nursing practice are also increasing. This paper describes how integration within a hospital information system (HIS) contributed to the development of a report format and computer generated alerts used by nurses. Discussion also includes how the report and alerts impact those nurses providing bedside care as well as how integration of an HIS creates challenges for nursing.

  6. Articulation Matrix for Home Health Aide, Nursing Assistant, Patient Care Assistant, Practical Nursing. (United States)

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

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

  7. From healthcare assistant to student nurse


    Adair, Fiona


    This article discusses research undertaken to investigate the journey that student nurses make who have previously worked as healthcare assistants (HCAs). It briefly identifies the research process, followed by in-depth discussion of one of the themes that emerged from the study: the difference between a student nurse and a healthcare assistant.\\ud \\ud The author chose to explore this theme in depth because more and more HCAs are undertaking the undergraduate degree programme to become a regi...

  8. Engagement, resilience and empathy in nursing assistants. (United States)

    Navarro-Abal, Yolanda; López-López, M José; Climent-Rodríguez, José A

    To analyse the levels of engagement, resilience and empathy, and the relationship between them, in a sample of nursing assistants working in different private institutions in Huelva. A transversal, descriptive study. The sample comprised 128 nursing assistants working in private health centres of Huelva. They were given the following instruments: resilience scale Wagnild and Young, Interpersonal Reactivity Index and Utrech Work Engagement Scale. There is a relationship between the cognitive and emotional components of engagement and empathy. Certain sociodemographic variables associated with the organisation of work and working conditions are associated with level of engagement. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  9. Pressure ulcers: knowledge and attitude of nurses and nursing assistants in Belgian nursing homes.

    NARCIS (Netherlands)

    Demarre, L.; Vanderwee, K.; Defloor, T.; Verhaeghe, S.; Schoonhoven, L.; Beeckman, D.


    AIMS: To gain insight into the knowledge and attitudes of nurses and nursing assistants and to study the correlation between knowledge, attitudes and the compliance with the pressure ulcer prevention guidelines provided to residents at risk of pressure ulcers in nursing homes. BACKGROUND: There is a

  10. Factors predicting dropout in student nursing assistants

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik


    BACKGROUND: The dropout rate among student nursing assistants (NAs) in Danish health and social care education is high at >20%. AIMS: To explore if recent low back pain (LBP) history is a predictor of dropout among NA students, taking into account conventional risk factors for LBP, general health...

  11. Staffing and job satisfaction: nurses and nursing assistants. (United States)

    Kalisch, Beatrice; Lee, Kyung Hee


    The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

  12. Delegation practices between registered nurses and nursing assistive personnel. (United States)

    Potter, Patricia; Deshields, Teresa; Kuhrik, Marilee


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

  13. Determinants of the nurses' and nursing assistants' request for antipsychotics for people with dementia

    NARCIS (Netherlands)

    Janus, Sarah I M; van Manen, Jeannette G; IJzerman, Maarten J; Bisseling, Marloes; Drossaert, Constance H C; Zuidema, Sytse U

    Background: Although physicians are responsible for writing the antipsychotic prescriptions for patients with dementia, the initiative is often taken by nurses or nursing assistants. To reduce antipsychotics uses, one needs to understand the reasons for nurses and nursing assistants to request them.

  14. Exploring the activity profile of health care assistants and nurses in home nursing. (United States)

    De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Moons, Philip


    Are home nurses (also known as community nurses) ready for their changing role in primary care? A quantitative study was performed in home nursing in Flanders, Belgium, to explore the activity profile of home nurses and health care assistants, using the 24-hour recall instrument for home nursing. Seven dates were determined, covering each day of the week and the weekend, on which data collection would take place. All the home nurses and health care assistants from the participating organisations across Flanders were invited to participate in the study. All data were measured at nominal level. A total of 2478 home nurses and 277 health care assistants registered 336 128 (47 977 patients) and 36 905 (4558 patients) activities, respectively. Home nurses and health care assistants mainly perform 'self-care facilitation' activities in combination with 'psychosocial care' activities. Health care assistants also support home nurses in the 'selfcare facilitation' of patients who do not have a specific nursing indication.

  15. Feelings about Nursing Assistants that Enhance the Work Motivation of Japanese Registered Nurses and Licensed Practical Nurses. (United States)

    Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi

    Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.

  16. Reflections on International Certified Nursing Assistants. (United States)

    Shaw, Penelope Ann


    The author, a former university faculty member who taught English to speakers of other languages and now a nursing home resident, shares her observations about how English language proficiency, culture, and religious differences affect her care. She provides examples of communication challenges that can be annoying or cause harm, her coping strategies, and reasons many certified nursing assistants might never be fully fluent in English. She explains how international certified nursing assistants can benefit residents because of skills developed by family-centered care in their countries of origin. She also discusses related issues-the importance of being culturally competent about U.S. culture. She points out how religiousness not only affects residents but is a buffer for staff against the stress of physically and emotionally demanding low-wage work. Overall, the author likes receiving care from individuals from other countries, finding reward in comparing how her personal struggle with illness and paralysis resonates with the trauma of migration and how learning firsthand about varying beliefs and attitudes clarifies her identity and place in world history.

  17. Nurse Assistant Communication Strategies About Pressure Ulcers in Nursing Homes. (United States)

    Alexander, Gregory L


    There is growing recognition of benefits of sophisticated information technology (IT) in nursing homes (NHs). In this research, we explore strategies nursing assistants (NAs) use to communicate pressure ulcer prevention practices in NHs with variable IT sophistication measures. Primary qualitative data were collected during focus groups with NAs in 16 NHs located across Missouri. NAs (n = 213) participated in 31 focus groups. Three major themes referencing communication strategies for pressure ulcer prevention were identified, including Passing on Information, Keeping Track of Needs and Information Access. NAs use a variety of strategies to prioritize care, and strategies are different based on IT sophistication level. NA work is an important part of patient care. However, little information about their work is included in communication, leaving patient records incomplete. NAs' communication is becoming increasingly important in the care of the millions of chronically ill elders in NHs. © The Author(s) 2014.

  18. American Nurses Association. position statement on assisted suicide. (United States)


    Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain and, at times, forgoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession.

  19. Evaluating the American Nurses Association's arguments against nurse participation in assisted suicide. (United States)

    Vogelstein, Eric


    This discussion paper critically assesses the American Nurses Association's stated arguments against nurse participation in assisted suicide, as found in its current (2013) position statement. Seven distinct arguments can be gleaned from the American Nurses Association's statement, based on (1) the American Nurses Association's Code of Ethics with Interpretive Statements and its injunction against nurses acting with the sole intent to end life, (2) the risks of abuse and misuse of assisted suicide, (3) nursing's social contract or covenant with society, (4) the contention that nurses must not harm their patients, (5) the sanctity of life, (6) the traditions of nursing, and (7) the fundamental goals of nursing. Each of these arguments is evaluated, and none are found to be convincing. This is crucial because the American Nurses Association's official stance on nurse participation in assisted suicide can have significant consequences for the well-being of nurses who care for patients in jurisdictions in which assisted suicide is legally available. The American Nurses Association should therefore have a strong and convincing justification for opposing the practice, if it is to take such a position. That it fails to evince such a justification in its official statement on the matter places a burden on the American Nurses Association to more strongly justify its position, or else abandon its stance against nurse participation in assisted suicide.

  20. Experiences of rural and remote nurses assisting with disasters. (United States)

    Kulig, Judith C; Penz, Kelly; Karunanayake, Chandima; MacLeod, Martha L P; Jahner, Sharleen; Andrews, Mary Ellen


    Globally, disasters are on the rise. Nurses play a significant role in responding to such events but little is known about rural and remote nurses' experiences. A national cross-sectional survey of regulated nurses (registered nurses, registered psychiatric nurses, licensed practical nurses and nurse practitioners) in rural and remote Canada provided the data (n=2465) for the logistic regression of predictors of assisting with a disaster event within the last five years. The types of disaster events were also examined and open-ended responses were explored to reveal nurses' perspectives. Nurse type, age, region of employment, employment status, number of rural communities worked, distance to advanced referral centre, remote community, personal-professional boundaries, burnout and work engagement were significant factors related to assisting with a disaster event. Open-ended data alluded to the importance of pre-disaster preparation, and the difficulties experienced when personal-professional relationships are impacted during a disaster. Nursing education curricula needs to include information about disasters and the nurse's role. Continuing education opportunities and preparation for nurses should be offered in the workplace. Psychosocial supports to assist rural nurses who attend to disasters in their workplace will help them deal with issues such as the blurring of personal-professional relationships. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  1. Pain in Alzheimer's disease : nursing assistants' and patients' evaluations

    NARCIS (Netherlands)

    Scherder, E; van Manen, F


    Aim. This paper reports on a study examining the level of agreement between the pain perceptions of nursing assistants, older people without dementia and patients with Alzheimer's dementia. It was hypothesized that nursing assistants would overestimate the pain experience of patients with


    Directory of Open Access Journals (Sweden)

    Eliana Bedin


    Full Text Available ABSTRACT: This study consisted in a bibliographic review, which goal was a survey of the main national literature that approaches the humanization in the surgical unit, identifying and demonstrating the needs and the importance of the nursing staff daily activities. The search was made selecting the key words and the period between 1985 and 2002, where 31 articles were selected. Analyzing them we discussed about the theme, classifying it in four stages that made sense to the humanization for the nursing assistance in the surgical unit, describing aspects of the nursing graduation releasing for humanization, making ethics considerations to the assistance and demonstrating the needs of the humanized care in the presence of the technological development. We concluded that the humanization of the nursing assistance in the surgical units is a challenge, however, the humanized care is possible and essential to the nursing practice, mainly in a technological environment like the surgical unit. KEYWORDS: Operating Room Nursing; Assistance; Ethics.

  3. The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce (United States)

    Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth


    Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

  4. Introduction of assistive devices: home nurses' practices and beliefs. (United States)

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


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

  5. Critical Cases Faced by Mental Health Nurses and Assistant Nurses in Psychiatric Hospitals in Greece

    Directory of Open Access Journals (Sweden)

    Evmorfia Koukia


    Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.

  6. Nurses' Experiences of Spiritual Communication with Seriously III Children. (United States)

    Ferrell, Betty; Wittenberg, Elaine; Battista, Vanessa; Walker, Gay


    The goal of this study was to explore nurse experiences in communication with children about spiritual topics in order to develop training in this area. Although spiritual care is essential in pediatric palliative care, few providers receive training about communication with ill children about spirituality. Researchers developed a brief survey to prompt nurses to reflect on pediatric palliative care experiences that included spiritual discussions. Nurses attending training courses voluntarily submitted stories. Qualitative data were thematically analyzed by members of the research team, consisting of two researchers with expertise in palliative care, spirituality, and communication and two expert pediatric palliative care clinicians. Nurses' spiritual conversations with children revealed that children question God and the reason for their illness, have a desire to talk about the afterlife as a way of understanding their limited lifespan, and to share descriptions of an afterlife, in these cases described as heaven. Nurses conveyed the importance of being present and engaging in spiritual communication with children. Communication training is needed and should prepare providers to respond to a child's spiritual questioning, assist parents when the child initiates discussion about the afterlife, and help parent and child understand the spiritual meaning of their illness. Chaplains serve as spiritual care experts and can help train nurses to screen for spiritual distress, have greater competence in spiritual communication, and to collaborate with chaplains in care. Quality palliative care is incomplete without attention to spiritual care.

  7. Back to the future: A practice led transition program from Assistant in Nursing to Enrolled Nurse. (United States)

    Faithfull-Byrne, Annette; Thompson, Lorraine; Welch, Tony; Williamson, Moira; Schafer, Keppel; Hallinan, Claire


    Continuing professional development is an essential element in professional nursing practice. In our Hospital and Health service, a gap in existing nursing pathways was identified for Assistants in Nursing (AINs), who wished to further their career in nursing and progress to Enrolled Nurse (EN). There is also little in the literature that addresses Assistants in Nursing wishing to progress their career to Enrolled Nurses. This article describes a quality improvement project designed to address this gap. The project was a collaborative venture between a Queensland Hospital and Health Service and an Institute of Tertiary and Further Education (TAFE). The focus was on creating a flexible career path for Assistants in Nursing, wishing to become Enrolled Nurses. The project resulted in the Diploma of Nursing program (theory and practice) being delivered within the hospital setting by nurse educators and clinical nurse consultants. This is unusual in that the program is normally delivered in the tertiary setting, by academic staff from the Institute of Further Education. Program implementation is described along with the challenges encountered. Outcomes from the project were: 78% completion rate; 100% employment on completion of their course of study; and 18% progressing to further their education such as Advance Enrolled Nurse or Registered Nurse. Student satisfaction regarding the program was also positive. The initiative established a local career path for Assistants in Nursing wishing to progress to Enrolled Nurse. This quality project demonstrates that collaborative ventures between the tertiary sector and hospital and health services, can create innovative flexible solutions for staff wishing to further their career in nursing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Assisted Living Facilities - MDC_NursingHome (United States)

    NSGIC Local Govt | GIS Inventory — Label (point) feature class of Miami-Dade County Nursing Homes Facilities. As of May 2004 the Office of Emergency Management (OEM) will provide updates for Nursing...

  9. The Trajectory of Professional Education of the Nursing Assistant

    Directory of Open Access Journals (Sweden)

    Carla Regina Ulian Manzato


    Full Text Available Among the technical courses offered in Brazil, the field of nursing corresponds to 49.6% of the healthcare sector. From this total, 57% are Nursing Assistant courses. The formation of mid-level human resources has been discussed by nursing teachers and by the institutions that offer nursing-professional training, with special emphasis on the issues related to the quality of technical courses. In this context, a brief historical review of Brazilian legislation on the education and practice of these professionals, including regulations related to this education and to professional nursing practice, is presented chronologically in this paper, examining the laws and the political factors that contributed to guide the trajectory and evolution of professional Nursing Assistant Education. A comparison of the offer of mid-level courses in the field of healthcare and the quantitative of workers reveals the dimensions of Education Institutions' challenge for health sector.

  10. Factors predicting dropout in student nursing assistants. (United States)

    Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik; Mortensen, Ole Steen


    The dropout rate among student nursing assistants (NAs) in Danish health and social care education is high at >20%. To explore if recent low back pain (LBP) history is a predictor of dropout among NA students, taking into account conventional risk factors for LBP, general health and physical fitness. Prospective study with 14-month follow-up (the duration of the education) in two schools of health and social care in the Region of Copenhagen, Denmark. Participants completed a comprehensive questionnaire, and their physical fitness (balance, back extension endurance, back flexion endurance and sagittal flexibility) was assessed at baseline. Dropout was defined as failure to complete NA education. A total of 790 subjects, 87% of those invited, completed the questionnaire; 612 subjects also completed the physical tests and were included in the present study and 500 (83%) were women. Recent LBP was not an independent predictor of school dropout. However, only among women who had LBP were other factors (a history of previous exposure to heavy physical workload, a low mental health score and failure to pass the back extension endurance test) associated with risk of dropout, OR (95% CI)=2.5 (1.2-5.3). Among men, only low height was significantly associated with dropout risk. A recent LBP history was not an independent single predictor of dropout from NA education but was a risk factor in combination with other factors.

  11. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study

    NARCIS (Netherlands)

    Lovink, M.H.; Persoon, A.; Vught, A.J. van; Schoonhoven, L.; Koopmans, R.T.C.M.; Laurant, M.G.H.


    INTRODUCTION: In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of

  12. Dutch nurses' attitudes towards euthanasia and physician-assisted suicide. (United States)

    van Bruchem-van de Scheur, Ada; van der Arend, Arie; van Wijmen, Frans; Abu-Saad, Huda Huijer; ter Meulen, Ruud


    This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half (45%) of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses (58.2%) found it too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics (62.9%) and inserting an infusion needle to administer the euthanatics (54.1%) should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide.

  13. The introduction of a nursing guideline on depression at psychogeriatric nursing home wards: effects on Certified Nurse Assistants.


    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.


    Background: To improve care for residents with depression in dementia, an evidence based nursing guideline was developed. Using the guideline has already shown positive effects on depression in psychogeriatric nursing home residents. Objective: To study the effects of the introduction of the nursing guideline ‘depression in dementia’ on perceived professional autonomy, workload and feelings of powerlessness and confidence in Certified Nurse Assistants. Design: A multi-center controlled interv...

  14. Animal-Assisted Interventions in Dutch Nursing Homes: A Survey. (United States)

    Schuurmans, Lonneke; Enders-Slegers, Marie-Jose; Verheggen, Theo; Schols, Jos


    Animal-assisted interventions (AAI) have become more and more popular in nursing homes in the past decade. Various initiatives for using animals in nursing homes have been developed over the years (eg, animal visiting programs, residential companion animals, petting zoos) and, on the whole, the number of nursing homes that refuse animals on their premises has declined. In this survey, we aimed to determine how many Dutch nursing homes offer AAIs, what type of interventions are used, and with what aim. We also focus on the use of underlying health, hygiene, and (animal) safety protocols. Using an online Dutch nursing home database, we invited all listed (457) nursing home organizations in the Netherlands (encompassing a total of 804 nursing home locations) to participate in our digital survey, powered by SurveyMonkey. The survey consisted of a total of 45 questions, divided into general questions about the use of animals in interventions; the targeted client population(s); and specific questions about goals, guidelines, and protocols. The results were analyzed with SPSS Statistics. In the end, 244 surveys, representing 165 organizations, were returned: 125 nursing homes used AAI in one way or another, 40 did not. Nursing homes that did not offer AAI cited allergy and hygiene concerns as the most important reasons. Most nursing homes offering AAI used visiting animals, mostly dogs (108) or rabbits (76). A smaller number of nursing homes had resident animals, either living on the ward or in a meadow outside. Almost all programs involved animal-assisted activities with a recreational purpose; none of the participating nursing homes provided animal assisted therapy with therapeutic goals. Psychogeriatric patients were most frequently invited to participate. A total of 88 nursing homes used alternatives when animals were not an option or not available. The most popular alternative was the use of stuffed animals (83) followed by FurReal Friends robotic toys (14). The

  15. Do personality traits predict work outcomes of certified nursing assistants? (United States)

    Kovach, Christine R; Simpson, Michelle R; Reitmaier, Amy B; Johnson, Addie; Kelber, Sheryl T


    The purposes of this study were to describe personality traits of certified nursing assistants (CNAs) employed at nursing homes and explore relationships between personality traits, job satisfaction, and job performance. The sample included 177 CNAs providing direct care to residents in three nursing homes. CNAs with high and low job performance skills were distinguished by the cluster of traits associated with teamwork skills. Overall, 21.3% of the variance in job satisfaction was explained by the personality traits of Adjustment, Prudence, Likeability, Excitable, and Dutiful, F(8, 145) = 4.899, p personality, job satisfaction, and job performance provide important information about the personality traits of nursing staff who are most likely to enjoy and perform well in the nursing home setting. Knowledge of these links may be useful for hiring the appropriate person for direct care nursing home positions. Copyright 2010, SLACK Incorporated.

  16. Religion and nurses' attitudes to euthanasia and physician assisted suicide. (United States)

    Gielen, Joris; van den Branden, Stef; Broeckaert, Bert


    In this review of empirical studies we aimed to assess the influence of religion and world view on nurses' attitudes towards euthanasia and physician assisted suicide. We searched PubMed for articles published before August 2008 using combinations of search terms. Most identified studies showed a clear relationship between religion or world view and nurses' attitudes towards euthanasia or physician assisted suicide. Differences in attitude were found to be influenced by religious or ideological affiliation, observance of religious practices, religious doctrines, and personal importance attributed to religion or world view. Nevertheless, a coherent comparative interpretation of the results of the identified studies was difficult. We concluded that no study has so far exhaustively investigated the relationship between religion or world view and nurses' attitudes towards euthanasia or physician assisted suicide and that further research is required.

  17. Nursing Assistant Burnout and the Cognitively Impaired Elderly. (United States)

    Novak, Mark; Chappell, Neena L.


    Examined burnout among nursing assistants (n=245). Found that both stressor and appraisal variables influenced feelings of burnout. Stressor variable, frequency of disturbing patient behaviors, best explained feelings of reduced Personal Accomplishment. Appraisal variable, reaction to patient behaviors, best explained Emotional Exhaustion. Found…

  18. The Role of Support in Alleviating Stress among Nursing Assistants. (United States)

    Chappell, Neena L.; Novak, Mark


    Tested the buffering hypothesis that negative effects of stressors (measured as burden, burnout, and perceived job pressure) on nursing assistants (n=245) in long-term care institutions are moderated by social support (at work and external to work). Buffering hypothesis was not confirmed, though some support for a main effects view was found.…

  19. The importance of social exchange to nurses and nurse assistants: impact on retention factors. (United States)

    Trybou, Jeroen; De Pourcq, Kaat; Paeshuyse, Michel; Gemmel, Paul


    The purpose of this study was to test the norm of reciprocity by examining relationships between perceived organisational support (POS), the quality of leader-member exchange (LMX) and psychological contract breach (PCB) and important nurse retention factors identified in the literature. A major cause of turnover among nurses is related to unsatisfying workplaces. Previous research, mainly outside the nursing setting, found that social exchange affects employees' work-related attitudes. A cross-sectional survey was conducted on 217 nurses and nursing assistants to test and refine a model linking POS, LMX, PCB with job satisfaction, trust and turnover intentions. Hierarchical multiple linear regression revealed that POS, PCB and LMX explained significant variance in all three retention factors: job satisfaction (adjusted R² = 0.502), trust (adjusted R² = 0.462) and turnover intentions (adjusted R² = 0.196). POS and PCB predicted most strongly job satisfaction (P < 0.001) and trust (P < 0.001 and P < 0.01, respectively). LMX predicted most strongly intention to leave (P < 0.01). In our study, POS, the quality of LMX and PCB were strongly related to job satisfaction, trust and turnover intentions. Nursing managers and leaders should recognize the importance of social exchange within their organisation to build trust, satisfy and retain scarce nurses and nursing assistants. © 2013 John Wiley & Sons Ltd.

  20. Application requirements for Robotic Nursing Assistants in hospital environments (United States)

    Cremer, Sven; Doelling, Kris; Lundberg, Cody L.; McNair, Mike; Shin, Jeongsik; Popa, Dan


    In this paper we report on analysis toward identifying design requirements for an Adaptive Robotic Nursing Assistant (ARNA). Specifically, the paper focuses on application requirements for ARNA, envisioned as a mobile assistive robot that can navigate hospital environments to perform chores in roles such as patient sitter and patient walker. The role of a sitter is primarily related to patient observation from a distance, and fetching objects at the patient's request, while a walker provides physical assistance for ambulation and rehabilitation. The robot will be expected to not only understand nurse and patient intent but also close the decision loop by automating several routine tasks. As a result, the robot will be equipped with sensors such as distributed pressure sensitive skins, 3D range sensors, and so on. Modular sensor and actuator hardware configured in the form of several multi-degree-of-freedom manipulators, and a mobile base are expected to be deployed in reconfigurable platforms for physical assistance tasks. Furthermore, adaptive human-machine interfaces are expected to play a key role, as they directly impact the ability of robots to assist nurses in a dynamic and unstructured environment. This paper discusses required tasks for the ARNA robot, as well as sensors and software infrastructure to carry out those tasks in the aspects of technical resource availability, gaps, and needed experimental studies.

  1. Nurses and nurse assistants' experiences with using a design thinking approach to innovation in a nursing home. (United States)

    Eines, Trude Fløystad; Vatne, Solfrid


    The aim of this study was to evaluate nurses' and nurse assistants' experiences with a design thinking approach to innovation used in a nursing home in Norway. A design thinking approach to innovation that focuses on users' needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls. This study is based on a thematic analysis of four focus group interviews with nurses and nurse assistants (n = 23). In the initial phase of developing the new service model, which included defining staff roles and responsibilities, participating nurses and nurse assistants felt engaged and motivated by the designers' inclusive and creative methods. However, during the new model's testing phase, they were critical of management's lack of involvement in the model`s implementation and therefore became less motivated about the project. The findings of the study highlight the importance of the designers cooperating with management and staff for the duration of the innovation process. Challenging innovation processes require strong managers who engage with designers, patients, staff and volunteers throughout all phases of an innovation process using a design thinking approach. © 2017 John Wiley & Sons Ltd.

  2. Complications of the natural childbirth: assistance of nurses obstetras

    Directory of Open Access Journals (Sweden)

    Zulmerinda Meira Oliveira


    Full Text Available The moment of the natural childbirth is a complex and dynamic event that demands assistance from the health professional that joins the humanized execution of procedures and actions respecting the singularity of the woman. In this way, the objectives of this study were: to know the main occurred complications at the moment of the natural childbirth and the assistance given by the nurse. It’s an exploratory research, in which the scene was a public hospital in the city of Jequié-Ba. The sampling consisted of five persons with specialization in obstetric nursing, and the used instrument for the data collection was the half-structuralized interview. After the data collection, the gotten information were submitted to the content analysis Bardin. Therefore, it’s possible to infer that the obstetric nurse faces in a positive way the complications lived deeply during the natural childbirth, through the exercise of a humanized and distinguished assistance as techniques/procedures endorsed by the literature. Thus, this can make us reflect the importance of this professional in the childbirth room as an executor and promoter of a worthy and welcoming assistance

  3. Nurses' satisfaction with use of a personal digital assistants with a mobile nursing information system in China. (United States)

    Shen, Li-Qiong; Zang, Xiao-Ying; Cong, Ji-Yan


    Personal digital assistants, technology with various functions, have been applied in international clinical practice. Great benefits in reducing medical errors and enhancing the efficiency of clinical work have been achieved, but little research has investigated nurses' satisfaction with the use of personal digital assistants. To investigate nurses' satisfaction with use of personal digital assistants, and to explore the predictors of this. This is a cross-sectional descriptive study. We conducted a cross-sectional survey targeting nurses who used personal digital assistants in a comprehensive tertiary hospital in Beijing. A total of 383 nurses were recruited in this survey in 2015. The total score of nurses' satisfaction with use of personal digital assistants was 238.91 (SD 39.25). Nurses were less satisfied with the function of documentation, compared with the function of administering medical orders. The time length of using personal digital assistants, academic degree, and different departments predicted nurses' satisfaction towards personal digital assistant use (all P < 0.05). Nurses were satisfied with the accuracy of administering medical orders and the safety of recording data. The stability of the wireless network and efficiency related to nursing work were less promising. To some extent, nurses with higher education and longer working time with personal digital assistants were more satisfied with them. © 2018 John Wiley & Sons Australia, Ltd.

  4. The waste of assistance material perceived by nursing students

    Directory of Open Access Journals (Sweden)

    Magaly Cecília Franchini Reichert


    Full Text Available The study aimed to identify the opinion of nursing students about the waste of assistance materials in practical learning activities. We conducted an exploratory, descriptive study with a quantitative approach. One hundred and eighty-six students composed the sample and they answered to an instrument with affirmatives measured by a Likert-type scale. More than half of students believed that institutions where they are interns waste materials; 76% of fourth grade students (p<0.001 acknowledged to waste materials during their internships and, 89% of the same year (p<0.001 attributed waste to conducting a procedure for the first time. The study allowed the discussion about waste materials during nursing training, alerting about the importance of adequate management of these resources besides the nursing responsibility with the environment and sustainable practices.

  5. Nursing delegation and medication administration in assisted living. (United States)

    Mitty, Ethel; Resnick, Barbara; Allen, Josh; Bakerjian, Debra; Hertz, Judith; Gardner, Wendi; Rapp, Mary Pat; Reinhard, Susan; Young, Heather; Mezey, Mathy


    Assisted living (AL) residences are residential long-term care settings that provide housing, 24-hour oversight, personal care services, health-related services, or a combination of these on an as-needed basis. Most residents require some assistance with activities of daily living and instrumental activities of daily living, such as medication management. A resident plan of care (ie, service agreement) is developed to address the health and psychosocial needs of the resident. The amount and type of care provided, and the individual who provides that care, vary on the basis of state regulations and what services are provided within the facility. Some states require that an RN hold a leadership position to oversee medication management and other aspects of care within the facility. A licensed practical nurse/licensed vocational nurse can supervise the day-to-day direct care within the facility. The majority of direct care in AL settings is provided by direct care workers (DCWs), including certified nursing assistants or unlicensed providers. The scope of practice of a DCW varies by state and the legal structure within that state. In some states, the DCW is exempt from the nurse practice act, and in some states, the DCW may practice within a specific scope such as being a medication aide. In most states, however, the DCW scope of practice is conscribed, in part, by the delegation of responsibilities (such as medication administration) by a supervising RN. The issue of RN delegation has become the subject of ongoing discussion for AL residents, facilities, and regulators and for the nursing profession. The purpose of this article is to review delegation in AL and to provide recommendations for future practice and research in this area.

  6. Teaching nursing assistant students about aphasia and communication. (United States)

    Welsh, Jessica Dionne; Szabo, Gretchen Beideman


    Research indicates that communication between patients with communication disorders and their health care providers may be compromised, which leads to adverse outcomes and reduced participation in patients' own health care. Emerging studies demonstrate that effective communication education programs may decrease communication difficulties. This feasibility study of an education program that includes people with aphasia as educators aims to improve nursing assistant students' knowledge of aphasia and awareness of supported communication strategies while also examining the experiences of participants with aphasia. This preliminary study suggests that explicit aphasia and communication training delivered in this format has positive learning outcomes for nursing assistant students and potential psychosocial benefits to participants with aphasia. The format can be modified for a variety of health care audiences and lends itself to implementation by community aphasia groups and centers. © Thieme Medical Publishers.

  7. Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes. (United States)

    Zhang, Yuan; Punnett, Laura; Nannini, Angela


    Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

  8. Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants. (United States)

    Rodwell, John; Demir, Defne; Gulyas, Andre


    Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers. © 2015 Wiley Publishing Asia Pty Ltd.

  9. Psychiatric wards with locked doors--advantages and disadvantages according to nurses and mental health nurse assistants. (United States)

    Haglund, K; von Knorring, L; von Essen, L


    To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for

  10. A National Overview of the Training Received by Certified Nursing Assistants Working in U.S. Nursing Homes (United States)

    Sengupta, Manisha; Harris-Kojetin, Lauren D.; Ejaz, Farida K.


    A few geographically limited studies have indicated that training of direct care workers may be insufficient. Using the first-ever nationally representative sample of certified nursing assistants (CNAs) from the 2004 National Nursing Assistant Survey (NNAS), this descriptive article provides an overview of the type of initial training and…

  11. Work motivation for Japanese nursing assistants in small- to medium-sized hospitals. (United States)

    Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Yoshimura, Emiko; Shibuya, Akitaka; Aizawa, Yoshiharu


    Nursing assistants can work without a professional certification to help registered nurses and licensed practical nurses. Nursing assistants engage in various tasks, e.g., washing laundry, cleaning up, and clerk tasks regarding nursing. Enhancing work motivation among nursing assistants is essential for every hospital, because when nursing assistants do their jobs well, it allows registered nurses and licensed practical nurses to complete their own specialized jobs. We examined the predictors significantly associated with nursing assistants' work motivation. For those predictors, we produced items to examine job satisfaction. Those items are classified into intrinsic and extrinsic facets. The subjects for this study were Japanese nursing assistants working in 26 hospitals with 62-376 beds (4 public and 22 private hospitals). A total of 516 nursing assistants were analyzed, with the average age and standard deviation of 42.7 ± 12.9 years; the age of 456 female subjects was 43.8 ± 12.7 years and that of 60 male subjects was 34.3 ± 11.0 years. Our results show that "work motivation" is significantly associated with "free time to do one's own things," "nursing assistants as important partners on the job," "feeling helpful to patients," "participating in decision making," and "job-skill improvement." Free time to do one's own things is an extrinsic item. Hospital administrators must monitor the workload and their quality of life among nursing assistants. All the other significant items are intrinsic. Nursing assistants are not only motivated by money. They highly value the intrinsic nature and experience of their jobs.

  12. Work-related musculoskeletal risks associated with nurses and nursing assistants handling overweight and obese patients: A literature review. (United States)

    Choi, Sang D; Brings, Kathryn


    Nurses and nursing assistants are susceptible to work-related musculoskeletal disorders and injuries (WMSDs) due to the increase in overweight and obese patients they are handling on a daily basis. This study aimed to review work-related musculoskeletal hazards and risks associated with handling overweight and obese patients, and summarize the recommended interventions to mitigate musculoskeletal concerns among nurses and nursing assistants. Approximately 350 publications were initially screened and 22 refereed articles were used to synthesize for this study on the bases of inclusion/exclusion relevance and strength of evidence on overweight or obese patient handling. Evidence suggested that the work-related musculoskeletal risks among nurses and nursing assistants included sprains/strains, low back pain, wrist, knee and shoulder injuries. The findings indicated that the WMSD risks increased when nurses and nursing assistants were manually moving or lifting patients, especially when the patients were overweight or obese. The recommended solutions included the lifting/transfer equipment and devices, ergonomic assessments and controls, no-lift policies, and training and education. To alleviate the risk of musculoskeletal disorders and injuries among nurses and nursing assistants handling overweight or obese patients, additional research and development into what safe patient handling interventions suit this growing population needs to be addressed.

  13. Nursing Assistants for Long-Term Care. Performance-Based Instructional Materials. (United States)

    Indiana Univ., Bloomington. Vocational Education Services.

    This guide is intended to assist students enrolled in programs to train nursing assistants for employment in an Indiana long-term health care facility. The first part discusses human development (growth, aging, and dying); communication with residents; sexuality; legal, ethical, and professional responsibilities of nursing assistants in long-term…

  14. Experiences of reduced work hours for nurses and assistant nurses at a surgical department: a qualitative study


    Gyllensten, Kristina; Andersson, Gunnar; Muller, Helena


    Background There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work?family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses? and assistant nurses? job satisfaction, work?life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nur...

  15. The assisted presentations of self in nursing home life. (United States)

    Næss, Anders; Fjær, Eivind Grip; Vabø, Mia


    In this paper, based on ethnographic data from five nursing homes, we introduce the concept of assisted self-presentation as an analytical tool for exploring how different care practices affect nursing home residents' dignity and sense of self. Practices of assisted self-presentation are geared at recognizing and preserving the individuality and autonomy of residents in situations where it may otherwise come under threat or be misrecognized. Sufficient or appropriate forms of attentiveness to residents' selves and sense of dignity is thus a matter of finding the right balance between intervening too much or too little in residents' production of their physical or social appearance. Here, staff-members' knowledge and recognition of the individuality of residents is essential. Whereas intervening too much in residents' appearance or performance of self might be perceived and experienced as pacifying, infantilizing, or as paternalistic overbearingness, intervening too little might be seen as neglectfulness or inhumane. Since practices of assisted self-presentation refer to a kind of social action, which will always be contingent upon the specific capacities and conditions of performing actors, it allows for the simultaneous recognition of failed or perverted work practices as well as promising practices through which residents' selves are successfully recognized. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Multidimensional intervention and sickness absence in assistant nursing students

    DEFF Research Database (Denmark)

    Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik


    BACKGROUND: When handling patients, nursing assistant (NA) students and nurse students are frequently exposed to risk factors for low back pain (LBP) including sudden loads and twisting and bending of the spine. Furthermore, LBP is a major cause of sickness absence. AIMS: To ascertain...... if a multidimensional prevention programme combining physical training, patient transfer technique and stress management prevents sickness absence and LBP in NA students. METHODS: The study was a 14-month cluster randomized controlled study. The participants were NA students from 37 randomly selected classes located...... at two schools of health and social care in Copenhagen, Denmark. The participants completed a comprehensive questionnaire regarding sickness absence, LBP and psychosocial factors on commencement and after completion of the study. RESULTS: Of 766 female NA students, 668 (87%) completed the baseline...

  17. Capillary refill time: a study of interobserver reliability among nurses and nurse assistants

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Hosbond, Susanne; Folkestad, Lars


    assistants would grade CRT. METHODS: We recorded a video of the index finger of six medical patients and these were shown to nurses and nurse assistants. They were asked to record the CRT and whether they found this value to be normal. The data were analyzed using the Fleiss Kappa Coefficient Analysis...... 130 mmHg. All had arterial blood oxygen saturation above 92% and all but one had normal body temperature. The kappa value for normality was 0.56. The interclass correlation of measurement of CRT was 0.62. CONCLUSION: This is the largest interobserver study of CRT when looking at the number...... of observers. We found an only moderate agreement for the exact value of CRT and a moderate agreement for normality. We believe that CRT should be used with caution in clinical practice....

  18. Exploring correlates of turnover among nursing assistants in the National Nursing Home Survey. (United States)

    Temple, April; Dobbs, Debra; Andel, Ross


    High turnover of nursing assistants (NAs) has implications for the quality of nursing home care. Greater understanding of correlates of NA turnover is needed to provide insight into possible retention strategies. This study examined nursing home organizational characteristics and specific job characteristics of staff in relation to turnover of NAs. Cross-sectional data on 944 nationally representative nursing homes were derived from the 2004 National Nursing Home Survey. Using a 3-month turnover rate, 25% of the facilities with the lowest turnover rates were classified as low turnover, 25% of the facilities with the highest turnover were classified as high turnover, and the remaining 50% of the facilities were classified as moderate turnover. Multinomial logistic regression was used to examine organizational and job characteristics associated with low and high turnover compared with moderate turnover. One organizational characteristic, staffing levels at or greater than 4.0 hours per patient day, was associated with greater odds of low NA turnover and reduced odds of high NA turnover. Job characteristics including higher wages and union membership were associated with greater odds of low NA turnover, whereas wages, fully paid health insurance, employee assistance benefits, and involvement in resident care planning were associated with reduced odds of high NA turnover. The results of this study suggest that job characteristics of NA staff may be particularly important for turnover. Specifically, the provision of competitive wages and benefits (particularly health insurance) and involvement of NAs in resident care planning could potentially reduce NA turnover, as could maintaining high levels of nurse staffing.

  19. Experiences of reduced work hours for nurses and assistant nurses at a surgical department: a qualitative study. (United States)

    Gyllensten, Kristina; Andersson, Gunnar; Muller, Helena


    There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation. The aim of the study was to investigate the experiences of reduced work hours and no lunch breaks among nurses and assistant nurses at an orthopaedic surgery department at a hospital in Sweden, with a particular focus on recovery and psychosocial working environment. A qualitative design was used in the study. Eleven nurses and assistant nurses working at the particular orthopaedic department took part in the study, and semi-structured interviews were used to collect data. The interviews were analysed by interpretative phenomenological analysis. Four main themes were developed in the analysis of the data: A more sustainable working situation, Improved work-life balance, Consequences of being part of a project, and Improved quality of care. Each theme consisted of subthemes. Overall, reduced work hours appeared to have many, mainly positive, effects for the participants in both work and home life.

  20. Japanese professional nurses spend unnecessarily long time doing nursing assistants' tasks. (United States)

    Kudo, Yasushi; Yoshimura, Emiko; Shahzad, Machiko Taruzuka; Shibuya, Akitaka; Aizawa, Yoshiharu


    In environments in which professional nurses do simple tasks, e.g., laundry, cleaning, and waste disposal, they cannot concentrate on technical jobs by utilizing their expertise to its fullest benefit. Particularly, in Japan, the nursing shortage is a serious problem. If professional nurses take their time to do any of these simple tasks, the tasks should be preferentially allocated to nursing assistants. Because there has been no descriptive study to investigate the amount of time Japanese professional nurses spent doing such simple tasks during their working time, their actual conditions remain unclear. Professional nurses recorded their total working time and the time they spent doing such simple tasks during the week of the survey period. The time an individual respondent spent doing one or more simple tasks during that week was summed up, as was their working time. Subsequently, the percentage of the summed time he or she spent doing any of those tasks in his or her summed working time was calculated. A total of 1,086 respondents in 19 hospitals that had 87 to 376 beds were analyzed (response rate: 53.3%). The average time (SD) that respondents spent doing those simple tasks and their total working time were 2.24 (3.35) hours and 37.48 (10.88) hours, respectively. The average percentage (SD) of the time they spent doing the simple tasks in their working time was 6.00% (8.39). Hospital administrators must decrease this percentage. Proper working environments in which professional nurses can concentrate more on their technical jobs must be created.

  1. An Exploration of Nursing Assistants' Perceptions About Job Satisfaction. (United States)

    Brady, Darcie M


    High levels of staff turnover of certified nursing assistants (CNAs) are costly and disruptive to patient care. A variety of factors contribute to a 36% turnover rate of CNAs nationwide (2015 Staffing Report, 2015). According to Stone and Wiener, high rates of turnover and staff vacancies have multilayered consequences; patient care suffers, cost of constantly replacing workers soars, and worker job dissatisfaction increases. This study examined the CNAs' beliefs about job satisfaction as an approach to prevent job turnover and retain high achieving staff in one acute care hospital in a south eastern region. The goal was to determine how CNAs define job satisfaction, evaluate their understanding of and gauge interest in the career options presented at information sessions as well as listen to their ideas on how they believe are the best approaches to achieve job satisfaction for the CNAs at this facility. A qualitative key informant design was used to interview a purposive sample of 9 nursing assistants who were currently employed at the hospital for at least 6 months and who attended a brief information session. Individual 20-minute face-to-face interviews of consented participants were recorded, transcribed, and coded for themes using constant comparative analysis. Four major categories emerged from the interviews: CNA views of job satisfaction, clinical ladder option, support services option, and what CNAs want.

  2. Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study. (United States)

    Liu, Justina Y W


    To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

  3. Nurse Practitioner/Physician Assistant | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and

  4. Euthanasia and assisted suicide in Dutch hospitals: the role of nurses. (United States)

    van Bruchem-van de Scheur, G G; van der Arend, Arie J G; Huijer Abu-Saad, Huda; van Wijmen, Frans C B; Spreeuwenberg, Cor; Ter Meulen, Ruud H J


    To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions. Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes. A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76.9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows. In almost half of the cases (45.1%), the nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultations between physicians and nurses quite often took place (78.8%). In several cases (15.4%), nurses themselves administered the euthanatics with or without a physician. It is not self-evident that hospitals have guidelines concerning euthanasia/physician-assisted suicide. In the decision-making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings. Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician-assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician-assisted suicide, especially in case these practices should become legalised.

  5. Death and Dying Attitudes, Anxieties, and Fears of Certified Nursing Assistants: A Descriptive Study (United States)

    Hamilton, Josephine A.


    The critical role of Certified Nursing Assistants (CNAs) to help elderly nursing home residents' move through declining conditions or diseases to death is salient. It is important for CNAs and nursing home leaders to understand CNAs' attitudes, fears, and anxieties toward death and dying. The quantitative study investigated CNA's…

  6. Pain in Alzheimer's disease: comparison of nursing assistents' assessment with the patient's own evaluation

    NARCIS (Netherlands)

    Scherder, E.J.A.; van Manen, F.M.


    Aim. This paper reports on a study examining the level of agreement between the pain perceptions of nursing assistants, older people without dementia and patients with Alzheimer's dementia. It was hypothesized that nursing assistants would overestimate the pain experience of patients with

  7. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees (United States)


    ... Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources... expansion supplements of $100,000 to 10 Nursing Assistant and Home Health Aide (NAHHA) Program grantees to... Management; Care Coordination and Follow Up; and Behavioral Health and Social Support for Home Health Aides...

  8. Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study. (United States)

    Vedana, Kelly Graziani Giacchero; Magrini, Daniel Fernando; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; de Souza, Jacqueline; Borges, Tatiana Longo


    To understand emergency nursing experiences in assisting people with suicidal behavior. Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Nursing Assistants' Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being (United States)

    Bishop, Christine E.; Weinberg, Dana Beth; Leutz, Walter; Dossa, Almas; Pfefferle, Susan G.; Zincavage, Rebekah M.


    Purpose: The purpose of this study was to investigate (a) whether certified nursing assistants (CNAs) are more committed to nursing home jobs when they perceive their jobs as enhanced (greater autonomy, use of knowledge, teamwork), and (b) whether CNA job commitment affects resident satisfaction. Design and Methods: A qualitative exploration of…

  10. Nursing home practices following resident death: the experience of Certified Nursing Assistants. (United States)

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R


    This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study. (United States)

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke J A H; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H


    In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated

  12. Does Assisted Living Capacity Influence Case Mix at Nursing Homes? (United States)

    Clement, Jan P; Khushalani, Jaya


    Assisted living facilities (ALFs) have grown over the past few decades. If they attract residents with lower care needs away from nursing homes (NHs), NHs may be left with higher case mix residents. We study the relationship between ALF bed market capacity and NH case mix in a state (Virginia) where ALF bed capacity stabilized after a period of growth. Similarly, NH capacity and use had been stable. While it is interesting to study markets in flux, for planning purposes, it is also important to examine what happens after periods of turbulence and adaptation. Our findings show some substitution of ALF for NH care, but the relationship is not linear with ALF market capacity. Communities need to consider the interplay of ALFs and NHs in planning for long-term care services and supports. Policies supporting ALFs may enable care needs to be met in a lower cost setting than the NH.

  13. Does Assisted Living Capacity Influence Case Mix at Nursing Homes?

    Directory of Open Access Journals (Sweden)

    Jan P. Clement PhD


    Full Text Available Assisted living facilities (ALFs have grown over the past few decades. If they attract residents with lower care needs away from nursing homes (NHs, NHs may be left with higher case mix residents. We study the relationship between ALF bed market capacity and NH case mix in a state (Virginia where ALF bed capacity stabilized after a period of growth. Similarly, NH capacity and use had been stable. While it is interesting to study markets in flux, for planning purposes, it is also important to examine what happens after periods of turbulence and adaptation. Our findings show some substitution of ALF for NH care, but the relationship is not linear with ALF market capacity. Communities need to consider the interplay of ALFs and NHs in planning for long-term care services and supports. Policies supporting ALFs may enable care needs to be met in a lower cost setting than the NH.

  14. Preventing home health nursing assistant back and shoulder injuries. (United States)

    Leff, E W; Hagenbach, G L; Marn, K K


    Franklin County Home Health Agency (St Albans, Vermont) undertook a performance improvement project in 1996 to reduce employee injuries. A review of recent injuries led to the prevention of licensed nursing assistants' (LNAs') back and shoulder injuries as the first priority. Root causes of injuries were agency communication, employee training, patient home environment, nursing assistant body mechanics, and failure to use safety measures. Given that injury causality is complex and multifactorial, a variety of improvement strategies were implemented over the following two to three years. IMPLEMENTATION OF POTENTIAL SOLUTIONS: Short-term (a few months), mid-term (six months), and long-term (one year) potential solutions to the LNA back and shoulder injury problem were charted. Safety and health training was the major focus of the team's short-term plan. Risk management forms were to be used to identify and follow up on hazardous situations. Project plans that were successfully implemented included revision of LNA plans of care, standardization of the return-to-work process after injury, development of guidelines for identifying unsafe patient lifts and transfers, improved follow-up of employee reports of injury-risk situations in patient homes, improved body mechanics screening of new employees, and a stronger injury-prevention training program for current employees. A less successful initiative was aimed at collecting more data about injuries and causal factors. Employee injuries were gradually reduced from 4-10 per quarter to 0-3 per quarter. Injury prevention requires commitment, persistence, and patience--but not expensive improvements. Multiple interventions increase the chances of success when there are many root causes and lack of evidence regarding the effectiveness of various approaches.

  15. End-of-Life Education and Discussions With Assisted Living Certified Nursing Assistants. (United States)

    Mohlman, Wendy L; Dassel, Kara; Supiano, Katherine P; Caserta, Michael


    In previous work, the current researchers examined attitudes and experiences of certified nursing assistants (CNAs) providing end-of-life (EOL) care in an assisted living facility (ALF). Results showed that 70% of participating CNAs felt unprepared to provide EOL care, largely due to not having received prior EOL care education within their schools or workplaces. Therefore, the goal of the current study was to implement and evaluate EOL and postmortem education to ALF CNAs. A focus group of 14 CNAs within an ALF was provided EOL education pertaining to the physiological and psychological changes observed in patients nearing EOL and postmortem care. Immediately following training, CNAs participated in a 30-minute focus group in which they discussed their experiences and educational needs regarding EOL care. Responses were recorded, transcribed, and analyzed for common themes using descriptive qualitative inquiry. All participants reported that CNA programs need to place greater emphasis on teaching EOL care, and 80% desired continuing education on EOL care through their employers. There is a need for CNAs to receive EOL care education to understand the psychological and physical signs and symptoms associated with the dying process to provide best practices in postmortem care. [Journal of Gerontological Nursing, 44(6), 41-48.]. Copyright 2018, SLACK Incorporated.

  16. Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses. (United States)

    Garrett, Bernard; Klein, Gerri


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

  17. Effects of the medication nursing assistant role on nurse job satisfaction and stress in long-term care. (United States)

    Walker, Margaret J


    Long-term care nurses continue to struggle with increasing workloads, fulfilling regulatory requirements and limited staffing resources. One method of impacting the workload is the introduction of the new medication nursing assistant (MNA) role to alleviate the nurse from prolonged time intervals spent administering medications. An early step in MNA role implementation is to evaluate its impact by comparing agencies using the MNA and those not using the role. This article presents findings from a mixed method study examining the efficacy of the MNA role in relationship to job satisfaction and the degree of perceived stress experienced by long-term care nurses. Ninety-one nurses employed at 2 large New Hampshire facilities responded. Findings offer empirical evidence supporting the use of the MNA to reduce job stress and increase satisfaction for licensed nurses. The MNA role is accepted by nurse leaders and viewed as a benefit. Findings also support a correlation between empowerment and decision making in the nursing environment with levels of nurse satisfaction.

  18. The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan. (United States)

    Naruse, Takashi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Sakai, Mahiro; Watai, Izumi; Murashima, Sachiyo


    This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses. A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement. Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group. Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes. The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness. In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial. © 2014 John Wiley & Sons Ltd.

  19. Laparoscopic assistance by operating room nurses: Results of a virtual-reality study. (United States)

    Paschold, M; Huber, T; Maedge, S; Zeissig, S R; Lang, H; Kneist, W


    Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. The study subjects were operating room nurses, medical students, and first year residents. Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Homogeneous electrochemical aptamer-based ATP assay with signal amplification by exonuclease III assisted target recycling. (United States)

    Liu, Shufeng; Wang, Ying; Zhang, Chengxin; Lin, Ying; Li, Feng


    A novel and homogeneous electrochemical aptamer-based adenosine triphosphate (ATP) assay was demonstrated with signal amplification by exonuclease III-assisted target recycling. A superior detection limit of 1 nM toward ATP with an excellent selectivity could be achieved.

  1. Physician Assistants and Nurse Practitioners in Rural Washington Emergency Departments. (United States)

    Nelson, Scott C; Hooker, Roderick S


    One role of physician assistants (PAs) and nurse practitioners (NPs) is to meet the growing demand for access to rural health care. Critical Access Hospitals, those with less than 25 beds, are usually located in rural communities, often providing continuity of care that clinics cannot deliver. Because little is known about staffing in these small hospital emergency departments, an exploratory study was undertaken using a mixed-methods approach. In Washington State, 18 of the 39 Critical Access Hospitals staff their emergency departments with PAs and NPs. Utilization data were collected through structured interviews by phone or in person on site. Most PAs and NPs lived within the community and staffing tended to be either 24 hours in-house or short notice if they lived or worked nearby. Emergency department visits ranged from 200 to 25,000 per year. All sites were designated level V or IV trauma centers and often managed cardiac events, significant injuries and, in some larger settings, obstetrics. In most instances, PAs were the sole providers in the emergency departments, albeit with physician backup and emergency medical technician support if a surge of emergency cases arose. Two-thirds of the PAs had graduated within the last 5 years. Most preferred the autonomy of the emergency department role and all expressed job satisfaction. Geographically, the more remote a Washington State Critical Access Hospital is, the more likely it will be staffed by PAs/NPs. The diverse utilization of semiautonomous PAs and NPs and their rise in rural hospital employment is a new workforce observation that requires broader investigation.

  2. Work values and intention to become a registered nurse among healthcare assistants. (United States)

    Trede, Ines; Schweri, Juerg


    To examine the work values of Swiss healthcare assistant students, who, at the end of their vocational education in hospitals and nursing homes, choose to pursue a registered nurse degree. A prospective, cross-sectional survey was administered to a full cohort of healthcare assistant students in their last year of study in the canton of Bern (n=272). Multivariate methods (logistic regression) were applied to estimate the joint effect of work experience and work values in choosing to pursue a registered nurse education. Among work values, extrinsic values (regarding wage, career und educational perspectives) had a strong effect on the decisions of healthcare assistant students to pursue further education as registered nurses. Grades, socio-economic background and satisfaction during education also had an effect. Higher valuation of income, career and further education affect the career intentions of nursing assistants who have already obtained a recognized healthcare education and nursing experience. Teachers and trainers should actively identify the work values and expectations of these students. Provision of adequate advice and suggestions for the career development of these students may be an important route by which to address the nursing shortage and recruitment problems. © 2013.

  3. The relationship between weight status and the need for health care assistance in nursing home residents

    DEFF Research Database (Denmark)

    Beck, Anne Marie


    Objective: The purpose of this study was to evaluate the relationship between underweight status and weight loss events on the need for health care assistance among a sample of Danish nursing home residents over 12-months. Design: Longitudinal, repeated measures design with three data collection...... points at baseline (2004) and six and 12 months post baseline. Setting: 11 Danish nursing home facilities. Participants: 441 Danish nursing home residents over the age of 65. Measurements: Resident Assessment Instrument (RAI-NH) data were abstracted for each participant at each of three data collection...... of this study suggest that elderly nursing home residents with a low BMI or weight loss may add to the substantial and costly burden of nursing home care due to the associated need for higher levels of ADL assistance....

  4. Sb(III)-Imprinted Organic-Inorganic Hybrid Sorbent Prepared by Hydrothermal-Assisted Surface Imprinting Technique for Selective Adsorption of Sb(III) (United States)

    Zhang, Dan; Zhao, Yue; Xu, Hong-Bo


    Sb(III)-imprinted organic-inorganic hybrid sorbent was prepared by hydrothermal-assisted surface imprinting technique and was characterized by Fourier transform infrared spectroscopy, scanning electron microscopy coupled to an energy dispersive spectrometer and N2 adsorption/desorption isotherms. Hydrothermal-assisted process can improve the selectivity of the Sb(III)-imprinted hybrid sorbent for Sb(III) due to stable control of temperature and pressure. The Sb(III)-imprinted hybrid sorbent IIS indicated higher selectivity for Sb(III), had high static adsorption capacity of 37.3 mg g-1 for Sb(III), displayed stable adsorption capacity in pH range from 4 to 8, reached an rapid adsorption equilibrium within 30 min. According to the correlation coefficient ( r 2 > 0.99), the experimental data fitted better the pseudo-second-order kinetic model and Langmuir equilibrium isotherm.

  5. Pros and cons of using paid feeding assistants in nursing homes. (United States)

    Remsburg, Robin E


    Recently the Centers for Medicare and Medicaid Services (CMS), citing increasing resident acuity, staffing shortages, and high turnover rates that make it difficult for nursing homes to provide adequate feeding assistance to residents who need minimal help at mealtimes, began allowing nursing facilities to use single-task workers to provide assistance during mealtimes. This article describes the use of single-task workers to provide feeding assistance to nutritionally at-risk residents during a 6-month clinical study designed to evaluate the effectiveness and feasibility of implementing a buffet-dining program in an academic long-term care facility.

  6. The relationship of positive work environments and workplace injury: evidence from the National Nursing Assistant Survey. (United States)

    McCaughey, Deirdre; McGhan, Gwen; Walsh, Erin M; Rathert, Cheryl; Belue, Rhonda


    With estimates of a 51% growth in the number of nursing assistants needed by 2016, there is a critical need to examine workplace factors that negatively contribute to the recruitment and retention of nursing assistants. Studies have shown that high demands, physical stress, and chronic workforce shortages contribute to a working environment that fosters one of the highest workforce injury rates in the United States. The aim of this study was to explore the relationship between nursing assistant injury rates and key outcomes, such as job satisfaction and turnover intent, while exploring workplace environment factors, such as injury prevention training, supervisor support, and employee engagement, that can decrease the rates of workplace injury. Data from the 2004 National Nursing Assistant Survey were used to examine the negative effects of workplace injury on nursing assistants and the workplace environment factors that are related to the rate of worker injury. Nursing assistants who experience job-related injuries have lower levels of job satisfaction, increased turnover intentions, and are less likely to recommend their facility as a place to work or seek care services. It was also found that nursing assistant injury rates are related to employee ratings of injury prevention training, supervisor support, and employee engagement. NAs with multiple injuries (>2) were 1.3-1.6 times more likely to report being injured at work than NAs who had not been injured when supervisor support, employee engagement, and training ratings were low. Evidence that health care organizations can use to better understand how workplace injuries occur and insight into ways to reduce the current staggering rate of on-the-job injuries occurring in health care workplaces were offered in this study. The findings also offer empirical support for an extension of the National Institute for Occupational Health and Safety/National Occupational Research Agenda Work Organization Framework for

  7. Exploring the Synergic Effects of Nursing Home Work on Work-Related Musculoskeletal Disorders Among Nursing Assistants. (United States)

    Ching, Shirley S Y; Szeto, Grace; Lai, Godfrey Kin Bun; Lai, Xiao Bin; Chan, Ying Tung; Cheung, Kin


    Little is known about how nursing assistants (NAs) perceive the nature of their work and how their work contributes to work-related musculoskeletal disorders (WMSDs). This qualitative study addressed these gaps. Twenty-four NAs with WMSDs working in four nursing homes participated in semistructured focus group interviews. Their WMSDs were not limited to the lower back but involved several body parts. The risk factors for WMSDs included physical, psychosocial, organizational, and personal factors as well as coworkers and clients. However, it is the synergistic effects of long work hours without sufficient rest, work even with musculoskeletal pain because of staff shortages, ineffective management with insufficient prework training and inadequate equipment maintenance, and an aging workforce with strong commitment to resident care that play a crucial role in WMSDs among NAs working in nursing homes. The study found that multidimensional intervention strategies using engineering, administrative, and personal controls should be developed to reduce WMSDs among NAs working in nursing homes.

  8. Views and experiences of mental health nurses working with undergraduate assistants in nursing in an acute mental health setting. (United States)

    Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Mannix, Judy; Jackson, Debra; Hunt, Glenn E


    Undergraduate nurses are employed as assistants in nursing (AIN) in inpatient mental health settings; however, there is a paucity of published research exploring registered nurses' (RN) views about the AIN role in these settings. This qualitative study documents the views and experiences of RN working with undergraduate AIN. Fifty structured face-to-face interviews were analysed, and the results are discussed in three sections. The first section outlines RN perceptions of qualities and skills required of AIN in mental health, and the responses primarily focus on communication skills, initiative, and willingness to learn. The second section targets factors in the workplace that might enhance the interest of AIN in a mental health nursing career; the responses emphasize their need to work with experienced staff. The last section outlines RN expectations of AIN, most of which are met and involve physical observations and technical tasks; less fulfilled activities primarily cluster around interactions with patients. Findings highlight the advantages and disadvantages of drawing on undergraduate nursing students as AIN in mental health settings. Communication skills, personal initiative, safety training to prevent violence, and education to increase knowledge and awareness about mental illness, diagnosis, and mental status-related skills were all important concerns articulated by RN. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  9. A sensitive electrochemical aptasensor for ATP detection based on exonuclease III-assisted signal amplification strategy. (United States)

    Bao, Ting; Shu, Huawei; Wen, Wei; Zhang, Xiuhua; Wang, Shengfu


    A target-induced structure-switching electrochemical aptasensor for sensitive detection of ATP was successfully constructed which was based on exonuclease III-catalyzed target recycling for signal amplification. With the existence of ATP, methylene blue (MB) labeled hairpin DNA formed G-quadruplex with ATP, which led to conformational changes of the hairpin DNA and created catalytic cleavage sites for exonuclease III (Exo III). Then the structure-switching DNA hybridized with capture DNA which made MB close to electrode surface. Meanwhile, Exo III selectively digested aptamer from its 3'-end, thus G-quadruplex structure was destroyed and ATP was released for target recycling. The Exo III-assisted target recycling amplified electrochemical signal significantly. Fluorescence experiment was performed to confirm the structure-switching process of the hairpin DNA. In fluorescence experiment, AuNPs-aptamer conjugates were synthesized, AuNPs quenched fluorescence of MB, the target-induced structure-switching made Exo III digested aptamer, which restored fluorescence. Under optimized conditions, the proposed aptasensor showed a linear range of 0.1-20 nM with a detection limit of 34 pM. In addition, the proposed aptasensor had good stability and selectivity, offered promising choice for the detection of other small molecules. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Substance use and mental illness among nurses: workplace warning signs and barriers to seeking assistance. (United States)

    Cares, Alexa; Pace, Elizabeth; Denious, Jean; Crane, Lori A


    Although some studies have examined the prevalence of substance use among nurses, few have assessed substance use in the workplace or early cues for identifying these health conditions. Primary data collected as part of a larger program evaluation were examined with the purpose of better understanding (a) the context and perceived consequences of substance use and mental illness among nurses and (b) barriers and opportunities for earlier identification and treatment of these issues among nurses, their colleagues, and employers. Anonymous surveys were mailed to 441 active and recent participants of a peer health assistance program in the summer of 2010. The survey examined drug-related behaviors in the workplace; behavioral cues that may permit earlier identification of substance use and mental illness; perceptions of barriers to seeking assistance; and strategies for preventing problems and overcoming barriers to seeking assistance. Responses were received from 302 nurses (69%). Nearly half (48%) reported drug or alcohol use at work, and two fifths (40%) felt that their competency level was affected by their use. More than two thirds of respondents thought their problem could have been recognized earlier. The most highly rated barriers to seeking assistance for substance use and mental illness included fear and embarrassment and concerns about losing one's nursing license. Respondents recommended greater attention be paid to early identification of risk factors during nurses' professional training as a prevention strategy. Findings from this study provide preliminary data that can be used by schools of nursing and health care employers to improve early identification of nurses' substance use and mental illness treatment needs. These data also suggest a need for more research to explore the prevention and early identification of co-occurring disorders in health care settings where nurses practice.

  11. The introduction of a nursing guideline on depression at psychogeriatric nursing home wards: effects on Certified Nurse Assistants

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; van Meijel, B.; Spreeuwenberg, P.M.; Ribbe, M.W.; Bensing, J.M.


    Background: To improve care for residents with depression in dementia, an evidence based nursing guideline was developed. Using the guideline has already shown positive effects on depression in psychogeriatric nursing home residents. Objective: To study the effects of the introduction of the nursing

  12. The introduction of a nursing guideline on depression at psychogeriatric nursing home wards: effects on Certified Nurse Assistants.

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Spreeuwenberg, P.M.M.; Ribbe, M.W.; Bensing, J.M.


    Background: To improve care for residents with depression in dementia, an evidence based nursing guideline was developed. Using the guideline has already shown positive effects on depression in psychogeriatric nursing home residents. Objective: To study the effects of the introduction of the nursing

  13. Essential competencies for the education of nursing assistants and care helpers in elderly care. (United States)

    Oeseburg, Barth; Hilberts, Rudi; Roodbol, Petrie F


    The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of professionals required to meet this demand. However, a recent study showed that the curricula in vocational education for nursing assistants and care helpers remains inadequate to prepare them for the social and healthcare needs of the elderly. To determine the essential competencies for the initial education of nursing assistants and care helpers in elderly care. First, a draft version of essential competencies for the education of nursing assistants and care helpers in elderly care (N=120) was developed and approved by experts, also members of the project steering committee. Second, a Delphi survey was conducted to determine the essential competencies. The Delphi panel consisted of eleven field experts (teachers/educational developers) working for different vocational education training colleges in the Netherlands. Ten panel members participated in a two-round consensus building process via email. A definitive set of 116 essential competencies for the initial education of nursing assistants and 42 essential competencies for the initial education of care helpers were determined. The competencies in the definitive set are more in line with social and healthcare needs of the elderly like: autonomy, daily functioning prevention of health problems, healthy ageing and wellbeing, involvement of informal care, collaboration between professionals and informal care. The main challenge now is to translate these competencies into educational programmes for vocational education training colleges for care helpers and nursing assistants. Recommendations are made for the implementation of these competencies in the Dutch vocational education training colleges for care helpers and nursing assistants. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [Religion and spirituality in education and nursing assistance]. (United States)

    Gussi, Maria Aparecida; Dytz, Jane Lynn Garrison


    Intersectional study between nursing discourse and precepts which embrace religion/religiousness and spirituality, and how these were incorporated and their reflection upon nursing practice, education and the history of the organization of the profession. For bibliographic review LILACS and BDENF databases of the Electronic Health Library were used. A total of 57 full-text articles, published from 1957 to 2007, were analyzed upon the light of the ideas of Maurice Halbwachs, about " collective memory" . The results show that Brazilian nursing has a religious root with profound ramifications on its development. This configuration is so embedded in the collective memory that, even with the expansion of non-religious institutions, the Christian precepts remain present and strong.

  15. Capacity development for community health nurses in Pakistan: the assistant manager role. (United States)

    Gulzar, S A; Mistry, R; Upvall, M J


    Community health nurses (CHNs), as leaders in developing countries, can promote successful outcomes in meeting the targets of the Millennium Development Goals. A community-based organization in Pakistan is striving to achieve the goals of maternal and child health through the development of the assistant manager role for community health nursing. The purpose of this study was to assess the perception of the role of the CHN assistant manager, with the goal of strengthening that role. This interpretive, qualitative study included 13 participants already familiar with CHNs in Pakistan. Interviewing was utilized to explore perceptions of the assistant manager role and to uncover challenges currently existing within this new role. Content analysis revealed the following themes: 'role perceptions', 'expectations of the role' and 'collaboration with other community healthcare providers'. Changes to the role are necessary including increased education of the assistant manager CHNs and preparing administration to work with the assistant mangers for effective leadership. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  16. Nurses' and nurse assistants' beliefs, attitudes and actions related to role and function in an inpatient stroke rehabilitation unit-A qualitative study

    DEFF Research Database (Denmark)

    Loft, Mia I; Poulsen, Ingrid; Esbensen, Bente A


    AIMS AND OBJECTIVES: To explore nurses' and nurse assistants' beliefs, attitudes and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current...... understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study. METHODS: Participant observations were conducted during 1 month in a stroke rehabilitation unit at a university hospital in the Capital Region...... stroke rehabilitation. We obtained insights into nursing staff's beliefs and attitudes about rehabilitation-as well as their own role and function-and furthermore how the latter affects their actions in daily practice. RELEVANCE TO CLINICAL PRACTICE: The nursing role and function are still not clearly...

  17. Nursing assistants' behavior during morning care: effects of the implementation of snoezelen, integrated in 24-hours dementia care.

    NARCIS (Netherlands)

    Weert, J.C.M. van; Janssen, B.M.; Dulmen, A.M. van; Spreeuwenberg, P.M.M.; Bensing, J.M.; Ribbe, M.W.


    Aim: This paper reports an investigation of the effects of the implementation of snoezelen, or multisensory stimulation, on the quality of nursing assistants' behaviour during morning care. Background: Nursing assistants in long-term dementia care are often unaware of the impact of their behaviour

  18. Bio-assisted synthesis and characterization of nanostructured bismuth (III) sulphide using Clostridium acetobutylicum

    International Nuclear Information System (INIS)

    Kamaraj, Sathish Kumar; Venkatachalam, Ganesh; Arumugam, Palaniappan; Berchmans, Sheela


    Nanostructured bismuth (III) sulphide is synthesized at room temperature using a hydrogen sulphide producing microorganism namely Clostridium acetobutylicum. On contrary to chemical routes involving both the high and room temperature methods, the present experimental procedure involves a bio-assisted approach. This method is free from the usage of toxic and hazardous chemicals making it an environment friendly route. The synthesized bismuth sulphide is characterized using transmission electron microscope (TEM), powder X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and cyclic voltammetry (CV). From our experiments we find that bismuth sulphide produced using this bio-assisted approach exhibits a hexagonal shaped plate-like structures and is stabilized by the extracellular proteins present in the culture medium. - Graphical abstract: A green chemistry approach towards the synthesis of bismuth (III) sulphide nanostructures at room temperature using a hydrogen sulphide producing microorganism namely, Clostridium acetobutylicum is demonstrated. - Highlights: • Environmentally benign (greener) route towards synthesis of Bi 2 S 3 nanostructures. • Bio-assisted synthesis of Bi 2 S 3 at room temperature using Clostridium acetobutylicum. • Extracellular proteins in H 2 S producing microorganism as stabilizer for Bi 2 S 3 NPs. • Hexagonal platelets of Bi 2 S 3 possessing an orthorhombic crystalline structure

  19. French hospital nurses' opinion about euthanasia and physician-assisted suicide: a national phone survey. (United States)

    Bendiane, M K; Bouhnik, A-D; Galinier, A; Favre, R; Obadia, Y; Peretti-Watel, P


    Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. A phone survey conducted among a random national sample of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.

  20. The Relationship between Home Nursing Coverage, Sleep and Daytime Functioning in Parents of Ventilator-Assisted Children


    Meltzer, Lisa J.; Boroughs, Deborah S.; Downes, John J.


    This descriptive study examined the relationship between home care nursing support, sleep and daytime functioning in familial caregivers of ventilator-assisted children. Thirty-six primary caregivers (27 mothers, seven fathers, one foster mother, and one grandmother) of ventilator-assisted children completed measures of home nursing support, sleep, depression, fatigue, and daytime sleepiness. Daytime nursing coverage was not related to caregiver sleep or daytime functioning, but caregivers wi...

  1. Euthanasia and physician-assisted suicide: knowledge, attitudes and experiences of nurses in Andalusia (Spain). (United States)

    Tamayo-Velázquez, María-Isabel; Simón-Lorda, Pablo; Cruz-Piqueras, Maite


    The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken.

  2. Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy. (United States)

    Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto


    A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

  3. Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003–2011 (United States)

    Lohman, Matthew; Leslie, Marc; Powell, Virginia


    Objectives. We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Methods. Data come from the Virginia Violent Death Reporting System (2003–2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Results. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. Conclusions. LTC may be an important point of engagement in suicide prevention. PMID:25973805

  4. Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011. (United States)

    Mezuk, Briana; Lohman, Matthew; Leslie, Marc; Powell, Virginia


    We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. LTC may be an important point of engagement in suicide prevention.

  5. Assistance algorithm of nursing for amiodarone intravenous infusion

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira


    Full Text Available This study aimed at identifying scientific publication on phlebitis caused by amiodarone and proposes a nursing care algorithm for interventions in intravenous amiodarone administration grounded in the Infusion Nursing Society and the Center for Disease Control and Prevention. It is a descriptive study mediated by integrative review in MedLine, LILACS, IBECS, BDENF, Cochrane Library and Scielo bases, published from 2006 to 2013. The sample consisted of nine articles. The evidence pointed the incidence of phlebitis due to the infusion of amiodarone and the need to control this event. The algorithm proposed shows the materials to be used and the procedure of drug administration in order to minimize injury. Besides subsidizing the development of future studies, this algorithm also promotes the incorporation of the best recommendation for the interventionist clinical practice.

  6. Dental nursing education and the introduction of technology-assisted learning. (United States)

    Sheridan, C; Gorman, T; Claffey, N


    The aim of this paper is to explore the profile of dental nursing students in the National Dental Nurse Training Programme of Ireland and their adjustment to a technology-assisted learning environment. Evaluation by students of the course and their reactions to the course were analysed. Dental nurses must possess the skills and knowledge to proficiently function in the modern day dental surgery. The implementation of a dental nurse programme that is heavily reliant on technology has started to create a group of dental nurses equipped with basic skills to access and retrieve information over a lifetime. However, the transition to a technology-assisted learning environment including online learning activities requires adaptation and expertise by educators and students alike. Careful evaluation and stakeholder feedback is imperative in the creation and maintaining of a quality programme. In conclusion, the students in this study responded well to the transition to a technology-based learning environment. Furthermore, the findings of this study suggest that the use of an online environment is an effective and stimulating learning environment for the students of a dental nurse programme; however, familiarity skills and knowledge of information technology is a prerequisite for success.

  7. [Nurses as a support to improve the quality of life during assisted reproduction]. (United States)

    Castells-Ayuso, Paula; Berenguer-Labaig, Cristina; Sánchez-Martín, Pascual; Sánchez-Martín, Fernando


    The aim of this study was to measure how infertility and assisted reproduction treatments (including artificial insemination) could affect the quality of life, and to evaluate how nurses could be helpful in this process, by alleviating anxiety and increasing the quality of life. A cross-sectional observational study was conducted on 48 patients (26 cycles) in an Assisted Reproduction Unit from 2nd December 2013 to 30th April 2014. Socio-demographic data were obtained, with the quality of life being assessed using the FertiQoL questionnaire before and after the treatment, and the consultations with a nurse by telephone or e-mail of these patients were also analyzed. The study results show a decreased quality of life in these patients, which was worse in men and in couples who had no previous children. Patient-centered care improved quality of life and tolerability to the assisted reproduction treatment. Patients frequently telephoned the nurse to solve their doubts and problems. The present study suggests that nurses can play an important role in improving the quality of life of patients undergoing assisted reproduction treatment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. Essential competencies for the education of nursing assistants and care helpers in elderly care

    NARCIS (Netherlands)

    Oeseburg, Barth; Hilberts, Rudi; Roodbol, Petrie F


    BACKGROUND: The Dutch health care system faces huge challenges with regard to the demand on elderly care and the competencies of professionals required to meet this demand. However, a recent study showed that the curricula in vocational education for nursing assistants and care helpers remains

  9. Physician-Assisted Dying: Are Education and Religious Beliefs Related to Nursing Students' Attitudes? (United States)

    Margalith, Ilana; Musgrave, Catherine F.; Goldschmidt, Lydia


    A survey of 190 Israeli nursing students found that just over half were opposed to legalization of physician-assisted dying. Exposure to theory about euthanasia or clinical oncology experience had a small effect on these attitudes. Religious beliefs and degree of religiosity were significant determinants of these attitudes. (Contains 23…

  10. Perceived barriers to effective job performance among nursing assistants in long-term care. (United States)

    Parmelee, Patricia A; Laszlo, Mary C; Taylor, Jo A


    This research explored perceived barriers to job performance among a national sample of nursing assistants (NAs). Specific objectives were (1) to clarify which of the problems identified by previous research are most troublesome for NAs, (2) to develop a reliable quantitative measure of perceived barriers to job performance, and (3) to test construct validity of the measure vis-à-vis work-related psychological empowerment and job satisfaction. Nursing assistants attending the 2006 national conference of the National Association of Health Care Assistants completed a paper-and-pencil survey including 33 barriers to job performance and standardized measures of empowerment and job satisfaction. The barriers were also rated by a small sample of NAs at a single Georgia nursing home. Factor analysis of barriers items yielded a 30-item Nursing Assistants Barriers Scale (NABS) comprising 6 subscales: Teamwork, Exclusion, Respect, Workload, Work Stress, and New NAs. Lack of teamwork and exclusion from communication processes were rated as most problematic by both samples. The 6 NABS subscales were significantly and independently associated with empowerment and satisfaction; different barriers predicted the 2 constructs. This study is a first step toward quantitative assessment of NAs' perceptions of barriers to doing their jobs. Primary limitations are the select sample and use of a job satisfaction measure that may have artificially inflated correlations with the NABS. Nonetheless, results confirm the validity of the new scale as an operationalization of the barriers construct. The concept of barriers to job performance is a unique construct from work empowerment and satisfaction with one's job. Nursing assistants clearly differentiate various barriers, converging on workload and lack of teamwork as most problematic. Further work is needed to substantiate validity and reliability of the NABS, particularly with respect to NAs' actual job performance, intent to stay on the

  11. Using computer assisted learning for clinical skills education in nursing: integrative review. (United States)

    Bloomfield, Jacqueline G; While, Alison E; Roberts, Julia D


    This paper is a report of an integrative review of research investigating computer assisted learning for clinical skills education in nursing, the ways in which it has been studied and the general findings. Clinical skills are an essential aspect of nursing practice and there is international debate about the most effective ways in which these can be taught. Computer assisted learning has been used as an alternative to conventional teaching methods, and robust research to evaluate its effectiveness is essential. The CINAHL, Medline, BNI, PsycInfo and ERIC electronic databases were searched for the period 1997-2006 for research-based papers published in English. Electronic citation tracking and hand searching of reference lists and relevant journals was also undertaken. Twelve studies met the inclusion criteria. An integrative review was conducted and each paper was explored in relation to: design, aims, sample, outcome measures and findings. Many of the study samples were small and there were weaknesses in designs. There is limited empirical evidence addressing the use of computer assisted learning for clinical skills education in nursing. Computer assisted learning has been used to teach a limited range of clinical skills in a variety of settings. The paucity of evaluative studies indicates the need for more rigorous research to investigate the effect of computer assisted learning for this purpose. Areas that need to be addressed in future studies include: sample size, range of skills, longitudinal follow-up and control of confounding variables.

  12. Intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants in nursing homes. (United States)

    Decker, Frederic H; Harris-Kojetin, Lauren D; Bercovitz, Anita


    We examined predictors of intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants (NAs). The study focused on NAs who worked 30 or more hours per week in a nursing home. Data on 2,146 NAs meeting this criterion came from the 2004 National Nursing Assistant Survey, the first telephone interview survey of NAs nationwide. Regression equations were calculated in which intrinsic satisfaction, overall satisfaction, and intention to leave were dependent variables. NA attributes (e.g., job tenure and education) and extrinsic job factors (e.g., assessment of supervisor behavior, pay satisfaction, and benefits) were exogenous variables. A positive assessment of the supervisor's behavior had the strongest association with intrinsic satisfaction. Pay satisfaction had the second strongest association with intrinsic satisfaction. Predictors with the strongest associations with intention to leave were overall and intrinsic satisfaction. Assessment of the supervisor was not associated directly with intention to leave. Assessments of the supervisor and pay may affect overall satisfaction and intention to leave in part through their direct effects on intrinsic satisfaction. Some facility and NA attributes were related to intrinsic satisfaction but not to overall satisfaction, suggesting that intrinsic satisfaction may be an intervening variable in the impact of these attributes on overall satisfaction. Intrinsic satisfaction and extrinsic job factors amenable to change appear central to NAs' overall satisfaction and intention to leave. A facility may be able to improve extrinsic job factors that improve NAs' job-related affects, including intrinsic satisfaction.

  13. Stage III nasopharyngeal angiofibroma: Improving results with endoscopic-assisted midfacial degloving and modification to the Fisch staging system. (United States)

    Shah, Saurin R; Keshri, Amit; Patadia, Simple; Sahu, Rabi Narayan; Srivastava, Arun Kumar; Behari, Sanjay


    To study outcomes with endoscopic-assisted midfacial degloving for Fisch stage III nasopharyngeal angiofibroma and propose a new staging system. Retrospective study of patients with Fisch stage III juvenile nasopharyngeal angiofibroma (JNA) including preoperative angiography, intraoperative blood loss and residue/recurrence following surgery. Tertiary care superspecialty referral center. Fifteen consecutive patients with Fisch stage III JNA undergoing operations over a period of 18 months. Preoperative angiography details, intraoperative blood loss, residue/recurrence, complications of surgery. Transarterial embolization with particulate agents followed by endoscopic-assisted midfacial degloving provides excellent outcomes with Fisch stage III JNAs. The modified Fisch staging system proposed would allow better preoperative evaluation and comparison of outcomes with different treatment options for stage III JNAs. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients. (United States)

    Wang, Bo; Shen, Guofang; Fang, Bing; Yu, Hongbo; Wu, Yong; Sun, Liangyan


    To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P .05). LP decreased from T0 to T1 (P lower anterior region in patients with Class III malocclusion. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Stayers, Leavers, and Switchers among Certified Nursing Assistants in Nursing Homes: A Longitudinal Investigation of Turnover Intent, Staff Retention, and Turnover (United States)

    Rosen, Jules; Stiehl, Emily M.; Mittal, Vikas; Leana, Carrie R.


    Purpose: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving…

  16. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial

    NARCIS (Netherlands)

    Finnema, E.J.; Dr�es, R.M.; Ettema, T.P.; Ooms, M.E.; Adèr, H.J.; Ribbe, M.W.; van Tilburg, W.


    Objectives: To examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. Design: A multi-site randomized clinical trial with matched groups, and measurements at baseline and after seven months. Setting: Sixteen psychogeriatric wards in

  17. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial

    NARCIS (Netherlands)

    Finnema, E.J.; Dr�es, R.M.; Ettema, T.P.; Ooms, M.E.; Adèr, H.J.; Ribbe, M.W.; Tilburg, van W.


    OBJECTIVES: To examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. DESIGN: A multi-site randomized clinical trial with matched groups, and measurements at baseline and after seven months. SETTING: Sixteen psychogeriatric wards in

  18. A Multidisciplinary Workplace Intervention for Chronic Low Back Pain among Nursing Assistants in Iran. (United States)

    Shojaei, Sarallah; Tavafian, Sedigheh Sadat; Jamshidi, Ahmad Reza; Wagner, Joan


    Interventional research with a 6-month follow-up period. We aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory. WRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP. We included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data. The comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group ( p working in hospitals.

  19. Acceptability of an e-learning program to help nursing assistants manage relationship conflict in nursing homes. (United States)

    Marziali, Elsa; Mackenzie, Corey Scott; Tchernikov, Illia


    Management of nursing assistants' (NAs) emotional stress from relationship conflicts with residents, families, and coworkers is rarely the focus of educational programs. Our objective was to gather feedback from NAs and their nursing supervisors (NSs) about the utility of our e-learning program for managing relationship stress. A total of 147 NAs and their NSs from 17 long-term care homes viewed the educational modules (DVD slides with voice-over), either individually or in small groups, and provided feedback using conference call focus groups. Qualitative analysis of NA feedback showed that workplace relationship conflict stress was associated with workload and the absence of a forum for discussing relationship conflicts that was not acknowledged by NSs. This accessible e-learning program provides NAs with strategies for managing stressful emotions arising from workplace relationship conflict situations and underscores the importance of supervisory support and team collaboration in coping with emotionally evoked workplace stress. © The Author(s) 2014.

  20. Assessment of dementia in nursing home residents by nurses and assistants

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Uhrskov; Foldspang, Anders; Gulmann, Nils Christian


    Objectives To describe the criterion validity of nursing home staff's assessment of organic disorder compared with ICD-10 criteria, and to identify determinants of staff assessment of organic disorder. Method Two hundred and eighty-eight residents were diagnosed using the GMS-AGECAT. Nursing staff...... members were interviewed about the residents' activities of Daily Living, behavioural problems, orientation in surroundings and communication skills, and asked if the resident had an organic disorder. Multiple logistic regression was used to select the items that most strongly determined staff assessment...... as under-labelling of residents, a tendency that will affect communication with medical personnel and may lead to inadequate or wrong medical treatment and to negative performance as well as negative role expectations in everyday life in nursing homes....

  1. Experiences of undergraduate nursing students in peer assisted learning in clinical practice: a qualitative systematic review. (United States)

    Carey, Matthew C; Kent, Bridie; Latour, Jos M


    The objective of this qualitative systematic review was to identify and synthesize the best available evidence on experiences of peer assisted learning (PAL) among student nurses in clinical practice so as to understand the value of PAL for this population. Peer-assisted learning considers the benefits of peers working in collaboration and supporting each other in professional roles. This approach to facilitate learning is effective within universities, but there is limited exploration within the clinical practice environment. Within the UK, 50% of student nurses' learning is undertaken within clinical practice, providing a large portion of student allocation within these areas, but is unexplored in relation to PAL. Therefore, existing evidence examining PAL in clinical practice needs further exploration for a better understanding of its value to student nurses' learning. The systematic review considered studies that included male and female nursing students aged 18-50 years that explored undergraduate nursing students' experiences of PAL within the clinical practice environment. Studies that utilized designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered. Other text such as opinion papers and reports were to be considered if no qualitative studies could be located. The review excluded quantitative studies, as well as those addressing PAL outside the nursing profession and students within the nursing profession but not including undergraduate student nurses. This review considered studies that included aspects related to experiences of PAL in the clinical practice setting, as seen by undergraduate nursing students and the researcher. A three-step search strategy was undertaken to find both published and unpublished studies in English from 2003 to 2017 in various databases, and included searching of reference lists within articles selected for appraisal. Each of the included studies were assessed for

  2. Identifying work ability promoting factors for home care aides and assistant nurses

    Directory of Open Access Journals (Sweden)

    Larsson Agneta


    Full Text Available Abstract Background In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services. Methods This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58 and assistant nurses (n = 79 replied to a self-administered questionnaire (response rate 46%. Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1 and work ability (model 2 for care aides and assistant nurses separately. Results Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p 2adj of 0.29, p = 0.001. Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides, and also by sex and age for the assistant nurses (R2adj of 0.31, p Conclusions The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in

  3. Stress, coping and presenteeism in nurses assisting critical and potentially critical patients

    Directory of Open Access Journals (Sweden)

    Juliane Umann


    Full Text Available Objective to verify the associations between stress, Coping and Presenteeism in nurses operating on direct assistance to critical and potentially critical patients. Method this is a descriptive, cross-sectional and quantitative study, conducted between March and April 2010 with 129 hospital nurses. The Inventory of stress in nurses, Occupational and Coping Questionnaire Range of Limitations at Work were used. For the analysis, the Kolmogorov-Smirnov test, correlation coefficient of Pearson and Spearman, Chi-square and T-test were applied. Results it was observed that 66.7% of the nurses showed low stress, 87.6% use control strategies for coping stress and 4.84% had decrease in productivity. Direct and meaningful relationships between stress and lost productivity were found. Conclusion stress interferes with the daily life of nurses and impacts on productivity. Although the inability to test associations, the control strategy can minimize the stress, which consequently contributes to better productivity of nurses in the care of critical patients and potentially critical.

  4. [Planned home births assisted by nurse midwives: maternal and neonatal transfers]. (United States)

    Koettker, Joyce Green; Brüggemann, Odaléa Maria; Dufloth, Rozany Mucha


    The objective of this explorative and descriptive study was to describe the rates and reasons for intrapartum transfers from home to hospital among women assisted by nurse midwives, and the outcomes of those deliveries. The sample consisted of eleven women giving birth and their newborns, from January 2005 to December 2009. Data was collected from the maternal and neonatal records and was analyzed using descriptive statistics. The transfer rate was 11%, most of the women were nulliparous (63.6%), and all of them were transferred during the first stage of labor. The most common reasons for transfer were arrested cervical dilation, arrested progress of the fetal head and cephalopelvic disproportion. Apgar scores were >7 for 81.8% of the newborns; and there were no admissions to the neonatal intensive care unit. The results show that planned home births assisted by nurse midwives following a clinical protocol, had good outcomes even when a transfer to the hospital was needed.

  5. Transformational leadership and workplace injury and absenteeism: analysis of a National Nursing Assistant Survey. (United States)

    Lee, Doohee; Coustasse, Alberto; Sikula, Andrew


    Transformational leadership (TL) has long been popular among management scholars and health services researchers, but no research studies have empirically tested the association of TL with workplace injuries and absenteeism among nursing assistants (NAs). This cross-sectional study seeks to explore whether TL is associated with workplace injuries and absenteeism among NAs. We analyzed the 2004 National Nursing Assistant Survey data (n = 2,882). A multivariate logistic regression analysis was performed to test the role of TL in the context of workplace performances. Results reveal that the TL model was positively linked to workplace injury in the level of NAs. Injury-related absenteeism was also associated with the TL style, indicating that TL behaviors may help address workplace absence among NAs. Findings suggest that introducing TL practices may benefit NAs in improving workplace performances.

  6. Certified nursing assistants' perspectives of nursing home residents' pain experience: communication patterns, cultural context, and the role of empathy. (United States)

    Dobbs, Debra; Baker, Tamara; Carrion, Iraida V; Vongxaiburana, Elizabeth; Hyer, Kathryn


    This study explored the following issues related to pain management among nursing home (NH) residents: 1) communication patterns between NH residents and certified nursing assistants (CNAs) about pain; 2) how race and ethnicity influence NH residents' pain experiences; and 3) CNAs' personal experiences with pain that may affect their empathy toward the resident's pain experience. The study consisted of a convenience sample of four focus groups (n = 28) from a NH in central Florida. A content analysis approach was used. Data were analyzed with the use of Atlas.ti version 6.2. The content analysis identified four main themes: 1) attitudes as barriers to communication about resident pain care; 2) cultural, religious, and gender influences of resident pain care by CNAs; 3) the role of empathy in CNAs care of residents with pain; and 4) worker strategies to detect pain. Attitudes among CNAs about resident cognitive status and perceived resident burden need to be recognized as barriers to the detection and reporting of pain by CNAs and should be addressed. In addition, NHs should consider a person-centered approach to pain that is culturally competent given the cultural influences of both residents and staff. Finally, educational programs for CNAs that include empathy-inducing scenarios could potentially improve the care provided by CNAs when dealing with residents' pain. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. Early assisted discharge with generic community nursing for chronic obstructive pulmonary disease exacerbations: Results of a randomised controlled trial

    NARCIS (Netherlands)

    C.M.A. Utens (Cecile); L.M.A. Goossens (Lucas); F.W.J.M. Smeenk (Frank); M.P.M.H. Rutten-van Mölken (Maureen); M. van Vliet (Monique); M.W. Braken (Maria); L. van Eijsden (Loes); O.C.P. Schayck (Onno)


    textabstractObjectives: To determine the effectiveness of early assisted discharge for chronic obstructive pulmonary disease (COPD) exacerbations, with home care provided by generic community nurses, compared with usual hospital care. Design: Prospective, randomised controlled and multicentre trial

  8. Dysphonia in nursing home and assisted living residents: prevalence and association with frailty. (United States)

    G Nichols, Brent; Varadarajan, Varun; Bock, Jonathan M; Blumin, Joel H


    Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. Prospective epidemiological survey. Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the voice handicap index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES > 3 = frailty). A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2-12.5. There was a significant relationship between VHI-10 and VES-13 score (P = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases. Copyright © 2015 The Voice Foundation. All rights reserved.

  9. Acetate-assisted Synthesis of Chromium(III) Terephthalate and Its Gas Adsorption Properties

    International Nuclear Information System (INIS)

    Zhou, Jingjing; Liu, Kaiyu; Kong, Chunlong; Chen, Liang


    We report a facile synthetic approach of high-quality chromium(III) terephthalate [MIL-101(Cr)] by acetate-assisted method in the absence of toxic HF. Results indicate that the morphology and surface area of the MIL-101(Cr) can be tuned by modifying the molar ratio of acetate/Cr(NO 3 ) 3 . The Brunauer-Emmett-Teller (BET) surface area of MIL-101(Cr) synthesized at the optimized condition can exceed 3300 m 2 /g. It is confirmed that acetate could promote the dissolution of di-carboxylic linker and accelerate the nucleation ratio. So the pure and small size of MIL-101(Cr) with clean pores can be obtained. CO 2 , CH 4 and N 2 adsorption isotherms of the samples are studied at 298 K and 313 K. Compared with the traditional method, MIL-101(Cr) synthesized by acetate-assisted method possess enhanced CO 2 selective adsorption capacity. At 1.0 bar 298 K, it exhibits 47% enhanced CO 2 adsorption capacity. This may be attributed to the high surface area together with clean pores of MIL-101(Cr)

  10. Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study. (United States)

    Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter


    The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings

  11. Occupational stress among nursing technicians and assistants: coping focused on the problem

    Directory of Open Access Journals (Sweden)

    Carla Araújo Bastos Teixeira


    Full Text Available Objective. To analyze the association between strategies used to cope with occupational stress that are focused on the problem wand the personal characteristics of nursing technicians and assistants. Methodology. This quantitative and correlational study was conducted in a large teaching hospital in the São Paulo State, Brazil, in 2013. A randomized sample with 310 participants (198 nursing assistants and 112 nursing technicians comprised the study population. Data were collected using a sociodemographic characteristics questionnaire and Scale of Ways of Coping with Problems. Data were submitted to univariate analysis, and variables with statistical significance (p<0.20 were submitted posteriorly in a multiple regression model. Results. Most employees were women (76.1% older than 40 years (67.7%, had nine to 11 years of formal education (73.5%, had a partner (58.7%, were Catholic (53.2%, and had children (74.5%. The final multiple regression model consisted of variable years of formal education and number of children. Conclusion. In this study, formal education and number of children were more strongly associated with a greater use of coping strategies focused on the problem. Such a strategy is related to minimal vulnerability to stress related to the working environment.

  12. Developing an e-learning resource for nurse airway assistants in the emergency department. (United States)

    Hersey, Peter; McAleer, Sean


    The aims of this project were to determine the required competencies for a nurse in the emergency department assisting with a rapid sequence induction of anaesthesia (RSI), and to produce a relevant e-learning resource. A three-round multidisciplinary Delphi process produced the following competencies: ability to describe the steps and sequence of events of an RSI, familiarity with the equipment used during an RSI, ability to recognise and help manage problems occurring during an RSI, ability to prepare for an RSI, ability to apply cricoid pressure, and understanding the modification of an RSI in special circumstances. An interactive e-learning package was produced and made available online. Twelve emergency department nurses took part in an evaluation of the e-learning package. All either agreed or strongly agreed that they had increased their knowledge and found the learning useful, and 11 out of 12 nurses reported being somewhat or very confident in the role of airway assistant following completion of the learning.

  13. [The construction of professional images of healthcare assistants and registered nurses]. (United States)

    Robin, Dominik; Schaffert, René


    In the field of nursing in Switzerland, educations have experienced a fundamental reorganization with the implementation of the new law on Vocational and Professional Education and Training (2004). Among other things, this change affects professional images. To show how the different professional images in the field of nursing are being constructed in the descriptions of professions by graduates after the reshaping of the educations and the occupational field in general. In 110 semi-structured interviews, healthcare assistants and registered nurses (college diploma and Bachelor of Science) in their early careers were asked to explain their professional image. The participant's answers were analysed based on a qualitative content analysis and considering the theoretical background of Berger and Luckmann (1977). The interviews show that professional images emerge on the interaction of societal attributes and individual processes of adoption and revision. Graduates are challenged to adjust stereotypes and to achieve a balance between their own professional image and a missing or inappropriately perceived societal image. There should be further emphasis on the differentiation between the professions and the different educations in the field of nursing in order to achieve a better public perception of the different professions.

  14. Nursing assistance for spring coil occlusion for the treatment of intracranial giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Ma Yugang; Mao Yanjun; Yuan Yili; Hu Yaqin; Liu Jing; Xi Juan


    Objective: To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant internal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods: Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results: Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion: The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant internal carotid artery aneurysms with spring coil occlusion. (authors)

  15. Non-physician practitioners in radiation oncology: advanced practice nurses and physician assistants

    International Nuclear Information System (INIS)

    Kelvin, Joanne Frankel; Moore-Higgs, Giselle J.; Maher, Karen E.; Dubey, Ajay K.; Austin-Seymour, Mary M.; Daly, Nancy Riese; Mendenhall, Nancy Price; Kuehn, Eric F.


    Purpose: With changes in reimbursement and a decrease in the number of residents, there is a need to explore new ways of achieving high quality patient care in radiation oncology. One mechanism is the implementation of non-physician practitioner roles, such as the advanced practice nurse (APN) and physician assistant (PA). This paper provides information for radiation oncologists and nurses making decisions about: (1) whether or not APNs or PAs are appropriate for their practice, (2) which type of provider would be most effective, and (3) how best to implement this role. Methods: Review of the literature and personal perspective. Conclusions: Specific issues addressed regarding APN and PA roles in radiation oncology include: definition of roles, regulation, prescriptive authority, reimbursement, considerations in implementation of the role, educational needs, and impact on resident training. A point of emphasis is that the non-physician practitioner is not a replacement or substitute for either a resident or a radiation oncologist. Instead, this role is a complementary one. The non-physician practitioner can assist in the diagnostic work-up of patients, manage symptoms, provide education to patients and families, and assist them in coping. This support facilitates the physician's ability to focus on the technical aspects of prescribing radiotherapy

  16. The Heartmate III: design and in vivo studies of a maglev centrifugal left ventricular assist device. (United States)

    Loree, H M; Bourque, K; Gernes, D B; Richardson, J S; Poirier, V L; Barletta, N; Fleischli, A; Foiera, G; Gempp, T M; Schoeb, R; Litwak, K N; Akimoto, T; Kameneva, M; Watach, M J; Litwak, P


    A compact implantable centrifugal left ventricular assist device (LVAD) (HeartMate III) featuring a magnetically levitated impeller is under development. The goal of our ongoing work is to demonstrate feasibility, low hemolysis, and low thrombogenicity of the titanium pump in chronic bovine in vivo studies. The LVAD is based on so-called bearingless motor technology and combines pump rotor, drive, and magnetic bearing functions in a single unit. The impeller is rotated (theta z) and levitated with both active (X, Y) and passive (Z, theta x, theta y) suspension. Six prototype systems have been built featuring an implantable titanium pump (69 mm diameter, 30 mm height) with textured blood contacting surfaces and extracorporeal electronics. The pumps were implanted in 9 calves (< or = 100 kg at implant) that were anticoagulated with Coumadin (2.5 < or = INR < or = 4.0) throughout the studies. Six studies were electively terminated (at 27-61 days), 1 study was terminated after the development of severe pneumonia and lung atelectasis (at 27 days) another study was terminated after cardiac arrest (at 2 days) while a final study is ongoing (at approximately 100 days). Mean pump flows ranged from 2 to 7 L/min, except for brief periods of exercise at 6 to 9 L/min. Plasma free hemoglobin ranged from 4 to 10 mg/dl. All measured biochemical indicators of end organ function remained within normal range. The pumps have met performance requirements in all 9 implants with acceptable hemolysis and no mechanical failures.

  17. Self-esteem among nursing assistants: reliability and validity of the Rosenberg Self-Esteem Scale. (United States)

    McMullen, Tara; Resnick, Barbara


    To establish the reliability and validity of the Rosenberg Self-Esteem Scale (RSES) when used with nursing assistants (NAs). Testing the RSES used baseline data from a randomized controlled trial testing the Res-Care Intervention. Female NAs were recruited from nursing homes (n = 508). Validity testing for the positive and negative subscales of the RSES was based on confirmatory factor analysis (CFA) using structural equation modeling and Rasch analysis. Estimates of reliability were based on Rasch analysis and the person separation index. Evidence supports the reliability and validity of the RSES in NAs although we recommend minor revisions to the measure for subsequent use. Establishing reliable and valid measures of self-esteem in NAs will facilitate testing of interventions to strengthen workplace self-esteem, job satisfaction, and retention.

  18. A survey on job satisfaction among nursing staff before and after introduction of the NIDCAP model of care in a level III NICU in the Netherlands

    NARCIS (Netherlands)

    Wielenga, Joke M.; Smit, Bert J.; Unk, Karel A.


    PURPOSE: To study the effect of introduction of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on nursing staff job satisfaction. SUBJECTS: Registered nurses, with specialist neonatal qualifications or in training, in a level III neonatal intensive care unit (NICU) in

  19. [Euthanasia and physician-assisted suicide : Attitudes of physicians and nurses]. (United States)

    Zenz, J; Tryba, M; Zenz, M


    The current debate about end-of-life decisions in Germany focuses on physician-assisted suicide (PAS). However, there is only limited information available on physicians' attitudes towards euthanasia or PAS, and no data on nurses' attitudes. The aim is to explore attitudes of physicians and nurses with a special interest in palliative care and pain medicine using a case-related questionnaire. An anonymous questionnaire, consisting of eight questions, was distributed to all participants of a palliative care congress and a pain symposium. The questions focused on two scenarios: (1) a patient with an incurable fatal illness, (2) a patient with an incurable but nonfatal illness. The question was: Should euthanasia or physician-assisted suicide (PAS) be allowed. In addition, the participants were asked what they wanted for themselves if they were the patient concerned. A total of 317 questionnaires were analyzed; the return rate was 70 %. The general support for euthanasia and PAS was high: 40.5 % supported euthanasia in case of a fatal illness ("definitely…", "probably should be allowed"), 53.5 % supported PAS. The support decreased in case of a nonfatal illness; however, it increased when the participants were asked about their attitudes if they were the patient concerned. Nurses were more open towards euthanasia and PAS. In physicians the rejection of PAS was directly related to a higher level of qualification in the field of palliative care. The fact that nurses had a more positive attitude towards euthanasia and PAS and that all respondents accepted life-ending acts for themselves more than for their patients hints to still existing severe deficits in Germany.

  20. Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study. (United States)

    Ramjan, Lucie M; Stewart, Lyn; Salamonson, Yenna; Morris, Maureen M; Armstrong, Lyn; Sanchez, Paula; Flannery, Liz


    It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2

  1. [Health, environment and nursing. Philosophical and theoretical foundations for the development and validation of a nursing interface terminology. Part III]. (United States)

    Juvé-Udina, Maria-Eulàlia


    This manuscript is the third of a triad of papers introducing the philosophical and theoretical approaches that support the development and validation of a nursing interface terminology as a standard vocabulary designed to ease data entry into electronic health records, to produce information and to generate knowledge. To analyze the philosophical and theoretical approaches considered in the development of a new nursing interface terminology called ATIC. Review, analysis and discussion of the main philosophical orientations, high and mid-range theories and nursing scientific literature to develop an interpretative conceptualization of the metaparadigm concepts "Health", "Environment" and "Nursing". In the 2 previous papers the ATIC terminology, its foundation on pragmatism, holism, post-positivism and constructivism and the construction of the meaning for the concept elndividualh is discussed. In this third paper, Health is conceptualized as a multidimensional balance state and the concepts of Partial health status, Disease and Being ill are explored within. The analysis of the Environment theories drives its conceptualization as a group of variables that has the potential to affect health status. In this orientation, Nursing is understood as the scientific discipline focused on the study of health status in the particular environment and experience of the individuals, groups, communities or societies. ATIC terminology is rooted on an eclectic philosophical and theoretical foundation, allowing it to be used from different trends within the totality paradigm.

  2. Euthanasia and physician-assisted suicide in cases of terminal cancer: the opinions of physicians and nurses in Greece. (United States)

    Parpa, Efi; Mystakidou, Kyriaki; Tsilika, Eleni; Sakkas, Pavlos; Patiraki, Elisabeth; Pistevou-Gombaki, Kyriaki; Govina, Ourania; Vlahos, Lambros


    The aim of this study was to investigate the opinions of physicians and nurses on euthanasia and physician-assisted suicide in advanced cancer patients in Greece. Two hundred and fifteen physicians and 250 nurses from various hospitals in Greece completed a questionnaire concerning issues on euthanasia and physician-assisted suicide. More physicians (43.3%) than nurses (3.2%, p < 0.0005) reported that in the case of a cardiac or respiratory arrest, they would not attempt to revive a terminally ill cancer patient. Only 1.9% of physicians and 3.6% of nurses agreed on physician-assisted suicide. Forty-seven per cent of physicians and 45.2% of nurses would prefer the legalization of a terminally ill patient's hastened death; in the case of such a request, 64.2% of physicians and 55.2% of nurses (p = 0.06) would consider it if it was legal. The majority of the participants tended to disagree with euthanasia or physician-assisted suicide in terminally ill cancer patients, probably due to the fact that these acts in Greece are illegal.

  3. Growth and characterization of III-N ternary thin films by plasma assisted atomic layer epitaxy at low temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Nepal, Neeraj; Anderson, Virginia R.; Hite, Jennifer K.; Eddy, Charles R.


    We report the growth and characterization of III-nitride ternary thin films (Al{sub x}Ga{sub 1−x}N, In{sub x}Al{sub 1−x}N and In{sub x}Ga{sub 1−x}N) at ≤ 500 °C by plasma assisted atomic layer epitaxy (PA-ALE) over a wide stoichiometric range including the range where phase separation has been an issue for films grown by molecular beam epitaxy and metal organic chemical vapor deposition. The composition of these ternaries was intentionally varied through alterations in the cycle ratios of the III-nitride binary layers (AlN, GaN, and InN). By this digital alloy growth method, we are able to grow III-nitride ternaries by PA-ALE over nearly the entire stoichiometry range including in the spinodal decomposition region (x = 15–85%). These early efforts suggest great promise of PA-ALE at low temperatures for addressing miscibility gap challenges encountered with conventional growth methods and realizing high performance optoelectronic and electronic devices involving ternary/binary heterojunctions, which are not currently possible. - Highlights: • III-N ternaries grown at ≤ 500 °C by plasma assisted atomic layer epitaxy • Growth of InGaN and AlInN in the spinodal decomposition region (15–85%) • Epitaxial, smooth and uniform III-N film growth at low temperatures.

  4. Growth and characterization of III-N ternary thin films by plasma assisted atomic layer epitaxy at low temperatures

    International Nuclear Information System (INIS)

    Nepal, Neeraj; Anderson, Virginia R.; Hite, Jennifer K.; Eddy, Charles R.


    We report the growth and characterization of III-nitride ternary thin films (Al x Ga 1−x N, In x Al 1−x N and In x Ga 1−x N) at ≤ 500 °C by plasma assisted atomic layer epitaxy (PA-ALE) over a wide stoichiometric range including the range where phase separation has been an issue for films grown by molecular beam epitaxy and metal organic chemical vapor deposition. The composition of these ternaries was intentionally varied through alterations in the cycle ratios of the III-nitride binary layers (AlN, GaN, and InN). By this digital alloy growth method, we are able to grow III-nitride ternaries by PA-ALE over nearly the entire stoichiometry range including in the spinodal decomposition region (x = 15–85%). These early efforts suggest great promise of PA-ALE at low temperatures for addressing miscibility gap challenges encountered with conventional growth methods and realizing high performance optoelectronic and electronic devices involving ternary/binary heterojunctions, which are not currently possible. - Highlights: • III-N ternaries grown at ≤ 500 °C by plasma assisted atomic layer epitaxy • Growth of InGaN and AlInN in the spinodal decomposition region (15–85%) • Epitaxial, smooth and uniform III-N film growth at low temperatures

  5. Burnout syndrome in nursing assistants of a public hospital in the state of São Paulo. (United States)

    Ferreira, Naiza do Nascimento; de Lucca, Sergio Roberto


    The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

  6. An exploration of how positive emotions are expressed by older people and nurse assistants in homecare visits. (United States)

    Heyn, Lena; Ellington, Lee; Eide, Hilde


    We don´t know how positive emotions are being expressed by patients and health care providers in consultations. The aim of this study is to identify positive emotions expressed by older people and nurse assistants to discuss the function of these in the visits. This paper presents secondary analysis of consultations in the COMHOME project. In this pilot study, six transcribed consultations between nurse assistants and older people in home health care were analysed using a coding system for positive emotions with seven categories capturing both content and emotional intensity of positive affect. We found 114 expressions of positive emotions, 63% from nurse assistants and 37% from patients. Patients mostly expressed gratitude, indicating that patients are grateful for being helped. Nurse assistants mostly expressed Praise or Support, indicating that they gave their patients positive affirmation. The praise and support given by nurse assistants to older people in home health care seemed effective in fostering relationships and maintaining patient resilience. Thus, we claim that emotional talk in communication also should include positive emotions. Teaching health care providers about the importance of expressions of positive emotions should be integrated in communication skills training. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. The use of computer assisted technology to enhance student psychiatric nurses learning during a practice placement. (United States)

    Denny, Margaret; Higgins, Agnes


    Despite the available literature that identifies the value of integrating computer-assisted learning into the curriculum, psychiatric nurse education lags behind in this area of curriculum development. The purpose of this paper is to report on a pilot project involving the use of a computer assisted learning (CAL) interactive multimedia (IMM) package called 'Admissions,' as a self-directed learning tool with two-second year psychiatric nursing students. The students were on a practice placement in an Irish mental health service. The aim of using the multimedia resource was to augment the students' learning during their practice placement and enable them to re-examine the issue of psychosis from a multiplicity of perspectives. This paper provides a brief description of the interactive multimedia package, together with a discussion on the support offered to the students during its use. experiential taxonomy is used as a framework to guide the discussion on the learning and evaluation process used. Feedback from the students suggests that the CAL package is easy to use, informative and promoted independence and self-directed study.

  8. Nursing Delegation to Unlicensed Assistive Personnel in the School Setting. Position Statement. Revised (United States)

    Cagginello, Joan; Blackborow, Mary; Porter, Jessica; Disney, Jody; Andresen, Kathleen; Tuck, Christine


    It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the registered professional school nurse (hereinafter referred to as school nurse), when based on the nursing definition of delegation (American Nurses Association [ANA], 2012) and in…

  9. Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home. (United States)

    Unroe, Kathleen T; Bernard, Brittany; Stump, Timothy E; Tu, Wanzhu; Callahan, Christopher M


    To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Associations between state regulations, training length, perceived quality and job satisfaction among certified nursing assistants: cross-sectional secondary data analysis. (United States)

    Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook


    In the U.S., there are federal requirements on how much training and annual continuing education a certified nursing assistant must complete in order to be certified. The requirements are designed to enable them to provide competent and quality care to nursing home residents. Many states also require additional training and continuing education hours as improved nursing home quality indicators have been found to be related to increased training. This study investigated the associations among state level regulations, initial training quality and focus, and job satisfaction in certified nursing assistants. Cross-sectional secondary data analysis. This study used the National Nursing Home Survey and National Nursing Assistant Survey as well as data on state regulations of certified nursing assistant training. 2897 certified nursing assistants in 580 nursing homes who were currently working at a nursing home facility, who represented 680,846 certified nursing assistants in US. State regulations were related to initial training and job satisfaction among certified nursing assistants using chi square tests and binomial logistic regression models. Analyses were conducted using SAS-callable SUDAAN to correct for complex sampling design effects in the National Nursing Home Survey and National Nursing Assistant Survey. Models were adjusted for personal and facility characteristics. Certified nursing assistants reporting high quality training were more likely to work in states requiring additional initial training hours (p=0.02) and were more satisfied with their jobs (OR=1.51, 95% CI=1.09-2.09) than those with low quality training. In addition, those with more training focused on work life skills were 91% more satisfied (OR=1.91, 95% CI=1.41-2.58) whereas no relationship was found between training focused on basic care skills and job satisfaction (OR=1.36, 95% CI=0.99-1.84). Certified nursing assistants with additional initial training were more likely to report that their

  11. A fluorescent biosensing platform based on the polydopamine nanospheres intergrating with Exonuclease III-assisted target recycling amplification. (United States)

    Qiang, Weibing; Wang, Xi; Li, Wei; Chen, Xiang; Li, Hui; Xu, Danke


    Rapid, cost-effective, sensitive and specific analysis of biomolecules is important in the modern healthcare system. Here, a fluorescent biosensing platform based on the polydopamine nanospheres (PDANS) intergrating with Exonuclease III (Exo III) was developed. Due to the interaction between the ssDNA and the PDANS, the fluorescence of 6-carboxyfluorescein (FAM) labelled in the probe would been quenched by PDANS through FRET. While, in the present of the target DNA, the probe DNA would hybridize with the target DNA to form the double-strand DNA complex. Thus, Exo III could catalyze the stepwise removal of mononucleotides from 3'-terminus in the probe DNA, releasing the target DNA. As the FAM was released from the probe DNA, the fluorescence would no longer been quenched, led to the signal on. As one target DNA molecule could undergo a number of cycles to trigger the degradation of abundant probe DNA, Exo III-assisted target recycling would led to the amplification of the signal. The detection limit for DNA was 5 pM, which was 20 times lower than that without Exo III. And the assay time was largely shortened due to the faster signal recovery kinetics. What is more, this target recycling strategy was also applied to conduct an aptamer-based biosensing platform. The fluorescence intensity was also enhanced for the assay of adenosine triphosphate (ATP). For the Exo III-assisted target recycling amplification, DNA and ATP were fast detected with high sensitivity and selectivity. This work provides opportunities to develop simple, rapid, economical, and sensitive biosensing platforms for biomedical diagnostics. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial. (United States)

    Fahlström, Gunilla; Kamwendo, Kitty; Forsberg, Jenny; Bodin, Lennart


    Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention. © 2017

  13. Conflict resolution styles: a comparison of assisted living and nursing home facilities. (United States)

    Small, Jeff A; Montoro-Rodriguez, Julian


    In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.

  14. Sickness absence in student nursing assistants following a preventive intervention programme

    DEFF Research Database (Denmark)

    Svensson, A L; Marott, J L; Suadicani, P


    reduced SF-36 scores for general health perception [general health (GH)], psychological well-being [mental health (MH)] and energy/fatigue [vitality (VT)] compared with the intervention group, which remained at the baseline level for all three measures. AIMS: To ascertain whether this effect remained......BACKGROUND: We have previously shown that a multidimensional programme combining physical training, patient transfer techniques and stress management significantly reduced sickness absence rates in student nurse assistants (NAs) after 14 months of follow-up. At follow-up, the control group had...... after a further 36 months of follow-up and to analyse the association of GH, MH and VT scores with sickness absence. METHODS: This was a cluster randomized prospective study. The original study involved assessment at baseline and follow-up at 14 months (the duration of the student NA course). Of 568...

  15. Biofeedback-assisted relaxation training to decrease test anxiety in nursing students. (United States)

    Prato, Catherine A; Yucha, Carolyn B


    Nursing students experiencing debilitating test anxiety may be unable to demonstrate their knowledge and have potential for poor academic performance. A biofeedback-assisted relaxation training program was created to reduce test anxiety. Anxiety was measured using Spielberger's Test Anxiety Inventory and monitoring peripheral skin temperature, pulse, and respiration rates during the training. Participants were introduced to diaphragmatic breathing, progressive muscle relaxation, and autogenic training. Statistically significant changes occurred in respiratory rates and skin temperatures during the diaphragmatic breathing session; respiratory rates and peripheral skin temperatures during progressive muscle relaxation session; respiratory and pulse rates, and peripheral skin temperatures during the autogenic sessions. No statistically significant difference was noted between the first and second TAI. Subjective test anxiety scores of the students did not decrease by the end of training. Autogenic training session was most effective in showing a statistically significant change in decreased respiratory and pulse rates and increased peripheral skin temperature.

  16. Animal assisted therapy and perception of loneliness in geriatric nursing home residents. (United States)

    Vrbanac, Zoran; Zecević, Iva; Ljubić, Marijana; Belić, Maja; Stanin, Damir; Bottegaro, Nika Brkljaca; Jurkić, Gabrijela; Skrlin, Branimir; Bedrica, Ljiljana; Zubcić, Damir


    Use of animals for therapeutic purposes, animal assisted therapy or AAT is a method for improving quality of life for long-term inpatients. The object of this paper was to evaluate dog companionship as a form of AAT and its effects on perception of loneliness in geriatric nursing home residents. The participants were involved in a six-month program of dog companionship three times weekly for 90 minutes. There were 21 residents included in the program, with a mean age of 80 years. Loneliness was measured by the short version of the UCLA Scale of loneliness. Comparison of test results before and after participation in the program showed that dog companionship reduces the perception of loneliness.

  17. The experience of clinical supervision for nurses and healthcare assistants in a secure adolescent service: Affecting service improvement. (United States)

    McCarron, R H; Eade, J; Delmage, E


    WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses. Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In

  18. Fe(III)-loaded collagen fiber as a heterogeneous catalyst for the photo-assisted decomposition of Malachite Green

    International Nuclear Information System (INIS)

    Liu Xiaohu; Tang Rui; He Qiang; Liao Xuepin; Shi Bi


    A heterogeneous catalyst for Fenton reaction was prepared by immobilizing Fe(III) onto collagen fiber and its catalytic activity for the photo-assisted decomposition of Malachite Green (MG) was investigated. The results indicated that this Fe(III)-immobilized collagen fiber (Fe-CF) can effectively catalyse the decoloration and decomposition/mineralization of MG in aqueous solution. Catalysed by Fe-CF, MG solution was completely decolorized in 30 min, while 55.0% of TOC was removed from the dye solution within 120 min in the presence of H 2 O 2 and UVA irradiation (365 nm, 10 W). Fe-CF was recycled for seven times with certain activity loss (32.6% in decoloration, 18.5% in TOC removal), and its catalytic activity can be easily recovered by re-immobilization of Fe(III). Therefore, Fe-CF could act as an efficient and cost-effective catalyst for the photo-assisted decomposition of MG, and shows potential applications in practice.

  19. [Nursing professionals and health care assistants' perception of patient safety culture in the operating room]. (United States)

    Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto


    To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  20. Managing nursing assistants with a web-based system: an empirical investigation of the mixed-staff strategy. (United States)

    Lin, I-Chun; Hou, Ying-Hui; Huang, Hui-Ling; Chu, Tsui-Ping; Chang, Ray-E


    Under the global shortage of Registered Nurses (RNs), some hospitals have integrated nursing assistants (NAs) into their teams to help to provide maximum quality care for acute patients, while keeping the hospital's staff-related costs down. However, the RNs may have to shoulder an increased burden of assigning and overseeing NAs. A web-based Nursing Assistants Management System (NAMS) was developed and evaluated for a case hospital in Taiwan to compare the processes of assigning and managing NAs before and after the NAMS intervention. The results showed that NAMS saved 80% of the time needed for manual operation and there were no more complains about NAs being slow in dealing with patients after the system intervention. The satisfaction levels of all NA managers and RNs were acceptable. Based on the research findings, the implication and limitations of this study were discussed.

  1. Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges. (United States)

    Massey, Meredith; Roter, Debra L


    Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Racial and ethnic disparities in work-related injuries and socio-economic resources among nursing assistants employed in US nursing homes. (United States)

    Tak, SangWoo; Alterman, Toni; Baron, Sherry; Calvert, Geoffrey M


    We aimed to estimate the proportion of nursing assistants (NAs) in the US with work-related injuries and insufficient socio-economic resources by race/ethnicity. Data from the 2004 National Nursing Assistant Survey (NNAS), a nationally representative sample survey of NAs employed in United States nursing homes, were analyzed accounting for the complex survey design. Among 2,880 participants, 44% reported "scratch, open wounds, or cuts" followed by "back injuries" (17%), "black eyes or other types of bruising" (16%), and "human bites" (12%). When compared to non-Hispanic white NAs, the adjusted rate ratio (RR) for wound/cut was 0.74 for non-Hispanic black NAs (95% confidence interval [CI]: 0.65-0.85). RRs for black eyes/bruises were 0.18 for non-Hispanic black NAs (95% CI: 0.12-0.26), and 0.55 for Hispanic NAs (95% CI: 0.37-0.82). Minority racial and ethnic groups were less likely to report having experienced injuries compared with non-Hispanic white NAs. Future research should focus on identifying preventable risk factors, such as differences by race and ethnicity in the nature of NA jobs and the extent of their engagement in assisting patients with activities of daily living. © 2010 Wiley-Liss, Inc.

  3. Perceived facilitators and inhibitors for the use of personal digital assistants (PDAs) by nurses: a systematic review. (United States)

    Moloney, Clint; Becarria, Lisa

    It is clear from the literature that more investigation into the infusion of this technology within nursing is required with a particular emphasis on the advantages of documenting best practices in nursing education. Current literature highlights the importance of incorporating wireless devices in nursing organisations without discussing how effectively nurses can collect data. Good information is found on the factors of adoption and barriers associated with such devices in nursing however the evidence supplied in such findings is yet to be well substantiated. Therefore, this study conducted an investigation into the factors of adoption of wireless applications for data collection. By doing so, this review has attempted to fill-in the gap in the literature and provides insights into those factors that need to be given priority when implementing handheld technologies in nursing. The overarching aim of this systematic review was therefore to explore and confirm the facilitators and inhibitors to the adoption of handheld technology in nursing. The objective of this review was to summarise the available evidence on the facilitators and inhibitors of adopting and utilising handheld wireless technology into the nursing profession. In particular this review set out to understand the supportive interventions that assist nurses to adjust to the use of such technology. Types of participants - This review was only interested in the nursing profession and was not limited to any one culture or setting. Therefore the review included nurses both Australian and overseas who were working in acute settings, community settings, and student nurses still in an academic setting.Types of intervention(s)/phenomena of interest - The review only considered studies that were endeavouring to understand the behavioural intention and user acceptance of handheld wireless technology (PDA's) in a nursing setting.Types of studies - This review considered studies that focus on qualitative data

  4. An ultrahigh vacuum, low-energy ion-assisted deposition system for III-V semiconductor film growth (United States)

    Rohde, S.; Barnett, S. A.; Choi, C.-H.


    A novel ion-assisted deposition system is described in which the substrate and growing film can be bombarded with high current densities (greater than 1 mA/sq cm) of very low energy (10-200 eV) ions. The system design philosophy is similar to that used in III-V semiconductor molecular-beam epitaxy systems: the chamber is an all-metal ultrahigh vacuum system with liquid-nitrogen-cooled shrouds, Knudsen-cell evaporation sources, a sample insertion load-lock, and a 30-kV reflection high-energy electron diffraction system. III-V semiconductor film growth is achieved using evaporated group-V fluxes and group-III elemental fluxes sputtered from high-purity targets using ions extracted from a triode glow discharge. Using an In target and an As effusion cell, InAs deposition rates R of 2 microns/h have been obtained. Epitaxial growth of InAs was observed on both GaSb(100) and Si(100) substrates.

  5. The influence of a change in medicare reimbursement on the effectiveness of stage III or greater decubitus ulcer home health nursing care. (United States)

    Eaton, Melody K


    This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.

  6. An ethical perspective on euthanasia and assisted suicide in The Netherlands from a nursing point of view. (United States)

    van der Arend, A J


    In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia or assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the 'slippery slope'.

  7. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review (United States)

    Walton, AnnMarie Lee; Rogers, Bonnie


    Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation. PMID:28534859

  8. Meaning making in long-term care: what do certified nursing assistants think? (United States)

    Gray, Michelle; Shadden, Barbara; Henry, Jean; Di Brezzo, Ro; Ferguson, Alishia; Fort, Inza


    Certified nursing assistants (CNAs) provide up to 80% of the direct care to older adults in long-term care facilities. CNAs are perceived as being at the bottom of the hierarchy among healthcare professionals often negatively affecting their job satisfaction. However, many CNAs persevere in providing quality care and even reporting high levels of job satisfaction. The aim of the present investigation was to identify primary themes that may help CNAs make meaning of their chosen career; thus potentially partially explaining increases in job satisfaction among this group. Focus groups were conducted with CNAs at three long-term care facilities. Four themes emerged from the data: CNA work is good or special; CNA as relationship builder; CNA as expert; CNA as team member. These themes reflect the perceptions that these CNAs held in regard to themselves and their relationships to others in the work environment and, when present, can contribute to intrinsic job satisfaction. Our meaning-making themes support the premise that CNAs do not passively accept the evaluations of others but instead actively frame identities that validate their importance to residents and the institution. © 2016 John Wiley & Sons Ltd.

  9. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review. (United States)

    Walton, AnnMarie Lee; Rogers, Bonnie


    Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.

  10. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review

    Directory of Open Access Journals (Sweden)

    AnnMarie Lee Walton


    Full Text Available Nursing assistants (NAs make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious, or exposure to hazardous drugs (chemical, literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed. More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.

  11. Effect of Integrating Computer-Assisted Language Learning in the TOEFL Performance of Nursing Students

    Directory of Open Access Journals (Sweden)

    Marlene R. Castillo


    Full Text Available The study aimed to determine the relationship between the use of a computer-assisted language learning (CALL software and the TOEFL performance of nursing students. This descriptive study used a pre-test and post-test and a survey questionnaire to gather data. Interviews and observations were also conducted to gain further insights in the use of the software. Results indicate that for the three areas of the TOEFL model practice test, there is a statistically significant increase in the gain scores of the students in the post-test after being exposed to the use of the software for two semesters. They performed well in Sentence Completion and Error Identification, both under Structure and Written Expression. On the other hand, they performed only fairly for Reading Comprehension and Vocabulary. For Structure and Written Expression, the areas of strength included correct choice of main verbs, subject pronouns, and comparative use of adjective while the areas of weaknesses include correlative conjunctions, adverb-related structures, and indefinite subject and verb agreement.

  12. The LEONARDO-DA-VINCI pilot project "e-learning-assistant" - Situation-based learning in nursing education. (United States)

    Pfefferle, Petra Ina; Van den Stock, Etienne; Nauerth, Annette


    E-learning will play an important role in the training portfolio of students in higher and vocational education. Within the LEONARDO-DA-VINCI action programme transnational pilot projects were funded by the European Union, which aimed to improve the usage and quality of e-learning tools in education and professional training. The overall aim of the LEONARDO-DA-VINCI pilot project "e-learning-assistant" was to create new didactical and technical e-learning tools for Europe-wide use in nursing education. Based on a new situation-oriented learning approach, nursing teachers enrolled in the project were instructed to adapt, develop and implement e- and blended learning units. According to the training contents nursing modules were developed by teachers from partner institutions, implemented in the project centers and evaluated by students. The user-package "e-learning-assistant" as a product of the project includes two teacher training units, the authoring tool "synapse" to create situation-based e-learning units, a student's learning platform containing blended learning modules in nursing and an open sourced web-based communication centre. Copyright 2009 Elsevier Ltd. All rights reserved.

  13. Are Nutrition and Food Security Concerns a Priority of Certified Nursing Assistants in Work and Family Environments?


    Holsinger, Amanda Joy Toscano


    Certified Nursing Assistants (CNAs) are responsible for the care of Americaâ s aging population. CNAs are paid a miniscule amount of money and are often ineligible for medical benefits through their employers. CNAs bathe, change, feed, and help toilet the residents of long-term care facilities. The stressful work and personal lives of CNAs leads to many problems such as high turnover rates, absenteeism, health problems, and elder abuse. In the United States, food insecurity is a concern ...

  14. Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making. (United States)

    Kageyama, Yoko; Asano, Midori


    The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

  15. Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study. (United States)

    Traynor, Michael; Nissen, Nina; Lincoln, Carol; Buus, Niels


    In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic. (United States)

    Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S


    Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

  17. Supporting Regional Aged Care Nursing Staff to Manage Residents' Behavioural and Psychological Symptoms of Dementia, in Real Time, Using the Nurses' Behavioural Assistant (NBA): A Pilot Site 'End-User Attitudes' Trial. (United States)

    Klein, Britt; Clinnick, Lisa; Chesler, Jessica; Stranieri, Andrew; Bignold, Adam; Dazeley, Richard; McLaren, Suzanne; Lauder, Sue; Balasubramanian, Venki


    This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.

  18. Effect of nursing care hours on the outcomes of Intensive Care assistance.

    Directory of Open Access Journals (Sweden)

    Tatiana do Altíssimo Nogueira

    Full Text Available To correlate the average number of nursing care hours dedicated to Intensive Care Unit (ICU patients with nursing care indicators.Transverse, descriptive study conducted between 2011 and 2013. Data were obtained from the electronic records system and from the nursing staff daily schedule. Generalized Linear Models were used for analysis.A total of 1,717 patients were included in the study. The average NAS (Nursing Activities Score value was 54.87. The average ratio between the number of nursing care hours provided to the patient and the number of nursing care hours required by the patient (hours ratio was 0.87. Analysis of the correlation between nursing care indicators and the hours ratio showed that the indicators phlebitis and ventilator-associated pneumonia significantly correlated with hours ratio; that is, the higher the hours ratio, the lower the incidence of phlebitis and ventilator-associated pneumonia.The number of nursing care hours directly impacts patient outcomes, which makes adjustment of nurse staffing levels essential.

  19. Aptamer based fluorescent cocaine assay based on the use of graphene oxide and exonuclease III-assisted signal amplification

    International Nuclear Information System (INIS)

    Zhang, Yulin; Zhang, Guo-Jun; Sun, Zhongyue; Tang, Lina; Zhang, Hong


    The article reports an aptamer based assay for cocaine by employing graphene oxide and exonuclease III-assisted signal amplification. It is based on the following scheme and experimental steps: (1) Exo III can digest dsDNA with blunt or recessed 3-terminus, but it has limited activity to ssDNA or dsDNA with protruding 3-terminus; (2) GO can absorb the FAM-labeled ssDNA probe and quench the fluorescence of probe, while the affinity between FAM-labeled mononucleotide and GO is negligible; (3) Cocaine aptamer can be split into two flexible ssDNA pieces (Probe 1 and Probe 2) without significant perturbation of cocaine-binding abilities; (4) The triple complex consisting of Probe 1, Probe 2 and cocaine can be digested by Exo III with the similar efficiency as normal dsDNA. Cocaine aptamer is split into two flexible ssDNA pieces (Probe 2 and 3′-FAM-labeled Probe 1). Cocaine can mediate the cocaine aptamer fragments forming a triplex. The triple complex has unique characteristic with 3′-FAM-labeled blunt end at the Probe 1 and 3′-overhang end at Probe 2. If exonuclease III is added, it will catalyze the stepwise removal of fluorescein (FAM) labeled mononucleotides from the 3-hydroxy termini of the special triplex complex, resulting in liberation of cocaine. The cocaine released in this step can produce a new cleavage cycle, thereby leading to target recycling. Through such a cyclic bound-hydrolysis process, small amounts of cocaine can induce the cleavage of a large number of FAM-labeled probe 1. The cleaved FAM-labeled mononucleotides are not adsorbed on the surface of graphene oxide (GO), so a strong fluorescence signal enhancement is observed as the cocaine triggers enzymatic digestion. Under optimized conditions, the assay allows cocaine to be detected in the 1 to 500 nM concentration range with a detection limit of 0.1 nM. The method was applied to the determination of cocaine in spiked human plasma, with recoveries ranging from 92.0 to 111.8 % and RSD of <12

  20. Formation of silicon Oxide nano thickness on Si (III) with the assistance of Cs

    International Nuclear Information System (INIS)

    Bahari, A.; Bagheri, M.


    : The possibility of controlling the growth of a uniform ultra thin oxide on silicon via oxygen dosing at low temperatures, would be a great interest for the projected further development of nano electronics. One way to achieve this is to be able to control the conversion of chemically adsorbed oxygen and retained at room temperature into oxide during subsequent heating. Oxygen is chemisorbed at room temperature on Si(111) surface to saturation ( >100 L O 2 ), and the experimental chamber is then evacuated. This leaves adsorbed oxygen as atomically inserted on Si surface which sits on the back bonds. This surface is then used as a base for further processing which in one case consists of annealing to 600- 700 d eg C and subsequent exposures equivalent to the first step. This is repeated again. As the focus of this work, a series of experiments are done with adsorbed Cs, which assists in retaining oxygen and in transforming the adsorbed oxygen into oxide upon heating. It was found that the oxide formed on the surface at low coverage clusters. Without any external influence, the clusters may be made to coalesce upon further oxygen adsorption at room temperature, and annealing terminates as a continuous monolayer of amorphous oxide on top of a well-ordered silicon substrate. This configuration is inert to further uptake of oxygen. A higher oxide thickness could be obtained with Cs. Also in this case, the oxide growth saturates in an inert oxide Iayer

  1. Cardiomiopatia Hipertrófica: atualização e assistência de enfermagem Cardiomiopatía Hipertrófica: actualización y atención de enfermería Hypertrophic Cardiomyophaty: update and nursing assistance

    Directory of Open Access Journals (Sweden)

    Samanta Mariano


    Full Text Available Trata-se de uma atualização cujo objetivo foi descrever aspectos da fisiopatologia da Cardiomiopatia Hipertrófica (CMH e suas terapêuticas, relacionando-as com a assistência de enfermagem. A fonte de dados considerou a Base de Dados LILACS, usando-se como expressão de pesquisa os unitermos "miocardiopatia hipertrófica" e "cuidados de enfermagem". A CMH é uma doença que surge a partir de alteração cromossômica causando hipertrofia do ventrículo esquerdo, tendo progressão rápida e podendo ocasionar insuficiência cardíaca classe funcional III e IV. O tratamento consiste do uso de medicações paliativas ou outros procedimentos como o implante de Marca-Passo, ventriculoplastia e transplante cardíaco. A assistência de enfermagem baseada em Diagnósticos e Intervenções de Enfermagem são apresentadas.Tratase de una actualización que objetivó describir algunos aspectos fisiopatológicos sobre la Cardiomioplatía Hipertófica y corelacionar con la atención de enfermería. La basis para la recogida de datos fue la basis de datos bibliograficos LILACS usandose la expresión de busqueda "Cardiomiopatía Hipertrófica" y "atención de enfermería". La CMH es una enfermedad que empeza con alteraciones cromosómicas teniendo rápida progresión y podiendo causar insuficiencia cardiaca clase funcional III o IV. El tratamiento consiste del uso de medicaciones paliativas o otros procedimientos como el implante de Marca-Paso, ventriculoplastia y transplante cardiaco. La atención de enfermería basada en Diagnósticos y Intervenciones de Enfermería son presentadas.This is an update that aimed to describe some aspects of physiopathology of Hypertrophic Cardiomyopathy (HCM and its therapeutics correlating them to nursing assistance. Data source was based on LILACS bibliographical database using the search expression "hypertrophic cardiomiopathy" and "nursing care". The HCM is a disease that appears from cromossomic alterations that causes

  2. Stayers, Leavers, and Switchers Among Certified Nursing Assistants in Nursing Homes: A Longitudinal Investigation of Turnover Intent, Staff Retention, and Turnover (United States)

    Rosen, Jules


    Purpose: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving and satisfaction following job transition. Design and Methods: A random sample of CNAs identified through the Pennsylvania Department of Health's CNA registry, working≥30 hr weekly in a nursing facility was surveyed by telephone at baseline and 1 year later. Results: Of the 620 responding to both surveys, 532 (85.8%) remained (stayers), 52 (8.4%) switched to another facility (switchers), and 36 (5.8%) left the industry (leavers). At baseline, switchers reported higher turnover intentions and fewer benefits compared with stayers and left for new opportunities. Leavers had lower job satisfaction and emotional well-being and left for health reasons. Turnover intentions were predicted by low job satisfaction and low emotional well-being. Actual turnover was predicted only by turnover intentions and by the absence of health insurance. Pay was not a predictor of turnover intent or turnover. Implications: There are two distinct groups of CNAs contributing to turnover. Attitudinal factors, such as job satisfaction and emotional well-being, are mediated via turnover intentions to effect actual turnover. Even accounting for methodological differences, this turnover rate is lower than previous studies, which use alternative methods and include part-time workers. This study should help nursing home administrators better understand the work-related factors associated with staff turnover. PMID:21498629

  3. Assessing the academic and professional needs of trauma nurse practitioners and physician assistants. (United States)

    Wilson, Laurie N; Wainwright, Gail A; Stehly, Christy D; Stoltzfus, Jill; Hoff, William S


    Because of multiple changes in the health care environment, the use of services of physician assistants (PAs) and nurse practitioners (NPs) in trauma and critical care has expanded. Appropriate training and ongoing professional development for these providers are essential to optimize clinical outcomes. This study offers a baseline assessment of the academic and professional needs of the contemporary trauma PAs/NPs in the United States. A 14-question electronic survey, using SurveyMonkey, was distributed to PAs/NPs at trauma centers identified through the American College of Surgeons Web site and other online resources. Demographic questions included trauma center level, provider type, level of education, and professional affiliations. Likert scale questions were incorporated to assess level of mentorship, comfort level with training, and individual perceived needs for academic and professional development. There were 120 survey respondents: 60 NPs and 60 PAs. Sixty-two respondents (52%) worked at level I trauma centers and 95 (79%) were hospital-employed. Nearly half (49%) reported working in trauma centers for 3 years or less. One hundred nineteen respondents (99%) acknowledged the importance of trauma-specific education; 98 (82%) were required by their institution to obtain such training. Thirty-five respondents (32%) reported receiving $1000 per year or less as a continuing medical education benefit. Insufficient mentorship, professional development, and academic development were identified by 22 (18%), 16 (13%), and 30 (25%) respondents, respectively. Opportunities to network with trauma PAs/NPs outside their home institution were identified as insufficient by 79 (66%). While PAs/NPs in trauma centers recognize the importance of continued contemporary trauma care and evidence-based practices, attending trauma-related education is not universally required by their employers. Financial restrictions may pose an additional impediment to academic development

  4. Comparison of the quality of patient referrals from physicians, physician assistants, and nurse practitioners. (United States)

    Lohr, Robert H; West, Colin P; Beliveau, Margaret; Daniels, Paul R; Nyman, Mark A; Mundell, William C; Schwenk, Nina M; Mandrekar, Jayawant N; Naessens, James M; Beckman, Thomas J


    To compare the quality of referrals of patients with complex medical problems from nurse practitioners (NPs), physician assistants (PAs), and physicians to general internists. We conducted a retrospective comparison study involving regional referrals to an academic medical center from January 1, 2009, through December 31, 2010. All 160 patients referred by NPs and PAs combined and a random sample of 160 patients referred by physicians were studied. Five experienced physicians blinded to the source of referral used a 7-item instrument to assess the quality of referrals. Internal consistency, interrater reliability, and dimensionality of item scores were determined. Differences between item scores for patients referred by physicians and those for patients referred by NPs and PAs combined were analyzed by using multivariate ordinal logistical regression adjusted for patient age, sex, distance of the referral source from Mayo Clinic, and Charlson Index. Factor analysis revealed a 1-dimensional measure of the quality of patient referrals. Interrater reliability (intraclass correlation coefficient for individual items: range, 0.77-0.93; overall, 0.92) and internal consistency for items combined (Cronbach α=0.75) were excellent. Referrals from physicians were scored higher (percentage of agree/strongly agree responses) than were referrals from NPs and PAs for each of the following items: referral question clearly articulated (86.3% vs 76.0%; P=.0007), clinical information provided (72.6% vs 54.1%; P=.003), documented understanding of the patient's pathophysiology (51.0% vs 30.3%; P<.0001), appropriate evaluation performed locally (60.3% vs 39.0%; P<.0001), appropriate management performed locally (53.5% vs 24.1%; P<.0001), and confidence returning patient to referring health care professional (67.8% vs 41.4%; P<.0001). Referrals from physicians were also less likely to be evaluated as having been unnecessary (30.1% vs 56.2%; P<.0001). The quality of referrals to an

  5. Patient-care time allocation by nurse practitioners and physician assistants in the intensive care unit. (United States)

    Carpenter, David L; Gregg, Sara R; Owens, Daniel S; Buchman, Timothy G; Coopersmith, Craig M


    Use of nurse practitioners and physician assistants ("affiliates") is increasing significantly in the intensive care unit (ICU). Despite this, few data exist on how affiliates allocate their time in the ICU. The purpose of this study was to understand the allocation of affiliate time into patient-care and non-patient-care activity, further dividing the time devoted to patient care into billable service and equally important but nonbillable care. We conducted a quasi experimental study in seven ICUs in an academic hospital and a hybrid academic/community hospital. After a period of self-reporting, a one-time monetary incentive of $2,500 was offered to 39 affiliates in each ICU in which every affiliate documented greater than 75% of their time devoted to patient care over a 6-month period in an effort to understand how affiliates allocated their time throughout a shift. Documentation included billable time (critical care, evaluation and management, procedures) and a new category ("zero charge time"), which facilitated record keeping of other patient-care activities. At baseline, no ICUs had documentation of 75% patient-care time by all of its affiliates. In the 6 months in which reporting was tied to a group incentive, six of seven ICUs had every affiliate document greater than 75% of their time. Individual time documentation increased from 53% to 84%. Zero-charge time accounted for an average of 21% of each shift. The most common reason was rounding, which accounted for nearly half of all zero-charge time. Sign out, chart review, and teaching were the next most common zero-charge activities. Documentation of time spent on billable activities also increased from 53% of an affiliate's shift to 63%. Time documentation was similar regardless of during which shift an affiliate worked. Approximately two thirds of an affiliate's shift is spent providing billable services to patients. Greater than 20% of each shift is spent providing equally important but not reimbursable

  6. Co-Designing Mobile Apps to Assist in Clinical Nursing Education: A Study Protocol. (United States)

    O'Connor, Siobhan; Andrews, Tom


    Mobile applications (apps) to train health professionals is gaining momentum as the benefits of mobile learning (mLearning) are becoming apparent in complex clinical environments. However, most educational apps are generic, off-the-shelf pieces of software that do not take into consideration the unique needs of nursing students. The proposed study will apply a user-centred design process to create a tailored mobile app for nursing students to learn and apply clinical skills in practice. The app will be piloted and evaluated to understand how nursing students use mobile technology in clinical settings to support their learning and educational needs.

  7. [The effects of multimedia-assisted instruction on the skin care learning of nurse aides in long-term care facilities]. (United States)

    Wu, Yu-Ling; Kao, Yu-Hsiu


    Skin care is an important responsibility of nurse aides in long-term care facilities, and the nursing knowledge, attitudes, and skills of these aides significantly affects quality of care. However, the work schedule of nurse aides often limits their ability to obtain further education and training. Therefore, developing appropriate and effective training programs for nurse aides is critical to maintaining and improving quality of care in long-term care facilities. This study investigates the effects of multimedia assisted instruction on the skin care learning of nurse aides working in long-term care facilities. A quasi-experimental design and convenient sampling were adopted in this study. Participants included 96 nurse aides recruited from 5 long-term care facilities in Taoyuan County, Taiwan. The experimental group received 3 weeks of multimedia assisted instruction. The control group did not receive this instruction. The Skin Care Questionnaire for Nurse Aides in Long-term Care Facilities and the Skin Care Behavior Checklist were used for assessment before and after the intervention. (1) Posttest scores for skin care knowledge, attitudes, behavior, and the skin care checklist were significantly higher than pretest scores for the intervention group. There was no significant difference between pretest and posttest scores for the control group. (2) A covariance analysis of pretest scores for the two groups showed that the experimental group earned significantly higher average scores than their control group peers for skin care knowledge, attitudes, behavior, and the skin care checklist. The multimedia assisted instruction demonstrated significant and positive effects on the skin care leaning of nurse aides in long-term care facilities. This finding supports the use of multimedia assisted instruction in the education and training of nurse aides in long-term care facilities in the future.

  8. Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study. (United States)

    Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne


    Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management

  9. Nursing and midwifery students' experiences with the course of infertility and assisted reproductive techniques: A focus group study from Turkey. (United States)

    Isbir, Gozde Gokçe; Ozan, Yeter Durgun


    Nurses and midwifes without sufficient knowledge of infertilitare not likely to provide counseling and support for people suffering from infertility. This study aimed to evaluate nursing and midwifery students' experiences with the Course on Infertility and Assisted Reproductive Techniques. Our study had a qualitative descriptive design. Total number of the participants was 75. The analysis revealed five primary themes and twenty-one sub-themes. The themes were (1) action, (2) learner centered method, (3) interaction, (4) nursing competencies, and (5) evaluation. The active learning techniques enabled the students to retrieve the knowledge that they obtained for a long time, contributed to social and cultural development and improved skills required for selfevaluation, communication and leadership, enhanced critical thinking, skills increased motivation and satisfaction and helped with knowledge integration. Infertility is a biopsychosocial condition, and it may be difficult for students to understand what infertile individuals experience. The study revealed that active learning techniques enabled the students to acquire not only theoretical knowledge but also an emotional and psychosocial viewpoint and attitude regarding infertility. The content of an infertility course should be created in accordance with changes in the needs of a given society and educational techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Tungsten disulfide nanosheet and exonuclease III co-assisted amplification strategy for highly sensitive fluorescence polarization detection of DNA glycosylase activity

    International Nuclear Information System (INIS)

    Zhao, Jingjin; Ma, Yefei; Kong, Rongmei; Zhang, Liangliang; Yang, Wen; Zhao, Shulin


    Herein, we introduced a tungsten disulfide (WS 2 ) nanosheet and exonuclease III (Exo III) co-assisted signal amplification strategy for highly sensitive fluorescent polarization (FP) assay of DNA glycosylase activity. Two DNA glycosylases, uracil-DNA glycosylase (UDG) and human 8-oxoG DNA glycosylase 1 (hOGG1), were tested. A hairpin-structured probe (HP) which contained damaged bases in the stem was used as the substrate. The removal of damaged bases from substrate by DNA glycosylase would lower the melting temperature of HP. The HP was then opened and hybridized with a FAM dye-labeled single strand DNA (DP), generating a duplex with a recessed 3′-terminal of DP. This design facilitated the Exo III-assisted amplification by repeating the hybridization and digestion of DP, liberating numerous FAM fluorophores which could not be adsorbed on WS 2 nanosheet. Thus, the final system exhibited a small FP signal. However, in the absence of DNA glycosylases, no hybridization between DP and HP was occurred, hampering the hydrolysis of DP by Exo III. The intact DP was then adsorbed on the surface of WS 2 nanosheet that greatly amplified the mass of the labeled-FAM fluorophore, resulting in a large FP value. With the co-assisted amplification strategy, the sensitivity was substantially improved. In addition, this method was applied to detect UDG activity in cell extracts. The study of the inhibition of UDG was also performed. Furthermore, this method is simple in design, easy in implementation, and selective, which holds potential applications in the DNA glycosylase related mechanism research and molecular diagnostics. - Highlights: • A fluorescence polarization strategy for DNA glycosylase activity detection was developed. • The present method was based on WS 2 nanosheet and exonuclease III co-assisted signal amplification. • A high sensitivity and desirable selectivity were achieved. • This method provides a promising universal platform for DNA glycosylase

  11. The effect of flooring on musculoskeletal symptoms in the lower extremities and low back among female nursing assistants. (United States)

    Wahlström, Jens; Ostman, Christina; Leijon, Ola


    This study examines the effect of changing the floor from a 2-mm homogenous vinyl floor to a 4-mm heterogeneous vinyl floor (1.5-mm wear layer and 2.5-mm foam layer) on musculoskeletal symptoms in the lower extremities and low back among nursing assistants in a geriatric care centre. A pre-post design with a reference group consisting of nursing assistants from a similar geriatric care centre was used. Follow-up measurements were carried out 12 and 24 months after the intervention by means of questionnaires. At the 1-year follow-up, the pain intensity score in the feet of the intervention group had decreased compared with the baseline value and remained statistically significant at the 2-year follow-up. The decrease in pain intensity score of the feet in the intervention group was statistically significantly different from the reference group, both after 1 and 2 years. The results show the importance of flooring in the workplace with regard to reducing musculoskeletal symptoms. Appropriate flooring is especially important in the female-dominated health care sector, where workers must stand or walk for long periods.

  12. Attitudes and Usage of the Food and Drug Administration Adverse Event Reporting System Among Gastroenterology Nurse Practitioners and Physician Assistants. (United States)

    Salk, Allison; Ehrenpreis, Eli D


    The Food and Drug Administration Adverse Event Reporting System (FAERS) is used for postmarketing pharmacovigilance. Our study sought to assess attitudes and usage of the FAERS among gastroenterology nurse practitioners (NPs) and physician assistants (PAs). A survey was administered at the August 2012 Principles of Gastroenterology for the Nurse Practitioner and Physician Assistant course, held in Chicago, IL. Of the 128 respondents, 123 (96%) reported a specialty in gastroenterology or hepatology and were included in analysis. Eighty-nine participants were NPs and 32 PAs, whereas 2 did not report their profession. Although 119 (98%) agreed or strongly agreed with the statement that accurately reporting adverse drug reactions is an important process to optimize patient safety, the majority of participants (54% NPs and 81% PAs) were unfamiliar with the FAERS. In addition, only 20% of NPs and 9% of PAs reported learning about the FAERS in NP or PA schooling. Our study shows enthusiasm among gastroenterology NPs and PAs for the reporting of adverse drug reactions, coupled with a lack of familiarity with the FAERS. This presents an opportunity for enhanced education about reporting of adverse drug reactions for gastroenterology NPs and PAs.

  13. Teamwork in Acute Care: Perceptions of Essential but Unheard Assistive Personnel and the Counterpoint of Perceptions of Registered Nurses. (United States)

    Bellury, Lanell; Hodges, Helen; Camp, Amanda; Aduddell, Kathie


    Teams of unlicensed personnel and registered nurses have provided hospital-based nursing care for decades. Although ineffective teamwork has been associated with poor patient outcomes, little is known of the perspectives of nursing assistive personnel (NAP). The purpose of this study was to gain insights into the perceptions of NAP and professional registered nurses (RNs) on teamwork in acute care. In a qualitative descriptive approach in a metropolitan hospital in the southeastern United States, 33 NAP participated in audio-recorded focus group sessions, and 18 RNs provided responses to open-ended electronic survey questions. Findings were examined in relation to previously identified coordinating mechanisms of teamwork: shared mental models, closed-loop communication, and mutual trust. None of the mechanisms was strongly represented in these data. In contrast to RNs' mental models, NAP perceptions of teamwork included the centrality of holistic caring to the NAP role, functional teams as NAP-only teams, NAPs and RNs working in parallel spheres rather than together, and team coordination in silos. Closed-loop communication was less common than one-way requests. Mutual trust was desired, but RNs' delegation of tasks conveyed to NAP a lack of value and respect for the NAP role, while RNs perceived a professional obligation to delegate care to ensure quality of care amid changing patient priorities. Further empirical research into NAP practice is needed to enhance understanding of teamwork issues and direct effective interventions to improve work environments and ultimately patient outcomes. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Homelessness as culture: How transcultural nursing theory can assist caring for the homeless. (United States)

    Law, Kate; John, William


    The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing (United States)

    Castle, Nicholas G.


    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  16. School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance (United States)

    Rickard, Megan L.; Hendershot, Candace; Khubchandani, Jagdish; Price, James H.; Thompson, Amy


    Background: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. Methods: This study assessed public school…

  17. Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis. (United States)

    Simmons, Sandra F; Hollingsworth, Emily K; Long, Emily A; Liu, Xulei; Shotwell, Matthew S; Keeler, Emmett; An, Ruopeng; Silver, Heidi J


    To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents. Randomized, controlled trial. Five community NHs. Long-stay NH residents with an order for caloric supplementation (N = 122). Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care. Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake. Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P staff time to provide assistance. It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents' between-meal intake. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  18. The role of health care assistants in supporting district nurses and family carers to deliver palliative care at home: findings from an evaluation project. (United States)

    Ingleton, Christine; Chatwin, John; Seymour, Jane; Payne, Sheila


    To examine the role of trained health and personal care assistants in supporting district nurses and family carers in providing palliative and end of life care in the community. In the UK, there is a policy directive to improve end of life care and to enable greater numbers of people to die at home. This places considerable demands on community nursing services and family carers. In response to this, the Complex and Palliative Continuing Care Service employing generic health and personal care assistants was developed as part of the Marie Curie Delivering Choice Programme in one city in the UK. This paper draws on findings from an independent evaluation of the scheme. The wider evaluation used a formative evaluation methodology. This paper draws on in-depth interviews with a range of stakeholders (n = 17), in-depth interviews with bereaved carers (n = 6) and an analysis of documentation. Stakeholders and bereaved carers perceived that the health and personal care assistants made a vital contribution to community palliative care. Careful recruitment, specific training, case management by district nursing with allocation of specific tasks and close ongoing communication were key features which stakeholders indentified. Family carers welcomed the way assistants developed relationships and became familiar and able to meet the care needs of patients. There were some problems reported which related to capacity, work flow and the need for extensive written care plans. Employing health care assistants under the supervision of district nurses appears to support patients and family at home during end of life care and contribute to good quality nursing care. The needs for community-based palliative and end of life care will increase rapidly over the course of the next 20 years, placing pressure on community nursing services and family carers. © 2011 Blackwell Publishing Ltd.

  19. [Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region]. (United States)

    Wang, Bo; Shen, Guo-fang; Fang, Bing; Sun, Liang-yan; Wu, Yong; Jiang, Ling-yong; Zhu, Min


    To investigate the changes of periodontal conditions after micro-osteotomy assisted lower incisor decompensation for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region. The sample consisted of 22 cases diagnosed as skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region, selected from consecutive patients of Department of Oral & Cranio-maxillofacial Science of Shanghai Ninth People's Hospital during 2009-2012. The samples were divided into 2 groups; G1 comprised 10 patients who accepted micro-osteotomy assisted lower incisor decompensation; G2 comprised 12 patients who chose traditional pre-surgical decomposition. The changes of periodontal conditions of both groups were evaluated with the help of cone-beam CT(CBCT). Data was processed using SAS8.02 software package. For subjects in G1, during the micro-osteotomy assisted pre-surgical orthodontics, no significant difference was found in the amount of root resorption of lower incisors.But labial and lingual vertical alveolar bone loss were 2.60 mm and 2.22 mm; alveolar bone thickness increased by 3.05 mm on the labial side and decreased by 0.88 mm on the lingual side (Ppre-surgical orthodontics was much safer than traditional orthodontics for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region.



    Agnes Schutz de Oliveira; Priscila da Silva Antonio


    ABSTRACT: Bullying is a devastating phenomenon that can affect the adolescent’s self-esteem and mental health. Generally occurs in school environment when the adolescent is more susceptible or vulnerable to verbal or moral aggressions that cause to them anguish and pain, meaning as a status of social exclusion. Most of time, health problems as anorexia, bulimia, depression, anxiety and also the suicide, appears. By the way, nurses are able to prevent injuries to various problems, and also con...

  1. HOROPLAN: computer-assisted nurse scheduling using constraint-based programming. (United States)

    Darmoni, S J; Fajner, A; Mahé, N; Leforestier, A; Vondracek, M; Stelian, O; Baldenweck, M


    Nurse scheduling is a difficult and time consuming task. The schedule has to determine the day to day shift assignments of each nurse for a specified period of time in a way that satisfies the given requirements as much as possible, taking into account the wishes of nurses as closely as possible. This paper presents a constraint-based, artificial intelligence approach by describing a prototype implementation developed with the Charme language and the first results of its use in the Rouen University Hospital. Horoplan implements a non-cyclical constraint-based scheduling, using some heuristics. Four levels of constraints were defined to give a maximum of flexibility: French level (e.g. number of worked hours in a year), hospital level (e.g. specific day-off), department level (e.g. specific shift) and care unit level (e.g. specific pattern for week-ends). Some constraints must always be verified and can not be overruled and some constraints can be overruled at a certain cost. Rescheduling is possible at any time specially in case of an unscheduled absence.

  2. What are community nurses experiences of assessing frailty and assisting in planning subsequent interventions? (United States)

    Britton, Hannah


    With an ageing population and increasing focus on community care, this study aimed to explore the experiences of community nurses in assessing frailty and planning interventions around frailty. Six community nurses were recruited for face-to-face semi-structured interviews as part of this qualitative study which was underpinned by a competence framework ( Royal College of Nursing, 2009 ). Thematic analysis was used and frailty was identified as an emerging topic within practice. Participants discussed several aspects associated with frailty; however, some uncertainty around the concept of frailty and its definition was noted, particularly for staff who had received limited frailty training. Participants had a growing awareness of frailty in practice, but challenges-including time constraints and staffing within some roles, a perception of limited services to support older people, and for some a lack of confidence and training-presented barriers to frailty assessment. The Rockwood frailty scale was used by participants within practice, but evidence suggested it was felt to lack validity within the community setting.

  3. The systematization of nursing Assistance in care when a patient with Anemia Falciform with Leg Ulcer

    Directory of Open Access Journals (Sweden)

    Gabriela Baptista Vieira


    Full Text Available Objetivo: levantar os diagnósticos de enfermagem mais evidentes e suas respectivas intervenções de acordo com Nursing Diagnostic Terminology (NANDA e Nursing Interventions Classification (NIC. Métodos: trata-se de um estudo exploratório o qual teve seu desenho metodológico baseado na vivência dos autores no ambulatório de curativo de um Hospital Estadual especializado em hematologia, como parte do programa de residência em enfermagem. Resultados: foram determinados oito DE, sendo dois de risco e seis reais, os quais foram descritos conforme a Taxonomia I da NANDA. Buscou-se também, após a determinação desses diagnósticos, propor intervenções de enfermagem baseadas na Nursing Interventions Classification (NIC. Conclusão: os achados revelaram que conhecer os diagnósticos de enfermagem dos indivíduos portadores de úlcera de perna secundária a anemia falciforme é de extrema importância para que os enfermeiros possam planejar individualmente o cuidado prestado a esta clientela. Descritores: Doença da hemoglobina SC; Diagnóstico de Enfermagem; Cuidados de Enfermagem

  4. Bridging the Gap Between Continuous Sedation Until Death and Physician-Assisted Death: A Focus Group Study in Nursing Homes in Flanders, Belgium

    NARCIS (Netherlands)

    Rys, S.; Deschepper, R.; Mortier, F.; Deliens, L.; Bilsen, J.


    The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a

  5. Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case-control trial. (United States)

    Majić, Tomislav; Gutzmann, Hans; Heinz, Andreas; Lang, Undine E; Rapp, Michael A


    To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F1,48 = 6.43; p <0.05) and depression (F1,48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Certified Nursing Assistants Balancing Family Caregiving Roles: Health Care Utilization Among Double- and Triple-Duty Caregivers. (United States)

    DePasquale, Nicole; Bangerter, Lauren R; Williams, Jessica; Almeida, David M


    This study examines how certified nursing assistants (CNAs) balancing family caregiving roles-child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)-utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers). A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months. Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits. CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  7. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. (United States)

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E; Rogers, Ann E


    To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through "on the job" training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap.

  8. The operationalisation of religion and world view in surveys of nurses' attitudes toward euthanasia and assisted suicide. (United States)

    Gielen, Joris; Van den Branden, Stef; Broeckaert, Bert


    Most quantitative studies that survey nurses' attitudes toward euthanasia and/or assisted suicide, also attempt to assess the influence of religion on these attitudes. We wanted to evaluate the operationalisation of religion and world view in these surveys. In the Pubmed database we searched for relevant articles published before August 2008 using combinations of search terms. Twenty-eight relevant articles were found. In five surveys nurses were directly asked whether religious beliefs, religious practices and/or ideological convictions influenced their attitudes, or the respondents were requested to mention the decisional basis for their answers on questions concerning end-of-life issues. In other surveys the influence of religion and world view was assessed indirectly through a comparison of the attitudes of different types of believers and/or non-believers toward euthanasia or assisted suicide. In these surveys we find subjective religious or ideological questions (questions inquiring about the perceived importance of religion or world view in life, influence of religion or world view on life in general, or how religious the respondents consider themselves) and objective questions (questions inquiring about religious practice, acceptance of religious dogmas, and religious or ideological affiliation). Religious or ideological affiliation is the most frequently used operationalisation of religion and world view. In 16 surveys only one religious or ideological question was asked. In most articles the operationalisation of religion and world view is very limited and does not reflect the diversity and complexity of religion and world view in contemporary society. Future research should pay more attention to the different dimensions of religion and world view, the religious plurality of Western society and the particularities of religion in non-Western contexts.

  9. Colorimetric detection of genetically modified organisms based on exonuclease III-assisted target recycling and hemin/G-quadruplex DNAzyme amplification. (United States)

    Zhang, Decai; Wang, Weijia; Dong, Qian; Huang, Yunxiu; Wen, Dongmei; Mu, Yuejing; Yuan, Yong


    An isothermal colorimetric method is described for amplified detection of the CaMV 35S promoter sequence in genetically modified organism (GMO). It is based on (a) target DNA-triggered unlabeled molecular beacon (UMB) termini binding, and (b) exonuclease III (Exo III)-assisted target recycling, and (c) hemin/G-quadruplex (DNAzyme) based signal amplification. The specific binding of target to the G-quadruplex sequence-locked UMB triggers the digestion of Exo III. This, in turn, releases an active G-quadruplex segment and target DNA for successive hybridization and cleavage. The Exo III impellent recycling of targets produces numerous G-quadruplex sequences. These further associate with hemin to form DNAzymes and hence will catalyze H 2 O 2 -mediated oxidation of the chromogenic enzyme substrate ABTS 2- causing the formation of a green colored product. This finding enables a sensitive colorimetric determination of GMO DNA (at an analytical wavelength of 420 nm) at concentrations as low as 0.23 nM. By taking advantage of isothermal incubation, this method does not require sophisticated equipment or complicated syntheses. Analyses can be performed within 90 min. The method also discriminates single base mismatches. In our perception, it has a wide scope in that it may be applied to the detection of many other GMOs. Graphical abstract An isothermal and sensitive colorimetric method is described for amplified detection of CaMV 35S promoter sequence in genetically modified organism (GMO). It is based on target DNA-triggered molecular beacon (UMB) termini-binding and exonuclease III assisted target recycling, and on hemin/G-quadruplex (DNAzyme) signal amplification.

  10. Knowing 'something is not right' is beyond intuition: development of a clinical algorithm to enhance surveillance and assist nurses to organise and communicate clinical findings. (United States)

    Brier, Jessica; Carolyn, Moalem; Haverly, Marsha; Januario, Mary Ellen; Padula, Cynthia; Tal, Ahuva; Triosh, Henia


    To develop a clinical algorithm to guide nurses' critical thinking through systematic surveillance, assessment, actions required and communication strategies. To achieve this, an international, multiphase project was initiated. Patients receive hospital care postoperatively because they require the skilled surveillance of nurses. Effective assessment of postoperative patients is essential for early detection of clinical deterioration and optimal care management. Despite the significant amount of time devoted to surveillance activities, there is lack of evidence that nurses use a consistent, systematic approach in surveillance, management and communication, potentially leading to less optimal outcomes. Several explanations for the lack of consistency have been suggested in the literature. Mixed methods approach. Retrospective chart review; semi-structured interviews conducted with expert nurses (n = 10); algorithm development. Themes developed from the semi-structured interviews, including (1) complete, systematic assessment, (2) something is not right (3) validating with others, (4) influencing factors and (5) frustration with lack of response when communicating findings were used as the basis for development of the Surveillance Algorithm for Post-Surgical Patients. The algorithm proved beneficial based on limited use in clinical settings. Further work is needed to fully test it in education and practice. The Surveillance Algorithm for Post-Surgical Patients represents the approach of expert nurses, and serves to guide less expert nurses' observations, critical thinking, actions and communication. Based on this approach, the algorithm assists nurses to develop skills promoting early detection, intervention and communication in cases of patient deterioration. © 2014 John Wiley & Sons Ltd.

  11. Tungsten disulfide nanosheet and exonuclease III co-assisted amplification strategy for highly sensitive fluorescence polarization detection of DNA glycosylase activity

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    Zhao, Jingjin; Ma, Yefei [Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources of Education Ministry, Guangxi Normal University, Guilin, 541004 (China); Kong, Rongmei [The Key Laboratory of Life-Organic Analysis, College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, Shandong 273165 (China); Zhang, Liangliang, E-mail: [Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources of Education Ministry, Guangxi Normal University, Guilin, 541004 (China); Yang, Wen; Zhao, Shulin [Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources of Education Ministry, Guangxi Normal University, Guilin, 541004 (China)


    Herein, we introduced a tungsten disulfide (WS{sub 2}) nanosheet and exonuclease III (Exo III) co-assisted signal amplification strategy for highly sensitive fluorescent polarization (FP) assay of DNA glycosylase activity. Two DNA glycosylases, uracil-DNA glycosylase (UDG) and human 8-oxoG DNA glycosylase 1 (hOGG1), were tested. A hairpin-structured probe (HP) which contained damaged bases in the stem was used as the substrate. The removal of damaged bases from substrate by DNA glycosylase would lower the melting temperature of HP. The HP was then opened and hybridized with a FAM dye-labeled single strand DNA (DP), generating a duplex with a recessed 3′-terminal of DP. This design facilitated the Exo III-assisted amplification by repeating the hybridization and digestion of DP, liberating numerous FAM fluorophores which could not be adsorbed on WS{sub 2} nanosheet. Thus, the final system exhibited a small FP signal. However, in the absence of DNA glycosylases, no hybridization between DP and HP was occurred, hampering the hydrolysis of DP by Exo III. The intact DP was then adsorbed on the surface of WS{sub 2} nanosheet that greatly amplified the mass of the labeled-FAM fluorophore, resulting in a large FP value. With the co-assisted amplification strategy, the sensitivity was substantially improved. In addition, this method was applied to detect UDG activity in cell extracts. The study of the inhibition of UDG was also performed. Furthermore, this method is simple in design, easy in implementation, and selective, which holds potential applications in the DNA glycosylase related mechanism research and molecular diagnostics. - Highlights: • A fluorescence polarization strategy for DNA glycosylase activity detection was developed. • The present method was based on WS{sub 2} nanosheet and exonuclease III co-assisted signal amplification. • A high sensitivity and desirable selectivity were achieved. • This method provides a promising universal platform for DNA


    Directory of Open Access Journals (Sweden)

    Agnes Schutz de Oliveira


    Full Text Available ABSTRACT: Bullying is a devastating phenomenon that can affect the adolescent’s self-esteem and mental health. Generally occurs in school environment when the adolescent is more susceptible or vulnerable to verbal or moral aggressions that cause to them anguish and pain, meaning as a status of social exclusion. Most of time, health problems as anorexia, bulimia, depression, anxiety and also the suicide, appears. By the way, nurses are able to prevent injuries to various problems, and also concerns about this traumatic incident in adolescence. The aim of this study was to identify feelings that can be related to” bullying “in adolescent students in 5th to 8th classes. It is a descriptive research by qualitative approach, developed in a religious setting state school. Data was collected by taped interviews and, after transcribed, submitted to thematic analysis. The results showed that feelings related to this phenomena are multiple and varied, being categorized as positive aspects character, negative aspects character and necessary aspects character. KEY WORDS: School Health; Pediatric Nursing; Teen Health; Violence.

  13. UV and visible activation of Cr(III)-doped TiO2 catalyst prepared by a microwave-assisted sol-gel method during MCPA degradation. (United States)

    Mendiola-Alvarez, S Y; Guzmán-Mar, J L; Turnes-Palomino, G; Maya-Alejandro, F; Hernández-Ramírez, A; Hinojosa-Reyes, L


    Photocatalytic degradation of 4-chloro-2-methylphenoxyacetic acid (MCPA) in aqueous solution using Cr(III)-doped TiO 2 under UV and visible light was investigated. The semiconductor material was synthesized by a microwave-assisted sol-gel method with Cr(III) doping contents of 0.02, 0.04, and 0.06 wt%. The catalyst was characterized using X-ray powder diffraction (XRD), scanning electron microscopy (SEM), nitrogen physisorption, UV-Vis diffuse reflectance spectroscopy (DRS), and atomic absorption spectroscopy (AAS). The photocatalytic activity for the photodegradation of MCPA was followed by reversed-phase high-performance liquid chromatography (HPLC) and total organic carbon (TOC) analysis. The intermediates formed during degradation were identified using gas chromatography-mass spectrometry (GC-MS). Chloride ion evolution was measured by ion chromatography. Characterization results showed that Cr(III)-doped TiO 2 materials possessed a small crystalline size, high surface area, and mesoporous structure. UV-Vis DRS showed enhanced absorption in the visible region as a function of the Cr(III) concentration. The Cr(III)-doped TiO 2 catalyst with 0.04 wt% of Cr(III) was more active than bare TiO 2 for the degradation of MCPA under both UV and visible light. The intermediates identified during MCPA degradation were 4-chloro-2-methylphenol (CMP), 2-(4-hydroxy-2-methylphenoxy) acetic acid (HMPA), and 2-hydroxybuta-1,3-diene-1,4-diyl-bis (oxy)dimethanol (HBDM); the formation of these intermediates depended on the radiation source.

  14. Assisted Living (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  15. Country of origin and racio-ethnicity: are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care? (United States)

    Allensworth-Davies, Donald; Leigh, Jennifer; Pukstas, Kim; Geron, Scott Miyake; Hardt, Eric; Brandeis, Gary; Engle, Ryann L; Parker, Victoria A


    Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations. To examine organizational cultural competence as perceived by nursing assistants and determine if this was related to differences in job satisfaction across countries of origin and racio-ethnic groups. Primary data collected from a cross-section of 135 nursing assistants at four New England nursing homes. Demographics, perceptions of organizational cultural competence, and ratings of job satisfaction were collected. A multivariate, generalized linear model was used to assess predictors of job satisfaction. A secondary analysis was then conducted to identify the most important components of organizational cultural competency. Perception of organizational cultural competence (p = .0005) and autonomy (p = .001) were the strongest predictors of job satisfaction among nursing assistants; as these increase, job satisfaction also increases. Neither country of origin nor racio-ethnicity was associated with job satisfaction, but racio-ethnicity was associated with perceived organizational cultural competence (p = .05). A comfortable work environment for employees of different races/cultures emerged as the strongest organizational cultural competency factor (p = .04). Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a

  16. How the perspectives of nursing assistants and frail elderly residents on their daily interaction in nursing homes affect their interaction: a qualitative study. (United States)

    Lung, Chi-Chi; Liu, Justina Yat Wa


    Good support from and positive relations with institutional staff can enhance the psychosocial wellbeing of residents admitted to a nursing home. Nursing assistants (NAs) interact most frequently with residents and play an important role in developing good rapport with them. Most studies have described the daily interactions between NAs and residents as task oriented. Only few have attempted to explore the perspectives of NAs and residents on their daily interactions. Therefore, the aim of this study was to identify the types of daily interactions perceived by NAs and residents. We also investigated those intentions/beliefs held by NAs and residents that might direct their interactive behaviors. A descriptive, exploratory, qualitative approach was used to explore the perspectives of 18 NAs (mean age: 51) and 15 residents (mean age: 84.4) on their daily interactions. Unstructured in-depth interviews were used to collect data. All of the interviews were conducted from July to December 2013. The collected data were transcribed verbatim and analyzed by content analysis. Three types of interactions were found that described the NAs' and residents' perspectives on their daily interactions: (1) physiologically-oriented daily interactions; (2) cordial interactions intended to maintain a harmonious atmosphere; and (3) reciprocal social interactions intended to develop closer rapport. One or more themes reflecting the participants' intentions or beliefs were identified from each group to support each type of interaction. An over-emphasis on the formal caring relationship and over-concern about maintaining a harmonious atmosphere contributed to a superficial and distant relationship between the two parties. Building close rapport takes time and involves repeated reciprocal social interactions. The findings showed that with good intentions to establish closer rapport, both NAs and residents did favors for each other. All of those favors were easily integrated in the care

  17. Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study. (United States)

    Lovink, Marleen H; van Vught, Anneke J A H; Persoon, Anke; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H


    More and more older adults desire to and are enabled to grow old in their own home, regardless of their physical and mental capabilities. This change, together with the growing number of older adults, increases the demand for general practitioners (GPs). However, care for older people lacks prestige among medical students and few medical students are interested in a career in care for older people. Innovative solutions are needed to reduce the demand for GPs, to guarantee quality of healthcare and to contain costs. A solution might be found in skill mix change by introducing nurse practitioners (NPs), physician assistants (PAs) or registered nurses (RNs). The aim of this study was to describe how skill mix change is organised in daily practice, what influences it and what the effects are of introducing NPs, PAs or RNs into primary healthcare for older people. In total, 34 care providers working in primary healthcare in the Netherlands were interviewed: GPs (n = 9), NPs (n = 10), PAs (n = 5) and RNs (n = 10). Five focus groups and 14 individual interviews were conducted. Analysis consisted of open coding, creating categories and abstraction. In most cases, healthcare for older people was only a small part of the tasks of NPs, PAs and RNs; they did not solely focus on older people. The tasks they performed and their responsibilities in healthcare for older people differed between, as well as within, professions. Although the interviewees debated the usefulness of proactive structural screening on frailty in the older population, when implemented, it was also unclear who should perform the geriatric assessment. Interviewees considered NPs, PAs and RNs an added value, and it was stated that the role of the GP changed with the introduction of NPs, PAs or RNs. The roles and responsibilities of NPs, PAs and RNs for the care of older people living at home are still not established. Nonetheless, these examples show the potential of these professionals. The

  18. Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report

    Directory of Open Access Journals (Sweden)

    Seyed Mohammadreza Safavi


    Full Text Available In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen due to collision with adjacent roots. This article showcases mandibular molar distalization utilizing miniscrews, inserted at the retromolar area to correct a Class-III problem. A 24-year-old girl with a mild skeletal Class-III malocclusion and dental Class-III molar and canine relationship bilaterally was referred for orthodontic treatment. The treatment plan included distalization of the lower molars bilaterally followed by full fixed appliance therapy, after third molar extractions. For the lower molar distalization, the miniscrews were inserted at the retromolar pad. At the end of 21 months, a Class-I molar and canine relationship, normal overjet and overbite were obtained. The average amount of distalization of mandibular first molar was 3.2 mm at the crown level. In conclusion, placing miniscrews at the retromolar pad area for lower molar distalization was found to be a simple and effective method for correcting anterior cross bite and mandibular anterior crowding or protrusion, without the need for patient compliance.

  19. The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes. (United States)

    Linder, Deborah E; Mueller, Megan K; Gibbs, Debra M; Siebens, Hannah C; Freeman, Lisa M

    Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.


    Directory of Open Access Journals (Sweden)

    Ana Leticia Monteiro Gomes


    Full Text Available Objetivos: Caracterizar o perfil profissional do enfermeiro e analisar os conhecimentos e habilidades essenciais dos enfermeiros que atuam no atendimento ao recém-nascido. Método: Quantitativo, transversal, descritivo, aplicado um formulário a 12 enfermeiros selecionados com técnica de amostragem por conglomerados. Os dados foram processados no Microsoft Office Excel 2007 e analisados através de manuais da Confederação Internacional das Parteiras e do Ministério da Saúde. Aprovado pelo comitê de ética da Secretaria Municipal de Saúde e Defesa Civil, CAAE:0265.0.314.000-10. Resultados: Identificou-se que 66,66% dos enfermeiros têm todos os 8 conhecimentos avaliados. E quanto às habilidades básicas, especialmente nos procedimentos de emergência, temos aproximadamente 46% de enfermeiros não treinados e 79% que não realizam os procedimentos. Conclusão: A ausência de conhecimento e habilidades estabelecidos pela Confederação Internacional das Parteiras confere um risco ao recém-nascido na assistência básica, principalmente nos casos de emergência, devendo o profissional ter um treinamento que assegure sua competência.procedimentos de emergência, temos aproximadamente 46% de enfermeiros não treinados e 79% que não realizam os procedimentos. Conclusão: A ausência de conhecimento e habilidades estabelecidos pela Confederação Internacional das Parteiras confere um risco ao recém-nascido na assistência básica, principalmente nos casos de emergência, devendo o profissional ter um treinamento que assegure sua competência.

  1. The effectiveness of delegation interventions by the registered nurse to the unlicensed assistive personnel and their impact on quality of care, patient satisfaction, and RN staff satisfaction: a systematic review. (United States)

    Hopkins, Una; Itty, Any Sajan; Nazario, Helen; Pinon, Miriam; Slyer, Jason; Singleton, Joanne

    Delegation by the registered nurse is a decision making process that includes assessment, planning, implementation, and evaluation. Due to an ever-expanding global shortage of nurses, registered nurses are increasingly dependent on unlicensed assistive personnel to assist in the provision of safe patient care. Delegation is recognised as a fundamental nursing skill that can be utilised effectively to improve quality care. To examine and synthesize the best available evidence regarding the impact of delegation interventions used by the registered nurse with the unlicensed assistive personnel and their impact on quality of care, patient satisfaction, and registered nurse staff satisfaction. Registered nurses and unlicensed assistive personnel in patient care settings where delegation occurs.This review considered studies that evaluated the effectiveness of delegation interventions by registered nurses to unlicensed assistive personnel.The outcomes examined were quality of care, patient satisfaction, and/or registered nurse staff satisfaction as measured by validated and reliable tools.The review first considered randomised controlled trials; in their absence other research designs, such as non-randomised controlled trials, or other quasi-experimental studies, observational studies and descriptive studies were considered for inclusion in the systematic review. The search strategy aimed to find both published and unpublished studies in the English language from the inception of the included databases through December 2011. The databases searched included the Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL, Healthsource Nursing/Academic edition, and PsycINFO. A search of the grey literature and electronic hand searching of relevant journals was also performed. The studies selected for retrieval were critically evaluated by two independent reviewers for methodological quality using standardised critical appraisal instruments from the Joanna

  2. Prescribing exercise for older adults: A needs assessment comparing primary care physicians, nurse practitioners, and physician assistants. (United States)

    Dauenhauer, Jason A; Podgorski, Carol A; Karuza, Jurgis


    To inform the development of educational programming designed to teach providers appropriate methods of exercise prescription for older adults, the authors conducted a survey of 177 physicians, physician assistants, and nurse practitioners (39% response rate). The survey was designed to better understand the prevalence of exercise prescriptions, attitudes, barriers, and educational needs of primary care practitioners toward older adults. Forty-seven percent of primary care providers report not prescribing exercise for older adults; 85% of the sample report having no formal training in exercise prescription. Practitioner attitudes were positive toward exercise, but were not predictive of their exercise prescribing behavior, which indicates that education efforts aimed at changing attitudes as a way of increasing exercise-prescribing behaviors would not be sufficient. In order to facilitate and reinforce practice changes to increase exercise-prescribing behaviors of primary care providers, results suggest the need for specific skill training on how to write an exercise prescription and motivate older adults to follow these prescriptions.

  3. The productivity of physician assistants and nurse practitioners and health work force policy in the era of managed health care. (United States)

    Scheffler, R M; Waitzman, N J; Hillman, J M


    Managed care is spreading rapidly in the United States and creating incentives for physician practices to find the most efficient combination of health professionals to deliver care to an enrolled population. Given these trends, it is appropriate to reexamine the roles of physician assistants (PAs) and nurse practitioners (NPs) in the health care workforce. This paper briefly reviews the literature on PA and NP productivity, managed care plans' use of PAs and NPs, and the potential impact of PAs and NPs on the size and composition of the future physician workforce. In general, the literature supports the idea that PAs and NPs could have a major impact on the future health care workforce. Studies show significant opportunities for increased physician substitution and even conservative assumptions about physician task delegation imply a large increase in the number of PAs and NPs that can be effectively deployed. However, the current literature has certain limitations that make it difficult to quantify the future impact of PAs and NPs. Among these limitations is the fact that virtually all formal productivity studies were conducted in fee-for-service settings during the 1970s, rather than managed care settings. In addition, the vast majority of PA and NP productivity studies have viewed PAs and NPs as physician substitutes rather than as members of interdisciplinary health care teams, which may become the dominant health care delivery model over the next 10-20 years.

  4. [Surgeons' hope: expanding the professional role of co-medical staff and introducing the nurse practitioner/physician assistant and team approach to the healthcare system]. (United States)

    Maehara, Tadaaki; Nishida, Hiroshi; Watanabe, Takashi; Tominaga, Ryuji; Tabayashi, Koichi


    The healthcare system surrounding surgeons is collapsing due to Japan's policy of limiting health expenditure, market fundamentalism, shortage of healthcare providers, unfavorable working environment for surgeons, increasing risk of malpractice suits, and decreasing number of those who desire to pursue the surgery specialty. In the USA, nonphysician and mid-level clinicians such as nurse practitioners (NPs) and physician assistants (PAs) have been working since the 1960s, and the team approach to medicine which benefits patients is functioning well. One strategy to avoid the collapse of the Japanese surgical healthcare system is introducing the NP/PA system. The division of labor in medicine can provide high-quality, safe healthcare and increase the confidence of the public by contributing to: reduced postoperative complications; increased patient satisfaction; decreased length of postoperative hospital stay: and economic benefits. We have requested that the Ministry of Health, Labor and Welfare establish a Japanese NP/PA system to care for patients more efficiently perioperatively. The ministry has decided to launch a trial profession called "tokutei (specifically qualified) nurse" in February 2010. These nurses will be trained and educated at the Master's degree level and allowed to practice several predetermined skill sets under physician supervision. We hope that all healthcare providers will assist in transforming the tokutei nurse system into a Japanese NP/PA system.

  5. 78 FR 54638 - Request for Information To Inform the Title III Technical Assistance Agenda and the Future... (United States)


    ... assistance needed and at what level (e.g., SEA, LEA, school or classroom)? a. Common Core State Standards or..., or students; k. ESEA flexibility and ELs; l. Science, technology, engineering, and math (STEM...; o. ELs at the secondary school level; p. ELs served under IDEA; q. Civil rights and ELs; or r. Other...

  6. Miniscrew-assisted mandibular molar distalization in a patient with skeletal class-III malocclusion: A clinical case report


    Seyed Mohammadreza Safavi; Farnaz Younessian; Sarvraj Kohli


    In nongrowing patients with mild skeletal Class-III malocclusion, premolar extraction or molar distalization in the lower arch can be done as a part of camouflage treatment. Temporary anchorage devices are widely used for this purpose because they do not produce undesirable reciprocal effects and do not depend on the patient′s cooperation. However, most reported cases in this regard have used interradicular miniscrews in the mandibular arch and these have a risk of failure as they can loosen ...

  7. [Benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of infertility patients]. (United States)

    Li, Xiao-Qin; Sun, Chao-Feng; Guo, Mei


    To investigate the benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of the outpatients with infertility. We randomly divided 600 females preliminarily diagnosed with infertility into a control and an experimental group, 288 in the former and 285 in the latter group excluding those whose husbands had azoospermia. For the women patients of the experimental group, we conducted nursing care intervention concerning related knowledge, skills, diet, excise, medication, and psychology, by one-to-one consultation, individualized or group communication, establishing files, telephone follow-up, and wechat guidance. After 3 months of intervention, we compared the compliance of medical visits, effectiveness of cycle management, sense of self-efficiency, satisfaction, and anxiety score between the two groups of patients. In comparison with the controls, the patients of the experimental group showed significantly better knowledge about assisted reproduction and higher effectiveness of self-cycle-management, self-efficiency, and satisfaction (P <0.05), but a markedly lower degree of anxiety (P <0.05). Nursing care service in the assisted reproduction clinic can improve the compliance of medical visits, effectiveness of self-cycle-management, self-efficiency, and satisfaction and reduce the anxiety of the patients.

  8. Fe(II)–Al(III) layered double hydroxides prepared by ultrasound-assisted co-precipitation method for the reduction of bromate

    International Nuclear Information System (INIS)

    Zhong, Yu; Yang, Qi; Luo, Kun; Wu, Xiuqiong; Li, Xiaoming; Liu, Yang; Tang, Wangwang; Zeng, Guangming; Peng, Bo


    Highlights: ► Fe(II)–Al(III) LDHs were synthesized by ultrasound-assisted co-precipitation method. ► The Fe–Al (30 min) exhibited highly reduction reactivity on bromate. ► Pseudo-first-order model described the experimental data well. ► The mechanisms of bromate removal were proposed. -- Abstract: Bromate is recognized as an oxyhalide disinfection byproduct in drinking water. In this paper, Fe(II)–Al(III) layered double hydroxides (Fe–Al LDHs) prepared by the ultrasound-assisted co-precipitation method were used for the reduction of bromate in solution. The Fe–Al LDHs particles were characterized by X-ray diffractometer, scanning electron microscopy and thermogravimetry–differential scanning calorimetry. It was found that ultrasound irradiation assistance promoted the formation of the hydrotalcite-like phase and then improved the removal efficiency of bromate. In addition, the effects of solid-to-solution ratio, contact time, initial bromate concentration, initial pH, coexisting anions on the bromate removal were investigated. The results showed the bromate with an initial concentration of 1.56 μmol/L could be completely removed from solution by Fe–Al LDHs within 120 min. When the initial bromate concentration was 7.81 μmol/L, the Fe–Al LDHs with irradiation time of 30 min exhibited the optimum removal efficiency and the bromate removal capacity (q e ) was 6.80 μmol/g. In addition, the appearance of sulfate and production of bromide were observed simultaneously in this process, which suggested that ion-exchange between sulfate and bromate, and the reduction of bromate to bromide by Fe 2+ were the main mechanisms responsible for the bromate removal by Fe–Al LDHs

  9. Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization. (United States)

    Jing, Yan; Han, Xianglong; Guo, Yongwen; Li, Jingyu; Bai, Ding


    This article reports the successful use of miniscrews in the mandible to treat a 20-year-old Mongolian woman with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a mildly protrusive mandible, an anterior crossbite, and a deviated midline. In light of the advantages for reconstruction of the occlusal plane and distal en-masse movement of the mandibular arch, we used a multiloop edgewise archwire in the initial stage. However, the maxillary incisors were in excessive labioversion accompanied by little retraction of the mandibular incisors; these results were obviously not satisfying after 4 months of multiloop edgewise archwire treatment. Two miniscrews were subsequently implanted vertically in the external oblique ridge areas of the bilateral mandibular ramus as skeletal anchorage for en-masse distalization of the mandibular dentition. During treatment, the mandibular anterior teeth were retracted about 4.0 mm without negative lingual inclinations. The movement of the mandibular first molar was almost bodily translation. The maxillary incisors maintained good inclinations by rotating their brackets 180° along with the outstanding performance of the beta-titanium wire. The patient received a harmonious facial balance, an attractive smile, and ideal occlusal relationships. The outcome was stable after 1 year of retention. Our results suggest that the application of miniscrews in the posterior area of the mandible is an effective approach for Class III camouflage treatment. This technique requires minimal compliance and is particularly useful for correcting Class III patients with mild mandibular protrusion and minor crowding. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Luís Felipe Pissaia


    Full Text Available The present study aims to share experiences of the implantation of the Nursing Assistance Systematization with the aid of computer science in a medical clinic unit of a small hospital in Vale do Taquari / RS, Brazil. This is a descriptive and exploratory experience report with a qualitative approach, in which nine nursing professionals were followed during the implantation of the SAE with the help of computer technology in a medical clinic unit of a general hospital, the implantation of the process began in September The results were analyzed as recommended by Bardin. There were some difficulties in the implementation of systematization, such as lack of knowledge about the process and difficulties in handling computer equipment. We also found facilities in the use of information technology during the implementation, such as the availability of information and improved communication between the multiprofessional team. Improvements such as client security and optimization of work processes were also observed. It is considered that the report has a limitation because it contemplates a short time of implantation of the process, nevertheless it leads to a greater discussion on the subject. It was observed the importance of a qualified training for nursing professionals regarding the use of this work methodology, as well as the qualification of assistance and implementation facilitated with the use of information technology.

  11. Modeling the chelation of As(III) in lewisite by dithiols using density functional theory and solvent-assisted proton exchange. (United States)

    Harper, Lenora K; Bayse, Craig A


    Dithiols such as British anti-lewisite (BAL, rac-2,3-dimercaptopropanol) are an important class of antidotes for the blister agent lewisite (trans-2-chlorovinyldichloroarsine) and, more generally, are chelating agents for arsenic and other toxic metals. The reaction of the vicinal thiols of BAL with lewisite through the chelation of the As(III) center has been modeled using density functional theory (DFT) and solvent-assisted proton exchange (SAPE), a microsolvation method that uses a network of water molecules to mimic the role of bulk solvent in models of aqueous phase chemical reactions. The small activation barriers for the stepwise SN2-type nucleophilic attack of BAL on lewisite (0.7-4.9kcal/mol) are consistent with the favorable leaving group properties of the chloride and the affinity of As(III) for soft sulfur nucleophiles. Small, but insignificant, differences in activation barriers were found for the initial attack of the primary versus secondary thiol of BAL and the R vs S enantiomer. An examination of the relative stability of various dithiol-lewisite complexes shows that ethanedithiols like BAL form the most favorable chelation complexes because the angles formed in five-membered ring are most consistent with the hybridization of As(III). More obtuse S-As-S angles are required for larger chelate rings, but internal As⋯N or As⋯O interactions can enhance the stability of moderate-sized rings. The low barriers for lewisite detoxification by BAL and the greater stability of the chelation complexes of small dithiols are consistent with the rapid reversal of toxicity demonstrated in previously reported animal models. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The growth of III-V nitrides heterostructure on Si substrate by plasma-assisted molecular beam epitaxy

    International Nuclear Information System (INIS)

    Beh, K.P.; Yam, F.K.; Chin, C.W.; Tneh, S.S.; Hassan, Z.


    This paper reports the growth of InGaN/GaN/AlN epitaxial layer on Si(1 1 1) substrate by utilizing plasma-assisted molecular beam epitaxy (PA-MBE) system. The as-grown film was characterized using high-resolution X-ray diffraction (HR-XRD) and photoluminescence (PL). High work function metals, iridium and gold were deposited on the film as metal contacts and their electrical characteristics at pre- and post-annealing were studied. The structural quality of this film is comparative to the values reported in the literature, and the indium molar fraction is 0.57 by employing Vegard's law. The relatively low yellow band emission signifies the grown film is of high quality. For metal contact studies it was found that the post-annealed sample for 5 min shows good conductivity as compared to the other samples.

  13. The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: a qualitative snapshot. (United States)

    Tuckett, Anthony; Hegney, Desley; Parker, Deborah; Eley, Robert M; Dickie, Robyn


    The attainment of a work-life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work-life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care. © 2011 Blackwell Publishing Asia Pty Ltd.

  14. The development of an ergonomics training program to identify, evaluate, and control musculoskeletal disorders among nursing assistants at a state-run veterans' home. (United States)

    Peterson, Erica L; McGlothlin, James D; Blue, Carolyn L


    Nursing assistants (NAs) who work in nursing and personal care facilities are twice and five times more likely, respectively, to suffer a musculoskeletal disorder compared to service industries and other health care facilities, respectively. The purpose of this study was to develop an ergonomics training program for selected NAs at a state-run veterans' home to decrease musculoskeletal disorders by 1) developing questionnaires to assess musculoskeletal stress, 2) evaluating the work environment, 3) developing and using a training package, and 4) determining the application of the information from the training package by NAs on the floor. Results show two new risk factors not previously identified for nursing personnel in the peer-reviewed literature. Quizzes given to the nursing personnel before and after training indicated a significant improvement in understanding the principles of ergonomics and patient-handling techniques. Statistical analysis comparing the pre-training and post-training questionnaires indicated no significant decrease in musculoskeletal risk factors and no significant reduction in pain or discomfort or overall mental or physical health.

  15. Bridging the gap between continuous sedation until death and physician-assisted death: a focus group study in nursing homes in Flanders, Belgium. (United States)

    Rys, Sam; Deschepper, Reginald; Mortier, Freddy; Deliens, Luc; Bilsen, Johan


    The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a form of euthanasia. Another group situates CSD between pain relief and ending life. Arguments for these perspectives refer to the following themes: intention, dosage of sedative drugs, unconsciousness, and the pace of the dying process. Generally, CSD is considered emotionally easier to deal with since it entails a gradual dying process. Nursing home clinicians have diverging perceptions of the relation between CSD and PAD; some consider CSD to be more than a purely palliative measure, that is, also as a means to hasten death. © The Author(s) 2014.

  16. Specific features of NH3 and plasma-assisted MBE in the fabrication of III-N HEMT heterostructures

    International Nuclear Information System (INIS)

    Alexeev, A. N.; Krasovitsky, D. M.; Petrov, S. I.; Chaly, V. P.; Mamaev, V. V.; Sidorov, V. G.


    The specific features of how nitride HEMT heterostructures are produced by NH 3 and plasma-assisted (PA) molecular-beam epitaxy (MBE) are considered. It is shown that the use of high-temperature AlN/AlGaN buffer layers grown with ammonia at extremely high temperatures (up to 1150°C) can drastically improve the structural perfection of the active GaN layers and reduce the dislocation density in these layers to values of 9 × 10 8 −1 × 10 9 cm −2 . The use of buffer layers of this kind makes it possible to obtain high-quality GaN/AlGaN heterostructures by both methods. At the same time, in contrast to ammonia MBE which is difficult to apply at T < 500°C (because of the low efficiency of ammonia decomposition), PA MBE is rather effective at low temperatures, e.g., for the growth of InAlN layers lattice-matched with GaN. The results obtained in the MBE growth of AlN/AlGaN/GaN/InAlN heterostructures by both PA-MBE and NH 3 -MBE with an extremely high ammonia flux are demonstrated

  17. Utilization of a biomedical device (VeinViewer® ) to assist with peripheral intravenous catheter (PIV) insertion for pediatric nurses. (United States)

    McNeely, Heidi L; Ream, Theresa L; Thrasher, Jodi M; Dziadkowiec, Oliwier; Callahan, Tiffany J


    Vascular access in pediatric patients can be challenging even with the currently available technological resources. This nurse-driven research study explored time, cost, and resources for intravenous access to determine if a biomedical device, VeinViewer ® Vision, would facilitate improvements in pediatric access. In addition, this study looked at nurse perceptions of skills and confidence around intravenous insertion and if the use of the VeinViewer ® impacted these perceptions. Literature examining pediatric intravenous access success rates compared with nurse perceived skills and confidence is lacking. Nonblinded randomized control trial of pediatric nurses working in an acute care hospital setting. A preliminary needs assessment solicited feedback from nurses regarding their practice, perceived skills, and confidence with placing peripheral intravenous catheters (PIVs). Due to the results of the preliminary needs assessment, a research study was designed and 40 nurses were recruited to participate. The nurses were randomized into either a VeinViewer ® or standard practice group. Nurse participants placed intravenous catheters on hospitalized pediatric patients using established procedures while tracking data for the study. Needs assessment showed a majority of nurses felt a biomedical device would be helpful in building their intravenous insertion skills and their confidence. The study results did not demonstrate any clinically significant differences between VeinViewer ® use and standard practice for intravenous catheter insertion in pediatric patients for success of placement, number of attempts, or overall cost. In addition, no difference was noted between nurses in either group on perceived skills or confidence with insertion of PIVs. The ongoing need for resources focused on building nurse skills and confidence for PIV insertion was highlighted and organizations should continue to direct efforts toward developing skills and competency for staff that

  18. A versatile and highly sensitive homogeneous electrochemical strategy based on the split aptamer binding-induced DNA three-way junction and exonuclease III-assisted target recycling. (United States)

    Hou, Ting; Li, Wei; Zhang, Lianfang; Li, Feng


    Herein, a highly sensitive and versatile homogeneous electrochemical biosensing strategy is proposed, based on the split aptamer-incorporated DNA three-way junction and the exonuclease (Exo) III-assisted target recycling. The aptamer of adenosine triphosphate (ATP, chosen as the model analyte) is split into two fragments and embedded in single-stranded DNA1 and DNA2, respectively. ATP specifically binds with the split aptamers, bringing DNA1 and DNA2 close to each other, thus inducing the DNA three-way junction formation through the partial hybridization among DNA1, DNA2 and the methylene blue-labelled MB-DNA. Subsequently, MB-DNA is specifically digested by Exo III, releasing a MB-labelled mononucleotide, as well as a DNA1-ATP-DNA2 complex, which acts as the recycled target and hybridizes with another intact MB-DNA to initiate the subsequent cycling cleavage process. As a result, large amounts of MB-labelled mononucleotides are released, generating a significantly amplified electrochemical signal toward the ATP assay. To the best of our knowledge, it is the first example to successfully incorporate split aptamers into DNA three-way junctions and to be adopted in a homogeneous electrochemical assay. In addition to high sensitivity, this strategy also exhibits the advantages of simplicity and convenience, because it is carried out in a homogeneous solution, and sophisticated electrode modification processes are avoided. By simply changing the sequences of the split aptamer fragments, this versatile strategy can be easily adopted to assay a large spectrum of targets. Due to its advantages of high sensitivity, excellent selectivity, versatility and simple operation, the as-proposed approach has great potential to be applied in biochemical research and clinical practices.

  19. Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

    Directory of Open Access Journals (Sweden)

    Nam-Ju Lee, DNSc, RN


    Conclusion: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

  20. Association Between the Nursing Home Minimum Data Set for Vision and Vision-Targeted Health-Related Quality of Life in Nursing Home Residents as Assessed by Certified Nursing Assistants

    Directory of Open Access Journals (Sweden)

    Mark W. Swanson


    Conclusions: Ratings by CNAs on the vision-targeted quality of life of nursing home residents under their care is in general agreement with the MDS category assigned by the nurse coordinator. However, CNA ratings are largely homogeneous in the adequate vision to moderately impaired categories.

  1. Do guidelines on euthanasia and physician-assisted suicide in Dutch hospitals and nursing homes reflect the law? A content analysis. (United States)

    Hesselink, B A M; Onwuteaka-Philipsen, B D; Janssen, A J G M; Buiting, H M; Kollau, M; Rietjens, J A C; Pasman, H R W


    To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process.

  2. Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: a cluster randomized controlled trial. (United States)

    Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Patil, Grete; Ihlebaek, Camilla


    The prevalence of neuropsychiatric symptoms in cognitively impaired nursing home residents is known to be very high, with depression and agitation being the most common symptoms. The possible effects of a 12-week intervention with animal-assisted activities (AAA) in nursing homes were studied. The primary outcomes related to depression, agitation and quality of life (QoL). A prospective, cluster randomized multicentre trial with a follow-up measurement 3 months after end of intervention was used. Inclusion criteria were men and women aged 65 years or older, with a diagnosis of dementia or having a cognitive deficit. Ten nursing homes were randomized to either AAA with a dog or a control group with treatment as usual. In total, 58 participants were recruited: 28 in the intervention group and 30 in the control group. The intervention consisted of a 30-min session with AAA twice weekly for 12 weeks in groups of three to six participants, led by a qualified dog handler. Norwegian versions of the Cornell Scale for Depression, the Brief Agitation Rating Scale and the Quality of Life in Late-stage Dementia scale were used. A significant effect on depression and QoL was found for participants with severe dementia at follow-up. For QoL, a significant effect of AAA was also found immediately after the intervention. No effects on agitation were found. Animal-assisted activities may have a positive effect on symptoms of depression and QoL in older people with dementia, especially those in a late stage. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Lost and misplaced items and assistive devices in nursing homes: Identifying problems and technological opportunities through participatory design research. (United States)

    Oude Weernink, C E; Sweegers, L; Relou, L; van der Zijpp, T J; van Hoof, J


    Modern healthcare, including nursing home care, goes together with the use of technologies to support treatment, the provision of care and daily activities. The challenges concerning the implementation of such technologies are numerous. One of these emerging technologies are location technologies (RTLS or Real-Time Location Systems). that can be utilized in the nursing home for monitoring the use and location of assets. This paper describes a participatory design study of RTLS based on context mapping, conducted in two nursing home organizations. Rather than investigating the technological possibilities, this study investigates the needs and wishes from the perspective of the care professional. The study identified semantic themes that relate to the practicalities of lost and misplaced items in the nursing home, as well as latent themes that cover the wishes regarding technology in the nursing homes. The organizational culture and building typology may play a role in losing items. The participants in this study indicated that RTLS can provide a solution to some of the challenges that they encounter in the workplace. However, the implementation of new technologies should be done with care and should be integrated into existing ICT systems in order to minimize additional training and posing a burden on the workload.

  4. A qualitative study exploring the impact of student nurses working part time as a health care assistant. (United States)

    Hasson, Felicity; McKenna, Hugh P; Keeney, Sinead


    National and international evidence indicates that university students engage in employment whilst studying. Research has suggested that nursing students either enter training with previous care experience or tend to work part time in a health related area whilst undertaking higher education. The impact of this on the socialisation process remains unclear. Based on the symbolic interactionist framework, this paper reports on a theme from a large mixed methods study - the extent and implications of student nurses' work experience on learning and training. One qualitative stage from a sequential exploratory mixed methods design. One higher education institution in the United Kingdom. Forty-five pre-registration nursing students. Thirty-two students took part in four focus groups and 13 took part in individual interviews. Findings revealed that 27 (60%) of students were in paid nursing related employment. This was reported to be advantageous by most participants with regards to enhancing confidence, skills and time spent in the clinical setting. However, it was also perceived by a small number of participants as being detrimental to subsequent learning resulting in role confusion, influencing placement behaviour, and preferences for future nursing practice. Student participants with no prior work experience believed this placed them at a disadvantage, negatively influencing their learning, ability to fit in, and adjustment on placement. Findings have suggested that student participants desire more recognition of the experience and skills they have gained from their employment. Whilst care experience among the student nursing population is advocated, the results of this study show that it is perceived to impinged on their learning and educational journey. Policy makers, educationalists and health service providers need to be aware of the students who operate within the dual roles of student and health care worker so as to provide guidance and appropriate direction

  5. Assistência de enfermagem perioperatória: ensino em cursos de enfermagem Enseñanza de enfermería perioperatoria en los cursos de Pre grado en enfermería The teaching of the perioperatory nursing assistance in undergraduate courses in Nursing

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Querido Avelar


    Full Text Available Buscou-se no presente estudo, retratar a realidade do ensino da assistência de enfermagem perioperatória, analisando e delineando suas tendências entre docentes de cursos de graduação em enfermagem que ministram esse conteúdo. A assistência de enfermagem perioperatória como processo realizado por profissionais de enfermagem, em uma fase específica de atenção ao paciente, frente ao procedimento anestésico-cirúrgico, envolve estratégias e orientações expressas na práxis do enfermeiro. Aqui o ensino da assistência de enfermagem perioperatória, como atividade dinâmica das ações dos docentes de Enfermagem em Centro Cirúrgico, desenvolvida num processo coletivo, emerge como práxis ritual no mundo do sistema, da razão técnica instrumental, distanciando-se do entendimento consensual, da razão comunicativa e do fomento às alternativas voltadas à práxis social/emancipatória.En el presente estudio se buscó retratar la realidad de la enseñanza de la asistencia de enfermería perioperatoria, analizando y delineando sus tendencias entre los docentes de enfermería perioperatoria. Como proceso realizado por los profesionales de enfermería en una fase específica de atención al paciente frente al procedimiento anestésico-quirúrgico, involucra estrategias y orientaciones expresadas en la praxis del enfermero. Se puede concluir que la enseñanza de la asistencia de enfermería perioperatoria, como actividad dinámica de las acciones de los docentes de Enfermería en Centro Quirúrgico, desarrollada en un proceso colectivo, emerge como praxis ritual en el mundo del sistema, de la razón técnica instrumental, distanciándose del entendimiento consensual de la razón comunicativa y de fomento de alternativas relativas a la praxis social/emancipadora.In the present study, the authors describe the reality of the perioperatory nursing assistance, analyzing and outlining its trends among professors of undergraduate courses in

  6. The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse. (United States)

    Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin


    Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered.Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta-analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Thirty three studies were included in the review: RCT (1), Quasi-experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1).Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence

  7. Assistência de enfermagem ao portador de Hanseníase: abordagem transcultural Asistencia de enfermería al portador de Lepra: abordaje transcultural Nursing assistance to a Leprosy-infected patient: transcultural approach

    Directory of Open Access Journals (Sweden)

    Fernando José Guedes da Silva Júnior


    com la lepra de forma culturalmente satisfactória.This is a case study, developed in a health center in Teresina-PI, which dealt with the issue of nursing assistance given to a patient with Multibacillary Leprosy, focusing on the Transcultural Nursing care, Diagnosis and Nursing Interventions according to NANDA Taxonomy II. A semi-structured interview and participant observation were carried out, which enabled data collection handled according to normative patterns, values and daily practices, ways of popular care and cares required in the professional system. In this study, we realized that nursing assistance planning aimed, especially, to contribute on the disease treatment support, reducing potential risks and using preservation, negotiation and re-standardization of the professional system. We also observed the support to the treatment and the development of self care turned to leprosy in a culturally satisfactory way.

  8. Assistência de enfermagem a paciente com fibrilação atrial Asistencia de enfermería al paciente con fibrilación atrial Nursing assistance to patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Lutgarde Magda Suzanne Vanheusden


    Full Text Available Este estudo tem por objetivo apresentar uma revisão atualizada sobre as questões que envolvem a assistência à paciente que desenvolve fibrilação atrial. Essa revisão discute a condição complexa dessa taquiarritmia que influencia a mortalidade, morbidade, abordando o seu elevado custo para o sistema de saúde. A assistência e o importante papel da educação para a enfermagem nessa área estão sendo discutidos. Como a prevalência da fibrilação atrial aumenta com a idade e o Brasil tem uma população idosa cada vez mais crescente, a enfermagem enfrenta atualmente o desafio para cuidar dessa população que apresenta necessidades variadas.Este estudio tiene por objetivo presentar una revisión actualizada sobre las cuestiones que envuelven la asistencia al paciente que desarrolla fibrilación atrial. Esa revisión discute la condición compleja de esa taquiarritmia que influencia la morbidad, mortalidad, enfocando el costo que es muy grande para el sistema de salud. Se discute también la asistencia y el importante papel de la educación para la enfermería en esa área. Como la prevalencia de la fibrilación atrial aumenta con la edad y como el Brasil tiene una población de ancianos cada vez más creciente, la enfermería, actualmente, enfrenta el desafío para cuidar de esa población que presenta necesidades variadas.The objective of this study is to present an up to date revision about the assistance of the patient that develops atrial fibrilation. This revision raises the discussion on the complexity of atrial fibrillation that influences the mortality, morbidity, and the high cost for the health system. The assistance and the important paper of education of nursing on atrial fibrillation are here discussed. The population of Brazil is increasing in time and age consequently the prevalence of atrial fibrillation is also increasing. Thus, nursing faces the current challenge to take care of this specific population that presents

  9. Stress, coping, and general health of nurses who work in units that assist AIDS-carriers and patients with


    Da Silva Britto, Eliane; Pimenta Carvalho, Ana Maria


    Based on Lazarus and Folkman’s theory about stress and coping, this research aimed at answering questions related to how nurses, who work in two specialized units of a general hospital, evaluate their working environment, their health and how they manage with stressing situations. In the unit of infectious diseases, the nurses’ evaluation of their working environment did not surpass the limits of what is considered as acceptable. In the unit of hematological alterations, the results showed hi...

  10. The impact of ethics and work-related factors on nurse practitioners' and physician assistants' views on quality of primary healthcare in the United States. (United States)

    Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine


    Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (pfactors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Blending technology in teaching advanced health assessment in a family nurse practitioner program: using personal digital assistants in a simulation laboratory. (United States)

    Elliott, Lydia; DeCristofaro, Claire; Carpenter, Alesia


    This article describes the development and implementation of integrated use of personal handheld devices (personal digital assistants, PDAs) and high-fidelity simulation in an advanced health assessment course in a graduate family nurse practitioner (NP) program. A teaching tool was developed that can be utilized as a template for clinical case scenarios blending these separate technologies. Review of the evidence-based literature, including peer-reviewed articles and reviews. Blending the technologies of high-fidelity simulation and handheld devices (PDAs) provided a positive learning experience for graduate NP students in a teaching laboratory setting. Combining both technologies in clinical case scenarios offered a more real-world learning experience, with a focus on point-of-care service and integration of interview and physical assessment skills with existing standards of care and external clinical resources. Faculty modeling and advance training with PDA technology was crucial to success. Faculty developed a general template tool and systems-based clinical scenarios integrating PDA and high-fidelity simulation. Faculty observations, the general template tool, and one scenario example are included in this article. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  12. Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings. (United States)

    Howe, Lynn


    This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

  13. Vacuum-assisted closure therapy for vascular graft infection (Szilagyi grade III) in the groin-a 10-year multi-center experience. (United States)

    Verma, Himanshu; Ktenidis, Kiriakos; George, Robbie K; Tripathi, Ramesh


    The aim of the study was to evaluate the benefit of vacuum-assisted closure (VAC) therapy in the management of deep, alloplastic graft infections (Szilagyi grade III) in the groin. From 2000 to 2009, we identified and included in our study 72 deep inguinal infections in 68 patients, involving native as well as synthetic graft or patch material. There were 29 early graft infections (infections (≥30 days after implantation). Among these, 17 cases involved native grafts/patches (12 grafts and 5 patches), while 55 cases involved non-native grafts/patches [26 polytetrafluorethylene (PTFE) grafts and 24 Dacron grafts (Haemashield, Meadox Medical, Boston Scientific Corporation, Natick, NY; Gelsoft graft, Vascutek, Inchinnan, Renfrewshire, Scotland, UK; Intervascular, Mahwah, NJ); INVISTA, and 5 Vascu-Guard(™) bovine pericardial patches; Synovis Surgical Innovation]. All patients were treated with multiple wound debridements, graft salvage, sartorius myoplasty, intravenous antibiotics and VAC therapy until thorough surface healing was achieved. Exclusion criteria were an alloplastic graft infection with proximal expansion above the inguinal ligament, blood culture positive for septicaemia or septic anastomotic herald or overt bleeding. Nine months after initiation of therapy, overall, graft/patch salvage was achieved in 61 of 72 (84·7%) cases. Of the native graft/patch group, infected graft material was replaced with an autogenous great saphenous vein graft or patch in four patients (23·5%). In the non-native group, vein or synthetic graft preservation without revision was achieved in 48 of 55 (87·3%) patients. The mean duration of VAC therapy was 16 ± 7·7 days, and postoperative mean hospital stay was 25·3 ± 8·5 days. In 23 of 72 (31·9%) cases, a secondary closure of the wound was achieved; in the other 49 cases, wound healing was achieved by meshed split-thickness skin grafting. Mean wound healing time for all wounds was 24·3 ± 12·5 days. Specific

  14. Quantitative determination of juvenile hormone III and 20-hydroxyecdysone in queen larvae and drone pupae of Apis mellifera by ultrasonic-assisted extraction and liquid chromatography with electrospray ionization tandem mass spectrometry. (United States)

    Zhou, Jinhui; Qi, Yitao; Hou, Yali; Zhao, Jing; Li, Yi; Xue, Xiaofeng; Wu, Liming; Zhang, Jinzhen; Chen, Fang


    In this paper, a method for the rapid and sensitive analysis of juvenile hormone III (JH III) and 20-hydroxyecdysone (20E) in queen larvae and drone pupae samples was presented. Ultrasound-assisted extraction provided a significant shortening of the leaching time for the extraction of JH III and 20E and satisfactory sensitivity as compared to the conventional shake extraction procedure. After extraction, determination was carried out by liquid chromatography-tandem mass spectrometry (LC-MS/MS) operating in electrospray ionization positive ion mode via multiple reaction monitoring (MRM) without any clean-up step prior to analysis. A linear gradient consisting of (A) water containing 0.1% formic acid and (B) acetonitrile containing 0.1% formic acid, and a ZORBAX SB-Aq column (100 mm × 2.1 mm, 3.5 μm) were employed to obtain the best resolution of the target analytes. The method was validated for linearity, limit of quantification, recovery, matrix effects, precision and stability. Drone pupae samples were found to contain 20E at concentrations of 18.0 ± 0.1 ng/g (mean ± SD) and JH III was detected at concentrations of 0.20 ± 0.06 ng/g (mean ± SD) in queen larvae samples. This validated method provided some practical information for the actual content of JH III and 20E in queen larvae and drone pupae samples. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Nursing and spirituality

    Directory of Open Access Journals (Sweden)

    Raphael de Brito Pedrão


    Full Text Available Objectives: To evaluate the spiritual well-being of nurses; to appraise their opinions as to the importance of offering patients spiritual assistance, and to verify whether nurses received any specific type of preparation during their professional training for giving spiritual assistance to patients. Methods: This is an exploratory and descriptive study, carried out with a sample of 30 nurses who worked at the Stepdown Unit and Oncology Unit of Hospital Israelita Albert Einstein, using the application of the Spiritual Well-Being Scale (SWS and a questionnaire prepared by the authors. Results: On the Spiritual Well-Being Scale, 76.6% of nurses produced positive scores. On the Existential Well-Being subscale, 80% had positive scores, and on the Religious Well-Being subscale, 76.6% had positive scores. On the SWBS, the general average score was 107.26, and for the Existential and Religious ones, the average scores were 54.4 and 53.2, respectively. Most nurses responded affirmatively as to the importance of offering patients spiritual assistance, and 40% of nurses offered as rationale “to provide well-being and comfort to the patient”. Most nurses reported not having received professional training for giving spiritual assistance to patients in any of the nursing courses they had done. Conclusions: The results indicate the need for professional training and/or continued education courses in nursing to extend the reflection and discussion on spirituality and spiritual assistance to patients.

  16. School Nurse Workload. (United States)

    Endsley, Patricia


    The purpose of this scoping review was to survey the most recent (5 years) acute care, community health, and mental health nursing workload literature to understand themes and research avenues that may be applicable to school nursing workload research. The search for empirical and nonempirical literature was conducted using search engines such as Google Scholar, PubMed, CINAHL, and Medline. Twenty-nine empirical studies and nine nonempirical articles were selected for inclusion. Themes that emerged consistent with school nurse practice include patient classification systems, environmental factors, assistive personnel, missed nursing care, and nurse satisfaction. School nursing is a public health discipline and population studies are an inherent research priority but may overlook workload variables at the clinical level. School nurses need a consistent method of population assessment, as well as evaluation of appropriate use of assistive personnel and school environment factors. Assessment of tasks not directly related to student care and professional development must also be considered in total workload.

  17. Sistematização da Assistência de Enfermagem em Unidade de Terapia Intensiva Sistematización de la Asistencia de Enfermería en Unidad de Terapía Intensiva Systematization of Nursing Assistance in Critical Care Unit

    Directory of Open Access Journals (Sweden)

    Thiago Christel Truppel


    Full Text Available Trata-se de uma pesquisa metodológica, cujo objetivo foi reestruturar a Sistematização da Assistência de Enfermagem (SAE em uma Unidade de Terapia Intensiva (UTI. Realizaram-se neste estudo as seguintes etapas: descrição da prática de enfermagem; transcrição dos diagnósticos; construção do protocolo de diagnósticos baseado na classificação internacional para a prática de enfermagem (CIPE; determinação das prescrições e construção de normas, rotinas e procedimentos. Caracterizou-se a prática da enfermagem em UTI e a complexidade do cuidado ao paciente crítico. Assim, compreende-se a SAE como um instrumento valioso de valorização da prática da Enfermagem.Tratase de una investigación metodologica, cuyo objetivo ha sido reestructurar la sistematización de assistência de enfermería en una unidad de terapia intensiva. Las siguientes etapas fueron realizadas en este estudio: descripción del los diagnósticos de enfermería, construcción del protocolo basado en la Clasificación Internacional para la Práctica de Enfermería (CIPE, determinación de prescripciones y construcción de reglas, rutinas e procedimientos. La práctica de enfermería y la complejidad de la asistencia a pacientes críticos en UTI fueron caracterizadas. Así, la sistematización de la asistencia de enfermería es comprendida cómo un instrumento de valoración de la práctica de enfermeria.This is a methodological research, which aimed at organizing the systematization of nursing assistance in a critical care unit. The following steps were carried out: description of the nursing practice; transcription of nursing diagnoses; elaboration of a protocol for nursing diagnosis based in International Classification for Nursing Practice (ICNP; determination of nursing prescriptions and the elaboration of guidelines for care and procedures. The nursing practice and care complexity in ICU were characterized. Thus, systematization of nursing assistance is

  18. The Systems Approach to Functional Job Analysis. Task Analysis of the Physician's Assistant: Volume II--Curriculum and Phase I Basic Core Courses and Volume III--Phases II and III--Clinical Clerkships and Assignments. (United States)

    Wake Forest Univ., Winston Salem, NC. Bowman Gray School of Medicine.

    This publication contains a curriculum developed through functional job analyses for a 24-month physician's assistant training program. Phase 1 of the 3-phase program is a 6-month basic course program in clinical and bioscience principles and is required of all students regardless of their specialty interest. Phase 2 is a 6 to 10 month period of…

  19. Auditoria do método de assistência de enfermagem Auditoria del método de asistencia de enfermería Auditing the nursing care methodology

    Directory of Open Access Journals (Sweden)

    Michel Maximiano Faraco


    Full Text Available Este estudo descreve o desenvolvimento de um processo de auditoria do Método de Assistência de Enfermagem em uma unidade de internação de um Hospital Universitário. Identificados os padrões, elaborou-se o instrumento, sob a forma de indicadores, no qual foram examinados, aleatoriamente, cinco prontuários com exame do usuário "in loco". Os dados foram mensurados e classificados numa quanti-qualificação da assistência de Enfermagem. Os resultados encontrados indicam a necessidade de revisão dos Padrões do Método de Assistência de Enfermagem e da retomada imediata do programa de auditoria da assistência de Enfermagem.Este estudio describe el desarrollo de un proceso de auditoría del Método de Asistencia de Enfermería en una unidad de la internación de un Hospital de la Universidad. Identificó los estándares, el instrumento fue elaborado, bajo forma de indicadores, en los cuales había sido examinado, al azar, cinco manuales con la examinación del usuario «in loco». Los datos habían sido agregar y clasificado en una quanti-calificación de la asistencia enfermería. Los resultados unidos indican la necesidad de la revisión de los estándares del método de asistencia enfermería y de vuelto a tomar el inmediato del programa de auditoría de la asistencia de enfermería.This study it describes the development of a process of audit of the Method of Assistance of Nursing in a unit of internment of a University Hospital. Identified the standards, the instrument was elaborated, under the form of indicators, in which had been examined, random, five handbooks with examination of the user "in loco". The data had been to add and classified in a quanti-qualification of the assistance of Nursing. The found results indicate the necessity of revision of the Standards of the Method of Assistance of Nursing and of the immediate retaking of the program of auditor of the assistance of Nursing.

  20. Changes in malnutrition and quality of nutritional care among aged residents in all nursing homes and assisted living facilities in Helsinki 2003-2011. (United States)

    Saarela, Riitta K T; Muurinen, Seija; Suominen, Merja H; Savikko, Niina N; Soini, Helena; Pitkälä, Kaisu H


    While nutritional problems have been recognized as common in institutional settings for several decades, less is known about how nutritional care and nutrition has changed in these settings over time. To describe and compare the nutritional problems and nutritional care of residents in all nursing homes (NH) in 2003 and 2011 and residents in all assisted living facilities (ALF) in 2007 and 2011, in Helsinki, Finland. We combined four cross-sectional datasets of (1) residents from all NHs in 2003 (N=1987), (2) residents from all ALFs in 2007 (N=1377), (3) residents from all NHs in 2011 (N=1576) and (4) residents from all ALFs in 2011 (N=1585). All participants at each time point were assessed using identical methods, including the Mini Nutritional Assessment (MNA). The mean age of both samples from 2011 was higher and a larger proportion suffered from dementia, compared to earlier collected samples. A larger proportion of the residents in 2011 were assessed either malnourished or at-risk for malnutrition, according to the MNA, than in 2003 (NH: 93.5% vs. 88.9%, pimprovement. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Multicomponent Synthesis of Isoindolinone Frameworks via RhIII -Catalysed in situ Directing Group-Assisted Tandem Oxidative Olefination/Michael Addition. (United States)

    Wang, Liang; Liu, Xi; Liu, Jian-Biao; Shen, Jun; Chen, Qun; He, Ming-Yang


    A Rh III -catalysed three-component synthesis of isoindolinone frameworks via direct assembly of benzoyl chlorides, o-aminophenols and activated alkenes has been developed. The process involves in situ generation of o-aminophenol (OAP)-based bidentate directing group (DG), Rh III -catalysed tandem ortho C-H olefination and subsequent cyclization via aza-Michael addition. This protocol exhibits good chemoselectivity and functional group tolerance. Computational studies showed that the presence of hydroxyl group on the N-aryl ring could enhance the chemoselectivity of the reaction. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Death Concern and Attitudes toward the Elderly in Nursing Home Personnel as a Function of Training. (United States)

    DePaola, Stephen J.; And Others


    Investigated the relationship between death fear, attitudes toward the elderly, and personal anxiety about aging in nursing home employees. Nursing professionals (registered nurses or licensed practical nurses) had lower levels of death concern than nursing assistants, and results also indicated that nursing assistants displayed significantly…

  3. Processo de Enfermagem: instrumento da Sistematização da Assistência de enfermagem na percepção dos enfermeiros Nursing process: systematization of the nursing care instrument in the perception of nurses

    Directory of Open Access Journals (Sweden)

    Silvana Alves Benedet


    Full Text Available Objetivo: com objetivo de identificar a percepção dos enfermeiros acerca da contribuição do Processo de Enfermagem para a Sistematização da Assistência de Enfermagem realizado em Hospital de Ensino do Sul do Brasil. Método: estudo qualitativo com caráter descritivo e exploratório. Os participantes da pesquisa foram 38 enfermeiros. A análise qualitativa foi de conteúdo e com os recursos do software Atlas Ti®. Resultados: após a análise foram encontradas as seguintes categorias temáticas: aspectos operacionais do Processo de Enfermagem; o Processo de Enfermagem e sua aplicação prática; facilidades e dificuldades na implementação do Processo de Enfermagem. Conclusão: a utilização de um modelo assistencial para guiar a prática de enfermagem há mais de três décadas, tem repercutido de maneira positiva na qualidade da assistência prestada, bem como na satisfação dos enfermeiros ao perceberem seu trabalho reconhecido. O Processo de Enfermagem melhora a sistematização da assistência de enfermagem, com a filosofia da Instituição e do Serviço de Enfermagem alinhadas a uma política de educação permanente.

  4. Cultivating future nurse leaders with student nurses associations. (United States)

    Akans, Merlana; Harrington, Maura; McCash, John; Childs, Ashlyn; Gripentrog, Jessica; Cole, Sharon; Fitzgerald, Kevin; Searing, Kimberly; Fuehr, Patricia


    Student nurses associations (SNAs) assist in developing tomorrow's nurse leaders. In this article, executive board members of an SNA in a traditional baccalaureate nursing program at a public regional university recounted common themes in their participation in an SNA. These broad themes included leadership, mentorship and communication, all which foster professional development through the acquisition of specific knowledge, skills and experiences. © 2013 AWHONN.

  5. Cuidados paliativos e bioética: estudo com enfermeiros assistenciais Palliative care and bioethics: study with assistance nurses

    Directory of Open Access Journals (Sweden)

    Cristiani Garrido de Andrade


    Full Text Available Objetivo: Objetivou-se investigar as observâncias éticas utilizadas pelos enfermeiros ao assistirem o paciente sem possibilidades de cura. Métodos: Pesquisa exploratória, de natureza qualitativa, realizada com 28 enfermeiros de um hospital público, localizado na cidade de João Pessoa – PB. Os dados foram coletados por meio de questionário, de agosto a outubro de 2012 e submetidos à técnica de análise de conteúdo. Resultados: As categorias identificadas foram: Cuidados Paliativos: princípios da Bioética ao paciente sem possibilidades de cura e Privacidade e sigilo profissional no âmbito dos cuidados paliativos. Tais categorias indicaram que os profissionais passam a valorizar os princípios da Bioética, assim como a privacidade e o sigilo profissional, utilizando-os como estratégia para auxiliar o cuidar ao paciente sem possibilidades de cura. Conclusão: Espera-se que este estudo subsidie novas investigações, pois ainda são incipientes as pesquisas que abordam a bioética na assistência ao paciente sob cuidados paliativos.

  6. Integrating a Career Planning and Development Program into the Baccalaureate Nursing Curriculum: Part III. Impact on Faculty's Career Satisfaction and Confidence in Providing Student Career Coaching. (United States)

    Waddell, Janice; Spalding, Karen; Navarro, Justine; Gaitana, Gianina


    As career satisfaction has been identified as a predictor of retention of nurses across all sectors, it is important that career satisfaction of both new and experienced nursing faculty is recognized in academic settings. A study of a curriculum-based career planning and development (CPD) program was conducted to determine the program's effects on participating students, new graduate nurses, and faculty. This third in a series of three papers reports on how the CPD intervention affected faculty participants' sense of career satisfaction and confidence in their role as career educators and coaches. Faculty who participated in the intervention CPD intervention group reported an increase in confidence in their ability to provide career coaching and education to students. They further indicated that their own career development served to enhance career satisfaction; an outcome identified as a predictor of faculty career satisfaction. Study results suggest that interventions such as the one described in this paper can have a potentially positive impact in other settings as well.

  7. Nursing on the medical ward. (United States)

    Parker, Judith M


    This paper considers some issues confronting contemporary medical nursing and draws upon psychoanalytic theories to investigate some seemingly straightforward and taken-for-granted areas of medical nursing work. I am arguing that the everyday work of medical nurses in caring for patients is concerned with bringing order to and placing boundaries around inherently unsettled and destabilized circumstances. I am also arguing that how nurses manage and organize their work in this regard stems from traditional practices that tend to be taken for granted and not explicitly thought about. It is therefore difficult for nurses to consider changing these practices that often have negative consequences for the nurses. I want to examine the impact upon nurses of the consequences of three taken-for-granted nursing practices: (i) the tendency of nurses to confine their reactions to what is going on so as to present a caring self; (ii) the tendency of nurses in their everyday talk to patients to confine, limit and minimize meaning; and (iii) the tensions and ambiguities that emerge for nurses in the policing function they perform in confining patients to the bed or the ward. Negative consequences on nurses of these practices potentially include stress and confusion regarding their ability to care for patients; an undervaluing of nursing skills; and a deterioration in the nurse-patient relationship. Clinical supervision for medical nurses is proposed as a means of facilitating greater understanding of the nature of nurses' relationships with patients and the complex dimensions of their medical nursing role.

  8. Advancing the nursing profession begins with leadership. (United States)

    O'Neill, Jennifer A


    This bimonthly department, sponsored by the American Organization of Nurse Executives (AONE), presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients.

  9. Motivational journey of Iranian bachelor of nursing students during clinical education: a grounded theory study. (United States)

    Hanifi, Nasrin; Parvizy, Soroor; Joolaee, Soodabeh


    This study explored how nursing students can be kept motivated throughout their clinical education. Motivation is a key issue in nursing clinical education for student retention. The study was conducted using grounded theory methods, which are appropriate when studying process in a social context. Sixteen students and four instructors, who were purposefully selected, participated in semistructured interviews. Data were analyzed using the constant comparative method. Students' motivational journey occurred in three steps: (i) social condition; (ii) encountering the clinical education challenges; and (iii) looking for an escape from nursing, or simply tolerating nursing. Struggling with professional identity emerged as the core variable. Iran's social context and many other conditions in the clinical education setting affect students' motivation. Identifying motivational process might assist educational authorities in offering solutions to promote motivation among students. © 2013 Wiley Publishing Asia Pty Ltd.

  10. Microwave irradiation-assisted deposition of Ga2O3 on III-nitrides for deep-UV opto-electronics (United States)

    Jaiswal, Piyush; Ul Muazzam, Usman; Pratiyush, Anamika Singh; Mohan, Nagaboopathy; Raghavan, Srinivasan; Muralidharan, R.; Shivashankar, S. A.; Nath, Digbijoy N.


    We report on the deposition of Ga2O3 on III-nitride epi-layers using the microwave irradiation technique. We also report on the demonstration of a Ga2O3 device: a visible-blind, deep-UV detector, with a GaN-based heterostructure as the substrate. The film deposited in the solution medium, at <200 °C, using a metalorganic precursor, was nanocrystalline. XRD confirms that the as-deposited film, when annealed at high temperature, turns to polycrystalline β-Ga2O3. SEM shows the as-deposited film to be uniform, with a surface roughness of 4-5 nm, as revealed by AFM. Interdigitated metal-semiconductor-metal devices with Ni/Au contact exhibited a peak spectral response at 230 nm and a good visible rejection ratio. This demonstration of a deep-UV detector on the β-Ga2O3/III-nitride stack is expected to open up possibilities of functional and physical integration of β-Ga2O3 and GaN material families towards enabling next-generation high-performance devices by exciting band and heterostructure engineering.

  11. Taking care of you and care for others: an analysis of the activity of the work of technical and nursing assistants of a psychiatric institution for children and adolescents. (United States)

    Mendes, Davidson Passos; Moraes, Geraldo Fabiano de Souza; Mendes, Juliana Cristina de Lima


    Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.


    Directory of Open Access Journals (Sweden)

    Renata Gomes Rodrigues


    Full Text Available SUMMARY: It is a historical study that has as objective to describe the early days of the assistance to the new-born babies in foreign countries and in Brazil, from 1870 to 1903. The primary sources are existing articles in the Foundation National Library. The secondary sources are pertinent studies to the thematic one. With the purpose to keep warm the premature babies, in the end of XIX century were created the first incubator. In Brazil, the “Lion” new-born babies arrived in the beginning of XX century (1903. The use of the new born babies and the peculiarities of the cares to the new-born babies are Importants landmarks for the development of the neonatology. KEY WORDS: Nursing; Neonatology; Nursing History.

  13. Ultrasound-assisted biodiesel production by a novel composite of Fe(III)-based MOF and phosphotangestic acid as efficient and reusable catalyst. (United States)

    Nikseresht, Ahmad; Daniyali, Asra; Ali-Mohammadi, Mahdi; Afzalinia, Ahmad; Mirzaie, Abbas


    In this work, esterification of oleic acid by various alcohols is achieved with high yields under ultrasonic irradiation. This reaction performed with a novel heterogeneous catalyst that fabricated by heteropoly acid and Fe(III)-based MOF, namely MIL-53 (Fe). Syntheses of MIL-53 and encapsulation process carry out by ultrasound irradiation at ambient temperature and atmospheric pressure. The prepared composite was characterized by various techniques such as XRD, FT-IR, SEM, BET and ICP that demonstrate excellent catalytic activities, while being highly convenient to synthesize. The obtained results revealed that ultrasound irradiation could be used for the appropriate and rapid biodiesel production. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Determination of total arsenic and arsenic(III) in phosphate fertilizers by hydride generation atomic absorption spectrometry after ultrasound-assisted extraction based on a control acid media. (United States)

    Rezende, Helen Cristine; Coelho, Nivia Maria Melo


    An ultrasound-assisted extraction procedure was developed for determination of inorganic arsenic (As) in phosphate fertilizer by hydride generation atomic absorption spectrometry. The variables that affect the hydride generation step were optimized, including the reducer, acid, sample flow rate, and concentrations of the acid and reducer. The determination of As(lll) was performed through the simple control of solution pH with a 0.5 M citric acid-sodium citrate buffer solution at pH 4.5, and total As was determined after a pre-reduction reaction with 1.0% (w/v) thiourea. Ultrasound-assisted acid extraction was performed, and the parameters sonication time and acid and Triton X-114 concentrations were optimized using a 23 factorial design and central composite design. LODs for As(lll) and total As were 0.029 and 0.022 microg/L, respectively. The accuracy of the method was confirmed with certified reference materials. The method was successfully applied in the determination of inorganic As in phosphate fertilizer samples.

  15. Nurses' experiences of using a smart mobile device application to assist home care for patients with chronic disease: a qualitative study. (United States)

    Chiang, Kuei-Feng; Wang, Hsiu-Hung


    To examine nurses' experiences regarding the benefits and obstacles of using a smart mobile device application in home care. The popularity of mobile phones and Internet technology has established an opportunity for interaction between patients and health care professionals. Line is an application allowing instant communication that is available for free globally. However, the literature relating to use of Line in this area is limited. A qualitative study involving individual in-depth interviews. Participants included community nurses (N = 17) from six home care facilities in southern Taiwan who had used Line for home care of chronically ill patients for at least six months. The study was conducted using semi-structured in-depth interviews, which were recorded and converted into transcripts for content analysis. Seven themes emerged from data analysis: reduction in medical care consumption and costs, reduction in workload and stress, facilitating improvement in the quality of care, promotion of the nurse-patient relationship, perceived risk, lack of organisational incentives and operating procedures and disturbance to personal life. Nurses considered Line valuable for use in home care. While this application has diverse functions, its video transfer function could in particular help nursing staff make prompt decisions about patients' problems and promote nurse-patient relationships. However, there might be hidden risks including legal consequences, safety risks to patients, possible violations of professionalism and increased risk of nurse burnout. Increasing nursing staff awareness of using mobile messaging software applications is necessary. This study provides relevant information about the benefits, disadvantages, risks and limitations of nurses' use of Line. The study also provides suggestions for software programmers and future organisational strategy and development. © 2016 John Wiley & Sons Ltd.

  16. Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study. (United States)

    van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda


    Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about

  17. Effects of treatment of the fat body trophocytes of Melipona quadrifasciata anthidioides nurse workers and virgin queens in culture by juvenile hormone III and ecdysterone (20-HE). (United States)

    Paes-De-Oliveira, Vagner Tadeu; Berger, Bruno; Poiani, Silvana Beani; Paulino Simões, Zilá Luz; Da Cruz-Landim, Carminda


    The fat body (FB) consists of two types of cells: throphocytes and oenocytes. Throphocytes are related to intermediary metabolism storing lipids, carbohydrates, and proteins while oenocytes play role in the lipids and lipoproteins production. The vitellogenin is the precursor of egg yolk (vitelline) and is synthesized on FB. The aim of this work was to analyze the effects of hormones acting in bee reproduction, as juvenile hormone (JH) and ecdisteroids (20 HE) on FB cells, where vitellogenin is synthesized. For the study were chose nurse workers that in Melipona quadrifasciata anthidioides present activated ovaries and produce eggs, and virgin queens whose ovaries are not yet activated, presenting only previtellogenic follicles. FB trophocytes from these classes of bees were cultivated in media containing different amounts of JH and 20-HE. The effects on trophocytes cytoplasm reserves of lipids, proteins, and activity of acid phosphatase were compared by observing preparations from cultured FB, treated and control, by transmission electron microscopy (TEM). The results showed that the hormones effects are related to the bee's caste and functional ovary stage. The role of acid phosphatase on mobilization of the trophocyte reserves was also determined. Copyright © 2012 Wiley Periodicals, Inc.

  18. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile) (United States)

    NSGIC State | GIS Inventory — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and 81...

  19. Sistematização da Assistência de Enfermagem ao portador de Diabetes Mellitus e Insuficiência Renal Crônica Sistematización de la Asistencia de Enfermería al portador de Diabetes Mellitus y Insuficiencia Renal Systematization of Nursing Assistance to patients with Diabetes Mellitus and Chronic Renal

    Directory of Open Access Journals (Sweden)

    Nildo Batista Mascarenhas


    Full Text Available Tratou-se de um estudo de caso clínico desenvolvido durante as atividades práticas da disciplina Enfermagem Clínico-Cirúrgica I, do curso de Graduação em Enfermagem de uma universidade pública do Estado da Bahia, que objetivou relatar a aplicação da Sistematização da Assistência de Enfermagem na assistência a um paciente portador de Diabetes Mellitus e Insuficiência Renal Crônica. Com o desenvolvimento do estudo, em especial após a melhora positiva da paciente face às condutas planejadas e implementadas e, considerando as reflexões que emergiram, foi possível constatar a necessidade da interface entre a Sistematização da Assistência de Enfermagem, equipe de enfermagem e paciente no processo do cuidar, frente à excelência e singularidade dos cuidados de enfermagemEste es un estudio de caso desarrollado durante las actividades prácticas de la disciplina de Enfermería Clínica Quirúrgica I, del curso de Grado en Enfermería en una universidad pública del Estado de Bahía, que tuvo por objetivo relatar la aplicación de la Sistematización de la Asistencia de Enfermería (SAE en asistencia a un paciente conducir a la Diabetes Mellitus y la Insuficiencia Renal Crónica. Con el desarrollo del estudio, sobre todo después de la mejora positiva del paciente, se enfrentan para llevar a cabo y planifiquen y ejecuten teniendo en cuenta las ideas que surgieron, es posible ver la necesidad de interfaz entre la Sistematización de la Asistencia de Enfermería y el personal de enfermería y el paciente en el proceso de atención, en la excelencia y la singularidad de los cuidados de enfermeríaThis is a clinical case study developed during the practical activities of the discipline Surgical Clinical Nursing I, of course of Graduation in Nursing of a public university of Bahia State, that aimed to report the application of the Systematization of Nursing Assistance in the assistance to a client whit Diabetes Mellitus and Chronic Renal

  20. Specific features of NH{sub 3} and plasma-assisted MBE in the fabrication of III-N HEMT heterostructures

    Energy Technology Data Exchange (ETDEWEB)

    Alexeev, A. N. [NTO ZAO (Russian Federation); Krasovitsky, D. M. [Svetlana-Rost ZAO (Russian Federation); Petrov, S. I., E-mail: [NTO ZAO (Russian Federation); Chaly, V. P.; Mamaev, V. V. [Svetlana-Rost ZAO (Russian Federation); Sidorov, V. G. [St. Petersburg State Polytechnic University (Russian Federation)


    The specific features of how nitride HEMT heterostructures are produced by NH{sub 3} and plasma-assisted (PA) molecular-beam epitaxy (MBE) are considered. It is shown that the use of high-temperature AlN/AlGaN buffer layers grown with ammonia at extremely high temperatures (up to 1150°C) can drastically improve the structural perfection of the active GaN layers and reduce the dislocation density in these layers to values of 9 × 10{sup 8}−1 × 10{sup 9} cm{sup −2}. The use of buffer layers of this kind makes it possible to obtain high-quality GaN/AlGaN heterostructures by both methods. At the same time, in contrast to ammonia MBE which is difficult to apply at T < 500°C (because of the low efficiency of ammonia decomposition), PA MBE is rather effective at low temperatures, e.g., for the growth of InAlN layers lattice-matched with GaN. The results obtained in the MBE growth of AlN/AlGaN/GaN/InAlN heterostructures by both PA-MBE and NH{sub 3}-MBE with an extremely high ammonia flux are demonstrated.

  1. Label-free colorimetric detection of Hg²⁺ based on Hg²⁺-triggered exonuclease III-assisted target recycling and DNAzyme amplification. (United States)

    Ren, Wang; Zhang, Ying; Huang, Wei Tao; Li, Nian Bing; Luo, Hong Qun


    This work reported a label-free colorimetric assay for sensitive detection of Hg(2+) based on Hg(2+)-triggered hairpin DNA probe (H-DNA) termini-binding and exonuclease Ш (Exo Ш)-assisted target recycling, as well as hemin/G-quadruplex (DNAzyme) signal amplification. The specific binding of free Hg(2+) with the thymine-thymine (T-T) mismatches termini of H-DNA could immediately trigger the Exo Ш digestion, and then set free G-quadruplex segments and Hg(2+). The Exo Ш impellent recycling of ultratrace Hg(2+) produced numerous G-quadruplexes. The corresponding DNAzymes catalyzed efficiently the H2O2-mediated oxidation of the ABTS(2-) to the colored product in the presence of hemin. Using the color change as the output signal, and the Exo Ш-aided Hg(2+) recycling and DNAzyme as the signal amplifier, the ultrasensitive assay system successfully achieved visual detection of Hg(2+) as low as 1.0 nM by the naked eye, and was suitable for field monitoring. The calibration curve was linear in the range of 50.0 pM to 20.0 nM for Hg(2+) (R=0.9962) with a detection limit of 10.0 pM. Moreover, this proposed strategy showed excellent selectivity, portability and low-cost, and was successfully applied to colorimetric detection of Hg(2+) in laboratory tap water and Jialing river water samples. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Atendimento à mulher vítima de violência sexual: protocolo de assistência de Enfermagem Atención a la Mujer Víctima de Violencia Sexual: Protocolo de Asistencia de Enfermería Assistance to women victims of sexual violence: a nursing care protocol

    Directory of Open Access Journals (Sweden)

    Rosângela Higa


    Full Text Available O Ministério da Saúde preconiza o atendimento integral e humanizado às mulheres vítimas de violência sexual. Teve-se por objetivo descrever o Protocolo de Enfermagem na Assistência às Mulheres Vítimas de Violência Sexual do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, recentemente revisado. Para tanto, seguiram-se as etapas do processo de enfermagem e após a identificação dos principais diagnósticos da North American Nursing Diagnosis Association (NANDA foram determinadas as intervenções, com base em normas técnicas nacionais e internacionais. O protocolo atual engloba o atendimento imediato e tardio, o acompanhamento ambulatorial e as ações relacionadas à interrupção legal da gravidez decorrente do estupro. O protocolo de enfermagem tem proporcionado à cliente um atendimento integral e humanizado e à enfermeira, maior autonomia na sua área de atuação, favorecendo o trabalho colaborativo e interativo com a equipe multidisciplinar.El Ministerio de Salud preconiza la atención integral y humanizada a las mujeres víctimas de violencia sexual. Se tuvo como objetivo describir el Protocolo de Enfermería en la Asistencia a las Mujeres Víctimas de Violencia Sexual del Centro de Atención Integral a la Salud de la Mujer de la Universidad Estatal de Campinas, recientemente revisado. Para tal efecto, se siguieron las etapas del proceso de enfermería y después de la identificación de los principales diagnósticos de la North American Nursing Diagnosis Association (NANDA fueron determinadas las intervenciones, con base en normas técnicas nacionales e internacionales. El protocolo actual engloba la atención inmediata y tardía, el acompañamiento ambulatorio y las acciones relacionadas a la interrupción legal del embarazo derivado de la violación. El protocolo de enfermería ha proporcionado a la cliente una atención integral y humanizada y a la enfermera, mayor autonomía en su

  3. Indicadores de gênero da assistência de enfermagem às mulheres Indicadores de género de la asistencia a las mujeres Gender indicators of nursing care for women

    Directory of Open Access Journals (Sweden)

    Enilda Rosendo do Nascimento


    Full Text Available O texto apresenta um estudo realizado em uma unidade assistencial de saúde de Salvador/ Bahia, com o propósito de construir indicadores de qualidade para a assistência de enfermagem a partir de uma perspectiva de gênero. A construção dos indicadores deu-se através de uma investigação que analisou as concepções de mulheres sobre a assistência pré-natal de enfermagem a elas prestadas, a partir da identificação de ações promotoras de autonomia, dignificação e participação. A coleta de dados realizou-se através de entrevista semi-estruturada a 14 mulheres usuárias da assistência pré-natal de enfermagem que aceitaram participar do estudo e tinham sido atendidas por uma enfermeira em gravidez (es anterior (es ou durante a gravidez atual. Foram construídos dois tipos de indicadores de gênero da assistência de enfermagem: indicadores práticos e indicadores estratégicos de gênero.El texto presenta un estudio realizado en una unidad asistencial de salud de Salvador/Bahia, con el propósito de construir indicadores de calidad para la asistencia de enfermería a partir de una perspectiva del género. La construcción de los indicadores se llevó a cabo a través de una investigación que analizó las concepciones de mujeres a cerca de la asistencia prenatal de enfermería a ellas dada, a contar de la identificación de acciones promotoras de autonomía, dignificación y participación. La coleta de dados se realizó a partir de la entrevista semiestructurada a 14 mujeres usuarias de la asistencia prenatal de enfermería que aceptaron participar del estudio y a quienes atendió una enfermera en embarazo(s anterior(es o durante el embarazo actual. Se adoptaron dos tipos de indicadores de género de la asistencia de enfermería: indicadores prácticos e indicadores estratégicos de género.This text presents a study carried out at a healthcare unit in Salvador/Bahia, with the purpose of building quality indicators for nursing

  4. Clinical judgement within the South African clinical nursing environment: A concept analysis

    Directory of Open Access Journals (Sweden)

    Anna C. van Graan


    The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.

  5. From Entry to Practice to Advanced Nurse Practitioner - The Progression of Competencies and How They Assist in Delivery of eHealth Programs for Healthy Ageing. (United States)

    Rodger, Daragh; Hussey, Pamela


    Most of the health issues encountered in persons of older age are the result of one or more chronic diseases. The evidence base reports that chronic diseases can be prevented or delayed by engaging in healthy behaviors. Education provides a cost effective intervention on both economic grounds in addition to delivery of optimal patient outcomes. Information and Communication Technology (ICT) increasingly is viewed as a critical utility in eHealth delivery, providing scope for expanding online education facilities for older persons. Developing nursing competencies in the delivery of eHealth solutions to deliver user education programs therefore makes sense. This chapter discusses nursing competencies on the development of targeted eHealth programs for healthy ageing. The role of Advanced Nurse Practitioner in Ireland and its associated competency set identifies how a strong action learning model can be designed to deliver eHealth educational programs for effective delivery of healthy ageing in place.

  6. Exploring nurses' and patients' perspectives of limit setting in a forensic mental health setting. (United States)

    Maguire, Tessa; Daffern, Michael; Martin, Trish


    Limit setting is an intervention that is frequently used by mental health nurses. However, limit setting is poorly conceptualized, its purpose is unclear, and there are few evidence-based guidelines to assist nurses to set limits in a safe and effective manner. What is known is that the manner in which nurses set limits influences patients' perceptions of the interactions and their emotional and behavioural responses. In this qualitative study, 12 nurses and 12 patients participated in personal, semistructured interviews that aimed to explore limit setting and to propose principles to guide practice. The findings suggested that: (i) limit setting is important to safety in mental health hospitals; (ii) engaging patients in an empathic manner is necessary when setting limits (when nurses engage in an empathic manner, the therapeutic relationship is more likely to be preserved and the risk of aggressive responses is reduced); and (iii) an authoritative (fair, respectful, consistent, and knowledgeable), rather than authoritarian (controlling and indifferent), limit-setting style enhances positive outcomes with regards to adherence, reduced likelihood of aggression, and preservation of the therapeutic relationship. In conclusion, a limit-setting style characterized by empathic responding and an authoritative, rather than authoritarian interpersonal, style is recommended. Elucidating the components of this style is critical for effective training and best practice of mental health nurses, and to reduce aggressive responses from limit setting. © 2013 Australian College of Mental Health Nurses Inc.

  7. Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes. (United States)

    Olsho, Lauren E W; Spector, William D; Williams, Christianna S; Rhodes, William; Fink, Rebecca V; Limcangco, Rhona; Hurd, Donna


    Pressure ulcers present serious health and economic consequences for nursing home residents. The Agency for Healthcare Research & Quality, in partnership with the New York State Department of Health, implemented the pressure ulcer module of On-Time Quality Improvement for Long Term Care (On-Time), a clinical decision support intervention to reduce pressure ulcer incidence rates. To evaluate the effectiveness of the On-Time program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. We employed an interrupted time-series design to identify impacts of 4 core On-Time program components on resident pressure ulcer incidence in 12 New York State nursing homes implementing the intervention (n=3463 residents). The sample was purposively selected to include nursing homes with high baseline prevalence and incidence of pressure ulcers and high motivation to reduce pressure ulcers. Differential timing and sequencing of 4 core On-Time components across intervention nursing homes and units enabled estimation of separate impacts for each component. Inclusion of a nonequivalent comparison group of 13 nursing homes not implementing On-Time (n=2698 residents) accounts for potential mean-reversion bias. Impacts were estimated via a random-effects Poisson model including resident-level and facility-level covariates. We find a large and statistically significant reduction in pressure ulcer incidence associated with the joint implementation of 4 core On-Time components (incidence rate ratio=0.409; P=0.035). Impacts vary with implementation of specific component combinations. On-Time implementation is associated with sizable reductions in pressure ulcer incidence.

  8. Series of selenoid valve pneumatic AC 220 volts with disposable contra angle as a replacement for micromotor in preclinic laboratory (experimental study on the health ministry of health polytechnic course D-III department of dental nursing Tasikmalaya

    Directory of Open Access Journals (Sweden)

    Hadiyat Miko


    Full Text Available To report on the essential performance characteristics of disposable air turbine handpiece and on aspect of their convenience and safety for preclinical use. The disposable handpiece is not recommended drilling in oral cavity. We use for student practical  in Operative Dentistry at preclinic laboratory. The other side micromotor low speed handpiece used as bur device on the phantom, the problem usually found in preclinik laboratory on practical conservation with the use of micromotor frequent damage to the handpiece (contra angel. Micromotor tend to heat up faster and have a low-speed, so it took a long time to complete the drilling, using the micromotor tend to be less safe because of the power generated from the flow of electricity at any time could damage. The price of  micromotor also is quite expensive. The limitations of the budget funds for maintenance, repair and procurement of mikromotor also became a problem. Based on these problems, the research team made a solution in the form of a replacement tool (substitute micromotor with the aim to resolve the existing problems as well as creating practices preclinic more effectively and efficiently. The use of a simple drill tool in the form of a series of Pneumatic Valve 220 volt (include electric compressor and Selenoid Disposible Handpiece Contra-angles as a new innovation in the laboratory of Dental Nursing. Majors preclinik Health Polytechnic Tasikmalaya  have been applied for last 3 years and have been able to more efficient cost of procurement tool of 70%. This disposible tool is apparently able to drill up to 20 times preparasicavity. This research uses descriptive method. Data collection techniques are used through the question form or questionnaire. Population and sample the study is a students collage 2nd years D-III of department of dental nursing Health Polytechnic Tasikmalaya. From the results of research that the majority of students expressed pleased and satisfied. This

  9. A nursing career lattice pilot program to promote racial/ethnic diversity in the nursing workforce. (United States)

    Sporing, Eileen; Avalon, Earlene; Brostoff, Marcie


    The nursing career lattice program (NCLP) at Children's Hospital Boston has provided employees with social, educational, and financial assistance as they begin or advance their nursing careers. At the conclusion of a pilot phase, 35% of employees in the NCLP were enrolled in nursing school and 15% completed nursing school. The NCLP exemplifies how a workforce diversity initiative can lead to outcomes that support and sustain a culture rich in diversity and perpetuate excellence in nursing in one organization.

  10. Improving Elderly's Dental Hygiene Through Nursing Home Staff's Dental Health Education at the Nursing Home


    Santoso, Bedjo; Eko Ningtyas, Endah Aryati; Fatmasari, Diyah


    Stomatitis often occurs in elderly at nursing home. They need nursing home staff assistance to maintain their dental and oral health. Therefore, nursing home staff need dental health education. Lecture or discussion methods, which are more effective to improve knowledge, attitude and skill of nursing home staff was the purpose of this research. The research design was quasi-experiment research and pretest-posttest with control group. The sample was 42 nursing home staffs and 74 elderlies, div...

  11. Satisfação do cliente na avaliação da assistência de enfermagem La satisfacción del cliente en la evaluación de la asistencia de enfermería The costumer's satisfaction in the nursing assistance avaluation

    Directory of Open Access Journals (Sweden)

    Regiane Polizer


    Full Text Available O estudo destaca a importância da percepção do cliente no processo de avaliação da assistência de enfermagem. Através da pesquisa bibliográfica no período compreendido entre 1990 e 2004. Realizou-se uma revisão sobre satisfação do cliente, onde foram identificados conceitos e publicações que abordassem a percepção do cliente como fator importante na avaliação da assistência de enfermagem. Assim, concluindo que o cliente tem papel importante na obtenção do verdadeiro resultado da assistência oferecida, pois se caracteriza como fonte de opiniões e sugestões auxiliando no processo de avaliação.Este estudio destaca la importancia de la opinión del cliente en el proceso de la evaluación de la asistencia de enfermería. Atravéz de la investigación bibliográfica en el período comprendido entre 1990 y 2004. Fue realizado una revisión acerca de la satisfacción del cliente, donde fueran identificados los conceptos y a las publicaciones de la opinión del cliente como factor importante en la evaluación de la asistencia de enfermería. La conclusíon fue que el cliente tiene papel importante en el obtencíon del verdadero resultado de la asistencia ofrecida, por lo tanto se caracteriza como fuente de las opiniones y sugestiones que asisten al proceso de la evaluación.This study detaches the importance of the perception of the customer in the process of evaluation of the nursing assistance. Through of bibliographical study research in the period understood between 1990 and 2004. This study reviewed on customer's satisfaction, where had been identified to concepts and publications that approached the perception of the customer as important factor in the evaluation of the nursing assistance. Thus, concluding, that customer has important paper in the attainment of the resulted real of the offered assistance, therefore characterizes as source of opinions and suggestions assisting in the process of evaluation.

  12. An international definition for "nursing home"

    NARCIS (Netherlands)

    Sanford, A.M.; Orrell, M.; Tolson, D.; Abbatecola, A.M.; Arai, H.; Bauer, J.M.; Cruz-Jentoft, A.J.; Dong, B.; Ga, H.; Goel, A.; Hajjar, R.; Holmerova, I.; Katz, P.R.; Koopmans, R.T.; Rolland, Y.; Visvanathan, R.; Woo, J.; Morley, J.E.; Vellas, B.


    There is much ambiguity regarding the term "nursing home" in the international literature. The definition of a nursing home and the type of assistance provided in a nursing home is quite varied by country. The International Association of Gerontology and Geriatrics and AMDA foundation developed a

  13. Nursing workloads: the results of a study of Queensland Nurses. (United States)

    Hegney, Desley; Plank, Ashley; Parker, Victoria


    This paper reports the findings of a survey undertaken in Queensland, Australia in October 2001. The participants were registered and enrolled nurses and assistants in nursing who were members of the industrial body - the Queensland Nursing Union (QNU), and who were in paid employment in nursing in Queensland. Participants were selected by random sampling from each of the three major employment groups - the aged care, public and private acute sectors. Of the 2800 invited participants, 1477 responded resulting in an overall response rate of 53%. The findings indicate that over 50% of nurses in the aged-care sector, 32% of nurses in the public and 30% of nurses in the private acute sector experience difficulties in meeting patient needs because of insufficient staffing levels. The nurses in this study also believed that there was poor skills-mix, mostly caused by lack of funding, too few experienced staff or too many inexperienced staff. Many nurses in this study expressed their anger and frustration about their inability to complete their work to their professional satisfaction in the paid time available. Further, many nurses also expressed the view that because of this inability they were planning to leave the nursing profession. These findings are consistent with other research into the nursing workforce both within Australia and internationally.

  14. Richard III

    DEFF Research Database (Denmark)

    Lauridsen, Palle Schantz


    Kort analyse af Shakespeares Richard III med fokus på, hvordan denne skurk fremstilles, så tilskuere (og læsere) langt henad vejen kan føle sympati med ham. Med paralleller til Netflix-serien "House of Cards"......Kort analyse af Shakespeares Richard III med fokus på, hvordan denne skurk fremstilles, så tilskuere (og læsere) langt henad vejen kan føle sympati med ham. Med paralleller til Netflix-serien "House of Cards"...

  15. Experiences of and support for nurses as second victims of adverse nursing errors: a qualitative systematic review. (United States)

    Cabilan, C J; Kynoch, Kathryn


    nurse that can last for a long time. In some cases, the error can alter nurses' perspectives and disrupt workplace relations; (ii) The type of support received influences how the nurse will feel about the error. Often nurses choose to speak with colleagues who have had similar experiences. Strategies need to focus on helping them to overcome the negative emotions associated with being a second victim; (iii) After the error, nurses are confronted with the dilemma of disclosure. Disclosure is determined by the following factors: how nurses feel about the error, harm to the patient, the support available to the nurse, and how errors are dealt with in the past; and (iv) Reconciliation is every nurse's endeavor. Predominantly, this is achieved by accepting fallibility, followed by acts of restitution, such as making positive changes in practice and disclosure to attain closure (see "Summary of findings"). Adverse errors were distressing for nurses, but they did not always receive the support they needed from colleagues. The lack of support had a significant impact on nurses' decisions on whether to disclose the error and his/her recovery process. Therefore, a good support system is imperative in alleviating the emotional burden, promoting the disclosure process, and assisting nurses with reconciliation. This review also highlighted research gaps that encompass the characteristics of the support system preferred by nurses, and the scarcity of studies worldwide.


    International Nuclear Information System (INIS)

    Jordan, H.; Sack, C.


    This report gives a detailed description of the latest version of the PARDISEKO code, PARDISEKO III, with particular emphasis on the numerical and programming methods employed. The physical model and its relation to nuclear safety as well as a description and the results of confirming experiments are treated in detail in the Karlsruhe Nuclear Research Centre report KFK-1989. (orig.) [de

  17. Planejamento da assistência de enfermagem: proposta de um software-protótipo Planificación del cuidado de enfermería: propuesta de un software-prototipo Nursing care planning: proposal for a software prototype

    Directory of Open Access Journals (Sweden)

    Dircelene Jussara Sperandio


    Full Text Available O propósito deste estudo foi descrever as etapas de desenvolvimento de um software-protótipo que possibilite aos enfermeiros, no âmbito hospitalar, atender ao planejamento da assistência de enfermagem, prescrição de enfermagem e a documentação de forma informatizada. A metodologia utilizada fundamentou-se no conceito do ciclo de vida de prototipação. Sedimentou-se em duas fases: a de definição e a de desenvolvimento. A fase de definiç��o iniciou-se com a etapa de planejamento, seguida pela definição e análise dos requisitos necessários para a construção e culminou com a produção da especificação de requisitos do software. A fase de desenvolvimento traduziu o conjunto de requisitos em um modelo informatizado, com 10 módulos, referentes ao processo de sistematização da assistência de enfermagem. A avaliação desse recurso inovador para a Sistematização da Assistência de Enfermagem nos diferentes estágios do seu processo será objeto de estudo posterior.El propósito de este estudio es desarrollar un software-prototipo para ayudar las enfermeras planear el cuidado de enfermería, hacer intervenciones y toda la documentación de una manera informatizada. La metodología se basa en el ciclo de vida de desarrollo del sistema, particularmente el concepto del prototipo, siguiendo dos fases: la definición y el desarrollo. La fase de la definición empezó con una etapa de planificación, seguido por la definición y el análisis de los requisitos para la construcción, y culminó con la especificación de los requisitos del software. La fase de desarrollo tradujo el grupo de requisitos en modelo informatizado, estructurado en 10 módulos, con respecto al proceso de alimentar el sistema del cuidado. El desempeño de este recurso innovador en las diferentes etapas del proceso de sistematización de la atención de enfermería será objeto de un estudio subsiguiente.This study aims to develop a software prototype to help

  18. Assessing the Effect of an Educational Intervention on Nurses' and Patient Care Assistants' Comprehension and Documentation of Functional Ability in Pediatric Patients with Sickle Cell Disease. (United States)

    Bernier, Katherine M; Strobel, Megan; Lucas, Ruth


    In 2014, the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) was developed to investigate patient's self-rated functional ability during times of acute pain in the inpatient clinical setting. Although it has great potential, the application of this tool has not been made a standard of care. The purpose of this multiple methods study was to determine if, through an educational intervention, hospital staff could consistently document the YAPFAQ in children with sickle cell disease (SCD) during a vaso-occlusive episode. Twenty-two staff members participated in an educational intervention and semi-structured group discussions. Pre/post surveys measured knowledge of the YAPFAQ before and after the intervention. Group discussions were recorded, transcribed verbatim, and analyzed for thematic clusters. Retrospective chart reviews of children with SCD were reviewed for YAPFAQ documentation frequency before and after the intervention. Staff knowledge of who completes the YAPFAQ increased after the intervention, (pcontinues to hold high potential for directing nursing care, but requires staff investment for clinical practice change. A seamless integration between nursing education and translation through EHR is recommended as technology continues to integrate into nursing practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Autonomia/mutualidade na assistência de enfermagem Autonomía/participación mutua en la asistencia de enfermería Autonomy/mutuality in nursing care

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Araújo Sadala


    Full Text Available Utilizando um estudo de caso como ilustração, a autora discute as possibilidades da participação ativa dos pacientes na assistência à saúde, visando estimulá-los ao autocuidado. A partir de considerações sobre as formas tradicionais e autoritárias da assistência à saúde nos quais os profissionais determinam os procedimentos e os pacientes aceitam passivamente o que lhes é determinado, o estudo discute as questões da dependência e independência da enfermeira e do cliente no processo saúde-doença, propondo uma inter-relação que mantenha a autonomia de um e de outro. No sentido de que ambos participem ativamente do processo de enfermagem. Tal postura entre a autonomia e a mutualidade é descrita como uma relação dialética entre duas pessoas que se percebem nas suas especificidades e potencialidades, tendo como objetivo comum desenvolver uma assistência de enfermagem que contempla os valores éticos e humanísticos.Teniendo como referenciales principales las consideraciones sobre las formas tradicionales y autoritarias en la asistencia a la salud, la autora discute las cuestiones de la dependencia e independencia de la enfermera y del enfermo en el proceso salud-enfermedad. Dentro de esto concepto se propone una relación de interdependencia en la cual se mantengan la autonomía de uno y de otro de forma que los dos tengan participación activa en el proceso de enfermería.Taking into consideration the traditional official health assistance forms, the present paper discusses questions related to dependence and independence of nurse and patient in the health/illness process. Under that perspective it proposes a relationship that preserves the autonomy of one and the other, so that both can participate in the process of nursing and self-care.

  20. Unlicensed Assistive Personnel: Their Role on the School Health Services Team. Position Statement (United States)

    Rose, Kathleen C.; Disney, Jody; Andresen, Kathleen; Tuck, Christine; Porter, Jessica; Bobo, Nicole


    It is the position of the National Association of School Nurses (NASN) that, where laws permit, unlicensed assistive personnel (UAP) can have valuable and necessary roles as assistants to school nurses. It is the professional responsibility of the registered professional school nurse (herein after referred to as school nurse) to identify UAP in…

  1. Free-lance nursing in Italy. (United States)

    Galli, E; Lindsay, J S


    In 1987 Registered Nurses Ernesta 'Tina' Galli and Joanne Lindsay embarked on a unique venture--a private agency* organized and run by nurses that engages free-lance nurses to fill the need for nursing assistance both at home and in public and private institutions. The response has been overwhelming. Today they have branches throughout Italy and have expanded their services to include research and primary health care. Below, their story.

  2. Determinants of the nurses’ and nursing assistants’ request for antipsychotics for people with dementia

    NARCIS (Netherlands)

    Janus, Sarah; van Manen, Jeanette Gabrielle; IJzerman, Maarten Joost; Bisseling, Marloes; Drossaert, Constance H.C.; Zuidema, Sytse U.


    Although physicians are responsible for writing the antipsychotic prescriptions for patients with dementia, the initiative is often taken by nurses or nursing assistants. To reduce antipsychotics uses, one needs to understand the reasons for nurses and nursing assistants to request them. This study

  3. Nursing, Nursing Education, and Anxiety. (United States)

    Biggers, Thompson; And Others

    In response to the current crisis in the field of nursing, a study examined nursing students' perceived work-related stress and differences among associate degree, diploma, and baccalaureate nursing programs in their preparation of nursing students. The 171 subjects, representing the three different nursing programs, completed a questionnaire…

  4. Nurses' experiences of guideline implementation

    DEFF Research Database (Denmark)

    Alanen, Seija; Välimäki, Marita; Kaila, Minna


    AIMS: The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines? BACKGROUND: The implementation of clinical guidelines seems...... to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning guideline implementation. DESIGN: Qualitative interview. METHODS: Data were generated by four focus group interviews involving nurses working in out-patient services in primary...... to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses' awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines...

  5. Fermilab III

    International Nuclear Information System (INIS)



    The total ongoing plans for Fermilab are wrapped up in the Fermilab III scheme, centrepiece of which is the proposal for a new Main Injector. The Laboratory has been awarded a $200,000 Illinois grant which will be used to initiate environmental assessment and engineering design of the Main Injector, while a state review panel recommended that the project should also benefit from $2 million of funding

  6. Fermilab III

    Energy Technology Data Exchange (ETDEWEB)



    The total ongoing plans for Fermilab are wrapped up in the Fermilab III scheme, centrepiece of which is the proposal for a new Main Injector. The Laboratory has been awarded a $200,000 Illinois grant which will be used to initiate environmental assessment and engineering design of the Main Injector, while a state review panel recommended that the project should also benefit from $2 million of funding.

  7. Excel-based scheduling for reallocation of nursing staff. (United States)


    Outi Annelli Tuominen and colleagues write in Nursing Management about the use of an Excel-based scheduling system for reallocation of nursing staff, which was trialled on ward managers and assistant ward managers.

  8. Nursing communication in nursing care to mastectomized women: a grounded theory study La comunicación de la enfermera em la asistencia de enfermería a la mujer mastectomizada: um estudio de Grounded Theory A comunicação da enfermeira na assistência de enfermagem à mulher mastectomizada: um estudo de Grounded Theory

    Directory of Open Access Journals (Sweden)

    Iliana Maria de Almeida Araújo


    Full Text Available The goal was to understand the nurse / patient communication process, emphasizing nursing care to mastectomized women. Symbolic Interactionism and Grounded Theory were used to interview eight nurses from a referral institution in cancer treatment, using the guiding question: how do nurses perceive their communication process with mastectomized women? Data analysis allowed for the creation of a central theory: the meaning of communication in nursing care to women, constituted by three distinct but inter-related phenomena: perceiving communication, the relationship nurse / mastectomized woman and rethinking the communication nurse / mastectomized woman. With a view to satisfactory communication, professionals need to get involved and believe that their presence is as important as the performance of technical procedures that relieve situations of stress.El objetivo fue comprender el proceso de comunicación enfermera/ paciente, con énfasis en la asistencia de enfermería a la mujer mastectomizada. Se utilizó el Interaccionismo Simbólico y la Grounded Theory, para entrevistar ocho enfermeras de una institución con reconocido prestigio en el tratamiento de cáncer, utilizándose la siguiente pregunta: ¿Cómo la enfermera percibe su proceso de comunicación con la mujer mastectomizada? El análisis de los datos permitió la creación de la teoría central: el significado de la comunicación en la atención de enfermería a la mujer; esta se constituye de tres fenómenos diferentes que se interrelacionan: percibiendo la comunicación, la relación enfermera/mujer mastectomizada y repensando la comunicación enfermera/mujer mastectomizada. Así, se comprende que, para que la comunicación se torne satisfactoria, la profesional precisa envolverse y creer que su presencia es tan importante como la realización de procedimientos técnicos y que disminuye situaciones de estrés.Objetivou-se, aqui, compreender o processo de comunicação enfermeira

  9. Suicide in Guyana: Nurses' Perspectives. (United States)

    Anthony, Maureen; Groh, Carla; Gash, Jean

    Guyana, an English-speaking country on the north coast of South America, has the highest suicide rate in the world. Nurses are an integral part of the healthcare team working with patients experiencing psychological distress and are uniquely qualified to add to the discourse on factors contributing to the high suicide rate in Guyana. The purpose of this study was to explore the attitudes and experiences of nurses and nurse assistants in Guyana related to suicide. Nine registered nurses and nurse assistants who worked at a private hospital in Georgetown, Guyana, were recruited to participate in a focus group. The focus group lasted approximately 70 minutes and was recorded. The audio recordings were later transcribed word for word. Four themes emerged from the data: family issues as they relate to the high suicide rate, suicide attempts as a cry for help, lack of support, and coping mechanisms used by nurses when caring for victims of attempted suicide. Nurses are uniquely positioned to intervene with families in crisis, whether it be suicide, suicide attempts, or the underlying factors of family dysfunction, child maltreatment, poverty, or alcoholism. Establishing forensic nursing as a specialty in Guyana would validate this important role through education and certification of nurses.

  10. Características de profesionales y auxiliares de enfermería del Huila. 2010 Características dos profissionais e auxiliares de enfermagem de Huila. 2010 Characteristics of Professionals and Nursing Assistants from Huila. 2010

    Directory of Open Access Journals (Sweden)

    Dolly Arias


    maioria são mulheres dos estratos sociais 1, 2 e 3 que moram desde há mais de dez anos em Huila. Os profissionais estão concentrados na capital do departamento e nos municípios mais habitados; 70 % é formado da Universidade Surcolombiana, 27 % tem estudos de pós-graduação e menos de 20 % tem alguma especialização no componente disciplinar. As auxiliares de enfermagem terminaram em escolas de Neiva, com uma caracterização laboral de perto de 60% dedicado à atenção curativa e menos de 35 % trabalhando em empresas sociais do Estado (ESE de primeiro nível. Trinta e três por cento dos profissionais são funcionários fixos e duas terceiras partes têm menos de cinco anos de vinculação com a empresa atual, 29,6 % dos auxiliares de enfermagem são funcionários fixos. Mais de 60 % dos profissionais ganham uma média de $1.600.000 e só 2,6 % recebe mais de $3.090.000; 73,4 % dos auxiliares ganham entre um e dois salários mínimos.Objective: Describe and analyze social-demographic and labor characteristics of nursing professionals and assistants who work in Huila. Methodology: Transversal descriptive study of a population of 308 nurses and 1025 nursing assistants distributed in the 37 municipalities of the department. Direct method and a self-managed questionnaire were used. The information was processed with Epi Info 6.04 D and Excel 2000. Results: Social and demographic characteristics: most of the population was women within class 1, 2 and 3 residing in Huila from over ten years. Professionals are concentrated in the capital of the department and in the most populated municipalities; 70 % graduated from the Universidad Surcolombiana, 27% has a master's degree and less than 20 % specialized in the disciplinary component. Nursing assistants ended up in schools of Neiva, work characteristics: about 60% works in healing assistance, less than 35 % work in first level Social State Companies (ESE. 33 % of professionals are part of the staff and two thirds have

  11. Experiences of final year nursing students in their preparedness to become registered nurses

    Directory of Open Access Journals (Sweden)

    S Carlson


    Full Text Available The objectives of this study were: firstly, to explore and describe the experiences of final year nursing students relating to how they experience their preparedness to fulfil the role of professional nurse; secondly, to explore and describe the experiences of novice professional nurses in the role of professional nurse; finally, to generate a model which will assist the final year nursing student to become a professional nurse. A theory-generative, qualitative, explorative, descriptive and contextual research design was utilized to reach the objectives of the study. Results indicated that final year nursing students experience a lack of confidence to take on the responsibilities of professional nursing. The results are displayed in table form and discussed in the article. This abstract forms part of a bigger study that addresses the professional maturity of the novice professional nurse for the practice of nursing.

  12. A assistência preventiva do enfermeiro ao trabalhador de enfermagem La asistencia preventiva de la enfermera al trabajador de enfermería Nurse's preventive attendance to the nursing worker

    Directory of Open Access Journals (Sweden)

    Ana Lúcia de Almeida Campos


    Full Text Available A temática do presente estudo surgiu da experiência que temos em nossa prática profissional, onde pudemos observar o absenteísmo dos profissionais de enfermagem decorrentes de doenças relacionadas ao trabalho, o que nos despertou o interesse em nos aprofundar no papel do enfermeiro nas ações preventivas relacionadas à saúde do trabalhador de enfermagem em sua trajetória profissional comparando-as com as Normas Regulamentadoras. As ações preventivas em saúde do trabalhador é uma busca constante, que necessita de mais investimento com o objetivo de melhorar as condições de trabalho, proporcionando um ambiente saudável.El tema del estudio presente resulta de la experiencia que nosotros tenemos en nuestra práctica profesional dónde nosotros podríamos observar el ausentismo de los profesionales relacionado com enfermedades, lo que se nos despertó el interés ahondándonos en el papel de la enfermera en las acciones preventivas relacionó a la salud del trabajador de enfermería en su camino profesional comparandolas con la Norma Regulatoria. Las acciones preventivas en la salud del trabajador son una búsqueda constant, que necesita más inversión con el objetivo de mejorar las condiciones de trabajo, mientras proporcionando una atmósfera saludable.The theme of the present study emerged from the experience that we have in our professional practice, where we could observe the absenteeism of nursing professionals related to diseases, what woke up us the interest in deepening in the nurse's paper in the preventive actions related to the nursing worker's health in his/her professional path comparing them with the Regulatory Norms. The preventive actions in the worker's health is a constant search, that needs more investment with the objective of improving the work conditions, providing a healthy atmosphere.

  13. Nursing home staff members' attitudes and knowledge about urinary incontinence: the impact of technology and training. (United States)

    Ehlman, Katie; Wilson, Amy; Dugger, Renee; Eggleston, Brandon; Coudret, Nadine; Mathis, Sherri


    Urinary incontinence (UI) poses challenges for nursing home personnel. The authors of this study explored differences in attitude and knowledge about UI among registered nurses, licensed practical nurses, and certified nursing assistants working in skilled nursing homes before and after study interventions.

  14. Nurses' professional and personal values. (United States)

    Rassin, Michal


    The purpose of this study was to measure professional and personal values among nurses, and to identify the factors affecting these values. The participants were 323 Israeli nurses, who were asked about 36 personal values and 20 professional values. The three fundamental professional nursing values of human dignity, equality among patients, and prevention of suffering, were rated first. The top 10 rated values all concerned nurses' responsibility towards patients. Altruism and confidentiality were not highly rated, and health promotion and nursing research were rated among the last three professional values. For personal (instrumental) values, honesty, responsibility and intelligence were rated first, while ambition and imagination were rated 14th and 16th respectively out of 18. Significant differences (P personal and professional values rated as functions of culture, education, professional seniority, position and field of expertise. The results may assist in understanding the motives of nurses with different characteristics and help to promote their work according to professional ethical values.

  15. How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study. (United States)

    McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia


    Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Aplikasi Asuhan Keperawatan Spiritual Muslim Di R. Firdaus III RS. Al-islam Bandung


    Team, Redaksi


    One of subject in idiploma three nursing curriculum is Moslem Spiritual Nursing Case which developed since 2004 and in year 2009 pilot project has been started in Al-Islam Hospital Bandung ward that is used was Firdaus III. This study used descriptive explorative design which described application of Muslim spiritually nursing care in Firdaus Ward by 71 second year nursing students from of Nursing Academy Aisyiyah Bandung. Data collection techniques used questionnaire, observation check list,...

  17. A relevância do exame físico do idoso para a assistência de enfermagem hospitalar La relevancia del examen fisico del anciano para la asistencia de enfermería hospitalar The relevance of physical examination of the elderly patient in the nursing assistance hospital

    Directory of Open Access Journals (Sweden)

    Juliana Coutinho de Paula


    contemplado. La mayoría de los entrevistados (88% realiza el examen físico y se muestra motivada para efectuarlo, aunque lo hagan de manera incompleta. Conn Los datos obtenidos apuntan la necesidad de capacitación de los enfermeros que cuidan de los ancianos, considerando las particularidades de este examen y las necesidades de estos pacientes.BACKGROUND: In nursing practice, it has been noticed that those examinations are rarely done in a singular and systematic way. AIM: To verify the importance attributed by nurses to the physical examination in elderly, for hospital nursing assistance. METHOD: Twenty five nurses from the following wards were interviewed: Surgery, Gastroenterology, Cardiology and Pneumology, and Adult General ward I - II at the Clinical Hospital, Campinas State University. RESULTS: Only one of the informants had no information on physical examination during graduation and most of them had lack of information or no information at all on senescence and senility. Most informants (88% perform the physical examination and show motivation to execute it, though they do it in an incomplete way. FINAL CONSIDERATIONS: This results show the requirement of capacitation for nurses who treats the aged, considering that physical examination in elderly has its specificities.

  18. Nurses' Needs for Care Robots in Integrated Nursing Care Services. (United States)

    Lee, Jai-Yon; Song, Young Ae; Jung, Ji Young; Kim, Hyun Jeong; Kim, Bo Ram; Do, Hyun-Kyung; Lim, Jae-Young


    To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in an integrated nursing care services. Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced 'integrated nursing care services'; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. The study applied a cross-sectional survey. In 2016, we conducted a multi-center survey involving 302 registered nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Trial center nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top three desired primary roles for care robots were 'measuring/monitoring', 'mobility/activity' and 'safety care'. 'Reduction in workload', especially in terms of 'other nursing services' which were categorized as non-value-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Care robots are expected to be effective in integrated nursing care services, particularly in 'measuring/monitoring'. Such robots should decrease nurses' workload and minimize non-value-added nursing activities efficiently. No matter how excellent care robots are, they must co-operate with and be controlled by nurses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Assistência de Enfermagem na opinião das mulheres com pré-eclâmpsia Asistencia de Enfermería en la opinión de las mujeres con preeclampsia Nursing assistance in the opinion of women with pre-eclampsia

    Directory of Open Access Journals (Sweden)

    Karla Joelma Bezerra Cunha


    técnicos, y cuanto a la insatisfacción, destacase la carencia de atención, apoyo y diálogo. La relación equipo de enfermería-paciente fué considerado impersonal y sin compromiso. No obstante, hay expectativas de mayor humanización en el equipo y el establecimiento de acciones dignas de confianza y motivación. Concluyese que la ayuda de enfermería debe ser más humana en la ayuda a las necesidades físicas, sociales y psicoemocionales de los clientes.Qualitative study whose object is the assistance of nursing in the optics of the women with pre-eclampsia. The objectives had been to describe the reasons of hospitalization and its expectations; and, to argue the assistance of nursing received in a public maternity of Teresina - Piaui (Brazil. The used methodology was a half-structuralized form which the technique of data collection was made through interview. The results had been presented in categories evidencing as reasons more common than had taken to the 12 women the internment: edema and chronic headache; the assistance of given nursing limited it the verification of the arterial pressure and medicine administration. How much to the satisfaction they had mentioned accomplishment to it of the procedures technician and the no satisfaction was distinguished for the lack of attention, support and dialogue. The relationship nursing team-patient was considered cold, impersonal and without commitment. However it has expectations of more humanization in the team and the establishment of trustworthy and motivation actions. It is concluded that the nursing assistance must be more human in the attendance to the physical, social and psycho emotions needs of the client.

  20. A training program to enhance recognition of depression in nursing homes, assisted living, and other long-term care settings: Description and evaluation. (United States)

    Abrams, Robert C; Nathanson, Mark; Silver, Stephanie; Ramirez, Mildred; Toner, John A; Teresi, Jeanne A


    Low levels of symptom recognition by staff have been "gateway" barriers to the management of depression in long-term care. The study aims were to refine a depression training program for front-line staff in long-term care and provide evaluative knowledge outcome data. Three primary training modules provide an overview of depression symptoms; a review of causes and situational and environmental contributing factors; and communication strategies, medications, and clinical treatment strategies. McNemar's chi-square tests and paired t-tests were used to examine change in knowledge. Data were analyzed for up to 143 staff members, the majority from nursing. Significant changes (p depressive disorder.

  1. American Nurses Association Position Statement on guidelines for commercial support of continuing nursing education. (United States)


    The attached guidelines on "Commercial Support of Continuing Nursing Education" have been developed by the American Nurses Association (ANA) to assist/guide nursing continuing educators who wish to utilize the resources of corporations to provide continuing education programs. These guidelines enable the provider to maintain a balance between the need for industry-supported dissemination of scientific information and promotional activities which meet the requirements of law, as well as professional standards of the American Nurses Association.

  2. Motivational Factors of Student Nurse Athletes Attributing to Academic Success. (United States)

    Forst, Kimberly A

    Student nurse athletes experience difficulties achieving academic success in nursing programs. The purpose of this study was to identify facilitators, barriers, and motivators of student nurse athletes that attribute to their academic success. Athletes ranked time management and prioritization as critical skills to success in the nursing program. This study reinforced the importance of academic support services for student nurse athletes to assist in their academic success.

  3. Percepções de enfermeiras sobre a assistência prestada a mulheres diante do óbito fetal Percepciones de enfermeros acerca de la atención a la mujeres delante de la muerte del feto Nurses' perception on the assistance provided to women facing fetal death

    Directory of Open Access Journals (Sweden)

    Camila da Silva Santos


    los recursos humanos, las cuestiones estructurales de los servicios de salud.This study aimed to assess the nurses' perception on the nursing care provided to women facing the diagnosis of fetal death. Research with qualitative approach carried out in a maternity school in Fortaleza-CE , Brazil, from September to October 2009. The sample was composed of nine nurses who worked in the service of high-risk pregnancy.The results showed that the focus of assistance offered was the provision of psychological support, through the permission given to women or family members to see the dead fetus. The difficulties most frequently mentioned were associated with the structural issue of motherhood that did not have a specific ward for mothers with a diagnosis of fetal death. They also mentioned the heavy workload, once they had functions that were not part of the procedures of praxis. Thus, we emphasize the need for a different assistance to women facing fetal death covering, in addition to human resources, structural issues of health services.

  4. Assistência de enfermagem às famílias de indivíduos que tentaram suicídio Asistencia de enfermería a la familia durante la atención de un miembro que intentó suicidio Nursing assistance to a family of a member who attempted suicide

    Directory of Open Access Journals (Sweden)

    Aline Aparecida Buriola


    pueden subsidiar la actuación de los enfermeros con vistas a una asistencia que considere la persona y la familia de manera holística.This qualitative study aimed to identify nursing care offered to families of individuals who attempted suicide. Data was collected in May and June 2008, from 21 active nurses in Emergency Care Units, of three cities in the South of Brazil, through a semi-structured interview. From the analysis two categories emerged: "The professional practice and care to the individual's family attempt suicide " and "Emotions that emerge in the life of a professional", which reveal that the families are usually sought for information on the case, but they rarely constitute focus of the assistance. Professionals appear to be unhappy with this situation. However, perceive themselves limited, although they believe that more attention would institute effective measures to a humanized care. These results can subsidize the performance of nurses with views to an assistance that considers the person and the family in a holistic manner.

  5. A percepção das enfermeiras sobre a competência social no desenvolvimento da assistência pré-natal La percepción de las enfermeras sobre la competencia social en el desarrollo de la asistencia prenatal Nurses' perception of social competence when delivering pre-natal assistance

    Directory of Open Access Journals (Sweden)

    Yara Macambira Santana Lima


    , comprendiendo la necesidad de la busca de una consciencia crítica de la realidad y el interés de superar las dificultades en los servicios de salud pública. No es suficiente solamente tener un bueno desempeño profesional, es fundamental el apoyo institucional para promover el crecimiento personal.This study, an extract from a dissertation in progress, aims to analyze a social competence of the nurses when delivering pre-natal assistance. Forty-two nurses, engaged in the Politics National Women's Health Care, carried out at the Municipal Health Care Centers in Belem, Pará, have taken part in the project. This is a qualitative research based on Claus Moller's quality standards (1992 which describes the human aspect of personal quality. Data has been collected through questionnaires completed under the researcher's supervision. The ethical issues raised were in compliance with the National Health Board Resolution number 196/96. As a result of the data analysis, the category of social competence emerged. According to the subjects interviewed , it comprises the nurses' professional commitment to the pregnant women they assist; their need to have a more critical attitude towards reality and their willingness to overcome the difficulties inherent in the public health services. This reseach shows that not only good professional performance, but also institutional support are essential to ensure personal development.

  6. Qualidade na assistência de enfermagem hospitalar: visão de alunos de graduação Calidad en la atención de enfermería hospitalaria: visión de alumnos de pregrado Quality in hospital nursing care: the view of undergraduate nursing students

    Directory of Open Access Journals (Sweden)

    Carmen Silvia Gabriel


    Full Text Available Estudo com abordagem qualitativa, desenvolvido em universidade pública do interior do Estado de São Paulo com o objetivo de identificar o conceito de qualidade na assistência de enfermagem hospitalar na perspectiva de alunos do último ano do curso de Bacharelado em Enfermagem. Foram realizadas entrevistas semi-estruturadas com 24 alunos, sendo as falas analisadas segundo o referencial de Bardin. Os núcleos de sentido das falas foram divididos em seis categorias: holismo, humanização, equipe capacitada técnica e cientificamente, promoção do autocuidado, gerenciamento adequado das unidades e respeito aos princípios de segurança na assistência. Os resultados nos permitiram concluir que a visão dos alunos acerca do tema é ampla, sendo necessário, no entanto, incorporar pontos importantes ao conceito de qualidade na assistência de enfermagem, tais como valorização do trabalho em equipe, sistematização da assistência e questões relacionadas à satisfação dos diversos atores envolvidos na assistência em saúde no ambiente hospitalar.Estudio cualitativo desarrollado en una universidad pública en el Estado de Sao Paulo, Brasil, con el objetivo de identificar el concepto de calidad en la atención de enfermería hospitalaria en la perspectiva de estudiantes del último año del curso de bachillerato en enfermería. Para la recolección de los datos, fueron realizadas entrevistas semi-estructuradas con 24 alumnos y las declaraciones fueron analizadas según el referencial de Bardin. Las ideas principales se dividían en seis categorías: holismo, humanización, equipo capacitado técnica y científicamente, promoción del auto cuidado, gerenciamiento adecuado de las unidades y respecto a los principios de seguridad en la atención. La visión de los alumnos acerca del tema es amplia pero aún es necesario que identifiquen temas importantes como la valoración del trabajo en equipo, sistematización de la atención y la satisfacci

  7. Sistematização da assistência de enfermagem na perspectiva dos enfermeiros: uma abordagem metodológica na teoria fundamentada Sistematización de la asistencia enfermería en vista de las enfermeras: un enfoque metodológico de la teoría fundamentada Nursing care systematization according to the nurses' view: a methodological approach based on grounded theory

    Directory of Open Access Journals (Sweden)

    Ana Lúcia de Medeiros


    enfermería en obstetricia. Se concluye que las enfermeras perciben el SAE como instrumento de articulación teórico-práctico que conduce a la asistencia personalizada.This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of Nursing Care (SNC in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon: "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff." The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as wellas considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.

  8. Factors contributing to nursing task incompletion as perceived by nurses working in Kuwait general hospitals. (United States)

    Al-Kandari, Fatimah; Thomas, Deepa


    Unfinished care has a strong relationship with quality of nursing care. Most issues related to tasks incompletion arise from staffing and workload. This study was conducted to assess the workload of nurses, the nursing activities (tasks) nurses commonly performed on medical and surgical wards, elements of nursing care activities left incomplete by nurses during a shift, factors contributing to task incompletion and the relationship between staffing, demographic variables and task incompletion. Exploratory survey using a self-administered questionnaire developed from IHOC survey, USA. All full time registered nurses working on the general medical and surgical wards of five government general hospitals in Kuwait. Research assistants distributed and collected back the questionnaires. Four working days were given to participants to complete and return the questionnaires. A total of 820 questionnaires were distributed and 95% were returned. Descriptive and inferential analysis using SPSS-11. The five most frequently performed nursing activities were: administration of medications, assessing patient condition, preparing/updating nursing care plans, close patient monitoring and client health teaching. The most common nursing activities nurses were unable to complete were: comfort talk with patient and family, adequate documentation of nursing care, oral hygiene, routine catheter care and starting or changing IV fluid on time. Tasks were more complete when the nurse-patient load was less than 5. Nurses' age and educational background influenced task completion while nurses' gender had no influence on it. Increased patient loads, resulting in increased frequency of nursing tasks and non-nursing tasks, were positively correlated to incompletion of nursing activities during the shift. Emphasis should be given to maintaining the optimum nurse-patient load and decreasing the non-nursing workload of nurses to enhance the quality of nursing care.

  9. image of nursing profession as viewed by secondary school

    African Journals Online (AJOL)

    explore factors that deter aspiration to enroll in nursing schools. Methods: The ... included 50 male and 50 female students who were opting for Physics, Chemistry and Biology from form III to ... by nurse education and the general community. .... 9 Nurses work with their hands a lot .... Middle School Students' Perceptions of.

  10. The level of knowledge and radiation safety practice amongst cardiovascular technology, medical assistant, nursing and diagnostic radiography students and dose monitoring in radiography laboratory of Kolej Islam Sains dan Teknologi, Kelantan

    International Nuclear Information System (INIS)

    Ainul Fadhlin Othman; Amran Abdul Majid


    Full-text: This study investigated the knowledge level and practices regarding radiation safety among the cardiovascular technology, medical assistant nursing and radiography diagnostic students of Kolej Islam Sains dan Teknologi (KIST). The objectives of this study are to monitor the dose rate at radiography lab and to propose the guideline on radiation safety topics to improve the syllabus. 274 respondents including 30 psychology students acting as the control group were asked to answer questions from the questionnaires which cover the topics of basic knowledge of radiation and radiation safety practice. There was a significant difference (p < 0.05) between the correct answers and courses for 18 questions except for the question 4. There was a significant different (p < 0.05) between the correct answers and year of study for the questions 4, 5, 7, 12 to 15 and 18 to 20. There was a significance different (p < 0.05) between the correct answers and gender for questions 7, 11 and 19. For area dose monitoring in the radiography diagnostic lab, the assessment report on film batches of 4 walls in the lab were recorded and Victoreen451-RYR survey meter was used to monitor the dose rate for 7 selected areas with the exposure factors set for the chest, abdomen, upper extremity, lower extremity and skull radiography examinations. The dose rates at area 1 to 4, area 5 during the examination of chest, abdomen and skull, area 6 during the examination of abdomen and area 7 during the examination of abdomen, had exceeded the dose limit for radiation worker. The dose rate at the area 1 and 4 are slightly higher than the other areas. The contributing factors are the distance, tube potential, collimation and X-ray tube angulation. This study had shown that the cardiovascular technology and diagnostic radiography students have better knowledge and radiation safety practice level than the medical assistant and nursing students. In general, the level of knowledge and radiation safety

  11. Priorities for the professional development of registered nurses in nursing homes: a Delphi study. (United States)

    Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara


    To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.

  12. Immigrant nurses' perceptions on cultural differences-based job concerns: A phenomenological study in Shanghai China. (United States)

    Yu, Haiping; Peng, Youqing; Hung, Yunying; Zhou, Lin


    To explore the experiences of immigrant nurses working in Shanghai, China. With the development of China, population growth has been accelerating. Simultaneously, the number of immigrant nurses in Shanghai has been increasing dramatically. Meanwhile, their turnover rate is abnormally high, primarily because of job concerns stemming from cultural differences. An understanding of immigrant nurses' job concerns caused by cultural differences can be used to help them to work more efficiently and cohesively. We aimed to investigate immigrant nurses' lived experiences regarding job concerns caused by cultural differences in Shanghai, China. This is a phenomenological study. In-depth semi-structured interviews were conducted with fifteen immigrant nurses from January-July 2016. Data were collected using audio-taped face-to-face interviews; the narratives were then transcribed verbatim and analysed thematically. The following three major themes emerged from the data: "communication difficulties," "work adjustment difficulties" and "life adjustment difficulties." The eight sub-themes within these were as follows: (i) language barrier, (ii) inability to integrate oneself with the local culture, (iii) feelings of unfairness, (iv) difficulty asking for leave, (v) feeling stressed, (vi) not being acclimatised, (vii) feeling helpless and (viii) feeling guilt at being unable to take care of their family. It is important to implement appropriate training programmes on language and cultural adaptation for immigrant nurses. To enhance integrate immigrant nurses into Shanghai's society, more support needs to be provided. Administrators in hospitals should pay attention to immigrant nurses' job concerns that are caused by cultural differences and provide timely and effective assistance. © 2017 John Wiley & Sons Ltd.

  13. Certified Nursing Assistants’ Explanatory Models of Nursing Home Resident Depression


    Piven, Mary Lynn; Anderson, Ruth A.; Colón-Emeric, Cathleen S.; Sandelowski, Margarete


    In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman’s Explanatory Models of Illness framework. Interview data were content analyzed and CNAs’ descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depressio...

  14. The district nursing service: a national treasure. (United States)

    Oldman, Crystal


    District nurses are a national treasure. They are the key professionals who will enable the agenda of patients being cared for at home to be realised. They are highly trusted and valued by communities who lead and manage teams of nurses and nursing assistants expertly to deliver high-quality care in the patient's own home. In an era where the focus is now turning to the community for more care, more actions are required to increase our district nursing workforce. This article discusses the above issues in relation to recent reports on the current status of community nursing.

  15. School Nurse Perceptions of Student Anxiety. (United States)

    Muggeo, Michela A; Ginsburg, Golda S


    Anxiety disorders are common in youth. Because somatic complaints are a hallmark feature of anxiety, these students frequently visit their school nurse, creating an ideal opportunity for nurses to identify and assist them. In an effort to better understand current practices, we surveyed a large sample ( N = 93) of school nurses. Results indicated that the majority of nurses perceived anxiety as the most prevalent mental health issue in their students. Moreover, the majority of nurses reported that they did not use any formal screening tool or intervention protocol and stated wanting to expand their training in anxiety intervention. These data suggest that school nurses identify anxiety as a top problem but do not receive adequate training to address it. Data from this survey may be used to plan how best to fill gaps in nurse training and practices that can enhance nurses' capacity to optimize outcomes for anxious students.

  16. Nurses who work outside nursing. (United States)

    Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M


    The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

  17. Promoting exercise behaviour in a secure mental health setting: Healthcare assistant perspectives. (United States)

    Kinnafick, Florence-Emilie; Papathomas, Anthony; Regoczi, Dora


    Individuals with severe mental illness engage in significantly less amounts of physical activity than the general population. A secure mental health setting can exacerbate barriers to exercise, and facilitate physical inactivity and sedentary behaviour. Healthcare assistants are intimately involved in the daily lives of patients and, therefore, should be considered integral to exercise promotion in secure mental health settings. Our aim was to explore healthcare assistants' perceptions of exercise and their attitudes to exercise promotion for adult patients in a secure mental health hospital. Qualitative semi-structured interviews were conducted with 11 healthcare assistants from a large UK-based secure mental health hospital. Topics included healthcare assistants' personal experiences of exercise within a secure facility, their perceptions of exercise as an effective treatment tool for mental health, and their perceived roles and responsibilities for exercise promotion. Thematic analysis was used to analyse the data. Three main themes were identified: (i) exercise is multi-beneficial to patients, (ii) perceived barriers to effective exercise promotion, and (iii) strategies for effectives exercise promotion. Healthcare assistants considered exercise to hold patient benefits. However, core organizational and individual barriers limited healthcare assistants' exercise promotion efforts. An informal approach to exercise promotion was deemed most effective to some, whereas others committed to more formal strategies including compulsory sessions. With education and organizational support, we propose healthcare assistants are well placed to identify individual needs for exercise promotion. Their consultation could lead to more efficacious, person-sensitive interventions. © 2018 Australian College of Mental Health Nurses Inc.

  18. A vivência de alunos de graduação em enfermagem na assistência à saúde da mulher em uma comunidade de baixa renda: uma abordagem fenomenológica The background got on assistance to woman health in a low income community by undergraduate students of nursing: A phenomenological approach

    Directory of Open Access Journals (Sweden)

    Miriam Aparecida Barbosa Merighi


    Full Text Available Neste estudo nossa trajetória dirigiu-se para a compreensão da experiência vivida pelos alunos do Curso de Graduação em Enfermagem, da EEUSP, na assistência à mulher em uma comunidade de baixa renda da cidade de São Paulo. Obtivemos descrições dos alunos e os dados foram analisados seguindo os passos da fenomenologia. Identificamos cinco temas: experiência gratificante, estimulante e valiosa; experiência de vida, de crescimento pessoal e de quebra de preconceito; atividade que permite conhecer o outro lado da assistência; atividade prática que possibilita sedimentação do conhecimento adquirido teoricamente; experiência importante e necessária. A experiência vivenciada pelos alunos mostrou-se satisfatória favorecendo o processo de ensino-aprendizagem.Our trajectory in this study has addressed to the comprehension of experience which undergraduate students in the Nursing School of USP. This work has been developed in a low incomme community of São Paulo city. We've got descriptions of the students and the data were discussed following the steps of phenomenological assay. We've identified five themes: rewarding experience, stimulant and necessary; experience of life, personal growth and disrupting with prejudice; activity which permits to know the other side of assistance; important and valuable experience; practice activity which makes possible the acquired know edge sedimentation theoretically. The graduation students experience was satisfactory and it was favorable to the teaching-learning process.

  19. Overview of Robotic Devices for Nursing Care Project. (United States)

    Hirukawa, Hirohisa


    METI/AMED are conducting a project on the development and deployment of robotic devices for nursing care to enhance the autonomy of elderly persons and assist care givers. An evaluation protocol is presented and the devices developed in the project are introduced. The devices consist of transfer assist devices (wearable/non-wearable), walking assist devices (outdoor/indoor), safety surveillance sensors (nursing home/private home), bath lift and toilet assist.

  20. Putting Safety in the Frame: Nurses' Sensemaking at Work. (United States)

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


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

  1. Social media use in nursing education. (United States)

    Schmitt, Terri L; Sims-Giddens, Susan S; Booth, Richard G


    As technological advances continue to expand connectivity and communication, the number of patients and nurses engaging in social media increases. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within healthcare. Social media is a platform that can assist nursing faculty in helping students to gain greater understanding of and/or skills in professional communication; health policy; patient privacy and ethics; and writing competencies. Although there are barriers to integration of social media within nursing education, there are quality resources available to assist faculty to integrate social media as a viable pedagogical method. This article discusses the background and significance of social media tools as pedagogy, and provides a brief review of literature. To assist nurse educators who may be using or considering social media tools, the article offers selected examples of sound and pedagogically functional use in course and program applications; consideration of privacy concerns and advantages and disadvantages; and tips for success.

  2. Nursing Homes (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  3. Conflict between nursing student's personal beliefs and professional nursing values. (United States)

    Pickles, David; de Lacey, Sheryl; King, Lindy


    work towards enhancing strategies that assist nursing students to reconcile any incongruity between their personal beliefs and requisite professional nursing values.

  4. "Dignity": A central construct in nursing home staff understandings of quality continence care. (United States)

    Ostaszkiewicz, Joan; Tomlinson, Emily; Hutchinson, Alison M


    To explore nursing home staff members' beliefs and expectations about what constitutes "quality continence care" for people living in nursing homes. Most nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice. A qualitative exploratory descriptive design. Qualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014-2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes. Participants' understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was "protecting residents' dignity" which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to "manage" incontinence, (iv) providing timely continence care, (v) considering residents' continence care preferences and (vi) communicating sensitively. The findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological

  5. Nursing Reclaims its Role. (United States)

    Diers, Donna


    An attempt is made to explain the nurses' role: what the nurse is, what the nurse does, how the nurse is viewed by society, why nurses suffer burnout, nursing costs, and health care system reform. (CT)

  6. Neonatal Nursing


    Crawford, Doreen; Morris, Maryke


    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  7. Sistematização da Assistência de Enfermagem: acidente por Loxosceles gaucho Sistematización de la Asistencia de Enfermería: accidente por Loxosceles gaucho Nursing Care Sistematization: accident by Loxosceles gaucho

    Directory of Open Access Journals (Sweden)

    Helayne Mika Kamimura


    Full Text Available Relato de experiência realizado em um hospital de ensino, com uma paciente vítima de acidente por aranha do gênero Loxosceles gaucho. Este tipo de acidente pode ser classificado como leve, moderado e grave, o que dependerá do tempo entre o ocorrido e o atendimento. Objetivou-se aplicar a sistematização da assistência de enfermagem de forma integralizada e humanizada. Foram estabelecidos os seguintes diagnósticos de enfermagem: dor aguda, integridade da pele prejudicada, riscos para infecção, constipação e baixa auto-estima. O relacionamento terapêutico favoreceu as interações aluna/paciente e possibilitou o reconhecimento das necessidades que mereciam intervenções de enfermagem. O processo de enfermagem foi um instrumento valioso e trouxe elementos importantes para a evolução diária da paciente e adequação do planejamento, priorizando a qualidade dos cuidados.Relato de experiencia realizado en un hospital de enseñanza, con una paciente víctima de accidente causado por araña del género Loxosceles gaucho. Este accidente puede ser clasificado como leve, moderado o grave, lo que dependerá del tiempo entre el suceso y la atención. Se pretendió aplicar la sistematización de la asistencia de enfermería de forma integral y humanizada. Se establecieron los siguientes diagnósticos de enfermería: dolor agudo, integridad de la piel perjudicada, riesgos de infección, constipación y baja autoestima; la relación terapéutica favoreció las interacciones alumna/paciente y posibilitó el reconocimiento de las necesidades que merecían intervenciones de enfermería. El proceso de enfermería fue un instrumento valioso y trajo elementos importantes para la evolución diaria de la paciente y adecuación de la planificación, lo que prioriza la calidad de los cuidados.Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of

  8. Academic report on burnout among Japanese nurses. (United States)

    Kitaoka, Kazuyo; Masuda, Shinya


    Japanese nurses have increasingly experienced "burnout" in the past several years. Studies on Japanese nurses are required in order to explore how to prevent nursing burnout. The objectives of this report were to: (i) introduce the concept, definition, and measurement of burnout; (ii) look at an overview of the prevalence, possible causes, and consequences of burnout among Japanese nurses; and (iii) explore how to prevent burnout among nurses. The authors and co-researchers have been studying burnout among Japanese workers for more than 15 years. Therefore, previously performed studies were reviewed and summarized. In Japan, approximately 36% of human services professionals, such as nurses, were burned out compared to 18% of civil servants, and 12% of company employees. It was quite obvious that nurses are prone to burnout. The possible causes and consequences of burnout among Japanese nurses were reviewed. Excessive workloads and interpersonal conflict in the workplace were possible causes of burnout among Japanese nurses. The consequences of nurse burnout are potentially very serious, including medical accidents/errors. Issues to prevent nursing burnout were then reviewed. Enhancement of cognitive coping skills for female nurses and problem-solving skills for male nurses could contribute to prevention of burnout in nurses. The authors' previous study revealed that the new model of the organizational context of burnout developed by Leiter and Maslach could be applied to Japanese. Further examination is needed. This report supports the call to scale up burnout prevention strategy for Japanese nurses. © 2012 The Authors. Japan Journal of Nursing Science © 2012 Japan Academy of Nursing Science.

  9. Learning from an Ambient Assisted Living Lab

    DEFF Research Database (Denmark)

    Bygholm, Ann; Kanstrup, Anne Marie


    -registration, diaries, observations, interviews and workshops with residents, nurses, nursing assistants, management, building officers, and purchasers from the Municipality. The paper presents an analysis within the overall themes of technology, use, and care, which is discussed by use of the SWOT framework presenting...

  10. Nursing curriculums may hinder a career in gerontological nursing: An integrative review. (United States)

    Garbrah, William; Välimäki, Tarja; Palovaara, Marjo; Kankkunen, Päivi


    To investigate what prevents undergraduate nursing students from choosing gerontological nursing as a career option. This study utilised an integrative literature review, which allows the inclusion of previous studies with diverse research designs to gain a broader view of the reasons why nursing students do not choose a gerontological nursing career. An electronic database search of CINAHL (Ebsco), Scopus and Eric elicited 251 scientific peer-reviewed empirical studies, published from 2006 to March 2016 in English. After meeting the inclusion criteria, 97 qualified for closer examination. Following exclusion, the final analysis and synthesis included 21 articles. Four main themes described nursing students' contributing reasons for not selecting gerontological nursing as a career option: socio-demographic factors; experiences, perceptions and knowledge about ageing; perceptions concerning the nature or status of gerontological nursing; and theoretical studies and practical education of nursing curriculum. Lack of positive experiences with older people before and during nursing students' studies led to their disinterest in gerontological nursing as a career option. The nursing curriculum also reinforces the perception of modern nursing as technical, with more emphasis on acute and critical care. The findings emphasise the need to implement an age-friendly curriculum and have nurses that specialise in gerontology to serve as mentors and role models. It is important to assist nursing students in identifying the potentials for career advancement in terms of gerontological nursing. There is also a need for nursing faculties to liaise with other stakeholders to develop or improve upon the clinical atmosphere for nursing students during gerontological nursing placement. Nursing faculties must review their curriculum to ensure that there is sufficient focus on the needs of older people within the curriculum for every student. Furthermore, respected role models who are

  11. Nursing: What's a Nurse Practitioner? (United States)

    ... as advanced practice nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification ... NP training emphasizes disease prevention, reduction of health risks, and thorough patient education. Like doctors, NPs are ...

  12. The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System. (United States)

    Lin, I-Chun; Lin, Chihung; Hsu, Chien-Lung; Roan, Jinsheng; Yeh, Jehn-Shan; Cheng, Yu-Han


    Many prior studies of technology adoption treat user intention as the single predictor of actual usage behavior. However, as many researchers of behavioral science have pointed out, multiple factors mediate the relationship between user intention and usage behavior. The present article explores the factors that mediate the relationship between intention and actual behavior. We develop a conceptual framework that is based on the Technology Acceptance Model III and behavior theory to further elicit system usage behavior and to confirm "intention stability" and "past experience" as two significant mediating factors in this relationship. The target system was a nursing information system that had been recently adopted by a medical center in central Taiwan. Data were collected using a questionnaire survey conducted in two rounds. Two hundred forty-five valid questionnaires were returned (response rate: 49%). Mediated moderation was analyzed to explore the presence of mediators or moderators between intention and behavior. The results support that intention stability is a mediated moderator and that prior experience is a moderator of the relationship between intention and behavior. These two factors increased by over 13.6% the explanatory power of intention on actual behavior. Furthermore, this study expanded the scope of prior research by confirming intention stability as a moderating variable between intention and behavior. Finally, this study identified the moderating effect of past experience on the intention-behavior relationship, indicating that past experience enhances the predictive power of intention on behavior. The findings of this study may assist hospital managers to better understand the nursing information system usage behaviors of nursing staff and to develop ways to enhance the intention stability of these staff. Managers may improve the familiarity of nursing staff with the system by increasing their system-related practice time. More experience should

  13. The Role of School Nursing in Telehealth. Position Statement (United States)

    Haynie, Kathey M.; Mauter, Elaine; Lindahl, Brenda; Simons-Major, Keisha; Meadows, Lynne; Maughan, Erin D.


    It is the position of the National Association of School Nurses (NASN) that utilization of telehealth technology may be a valuable tool to assist registered professional school nurses (herein referred to as a school nurse) to provide school health services. The health of many students is impacted by lack of access to primary care and specialty…

  14. A busca da graduação em enfermagem como opção dos técnicos e auxiliares de enfermagem La búsqueda del pre grado en enfermería como opción de los técnicos y auxiliares de enfermería Undergratuate nursing education as an option for nursing technicians and assistants

    Directory of Open Access Journals (Sweden)

    Neuma Vital Julca Medina


    Full Text Available Este estudo teve como objetivo apreender os motivos que levam técnicos e auxiliares de enfermagem a buscarem a graduação nesta profissão. Realizado em um hospital escola, na cidade de São Paulo, sob a perspectiva da pesquisa qualitativa e como metodologia, a História Oral Temática e a Análise Categorial Temática. Deste trabalho participaram onze colaboradores: três técnicas de enfermagem e oito auxiliares de enfermagem.Este estudio tuvo como objetivo, conocer los motivos que influenciaron al técnico y auxiliar de enfermería a graduarse, a nivel superior, en su misma profesión. Fue realizado en un hospital docente de la ciudad de San Pablo, bajo la perspectiva de la investigación cualitativa y como metodología, la historia oral temática y el análisis de categoría temática. Paticiparon once colaboradores, siendo tres técnicos de enfermería y ocho auxiliares de enfermería.The aim of this study was to understand the reasons that lead both nursing technicians and assistants to enter undergraduate nursing programs. This study was carried out in a teaching hospital in the city of Sao Paulo, under a qualitative research perspective, and the methodologies adopted were the Thematic Oral History and the Thematic Categorical Analysis. There were eleven participants: three nursing technicians and eight nursing assistants.

  15. Occupational stressors in nursing

    Directory of Open Access Journals (Sweden)

    N. Nikpeyma


    Full Text Available Background and aimsNursing provides a wide range of potential workplace stressors as it is  a profession that requires a high level of skill, teamworking in a variety of situations and provision  of 24-hour delivery of care .Occupational stress is a major factor of Staff sickness an  absenteeism.This study investigates the main occupational stressors in nursing profession in the  hope of identification and reducing it.MethodsIn this study a questionnaire consisting of three parts:demoghraphic data,the nurses  background and questions about occupational stress from Revised index fulfilled by 140 nurses.ResultsLack of reward for work well done(48/6%, Heavy workload(46/4% ,lack of Participation in decisions (39/3% , poor Control of work place(38/4%and lack of job  development (36/4% have been the main sources of Occupational stress for nurses.chronic  diseases, Night Shift working and working hours were positively associated with occupstional  stress.Conclusion Analysis indicated that effects of work factors on occupational stress are more than demoghraphic data. The findings of this study can assist health service organisations to provide an attractive working climate in order to decrease side effects and consequences of occupational stress. Furthermore, understanding this situation can help to develop coping strategies in order to reduce work-related stress.

  16. Nurses' reflections on pain management in a nursing home setting. (United States)

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


    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.

  17. Tecnologia e humanização: desafios gerenciados pelo enfermeiro em prol da integralidade da assistência Tecnología y humanización: desafíos enfrentados por el enfermero en pro de le la asistencia completa Technology and humanization: managed challlenges by the nurse in behalf of complete assistance

    Directory of Open Access Journals (Sweden)

    Evanisa Maria Arone


    Full Text Available Este ensaio aborda as temáticas tecnologia e humanização nas organizações hospitalares, enfatizando aspectos conceituais e estratégicos dessas duas áreas no universo da Enfermagem, onde a forte presença da dimensão tecnológica necessita ser revigorada por meio da valorização da natureza humana, quer no uso de um produto ou de um processo no cuidar, agregando outras ênfases mais integradoras, uma vez que ambas sofreram historicamente uma dicotomia e, hoje se apresentam indissociáveis e complementares, como desafios, a serem gerenciados pelo enfermeiro, em prol da integralidade da assistência.Este ensayo aborda la tecnología y la humanización de organizaciones hospitalarias, enfocando los aspectos conceptuales y estratégicos de ambas las áreas en el campo de la enfermería, donde se necesita revitalizar la fuerte presencia de los elementos tecnológicos a través de la valoración de la naturaleza humana, tanto en el uso de un producto como en el proceso de cuidados, poniéndoles énfasis aún más integradoras, pues ambos los elementos históricamente enfrentaron una dicotomía y a la fecha resultan indisociables y complementarios, generando desafíos que el enfermero necesita enfrentar en pro de la asistencia completa.This essay approaches the technology and humanization ofhHospital organizations, focusing on conceptual and strategic aspects of both areas in the realm of nursing, where the strong presence of technological elements needs to be jumpstarted by giving value to human nature, both in the use of a product or in a caregiving process, placing further integrating emphases, since both elements historically faced a dichotomy and at present are unseverable and complementary, posing challenges to be dealt with by the nurse on behalf of complete assistance.

  18. Saberes e práticas de enfermeiros e obstetras: cooperação e conflito na assistência ao parto Cooperation and conflict in childbirth care: representations and practices of nurses and obstetricians

    Directory of Open Access Journals (Sweden)

    Antonia Angulo-Tuesta


    Full Text Available A incorporação crescente de enfermeiros constitui uma das estratégias para melhorar a assistência obstétrica no Brasil, onde o parto é atendido sobretudo por obstetras e em hospitais públicos. Nosso estudo, realizado em duas maternidades do Rio de Janeiro, busca compreender as representações de obstetras e de enfermeiras sobre o trabalho em equipe. Analisa de que forma as dimensões de poder, cooperação e conflito, e autonomia técnica são permeadas por concepções dualistas que influem na organização e qualidade da atenção à parturiente. Os resultados revelam, de um lado, o consenso sobre as vantagens da cooperação profissional para a melhoria da atenção, tendo como premissas a definição de papéis e a valorização de habilidades pessoais. De outro, conflitos vinculados às atribuições profissionais e condutas terapêuticas no parto refletem a percepção dos entrevistados a respeito da autonomia e da hierarquia profissional que relacionam o cuidado obstétrico à "observação objetiva" da parturiente. A magnitude dos conflitos apresenta-se diferenciada segundo o contexto institucional, indicando ser relacionada a limitações advindas de concepções dualistas que separam objetivo/subjetivo, racional/emocional, masculino/feminino, etc.In Brazil, where birthing generally occurs in hospitals and under the care of obstetricians, the incorporation of nurses is a strategy that has been used recently in an attempt to improve obstetric care. This study, conducted in two maternity hospitals in Rio de Janeiro, focuses on representations of obstetricians and nurses regarding teamwork and analyzes how the dimensions of power, cooperation/conflict, and technical autonomy are permeated by dualistic conceptions which influence the quality of health care for women during childbirth. On the one hand, the results show a consensus regarding the advantages of professional cooperation in the improvement of health care, assuming the

  19. The Relationship between Religiosity and Attitudes of Nurses Aides toward Sexual Expression by Older Adults in Nursing Homes. (United States)

    Stevenson, Robert T.; Courtenay, Bradley C.

    Systematic research on attitudes of nursing home staff toward the sexual expression of older residents is sparse and of recent origin. In order to determine the relationship between the degree of religiosity (religious commitment) of nursing home aides and their degree of tolerance concerning sexuality and aging, female nursing assistants (N=101)…

  20. Factors that facilitate registered nurses in their first-line nurse manager role. (United States)

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


    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.

  1. Designing nursing excellence through a National Quality Forum nurse scholar program. (United States)

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


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

  2. Missed nursing care and its relationship with confidence in delegation among hospital nurses. (United States)

    Saqer, Tahani J; AbuAlRub, Raeda F


    To (i) identify the types and reasons for missed nursing care among Jordanian hospital nurses; (ii) identify predictors of missed nursing care based on study variables; and (iii) examine the relationship between nurses' confidence in delegation and missed nursing care. Missed nursing care is a global concern for nurses and nurse administrators. Investigating the relation between the confidence in delegation and missed nursing care might help in designing strategies that enable nurses to minimise missed care and enhance quality of services. A correlational research design was used for this study. A convenience sample of 362 hospital nurses completed the missed nursing care survey, and confidence and intent to delegate scale. The results of the study revealed that ambulating and feeding patients on time, doing mouth care and attending interdisciplinary care conferences were the most frequent types of missed care. The mean score for missed nursing care was (2.78) on a scale from 1-5. The most prevalent reasons for missed care were "labour resources, followed by material resources, and then communication". Around 45% of the variation in the perceived level of "missed nursing care" was explained by background variables and perceived reasons for missed nursing. However, the relationship between confidence in delegation and missed care was insignificant. The results of this study add to the body of international literature on most prevalent types and reasons for missed nursing care in a different cultural context. Highlighting most prevalent reasons for missed nursing care could help nurse administrators in designing responsive strategies to eliminate or reduces such reasons. © 2018 John Wiley & Sons Ltd.

  3. Nursing students assess nursing education. (United States)

    Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert


    This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

  4. Nursing intellectual capital theory: implications for research and practice. (United States)

    Covell, Christine L; Sidani, Souraya


    Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.

  5. Primeiro episódio da esquizofrenia e assistência de enfermagem Primer episodio de la esquizofrenia y asistencia de enfermería First episode of schizophrenia and nursing care

    Directory of Open Access Journals (Sweden)

    Bianca Cristina Ciccone Giacon


    Full Text Available A esquizofrenia é um dos principais problemas de saúde da atualidade, exigindo considerável investimento do sistema de saúde. A intervenção no primeiro episódio do transtorno oferece uma oportunidade única no tratamento da esquizofrenia, influenciando no curso da doença. O presente artigo consiste em uma revisão crítica de literatura cujos objetivos são examinar o conhecimento sobre o primeiro surto de esquizofrenia e discutir a contribuição da enfermagem na assistência. Foi utilizada pesquisa bibliográfica em índice informatizado de referências. Os dados obtidos permitiram organizar informações sobre o conceito geral de esquizofrenia, seu primeiro surto, tipos de intervenções e a atuação de enfermagem. Observamos que existe pouca literatura brasileira relacionada ao primeiro surto esquizofrênico, na área da enfermagem, poucos serviços especializados e disponíveis e poucos recursos sociais. Tal condição mostra a necessidade de estudos relacionados ao primeiro surto.La esquizofrenia es uno de los principales problemas de salud de la actualidad, exigiendo considerable inversión del sistema de salud. La intervención en el primer episodio del trastorno ofrece oportunidad única en el tratamiento de la esquizofrenia, influyendo en el curso de la enfermedad. El presente artículo consiste en una revisión crítica de la literatura cuyos objetivos son examinar el conocimiento sobre el primer episodio de esquizofrenia y discutir acerca de la contribución de la enfermería en la asistencia. Fue utilizada la investigación bibliográfica en índice informatizado de referencias. Los datos obtenidos permitieron organizar informaciones sobre el concepto general de esquizofrenia, su primer episodio, tipos de intervenciones y la actuación de enfermería. Observamos que existe poca literatura brasileña relacionada a la primera aparición de signos de esquizofrenia, en el área de la enfermería, pocos servicios especializados

  6. Assistência pré-natal: competências essenciais desempenhadas por enfermeiros Atención prenatal: competencias esenciales desempeñadas por enfermeros Prenatal care: core competencies performed by nurses

    Directory of Open Access Journals (Sweden)

    Margarida de Aquino Cunha


    Full Text Available Pesquisa com objetivo de analisar as competências essenciais desenvolvidas, na prática, pelos enfermeiros que atuam na atenção ao pré-natal. Trata-se de estudo descritivo com abordagem quantitativa, realizado em 16 unidades da rede básica de saúde do município de Rio Branco-AC. A coleta de dados foi realizada por meio de observação sistemática e não participante. Dos enfermeiros que realizam a consulta pré-natal, apenas dois (11,76% cursaram especialização em obstetrícia. Constatamos que a grande maioria das competências essenciais esperadas na assistência pré-natal foi desenvolvida; entretanto, algumas foram realizadas com baixa frequência, ou seja, não foram realizadas em todas as consultas. Os resultados revelaram que, apesar do bom desempenho dos enfermeiros, é pertinente avaliar a necessidade de esclarecimentos sobre a importância da incorporação de protocolos assistenciais para a melhoria da qualidade dos serviços, a fim de alcançar um nível ótimo de competência na atenção pré-natal.Investigación con objetivo de analizar las competencias esenciales desarrolladas en La práctica por enfermeros que actúan en la atención al prenatal. Se trata de estudio descriptivo con aproximación cuantitativa, realizado en 16 unidades de la red básica de salud del municipio de Rio Branco-AC en 2006. La recolecta de datos fue realizada mediante observación sistemática y no participante. De los enfermeros que realizan la consulta prenatal, sólo 02 (11,76% cursaron especialización en obstetricia. Constatamos que la gran mayoría de las competencias esenciales esperadas en la atención prenatal fue desarrollada, entretanto, algunas fueron realizadas con baja frecuencia, o sea, no fueron realizadas en todas las consultas. Los resultados revelaron que, a pesar del buen desempeño de los enfermeros, es pertinente evaluar la necesidad de esclarecimientos sobre la importancia de la incorporación de protocolos asistenciales

  7. Physician assistant education in Germany

    NARCIS (Netherlands)

    M. Dierks; L. Kuilman; C. Matthews


    The first physician assistant (PA) program in Germany began in 2005. As of 2013 there are three PA programs operational, with a fourth to be inaugurated in the fall of 2013. The programs have produced approximately 100 graduates, all with a nursing background. The PA model of shifting tasks from

  8. Peaceful Death: Recommended Competencies and Curricular Guidelines for End-of-Life Nursing Care. (United States)

    American Association of Colleges of Nursing, Washington, DC.

    A group of health care ethicists and palliative care experts convened by the American Association of Colleges of Nursing developed a set of competencies that should be achieved through nursing curricula. The purpose of the 15 competency statements is to assist nurse educators in incorporating end-of-life content into nursing curricula. Every…

  9. Sistematização da assistência de enfermagem como ferramenta da gerência do cuidado: estudo de caso Sistematización de la asistencia de enfermería como herramienta de la gerencia del cuidado: estudio de caso Systematization of nursing assistance as a care management tool: case study

    Directory of Open Access Journals (Sweden)

    Érica Torres


    de los servicios de enfermería en estos aspectos.It's about a qualitative study, a single case study type, where was adopted a triangulation of techniques in order to obtain data collection (structured questionnaire, systematic observation and documental analysis and content analysis according to Bardin for analysis. The objective was to determine whether the nurses of the infectious diseases of a university hospital consider the Systematization of nursing assistance (SNA as a tool for care management and examine whether the SNA as a management instrument, provides the basis for their actions of caring. It was identified that the subjects understand what the SNA is and what the care management means, and that they see a relationship between both of them. It was detected that there is a gap between what is said and what is really practiced. It's not possible to consider that the SNA, as a management tool, provides the basis for caring. Strategies that allow the management of nursing services to get a feedback on these aspects are recommended.

  10. Vulnerabilidades socioeconômicas e o cotidiano da assistência de enfermagem pediátrica: relato de enfermeiras Vulnerabilidad socioeconómica y el cuidado diario de la enfermería pediátrica: informe de enfermeras Socio-economic vulnerability and pediatric nursing care routine: nurses report

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Rodrigues Pedroso


    Full Text Available A equipe de saúde, quando considera as vulnerabilidades em que a criança e sua família estão inseridas, pode planejar e executar um cuidado integral a estas. Este estudo objetivou compreender as percepções dos enfermeiros sobre as influências das vulnerabilidades socioeconômicas no cuidado à criança e sua família, no ambiente de Unidades de Internação Pediátricas de um Hospital Universitário no Município de Porto Alegre. Trata-se de uma pesquisa qualitativa na perspectiva de um estudo exploratório descritivo. A coleta de informações ocorreu com nove participantes por meio de entrevistas individuais semiestruturadas, analisadas conforme referencial da Análise de Conteúdo. Emergiram três categorias de análise, duas das quais serão aqui exploradas: Vulnerabilidades socioeconômicas e o cotidiano da assistência de enfermagem pediátrica; Propostas e alternativas para o manejo das situações de vulnerabilidades socioeconômicas. Os resultados forneceram exemplos práticos e apontaram soluções para as vulnerabilidades socioeconômicas relacionadas com a assistência de enfermagem à criança e sua família.El equipo de salud, cuando considera la vulnerabilidad en la cual están inmersos el niño y su familia, puede planificar y brindarles un cuidado integral. Este estudio tuvo como objetivo comprender la percepción que tienen los enfermeros sobre la influencia de la vulnerabilidad socioeconómica , en el cuidado del niño y la familia, en el ámbito de las Unidades de Internación Pediátrica en un Hospital Universitario en el Municipio de Porto Alegre. Se trata de una investigación cualitativa desde la perspectiva de un estudio explorable descriptivo. La recopilación de las informaciones se realizó con nueve participantes a través de entrevistas individuales semiestructuradas, analizadas según referencial del Análisis de Contenido. Surgieron tres categorías de análisis, de las cuales dos son analizadas aqu

  11. Iranian Nurses' Attitudes and Perception towards Patient Advocacy. (United States)

    Motamed-Jahromi, Mohadeseh; Abbaszadeh, Abbas; Borhani, Fariba; Zaher, Homa


    Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses' attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers.

  12. Needs assessment: blueprint for a nurse graduate orientation employer toolkit. (United States)

    Cylke, Katherine


    Southern Nevada nurse employers are resistant to hiring new graduate nurses (NGNs) because of their difficulties in making the transition into the workplace. At the same time, employers consider nurse residencies cost-prohibitive. Therefore, an alternative strategy was developed to assist employers with increasing the effectiveness of existing NGN orientation programs. A needs assessment of NGNs, employers, and nursing educators was completed, and the results were used to develop a toolkit for employers.

  13. Mitigating the Impact of Nurse Manager Large Spans of Control. (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.

  14. Nurses' Spirituality Improves Caring Behavior (United States)

    Bakar, Abu; Nursalam; Adriani, Merryana; Kusnanto; Qomariah, Siti Nur; Hidayati, Laily; Pratiwi, Ika Nur; Ni'mah, Lailatun


    Caring is a behavior of giving holistic assistance to individuals. In fact, this important behavior still has not routinely performed in current nursing practice. Personality and sipirituality are important factors in forming one's caring behavior. Spirituality is a passion or impulse to perform noble action. The objective of this study was to…

  15. Motivations to nurse: an exploration of what motivates students in Pacific Island countries to enter nursing. (United States)

    Usher, Kim; West, Caryn; Macmanus, Mary; Waqa, Silina; Stewart, Lee; Henry, Renee; Lindsay, David; Conaglen, Jo; Hall, Julianne; McAuliffe, Marie; Redman-MacLaren, Michelle


    The aim of this study was to explore the motivations of student nurses enrolled in nursing courses across a variety of Pacific Island countries. The image of nursing, the desire to help others, family and friends in the profession, personal experience, security, travel opportunities and flexibility have all been identified as motivators for people to enter nursing. To date, what motivates students in Pacific Island countries to enrol in a nursing course has not been investigated. An exploratory qualitative approach using focus group interviews with 152 nursing students was undertaken. Data were analysed using thematic content analysis, revealing four themes: (i) helping others; (ii) 'making a difference for my people'; (iii) following in the footsteps of others; and (iv) financial and professional gain. In a time of health and nursing workforce shortages, developing a deeper understanding of what drives people can be used to improve recruitment strategies in the future. © 2013 Wiley Publishing Asia Pty Ltd.

  16. 9th Ambient Assisted Living Congress

    CERN Document Server

    Mand, Beate


    In this book, leading authors in the field discuss the habitats of tomorrow. These habitats will be connected through autonomous and assistive systems, turning habitats into health resorts. This book discusses how assistance technologies enable a smooth transition from comfortable health support to medical or nursing care. The contributions have been chosen and invited at the 9th AAL congress, Frankfurt. .

  17. Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations. (United States)

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


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

  18. Enhancing nurse satisfaction: an exploration of specialty nurse shortage in a region of NHS England. (United States)

    Gray, Keith; Wilde, Rebecca; Shutes, Karl


    This article offers nurse managers guidance on analysing, managing and addressing a potentially dissatisfied nursing workforce, focusing on three priority shortage specialties: emergency care, paediatrics and cardiology. The aim of the study was to explore to what extent registered nurses and healthcare assistants, referred to collectively here as 'nursing staff', are satisfied with teamworking opportunities, continuing professional development (CPD) opportunities and workplace autonomy. A survey questionnaire was developed to evaluate three derived determinants of nurse satisfaction: team working, CPD and autonomy. The NHS West Midlands region was the focus given that it is among the poorest performing regions outside London in filling nursing posts. Overall, nursing staff respondents were satisfied with teamworking, CPD and autonomy, which challenges the perception that nurses in NHS England are dissatisfied with these satisfaction determinants. The findings give a complex picture of nurse satisfaction; for example a large minority of respondents were dissatisfied with their ability to carry out duties as they see fit. When developing management systems to investigate, manage and enhance nurse satisfaction, nurse managers must recognise the complexity and subtleties of determining factors. This will increase as nursing becomes more specialised. Subsequently, nurse managers need to work closely with staff at higher education institutions and other professional agencies to commission appropriate professional development. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  19. Nurses to Their Nurse Leaders: We Need Your Help After a Failure to Rescue Patient Death. (United States)

    Bacon, Cynthia Thornton

    The purpose of this study was to describe nurses' needs and how they are being met and not met after caring for surgical patients who died after a failure to rescue (FTR). A qualitative, phenomenologic approach was used for the interview and analysis framework. Methods to ensure rigor and trustworthiness were incorporated into the design. The investigator conducted semistructured 1:1 interviews with 14 nurses. Data were analyzed using Colaizzi's methods. Four themes were identified: (1) coping mechanisms are important; (2) immediate peer and supervisor feedback and support are needed for successful coping; (3) subsequent supervisor support is crucial to moving on; and (4) nurses desire both immediate support and subsequent follow-up from their nurse leaders after every FTR death. Nurses' needs after experiencing an FTR patient death across multiple practice areas and specialties were remarkably similar and clearly identified and articulated. Coping mechanisms vary and are not uniformly effective across different groups. Although most nurses in this study received support from their peers after the FTR event, many nurses did not receive the feedback and support that they needed from their nurse leaders. Immediate nurse leader support and follow-up debriefings should be mandatory after patient FTR deaths. Developing an understanding of nurses' needs after experiencing an FTR event can assist nurse leaders to better support nurses who experience FTR deaths. Insight into the environment surrounding FTR deaths also provides a foundation for future research aimed at improving patient safety and quality through an improved working environment for nurses.

  20. An investigation on task-technology fit of mobile nursing information systems for nursing performance. (United States)

    Hsiao, Ju-Ling; Chen, Rai-Fu


    This study investigates factors affecting the fit between nursing tasks and mobile nursing information systems and the relationships between the task-technology fit of mobile nursing information systems and nurse performance from the perspective of task-technology fit. Survey research recruited nursing staffs as subjects from selected case hospital. A total of 310 questionnaires were sent out, and 219 copies were obtained, indicating a valid response rate of 70.6%. Collected data were analyzed using the structural equation modeling technique. Our study found that dependence tasks have positive effects on information acquisition (γ=0.234, Pinformation identification (γ=0.478, Pinformation acquisition (γ=0.213, Pintroduction of mobile nursing information systems in assisting nursing practices can help facilitate both independent and dependent nursing tasks. Our study discovered that the supporting functions of mobile nursing information systems have positive effects on information integration and interpretation (γ=0.365, Pinformation acquisition (γ=0.253, Pinformation systems have positive effects on information acquisition (γ=0.318, Pinformation integration and interpretation (γ=0.143, Pinformation identification (β=.055, Pinformation acquisition (β=.176, Pinformation integration and interpretation (β=.706, Pinformation systems have positive effects on nursing performance, indicating 83.2% of totally explained variance. As shown, the use of mobile nursing information systems could provide nursing staffs with real-time and accurate information to increase efficiency and effectiveness in patient-care duties, further improving nursing performance.

  1. Characteristics of Nursing Profession in the Spanish Context from the Experience of Nursing


    Olga Rodrigo Pedrosa; Jordi Caïs Fontanella; Cristina Monforte Royo


    The overall objective of this research was to determine – from the discourse of the former Ayudantes Técnicos Sanitarios (Technical Nursing Assistants) who are pioneers in teaching the subject of "Nursing Fundamentals" – what the characteristics of the nursing profession are in the current Spanish context. The design was qualitative and analytical induction was used as methodological strategy. The sampling was theoretical and in-depth interview was used as a technique for data collection. For...

  2. Ethical dilemmas and nursing. (United States)

    Helm, A


    Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than resortative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within th e nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. It is imperative that professional nurses assess the administrative, legal, and ethical ramifications of their actions in terms of ethical codes of practice, patients' rights, institutional and personal liability, civil and criminal laws, and private conscience. An understanding of these issues, passive and active euthansia, state and national trends, and uniform legislation can assist in resolutions of the no-code dilemma. Nursing as a profession must strive to develop sound and consistent guidelines and rationale for the scope of practice in ethical dilemmas.

  3. Nursing informatics and nursing ethics

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer


    All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...

  4. Nurses stand by, on standby

    DEFF Research Database (Denmark)

    Kjær, Malene; Raudaskoski, Pirkko Liisa

    Nursing profession consists of never-ending diagnostic work and she has to treat smells, visual cues and noises from people and machines as being potentially relevant next attention and action spaces A nurse needs to have a broad perspective on the daily routines: which patient is next in line...... for surgery, does any colleague need assistance, and so on. To do this diagnostic work, nurses move within and between different hospital spaces and, at the same time, their level of attention (Norris, 2004) shifts between local, often occasioned, sites of engagement (Scollon & Scollon, 2004) or contextual...... configurations (Goodwin, 2000) and more overall activities (that are, of course, also accomplished locally). In the professional literature, this alertness is often ‘hidden’ in the definition of nursing as a symbiosis of communication, ethics for the patient and technical skills. With this study we want to fill...

  5. Measuring the Level of Effectiveness of the High School Assistant Principal and the High School Instructional Leadership Team (ILT) in Preparing Their English I, II, and III Teachers and Students for End of Course/TN Ready Assessments (United States)

    Black, Rhonda


    This research study addressed measuring the level of instructional leadership effectiveness of the high school assistant principal and the high school instructional leadership teams (ILT) at over forty (40) Shelby County Schools. More specifically, this research study examined their impact on teacher effectiveness and student achievement in their…

  6. Nursing students' attitudes about home health nursing. (United States)

    Prestia, Mindy; Murphy, Susan; Yoder, Marian


    In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

  7. Fostering nursing ethics for practical nursing


    森田, 敏子; モリタ, トシコ; Morita, Toshiko


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

  8. Baccalaureate nursing students' perspectives of peer tutoring in simulation laboratory, a Q methodology study. (United States)

    Li, Ting; Petrini, Marcia A; Stone, Teresa E


    The study aim was to identify the perceived perspectives of baccalaureate nursing students toward the peer tutoring in the simulation laboratory. Insight into the nursing students' experiences and baseline data related to their perception of peer tutoring will assist to improve nursing education. Q methodology was applied to explore the students' perspectives of peer tutoring in the simulation laboratory. A convenience P-sample of 40 baccalaureate nursing students was used. Fifty-eight selected Q statements from each participant were classified into the shape of a normal distribution using an 11-point bipolar scale form with a range from -5 to +5. PQ Method software analyzed the collected data. Three discrete factors emerged: Factor I ("Facilitate or empower" knowledge acquisition), Factor II ("Safety Net" Support environment), and Factor III ("Mentoring" learn how to learn). The findings of this study support and indicate that peer tutoring is an effective supplementary strategy to promote baccalaureate students' knowledge acquisition, establishing a supportive safety net and facilitating their abilities to learn in the simulation laboratory. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Ethics, culture and nursing practice in Ghana. (United States)

    Donkor, N T; Andrews, L D


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

  10. American Nurses Association Nursing World (United States)

    ... Standards Nursing Quality Ethics / Genetics & Genomics Code of Ethics Workplace Safety / Safe Patient Handling Needlestick Prevention Environmental Health Policy & Advocacy / Take Action Position Statements Member ...

  11. Análise da implementação da Sistematização da Assistência de Enfermagem em uma unidade de reabilitação Análisis de la implementación de la Sistematización de la Asistencia de Enfermería en una unidad de rehabilitación Analysis of the implementation of Nursing Assistance Systematization in a rehabilitation unit

    Directory of Open Access Journals (Sweden)

    Rinaldo de Souza Neves


    Full Text Available O estudo tem como objetivo analisar a execução das etapas da Sistematização da Assistência de Enfermagem. Utilizou-se abordagem quantitativa, exploratória e retrospectiva. Realizou-se análise retrospectiva de 25 prontuários que continham 25 formulários de históricos, 12 de diagnósticos, 100 de prescrição e 100 de evolução de enfermagem. Os resultados demonstraram dificuldades dos enfermeiros para operacionalização da SAE, pois, embora todas as etapas da SAE: histórico, diagnóstico, prescrição, evolução e anotação de enfermagem sejam realizadas, verificou-se que ocorre o preenchimento, com maior freqüência, da prescrição e histórico, e com menor freqüência da evolução e diagnóstico de enfermagem. Em suma, constata-se que a implementação da SAE ocorre de forma ainda bastante fragmentada, o que indica a necessidade de reorganização dessa metodologia de assistência, sobretudo por meio do investimento na educação permanente dos enfermeiros, para melhorar a qualidade do cuidado ao cliente.Ese trabajo tiene por propósito analizar la ejecución de las fases de la Sistematización de la Asistencia de Enfermería. Para tal se hizo un abordaje cuantitativo, exploratorio y retrospectivo. En el análisis retrospectivo se utilizó 25 prontuarios que contenían 25 formularios de históricos, 12 de diagnósticos, 100 de prescripción y 100 de la evolución de la atención del enfermero. Los resultados demostraran las dificultades de los enfermeros para dejar operativo el SAE, mismo con el cumplimiento de todas sus etapas: histórico, diagnóstico, prescripción, evolución y registro. También se pudo verificar que los formularios de prescripción y histórico son los que se llenan con mayor frecuencia y los formularios de evolución y diagnóstico con menor frecuencia. En síntesis, se verificó que la implementación de la SAE ocurre de manera bastante fragmentaria, que indica la necesidad de una reorganización de

  12. Sistemas de classificação de enfermagem e sua aplicação na assistência: revisão integrativa de literatura Sistemas de clasificación de enfermería y su aplicación en la atención: revisión integradora de literatura Nursing classification systems and their application in care: an integrative literature review

    Directory of Open Access Journals (Sweden)

    Rejane Kiyomi Furuya


    Full Text Available O objetivo deste estudo foi buscar evidências sobre o uso de sistemas de classificação de enfermagem na assistência, por meio de revisão integrativa da literatura. Com a busca nas bases LILACS e PubMed, com as palavras-chave classificação, enfermagem, padronizado, sistema, linguagem, selecionaram-se 38 artigos. Encontraram-se cinco sistemas de classificação principais implementados nos serviços: de diagnósticos de enfermagem (da North American Nursing Diagnosis Association International, intervenções de enfermagem (Nursing Interventions Classification, resultados de enfermagem (Nursing Outcomes Classification, a Classificação Internacional para a Prática de Enfermagem e a Classificação Internacional das Práticas de Enfermagem em Saúde Coletiva. Os artigos abordaram aspectos relacionados à implementação, avaliação, educação continuada e validação de termos relacionados aos sistemas de classificação. Há benefícios para a assistência com a implementação desses sistemas, com melhora da assistência, da qualidade das informações e da organização do serviço.Este estudio buscó evidencias sobre el uso de sistemas de clasificación de enfermería en la atención, a través de revisión integradora de la literatura. Fueron utilizadas las bases de datos LILACS y PubMed, con las palabras clave clasificación, enfermería, estandarizado, sistema se seleccionaron 38 artículos. Los principales sistemas de clasificación fueron: diagnósticos de enfermería (North American Nursing Diagnosis Association International, intervenciones de enfermería (Nursing Interventions Classification, resultados de enfermería (Nursing Outcomes Classification, Clasificación Internacional para la Práctica de Enfermería y Clasificación Internacional de Prácticas de Enfermería en Salud Pública. Los artículos aproximan aspectos relacionados con la implementación, evaluación, educación continua y validación de los t

  13. Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment. (United States)

    Winsett, Rebecca P; Rottet, Kendra; Schmitt, Abby; Wathen, Ellen; Wilson, Debra


    The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Job satisfaction among Swedish mental health nursing personnel: Revisiting the two-factor theory. (United States)

    Holmberg, Christopher; Caro, Jino; Sobis, Iwona


    Swedish mental health-care services are experiencing a critical shortage of nursing personnel. Researchers suggest that this shortage is due to low levels of job satisfaction. Job satisfaction is frequently studied with the assistance of Herzberg's two-factor theory, and this theory has foremost been explored with studies using quantitative methods. The purpose of the present study was to provide a better understanding of Herzberg's theory in relation to job satisfaction among Swedish mental health nursing personnel within inpatient psychiatric care while using qualitative methodology. This explorative study was based on semistructured interviews with 25 nursing personnel. Qualitative content analysis of interview transcripts identified three main categories: (i) respondents' perception of their work duties, which was perceived as important, meaningful, and demanding; (ii) respondents' relations with colleagues and supervisors, which provided valuable support in everyday work; and (iii) the way the respondents experienced their professional role as mental health nurses, which was described as unclear and vague. Job satisfaction primarily stemmed from working for patients and with other professionals, but their perceived limited progression of responsibilities discouraged a career in the profession. Herzberg's theory proved useful in exploring job satisfaction in this setting, but the findings partly contradict the basic tenets of the theory. Career advancements and incentives, such as salary and compensation, were perceived as lacking, which negatively influenced job satisfaction. Ward managers should establish clinical ladder programmes to recognize and motivate the continuing professional development of nurses. This needs to be coupled with monetary incentives, and linked with increased clinical authority. © 2017 Australian College of Mental Health Nurses Inc.

  15. Analysing the role of the PICU nurse to guide education of new graduate nurses. (United States)

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


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

  16. Assistive Technology (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  17. Development and psychometric evaluation of the Core Nurse Resource Scale. (United States)

    Simpson, Michelle R


    To examine the factor structure, internal consistency reliability and concurrent-related validity of the Core Nurse Resource Scale. A cross-sectional survey study design was used to obtain a sample of 149 nurses and nursing staff [Registered Nurse (RNs), Licensed Practical Nurse (LPNs) and Certified Nursing Assistant (CNAs)] working in long-term care facilities. Exploratory factor analysis, Cronbach's alpha and bivariate correlations were used to evaluate validity and reliability. Exploratory factor analysis yielded a scale with 18 items on three factors, accounting for 52% of the variance in scores. Internal consistency reliability for the composite and Core Nurse Resource Scale factors ranged from 0.79 to 0.91. The Core Nurse Resource Scale composite scale and subscales correlated positively with a measure of work engagement (r=0.247-0.572). The initial psychometric evaluation of the Core Nurse Resource Scale demonstrates it is a sound measure. Further validity and reliability assessment will need to be explored and assessed among nurses and other nursing staff working in other practice settings. The intent of the Core Nurse Resource Scale is to evaluate the presence of physical, psychological and social resources of the nursing work environment, to identify workplaces at risk for disengaged (low work engagement) nursing staff and to provide useful diagnostic information to healthcare administrators interested in interventions to improve the nursing work environment. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

  18. Doulas na assistência ao parto: concepção de profissionais de enfermagem Doulas en la asistencia al parto: concepción de los profesionales de enfermería DOULAS in delivery assistance: perceptions of nursing professionals

    Directory of Open Access Journals (Sweden)

    Denise da Silva Santos


    ísico proporcionado a la mujer, y como dificuldades, la indefinición del papel y la falta de clareza en lo que a los límites de actuación de las doblas se refiere. Se confirmó que las mujeres entrevistadas reconocen la importancia de la actuación de la doula pero enfatizan problemas resultantes de la forma como las doulas son inseridas en el servicio.This is a descriptive and exploratory study. The study aimed to describe the perceptions of nursing professionals regarding the participation of doulas assisting women in labor. A qualitative methodology with semi-structured interviews was utilized for this study. Subjects included 11 nurse assistants and 5 nurses from an Obstetric Center's public maternity ward in the city of Salvador in the state of Bahia. The results illustrated three categories: from idea to the reality of the initiative "doulas in the delivery room;" benefits with their inclusion; and difficulties with their presence. It is clear that this initiative aims to fulfill the gap of a companion at the obstetric center of the institution. Among the benefits found, it is relevant to note the replacement of a family member as well as the physical comfort given to the woman in labor. The difficulties of having a doula are concerned with their undefined role and the lack of clarity of their work limits. The interviewees recognize the importance of the work by doulas; however, they highlight problems due to the manner of their insertion in the service.

  19. The Study of Nursing Care project: back to the future for contemporary nursing research? (United States)

    Smith, Kylie M; Crookes, Patrick A


      To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research.   It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required.   In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants.   The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing.  The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a national scheme.   The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century. © 2012 Blackwell Publishing Ltd.

  20. Naturalistic nursing. (United States)

    Hussey, Trevor


    Where nurse education aims to provide an overarching intellectual framework, this paper argues that it should be the framework of naturalism. After an exposition of the chief features of naturalism and its relationship to science and morality, the paper describes naturalistic nursing, contrasting it with some other perspectives. There follows a defence of naturalism and naturalistic nursing against several objections, including those concerning spirituality, religion, meaning, morality, and alternative sources of knowledge. The paper ends with some of the advantages of the naturalistic approach. © 2010 Blackwell Publishing Ltd.

  1. Antithrombin III blood test (United States)

    ... Antithrombin III blood test To use the sharing features on this page, ... a protein that helps control blood clotting. A blood test can determine the amount of AT III present ...

  2. Monitorando indicadores de desempenho relacionados ao tempo de assistência da equipe de enfermagem Identificando indicadores de desempeño relativos al tiempo de asistencia del equipo de enfermería Monitoring performance indicators regarding the length of care by the nursing team

    Directory of Open Access Journals (Sweden)

    Danielle Fabiana Cucolo


    enfermería varió entre 4,1 a 5,1 horas. Los valores mostraron que las horas de asistencia dispensadas por el equipo de enfermería eran insuficientes para atender a la complejidad asistencial de los pacientes.The objectives of the present study were to: characterize medical-surgical clinic units of a philanthropic hospital and the nursing team performing in these units; identify the clientele's care profile, investigate the time length of care provided to the patients by the nursing team. Data were collected from documents of Personnel and Nursing Departments and the application of the classification instrument of patients. To calculate the care hours; the equation proposed by the Hospital Commitment Quality (HCQ was used. The findings showed relationship of 1:1 nursing professional/bedside and variation from 0.10 to 0.21 nursing/bedside. The patients needed, mainly, minimum (47.1% to 79.6% and intermediate (17.7% to 38.6% care, and the average time spent by the nursing team ranged from 4.1 to 5.1 hours. The values showed that the care hours provided by the nursing team were not enough to assist to the patients' care complexity.

  3. Resilience in nurses: an integrative review. (United States)

    Hart, Patricia L; Brannan, Jane D; De Chesnay, Mary


    To describe nursing research that has been conducted to understand the phenomenon of resilience in nurses. Resilience is the ability to bounce back or cope successfully despite adverse circumstances. Nurses deal with modern-day problems that affect their abilities to remain resilient. Nursing administrators/managers need to look for solutions not only to recruit nurses, but to become knowledgeable about how to support and retain nurses. A comprehensive search was undertaken for nursing research conducted between 1990 and 2011. Key search terms were nurse, resilience, resiliency and resilient. Whittemore and Knafl's integrative approach was used to conduct the methodological review. Challenging workplaces, psychological emptiness, diminishing inner balance and a sense of dissonance are contributing factors for resilience. Examples of intrapersonal characteristics include hope, self-efficacy and coping. Cognitive reframing, toughening up, grounding connections, work-life balance and reconciliation are resilience building strategies. This review provides information about the concept of resilience. Becoming aware of contributing factors to the need for resilience and successful strategies to build resilience can help in recruiting and retaining nurses. Understanding the concept of resilience can assist in providing support and developing programmes to help nurses become and stay resilient. © 2012 John Wiley & Sons Ltd.

  4. Comparison of Nursing Student and Instructor Preferences for Block and Nonblock Clinical Models. (United States)

    Rohatinsky, Noelle; Chachula, Kathryn; Sedgwick, Monique; Press, Madeline M; Compton, Roslyn M; Lane, Brenda


    Clinical experiences are the hallmark of prelicensure nursing programs and assist students with applying nursing theory into practice. The literature is limited with respect to nursing student and instructor preferences for type of clinical model to facilitate student learning. This article explores these perceptions in the nursing programs of 5 universities located in 4 Western Canadian provinces. Findings support the use of both nonblock and block clinical models throughout nursing education programs.

  5. Sistematização da Assistência de Enfermagem em Unidade de Terapia Intensiva sustentada pela Teoria de Wanda Horta Sistematización de la asistencia de enfermería en una unidad de terapia intensiva basada en la Teoría de Wanda Horta Nursing care systematization at the intensive care unit (ICU based on Wanda Horta's theory

    Directory of Open Access Journals (Sweden)

    Lúcia Nazareth Amante


    Full Text Available O objetivo foi implementar a Sistematização da Assistência de Enfermagem (SAE, tendo como referencial a Teoria das Necessidades Humanas Básicas de Wanda de Aguiar Horta e o Diagnóstico de Enfermagem da North American Nursing Diagnosis Association (NANDA, partindo da avaliação do conhecimento da equipe de enfermagem sobre a SAE e incluindo a sua participação nesse processo. É uma pesquisa-ação de cunho qualitativo, realizada na Unidade de Terapia Intensiva de um Hospital da cidade de Brusque, Santa Catarina, de outubro de 2006 a março de 2007. Pode-se perceber que os profissionais da enfermagem sabem pouco sobre a SAE, porém possuem grande interesse em aprender e desenvolvê-la em sua prática diária. Conclui-se que foi possível realizar uma sistematização de assistência de fácil aplicação, através da utilização de impressos simples que forneceram todas as informações necessárias para o desenvolvimento qualificado do cuidado de enfermagem.El objetivo fue implementar la Sistematización de la Asistencia de Enfermería (SAE utilizando como marco teórico la Teoría de las Necesidades Humanas Básicas de Wanda de Aguiar Horta y el Diagnóstico de Enfermería de la North American Nursing Diagnosis Asociation (NANDA, partiendo de la evaluación del conocimiento del equipo de enfermería sobre la SAE e incluyendo su participación en ese proceso. Se trata de una investigación de tipo cualitativo, realizada en la Unidad de Terapia Intensiva de un Hospital de la ciudad de Brusque, en el estado de Santa Catarina, en los meses de octubre de 2006 a marzo de 2007. Se puede percibir que los profesionales de enfermería saben poco sobre la SAE; sin embargo poseen un gran interés en aprenderla y desarrollarla en su práctica diaria. Se concluye que fue posible realizar una sistematización de la asistencia de fácil aplicación, a través de la utilización de folletos simples que ofrecen todas las informaciones necesarias para el

  6. Job satisfaction of Slovenian hospital nursing workforce. (United States)

    Prosen, Mirko; Piskar, Franka


    To test the psychometric properties of the McCloskey-Mueller Satisfaction Scale and to assess which of the McCloskey-Mueller Satisfaction Scale dimensionalities have a considerable impact on job satisfaction of nursing employees in three public Slovenian hospitals. Job satisfaction of nurses is linked to productivity, turnover, absenteeism and patient outcomes. Little is known about the factors contributing to job satisfaction among Slovenian hospital nurses. Understanding the contributing factors could help nurse managers to take appropriate measures. A cross-sectional survey study was used to obtain a sample of 169 registered nursing assistants and 74 registered nurses working in three public hospitals in Slovenia, from which data was obtained using the McCloskey-Mueller Satisfaction Scale. Dimensionality was tested using exploratory factor analysis. A seven-factor structure of 29 items was obtained, which accounted for 54.3% of the total variance in job satisfaction, and was internally consistent (Cronbach's alpha coefficient of the instrument was 0.78). The first factor 'Satisfaction with Interaction Opportunities', which is a component of the social rewards dimension in the McCloskey-Mueller Satisfaction Scale, explained 30.6% of the variation. The registered nursing assistants' job dissatisfaction was higher than that of the registered nurses. Both were mostly dissatisfied with professional opportunities. Using the factor analysis, a seven-factor structure was found instead of the originally introduced eight-factor model, which suggests a need for further redevelopment of the McCloskey-Mueller Satisfaction Scale. The results suggest that operational management needs to revitalize the work environment by ensuring proactive leadership and allowing participation in the decision-making process, while health-care organisations need to support the professional development of registered nursing assistants and registered nurses in order to achieve sustainable effects

  7. Demystifying Nursing Theory: A Christian Nursing Perspective. (United States)

    Schaffer, Marjorie A; Sandau, Kristin; Missal, Bernita

    How does nursing theory apply to nursing practice? Nursing theory can explain the why and how of nursing practice, guide nursing interventions, and provide a framework for measuring outcomes. This article briefly explains nursing theory, provides examples for applying theory to nursing practice, and proposes questions for examining the consistency of nursing theories with Christian perspectives. A helpful table illustrating grand, middle-range, and situation-specific theories and their application to nursing practice and research, along with references, is provided online as supplemental digital content. Three caring theories are analyzed from biblical beliefs.

  8. Preparing nurse leaders for 2020. (United States)

    Huston, Carol


    This article highlights eight leadership competencies likely to be an essential part of the nurse leader's repertoire in 2020. Planning for the future is difficult, even when environments are relatively static. When environments are dynamic, the challenges multiply exponentially. Unfortunately, few environments have been more unpredictable in the 21st century than health care. The healthcare system is in chaos, as is much of the business world. It is critical then that contemporary nursing and healthcare leaders identify skill sets that will be needed by nurse leaders in 2020 and begin now to create the educational models and management development programs necessary to assure these skills are present. Essential nurse leader competencies for 2020 include: (i) A global perspective or mindset regarding healthcare and professional nursing issues. (ii) Technology skills which facilitate mobility and portability of relationships, interactions, and operational processes. (iii) Expert decision-making skills rooted in empirical science. (iv) The ability to create organization cultures that permeate quality healthcare and patient/worker safety. (v) Understanding and appropriately intervening in political processes. (vi) Highly developed collaborative and team building skills. (vii) The ability to balance authenticity and performance expectations. (viii) Being able to envision and proactively adapt to a healthcare system characterized by rapid change and chaos. Nursing education programmes and healthcare organizations must be begin now to prepare nurses to be effective leaders in 2020. This will require the formal education and training that are a part of most management development programmes as well as a development of appropriate attitudes through social learning. Proactive succession planning will also be key to having nurse leaders who can respond effectively to the new challenges and opportunities that will be presented to them in 2020.

  9. Care systematization in psychiatric nursing within the psychiatric reform context. (United States)

    Hirdes, A; Kantorski, L P


    The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.

  10. Atenção à mulher mastectomizada: discutindo os aspectos ônticos e a dimensão ontológica da atuação da enfermeira no Hospital do Câncer III Atención a la mujer mastectomizada: discutiendo los aspectos ónticos y la dimensión ontológica de la actuación de la enfermera en el Hospital del Cáncer III Care to mastectomized woman: discussing ontic aspects and the ontological dimension in nurses performance at a Cancer Hospital

    Directory of Open Access Journals (Sweden)

    Teresa Caldas Camargo


    se traduce tan solo en la aplicación de técnicas científicas, orientaciones e informaciones, sino también, percibe, comprende y cuida de la mujer ciudadana en su singularidad.This reflection approaches aspects related to the ontic and ontological dimensions that constitute and, therefore, permeate nursing care delivered to the client with breast cancer submitted to mastectomy. This reflexive analysis was developed considering the author's professional experience as a clinical nurse at the Cancer Hospital III and at the National Cancer Institute (INCA as well as using the theoretical frameworks studied during her master and doctoral courses. Through a comprehensive attitude and using phenomenological interpretation, this study aimed at reflecting about nurse's clinical actions in the routine of an institution, pointing out possibilities for a care based on the existential dimension of the involved persons. Therefore, the author emphasizes nurse's performance with the client that is not only translated in the application of scientific techniques, orientations and information but also considering the perception, understanding and care provided by a human being in his/her singularity.

  11. Nurses and Aides (United States)

    Franklin, John


    Gerontological nursing (the care of the elderly) as a specialization for registered nurses, licensed practical nurses, and nursing aides is discussed with respect to training and qualifications, employment outlook, and earnings for each group. (JT)

  12. Primary Nurse - Role Evolution (United States)

    Mundinger, Mary O'Neil


    Primary nursing means that each patient has an individual nurse who is responsible for assessing his nursing needs and planning and evaluating his nursing care. The article describes the advantages and problems connected with this approach to patient care. (AG)

  13. Pilot Testing of the NURSE Stress Management Intervention. (United States)

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


    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.

  14. Assistência à parturiente por enfermeiras obstétricas no Projeto Midwifery: um relato de experiência Atención a la parturienta por parte de enfermeras obstetricas en el Proyecto Midwifery: uno relato de experiencia The care to the parturient provided by obstetric nurses in the Midifery Project: an experience report

    Directory of Open Access Journals (Sweden)

    Rejane Marie Barbosa Davim


    Full Text Available Este estudo destaca os modelos assistenciais de enfermagem que valorizam a mulher no processo do trabalho de parto, parto e nascimento. Descreve a assistência humanizada prestada à parturiente por enfermeiras obstétricas no Projeto Midwifery de uma maternidade escola. Ressalta que a prática desses modelos possibilita a participação ativa do enfermeiro no processo de trabalho de parto, parto e nascimento, proporcionando, fundamentalmente, satisfação à parturiente e ao profissional.Este estudio destaca los modelos asistenciales de enfermería que valoran la mujer en el proceso de trabajo de parto, parto y nacimiento. Describe la atención humanizada prestada a la parturienta por enfermeras obstétricas en el Proyecto Midwifery de una maternidad escuela. Resalta que la práctica de estos modelos facilita la participación activa de lo enfermero en el proceso de trabajo de parto, parto y nacimiento, ofreciendo, fundamentalmente, satisfacción a la parturienta y al profesional.This study focuses on the nursing care models that value the woman in childbirth process. Authors described the humanized care provided to the parturient by obstetric nurses in the "Midwifery Project" developed at a University Maternity Hospital. They emphasized that the practice of these models enable the nurse's active participation in the childbirth process, resulting in the satisfaction of the parturient and of the professional.

  15. Mapping the literature of nursing administration. (United States)

    Galganski, Carol J


    As part of Phase I of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association, this study identifies the core literature cited in nursing administration and the indexing services that provide access to the core journals. The results of this study will assist librarians and end users searching for information related to this nursing discipline, as well as database producers who might consider adding specific titles to their indexing services. Using the common methodology described in the overview article, five source journals for nursing administration were identified and selected for citation analysis over a three-year period, 1996 to 1998, to identify the most frequently cited titles according to Bradford's Law of Scattering. From this core of most productive journal titles, the bibliographic databases that provide the best access to these titles were identified. Results reveal that nursing administration literature relies most heavily on journal articles and on those titles identified as core nursing administrative titles. When the indexing coverage of nine services is compared, PubMed/MEDLINE and CINAHL provide the most comprehensive coverage of this nursing discipline. No one indexing service adequately covers this nursing discipline. Researchers needing comprehensive coverage in this area must search more than one database to effectively research their projects. While PubMed/MEDLINE and CINAHL provide more coverage for this discipline than the other indexing services, none is sufficiently broad in scope to provide indexing of nursing, health care management, and medical literature in a single file. Nurse administrators using the literature to research current work issues need to review not only the nursing titles covered by CINAHL but should also include the major weekly medical titles, core titles in health care administration, and general business sources if they wish to

  16. Enfermagem em centro cirúrgico: trinta anos após criação do Sistema de Assistência de Enfermagem Perioperatória Enfermería en centro quirúrgico: treinta años después de la creación del Sistema de Asistencia de Enfermería Perioperatoria Operation room nursing in Brazil: thirty years after the Institution of Perioperative Nursing Process

    Directory of Open Access Journals (Sweden)

    Rosa Maria Pelegrini Fonseca


    Full Text Available OBJETIVOS: Levantar os artigos publicados pela enfermagem brasileira em centro cirúrgico (CC, identificar os autores, tipos de pesquisa, resultados e analisar descritivamente seus resultados. MÉTODOS: Revisão integrativa, referente à produção nacional na área de enfermagem em CC, com o propósito de sumarizar os estudos já publicados em periódicos nacionais de 1978 a 2006, indexados nas bases de dados: LILACS, DEDALUS e SciELO. Os 56 artigos foram classificados em seis temas: visita pré-operatória; assistência no transoperatório; na sala de recuperação pós-anestésica; visita pós-operatória; construção ou validação de instrumento e percepção do paciente. RESULTADOS: Os artigos abordaram as facilidades e adversidades vivenciadas pelo enfermeiro e sua equipe para prestar uma assistência com a melhor qualidade possível. Confirmou-se a importância da assistência humanizada e individualizada. CONCLUSÃO: As pesquisas analisadas contribuem para a construção do conhecimento e influenciam positivamente o enfermeiro no bom desempenho da assistência ao paciente cirúrgico e família.OBJETIVOS: Buscar artículos publicados por la enfermería brasileña en centro quirúrgico (CC, identificar los autores, tipos de investigación, resultados y analizar descriptivamente sus resultados. MÉTODOS: Revisión integradora, referente a la producción nacional en el área de enfermería en CC, con el propósito de resumir los estudios ya publicados en periódicos nacionales de 1978 al 2006, indexados en las bases de datos: LILACS, DEDALUS y SciELO. Los 56 artículos fueron clasificados en seis temas: visita pre-operatoria; asistencia en el transoperatorio; en la sala de recuperación post-anestésica; visita post-operatoria; construcción o validación del instrumento y percepción del paciente. RESULTADOS: Los artículos abordaron las facilidades y adversidades vivenciadas por el enfermero y su equipo para prestar una asistencia con la

  17. Adaptação de instrumento para dimensionar horas diárias de assistência de enfermagem residencial Adaptacion de instrumento para medir horas diarias de atención de enfermería domiciliaria Adaptation of an instrument for the measurement of daily hours for nursing care at patient's home

    Directory of Open Access Journals (Sweden)

    Luiza Watanabe Dal Ben


    Full Text Available O Therapeutic Intervention Scoring System Intermediate: TISS-Intermediário foi traduzido para a língua portuguesa e adaptado para estabelecer horas diárias de assistência domiciliar. O processo de modificação do instrumento, desenvolvido através da Técnica Delphi, teve como participantes 16 enfermeiros, que atuam em empresas de assistência domiciliar e determinam horas diárias de assistência de enfermagem para pacientes na residência, após a hospitalização. Ao término do estudo obteve-se um instrumento com 104 itens, para ser no futuro validado clinicamente. Tal instrumento ajudará enfermeiros a estender cuidados de enfermagem a pacientes em casa, após a alta hospitalar, especialmente na tomada de decisões relativas à avaliação dos pacientes.El Therapeutic Intervention Scoring System Intermediate: TISS-Intermedio, fue traducido para el idioma portugués y adaptado para establecer las horas diarias de asistencia en el domicilio. Dieciséis enfermeros participaron del proceso de modificación del instrumento desarrollado a través de la Técnica Delphi. Esos enfermeros actúan en empresas de atención a domicilio y determinan las horas diarias de atención de enfermería a los pacientes en su domicilio después del alta. Al término del estudio se obtuvo un instrumento con 104 items para ser validado clínicamente.Tal instrumento ayudará a los enfermeros a extender sus cuidados de enfermería a pacientes que se encuentran en casa, después del alta hospitalario, especialmente en la toma de decisiones relacionadas con la evaluación de los pacientes.The Therapeutic Intervention Scoring System Intermediate: TISS-Intermediate, was translated into Portuguese and adapted to establish the number of hours daily of home care. The adaptation process of the instrument, developed with the Delphi Technique, used 16 nurses, who work in home care service providers and helped in calculating the number of nursing care hours for patients at

  18. Restructuring the Nursing Staff and its Influence on Care Hours Reestructuración del cuadro de personal de enfermería y su impacto sobre las horas de asistencia Reestruturação do quadro de pessoal de enfermagem e seu impacto sobre as horas de assistência

    Directory of Open Access Journals (Sweden)

    Danielle Fabiana Cucolo


    Full Text Available This descriptive study aimed to calculate and compare the nursing staff at the medical-surgical clinical units of a philanthropic hospital in current and projected situations, and to investigate how much time the nursing team delivers patient care in the current and projected situations. Gaidzinski's method was used to calculate the nursing staff, and the equation proposed by the Hospital Quality Commitment (HQC to estimate care hours. The findings showed an increase of 33% in the staff, with a 68.4% increase in the number of nurses and 15.6% in the number of technicians / nursing auxiliaries. According to the projected situation, the care hours varied from 5.7 to 7.2. The number of nursing and the mean care time provided to the patients were inadequate according to the clientele's care needs. This could impair the quality of care.Este estudio descriptivo tuvo por objetivo dimensionar y comparar el cuadro de personal de enfermería de las unidades de clínica médico-quirúrgica de un hospital filantrópico, en las situaciones actuales y proyectadas, e investigar el tiempo de asistencia utilizado en los pacientes por el equipo de enfermería en las dos situaciones. Para dimensionar se utilizó el método propuesto por Gaidzinski, y, para el cálculo de las horas de asistencia, la ecuación propuesta por el Compromiso con la Calidad Hospitalaria (CCH. Lo encontrado colocó en evidencia la necesidad de aumentar en 33% el cuadro de personal, con aumento de 68,4% de enfermeros y de 15,6% en el número de técnicos/auxiliares de enfermería. En la situación proyectada, las horas de asistencia variaron de 5,7 a 7,2. El cuantitativo de enfermería y el tiempo promedio utilizado con los pacientes se revelaron inadecuados para atender las necesidades de la clientela, lo que puede comprometer la calidad de la asistencia.Este estudo descritivo objetivou dimensionar e comparar o quadro de pessoal de enfermagem das unidades de clínica médico-cirúrgica de

  19. Auxiliares de enfermagem: mercado de trabalho, perfil, satisfação e expectativas no Programa de Saúde da Família na cidade de São Paulo Nursing assistants: job market, profile of professionals, satisfaction and expectations in the Family Health Program of the city of São Paulo.

    Directory of Open Access Journals (Sweden)

    Regina Maria Giffoni Marsiglia


    Full Text Available São escassos os estudos sobre os auxiliares de enfermagem, mesmo nas equipes de saúde da família. Este artigo se baseia em estudo que procurou identificar o perfil dos auxiliares de enfermagem do Programa de Saúde da Família (PSF na Região Metropolitana de São Paulo, o grau de satisfação com o trabalho, sugestões para melhorar o PSF e expectativas quanto ao futuro profissional. Em 2004, o Departamento de Atenção Primária à Saúde e Programa de Saúde da Família da Secretaria Municipal de Saúde da Cidade de São Paulo, aplicou um questionário entre os integrantes das equipes implantadas no município. A análise das respostas de 901 auxiliares de enfermagem contou com o apoio da Unesco. Os principais resultados apresentados neste artigo são: predominância de mulheres, jovens, nível médio de escolarização; capacitação inicial para o PSF, baixa proporção de profissionais com nível técnico. As relações e o processo de trabalho constituem motivos de maior satisfação e as condições de trabalho são pouco satisfatórias. Razões mais citadas para a escolha da profissão, solidariedade e cuidado com o 'próximo'; para a inserção no PSF, nova alternativa no mercado de trabalho e reconhecimento da sociedade. A maioria pretende continuar sua formação, com graduação em Enfermagem e especialização em Saúde Pública ou Saúde da Família².Studies on nursing assistants are rare, even on nursing assistants in family health teams. The article is based on a study that intended to determine the profile of Nursing Assistants in the Family Health Program in the Metropolitan Area of São Paulo, to identify their level of satisfaction with work, to seek suggestions for improving the Family Health Program, and to assess their expectations as to their professional future. In 2004, the Department of Primary Health Care and Family Health Program of the Municipal Health Secretariat of São Paulo sent out a questionnaire to the

  20. Value of intensified nursing


    Raymann, Cornelia; Konta, Brigitte; Prusa, Nina; Frank, Wilhelm


    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. ...

  1. What stresses remote area nurses? Current knowledge and future action. (United States)

    Lenthall, Sue; Wakerman, John; Opie, Tess; Dollard, Maureen; Dunn, Sandra; Knight, Sabina; Macleod, Martha; Watson, Colin


    Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands-resources (JD-R) model. A comprehensive literature review was conducted using the meta-databases Ovid and Informit. Remote Australian primary health care centres. The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high-demand, low-resource context, the JD-R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems. There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD-R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.

  2. A self-management approach using self-initiated action plans for symptoms with ongoing nurse support in patients with Chronic Obstructive Pulmonary Disease (COPD) and comorbidities: the COPE-III study protocol. (United States)

    Lenferink, Anke; Frith, Peter; van der Valk, Paul; Buckman, Julie; Sladek, Ruth; Cafarella, Paul; van der Palen, Job; Effing, Tanja


    Chronic Obstructive Pulmonary Disease (COPD) frequently coexists with other diseases. Whereas COPD action plans are currently part of usual care, they are less suitable and potentially unsafe for use in the presence of comorbidities. This study evaluates whether an innovative treatment approach directed towards COPD and frequently existing comorbidities can reduce COPD exacerbation days. We hypothesise that this approach, which combines self-initiated action plans and nurse support, will accelerate proper treatment actions and lead to better control of deteriorating symptoms. In this multicenter randomised controlled trial we aim to include 300 patients with COPD (GOLD II-IV), and with at least one comorbidity (cardiovascular disease, diabetes, anxiety and/or depression). Patients will be recruited from hospitals in the Netherlands (n = 150) and Australia (n = 150) and will be assigned to an intervention or control group. All patients will learn to complete daily symptom diaries for 12-months. Intervention group patients will participate in self-management training sessions to learn the use of individualised action plans for COPD and comorbidities, linked to the diary. The primary outcome is the number of COPD exacerbation days. Secondary outcomes include hospitalisations, quality of life, self-efficacy, adherence, patient's satisfaction and confidence, health care use and cost data. Intention-to-treat analyses (random effect negative binomial regression and random effect mixed models) and cost-effectiveness analyses will be performed. Prudence should be employed before extrapolating the use of COPD specific action plans in patients with comorbidities. This study evaluates the efficacy of tailored action plans for both COPD and common comorbidities. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center. (United States)

    Basu, Mohua; Linebarger, Jared; Gabram, Sheryl G A; Patterson, Sharla Gayle; Amin, Miral; Ward, Kevin C


    A patient navigation process is required for accreditation by the National Accreditation Program for Breast Centers (NAPBC). Patient navigation has previously been shown to improve timely diagnosis in patients with breast cancer. This study sought to assess the effect of nurse navigation on timeliness of care following the diagnosis of breast cancer by comparing patients who were treated in a comprehensive cancer center with and without the assistance of nurse navigation. Navigation services were initiated at an NAPBC-accredited comprehensive breast center in July 2010. Two 9-month study intervals were chosen for comparison of timeliness of care: October 2009 through June 2010 and October 2010 through June 2011. All patients with breast cancer diagnosed in the cancer center with stage 0 to III disease during the 2 study periods were identified by retrospective cancer registry review. Time from diagnosis to initial oncology consultation was measured in business days, excluding holidays and weekends. Overall, 176 patients met inclusion criteria: 100 patients prior to and 76 patients following nurse navigation implementation. Nurse navigation was found to significantly shorten time to consultation for patients older than 60 years (B = -4.90, P = .0002). There was no change in timeliness for patients 31 to 60 years of age. Short-term analysis following navigation implementation showed decreased time to consultation for older patients, but not younger patients. Further studies are indicated to assess the long-term effects and durability of this quality improvement initiative. © 2013 American Cancer Society.

  4. Dosis elevada en el dosímetro personal de una auxiliar de enfermería en Electrofisiología A high dose in the personal dosage meter of nursing assistant in Electrophysiology field

    Directory of Open Access Journals (Sweden)

    Raquel Barquero Sanz


    Full Text Available En una sala de Electrofisiología del Servicio de Cardiología en donde se efectúan procedimientos guiados con rayos X de ablación con radiofrecuencia y de implantes de desfibrilador biventricular, se registraron dosis mensuales anormalmente elevadas en el dosímetro personal de solapa de una auxiliar de enfermería que trabaja en la misma, con valores de dosis equivalente personal, Hp(10, de 125 mSv y de dosis equivalente personal superficial, Hp(0.07 de 128.1 mSv. Ante la ansiedad producida en la trabajadora al conocer las lecturas de su dosímetro, y dado que no se dispone de precedentes investigados en la instalación, se ha realizado un estudio para dilucidar si la dosis registrada ha podido ser recibida por la trabajadora o si solo ha sido recibida por el dosímetro. Se hacen medidas con un monitor ambiental en condiciones simuladas de los procedimientos, para estimar las dosis reales que pueda recibir el personal de la sala. Se comparan estos valores con los del rendimiento del equipo de RX en haz directo medidos durante la revisión anual de control de calidad del mismo, concluyéndose que ha sido el dosímetro, y no la trabajadora, el que se ha expuesto a radiación directa, siendo la situación más probable la de que dicho dosímetro cayó sobre el tubo de RX, normalmente orientado hacia el techo, un tiempo del orden de 1 minuto. Paralelamente a estas estimaciones dosimétricas, el Servicio de Prevención de Riesgos Laborales realizó la vigilancia de la salud, concluyendo que la trabajadora no tenía ningún indicio de haber recibido dosis de la magnitud registrada por su dosímetro.In a room of electrophysiology from the cardiology service where procedures are made guided with X-Rays of ablation with radiofrequency and from implants ventricular defibrillation; there were registered monthly doses usually high in the same personal dosimeter flap of a nursing assistant who works there with values of equivalent personal doses, Hp (10

  5. Situações vivenciadas pelos trabalhadores de enfermagem na assistência ao portador de tuberculose pulmonar La asistencia al portador de tuberculosis pulmonar bajo la óptica de los trabajadores de enfermería Nursing workers' experiences in care for pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Érika do Carmo Bertazone


    Full Text Available Este estudo teve como objetivo identificar os aspectos positivos e negativos relacionados à assistência prestada ao portador de tuberculose pulmonar, com base nos relatos dos trabalhadores de enfermagem de uma unidade de isolamento. Categorizamos os relatos de 26 trabalhadores de enfermagem (enfermeiros, auxiliares, técnicos e atendentes de enfermagem, com referências positivas e negativas. Obtivemos 24 relatos, dos quais extraímos um total de 94 (100% situações, sendo 38 (40,5% consideradas positivas e 56 (59,5% negativas. As categorias de situações que apresentaram maior frequência foram relacionadas às orientações sobre o tratamento, aos sentimentos vivenciados pelo paciente em relação à sua doença e ao despreparo da equipe de enfermagem.La finalidad de este estudio fue identificar los aspectos positivos y negativos relacionados a la atención prestada al portador de tuberculosis pulmonar, con base en los informes de los trabajadores de enfermería de una unidad de aislamiento. Categorizamos los informes de 26 trabajadores de enfermería (enfermeros, auxiliares, técnicos y asistentes de enfermería. Obtuvimos 24 relatos, con un total de 94 (100% situaciones, de las cuales 38 (40,5% fueron considerados positivos y 56 (59,5% negativos. Las categorías de situaciones con mayor frecuencia estaban relacionadas a las orientaciones sobre el tratamiento, a los sentimientos vividos por el paciente respecto a su enfermedad y a la falta de preparación del equipo de enfermería.This descriptive study aimed to identify the positive and negative aspects related to nursing care for pulmonary tuberculosis patients, based on the reports of nursing workers at an isolation unit. We categorized the reports of 26 nursing workers (nurses, auxiliaries, technicians and nursing attendants in terms of positive and negative references. We obtained 24 reports, resulting in 94 (100% situations, 38 (40.5% of which were seen as positive and 56 (59.5% as

  6. [Nurse's image: review of the literature]. (United States)

    Nauderer, Taís Maria; Lima, Maria Alice Dias da Silva


    The society's image about the nurses is permeated of stereotypes that include figures like saints, prostitutes, witches, heroines and are related to the function of assisting doctors and to a lack of social life. Moreover, the image that the nurses have of themselves and of their work is negative, causing frustration for the lack of autonomy found on the professional reality. Seeking for a better understanding of this problem, a literature review was proceeded, aiming to characterize and analyze the nurse's image. The national scientific production is considered small on the subject. Conclusions indicate that stereotypes negatively influence nursing practice and that in Nursing history it is found many reasons for the existing distortions.

  7. Health issues in nursing in Vietnam. (United States)

    Kristy, S J


    Major health concerns are not currently addressed in Vietnam as the country strives to upgrade its economic status. The current standard of medical care is rudimentary at best, as is the education and practice of Vietnamese nurses. The Ministry of Health in Vietnam has directed the Medical College of Hanoi to commence a 4-year degree in nursing in 1994. Historical, practical, political, economic, social, and cultural issues affect the development of nursing as a profession. Assistance from the West is sought by the Medical College in Hanoi.

  8. Transforming home health nursing with telehealth technology. (United States)

    Farrar, Francisca Cisneros


    Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.


    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus


    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  10. Effect of III/V ratio on the polarity of AlN and GaN layers grown in the metal rich growth regime on Si(111) by plasma assisted molecular beam epitaxy

    International Nuclear Information System (INIS)

    Agrawal, Manvi; Dharmarasu, Nethaji; Radhakrishnan, K.; Pramana, Stevin Snellius


    Wet chemical etching, reflection high energy electron diffraction, scanning electron microscope and convergent beam electron diffraction have been employed to study the polarities of AlN and the subsequently grown GaN as a function of metal flux in the metal rich growth regime. Both AlN and GaN exhibited metal polarity in the intermediate growth conditions. However, in the droplet growth regime, the polarity of AlN and GaN were N polar and Ga polar, respectively. It was observed that Ga polar GaN could be obtained on both Al and N polar AlN. AlGaN/GaN high electron mobility transistor (HEMT) heterostructure exhibiting hall mobility of 900 cm 2 V -1 s -1 and sheet carrier density of 1.2 × 10 13 cm -2 was demonstrated using N polar AlN which confirmed Ga polarity of GaN. Al metal flux was likely to play an important role in controlling the polarity of AlN and determining the polarity of the subsequent GaN grown on Si(111) by plasma assisted molecular beam epitaxy (PA-MBE). (author)

  11. Incorporating Political Socialization Theory into Baccalaureate Nursing Education. (United States)

    Brown, Sandra Godman


    Nurses must incorporate a political component into their professional role identity to meet the future challenges of the health care system. Political socialization theory can assist faculty in adding a political thread to the curriculum. (SK)

  12. Mental health nurses' attitudes toward self-harm: Curricular implications

    Directory of Open Access Journals (Sweden)

    David G. Shaw


    Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.

  13. WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes. (United States)

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


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

  14. Why did I become a nurse? Personality traits and reasons for entering nursing. (United States)

    Eley, Diann; Eley, Rob; Bertello, Marisa; Rogers-Clark, Cath


    This article is a report of a mixed method study of the association between personality traits of nurses and their reasons for entering nursing. Background.  The worldwide nursing shortage prompts research into better understanding of why individuals enter nursing and may assist in exploring ways to increase their recruitment and long term retention. A mixed method sequential explanatory design employed semi-structured interviews and a validated personality inventory measuring temperament and character traits. Registered Nurses (n = 12) and nursing students (n = 11) working and studying in a regional area of Queensland Australia were purposively sampled for the interviews in 2010 from their participation in the survey in 2009 investigating their personality traits. Qualitative data collection stopped at saturation. A thematic content analysis of the qualitative data using the framework approach was interpreted alongside their personality trait profiles. Two dominant themes were identified from the participant interviews about reasons for entering nursing; 'opportunity for caring' and 'my vocation in life'. These themes were congruent with key temperament and character traits measured in the participants. All nurses and students were very high in traits that exude empathy and altruistic ideals regardless of other characteristics which included highly pragmatic and self-serving principles. Qualitative and quantitative findings suggest that a caring nature is a principal quality of the nursing personality. Recruitment and retention strategies whilst promoting multiple benefits for the profession should not forget that the prime impetus for entering nursing is the opportunity to care for others. © 2012 Blackwell Publishing Ltd.

  15. Learning styles of registered nurses enrolled in an online nursing program. (United States)

    Smith, Anita


    Technological advances assist in the proliferation of online nursing programs which meet the needs of the working nurse. Understanding online learning styles permits universities to adequately address the educational needs of the professional nurse returning for an advanced degree. The purpose of this study was to describe the learning styles of registered nurses (RNs) enrolled in an online master's nursing program or RN-bachelor of science in nursing (BSN) program. A descriptive, cross-sectional design was used. Kolb's learning style inventory (Version 3.1) was completed by 217 RNs enrolled in online courses at a Southeastern university. Descriptive statistical procedures were used for analysis. Thirty-one percent of the nurses were accommodators, 20% were assimilators, 19% were convergers, and 20% were divergers. Accommodators desire hand-on experiences, carrying out plans and tasks and using an intuitive trial-and-error approach to problem solving. The learning styles of the RNs were similar to the BSN students in traditional classroom settings. Despite their learning style, nurses felt that the online program met their needs. Implementing the technological innovations in nursing education requires the understanding of the hands-on learning of the RN so that the development of the online courses will satisfactorily meet the needs of the nurses who have chosen an online program. Copyright 2010 Elsevier Inc. All rights reserved.

  16. [Application of clinical nursing path integrated with holistic nursing in advanced schistosomiasis patients with ascites]. (United States)

    Mei-Zhi, Yuan; Jing-Ru, Sun; Tao, Chen; Xiao-Yu, Zhang; Liang-Cai, He; Jia-Song, Wang


    To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites. A total of 226 advanced schistosomiasis patients with ascites were randomly divided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing, while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed, and the quality of life of the patients before and after hospital discharge was assessed. The improvement rate, satisfaction degree, and awareness rate of health knowledge of the patients in the experiment group were 93.8%, 100% and 97.4%, respectively, which were significantly higher than those of the control group (all P holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites; meanwhile, it can shorten the hospitalization time and save the hospitalization cost. Therefore, this nursing model is suitable for popularization and application in the treatment and nursing work of the advanced schistosomiasis assistance.

  17. [Expectations of hospital administrators about administrative functions of nurses]. (United States)

    Melo, M R; Fávero, N; Trevizan, M A; Hayashida, M


    The objective of the present study was to investigate hospital administrator's expectations about the administrative role played by nurses, utilizing functions proposed by the Neoclassical Theory of Administration: planning, organization, direction, and control as theoretical references. An instrument established in TREVIZAN (1989) was applied to 11 hospital administrators. The results showed they expect the four functions to be done by nurses. Therefore, the interaction between nurses and hospital administrators is critical to improve the patient's assistance.

  18. The influence of korean nurses' immigration into Germany on the nursing culture and policy of the countries: a transnational perspective. (United States)

    Sim, Na Hye


    While many studies have addressed the Korean nurse immigration to Germany in 1960s-70s in terms of the nurses' personal histories from a national perspective, few studies have pointed to its transnational impact on the medical field. Given this gap, the paper discusses its significance in the medical history through examining the nursing culture and policy changes made in both countries initiated by the immigration of the qualified Korean nurses. For this end, the paper first discusses differences between Korea and Germany in the nursing culture and professional standards at the time of the nurse immigration. The study then examines the transnational changes in the two nations in the nursing professional culture and related policies including nurse education and qualification process. More specifically, the paper argues that the Korean female nurses not only supplied labor in need but also contributed to the medical policy changes in Germany. The prevalent stereotype of nursing as a non-professional field in the German society begin to change while experiencing professionally qualified Asian immigrant nurses and practiced treatments that had been conduced by German doctors by then. This observation actually leads to the policy level reforms in nursing education and qualification process to meet the need of high-quality nurses when the labor immigration was stopped in mid-1970s. The paper also points out that the influence of the nurse immigration on the Korean society is not merely economic; it brought the policy level reforms in nurse education and qualification as well. The immigration, resulting in a lack of nurses in the Korean society, triggered two main responses: the expansion of the existing nurse education system and the establishment of a new system called "nursing assistant."

  19. Prevention and nursing care in the first case of Ebola virus disease contracted outside Africa. (United States)

    Cerón-Serrano, Alicia; Jiménez-Castellano, Rafael; Gómez-Campos, Ana María

    After the evacuation from Africa to Western hospitals of several international workers with the Ebola virus disease, the first case of contagion outside Africa occurred in Madrid, Spain. A nursing care assistant who had attended a missionary repatriated from Sierra Leone contracted the disease. On October 7 th 2014, the patient arrived at the University Hospital La Paz-Carlos III in Madrid. She remained in the hospital for 30 days, 25 of which were in strict isolation in a negative pressure room with air lock anteroom; personal protective equipment was required. During the last five days, the patient was moved to a standard room. Protection measures were used in accordance with the Hospital Occupational Health Department. According to its evolution, we differentiate three phases with specific care demands which were conditioned by the risk of transmission, forcing extreme measures of prevention. The largest numbers of direct interventions fall within the realm of the nursing profession. It is essential that specialized units with regular training be created for highly contagious diseases. In addition, this and other cases should be analyzed from the point of view of nursing, to allow standardized care. We also recognize the importance of managing communication to prevent social unrest and stigmatization of staff. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  20. Assisted Living (United States)

    ... are not licensed by the federal government, the services provided and quality controls vary by state.) More than 500,000 ... residents ( Note : This does not mean that skilled nursing must be available 24 hours a day.) Social services Housekeeping and laundry Recreation and meals Help with ...

  1. Faculty support for ESL nursing students: action plan for success. (United States)

    Hansen, Eileen; Beaver, Shirley


    Nursing students whose first language is not English have lower retention and NCLEX-RN pass rates. This review identifies four areas of difficulty and recommends strategies that can be employed by supportive faculty to assist these students and help ensure a more diverse nursing workforce to care for our increasingly diverse patient population.

  2. Experiences of registered nurses caring for patients with an open ...

    African Journals Online (AJOL)

    Three themes emerged: Difficulty in nursing care, complications such as fistula and infections, and poor hospital administration. Recommendations for assisting registered nurses in taking care of patients with an open abdomen were then made based on the findings of the four focus group interviews. Ethical principles and ...

  3. Design and Implementation of a Caring Curriculum in Nursing Education (United States)

    Ramirez, Becky


    Although the nursing profession has traditionally been associated with compassionate, patient, and caring behaviors, living in this advanced technological environment where patient related skills and tasks are often rushed caring behaviors are sometimes not seen. In order to improve high school nursing assistant student caring behaviors as well…

  4. Becoming a professional: What is the influence of registered nurses on nursing students' learning in the clinical environment? (United States)

    Ó Lúanaigh, Padraig


    This research was undertaken to understand the influence of registered nurses on nursing students' learning in the clinical environment to inform strategies to enable registered nurses to provide effective support to learners while also assisting nursing students to adopt approaches to maximise their learning in the clinical environment. A case study approach was applied in this research to explore descriptions of clinical experience of five final year nursing students. The student participants identified the importance of the clinical environment to their learning and wanted to and had actively managed their learning in the clinical environment. The students did not passively acquire knowledge or simply replicate what they observed from others. There was evidence that the students had strong and established perceptions of what constituted 'good' nursing and described an ability to discriminate between differing levels of nursing practice. Nursing knowledge was gained from respected registered nurses who were best able to describe and demonstrate the 'tricks of the trade' and 'little things that matter' when providing 'good' nursing. The outcomes from this research indicate an important role for registered nurses in both shaping nursing students' professional nursing identity and access to clinical learning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. International assistance. Licensing assistance project

    International Nuclear Information System (INIS)

    Aleev, A.


    Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme

  6. O desafio de implantar a sistematização da assistência de enfermagem sob a ótica de discentes El desafío de implantar la sistematización de la asistencia de enfermería según la óptica de los discentes The challenge of to implant the nursing assistance systematization according to the students' view

    Directory of Open Access Journals (Sweden)

    Lucimar Ramos Ribeiro Gonçalves


    discentes valoraran la SAE como instrumento metodológico necesario al funcionamiento de la práctica profesional, bien como consideraron que la participación en la implantación del proyecto hizo posible las condiciones para ejercitarla con autonomía en la vida profesional.Study with qualitative approach objectifying to argue relative aspects to the project of implantation of the Systematization of the Assistance of Nursing - SAE in a public maternity, according to the view of the nursing students of the UFPI. The study was developed with 28 students, by written stories, grouped in three categories, whose analysis of the contents made possible the characterization of the signification units. The results showed that the SAE, although the initial resistance of the health professionals to its adoption, favored the learning of the nursing care and the assistance offered to the clientele, reflecting in the satisfaction of the students, of the users of the service and of the family. In the operating of the SAE was pointed difficulties related to the fulfilling of the adopted. The students valued the SAE as a necessary methodological instrument to the performance of the professional practice, as well had considered that the participation in the implantation of the project make possible the conditions to exercise it with autonomy in the professional life.

  7. Delegation Guided by School Nursing Values: Comprehensive Knowledge, Trust, and Empowerment (United States)

    Gordon, Shirley C.; Barry, Charlotte D.


    As health care institutions in the United States respond to shrinking budgets and nursing shortages by increasing the use of unlicensed assistive personnel (UAP), school nursing practice is changing from providing direct care to supervising activities delegated to UAP. Therefore, delegation is a critical area of concern for school nurses. The…

  8. Nursing Staff Perceptions of Fall Risk: The Emergence of Learned Helplessness as a Theme. (United States)

    Gibson, Terri Lea; Lloyd, Susan L


    Nurses and unlicensed assistive personnel on 2 medical-surgical units were asked about their perceptions regarding patient falls. Their responses reflect learned helplessness and a lack of nurse empowerment that are relevant findings as nurse executives work to decrease patient falls.

  9. Abstract: Use of E-Learning to Advance Nursing Education in Rwanda

    African Journals Online (AJOL)

    As of 2011, there were 6,970 nurses in Rwanda with 90% trained at the high school level. The Ministry of Health has set the goal of upgrading high school trained nurses to a diploma by 2020. To assist in educating nurses and advancing their education, E-Learning (distance education) has been adopted as a model to ...

  10. Philosophical inquiry and the goals of nursing: a critical approach for disciplinary knowledge development and action. (United States)

    Grace, Pamela J; Perry, Donna J


    Philosophical inquiry remains critically important for nursing education, practice, and knowledge development. We propose a 3-level taxonomy of philosophical inquiry to guide nursing curricula and research development. Important background information about philosophy and the development of philosophical methods is given. Then philosophical inquiry is linked to the goals of nursing using our proposed taxonomy: level I-cultivating an attitude of "critical consciousness" related to all nursing situations and actions, level II-analysis and application of philosophical perspectives to nursing problems and level III-generating new knowledge for nursing purposes including new theories of practice and research.

  11. [Nurse practitioner's capability]. (United States)

    Cheng, Chen-Hsiu; Chen, Shih-Chien


    Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.

  12. Training of Home Health Aides and Nurse Aides: Findings from National Data (United States)

    Sengupta, Manisha; Ejaz, Farida K.; Harris-Kojetin, Lauren D.


    Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 home health aides (HHAs) from the National Home Health Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the…

  13. Experiences of Iranian Nurses that Intent to Leave the Clinical Nursing: a Content Analysis

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh


    Full Text Available Introduction: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. Methods: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. Results: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I Entry routes into nursing (implicitly entry, targeted entry, (II Defects in dignity (lack of professional vision toward the nurses, social status of nurses, (III Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement, and (IV Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours. Conclusion: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field.

  14. Sistema de informação para apoio à Sistematização da Assistência de Enfermagem Sistema de información para apoyo a la Sistematización de la Asistencia de Enfermería Information system for supporting the Nursing Care Systematization

    Directory of Open Access Journals (Sweden)

    Andreia Malucelli


    Full Text Available A importância, pertinência e necessidade de implantação da Sistematização da Assistência de Enfermagem nos diferentes ambientes da prática profissional é fato inquestionável. Tendo isso como princípio, objetivou-se elaborar um sistema de informação para apoio à Sistematização da Assistência de Enfermagem, baseado nas etapas do Processo de Enfermagem, nas Necessidades Humanas e utilizando a linguagem de diagnósticos, intervenções e resultados de enfermagem para documentação da prática profissional. Neste artigo, são descritas as etapas metodológicas e os resultados do desenvolvimento do referido sistema de informação - levantamento de requisitos, modelagem, mapeamento objeto-relacional, implementação e validação do sistema.La importancia, pertinencia y necesidad de implantación de la Sistematización de la Asistencia de Enfermería en los diferentes ambientes de la práctica profesional es facto incuestionable. Así se objetivó elaborar un sistema de información para apoyo a Sistematización de la Asistencia de Enfermería, basado en las etapas del Proceso de Enfermería, en las Necesidades Humanas e utilizando la lenguaje de diagnósticos, intervenciones y resultados de enfermería para documentación de la práctica profesional. En este artículo, son descriptos las etapas metodológicas y los resultados del desarrollo del referido sistema de información levantamiento de requisitos, modelaje, mapeamento objeto-intencional, implementación y validación del sistema.It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional

  15. Competências na formação de Técnicos de Enfermagem para implementar a Sistematização da Assistência de Enfermagem Competencias em la formación de Técnicos de Enfermería para implementar la Sistematización de la Atención de Enfermería Competencies in the education of Nursing Technicians to implement the Nursing Care Systematization

    Directory of Open Access Journals (Sweden)

    Andréa de Mello Pereira da Cruz


    Full Text Available Trata-se de pesquisa qualitativa, exploratória e descritiva, com o objetivo geral de conhecer, considerando a perspectiva do técnico de enfermagem que atua em hospital universitário, as competências desenvolvidas durante sua formação para implementar a Sistematização da Assistência de Enfermagem (SAE. A coleta e análise das informações ocorreram por meio de grupo focal, com técnicos de enfermagem e da análise de conteúdo. Emergiram duas categorias temáticas: A participação do técnico de enfermagem na SAE e As competências na formação do técnico de enfermagem. Cada qual recebeu duas sub-categorias: Concepção da SAE e (Des Valorização da SAE, e Competência técnico-científica e Competência na relação interpessoal, respectivamente. Constatou-se que a SAE necessita ser compartilhada, discutida e divulgada entre os profissionais de enfermagem, para que eles se reconheçam protagonistas de sua metodologia e tomem ciência de que suas práticas determinam os resultados.Se trata de una investigación cualitativa, exploratoria y descriptiva, con el objetivo general de conocer, considerando la perspectiva de técnicos de enfermería que actúan en un hospital universitario, las competencias desarrolladas en su formación para implementar la Sistematización de la Atención de Enfermería (SAE. La recolección y análisis de los datos se efectuó a través de grupo focal con técnicos de enfermería y análisis de contenido. Surgieron dos categorías temáticas, La participación del técnico de Enfermería en la SAE y Las competencias en la formación del Técnico de Enfermería, cada una de ellas con dos subcategorías, Concepción de la SAE y (Des Valorización de la SAE; Competencia técnico-científica y Competencia en la relación interpersonal, respectivamente. Se constató que la SAE necesita ser compartida, discutida y divulgada entre los profesionales de la Enfermería para que los mismos perciban que son los

  16. Metallothionein (MT)-III

    DEFF Research Database (Denmark)

    Carrasco, J; Giralt, M; Molinero, A


    Metallothionein-III is a low molecular weight, heavy-metal binding protein expressed mainly in the central nervous system. First identified as a growth inhibitory factor (GIF) of rat cortical neurons in vitro, it has subsequently been shown to be a member of the metallothionein (MT) gene family...... injected rats. The specificity of the antibody was also demonstrated in immunocytochemical studies by the elimination of the immunostaining by preincubation of the antibody with brain (but not liver) extracts, and by the results obtained in MT-III null mice. The antibody was used to characterize...... the putative differences between the rat brain MT isoforms, namely MT-I+II and MT-III, in the freeze lesion model of brain damage, and for developing an ELISA for MT-III suitable for brain samples. In the normal rat brain, MT-III was mostly present primarily in astrocytes. However, lectin staining indicated...

  17. Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings. (United States)

    Sving, Eva; Gunningberg, Lena; Högman, Marieann; Mamhidir, Anna-Greta


    To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. A descriptive design with a multimethods approach. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare

  18. Nursing staff perceptions of student contributions in clinical settings. (United States)

    Slaughter-Smith, Cheryl; Helms, Jennifer E; Burris, Rebecca


    Because nursing is a practice discipline, students are placed in clinical settings to collaborate with professional nurses in caring for patients. This descriptive study aimed to explore the benefits and limitations of undergraduate nursing students in the clinical setting. A 54-item instrument, Nursing Students' Contributions to Clinical Agencies, was used to collect data from staff nurses (N = 84) at three hospitals. The instrument also provided space for participants to share qualitative data, which revealed perceptions with which staff nurses were likely to agree and three key themes: Eager to Learn, Willing to Help, and Serving Their Time. The major implication for students is that they are often judged on their assertiveness skills and should offer assistance so they appear eager to learn. Faculty must ascertain that students understand their objectives for the clinical rotation and share those objectives with the staff nurses to enhance their learning experience. Copyright 2012, SLACK Incorporated.

  19. Trappings of technology: casting palliative care nursing as legal relations. (United States)

    Larsen, Ann-Claire


    Community palliative care nurses in Perth have joined the throng of healthcare workers relying on personal digital assistants (PDAs) to store, access and send client information in 'real time'. This paper is guided by Heidegger's approach to technologies and Habermas' insights into the role of law in administering social welfare programs to reveal how new ethical and legal understandings regarding patient information add to nursing's professional responsibilities. This qualitative research interprets data from interviews with twenty community palliative care nurses about clients' legal rights to informational privacy and confidentiality. It explores nurses' views of their nursing responsibilities regarding clients' legal rights, liability issues, bureaucratic monitoring and enforcement procedures. It concludes that nurses and clients are construed as legal subjects entrenched in legal relations that have magnified since these nurses began using PDAs in 2005/2006. © 2011 Blackwell Publishing Ltd.

  20. Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis. (United States)

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


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

  1. Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes. (United States)

    Trinkoff, Alison M; Han, Kihye; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook


    The authors examined the relationship of staff turnover to selected nursing home quality outcomes, in the context of staffing and skill mix. Staff turnover is a serious concern in nursing homes as it has been found to adversely affect care. When employee turnover is minimized, better care quality is more likely in nursing homes. Data from the National Nursing Home Survey, a nationally representative sample of US nursing homes, were linked to Nursing Home Compare quality outcomes and analyzed using logistic regression. Nursing homes with high certified nursing assistant turnover had significantly higher odds of pressure ulcers, pain, and urinary tract infections even after controlling for staffing, skill mix, bed size, and ownership. Nurse turnover was associated with twice the odds of pressure ulcers, although this was attenuated when staffing was controlled. This study suggests turnover may be more important in explaining nursing home (NH) outcomes than staffing and skill mix and should therefore be given greater emphasis.

  2. Men student nurses: the nursing education experience. (United States)

    Meadus, Robert J; Twomey, J Creina


    This study explored the phenomenon of being a male in a predominately female-concentrated undergraduate baccalaureate nursing program. Men remain a minority within the nursing profession. Nursing scholars have recommended that the profile of nursing needs to change to meet the diversity of the changing population, and the shortfall of the worldwide nursing shortage. However, efforts by nursing schools and other stakeholders have been conservative toward recruitment of men. Using Giorgi's method, 27 students from a collaborative nursing program took part in this qualitative, phenomenological study. Focus groups were undertaken to gather data and to develop descriptions of the experience. Five themes highlighted men students' experience of being in a university nursing program: choosing nursing, becoming a nurse, caring within the nursing role, gender-based stereotypes, and visible/invisible. The experiences of the students revealed issues related to gender bias in nursing education, practice areas, and societal perceptions that nursing is not a suitable career choice for men. Implications for nurse educators and strategies for the recruitment and retention of men nursing students are discussed. © 2011 Wiley Periodicals, Inc.

  3. Nursing shortages and international nurse migration. (United States)

    Ross, S J; Polsky, D; Sochalski, J


    The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

  4. A scoping review identifying contemporary issues in rural nursing leadership. (United States)

    Bish, Melanie; Kenny, Amanda; Nay, Rhonda


    Rural nurse leaders on a global scale are being challenged to create structures and processes to enable excellence in nursing care. The purpose of this scoping review is to offer an indication of the available literature relating to contemporary issues in rural nursing leadership. A review of contemporary issues facing rural nurse leaders is timely to assist strategy development that will achieve the goal of excellence in nursing. An interpretative scoping literature review methodological framework has been used with an emphasis on thematic construction. Literature published between 2008 and 2012 was reviewed from five electronic databases using the key words rural, nursing, and leadership. Four themes have been identified: expectations of rural nursing leadership, a highly educated workforce, competing interests, and partnering within rural healthcare systems. The content may resonate with rural nurse leaders and encourage a greater awareness of their relevance to leadership practices. The findings provide a greater awareness and understanding of contemporary issues facing rural nurse leaders and may assist with the development of context-sensitive leadership strategies to facilitate excellence in nursing care. © 2012 Sigma Theta Tau International.

  5. Application of theoretical and methodological components of nursing care

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    Rosa del Socorro Morales-Aguilar


    Full Text Available Introduction: the theoretical and methodological components are the proper expertise in nursing, and it refers to models, theories, care process, taxonomy of nursing diagnoses, system of nursing intervention classification, and system of outcomes classification, which base nursing care into professional practice. Methodology: research was performed on Google Scholar, reviewing the databases of Scielo, Ciberindex, Index Enfermería, Dialnet, Redalyc, Medline, identifying 70 published articles between 2005-2015, and selecting 52 of them. The keywords used were: nurse care, nursing diagnostic, classification, nursing theory, in spanish and portuguese. Results: training students, receive knowledge in the nursing process, NANDA International, classification of the interventions, nurse results and theoretical components. The Dorothea Orem, Callista Roy, Nola Pender, Virginia Henderson, Florence Nightingale, and Betty Neuman theories are applied. The application of the nursing process is limited and low familiarity with the international taxonomy by nurse professionals in the assistance area is noticed. Conclusions: the challenge of nursing is to continue to solidify the scientific knowledge and to undo the gap between theory and practice.

  6. Effect of the clinical support nurse role on work-related stress for nurses on an inpatient pediatric oncology unit. (United States)

    Chang, Ann; Kicis, Jennifer; Sangha, Gurjit


    High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.

  7. Leaders from Nursing's History. (United States)

    Fondiller, Shirley H.; And Others


    Looks at the lives and accomplishments of four leaders in professional nursing: (1) Loretta Ford, who championed the cause of nurse practitioners; (2) Mable Staupers, a pioneer in community health and nursing; (3) Janet Geister, a leader in private nursing; and (4) Isabel Stewart, who led the movement to standardize nursing education. (JOW)

  8. Japanese experience of evolving nurses' roles in changing social contexts. (United States)

    Kanbara, S; Yamamoto, Y; Sugishita, T; Nakasa, T; Moriguchi, I


    To discuss the evolving roles of Japanese nurses in meeting the goals and concerns of ongoing global sustainable development. Japanese nurses' roles have evolved as the needs of the country and the communities they served, changed over time. The comprehensive public healthcare services in Japan were provided by the cooperation of hospitals and public health nurses. The nursing profession is exploring ways to identify and systemize nursing skills and competencies that address global health initiatives for sustainable development goals. This paper is based on the summary of a symposium, (part of the 2015 annual meeting of the Japan Association for International Health) with panel members including experts from Japan's Official Development Assistance. The evolving role of nurses in response to national and international needs is illustrated by nursing practices from Japan. Japanese public health nurses have also assisted overseas healthcare plans. In recent catastrophes, Japanese nurses assumed the roles of community health coordinators for restoration and maintenance of public health. The Japanese experience shows that nursing professionals are best placed to work with community health issues, high-risk situations and vulnerable communities. Their cooperation can address current social needs and help global communities to transform our world. Nurses have tremendous potential to make transformative changes in health and bring about the necessary paradigm shift. They must be involved in global sustainable development goals, health policies and disaster risk management. A mutual understanding of global citizen and nurses will help to renew and strengthen their capacities. Nursing professionals can contribute effectively to achieve national and global health goals and make transformative changes. © 2017 International Council of Nurses.

  9. Proposta de modelo para dimensionamento do pessoal de enfermagem em assistência domiciliária Propuesta de modelo para la provisión de personal de enfermería en asistencia domiciliaria Proposal for a model for calculating the size of nursing staff in home care

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    Luiza Watanabe Dal Ben


    Full Text Available A assistência domiciliária (AD suscita questionamentos sobre a necessidade do número de horas diárias e dos dias de assistência de enfermagem por parte dos compradores da prestação de serviços à saúde em domicílio. Identificar os critérios adotados por gerentes e enfermeiras para o dimensionamento do pessoal de enfermagem. Os dados foram coletados por meio de entrevista semi-estruturada e analisados segundo o método de análise de conteúdo. Identificaram-se três categorias: elegibilidade do paciente; tempo despendido na assistência e perfil de competência do profissional. As etapas consideradas foram: identificação da carga média diária de trabalho; determinação da proporção das categorias profissionais; jornada de trabalho dos profissionais de enfermagem e identificação do índice de segurança técnica para cobertura de ausências previstas e de não previstas. Com base nessas variáveis, propusemos um modelo para calcular o quadro de profissionais de enfermagem em AD, agilizando o processo de tomada de decisão.La asistencia domiciliaria (AD suscita interrogantes sobre la necesidad del número de horas diarias y de los días de asistencia de enfermería por parte de los compradores de prestación de servicios a la salud en domicilio. Tuvo por objetivo identificar los criterios adoptados por gerentes y enfermeras para el cálculo del personal de enfermería. Los datos fueron recolectados por medio de una entrevista semi-estructurada y analizados según el método de análisis de contenido. Se identificaron tres categorías: elegibilidad del paciente, tiempo invertido en la asistencia y perfil de competencia del profesional. Las etapas consideradas fueron: identificación de la carga promedio diario de trabajo; determinación de la proporción de las categorías profesionales; jornada de trabajo de los profesionales de enfermería e identificación del índice de seguridad técnica para la cobertura de ausencias

  10. Sistematização da assistência de enfermagem: vislumbrando um cuidado interativo, complementar e multiprofissional Sistematización de la asistencia en enfermería: vislumbrando un cuidado interactivo, complementario y multiprofesional Systematization of nursing care: viewing care as interactive, complementary and multi-professional

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    Keyla Cristiane do Nascimento


    Full Text Available O presente estudo é fruto de um projeto ampliado, intitulado A sistematização da assistência de enfermagem à luz do pensamento complexo. Trata-se de um estudo qualitativo, que objetivou compreender o significado da sistematização da assistência de enfermagem para os profissionais de saúde. Utilizou-se como referencial metodológico a Teoria Fundamentada nos Dados. Os dados foram coletados por meio de entrevistas com três grupos amostrais, totalizando quinze profissionais de saúde. A codificação e análise dos dados conduziram ao tema central: Vislumbrando a Sistematização da Assistência de Enfermagem como Fenômeno Interativo e Complexo. Esse tema é complementado por dois fenômenos. Nesse artigo discutiremos o fenômeno Verificando a necessidade de um processo interativo, complementar e multiprofissional. A SAE é parte de um processo que vem sendo desenvolvido ao longo do tempo por enfermeiros comprometidos em melhorar cada vez mais o cuidado prestado ao paciente, pois vislumbram a necessidade do cuidar interativo, complementar e multiprofissional.Este estudio es fruto de un proyecto amplio intitulado La sistematización de la asistencia en enfermería según el pensamiento complejo. Se trata de un estudio cualitativo con el objetivo de comprender el significado de la sistematización de la asistencia en enfermería con profesionales de salud. Se utilizó como metodología a la Teoría Fundamentada en Datos, recolectados a través de entrevistas con tres grupos de muestras, totalizando quince profesionales. La codificación y el análisis dirigieron el tema central: Vislumbrando la Sistematización de la Asistencia de Enfermería como Fenómeno Interactivo y Complejo. Este tema, complementado por dos fenómenos, discutiremos en este artículo el fenómeno Verificando la necesidad de un proceso interactivo, complementario y multiprofesional. La SAE es parte de un proceso que ya viene siendo realizado por enfermeros

  11. Sistematização da assistência de enfermagem em unidade de reabilitação segundo o modelo conceitual de horta Sistematización de la asistencia de enfermería según el modelo conceptual de horta Nursing attendance systematization in rehabilitation unit, in accordance to horta's conceptual model

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    Rinaldo de Souza Neves


    Full Text Available A utilização de modelo conceitual na Sistematização da Assistência de Enfermagem permite o desenvolvimento de ações fundamentadas em um referencial teórico que possa guiar a implantação e implementação do processo de enfermagem nas unidades hospitalares. Desta forma discute-se neste artigo a escolha do modelo conceitual de Horta na construção de um sistema de assistência de enfermagem em Unidade de Reabilitação de um hospital público do Distrito Federal. Através da utilização deste referencial teórico foi possível confeccionar o instrumento de coleta de dados baseado nas necessidades humanas básicas. A identificação destas necessidades possibilitou a construção da pirâmide hierarquizada das necessidades básicas alteradas em pacientes neurológicos. Através deste referencial pretende-se elaborar a prescrição e evolução de enfermagem fundamentados nos conceitos e significados do processo de enfermagem de Horta, possibilitando o inter-relacionamento de todas as fases que compõem esta metodologia de assistência.La utilización del modelo conceptual en la Sistematización de la Asistencia de Enfermería permite el desarrollo de acciones fundamentadas en un referencial teórico que pueda guiar la implantación e implementación del proceso de enfermería en las unidades hospitalarias. De esta forma se discute en este artículo la elección del modelo conceptual de Horta en la construcción de un sistema de asistencia de enfermería en la Unidad de Rehabilitación de un hospital público del Distrito Federal. A través de la utilización de este referencial teórico fue posible confeccionar el instrumento de colecta de datos basado en las necesidades humanas básicas. La identificación de estas necesidades posibilitó la construcción de la pirámide jerarquizada de las necesidades básicas alteradas en pacientes neurológicos. A través de este referencial se pretende elaborar la prescripción y evolución de la

  12. An integrative review on conflict management styles among nursing students: Implications for nurse education. (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M


    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.

  13. How American Nurses Association Code of Ethics informs genetic/genomic nursing. (United States)

    Tluczek, Audrey; Twal, Marie E; Beamer, Laura Curr; Burton, Candace W; Darmofal, Leslie; Kracun, Mary; Zanni, Karen L; Turner, Martha


    Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession's norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.

  14. Assistência ao paciente obeso mórbido submetido à cirurgia bariátrica: dificuldades do enfermeiro Asistencia al paciente obeso mórbido sometido a la cirugía bariátrica: dificultades del enfermero Perioperative care for morbid obese patient undergoing bariatric surgery: challenges for nurses

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    Denise Spósito Tanaka


    Full Text Available OBJETIVO: Identificar as dificuldades de enfermeiros de centro cirúrgico ao assistir pacientes obesos mórbidos submetidos à cirurgia bariátrica no período transoperatório. MÉTODOS: A amostra constou de 70 enfermeiros com experiência em assistência ao paciente obeso mórbido. Os dados foram coletados durante o 7º Congresso Brasileiro de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização por meio de um questionário. RESULTADOS: A análise dos resultados apontou como dificuldades aquelas relacionadas ao espaço físico, materiais e equipamentos e à assistência de enfermagem específica ao paciente obeso mórbido. CONCLUSÃO: O conhecimento específico, a especialização e a experiência em Centro Cirúrgico darão o conforto, a segurança física e emocional necessárias a estes pacientes.OBJETIVO: Identificar las dificultades de enfermeros de centro quirúrgico en el cuidado a pacientes obesos mórbidos sometidos a cirugía bariátrica en el período transoperatorio. MÉTODOS: La muestra constó de 70 enfermeros con experiencia en asistencia al paciente obeso mórbido. Los datos fueron recolectados por medio de un cuestionario durante el 7º Congreso Brasileño de Enfermeros de Centro Quirúrgico, Recuperación Anestésica y Centro de Material y Esterilización. RESULTADOS: El análisis de los resultados identificó como dificultades aquellas relacionadas al espacio físico, materiales y equipos y a la asistencia de enfermería específica al paciente obeso mórbido. CONCLUSIÓN: El conocimiento específico, la especialización y la experiencia en Centro Quirúrgico darán el confort, la seguridad física y emocional que necesitan estos pacientes.OBJECTIVE: To identify the challenges for nurses during the perioperative for patients undergoing bariatric surgery. METHODS: The sample consisted of 70 nurses who had experience in providing care for morbid obese patients. Data were collected

  15. Survival strategies of male nurses in rural areas of Japan. (United States)

    Asakura, Kyoko; Watanabe, Ikue


    This study seeks to describe the survival strategies of male nurses in Japanese rural areas. Interviews were conducted with 12 male nurses who described their occupational experiences. The modified grounded theory approach was used for the data collection and analysis. The survival strategies of these male nurses can be categorized into four types: (i) giving priority to the achievement of financial security; (ii) agreeing to a dependent relationship with doctors; (iii) maintaining one's male identity through supporting the female nurses; and (iv) making an appeal to the significance of men in the female-dominated nursing profession. The survival strategies that were used by the male nurses were subtle, allowing them to influence indirectly both the female nurses and the doctors. These findings contribute to our understanding of the experiences of male nurses, a gendered minority in a female-dominated workplace, and encourage gender equality in the nursing profession. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

  16. Student nurses as school nurse extenders. (United States)

    Rossman, Carol L; Dood, Florence V; Squires, Darcy A


    The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the results that have the potential to impact on student health in an urban elementary school. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Patient Safety Incidents and Nursing Workload 1 (United States)

    Carlesi, Katya Cuadros; Padilha, Kátia Grillo; Toffoletto, Maria Cecília; Henriquez-Roldán, Carlos; Juan, Monica Andrea Canales


    ABSTRACT Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. Results: 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919) and rate of falls (r = 0.8770). The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. Conclusions: the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload. PMID:28403334

  18. Patient Safety Incidents and Nursing Workload

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    Katya Cuadros Carlesi

    Full Text Available ABSTRACT Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs was performed using the Therapeutic Interventions Scoring System (TISS-28 and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. Results: 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919 and rate of falls (r = 0.8770. The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. Conclusions: the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload.

  19. Use of Action Research in Nursing Education

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    Susan D. Moch


    Full Text Available Purpose. The purpose of this article is to describe action research in nursing education and to propose a definition of action research for providing guidelines for research proposals and criteria for assessing potential publications for nursing higher education. Methods. The first part of this project involved a search of the literature on action research in nursing higher education from 1994 to 2013. Searches were conducted in the CINAHL and MEDLINE databases. Applying the criteria identified, 80 publications were reviewed. The second part of the project involved a literature review of action research methodology from several disciplines to assist in assessing articles in this review. Results. This article summarizes the nursing higher education literature reviewed and provides processes and content related to four topic areas in nursing higher education. The descriptions assist researchers in learning more about the complexity of both the action research process and the varied outcomes. The literature review of action research in many disciplines along with the review of action research in higher education provided a framework for developing a nursing-education-centric definition of action research. Conclusions. Although guidelines for developing action research and criteria for publication are suggested, continued development of methods for synthesizing action research is recommended.

  20. Workforce issues in nursing in Queensland: 2001 and 2004. (United States)

    Hegney, Desley; Eley, Robert; Plank, Ashley; Buikstra, Elizabeth; Parker, Victoria


    The aim of the study was to identify the factors having an impact upon nursing work and to use the results to inform strategic planning of the Queensland Nurses Union. In 2001 and 2004, a study was undertaken to gather data on the level of satisfaction of nurses with their working life. This paper reports the 2004 results on workload, skill mix, remuneration and morale. Where applicable, the results are compared with 2001 data. A questionnaire was mailed to 3000 Assistants-in-Nursing, Enrolled and Registered Nurses in October 2004. All participants were members of the Queensland Nurses Union. The results are reported in three sectors - public, private and aged care. A total of 1349 nurses responded to the survey, a response rate of 45%. Nurses in the 2004 study believed: their workload was heavy; their skills and experience poorly rewarded; work stress was high; morale was perceived to be poor and, similar to 2001, deteriorating; the skill mix was often inadequate; and the majority of nurses were unable to complete their work in the time available. Nursing morale was found to be associated with autonomy, workplace equipment, workplace safety, teamwork, work stress, the physical demand of nursing work, workload, rewards for skills and experience, career prospects, status of nursing and remuneration. Overall the findings of the study are consistent with those determined by the 2001 survey. The findings of this study indicate the importance of factors such as workplace autonomy, teamwork, the levels of workplace stress, workload and remuneration on nursing morale. The data also indicate that workplace safety and workplace morale are linked. These findings provide information for policy makers and nurse managers on areas that need to be addressed to retain nurses within aged care, acute hospital and community nursing.

  1. Factors influencing Macao nurses' intention to leave current employment. (United States)

    Chan, Moon Fai; Luk, Andrew Leung; Leong, Sok Man; Yeung, Siu Ming; Van, Iat Kio


    To investigate factors associated with nurses' intention to leave current employment in Macao. The shortage of nursing staff and nurses voluntarily leaving their jobs has continued to be a problem affecting the delivery of health care all over the world. One way to alleviate this shortfall is via recruitment, but this is not always successful. Another way is to reduce the rate at which nurses voluntarily leave their work places. A descriptive survey was conducted and data were collected using a self-reported structured questionnaire. Nurses were recruited in the Health Bureau and one private hospital in Macao. The status of nurses' intention to leave current employment (yes vs. no) was the dependent variable and nurses' predisposing characteristics, organisational environments and five components on job satisfaction outcomes were independent variables. Of 426 nurses, 166 (39.0%) indicated an intention to leave current employment. The results showed that age (p job satisfaction: pay and benefits (p third of the nurses in Macao indicated an intention to leave current employment. This figure may be a cause of concern for the